scholarly journals Randomized control trial to compare the effectiveness of mifepristone followed by misoprostol at 12 hours interval versus misoprostol alone in second trimester medical termination of pregnancy

2018 ◽  
Vol 7 (8) ◽  
pp. 3299
Author(s):  
Preet Kamal Bedi ◽  
Arunima Saini
Keyword(s):  
Side Effects ◽  
Cervical Dilatation ◽  
Secondary Outcome ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Mifepristone priming in second trimester abortions not only decreases the induction-abortion interval (IAI) but also lessens the total misoprostol dose required and hence reduces adverse effects. The present study aims to compare the role of mifepristone priming 12 hours before misoprostol administration so as to increase patient compliance and shorten the duration of hospital stay.Methods: This prospective study was conducted over a period of one year, on 50 patients requiring second trimester abortion, at Department of Obstetrics and Gynaecology, Government Medical College, Amritsar. The patients were divided into two groups with 1:1 randomization. In Group A, 25 women were given tablet mifepristone 200 mg orally followed 12 hours later by tablet misoprostol 400 µg per vaginum followed by the same dose 3 hourly for a maximum of five doses per 24 hours. In group B, 25 women received only tablet misoprostol 400 µg vaginally in the posterior fornix followed by the same dose 3 hourly for a maximum of five doses per 24 hours. Primary outcome was to compare the completeness of expulsion of products of conception by pelvic ultrasound after 48 hours of the last dose administered. Secondary outcome was to compare the Induction abortion interval (IAI), mean dose of misoprostol required, side effects, effect of parity, gestational age and cervical dilatation on IAI with both the regimens used.Results: The success rate was 76% in group A and 64% in group B. The mean induction abortion interval in group A was 8.9±4.70 hours whereas in group B, it was 13.14±6.03 hours and this difference was statistically significant (p = 0.008). A statistically significant difference was also observed in mean dose of misoprostol required in group A and B being 1232.00±398.60 µg and 1584.00±423.94 µg respectively (p=0.004). The side effects were less in group A. Parity and cervical dilatation hold an inverse relation with the mean IAI whereas it has a direct relation with the gestational age.Conclusions: Regimen involving mifepristone priming 12 hours before misoprostol is better than misoprostol alone regimen with significant reduction in IAI, mean dose of misoprostol and less side effects. 

scholarly journals Comparative effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen of mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion

2018 ◽  
Vol 7 (6) ◽  
pp. 2449
Author(s):  
Arunima Saini ◽  
Preet Kamal Bedi ◽  
Nisha Bhagat
Keyword(s):  
Gestational Age ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Simultaneous Administration ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Group A ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Group B

Background: In second trimester abortion, medical methods are preferred. Prostaglandins are the most widely used. Amongst them, misoprostol is the most commonly used. Thus, the study was conducted to delineate the effectiveness of simultaneous administration of mifepristone and misoprostol versus interval regimen mifepristone followed by misoprostol 12 hours apart in second trimester medical abortion.Methods: It was a prospective, single centered, comparative study conducted on 50 patients in Department of Obstetrics and Gynaecology, GMC, Amritsar coming for second trimester abortion, either elective or emergency, with gestational age between 12-20 weeks. Initially, 53 patients were enrolled in the study, 3 patients dropped out at different stages of study. Finally, 50 patients were enrolled and divided into two groups of 25 patients each by 1:1 randomization. In Group-A, mifepristone 200 mg orally along with misoprostol 600µg vaginally were given simultaneously, followed by 400 µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Group-B initially received mifepristone 200 mg per oral followed by 12 hours later misoprostol 400µg vaginally and then 400µg vaginal misoprostol every 4 hours for a maximum of five doses in 24 hours. Primary outcome measure was effectiveness of regimen in complete abortion, which was confirmed on pelvic ultrasound 1-week after the last dose. Secondary outcome measure was to compare the induction abortion interval (IAI), dose of misoprostol required and adverse drug reaction (ADR) among both the regimens. P-value <0.05 was taken as statistically significant.Results: Mean age in Group-A was 25.68±3.79 years while in Group-B was 23.40±2.73 years. Both the regimens had success rate of 76% for complete abortion. However, IAI in Group-A was 5.9±4.47 hours whereas in Group-B was 9.6±5.07 hours, which was statistically significant (p= 0.009). A statistically significant difference was also observed in the mean dose of misoprostol between two groups that is, 1000±200µg and 1425±437.41µg respectively (p=0.01). Gestational age was related to IAI from 13 to 17.6 weeks in both groups (p=0.01) while no significant relation was seen between them in more than 17.6 weeks of gestation (p=0.63).Conclusions: Simultaneous administration of mifepristone and misoprostol showed better results than interval regimen in term of significant lesser induction abortion interval, lower dosages of misoprostol required with comparable success rates.

