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Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience
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作者 Vivek Kumar Jha Md Abir Tazim Chowdhury +6 位作者 Munama Magdum manoj tiwari Md Abul Bashar Maruf Md Saiful Islam Khan Priyanka Sinha Rajesh Naryan Kapar Md. Rezwanul Hoque 《World Journal of Cardiovascular Diseases》 CAS 2024年第4期252-267,共16页
Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of posto... Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at BSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting. 展开更多
关键词 Coronary Artery Bypass Grafting (CABG) Serum Cortisol Postoperative Delirium BANGLADESH
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Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh
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作者 manoj tiwari Md. Abir Tazim Chowdhury +5 位作者 Hema Poudel Munama Magdum Md. Mostafizur Rahman Vivek Kumar Jha Md. Ahaduzzaman Md. Abul Bashar Maruf 《World Journal of Cardiovascular Diseases》 2023年第9期565-577,共13页
Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preven... Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0<sup>th</sup>, 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventative measure for postoperative atrial fibrillation in such cases. 展开更多
关键词 Atrial Fibrillation (AF) Coronary Artery Bypass Grafting (CABG) Postopera-tive Atrial Fibrillation (POAF) Magnesium Sulfate Bangladesh.
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Luminescence and ESR Studies of CaS:Dy Phosphor
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作者 Vijay Singh 朱俊杰 +2 位作者 T. K. Gundu Rao manoj tiwari 潘宏程 《Chinese Physics Letters》 SCIE CAS CSCD 2005年第12期3182-3185,共4页
CaS phosphor activated with Dy ions is prepared by the solid-state diffusion method. The phosphor is characterized by x-ray powder diffraction, thermogravimetric analysis and photoiuminescence. Defect centres formed i... CaS phosphor activated with Dy ions is prepared by the solid-state diffusion method. The phosphor is characterized by x-ray powder diffraction, thermogravimetric analysis and photoiuminescence. Defect centres formed in CaS:Dy are studied using the technique of electron spin resonance. The thermoluminescence glow curve shows peaks at around 117℃ and 345℃. Irradiated CaS:Dy exhibits ESR lines due to defect centres. The thermal annealing behaviour of one of the defect centres appears to correlate with the TL peaks at 117℃ and 345℃. This centre is characterized by an isotropic g-value of 2.0035 and is assigned to an F^+ centre. 展开更多
关键词 ELECTRON SPIN RESONANCE CALCIUM SULFIDE THIN-FILMS CATHODOLUMINESCENCE PARAMETERS EU
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Treatment Initiation among Patients with Multidrug Resistant Tuberculosis in Bhopal District, India
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作者 Hemant Deepak Shewade Arun M. Kokane +9 位作者 Akash Ranjan Singh manoj Verma Malik Parmar Sanjay Singh Chahar manoj tiwari Sheeba Naz Khan Mukesh Nagar Sanjai Kumar Singh Pradeep Kumar Mehra Ajay M. V. Kumar 《Journal of Tuberculosis Research》 2017年第4期237-242,共6页
Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to foll... Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to follow-up (non-initiation of treatment by programme within 6 months of diagnosis) and time from diagnosis to treatment initiation in Bhopal district, central India (2014). Pre-treatment loss to follow-up was 13% (0.95 CI: 7%, 23%), not significantly different from the national estimates (18%) and median time to initiate treatment was seven days, lower than that reported elsewhere in the country. Bhopal was performing well with reference to time to treatment initiation in programmatic settings. 展开更多
关键词 MULTIDRUG-RESISTANT TUBERCULOSIS Operational Research Pre-Treatment Attrition Diagnosis and TREATMENT Pathway Initial Loss to FOLLOW-UP
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