A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

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Acute hypervolemic hemodilution combined with controlled hypotension to minimize blood loss during operations of spine fusion: remifentanil versus magnesium sulfate

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00165-3 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Khaled Mohammed Elnaghy ◽

Ibrahimabd-Elsalam Nasr ◽

Eman Mohamed Kamal

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Magnesium Sulfate ◽

Spine Fusion ◽

Controlled Hypotension ◽

Group Iii ◽

Group I ◽

Estimated Blood Loss ◽

Hypervolemic Hemodilution ◽

Group Ii

Abstract Background Blood loss is one of the major problems during operations of spine fusion. Several blood-conservative measures were applied to reduce the incidence of blood loss—among them, acute hypervolemic hemodilution (AHH) and controlled hypotension (CH). This study was designed to detect the effect of combination of AHH with CH induced by remifentanil versus magnesium sulfate on the volume of blood loss, allogeneic blood transfusion, hemodynamics, coagulation, and electrolytes during operations for spine fusion which are risky operations with high incidence of blood loss and blood transfusion. Sixty patients scheduled for posterior fusion of the spine were randomly allocated into three groups of 20 patients each (group I (AHH), group II (AHH combined with remifentanil-based CH), and group III (AHH combined with magnesium sulfate-based CH)). Estimated blood loss and total volume of packed red blood cells (PRBCS) transfused were recorded. Arterial blood pressure (ABP) and heart rate (HR) measures were recorded. Blood samples were obtained for the detection of hemoglobin (Hb) and hematocrit (HCT). Results Estimated blood loss, percentage blood loss, and intraoperative RBC transfusion units were significantly high in group I in relation to group II and group III (Table 2). Cardiac output was significantly higher in group I in relation to group II and group III at 10, 15, 30, 45, and 60 min after start of AHH. MBP and HR results were significantly high in group I in comparison with group II and group III at 30, 45, 60, and 90 min and 2 and 3 h after start of study drugs. CVP results were significantly high in group I in relation to group II and group III at 15, 30, 45, 60, and 90 min after start of AHH. PTT was significantly increased in the three study groups in comparison with baseline inside each group after AHH. Conclusion Combination of AHH with CH induced by remifentanil or magnesium sulfate was associated with reduction in estimated blood loss, and total volume of PRBCS transfused. There was no significant difference between hemodynamic parameters with the use of remifentanil or magnesium sulfate except that SBP, DBP, and MBP results were significantly high with magnesium sulfate at 15 min after drug infusion. There was significant increase in PT and PTT after AHH that was not reflected by significant blood oozing from the operative field, or by difficulty in hemostasis.

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Efficacy of Preoperative Misoprostal in Reducing Hemorrhage during Abdominal Myomectomy

10.53350/pjmhs211561934 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1934-1936

Author(s):

Irum Batool Hashmi ◽

Asim Shafi ◽

Ayesha Choudhary ◽

Wasim Ahmad ◽

Muhammad Hamayun Khan ◽

...

Keyword(s):

Body Mass Index ◽

Blood Transfusion ◽

Blood Loss ◽

Body Mass ◽

Intraoperative Blood Loss ◽

Abdominal Myomectomy ◽

Group I ◽

Group Ii ◽

One Year ◽

Double Blinded

Objective: The aim of this study is to determine the efficacy of preoperative misoprostal in reducing hemorrhage during abdominal myomectomy. Study Design: Prospective comparative randomized double blinded Place and Duration: Conducted at DHQ Zanana hospital Dera Ismail Khan for one year duration from January 2019 to December 2019. Methods: Total 100 patients underwent abdominal myomectomy were presented in this study. Patients were aged between 18-45 years of age. Patients’ detailed demographics including age, body mass index and parity were recorded after taking informed written consent. Patients were categorized equally into two groups, I and II. Group I had 50 patients and received single dose 400 micrograms of misoprostol transrectally one hour preoperatively and group II had 50 patients and received 2-tablets of placebo preoperatively. Outcomes intraoperative blood loss, blood transfusion, hysterectomy and complications among both groups were assessed. Complete data was analyzed by SPSS 23.0 version. Results: Mean age of the patients was 32.16±9.44 with mean BMI 26.07±10.44 kg/m2. There were no significantly difference among age and body mass among both groups. 60 Patients had 0 parity, 30 patients had parity 1 and the rest were had parity 2. Mean pre-operative hemoglobin in group I was 13.64±8.55 and post-operative was 9.88±8.55 and in group II mean pre-operative hemoglobin was 13.55±8.55 and post-operative was 9.12±5.55. Mean intraoperative blood loss in group I was 388.17±37.18 ml and in group II was 501.16±17.64 ml. Post-operatively blood transfusion in group I was among 2(4%) cases and 3 (6%) in group II. Mean hospital stay in group II was greater as compared to group I. Nausea, vomiting and shivering were the complications found in this study. Conclusion: We concluded in this study that the use ofmisoprostol preoperatively during abdominal myomectomy was effective safe and useful in reduction of intraoperative blood loss and post-operatively blood transfusion among patients. Keywords: Abdominal myomectomy, Misoprostol, Placebo, Intraoperative, Blood loss

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Impact of an Autotransfusion System during Endoluminal Repair of Abdominal Aortic Aneurysms: Does it Decrease the use of Allogeneic Blood?

