scholarly journals A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

2018 ◽  
Vol 7 (12) ◽  
pp. 5140
Author(s):  
Reena Sharma ◽  
B. R. Sharma ◽  
Poojan Dogra
Keyword(s):  
Comparative Study ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Retrospective Comparative Study ◽  
Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

A COMPARATIVE STUDY OF MIFEPRISTONE AND MISOPROSTOL VERSUS MISOPROSTOL ALONE IN INDUCTION OF LABOUR IN LATE INTRAUTERINE FETAL DEATH

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Shivpal Moond ◽  
K.P. Banerjee ◽  
Rakhi Arya
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Fetal Death ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare efficacy, safety and tolerance of combination of Mifepristone and Misoprostol versus Misoprostol alone in induction of labour in late intrauterine fetal death (>24 weeks). Methods: This prospectively study included 160 women with late intrauterine fetal death (IUFD) after 24 weeks of gestation and divided the women randomly into two groups each containing 80 women. In Group-A : Mifepristone 200 mg single dose was given and after 24 hrs Tab Misoprostol (intravaginally) administered and repeated 4 hourly upto a maximum of 5 doses, while in Group-B : Only Tab Misoprostol administered intravaginally 4 hourly upto maximum 5 doses. Induction-delivery interval and number of doses of Misoprostol was calculated.    Results: The mean induction-delivery interval in Group-A was 13.02 ± 3.74 hours and in Group-B was 16.09 ± 2.99 hours (p-value <0.0001). Mean doses of Misoprostol required in Group-A was 3.36 ± 1.08 hours and in Group-B was 4.32 ± 0.65 hours (p-value <0.0001). Conclusion: Combination of Mifepristone and Misoprostol is more effective as comparison to Misoprostol in terms of induction-delivery interval and number of doses of misoprostol required.    Keywords: IUFD, mifepristone, misoprostol, induction of labour, induction-delivery interval.

scholarly journals Is robotic radical nephroureterectomy a safe alternative to open approach: The first prospective analysis

2021 ◽  
Vol 93 (4) ◽  
pp. 408-411
Author(s):  
Panagiotis Mourmouris ◽  
Omer Burak Argun ◽  
Lazaros Tzelves ◽  
Mustafa Bilal Tuna ◽  
Maria Gourtzelidou ◽  
...  
Keyword(s):  
Upper Urinary Tract ◽  
Open Approach ◽  
Radical Nephroureterectomy ◽  
Drain Removal ◽  
Estimated Blood Loss ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Group 1

Purpose: To test the efficacy and safety profile of robotic radical nephroureterectomy compared to the open approach. Methods: We enrolled 45 consecutive patients who suffered from non-metastatic, upper urinary tract urothelial carcinoma from September 2019 to March 2021 and underwent radical nephroureterectomy. Patients were divided in two groups: group A consisted of 29 patients (open approach) and group B consisted of 16 patients (robotic approach). The factors which were taken into consideration were age, sex, body mass index, tumour size, side and grade, cancer stage, ASA score, operation time, drain removal time, foley time, hospitalization time, estimated blood loss, surgical margins, preoperative and postoperative creatinine, Hct and bladder recurrences. Statistical analysis was performed with the use of SPSS version 26 and p < 0.05 was the cut-off for reaching statistical significance. Results: The mean age in group 1 was 67.12 years and in group 2 68.12 years, whereas the mean body mass index (BMI) in group 1 was 26.54 kg/m2 and in group 2 25.20 kg/m2. Operative time was better in group A (124 vs 186 mins p < 0.001) and estimated blood loss were better in group B compared to group A (137 vs 316 ml p < 0.001). Length of stay (LOS) was significantly less in the robotic group (5.75 vs 4.3 days p = 0.003) and the same applied for time required for drain removal (4.5 vs 3.3 days p = 0.006). Conclusions: Robotic radical nephroureterectomy is a safe and efficient alternative to open approach. It provides a favorable perioperative profile in patients suffering from upper urinary tract carcinoma without metastasis.

scholarly journals Trans-thoracic versus trans-hiatal resection for oesophageal carcinoma: a retrospective comparative study of a single-centre case series

