Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial.

PURPOSE: The present study aims to investigate the combined effect of slow breathing exercise (SBE) and progressive muscle relaxation (PMR) technique on blood pressure (BP), heart rate (HR), respiratory rate (RR), and anxiety in patients diagnosed with essential hypertension. TRIAL DESIGN: This study was based on a 4-arm parallel-group, randomized control design. METHODS: Sixty-four participants diagnosed with essential hypertension were randomly allocated into SBE, PMR, SBE-PMR, and Control groups, with 16 subjects each. All 3 groups received different treatments according to their name; however, the Control group received no treatment. Systolic and diastolic BP (SBP and DBP), HR, RR, and anxiety were all evaluated as the study outcomes using a digital sphygmomanometer and perceived stress scale (PSS) at baseline (pretest), 2nd week and 4th weeks post-intervention. A repeated measure analysis of variance test assessed intra-group comparison (overall) analyses across multiple time points. Bonferroni multiple comparison tests were used to analyze the mean differences between the groups. The confidence interval was kept at 95% for all the statistical analyses, that is, P < .05 is considered significant. RESULTS: There was a significant change in the HR (F = 239.04, P = .0001), RR (F = 167.74, P = .0001), SBP (F = 266.64, P = .0001), DSP (F = 279.80, P = .0001), and PSS (F = 473.42, P = .0001) as an outcome of baseline measurements versus (vs) the following weeks. There were significant (F = 48.57, P = .001) differences among different training on HR. The SBE vs SBE-PMR showed an insignificant difference (F = 48.54, P = 1.000). The RR showed significant differences (F = 32.05, 0.0001) between the SBE vs PMR, SBE vs Control, PMR vs Control, and SBE-PMR vs Control groups and insignificant differences for the SBE vs SBE-PMR and PMR vs SBE-PMR groups. The SBE vs SBE-PMR groups showed insignificant differences for DPP and SBP. However, PSS showed significant differences (F = 67.12, P = .0001) among the intervention groups except for the PMR and SBE-PMR groups. CONCLUSIONS: The combined interventions of SBEs and progressive muscle relaxation techniques can effectively reduce the heart rate, respiratory rate, BP, and anxiety in essential hypertensive patients compared to both techniques when given alone.

Combination of topical and oral glutathione as a skin-whitening agent: a double-blind randomized controlled clinical trial.

BACKGROUND: The antimelanogenesis effect of topical and oral glutathione has been shown in several in vitro and clinical studies. However, whether combination of topical and oral glutathione is superior to topical or oral monotherapy is unknown. This study aimed to compare the skin-whitening effect of topical and oral glutathione combination therapy against topical and oral monotherapy. METHODS: This double-blind randomized controlled study was done on 46 participants who were divided into two equal groups. Each group received oral placebo and oral glutathione, respectively. All participants were also instructed to apply topical placebo and glutathione to each facial side, respectively. Colorimeter examination was done biweekly using mexameter and chromameter for 8 weeks. One-way ANOVA test was used to compare the results of all groups. RESULTS: The combination group showed significantly lower melanin index (MI) and L* score to placebo (P < 0.05). The mean MI and L* score of the combination group were the highest of all groups. Statistical significance of difference in L* score was reached when the combination group was compared to the oral placebo and topical glutathione group (P < 0.05). CONCLUSION: This study showed that topical and oral glutathione were effective skin-lightening agents. Furthermore, combination of topical and oral glutathione might be superior to monotherapy.

Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals.

To compare the effectiveness of tranexamic acid (TA) combination serum with hydroquinone, the gold standard in whitening agents for healthy populations. This was a three-arm randomized controlled trial. The subjects were divided into three groups: the first group received 3% TA combination serum (3% TA, 4% galactomyces ferment filtrate, 2% niacinamide, and 4% alpha arbutin), the second group received 2% TA combination serum, and the third group received 4% hydroquinone. One milliliter of each serum was applied on three holes: Hole A, which was located 4 cm from the left cubital fossa, Hole B, which was located 4 cm from the first hole, and Hole C, which was located 4 cm from the right cubital fossa. The skin brightness and pigmentation intensity were evaluated each week for 4 weeks using a chromameter. A total of 44 subjects were recruited for this study. All groups showed a significant improvement in skin brightness and pigmentation intensity after 4 weeks (p < .001). There were no differences between the treatment groups and hydroquinone (p > .05). TA serum (2 and 3%) combined with 4% galactomyces ferment filtrate, niacinamide, and alpha arbutin is an effective depigmenting agent.

2-[(2-Meth-oxy-benzyl-idene)amino]-phenol.

In the title compound, C(14)H(13)NO(2), the azomethine double bond adopts an E conformation and the benzene rings form a dihedral angle of 77.70 (7)°. In the crystal, mol-ecules are linked by O-H⋯N and C-H⋯O hydrogen bonds and arranged in a zigzag fashion, forming infinite chains parallel to the c axis, resulting in a graph-set R(2) (2)(9) motif.