The American Surgeon ◽

10.1177/000313480507100919 ◽

2005 ◽

Vol 71 (9) ◽

pp. 786-790

Author(s):

Carlos Donayre ◽

Uzoamaka Adimora ◽

Tae Song ◽

George Kopchok ◽

Maurice Lippmann ◽

...

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Abdominal Aortic Aneurysms ◽

Group Iv ◽

Aortic Aneurysms ◽

Group Iii ◽

Endoluminal Repair ◽

Group I ◽

Abdominal Aortic ◽

Group Ii

Endoluminal repair of abdominal aortic aneurysms (AAA) is associated with decreased blood loss and transfusion requirements when compared to open AAA repair. We evaluated the use of an intraoperative autotransfusion system during endoluminal exclusion of AAAs. Fifty endoluminal AAA procedures selected at random were reviewed retrospectively. Patients were divided into 4 groups according to their estimated blood loss: Group I, 20 patients (0–500 cc); Group II, 18 patients (501–1,000 cc); Group III, 7 patients (1,001–1,500 cc); and Group IV, 5 patients (1,501–3,400 cc). The average blood loss was 327 cc for Group I, 728 cc for Group II, 1,217 for Group III, and 2,125, for Group IV. The overall blood loss was 834 cc, but 75 per cent was recovered. Hematuria was always present when greater than 1,000 cc of blood was retransfused, but renal function was not affected even with the concomitant administration of radiographic contrast. Only one patient required an autologous blood transfusion. The use of an autotransfusion device is safe, efficacious, and appears to further limit the need for homologous blood transfusion in patients undergoing endoluminal AAA repair.

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Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

HEALTH OF WOMAN ◽

10.15574/hw.2016.113.108 ◽

2016 ◽

pp. 108-111

Author(s):

T.F. Tatarchuk ◽

◽

D.G. German ◽

Keyword(s):

Reproductive Age ◽

Cervix Uteri ◽

Control Group ◽

Women Of Reproductive Age ◽

Endometrial Polyps ◽

Group Iii ◽

Aggressive Form ◽

Group I ◽

Group Ii ◽

Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

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Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2015-0371 ◽

2016 ◽

Vol 94 (4) ◽

pp. 359-362 ◽

Cited By ~ 7

Author(s):

Fatma H. Rizk ◽

Samah A. Elshweikh ◽

Amira Y. Abd El-Naby

Keyword(s):

Metabolic Syndrome ◽

Liver Enzymes ◽

Resistance Index ◽

Control Group ◽

Model Assessment ◽

Group Iii ◽

Group I ◽

Elevated Liver Enzymes ◽

Liver Functions ◽

Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

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Effect of Oral Erythropoietin in Prevention of Anemia of Prematurity

Bangladesh Journal of Child Health ◽

10.3329/bjch.v41i2.36106 ◽

2018 ◽

Vol 41 (2) ◽

pp. 101-109

Author(s):

Md Jamshed Alam ◽

Md Kamrul Ahsan Khan ◽

Nazmun Nahar ◽

Sanjoy Kumer Dey ◽

Md A Mannan ◽

...

Keyword(s):

Birth Weight ◽

Breast Milk ◽

Blood Transfusion ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Control Group ◽

