International journal of clinical practice
-
Int. J. Clin. Pract. · Jul 2021
Randomized Controlled TrialClinical and Hemodynamic Effects of Oral Sildenafil on Biventricular Function on Patients with Left Ventricular Systolic Dysfunction.
We explore the dual benefits of sildenafil on bi-ventricular functions in the form of improvement of ejection fraction, pulmonary vascular resistance and functional capacity of systolic heart failure patients either related to dilated or ischemic cardiomyopathy. ⋯ In patients with left ventricular systolic dysfunction secondary to dilated or ischemic cardiomyopathy, relatively small doses of sildenafil significantly enhances exercise period and functional ability, with substantial improvement in left ventricular systolic function irrespective of the existence of major pulmonary hypertension.
-
Int. J. Clin. Pract. · Jul 2021
Multicenter StudyEffect of COVID-19 Medications on Corrected QT Interval and Induction of Torsade de Pointes: Results of a Multicenter National Survey.
There are some data showing that repurposed drugs used for the Coronavirus disease-19 (COVID-19) have potential to increase the risk of QTc prolongation and torsade de pointes (TdP), and these arrhythmic side effects have not been adequately addressed in COVID-19 patients treated with these repurposed medications. ⋯ This cohort showed significant QTc prolongation with all COVID-19 medications studied, however, life-threatening arrhythmia of TdP occurred rarely. Among the repurposed drugs studied, hydroxychloroquine or lopinavir-ritonavir alone or in combination with azithromycin clearly demonstrated to increase the risk of critical QT prolongation and/or TdP.
-
Int. J. Clin. Pract. · Jul 2021
Randomized Controlled TrialEfficacy and safety of tamsulosin versus its combination with mirabegron in the management of lower urinary tract non-neurogenic overactive bladder symptoms (OABS) due to Benign Prostatic Enlargement (BPE)-An open label randomised controlled clinical study.
The efficacy and safety of βeta-3 agonists (Mirabegron 50 mg) have been sparingly assessed in the published English literature. We aim to do an efficacy-safety analysis of Mirabegron-Tamsulosin combination therapy vs tamsulosin-placebo monotherapy in a select subset of medication virgin Benign Prostatic Enlargement (BPE) patients with coexisting predominant non-neurogenic overactive bladder symptoms (OABS). ⋯ Mirabegron can be significantly efficacious and safe in ameliorating non-neurogenic OABS induced by BPE vs placebo by initiating combination therapy from the start as opposed to the usual 'add on therapy' protocol. This combination appeared to be superior in terms of overall safety, minimal side effects, better compliance and tolerability vs Tamsulosin monotherapy in select BPE patients with predominant non-neurogenic OABS.
-
Int. J. Clin. Pract. · Jul 2021
Prognostic Value of C-Reactive Protein to Albumin Ratio in Patients Resuscitated from Out-of-Hospital Cardiac Arrest.
Despite major advances in basic and advanced life supports, patients who survived from out-of-hospital cardiac arrest (OHCA) have still poor prognosis. Several inflammatory parameters have been used to determine early and long-term prognosis in patients with OHCA. C-reactive protein-to-albumin ratio (CAR) is also a novel marker of systemic inflammation. To our knowledge, there is no study evaluating the clinical importance of CAR in OHCA patients. ⋯ We have demonstrated for the first time that CAR was an independent predictor of in-hospital mortality in OHCA patients.
-
Int. J. Clin. Pract. · Jul 2021
Predictors of Depression among Older Adults with Acute Coronary Syndrome Seeking Emergency Care.
Psychological and traumatic events may cause disruption to daily life for patients, in particular, older adult patients with acute coronary syndrome (ACS). The present study aimed to identify the prevalence of depression and explore its predictors amongst older adults with ACS seeking emergency care. ⋯ Depression rate is high amongst those patients, so healthcare providers (HCPs) should assess those patients for depression and be prepared to intervene accordingly. Depression amongst older adult patients with ACS seeking emergency care necessitates emergency management protocol by HCPs to manage depression amongst this cohort of at-risk patients.