scholarly journals Effect of Hysterectomy on Colonoscopy Completion Rate

2010 ◽  
Vol 24 (6) ◽  
pp. 365-368 ◽  
Author(s):  
Mélanie Lacasse ◽  
Geneviève Dufresne ◽  
Emilie Jolicoeur ◽  
Luc Rochon ◽  
Charles Sabbagh ◽  
...  
Keyword(s):  
Pain Perception ◽  
Intubation Rate ◽  
Review Of The Literature ◽  
Control Groups ◽  
Cecal Intubation ◽  
Significant Difference ◽  
Detectable Difference ◽  
Procedural Complication ◽  
Cecal Intubation Rate ◽  
And Control

BACKGROUND: Several studies show that colonoscopies are technically more difficult to perform in women than men, especially in women who have undergone abdominal and gynecological surgeries. A review of the literature indicates an increased rate of noncompletion of colonoscopies in most cases; however, no studies have investigated the procedural complication rate, sedation requirements and perception of pain in colonoscopies.OBJECTIVE: To determine whether women who have undergone a previous hysterectomy have a higher noncompletion rate when undergoing a colonoscopy, and to assess whether there is a higher percentage of complications. Furthermore, the present study also aimed to ascertain whether these women required more sedation and whether their perception of pain is greater than that of women who did not undergo previous abdominal surgeries.METHODS: The present study was a prospective cohort study of women, 45 to 80 years of age, who underwent colonoscopy (n=508). A total of 229 patients were eligible for the study; they completed a questionnaire, and were subsequently divided into control and hysterectomy groups. Gastroenterologists performed all procedures. After colonoscopy, the patient and endoscopist completed a pain perception questionnaire. Cecal intubation rates were also recorded.RESULTS: No significant difference for cecal intubation rates were detected between the two groups (95.7% and 98.7% in hysterectomy and control groups, respectively; P=0.176). The crude OR for the success rate was 0.29 (95% CI 0.05 to 1.90). There was no significant difference between groups regarding sedation or the type of colonoscope. No correlation between the gastroenterologists’ evaluation of pain and patients’ pain was observed.CONCLUSION: Hysterectomy did not significantly diminish the cecal intubation rate, and there was no detectable difference in pain perception or sedative dose. Colonoscopy remains an excellent screening and diagnostic tool for all women.

scholarly journals Efficacy of Endocuff-assisted colonoscopy in the detection of colorectal polyps

2018 ◽  
Vol 06 (04) ◽  
pp. E425-E431 ◽  
Author(s):  
Yoshiki Wada ◽  
Masayoshi Fukuda ◽  
Kazuo Ohtsuka ◽  
Mamoru Watanabe ◽  
Yumiko Fukuma ◽  
...  
Keyword(s):  
Detection Rate ◽  
Colorectal Polyps ◽  
Colorectal Adenomas ◽  
Insertion Time ◽  
Intubation Rate ◽  
Cecal Intubation ◽  
Withdrawal Time ◽  
Significant Difference ◽  
Cecal Intubation Rate ◽  
The Mean

Abstract Background and study aims Colonoscopy is the gold standard for detecting colorectal adenomas and cancers. Endoscopic surveillance has been shown to be effective for preventing colorectal cancer. Although detection of colorectal polyps at an early stage is important, endoscopic visualization of early neoplasia can be difficult. The Endocuff is a new device that can be attached to the tip of the colonoscope to hold the colonic folds away from the field of view during withdrawal. The aim of this study was to compare the adenoma detection rate (ADR) and the mean number of adenomas detected per patient (MAP) achieved using Endocuff-assisted colonoscopy (EAC) and standard colonoscopy (SC). Patients and methods This randomized prospective study was conducted at two academic endoscopy departments in Japan. A total of 447 patients underwent a complete colonoscopic examination between April 2015 and September 2015. The EAC group included 239 patients. The cecal intubation rate, insertion time, withdrawal time, pain score, complications, polyp detection rate (PDR), ADR, the mean number of polyps detected per patient (MPP), and the MAP were assessed. Results There were no differences between the EAC and SC groups in terms of cecal intubation rate, insertion time, withdrawal time, or pain scores. The PDR in patients increased by about 12 % (61.9 % vs. 49.2 %, P = 0.013) and ADR increased by 15 % (52.5 % vs. 39.2 %, P = 0.001) with the use of the Endocuff. The advanced ADR was higher in the EAC group but no statistically significant difference was found (7.7 % vs. 4.6 %, P = 0.17). Both MPP and MAP were also higher in the EAC group (mean ± SD: 1.33 ± 1.43 vs. 0.83 ± 0.99 per patient; P < 0.01, 1.11 ± 1.41 vs. 0.66 ± 0.99 per patient; P < 0.01, respectively). No major complications occurred. Conclusions EAC not only enabled a higher ADR but also significantly increased the mean number of adenomas identified per patient, as compared with SC.

Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Coconut Oil ◽  
Test Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Virgin Coconut Oil ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.

Stick Figure and Think, Talk And Write: Integrating Media With Teaching Strategy For A Better Writing Competence

2017 ◽  
Vol 2 (1) ◽  
pp. 46
Author(s):  
Eva Sudarwati ◽  
Shynta Amalia
Keyword(s):  
Teaching Strategy ◽  
T Test ◽  
Narrative Writing ◽  
Control Groups ◽  
Stick Figure ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Mean Differences ◽  
And Control ◽  
Writing Competence

Abstract This study attempts to see the effect of Think, Talk, and Write strategy on the students’ narrative writing competence. Considering the importance of the use of teaching media, this study tries to integrate Stick Figure as a teaching media in Think, Talk, and Write Strategy. A quasi experimental study was conducted to see the improvement of the students’ narrative writing competence. It involved 42 students who were selected on the basis of convenience sampling and assigned into two groups; experimental and control groups. The statistical analyses of paired sample t-test in experimental group showed that there was significant improvement on the students’ writing competence before (M=5.77, SD= 2.342) and after (M= 11.79, SD= 2.342), t(21)=12.059, p<0.05.Moreover, the result of independent t-test between experimental and control groups showed a significant difference. It can be seen that the mean differences was 3.79545 and the significance value is lower than 0.05, 0.000<0.05.

Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spinal Surgery ◽  
Control Group ◽  
Control Groups ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Surgical Data ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

Investigation of the Association Between Carotid Artery Intima-Media Thickness (IMT) and Cardiac Risk Factors in Patients with Systemic Lupus Erythematosus

2020 ◽  
Vol 16 (2) ◽  
pp. 125-133
Author(s):  
Zahra Rezaieyazdi ◽  
Sima Sedighi ◽  
Masoumeh Salari ◽  
Mohammadreza H. Fard ◽  
Mahmoud R. Azarpazhooh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Serum Insulin ◽  
Venous Blood ◽  
Test Group ◽  
Control Groups ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Background: The relationship between SLE and traditional risk factors for cardiovascular events was evaluated. Methods: The data regarding sixty patients with SLE and 30 healthy controls (age and sex matched) were gathered using SLEDAI forms. Venous blood (10mL) from all the participants was examined for hs-CRP, homocysteine, VCAM1, CBC, anti-DNA antibody, C3, C4, low-density lipoprotein (LDL), cholesterol, FBS and triglyceride. : The IMT of carotid arteries was determined bilaterally by ultrasound. Other measurements included insulin levels via Elisa (Linco/Millipore Corp) and the HOMA-IR index for insulin resistance. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. Results: The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. : The average IMT in the test group was directly related to serum levels of VCAM1 (p<0.001), homocysteine (p<0.001), cholesterol (p<0.009), LDL (p<0.001), TG (p<0.001), and FPG (p=0.004). The association between other risk factors, insulin resistance, carotid IMT and SLEDAI, was nonexistent. Mean insulin and insulin resistance levels in all the participants were 0.43±2.06 µU/mL and 0.09±0.44, respectively. There was no significant difference between the test and control groups regarding serum insulin and insulin resistance levels (p=0.42 and p=0.9, respectively). None of the risk factors, such as hsCRP, VCAM1, or homocysteine, were shown to be related to insulin resistance (p=0.6, p=0.6, p=0.09, respectively). Conclusion:: Our findings did not show an increase in the prevalence of atherosclerosis in patients with SLE. There was no association between IMT and insulin resistance. However, the former was associated with FPG, total cholesterol, LDL, TG, homocystein and VCAM1.