scholarly journals Short Practical Regimen of Acupuncture for Melasma: A Prospective Cohort Study in a Tertiary Hospital in Thailand

2021 ◽  
Vol 9 ◽  
Author(s):  
Thanan Supasiri ◽  
Nuntida Salakshna ◽  
Krit Pongpirul
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Severity Index ◽  
Tertiary Hospital ◽  
Optimal Number ◽  
Significant Difference ◽  
Patient Reported ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Acupuncture shows benefits for patients with melasma, although no optimal number of sessions have been determined.Methods: The prospective observational study was conducted in melasma patients who were treated with acupuncture procedures two times a week and were evaluated after the 5th and the 10th sessions of acupuncture, with a 1-week follow-up after the last session. Participants Groups A and B received five and 10 acupuncture sessions, respectively. Melasma was assessed by using the melanin index (MI), melasma area and severity index (MASI), patient-reported improvement scores, and acupuncture-related adverse events.Results: Out of 113 participants, 67 received five sessions of acupuncture treatment while 39 received 10 sessions. At 1 week after five sessions of acupuncture in Group A, the mean MI decreased by 28.7 (95% CI −38.5 to −18.8, p &lt; 0.001), whereas the median MASI decreased by 3.4 (95% CI −6.9 to −1.2, p &lt; 0.001) points. At 1 week after ten sessions of acupuncture in Group B, the mean MI decreased by 31.3 (95% CI −45 to −17.6, p &lt; 0.001), whereas the median MASI decreased by 5.4 (95%CI −9.9 to −3, p &lt; 0.001) points. The first five sessions of acupuncture had a higher incremental effect than the last five sessions, although there was no statistically significant difference. Twenty-nine participants reported minor side effects. Group B had a risk ratio (RR) of having adverse events 1.8 times (95% CI 1.0–3.4, p = 0.05) compared with Group A.Conclusion: Short acupuncture regimens of 5–10 sessions in melasma seem to be effective and practical with minor side effects.

scholarly journals Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion

2018 ◽  
Vol 7 (11) ◽  
pp. 4545
Author(s):  
Michelle N. Fonseca ◽  
Vernica Sah
Keyword(s):  
Side Effects ◽  
Foley Catheter ◽  
Medical Abortion ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Sequential Administration ◽  
Group A ◽  
Low Incidence ◽  
Vaginal Misoprostol ◽  
Group B

Background: Abortions are one of the most commonly performed procedures in gynaecological departments worldwide. They are still a major problem in developing countries contributing to a significant percentage of maternal morbidity and mortality. The main objective of this study is to compare the efficacy, side effects and acceptability of intracervical Foley and oral Mifepristone both followed with sequential administration of vaginal misoprostol for second trimester medical abortion.Methods: This was a prospective randomized trial of 36 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation between 12 to 20 completed weeks. Intracervical Foley catheter with administration of misoprostol (200µg) vaginally was done for Group A. Mifepristone 200mg was administered on day one followed by misoprostol (200µg) vaginally, 48 hours later, to Group B. Both groups received misoprostol (200µg) vaginally at 4 hourly intervals. Completeness of abortion was assessed, and surgical evacuation was performed, if abortion was found to be incomplete.Results: The two groups were comparable with respect to age, parity and gestational age. 83-89% of the women in both the groups had complete abortion. The mean induction abortion interval was 20.11 hours in Group A and 54.77 hours in Group B, which was statistically significant. Side effect profile was comparable in both groups however the intensity and the duration of persistence of pain was greater among patients from Group A.Conclusions: Authors conclude that medical abortions with both methods were found to be safe, effective, inexpensive and acceptable methods. Whereas a shorter induction abortion interval was observed in the Foley induction group, induction with mifepristone was the preferred regimen in second trimester abortion because of its high efficacy, low incidence of side effects, better tolerance by the patients and due to lower dose of misoprostol required following mifepristone administration.

scholarly journals Comparative study between intravaginal misoprostol and extra-amniotic instillation of ethacridine lactacte for second trimester abortion