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Aram Baram ◽  
Hiwa Sherzad
Keyword(s):  
Comparative Study ◽  
Case Series ◽  
Oesophageal Carcinoma ◽  
Single Centre ◽  
Term Survival ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Retrospective Comparative Study

Abstract Background Oesophageal carcinoma (EC) is the eighth most common cancer. Surgery is the cornerstone of management for resectable EC. Trans-thoracic oesophagectomy (TTE) and trans-hiatal oesophagectomy (THE) are the two most widely practised procedures. Most of the related controversies are centred on both early and late post-operative complications and mortality (in terms of overall survival and cancer-free survival). This was a single-centre, retrospective, comparative study analysing the outcomes of two EC resection methods. All 87 patients underwent surgery by the same surgical team over 13 years. Consequently, 87 oesophagectomies with curative intent were performed and divided into the TTE group (group A = 47) and the THE group (group B = 40). Results The mean patient age was 65.60 ± 6.30 years in the TTE group and 63.48 ± 9.34 years in the THE group. No significant difference was found in operative time, blood loss or duration of stay in the intensive care unit. The duration of hospital stay was significantly different between the THE and TTE groups (17.25 ± 5.92 vs. 12.93 ± 3.44, respectively; P ≤ 0.001). In-hospital mortality was higher in the TTE group (9/47, 19.14%) than in the THE group (5/40, 12.5%) (P = 0.400). The mean survival rate from our series showed the superiority of group A (TTE) (65.56 months) over group B (THE) (45.01 months), with P = 0.146. Conclusion No high level of evidence suggests the superiority of one surgical procedure over another. The THE procedure is less time-consuming concerning care and follow-up, and most patients were more satisfied and experienced less pain than with the TTE procedure. Both THE and TTE have comparable post-operative anastomotic complications, and they have no significant long-term survival differences.

scholarly journals Comparative study to evaluate the efficacy and safety of oral Mifepristone versus intracervical Dinoprostone gel for induction of labour and their effects on fetomaternal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2678
Author(s):  
Anu Pathak ◽  
Saroj Singh ◽  
Shikha Singh ◽  
Rajesh Kumar ◽  
Arpita Tyagi
Keyword(s):  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Uterine Contractions ◽  
Group A ◽  
Oxytocin Augmentation ◽  
Nicu Admission ◽  
Group B ◽  
Control Study

Background: Mifepristone and Dinoprostone are used in inducing labour in pregnancy by acting as cervical ripening drugs. A randomized case control study to evaluate the efficacy, safety and fetomaternal outcome of induction of labour with oral Mifepristone and intracervical Dinoprostone gel was done.Methods: About 300 patients were included after taking informed consent. 150 patients were placed in each group A and B. In group A patients received 200 mg oral Mifepristone tablet and in group B 0.5 mg Dinoprostone gel was given intracervically and 2nd dose was repeated after 6 hours later if adequate uterine contractions were not achieved. A detailed analysis was carried out in both groups regarding efficacy and safety of drugs in terms of necessity of augmentation of labour with oxytocin, induction to delivery interval, fetal outcome in terms of NICU admission.Results: 59.33% cases in Mifepristone group and 72% case in Dinoprostone group required augmentation with oxytocin. Mean induction delivery interval in Mifepristone group in primigravida was 17.998±1.128 hrs and mean induction delievery interval in multigravida was 11.648±1.112 hours. 88% cases in mifipristone group and 80% cases in Dinoprostone group delivered vaginally. NICU admission was 1.33% in Mifepristone group and 2.66% in PGE2 gel group.Conclusions: Mifepristone when compared with intracervical Dinoprostone gel, acts as a better cervical ripening agent and requires lesser need for Oxytocin augmentation. Though, mean induction delivery interval was more with Mifepistone, the incidence of successful vaginal delivery was higher as compared to Dinoprostone.

scholarly journals Comparative study of efficacy and adverse effects of different doses of vaginal misoprostol for cervical ripening 10-12 hours before diagnostic hysteroscopy

2018 ◽  
Vol 7 (3) ◽  
pp. 1065
Author(s):  
Taru Gupta ◽  
Syed Nawaz Ahmad ◽  
Sonu Kumari
Keyword(s):  
Adverse Effects ◽  
Comparative Study ◽  
Cervical Ripening ◽  
Procedural Time ◽  
Diagnostic Hysteroscopy ◽  
The Mean ◽  
Group 2 ◽  
Vaginal Misoprostol ◽  
Different Doses ◽  
Group 1