The possible regulatory mechanisms of aqueous, ethyl acetate and nhexane fractions of the Ribes khorassanicum extract on acute hypertension in rats

2020 ◽  
Vol 20 ◽  
Author(s):  
Reza Mohebbati ◽  
Yasamin Kamkar-De ◽  
Mohammad Naser Shafei
Keyword(s):  
Ethyl Acetate ◽  
Antihypertensive Effect ◽  
Cardiovascular Responses ◽  
Regulatory Mechanisms ◽  
Hypertensive Rats ◽  
Control Groups ◽  
Acute Hypertension ◽  
The North ◽  
Significant Difference ◽  
And Control

Objective: Our previous studies showed the antihypertensive effect of Ribes khorassanicum (R. khorassanicum), a medicinal herb growing in the North Khorasan Province of Iran. For further evaluation, the present study investigated the effect of n-hexane (HX), ethyl acetate (EA), and aqueous (AQ) fractions of hydroalcoholic R. khorassanicum extract on cardiovascular responses in angiotensin II (AngII) and NG-nitro-L-arginine methyl ester (L-NAME) hypertensive rats. Methods: Wistar rats were randomly divided into 11 groups (n=5): 1) control, 2) AngII (50 ng/kg, i.v), 3) AngII + losartan (10 mg/kg, i.p), 4) L-NAME (10 mg/kg, i.v), 5) L-NAME+ sodium nitroprusside (SNP) (50 mg/kg, i.p), 6,7,8) one dose of each fraction of R. khorassanicum (AQ/EA/HX (50 mg/kg, i.p)) +AngII, and 9,10,11) one dose of each fraction of R. khorassanicum (AQ/EA/HX (50 mg/kg, i.p)) + L-NAME. Treated rats received three fractions 30 min before the injection of L-NAME and AngII in separate groups. The cardiovascular parameters were recorded by the Power Lab instrument via an angiocath inserted into the femoral artery. The peak changes (∆) of mean arterial pressure (MAP), systolic blood pressure (SBP), and heart rate (HR) in treated groups were compared with those of the hypertensive and control groups. Result: AngII and L-NAME significantly increased ∆MAP and ∆SBP and attenuated by pretreatment of LOS and SNP, respectively. Pretreatment with polar (AQ) and semipolar (EA) fractions of R. khorassanicum reduced the peak changes of MAP and SBP in both AngII and L-NAME-treated groups. Only the fraction of the herb attenuated the HR increased in the L-NAME group. The HR in other groups did not demonstrate any significant difference. Conclusion: All fractions of R. khorassanicum have an antihypertensive effect. However, the effect of polar fractions is more salient. It is also conceivable that the antihypertensive effect of fractions is mostly mediated by the inhibition of AngII.

scholarly journals A117 PROPOFOL SEDATION DOES NOT IMPROVE MEASURES OF COLONOSCOPY QUALITY – FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 97-98
Author(s):  
M Sey ◽  
B Yan ◽  
Z Hindi ◽  
M Brahmania ◽  
J C Gregor ◽  
...  
Keyword(s):  
Detection Rate ◽  
Conscious Sedation ◽  
Intubation Rate ◽  
Polyp Detection ◽  
Cecal Intubation ◽  
Propofol Sedation ◽  
Serrated Polyp ◽  
Polyp Detection Rate ◽  
Cecal Intubation Rate ◽  
Colonoscopy Quality

Abstract Background The use of propofol during colonoscopy has gained increased popularity due to deeper anesthesia compared to conscious sedation. Prior studies examining the use of propofol sedation during colonoscopy have primarily focused on anesthesia outcomes. Whether propofol sedation is associated with improvements in colonoscopy outcomes is uncertain. Aims The primary outcome was adenoma detection rate (ADR). Secondary outcomes were the detection of any adenoma (conventional adenoma, sessile serrated polyp, and traditional serrated adenoma), sessile serrated polyp detection rate, polyp detection rate, cecal intubation rate, and perforation rate. Methods The Southwest Ontario Colonoscopy cohort consists of all patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 hospitals serving a large geographic area in Southwest Ontario. Procedures performed in patients less than 18 years of age or by endoscopist who perform &lt;50 colonoscopies/year were excluded. Data were collected through a mandatory quality assurance form that was completed by the endoscopist after each procedure. Pathology reports were manually reviewed. Results A total of 46,634 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others) of which 16,408 (35.2%) received propofol and 30,226 (64.8%) received conscious sedation (e.g. combination of a benzodiazepine and a narcotic). Patients who received propofol were likely to have a screening indication (49.2% vs 45.5%, p&lt;0.0001), not have a trainee endoscopist present and be performed at a non-academic centre (32.2% vs 44.6%, p&lt;0.0001). Compared to conscious sedation, use of propofol was associated with a lower ADR (24.6% vs. 27.0%, p&lt;0.0001) and detection of any adenoma (27.7% vs. 29.8%, p&lt;0.0001); no difference was observed in the detection ofsessile serrated polyps (5.0% vs. 4.7%, p=0.26), polyp detection rate (41.2% vs 41.2%, p=0.978), cecal intubation rate (97.1% vs. 96.8%, p=0.15) or perforation rate (0.04% vs. 0.06%,p=0.45). On multi-variable analysis, the use of propofol was not significantly associated with any improvement in ADR (RR=0.90, 95% CI 0.74–1.10, p=0.30), detection of any adenoma (RR=0.93, 95% CI 0.75–1.14, p=0.47), sessile serrated polyp detection rate (RR=1.20, 95%CI 0.90–1.60, p=0.22), polyp detection rate (RR=1.00, 95% CI 0.90–1.11, p=0.99), or cecal intubation rate (RR=1.00, 95%CI 0.80–1.26, p=0.99). Conclusions The use of propofol sedation does not improve colonoscopy quality metrics. Funding Agencies None

