DocumentsDate added
ORIGINAL ARTICLE
Ke Jian1, Fu Wen-Juan1,Pan Jian-Hao1, Ma Xian-Peng2,Bi Chang-Qiong2, Wei Wei2,Zhao Jing3, Ge Fa-Huan4,Nie Hong1*
1 Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China
2 Guizhou Jingfeng Injection Co. Ltd., Guiyang, 550018, China
3 State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China
4 School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, 510006, China
Address reprint requests to
*Prof. Nie Hong, PhD,
Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
Article citation: Jian K, Wen-Juan F,Jian-Hao P, Xian-Peng M, Chang-Qiong B,Wei W, Jing Z, Fa-Huan G, Hong N. The protective effect of salivae miltiorrhizae liguspyragine hydrochloride and glucose injection on isoproterenol-induced acute myocardial infarction in rats. J Pharm Biomed Sci 2016;06(03):165–170. Available at www.jpbms.info
ABSTRACT
Salivae miltiorrhizae liguspyragine hydrochloride and glucose injection (SGI) are widely used in the clinical treatment of ischemic cerebrovascular diseases, but researches on the prevention and treatment of acute myocardial infarction (AMI) and other cardiovascular diseases are rarely reported. So, the purpose of this study is to evaluate preventive effect of SGI on AMI in rats and to explore its possible mechanism. In this study, isoproterenol- (ISO) induced AMI model in rats was established. Based on that, we studied the effect of SGI on ECG and cardiac function. We then investigated the effect of SGI on heart infarction area and heart histomorphology in AMI rats. Moreover, to explore the possible mechanisms, we tested the activities of myocardial enzymes in blood. Our study found that, SGI can improve the ECG of AMI rats and promote cardiac function to normal.
In addition, SGI can reduce the infarct size and inhibit myocardial injury. Moreover, SGI can reduce the content of serum CK, LDH, cTnI and BNP in AMI rats. Therefore, we confirmed that SGI possessed remarkably protective effects against ISO-induced AMI in rats.
KEYWORDS salivae miltiorrhizae, liguspyragine hydrochloride, acute myocardial infarction, protective effect, isoproterenol, cardiac function
REFERENCES
1.Rizza S, Copetti M, Rossi C, Cianfarani M, Zucchelli M, Luzi A, et al.Metabolomics signature improves the prediction of cardiovascular events in elderly subjects. Atherosclerosis. 2014;232:260–264.
2.Pagidipati NJ, Gaziano TA. Estimating deaths from cardiovascular disease: a review of global methodologies of mortality measurement.Circulation. 2013;127:749–756.
3.Somasundaram K, Ball J. Medical emergencies: Atrial fibrillation and myocardial infarction. Anaesthesia. 2013;68:84–101.
4.Li YJ, Chang L. China percutaneous coronary intervention guide interpretation of China. Chin J Evid Cardiovas Med. 2012;4:294–296.
5.Bertinchant J, Robert E, Polge A, Marty-Double C, Fabbro-Peray P,Poirey S, et al. Comparison of the diagnostic value of cardiac troponin I and T determinations for detecting early myocardial damage and the relationship with histological findings after isoprenaline-induced cardiac injury in rats. Clinica Chimica Acta.2000;298:13–28.
6.Rona G, Chappel CI, Balazs T, Gaudry R. An infarct-like myocardial lesion and other toxic manifestations produced by isoproterenol in the rat. AMA Arch Pathol. 1959;67:443–455.
7.Xu SY, Bian RL, Chen X. Experimental methodology of pharmacology.Beijing: People’s Medical Publishing House; 2002.
8.Liu Z, Liu ZZ, Yang YT. The study of comparing two models of myocardial infarction in rats. Progress in Veterinary Medicine.2010;31:19–25.
9.Karthikeyan K, Bai BRS, Devaraj SN. Cardioprotective effect of grape seed proanthocyanidins on isoproterenol-induced myocardial injury in rats. Int J Cardiol. 2007;115:326–333.
10.Karthikeyan K, Bai BRS, Devaraj SN. Grape seed proanthocyanidins ameliorates isoproterenol-induced myocardial injury in rats by stabilizing mitochondrial and lysosomal enzymes: an in vivo study. Life Sci. 2007;81:1615–1621.
