The impact of music guided deep breathing exercise on blood pressure control - A participant blinded randomised controlled study.

INTRODUCTION: As pharmacological treatment of hypertension has become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. The objective was to determine if music guided, slow and deep breathing will reduce the blood pressure among patients with hypertension in eight weeks. METHODS: A participant blinded, multi-centre, randomised controlled trial was conducted in which the participants in the intervention group (IG) practiced deep breathing exercise guided by sound cues and those in the control group (CG) listened to the music. The primary end point was reduction in blood pressure at eight weeks. RESULTS: 87 patients, 46 males and 41 females with mean age of 61.1 years were recruited and 93.1% of them successfully completed the study. There was significant reduction in systolic and diastolic Blood Pressure from baseline by 8 weeks in both groups. The reduction in Mean systolic blood pressure (SBP) in the control arm was 10.5mmHg compared to 8.3mmHg (p<0.001) in intervention group. Diastolic blood pressure (DBP) reduction in control and intervention groups were 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001) respectively. The absolute difference in SBP reduction from baseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBP was -0.4 (95%CI: -2.9 to 3.6). However, blood pressure reduction between the two groups was not significant. CONCLUSIONS: Both listening to music and deep breathing exercise were associated with a clinically significant reduction in SBP and DBP. However, deep breathing exercise did not augment the benefit of music in reducing BP.

Better Predictor of Adverse Pregnancy Outcome: Asian or WHO International Cutoff? A Single-Centre Prospective Study.

OBJECTIVES: To compare the Asian Indian body mass index (BMI) and waist circumference (WC) with World Health Organization (WHO) BMI and WC in the prediction of adverse maternal and perinatal outcome in overweight and obese women. MATERIALS AND METHODS: Prospective analysis of 239 women booked within 10 weeks of pregnancy and followed till delivery at our centre was performed. RESULTS: The mean age of the study group was 26.08 years, of which elderly gravida was 1.3 %. Overall, 17.6 % were overweight, 29.7 % were obese, and 42.7 % had abdominal obesity as per Asian Indian BMI and WC cutoff, whereas only 8.5 % were obese, and 14.2 % had abdominal obesity as per WHO. In high-risk group, gestational diabetes was commonest complication (20 %). Compared to WHO, Asian Indian BMI cutoff has statistically significant predictability for gestational diabetes, preeclampsia and its complications, labour induction, and Caesarean section rate. On the other hand, Asian WC has the best predictability only for preeclampsia and its complications. Sensitivity, specificity, and negative predictive value of Asian BMI were 82, 55 and 96 % when compared with 60.7, 72.3 and 92 % of WHO BMI. CONCLUSION: Categorising women using Asian BMI, an increase in the prevalence of obesity by threefold is noted. Asian BMI and WC have high sensitivity in predicting adverse maternal and foetal outcomes and should be widely implemented in obstetric practice.

A Pilot Randomized Control Cross over Study Evaluating the Effectiveness and Safety of Mechanical Percussor Compared with Conventional Chest Physiotherapy in Adults with Productive Cough.

INTRODUCTION: Conventional Chest Physiotherapy (CCPT) remains the mainstay of treatment for sputum mobilization in patients with productive cough such as bronchiectasis and "Chronic Obstructive Airway Disease" (COPD). However CCPT is time consuming requires the assistance of a physiotherapist and limits the independence of the patient. Mechanical percussors which are electrical devices used to provide percussion to the external chest wall might provide autonomy and greater compliance. We compared safety and efficacy of a mechanical chest percusser devised by Formedic Technology with conventional chest percussion. METHODS: Twenty patients (mean age 64years) were randomly assigned to receive either CCPT or mechanical percussor on the first day and crossed over by "Latin square randomisation" to alternative treatment for 6 consecutive days and the amount of sputum expectorated was compared by dry and wet weight. Adverse events and willingness to use was assessed by a home diary and a questionnaire. RESULTS: There were 13 males and 7 females, eight diagnosed as bronchiectasis and 12 COPD. The mean dry weight of sputum induced by CCPT (0.54g ± 0.32) was significantly more compared with MP (0.40g + 0.11); p-value = 0.002. The mean wet weight of sputum with CCPT (10.71g ± 8.70) was also significantly more compared with MP (5.99g ± 4.5); p-value < 0.001. There were no significant difference in adverse events and majority of patients were willing to use the device by themselves. CONCLUSION: The mechanical percussor although produces less sputum is well tolerated and can be a useful adjunct to CCPT.

Long-term efficacy and safety of a generic atorvastatin in usual clinical care setting.

A multicentre study was conducted to assess the long term efficacy and safety of a generic atorvastatin in the treatment of primary hypercholesterolaemia. Eighty five patients who received 10mg or 20 mg of atorvastatin for 8 weeks depending on target cholesterol goal were followed up by their own physicians and had final evaluation at 52 weeks. Reduction in mean low density Lipoprotein (LDL-C) was 36.5%, 37.9% and 32.2% at weeks 4, 8 and 52 respectively. LDL-C target was maintained in 81% and 69% of patients at week 8 and 52 respectively without drug related serious adverse events. Generic atorvastatin is safe and effective in usual clinical care setting.

A multicenter study in Malaysia to determine the efficacy and safety of a generic atorvastatin.

A multicenter study was conducted to assess the efficacy of a generic form of Atorvastatin (Ranbaxy's Storvas) in the treatment of Primary Hypercholesterolemia. One hundred and nineteen patients were given 10 mg of Storvas for four weeks and increased to 20 mg if target LDL-Cholesterol was not achieved. LDL-Cholesterol was reduced by 36.6% at four weeks and 37.5% at eight weeks from baseline. Total cholesterol and triglycerides were significantly reduced. There were no drug-related serious adverse events. We conclude that the generic atorvastatin is safe and effective in the treatment of primary hypercholesterolaemia and the results are comparable to published data on innovator atorvastatin.