scholarly journals Ayurveda Body–Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions

2021 ◽  
pp. 097275312110000
Author(s):  
Madhava Sai Sivapuram ◽  
Vinod Srivastava ◽  
Navneet Kaur ◽  
Akshay Anand ◽  
Raghuram Nagarathna ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Lipid Profiles ◽  
Control Groups ◽  
Yoga Intervention ◽  
Positive Effects ◽  
Study Results ◽  
Significant Difference ◽  
And Control

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

457 The Impact of PAP Therapy on Hematocrit in OSA and Polycythemia: A Pilot Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A180-A181
Author(s):  
Mustafa Jafri ◽  
Gabrielle Rosa-Acosta ◽  
Jose Flores Martinez ◽  
Elizabeth Schofield ◽  
Cy Wilkins ◽  
...  
Keyword(s):  
Intervention Group ◽  
Smoking History ◽  
Event Analysis ◽  
Control Groups ◽  
Testosterone Therapy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Testosterone Administration ◽  
And Control ◽  
The Impact

Abstract Introduction Untreated polycythemia leads to complications including thrombosis. Obstructive sleep apnea (OSA) is commonly associated with secondary erythrocytosis, which testosterone therapy can perpetuate. Effects of positive airway pressure (PAP) on elevated hematocrit (HCT) is unknown. We hypothesize PAP adherence can reduce HCT in men with OSA and polycythemia. Methods Retrospective chart review of male outpatients with newly diagnosed OSA and HCT≥45% at or 3 months before polysomnography (PSG) was conducted. Intervention group consisted of patients initiating PAP for OSA. HCT within 6 months of PAP initiation and PSG were recorded for intervention and control groups, respectively. Primary endpoint was time-to-HCT reduction of HCT&lt;50% plus 3% decrease. Cox proportional-hazards analysis was used to assess time-to-HCT response. Demographics, smoking history, testosterone administration, STOP-Bang score, AHI, and PAP compliance data were obtained. Patients excluded if PAP not indicated, or if PSG, PAP compliance, or repeat HCT were unavailable. Results 41 men with OSA had HCT≥45%, of which 16 had HCT≥50%. Median age was 60 years and median BMI was 32 kg/m2. 28 started PAP. 21 met definition for PAP compliance within 6 months. Median AHI of intervention and control groups were 23 and 19 events/hr, respectively. Mean baseline HCT of both groups were 49 and 50, respectively. No significant difference in age, BMI, smoking history, testosterone therapy, and baseline HCT between both groups noted. 39% of intervention group exhibited HCT response at 1 or more longitudinal assessments, versus 38% of control. Intervention group had higher mean STOP-Bang than control (mean 5.9 vs. 4.6, p=0.01) and trended towards higher mean baseline AHI (27.4 vs. 19.0, p= 0.06). Time-to-event analysis controlling for STOP-Bang and AHI demonstrated PAP was not associated with time-to-HCT response (HR = 1.3, 95% CI = 0.4–4.4). In moderate-severe OSA patients, 40% of intervention group had HCT response compared to 14% of control, though difference was not significant (HR = 2.5, 95% CI = 0.3–20.0). Conclusion Moderate-severe OSA patients trended towards reduction in HCT with PAP, although not statistically significant. Testosterone administration did not affect HCT response to PAP in this cohort. Larger studies are required to determine HCT response to PAP in these patients. Support (if any):

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