2017 ◽  
Vol 6 (6) ◽  
pp. 2575
Author(s):  
Suryaprakash Jagdevappa Karande ◽  
Meena Shantanu Gunjotikar
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Ethacridine Lactate ◽  
Second Trimester Pregnancy ◽  
Group A ◽  
Second Trimester Abortion ◽  
Group B

Background: The methods of terminating pregnancy in the first trimester are simple, safe and effective. Factors like lack of knowledge about availability of MTP services, ignorance, denial of pregnancy, fear of society may account for decrease in number of first trimester abortions. The aims of the present study were to compare the efficacy, induction abortion interval and side effects of intravaginal misoprostol with extra amniotic installation of ethacridine lactate for second trimester abortion.Methods: 60 women coming to MTP clinics requesting second trimester pregnancy termination between 12 to 20 weeks were selected. Detail history and examination was carried out in each patient. They divided into two groups, Group A (30) intravaginal misoprostol 400 initially followed by 400 micrograns every 6 hourly if required. Group B (30) extra-amniotic 0.1% ethacridine lactate 150 cc.Results: In Group A success rate was 100% while in Group B it was 76.66%, which is highly statistically significant (P< 0.01). Mean I – A interval in Group A was 14.58+5.25 hours was highly significantly less than in Group B, it was 33.91 + 3.97 hours (p<0.0001). In Group A complete abortion has occurred in 28 cases (93.33%) and in Group B in 12 cases (52.17%).Conclusions: We conclude that, as compared to extra-amniotic instillation of ethacridinelactate intravaginal misoprostol is the preferred regimen in second trimester abortion because of its high efficacy, shorter induction abortion interval, high incidence of completeness of abortion, low incidence of side effects and better tolerance by the patient. 

Age Related Change of Total Length of Fallopian Tubes in Bangladesh Female Cadaver

2013 ◽  
Vol 1 (2) ◽  
pp. 13-16 ◽  
Author(s):  
Hasna Hena ◽  
Shamim Ara ◽  
Md Enayet Ullah ◽  
Rubina Qasim ◽  
Dilruba Siddiqua ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Human Life ◽  
Fallopian Tubes ◽  
Medical College ◽  
Total Length ◽  
Age Related ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Context: Human life begins in the fallopian tube. It receives the oocyte from the ovary and fertilization take place here. It provides nourishment for the fertilized ovum and transports it to the uterus. So the Fallopian tube is one of the vital organs for human fertility. In treatment of infertility (in ART) and in the management of ectopic (tubal) pregnancies, the knowledge of the anatomy of the fallopian tube is necessary. Study Design: Descriptive type of study.Place & period of study: Department of Anatomy, Dhaka Medical College, Dhaka from July 2008 to June 2009. Materials: 120 postmortem human fallopian tubes were collected from 60 unclaimed dead bodies that were under examination in the morgue of Department of Forensic Medicine, Dhaka Medical College, Dhaka. Methods: The samples were divided into three age groups: Group-A (10-13 years), Group-B (14-45 years) and Group-C (46-50 years). Results: In the present study, the mean (± SD) total length of the right and left Fallopian tubes were 9.60 ± 0.55 cm & 9.28 ± 0.48 cm in group A, 11.54 ± 0.80 cm & 11.28 ± 0.71 cm in Group B and 9.25 ± 0.26 cm & 9.10 ± 0.31 cm in Group C respectively. There was no significant difference between the mean length of right and left Fallopian tubes. The highest mean length was found in group B and lowest mean length was in group C. The difference in mean length of the Fallopian tube between Group A & Group B and Group B & Group C were statically significant (P < 0.001).Conclusion: In this study, it was observed that there was significant change in length of fallopian tubes in relation to age.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13980 Update Dent. Coll. j. 2011: 1(2): 13-16

1470 nm diode laser for endovenous ablation (EVLA) of incompetent saphenous veins - a prospective randomized pilot study comparing warm and cold tumescence anaesthesia