Group Iii ◽

Anemia Of Prematurity ◽

The Mean ◽

Group Ii

Introduction: Anemia of prematurity (AOP) is a common problem of very low birth weight babies. Blood transfusion is a necessity when it occurs in moderate to severe form putting the child in to the risk of transfusion related complications. Erythropoietin, a potent stimulator of hemopoesis is available in breast milk in good amount and absorbed intact under physiologic condition. In this background oral recombinant human erythropoietin (rhEPO) can be a useful alternative to its subcutaneous administration in prevention of AOP.Objective: To evaluate the efficacy of oral rhEPO in the prevention of AOP in very low birth weight (VLBW) neonates.Methods: This randomized controlled study conducted in the NICU of BSMMU over one year. Total 60 preterm (<34 weeks)VLBW (<1500g) infants were enrolled and randomly divided into Control (group-I), Oral (group-II) and Subcutaneous (group III). Experimental groups (group-II & group-III) received rhEPO 400 IU/Kg, 3 times weekly in oral and subcutaneous (S/C) route respectively and continued for 2 weeks (Total 6 doses). Therapy was initiated 14 days after birth when the baby achieved oral feeding of at least 50 ml/kg/day of breast milk. All infants received oral iron and folic acid supplementation up to 12 weeks of postnatal age. Transfusion data were recorded. Anthropometric and hematological assessments were done at 2, 4, 6 and 12 weeks of age.Results: Baseline clinical characteristics and hematological values were almost similar in all groups. Mean hemoglobin were 11.34±0.68gm/dl, 11.88±0.54gm/dl& 12.12±1.32 gm/dl, the mean hematocrit were 34.11±2.03%, 35.66±1.65% & 36.38±3.97% and the mean reticulocyte were 7.56±2.48%, 9.85±1.50% & 9.22±3.11% in the control, oral and subcutaneous group respectively and the differences are statistically significant (p<0.05).Weight gain was higher in the intervention group at 6 and 12 weeks follow up than the control group(p<0.05).Only 2 (5.25%) infants, one in each of the intervention groups required blood transfusion, compared to 6 (31.5%) infants in control group (p<0.01).Conclusion: Oral EPO is as good as subcutaneous use of EPO in stimulating erythropoesis, maintaining HCT and Hb at high level and is safe in preterm baby.Bangladesh J Child Health 2017; VOL 41 (2) :101-109

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Effect of Fiber Rich Product on Childhood Obesity and Lipid Profile Aged 10-12 Years

Indian Journal of Pure & Applied Biosciences ◽

10.18782/2582-2845.7030 ◽

2021 ◽

Vol 9 (3) ◽

pp. 87-90

Author(s):

A. Jyoth ◽

Keyword(s):

Exercise Group ◽

Control Group ◽

Group Iii ◽

Group I ◽

Diet Survey ◽

Group Ii ◽

And Control ◽

Experimental Group ◽

Positive Results ◽

Green Peas

The effect of fiber rich product on child hood obesity studied with 60 sample which were collected randomly among 10-12 years and categorized into 2 groups i.e, experimental group and control group. Experimental group further categorized into three groups i.e, supplementation with exercise (n=15), only supplementation group (n=15), only exercise group (n=15) and control group consists of (n=15).Anthropometric, and diet survey conducted as parameters. A fiber rich product was prepared and supplemented for 2 months to the selected subjects and it consists of whole Bengal gram, whole green gram, green peas, barley and jaggery. Positive results were obtained in three experimental groups. Significant decrease observed inweight, and BMI, Total cholesterol, Triglycerides, LDL, VLDL significant increase observed in HDL in group I II and III. The results were (51.60-48.26kg, 24.7-23.1, 195.2-152.3 mg/dl, 168.2-145.0 mg/dl, 52.2-54.13 mg/dl, 109.4- 69.4mg/dl, 33.6-28.7mg/dl) in group I, In group II the results are (50.3-49.86kg, 23.7-23.4, 168.6-161.0mg/dl, 145.4-129.6mg/dl, 44.2-45.2 mg/dl, 95.3-90.0mg/dl, 29.1-28.3mg/dl).In group III the tesults aere (50.7-49.6kg, 24.5-23.9, 143.2-139.3mg/dl, 139-134.5mg/dl, 38.2-38.7mg/dl 76.8-74.1 mg/dl, 25.6-28.1mg/dl) .From the results it was clear that when compared to group II and III group I has shown better results.

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Immunization of Guineapigs against Ascaris suum

Journal of Helminthology ◽

10.1017/s0022149x00021258 ◽

1960 ◽

Vol 34 (3-4) ◽

pp. 347-348 ◽

Cited By ~ 5

Author(s):

L. F. Taffs

Keyword(s):

Control Group ◽

Group Iii ◽

Successful Attempt ◽

Group I ◽

Third Stage ◽

Previous Infection ◽

Group Ii ◽

Intravenous Inoculation ◽

Subcutaneous Inoculation ◽

Control Group Group

It has been shown that guineapigs can be effectively protected against re-infection by the subcutaneous inoculation of embryonated Ascaris eggs (Soulsby, 1957). The purpose of this communication is to report a successful attempt to immunize guineapigs against a lethal oral challenge dose of eggs by the intravenous inoculation of third stage larvae of A. suum.Three groups, each containing nine guineapigs, were infected with Ascaris as follows: Group I was given 10,000 eggs by mouth. Group II Was inoculated intravenously with 2,000 third stage Ascaris larvae which had been obtained from the lungs of other guineapigs on the sixth day of infection. Both groups were challenged at the same time with 250,000 eggs by mouth, along with a control group (Group III) which had no previous infection. The guineapigs in Group I were re-infected after 18 days and those in Group II after 12 days.