{2-[(3-Bromo-benzyl-idene)amino]-5-chloro-phen-yl}(phen-yl)methanone.

In the title compound, C(20)H(13)BrClNO, the azomethine double bond [C=N = 1.246 (4) Å] adopts an E conformation. The bromo- and chlorophenyl rings are inclined to one another by 13.70 (11)°, and form dihedral angles of 76.68 (10) and 74.24 (7)°, respectively, with the phenyl ring. In the crystal, mol-ecules are linked by C-H⋯O hydrogen bonds to form double stranded chains propagating along the b-axis direction.

17-(Pyrimidin-2-yl)-8,16-dioxa-17-aza-tetra-cyclo-[7.7.1.0.0]hepta-deca-2,4,6,10,12,14-hexa-ene.

In the title compound, C(18)H(13)N(3)O(2), the benzene rings form a dihedral angle of 78.49 (9)°. The dihedral angles between the benzene rings and the pyrimidine ring are 76.53 (10) and 27.73 (11)°. The two cis-fused six-membered heterocyclic rings adopt half-chair confirmations. In the crystal, mol-ecules are linked by C-H⋯O hydrogen bonds, forming chains parallel to the b axis.

{5-Chloro-2-[(4-nitro-benzyl-idene)amino]-phen-yl}(phen-yl)methanone.

The mol-ecule of the title Schiff base compound, C(20)H(13)ClN(2)O(3), assumes an E configuration about the C=N bond. The aromatic rings of the nitro-benzene and chloro-benzene groups are twisted by 13.89 (13)° and form dihedral angles of 76.38 (13) and 84.64 (13)°, respectively, with the phenyl ring. In the crystal, mol-ecules are linked into chains parallel to the b axis by C-H⋯π inter-actions.

{5-Chloro-2-[(2-hy-droxy-benzyl-idene)amino]-phen-yl}(phen-yl)methanone.

The title Schiff base compound, C(20)H(14)ClNO(2), adopts an E configuration about the azomethine bond. The phenol and chloro-benzene rings form dihedral angles of 84.71 (9) and 80.70 (8)°, respectively, with the phenyl ring and are twisted by 15.32 (8)° with respect to one another. The mol-ecular conformation is stabilized by an intra-molecular O-H⋯N hydrogen bond, which forms an S(6) ring motif. In the crystal, mol-ecules are linked by C-H⋯O hydrogen bonds, forming columns parallel to the a axis.

Lupene-type triterpenes from Periploca aphylla.

Two new lupane derivatives, 3beta,6alpha-dihydroxylup-20(29)-ene (1) and 6alpha-hydroxylup-20(29)-en-3beta-octadecanoate (2), have been isolated from the stems of Periploca aphylla, in addition to beta-sitosterol and lupeol. The structures of 1 and 2 were determined by spectral and chemical methods. Compound 1 showed strong inhibition of alpha-glucosidase type VI and a moderate antibacterial activity.

Right Ventricular Dysfunction Secondary to Myocardial Ischemia Provoked by Stress Testing.

We present the cases of two patients, aged 59 and 85 years, who were evaluated with stress echocardiography for chest pain. Both patients developed dramatic echocardiographic findings consisting of severe right ventricular enlargement and hypokinesis, as well as enlargement of the right atrium at relatively low-level exercise. One patient collapsed with severe sinus bradycardia, junctional rhythm, ST elevation in the inferior leads, marked hypotension, and neck vein congestion. The other patient developed staggering and symptoms of hypoperfusion. In both patients, correction of critical proximal right coronary artery stenosis by angioplasty resulted in complete resolution of the right ventricular dysfunction on repeat stress testing. We conclude that in some patients, stress-induced myocardial ischemia may involve primarily the right ventricle with little or no evidence of ischemic changes in the left ventricle. An assessment of right ventricular function should be included in stress echocardiographic studies.

Aortic Dissection in Progress Diagnosed by Transthoracic Echocardiography.

This report describes a patient who presented with vague chest pain, syncope, and seizures. The diagnosis of dissection of the ascending aorta was clearly established by transthoracic echocardiography. The dissection was initially limited to the ascending aorta. Using the suprasternal window, it was possible to monitor the progression of the dissection almost beat by beat as it extended from the ascending aorta and across the aortic arch to the descending thoracic aorta. Surgical intervention was carried out immediately with successful results. Although transesophageal echocardiography is the procedure of choice in aortic dissection, definitive information can be obtained quickly and safely using the transthoracic approach. The suprasternal window in this case showed the dramatic progression of the disease process. (ECHOCARDIOGRAPHY, Volume 13, January 1996)