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Pannier ◽  
Rabe ◽  
Maurins
Keyword(s):  
Side Effects ◽  
Diode Laser ◽  
Clinical Score ◽  
Patient’S Satisfaction ◽  
Saphenous Veins ◽  
Vein Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Major side effects after endovenous laser ablation (EVLA) are pain and bruising. Low temperature of the tumescence fluid might cause additional venous constriction and a cooling effect around the vein. The aim of this study was to show outcome and side effects after EVLA of incompetent great saphenous veins (GSV) with a 1470 nm Diode laser (Ceralas E, biolitec) using cold or warm tumescence fluid for anaesthesia. Patients and methods: Between August and November 2007, 85 consecutive patients (85 legs) with an incompetent GSV were treated by EVLA. The patients were randomized in two groups. In 42 patients (Group A) a warm (37 °C) and in 43 patients (Group B) a cold (5 °C) tumescence fluid (TF) was used for local anaesthesia in the track of GSV. All patients were re-examined after 1, 10 and 30 days clinically and by duplex for complications and occlusion in the treated vein segment. Patient’s satisfaction was assessed on a 0 to 4 points scale. Results: In each group one patient was lost to follow-up. There was no significant difference concerning gender, age, C of CEAP, BMI or diameter of the treated vein. In Group A a mean of 462 ml TF and in Group B a mean of 428 ml TF were used. In Group A the mean LEED (average linear endovenous energy density) was 114 J / cm and in Group B 115 J / cm. In both groups occlusion of the treated veins was achieved for all patients. The diameter of the GSV at 3 cm below the sapheno-femoral junction shrunk from 1.0 to 0.7 cm in both groups. The modified CEAP clinical score improved in Group A from 2.9 to 0.7 (mean value) and in Group B from 3.0 to 1.1. The mean pain score on a scale from 0 to 4 during day 2 to day 10 was 1.2 in Group A and 1.0 in Group B. At this time patients in Group A took a mean of 3.4 and in Group B 1.7 analgetic tablets. Ecchymoses were rare in both groups (4 in Group A, 7 in Group B). Conclusions: In this prospective randomized comparative study the temperature of the tumescence fluid did not influence the occlusion rate when a high LEED was used. In both groups pain and ecchymoses are less frequent in this study with a 1470 nm diode laser than reported in studies with 810-980 nm systems. Cold tumescence fluid reduced pain slightly and reduced the intake of analgetics significantly.

scholarly journals A comparative evaluation of analgesic effects of using intravenous paracetamol versus intravenous diclofenac post-operatively in laparoscopic cholecystectomy patients in SMIH, department of surgery, Dehradun

2019 ◽  
Vol 6 (5) ◽  
pp. 1716
Author(s):  
Anurag Bijalwan ◽  
Pradeep Singhal ◽  
Syed Altamash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Diclofenac Sodium ◽  
Analgesic Efficacy ◽  
Early Mobilization ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Post-operative adequate analgesia plays an important role in early mobilization, short hospital stay and patient satisfaction in laparoscopic cholecystectomy. The use of opioids for providing postoperative analgesia has been marked by side effects like vomiting, nausea, sedation, respiratory distress, etc. hence, alternate drugs like paracetamol (PCM) and diclofenac are commonly used. In this study, we have compared the analgesic efficacy and any associated side effects of the two commonly used non-opioid NSAIDS namely paracetamol and diclofenac.Methods: We compared 50 patients undergoing laparoscopic cholecystectomy in ASA I and II. They were randomly divided into two groups, Group A and Group B. Group A was administered intravenous PCM and Group B was administered injection diclofenac sodium. Postoperatively, these patients were assessed for pain, blood pressure, respiratory rate, and presence of any side effects like nausea, vomiting or any respiratory discomfort.Results: The mean DBP, MAP and VAS score was significantly (p-value <0.05) in Group A as compared to Group B patients at 4, 8, 12 and 24 hours postoperatively. There was no statistically significant difference in mean SBP and O2 saturation in both groups. The mean pulse rate was lower in Group A as compared to Group B at 8, 12 and 24 hours.Conclusions: This study concluded that postoperative PCM infusion provided better analgesia for a prolonged period of time with minimal side effects. 

scholarly journals Drotaverine hydrochloride versus valethamate bromide for cervical dilatation in labour: a comparative study

2020 ◽  
Vol 9 (5) ◽  
pp. 1986
Author(s):  
Deepshikha . ◽  
Monica Soni ◽  
Deepak Gupta ◽  
Santosh Godara
Keyword(s):  
Active Phase ◽  
Cervical Dilatation ◽  
Obstetrics And Gynecology ◽  
Medical College ◽  
Group A ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Better Than