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Effect of Ethanolic Extract of Carica Papaya seeds in Drug-Induced Acute Nephrotoxicity

10.53350/pjmhs2115112951 ◽

2021 ◽

Vol 15 (11) ◽

pp. 2951-2953

Author(s):

Sameer Ahmed ◽

Muhammad Tahir ◽

Attiya Munir ◽

Amtul Hafeez ◽

Sher Afghan Khan ◽

...

Keyword(s):

Carica Papaya ◽

Ethanolic Extract ◽

Control Group ◽

Standard Diet ◽

Serum Urea ◽

Once Daily ◽

Group Iii ◽

Group I ◽

Papaya Seeds ◽

Group Ii

Background: Nephrotoxicity is characterized by raised serum urea and creatinine levels and kidneys being one of the primary organs of drug concentration and excretion are vulnerable to many widely used marketed drugs, including anti-cancer drugs, antibiotics, immunosuppressants, and radio contrast agents, are nephrotoxic. Aim: To determine the nephroprotective effect of ethanolic extract of Carica papaya seeds in Aminoglycoside induced acute nephrotoxicity. Study design: Quasi Experimental study. Methodology: Thirty Sprague Dawley rats were sub divided into 3 groups i.e., I, II and III with 10 rats in each group. Group II and III were administered Aminoglycoside drug; Gentamycin in 80 mg/kg) via intraperitoneal route once daily for 5 consecutive days to induce acute nephrotoxicity. At day 6, nephrotoxicity was confirmed by measuring serum urea and creatinine. Ethanolic extract of Carica papaya seeds (1000 mg/kg) was started once daily through oral route in group III for 5 consecutive days to see the nephroprotective effects of seed extract after causing acute kidney injury. All animals were given standard diet pellets manufactured at NIH. Results: Mean serum urea and creatinine for Group I (Control Group) at day 0 were 24.90 mg/dL ± 1.633 and .750 mg/dL ± .0619 respectively. Mean serum urea and creatinine for Group II (Disease Control Group) was 81.00 mg/dL ± 1.247 and 1.980mg/dL ± .0467 at day 6th. This suggested induction of nephrotoxicity by Gentamycin. Mean serum urea and creatinine for Group III (Ethanolic Extract Treated Group) at 11 day was 72.40mg/dL± .991 and 1.680 mg/dL± .0467 after 5 days treatment with ethanolic extract of Carica papaya seeds. Conclusion: We concluded that ethanolic extract of Carica papaya seeds has significant nephroprotective effects on Aminoglycoside induced acute nephrotoxicity in rats. Keywords: COVID-19, Vaccination, Awareness and Adverse Effects

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Adaptive dose response pilot study of intravaginal Prostaglandin E2 application in free farrowing sows during parturition

10.21203/rs.3.rs-22844/v1 ◽

2020 ◽

Author(s):

Ramona Bill ◽

Heiko Nathues ◽

Alexander Grahofer

Keyword(s):

Prostaglandin E2 ◽

Total Duration ◽

Group Iv ◽

Control Group ◽

Birth Process ◽

Group Iii ◽

Beneficial Effects ◽

Group I ◽

Group Ii ◽

Meconium Staining

Abstract Background The duration of birth is an important factor influencing the survival of piglets and the health of sows. A prolonged parturition is usually treated with oxytocin, even though several undesirable side effects are described. Therefore, the aim of this study was to evaluate the safety and efficacy of Prostaglandin E2 (PGE2) of different concentrations as an intravaginal applied gel in sows. MethodsTwelve sows were randomly allocated to one of four treatment groups: Group I (control group) application of placebo gel; Group II application of 2.0 mg PGE2; Group III application of 1.0 mg PGE2; Group IV application of 0.5 mg PGE2. The gel was administered intravaginal after the birth of the fourth piglet. Total duration of birth (time between first piglet and last placenta), piglet interval and placenta expulsion duration (time between first and last placenta) were recorded, and each piglet was scored for meconium staining and vitality. Furthermore, stillborn piglets were categorized into ante-partum and intra-partum deaths. Results Although no significant differences between the groups were detected, a beneficial tendency in several parameters was observed in group III. The duration of birth was 284 min (average of 14.3 piglets per litter), whereas in all other groups it was more than 400 min (average of 18.0 piglets per litter). The piglet interval was 10.1 min in group II compared to 10.2 min in group III, 16 min in group IV and 21.4 min in group I. In group III the placenta expulsion duration was 119 min in contrast to the other groups with more than 266 min. Severe meconium staining in more than 10% of piglets was observed in group II and IV. Moreover, piglets of group II showed oedematous and haemorrhagic umbilical cords, lethargy and anoxia, and intra-partum deaths were recorded. Conclusion Although the sample size is limited in this study, it is assumed that an application of 1mg PGE2 intra-partum instead of lower or higher dosages has the most beneficial effects on the birth process in sows and on the vitality of piglets. Further investigation is necessary to confirm the positive effect of PGE2 in daily practise.

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