11.Piet C, Frank W, Christoph D, Virginie B, Heinzel FR, Jan DH, et al.Mechanisms of postsystolic thickening in ischemic myocardium:mathematical modelling and comparison with experimental ischemic substrates. Ultrasound Med Biol. 2007;33:1963–1970.
12.Bederson JB, Pitts LH, Germano S, Nishimura M, Davis R,Bartkowski H. Evaluation of 2,3,5-triphenyltetrazolium chloride as a stain for detection and quantification of experimental cerebral infarction in rats. Stroke. 1986;17:1304–1308.
13.Remmele W, Rick W. Der einfluss von thiolverbindungen auf die veränderungen des zellstoffwechsels durch triphenyltetrazoliumchlorid (TTC). Klin Wochenschr. 1958;36:876–877.
14.Shen J, Luo SX, Ma KH, Qin S. The research progress in acute myocardial infarction biochemical markers. Adv Cardiovas Dis.2012;33:106–110.
15.Han L, Chen KJ. The protective effect of Yixinnao capsule on mitochondria structure and function of myocardial. Chin J ChinMat Med. 2001;26:773–777.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Acknowledgment: The authors gratefully acknowledge the financial supports by National Natural Science Foundation of China (81373993).
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
ORIGINAL ARTICLE
Alin Kumar Nayak1*,Amit Anand2,Duryodhan Sahoo3
1 Dr Alin Kumar Nayak 3rd year PG student, Department of General Surgery,
Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
2 Dr Amit Anand, 3rd year PG student, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
3 Dr Duryodhan Sahoo, M.S., Professor, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
The name of the department(s) and
institution(s) to which the work should be attributed:
Department of general surgery, Hi-tech Medical College and Hospital, Bhubaneswar, Odisha, India
Address reprint requests to
*Dr Alin Kumar Nayak,
3rd yearr PG student, Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
Article citation: Nayak AK, Anand A, Sahoo D. Role of pathological organisms in gallstone disease. J Pharm Biomed Sci 2016;06(03):155–157. Available at www.jpbms.info
ABSTRACT
Background Gallstone disease is the commonest disease in India. Patients present with pain abdomen and nausea and vomiting. This study deals with etiology, pathogenesis including the role of bacteria in the formation of gallstones. It also deals with role of bacteria in different type of gallstones. By knowing the bacteriological etiology it will help in prevention as well as better treatment of gallstone disease in the features.
Materials and Methods Sixty patients with gallstone disease who underwent cholecystectomy in Hi-Tech Medical College and Hospital during October 2013 to September 2015 were studied. Data related to the objectives of the study were collected.
Results Majority of patients with gallstone disease were women aged from 41 to 50 years. Male to female ratio was 1:3. Most of the patients had mixed gallstones (31 cases) followed by pigment stones (19 cases) and cholesterol stones (10 cases) in the gallbladder. Bile culture was positive in 18 cases. Highest proportion of bile culture positivity was found in pigment gallstones i.e. 8 out of 19 cases. Escherichia coli was the most common organism isolated from the bile culture.
Conclusion We conclude that gallstone disease is common in women aged 41–50 years. Infection plays a major role in the formation of pigment gallstones. The role of bacteria in cholesterol gallstone and mixed gallstone formation is found to meager. Mixed gallstones are the most common stones found in this geographical area.
KEYWORDS cholesterol gallstone, pigment gallstone, mixed gallstone, bile culture.
BIBILIOGRAPHY
1.Small DM. Cholesterol nucleation and growth in gallstone formation. N Engl J Med. 1980;302:1305–11.
2.Jaraari AM, Jagannadharao P, Patil TN, Hai A, Awamy HA,El Saeity SO, et al. Quantitative analysis of gallstones in Libyan patients. Libyan J Med. 2010;5.
3.Chandran P, Kuchhal NK, Garg P, Pundir CS. An extended chemical analysis of gallstone. Indian J Clin Biochem. 2007;22(2):145–50.
4.Shrestha HG, Bajracharya M. Incidence of cholelithiasis and its correlation with cancer of gallbladder at TU teaching hospital.JNMA. 1991;29:264–7.
5.Maskey CP, Shrestha ML, Sato Y. Gallstone in TUTH. JIOM. 1990;12:45–54.
6.Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F. Diet as arisk factor for cholesterol gallstone disease. J Am Coll Nutr.2004;3:187–96.
7.Pradhan SB, Joshi MR, Vaidya A. Prevalence of different types of gallstone in the patients with cholelithiasis at Kathmandu Medical College, Nepal. Kathmandu University Med J. 2009;7:268–71.
