Balraj S Heran

Overall accuracy of the BpTRU--an automated electronic blood pressure device.

BackgroundThe objective of this report is to combine the data from an earlier adult study with the data from a paediatric study in order to determine the overall accuracy of the BpTRU™ (BPM-100 model) as compared to the recognized standard, auscultatory mercury sphygmomanometer. DesignThe individual blood pressure points recorded for both adult and paediatric studies were compared directly to its corresponding observer reference measurements from data collected and stored from the two separate studies. There were 255 sets of readings in the adult study and 162 sets from the paediatric study, which were combined to make 417 pairs of blood pressure readings for this study. MethodsThe overall observer standard reference mean for the 417 measurements was calculated and the difference between this and the overall mean BPM-100 was calculated with SD and ranges. Measurements within 5, 10 and 15 mmHg agreement were expressed as percentages. ResultsA total of 121 subjects were included for this study (85 from the adult study and 36 from the paediatric study). From these, 417 paired measurements were recorded. The mean difference between the BpTRU™ and the reference standard systolic blood pressure (BP) was 0.47±5.40 mmHg with 89.2% measurements within 5 mmHg, 96.4% within 10 mmHg and 99.3% within 15 mmHg. The mean difference between the BpTRU™ and reference diastolic BP was −2.12±5.93 mmHg with 81.1% within 5 mmHg, 92.1% within 10 mmHg and 97.6% within 15 mmHg. ConclusionThe BpTRU™ has been shown to be an accurate non-invasive blood pressure monitoring device in the general population over a wide range of ages (3–83 years). This combined study meets all requirements of the Association of Advancement of Medical Instrumentation and achieved a grade ‘A’ in the BHS protocol.

Persistent Sexual Dysfunction and Suicidal Ideation in Young Men Treated with Low-Dose Finasteride: A Pharmacovigilance Study.

Finasteride, a 5α‐reductase inhibitor, is marketed in a low dose (1 mg) as a popular therapy for androgenic alopecia in young men. As case reports and small surveys have suggested a link between persistent sexual dysfunction (SD) and suicidal ideation (SI) with low‐dose finasteride, the aim of this study was to detect signals of SD and SI secondary to low‐dose finasteride use in young men.

Comparison of the automated non-invasive oscillometric blood pressure monitor (BpTRU) with the auscultatory mercury sphygmomanometer in a paediatric population.

BackgroundTo directly compare the accuracy of the BpTRU™ (an automated oscillometric blood pressure device) with standard auscultatory mercury sphygmomanometry in a pediatric population. DesignThe BpTRU™ was connected in parallel with a standard mercury sphygmomanometer. Two observers measured the blood pressures at the same time as it was being measured by the BpTRU™. The observers and the BpTRU™ were all blinded from each other. MethodsFor each of the demographic data—subject age, sex and arm sizes—the mean, standard deviation (SD) and range was calculated. The difference between the mean BpTRU™ and the standard reference measurements (observer average) was calculated with SD and ranges. The percentage of measurements within 5, 10 and 15 mmHg agreement was expressed. ResultsFrom the 36 subjects recruited aged 3–18 years, 162 pairs of sitting blood pressures were included. The difference between the mean BpTRU™ readings and the reference standard measurements (as determined by the observers) was 1.45±5.67 mmHg for systolic blood pressures, and –3.24±7.39 mmHg for diastolic pressure and 0.20±2.47 bpm for heart rate. ConclusionThe BpTRU™ is of similar accuracy in measuring blood pressure in children as it was in an adult population.

Persistent Sexual Dysfunction with Finasteride 1 mg Taken for Hair Loss

To examine the risk of persistent sexual dysfunction (PSD) with finasteride 1 mg.

Effect of medication timing on anticoagulation stability in users of warfarin (the INRange RCT): Study protocol for a randomized controlled trial

BackgroundWarfarin is an oral anticoagulant medication that disrupts the liver’s production of clotting factors. While this medication is highly effective for the prevention of thromboembolic events, it also has a narrow therapeutic range and a vulnerability to interactions with other drugs and vitamin K-containing foods. Warfarin is commonly ingested at dinnertime, the same time of day that dietary vitamin K consumption (found largely in green leafy vegetables) is most variable. While the long half-life of warfarin might make this irrelevant, the ultra short half-life of vitamin K and the possibility of a hepatic first-pass effect for warfarin make it worth evaluating whether morning ingestion of warfarin, when vitamin K levels are consistently low, leads to greater stability of its anticoagulant effect. An examination of the timing of administration on the effectiveness of warfarin has never before been conducted.Methods/designThis is a 7-month Prospective Randomized Open Blinded End-point (PROBE) study in which established evening warfarin users (primary care managed Canadian outpatients in the provinces of British Columbia and Alberta) will be randomized to either switch to morning ingestion of warfarin (the intervention) or to continue with evening use (the control). The primary outcome is the percent change in the proportion of time spent outside the therapeutic range of the international normalized ratio (INR) blood test. Secondary outcomes include change in proportion of time spent within the therapeutic INR range (TTR), percentage of patients with TTR >75 %, percentage of patients with TTR <60 %, and major warfarin-related cardiovascular events (including all-cause mortality, hospitalization for stroke, hospitalization for GI bleeding, and deep venous thrombosis/pulmonary embolism). We will also compare whether day-to-day variability in the consumption of high vitamin K-containing foods at baseline affects the baseline TTR in this cohort of evening warfarin users.DiscussionThis study addresses whether the timing of warfarin ingestion influences the stability of its anticoagulant effect. Should morning ingestion prove superior, the safety and effectiveness of this medication, and hence the prevention of stroke, pulmonary embolus, and major hemorrhage, could potentially be improved with no added cost or inconvenience to the patient.Trial registrationClinicalTrials.gov: NCT02376803. Registered on 25 February 2015.