Background: Hysteroscopy first described by Panteleoni in 1869 has evolved into a standard procedure for the diagnosis and treatment of intrauterine pathologies such as polyps, fibroids, septae, adhesions, evaluation of abnormal uterine bleeding, evaluation and treatment of infertility, removal of an intrauterine device or foreign body. Present study was carried out to compare the efficacy and complications different doses of vaginal misoprostol for cervical ripening10-12 hours before diagnostic hysteroscopy.Methods: It was a prospective and interventional, double-blinded randomized comparative study. Sixty women, fulfilling the inclusion criteria, requiring diagnostic hysteroscopy for evaluation of infertility were enrolled. The study subjects randomly received either 200μg (group 1) or 400μg (group 2) of vaginal misoprostol 10-12 hours before hysteroscopy with equal number of subjects in both the groups. Hysteroscopy was performed with a standard rigid 6 mm and 300 hysteroscope. The largest dilator that could be inserted without resistance was recorded as the baseline cervical dilatation. The ease of dilatation was recorded on a 5 point LIKERT scale. Procedural time was measured as time taken from the beginning of cervical dilatation to the visualisation of the uterine cavity.Results: The mean base line cervical width in group 1 was 6.41±0.29 mm while in group 2 it was 6.43±0.21 mm (p=0.084). In group 1, 26.6% patients had very easy entry, 53.4% had easy entry while in group 2, 30% patients had very easy entry, 43.4% had easy entry. The mean procedural time 35.5±6.9 seconds in group 1 and 33.2±6.8 seconds in group 2 (p=0.212). Adverse effects like abdominal pain, vaginal bleeding, shivering and fever  were observed more often in group 2 compared to group 1(p=0.038).Conclusions: Two hundred microgram of vaginal misoprostol is safer and equally effective as 400 μg for cervical ripening when used 10-12 hours before diagnostic hysteroscopy.

scholarly journals Intra-cervical foley’s catheter or PGE2 gel for induction of labour: which one is better: a prospective study

2021 ◽  
Author(s):  
Khushpreet Kaur ◽  
Balwinder Kaur ◽  
Navneet Kaur ◽  
Gagandeep Kaur
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Group A ◽  
The Mean ◽  
Foley’S Catheter ◽  
Group B

Background: Labour is clinically defined as the initiation and perpetuation of uterine contraction with goal of producing progressive cervical effacement and dilatation. The Foley’s catheter is an effective alternative to prostaglandins for cervical ripening/labour induction. Study was done to compare the efficacy of intracervical Foley’s catheter and PGE2 gel as a cervical ripening agent and to study maternal and fetal outcome in terms of mode of delivery and Apgar score.Methods: This randomized controlled study was conducted in Obstetrics and Gynaecology department, Government Medical College, Patiala. 200 women with indication for induction of labour were enrolled in the study to investigate the efficacy and fetomaternal outcome of induction of labour with intracervical Foley’s catheter comparing with PGE2 gel.Results: The mean age in group A was 24.41±3.37 and in group B was 24.24±3.17 years. The 95% women were induced successfully in group A and 97% were successfully induced in group B. Preeclampsia and postdatism were the most common indications for induction in both groups. The mean induction delivery interval in group A was 15.20±4.53 hours and in group B was 15.86±4.79 hours. 4.21% cases required NICU admission in group A while in group B, it was 5.15% cases.Conclusions: Our study concludes that there is no difference in efficacy between intracervical Foley’s catheter and intracervical PGE2 gel for induction of labour and both methods are complementary to each other.