8.Idris SA, Elsiddig KE, Hamza AA, Hafiz MH, Shalayel MHF.Extensive quantitative analysis of gallstones. Int J Clin Med.2014;5:42–50.
9.Sattar I, Aziz A, Rasul S, Mehmood Z, Khan A. Frequency of infection in cholelithiasis. J Coll Physicians Surg Pak. 2007;17:48–50.
10.Al Harbi M, Osoba AO, Mowallid A, Al-Ahmadi K. Tract microflora in Saudi patients with cholelithiasis. Trop Med Int Health.2001;6:570–4.
11.Csendes A, Burdiles P, Maluenda F, Diaz JC, Cseudes P, Mitru N. Simultaneous bacteriological assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg. 1996;131:389–94.
12.Kaufman HS, Magnuson TH, Lillemoe KD, Frasca P, Pitt HA. The role of bacteria in gallbladder and common duct stone formation. Ann Surg. 1989;209:584–91.
13.Ballal M. Bacteriological spectrum of cholecystitis and its antibiogram.Indian J Med Microbiol. 2001;19:212–4.
14.Darko R, Archampong EQ. The microflora of bile in Ghanians.West Afr J Med. 1994;13:113–5.
15.Al Harbi M, Osoba AO, Mowallid A, Al-Ahmadi K. Tract microflora in Saudi patients with cholelithiasis. Trop Med Int Health.2001;6:570–4.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
ORIGINAL ARTICLE
Manju1,Vanita Kumar1,Neelu Gupta1,Akhil Kapoor2*,Harvindra Singh Kumar2
1 Department of Pathology, Sardar Patel Medical College & Associated Group of Hospitals, Bikaner, Rajasthan, India
2 Department of Oncology, Acharya Tulsi Regional Cancer Treatment & Research Institute, Sardar Patel Medical College & Associated Group of Hospitals, Bikaner,Rajasthan, India
Address reprint requests to
*Dr. Akhil Kapoor, Room No. 73, PG Boys Hostel, PBM Hospital Campus, Bikaner,Rajasthan, India 334003
Article citation: Manju, Kumar V, Gupta N, Kapoor A, Kumar HS. Role of bone marrow aspiration and biopsy in diagnosis of hematological disorders: a prospective study. J Pharm Biomed Sci 2016; 06(03):150–154. Available at www.jpbms.info
ABSTRACT
Background The use of bone marrow biopsy as a diagnostic procedure is being increasingly used in recent years. In the present study, an attempt has been made to find out the diagnostic utility of bone marrow aspiration and biopsy with their comparative study. The objective of this study is to correlate the bone marrow aspiration and biopsy findings.
Materials and Methods This study was hospital-based prospective study in which 35 consecutive patients with haematological disorders were evaluated by both bone marrow aspiration and biopsy. The results were compared with that of previously published literature.
Results Out of 35 cases, maximum number of cases were of acute leukemias 12 (34.28%) followed by lymphoprotiferatide disorders 7 (25%), and one case (2.86%) of myelodysplastic syndrome. Bone marrow aspiration resulted in dry tap in 4 (11.42%)cases, which was observed in aplastic anaemia, myelodysplastic syndrome, primary myelofibrosis and NHL, one case in each.
Conclusions Bone marrow biopsy is more reliable in assessing cellularity, bone marrow architectural pattern, distribution and fibrosis. Bone marrow biopsy is diagnostic investigation in ‘dry tap’ aspiration cases, which occur when the marrow is fibrotic or densely cellular. Overall both the procedures are complementary to each other and must be performed together for better evaluation of bone marrow.
KEYWORDS bone marrow aspiration, bone marrow biopsy, haematological disorders
REFERENCES
1.Mauch P, Bothick LE, Hannon EC, Obbagy J, Hellman S. Decline in bone marrow proliferative capacity as a function of age.Blood 1982;60:245–52.
2.Riley RS, Hogan TF, Pavot DR, Forysthe R, Massey D, Smith E,et al. A pathologist’s perspective on bone marrow aspiration and biopsy; performing a bone marrow examination. J Clin Lab Anal. 2000;18:70–90.
3.Pasquale D, Chikkapa G. A comparative evaluation of bone marrow aspirate particle smears, biopsy imprints and biopsy sections. Am J Hematol. 1986;22:381–9.