Background: Labor is the most perilous journey a woman has to undertake. Painless and short labor is desired by every woman and is a constant aim for obstetrician. Objective of this study was to compare the efficacy of drotaverine hydrochloride with valethamate bromide for cervical dilatation in labor in primigravida.Methods: The present study was conducted in the department of obstetrics and gynecology, S. P. Medical College and Associated Group of Hospitals, Bikaner, Rajasthan from 1st August 2018 to 31st July 2019 over a period of 1 year. Total of 300 patients were included in the study with 150 patients in each of the two groups. In this study the effects of Drotaverine hydrochloride (Group A) and Valethamate bromide (Group B) on cervical dilatation were compared.Results: In our study, the mean drug delivery interval was 101.58±78.06 mins in Group A and 134.24±94.12 mins in Group B. The mean number of doses of drug required was 1.27±0.55 in Group A and 4.17±1.62 in Group B.  The difference was statistically highly significant (p <0.001).Conclusions: Drotaverine hydrochloride is found to be better than valethamate bromide in shortening the duration of active phase of labor in primigravidae. Drotaverine was found to be a better drug, hence, can be used to reduce the agony of the laboring woman without any significant side effects on the mother or the fetus.

scholarly journals Methods of induction of labor in intrauterine fetal demise: a comparative study

2017 ◽  
Vol 6 (9) ◽  
pp. 3911
Author(s):  
Saurav Maheshwari ◽  
Deepa Borgohain
Keyword(s):  
Side Effects ◽  
Comparative Study ◽  
Combination Regimen ◽  
Fetal Demise ◽  
Medical College ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Group B ◽  
Better Than

Background: This study was undertaken to evaluate and compare the efficacies of two different regimen for induction of labour in IUFD in an effort to find a better management of woman with IUFD.Methods: It was a hospital based prospective comparative study taken up in the Department of Obstetrics and Gynaecology, Assam Medical College and Hospital (AMCH), Dibrugarh for a period of 1 year. A total number of 90 cases were selected and randomly divided into 2 groups. The two groups were induced using regimen recommended by the RCOG. Group A was induced with Mifepristone - Misoprostol Combined Regimen while Group B was induced with only Misoprostol.Results: Both the groups were found to be comparable with respect to mean Pre – induction Bishops score. The mean Induction to Onset of Labour Interval and Induction to Delivery Interval were significantly less in Group A as compared to Group B. Mean dose of Misoprostol required was less in Group A compared to Group B. In terms of side effects tolerance to Group A was better than Group B.Conclusions: It was observed in the study that both the regimen were equally safe, easy to administer and affordable but the Combination Regimen had a slight edge over misoprostol alone regimen in terms of tolerance, fewer side effects and efficacy with regard to early onset of labour, shorter Induction to Delivery Interval and relatively less dose of misoprostol than misoprostol alone regimen.

scholarly journals Mifepristone and Misoprostol Vs Misoprostol Alone in Second Trimester Termination of Pregnancy

2018 ◽  
Vol 56 (213) ◽  
pp. 856-860
Author(s):  
Deepa Shah ◽  
Pappu Rijal ◽  
Achala Thakur ◽  
Rubina Rai
Keyword(s):  
Side Effects ◽  
Termination Of Pregnancy ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Highly Effective ◽  
Group A ◽  
Complete Failure ◽  
Second Trimester Abortion ◽  
The Difference ◽  
Group B

Introduction: During the last decade, medical methods for second trimester abortion have considerably improved and become safe and more accessible. The combination of mifepristone and misoprostol is now an established and highly effective method for second trimester abortion. But where mifepristone is not available or affordable, misoprostol alone has also been shown to be effective. The objective of this study is to compare the efficacy of mifepristone with misoprostol and misoprostol alone for second trimester termination of pregnancy. Methods: It is a comparative study conducted on 60 patients from 13 to 18 weeks of gestation admitted for second trimester termination on legal indications. Results: Mean induction abortion interval was comparable in both the groups. Of the 30 cases in each group, nine cases in each Group A and six cases in Group B had incomplete/failed expulsion. Among these 15 cases, only nine required check curettage for complete evacuation while others received oxytocics only for completion. The distribution of these cases was also comparable in both the groups. Only one patient in Group B had complete failure of expulsion and underwent surgical evacuation. However, the difference in dosage of misoprostol required for complete expulsion and incidence of side effects were significantly higher in the group B. Conclusions: Mifepristone and misoprostol combined together is now an established, highly effective and safe method for medical method of second trimester termination. However, when mifepristone is not available or affordable, misoprostol alone can also be used effectively, although a higher total dose is needed and side effects are higher than with the combined regimen.

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