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Introduction: Despite the advancement in medicine,management of heart failure (HF), which usually presentsas a disease syndrome, has been a challenge to healthcareproviders. The study was commenced with objective tostudy the profile of patients presented with heart failure withreduced left ventricular ejection fraction (LVEF) in a tertiarycare hospital.Material and Methods: It was a cross sectional hospitalbased study. Both male and female patients presented withheart failure with reduced ejection fraction (HFrEF) treated indepartment of General Medicine, GITAM Institute of MedicalSciences & Research were included based on inclusion andexclusion criteria. A total of 100 consecutive patients werestudied during February to October 2019. After obtainingapproval from Institutional Ethics Committee and informedconsent taken from all study participants data was collected.Data entered in MS excel sheet and analyzed by using SPSSsoftware.Results: Among total 100 heart failure patients males were69, females were 31. The mean age of study population was56.61±13.01 years. All patients presented with shortness ofbreath of varying degree of New York Heart Association(NYHA) class. The common risk factors observed werehypertension (53%), diabetes (36%), alcohol (14%), smoking(40%). The common causes for heart failure found wereIschemic heart disease (64%), followed by non-ischemicdilated cardiomyopathy (21%) and rheumatic heart disease(15%). Majority of the study participants were receivingtreatment with diuretics (66%), statins (65%), followed bybeta blockers (25%), aldosterone antagonist (25%), ACEinhibitors (30%).Conclusions: Early detection and optimal treatment ofcommon risk factors might play role in preventing Heartfailure and thereby reducing disease burden in the country
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Atropine has been an effective drug antagonizing M-like symptoms induced by severe acute organophosphate pesticide poisoning (AOPP), which could relieve bronchospasm, inhibit glandular secretion, and prevent pulmonary edema. In the rescue of severe AOPP, a hypo-dose of atropine is difficult to effectively block the effect of acetylcholine, and overdose plays great risk of atropine poisoning. When the patient's condition improves, the rebound often occurs in the process of withdrawal. Medical workers at home and abroad have conducted a lot of study to explore the personalized judgment of atropinization and optimal treatment of atropine for severe AOPP, including the initial bolus of atropine,the sustained infusion for the treatment of pulmonary edema, the maintenance dose, extenuation and withdrawal of atropine for the prevention of its overdose. Related researches in recent years were reviewed to provide the clinical reference.
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Objective To optimize the treatment of chronic hepatitis C recurrence.Methods During May 2008 to May 2012, 50 patients with chronic recurrent hepatitis C were chosen in the infectious department of our hospital.They were divided into two groups with 25 cases in each group.Group A was treated by standard extended treatment scheme,while Group B was treated by standard large dose scheme.The effect was estimated by the observation of sustained virologic response in the two groups (sus-tained virologic response,SVR).Results 32% SVR rate was found in group A and 23% SVR rate was found in Group B.38% re-currence rate appeared in group A after six months and 43% recurrence rate occurred in group B,there were significant difference between two groups(P <0.05).Conclusion The standard extended treatment schemes of pegylated interferon and ribavirin is su-perior to group B in SVR rate.
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Depressive illness is a major public health problem with important medical, social and economic implications. The efficacy of various antidepressants in treating depression has been demonstrated in randomized controlled trials (RCTs). However, these studies do not adequately address the complexities of clinical practice. Although most of RCTs assumed there was no difference in efficacy between the tricyclic antidepressants (TCAs) and serotonin specific reuptake inhibitors (SSRIs), naturalistic studies show that patients who take TCAs often receive subtherapeutic doses for inadequate duration than those with SSRIs. Because the benefits of the implementation of current guidelines are limited, the optimal choice of medication must be guided by detailed history and careful consideration of the real-world efficacy of antidepressants and long-term health care costs.
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Humanos , Antidepressivos , Antidepressivos Tricíclicos , Depressão , Custos de Cuidados de Saúde , Saúde Pública , SerotoninaRESUMO
Some questions like the hardship of treatment and lacking of standard on diagnosis are existing in steroid-resistant nephritic syndrome(SRNS).This article make an ethical analysis on these questions and assumes that we should persist in treating the patients carefully with humanism,carry on informed consent principle,implement the optimal treatment and perfect the standard of diagnosis and treatment,carry on clinical ethics education and promote the judgment level of clinical ethics.