4.Greer JP, Foester J, Rodgers GM, Paraskevas F, Glador B. Wintrobe’s Clinical Hematology 12th ed. Lippincott Williams and Wilkins; 2009.
5.Barekman CL, Fair KP, Cotelingam JD. Comparative utility of diagnostic bone marrow components: a 10 year study. Am J Hematol. 1997;56: 37–41.
6.Jamshidi K, Swaim WR. Bone marrow biopsy with unaltered architecture: a new biopsy device. J Lab Clin Med. 1971;77:335–42.
7.Trewhitt KG. Bone marrow aspiration and biopsy. Collection and interpretation. Oncol Nurs Forum. 2001;28:1409–15.
8.Bain BJ. Bone marrow aspiration. J Clin Pathol. 2001;54:657–63.
9.Bearden JD, Ratkin GA, Cottman. Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease. J Clin Pathol. 1974;27:738–40.
10.Hartsock RJ, Smith EB, Petty CS. Normal variations with aging of the amount of haematopoietic tissue in bone marrow from anterior iliac crest. Am J Clin Pathol. 1965;43:326–31.
11.Ioannides K, Rywlin AM. A comparative study of histologic sections of bone marrow obtained by aspiration and by needle biopsy. Am J Clin Pathol. 1976;65:267.
12.Cruikshank B, Thomas MJ. Mineral oil (follicular) lipidosis II.Histologic studies of spleen, liver, lymphonodes and bone marrow. Hum Pathol. 1984;15:731–7.
13.Rywlin AM, Ortega R. Lipid granulomas of the bone marrow.Am J Clin Pathol. 1972;57:457–62.
14.Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA,Gralnick HR. Proposed revised criteria for the classification of acute myeloid leukemia: a report of the French-American-British Co-operative group. Ann Intern Med. 1985;103:620–5.
15.Cheson BD, Cassileth PA, Head DR, Schiffer CA, Bennet JM,Bloomfield CD. Report of the National cancer institute sponsored workshop on definition of diagnosis and responses in acute myeloid leukemia. J Clin Oncol. 1990; 8: 813–9.
16.Sitalakshmi S, Srikrishna A, Devi S, Damodar P, Alexander B. The diagnostic utility of bone marrow trephine biopsies. Indian J Pathol Microbiol. 2005;48(2):173–6.
17.De Wolf-Peeters C. Bone marrow trephine interpretation: diagnostic utility and potential pitfalls. Histopathology. 1991;18:489–93.
18.Rao S, Sen R, Singh S, Ghalut PS, Arora BB. Grading of marrow fibrosis in chronic myeloid leukemia- a comprehensive approach. Indian J Pathol Microbiol. 2005;48(3):341–4.
19.Clough V, Greary CG, Hashmik, Davson J, Knowlson T. Myelofibrosis in chronic granulocytic leukemia. Br J Hematol. 1979;42:515–26.
20.Gralnick HR, Harbor J, Vogel C. Myclofibrosis in chronic granulocytic leukemia. Blood. 1971;37:152–62.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript. The first two authors contributed equally to the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
CASE REPORT
Shams UL Nisa1*,Tajinder Kaur Saggu2,Namrata Harchandani3,Shameeka Thopte4
1Assistant Professor, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, India
2Reader, Department of Oral & Maxillofacial Pathology, Gurunank Dev Dental College & Research Institute, Sunam. Punjab, India
3Dental Practitioner, Sparkle Dental Hub, Advanced Centre for Orthodontics & Multi-Specialty Family Dental Care, E8-19/Gulmohar, opp. Ram Arcade, Savoy Complex Sq, BPL-39., Madhya Pradesh 462016
4Assistant Professor, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, India
Address reprint requests to
*Dr. Shams UL Nisa,
Assistant Professor, Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University Dental College and Hospital, Room no.: 14, Katraj–Dhankawadi, Pune, 411043, India
Article citation: Ul Nisa S, Saggu TK, Harchandani N, Thopte S. Pleomorphic adenoma of the upper lip: a case report. J Pharm Biomed Sci 2016;06(03):171–173.Available at www.jpbms.info
ABSTRACT
Pleomorphic adenoma is a benign mixed tumour which is the most common benign tumour of salivary glands. It mostly occurs in the parotid or submandibular glands, but may also be found in the minor salivary glands that are distributed throughout the oral cavity. Surgical removal with adequate margins is the principal treatment. Due to its microscopic projections, this tumour requires a wide resection to avoid recurrence. The authors report a case of a pleomorphic adenoma in the upper lip, the second site for frequency for benign tumours of minor salivary glands, after the hard and soft palate.
KEYWORDS pleomorphic adenoma, minor salivary gland tumours, upper lip
REFERENCES
1.Rosai J. Major and minor salivary glands. In: Rosai J (ed.):Ackerman’s Surgical Pathology, Vol. 2, 9th ed. Elsevier St. Louis:Mosby; 2004. pp. 873–916.
2.Pires FR, Pringle GA, de Almeida OP, Chen SY. Intra oral minor salivary gland tumors: a clinic-pathological study of 546 cases.Oral Oncol. 2007;43:463–70.
3.Eisele DW, Johns ME. Salivary gland neoplasm. In: Bailey BJ (ed.):Head & Neck Surgery: Otolaryngology. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 1279–97.
4.Tanigaki Y, Mikami Y, Ono M, Tsukuda M. Pleomorphic adenoma of the lateral side of the tongue. Acta Otolaryngol. 2004;124:694–51.
5.Gupta AK, Singhal SK, Mann SB, Bapuraj JR, Saran RK. Pleomorphic adenoma presenting as a base of tongue mass. J Laryngol Otol. 1997;111:1177–8. 5.
6.Sawatsubashi M, Tuda K, Tonkunga O, Shin T. Pleomorphic adenoma of the larynx: a case and a review of the literature in Japan. Otolaryngol Head Neck Surg. 1997;117:415–7.
7.Bizal JC, Righal SK, Kesler KA. Pleomorphic adenoma of the trachea.Otolaryngol Head Neck Surg. 1997;116:139–40.
8.Boneu F, Gonzalez-Lagunas J, Huguet P, Bassas C. Massive malignant pleomorphic adenoma of the palate. J Oral Maxillofac Surg. 1998;56(1):91–6.
9.Forty MJ, Wake MJC. Pleomorphic salivary adenoma in an adolescent.Br Dent J. 2000;188:545–6.
10.Chaudhry AP, Vickers RA, Gorlin RJ. Intraoral minor salivary gland tumors: an analysis of 1414 cases. Oral Surg. 1961;14:1194–226.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Original article
Renu Agarwal1,Rita Hajela2*,GS Kochhar3,Naveen Jain4
1 Senior Resident, Department of Pediatrics, Maharishi Markandeshwar Medical College and Hospital, Solan, India
2 Assistant Professor, Department of Pediatrics, Maharishi Markandeshwar Medical College and Hospital, Flat No. B-13, Type B residence, Solan, 173229, India
3 Senior Consultant, Department of Pediatrics, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi, India
4 Senior Consultant, Department of Pediatrics, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi, India
Address reprint requests to
*Dr. Rita Hajela, Assistant Professor, Department of Pediatrics, Maharishi Markandeshwar Medical College and Hospital, Flat No. B-13, Type B residence, Solan, 173229, India
Article citation: Agarwal R, Hajela R, Kochhar GS, Jain N. Optimum initiating pressure of nasal CPAP in newborns with moderate respiratory distress: a randomised controlled trial. J Pharm Biomed Sci 2016;06(03):189–192.Available at www.jpbms.info
ABSTRACT
Objective To decide the optimum initiating pressure of nasal CPAP in newborns with respiratory distress.
Methods The study was done in neonatal intensive care unit (NICU) between November 2009 and November 2011 as a prospective randomised trial in 50 newborns with respiratory distress with Silverman Anderson score of 4–6, excluding babies with major congenital malformation, severe cardiovascular instability and frequent apnea at birth or requiring surfactant at birth. Alternate newborn enrolled was put on nasal CPAP with PEEP of 5 cm of water and FiO2 of 50% or PEEP of 7 cm of water and FiO2 of 50%. Clinical and investigative monitoring was done with X-ray chest on admission to confirm indication and repeated at 3–5 h to check lung expansion and rule out any contraindication or complication. USG Skull was done between 3–5 days to rule out intracranial hemorrhage.
Results Twenty-five babies in each group were put on nasal CPAP with starting FiO2 of 50% and PEEP of 5 cm of water in one group and FiO2 of 50% and PEEP of 7 cm of water in other group. No statistically significant difference was found between various characteristics of both groups like sex, mode of delivery, gestation and birth weight etc. All the patients survived in each group and there was no statistically significant difference between the outcomes of each group. Two patients on initial PEEP of 5 cm group failed on CPAP and three patients on PEEP 7 group failed and had to be shifted on mechanical ventilation.
Conclusions There is no difference in outcome of patients with initial PEEP of 5 cm of water or 7 cm of water. We should initiate CPAP on PEEP of 5 cm, as there is no benefit of starting at a higher PEEP of 7 cm of water; although we got a range of initiating pressure from 5 to 7 cm which is safe in newborns with respiratory distress.
KEYWORDS CPAP, respiratory distress, initiating pressure, newborn
REFERENCES
1.NNF recommended basic perinatal, neonatal nomenclatureprinciples and practice. 1st ed. New Delhi: Jaypee Brothers;1998. pp. 131–132.
2.Dreyfus D, Saumon G. Ventilator induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med. 1998;157:294–323.
3.Hall RT, Rhodes PG. Pneumothorax and pneumomediastinum in infants with idiopathic respiratory distress syndrome receiving CPAP. Paediatrics. 1975;55(4):493–496.
4.Saunders RA, Milner AD, Holphin IE. The effects of continuous positive airway pressure on lung mechanics and lung volumes in the neonate. Biol Neonate. 1976;29:178–186.
5.Tanswell AK. Continuous distending pressure in the respiratory distress syndrome of the newborn: who, when, and why? Respir Care. 1982;27(3):257–266.
6.Tanswell AK, Clubb RA, Smith BT, Boston RW. Individualised continuous distending pressure applied within 6 hours of delivery in infants with respiratory distress syndrome. J Trop Pediatr.2000;46(3):172–175.
7.Elgellab A, Riou Y, Abbazine A, et al. Effects of nasal continuous positive airway pressure (NCPAP) on breathing pattern in spontaneously breathing premature newborn infants. Intensive Care Med. 2001;27:1782–1787.
8.Kumar A, Bhat BV. Epidemiology of respiratory distress of newborn. Indian J Pediatr. 1996;63:93–98.
9.Report of National Neonatology perinatal database. National Neonatology Forum, India, 2000
10.Cotton RB, Lindstrom DP, Kanarek KS, Sundell H, Stalhman MT. Effect of positive end expiratory pressure on right ventricular output in lambs with hyaline membrane disease. Acta Paediatrica Scandinavica. 69:603–606.
11.Miller MJ, Carlo WA, Martin RJ. Continuous positive airway pressure selectively reduces obstructive apnea in preterm infants.J Pediatr. 1985;106:91–94.
12.Poets CF, Sen B. Changes in intubation rates and outcome of VLBW a population based study. Pediatrics. 1996;98:24–27.
13.Gitterman MK, Fusch C, Gitterman AR, Regazzoni BM, Moessinger AC. Early nasal continuous positive airway pressure treatment reduces need for intubation in very low birth infants. Eur J Pediatr. 1997;156:384–388.
14.Miller MJ, DiFiore JM, Strohl KP, Martin RJ. Effects of nasal CPAP on supraglottic and total pulmonary resistance in preterm infants. J App Physiol. 1990;56:141–146.
15.Gregory GA, Norwalk CT. Continuous Positive Airway Pressure.Neonatal Pulmonary Care, 2nd ed. Norwalk, CT Appleton and Lang; 1986. p. 355.
16.Halamek LP, Morley C. Continuous positive airway pressure during neonatal resuscitation. Clin Perinatol. 2006;33:83–98.
17.Yu VYH, Liew SW, Robertson NRC. Pneumothorax in the newborn: changing pattern. Arch Dis Child. 1975;50(6):449–453.
18.Sankar MJ, Sankar J, Agrawal R, Paul VK, Deorari AK. Proptocol for administering CPAP in neonates. Indian J Pediatr. 2008;75(5):471–478.
19.Morley CJ, Davis PG. Continuous positive airway pressure:scientific and clinical rationale. Curr Opin Pediatr. 2008;20:119–124.
20.De Paoli AG, Davis PG, Faber B, et.al. Devises and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in pre term neonates. Cochrane Database Syst Rev. 2002;3:CD002977.
21.Jeena P, Pillay P, Adhikari M. Nasal CPAP in newborns with acute respiratory failure. Ann Trop Paediatr. 2002;22(30):201–207.
Statement of originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Sources of funding: None.
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents, and royalties through this collaborative research.
All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.