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

scholarly journals A comparative study of vaginal misoprostol versus oral misoprostol for induction of labour

2020 ◽  
Vol 9 (6) ◽  
pp. 2520
Author(s):  
Raj M. Mehta ◽  
Babulal S. Patel ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
Vismay B. Patel ◽  
...  
Keyword(s):  
Adverse Events ◽  
Comparative Study ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Successful Outcome ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: Induction of labour defined as artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods. The successful outcome depends on the Bishop Score, maternal age and parity. Authors compared the most preferred two routes; vaginal and oral for induction and outcome, adverse events and side effects were noted.Methods: This was a prospective comparative study carried out at SVPIMSR, Ahmedabad, from January 2019 to June 2019, Gujarat, 100 patients who required induction were randomly divided in two groups- Group A received 25µg oral misoprostol, Group B - received 25µg vaginal misoprostol repeated 4 hourly up to maximum five doses in both groups. The induction to delivery interval, mode of delivery, maternal and neonatal outcome and complications were observed.Results: The mean induction to delivery interval was less in vaginal group than oral (18.7 hours in vaginal versus 22.4 hours in oral). Vaginal delivery and caesarean section rates were comparable in both groups. 60% patients in Group A required more than two doses as compared to 36% in Group B. No major complications or adverse events were observed.Conclusions: Both oral misoprostol in a dose of 25μg and vaginal misoprostol 25μg every four hours, to a maximum of five doses, have safety and efficacy for induction. With The vaginal route, delivery occurs in less time and few doses required as compared to oral.

scholarly journals Topical Nitroglycerine Versus Lateral Sphincterectomy for Fissure in Ano: A Hospital Based Comparative Study

2018 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Bimarsh Adhikari ◽  
Sunil Kumar Yadav ◽  
S. N. Gupta
Keyword(s):  
Comparative Study ◽  
College Teaching ◽  
Pain Reduction ◽  
Lateral Sphincterotomy ◽  
Female Ratio ◽  
Benign Condition ◽  
Number Of Patients ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Anal fissure is a common benign condition presenting as severe pain, constipations and bleeding per rectum. It is defined as longitudinal tear or defect in anal canal skin. Surgical treatment of this conditions requires hospital admission and complications, like bleeding, infection and to its severe extent continence disturbances. That warrants a new treatment modality as pharmacological sphincterotomy i. e topical GTN (glycerine trinitrate) whose effects are reversible, cost effective and simple. Objective: The objective is to compare the effectiveness of topical GTN over lateral sphincterotomy in terms of pain management and healing of fissure. Method: This was a comparative study carried out in the department of Surgery at Nepalgunj Medical College, Teaching Hospital. Two groups were created and 25 patients in each group were put randomly. First group (Group 1) used topical GTN whereas second group(Group 2) underwent lateral sphincterotomy for treatment of fissure. The two groups were reassessed at 4 and 8 weeks for pain and fissure healing. Result: Total number of patients was 50. Each group consisted of 25 patients. The male to female ratio in group 1 was 1:1.5 and in group 2 it was 1: 1.8. In group 1 patients after 4 weeks of application of GTN pain reduced from the mean of 80±15 at the time of presentation to 50±9.27. When these patients were seen after 8 weeks, the pain reduction on VAS was nil in 21 patients out of 25. In group 2 the mean score fell from 75±15 to 20±10 after 4 weeks and at 8weeks 23 out of 25 patients didn't have any pain. It was observed that the pain reduction and healing were faster in group 2 patients when evaluated after 4 weeks (p=0.0029). but at the end of 8 weeks both group patients were similar in terms of pain reduction and healing of fissure (p=.28). Conclusion: According to study local GTN application is as effective as lateral sphincterotomy with cost effectiveness, simple with tolerable side effect and no continence disturbances.

scholarly journals A comparative study of early postoperative feeding versus conventional feeding for patients undergoing caesarean section

2019 ◽  
Vol 8 (12) ◽  
pp. 5002
Author(s):  
Neeraja S. ◽  
Naritha Reddy ◽  
Naima Fathima
Keyword(s):  
Cesarean Section ◽  
Comparative Study ◽  
Caesarean Delivery ◽  
Normal Diet ◽  
Early Feeding ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Postoperative Feeding

Background: Early alimentation after caesarean delivery probably has limited clinical significance in terms of improved energy and protein intake. Decreasing the post-operative ileus is possible with early feeding. Objective of this study was to study efficacy of early postoperative feeding versus conventional feeding for patients undergoing caesarean section.Methods: Present study was hospital based comparative study carried out among 200 women who fulfilled the selection criteria. The cases were divided into 2 groups of 100 each by suitable random sampling technique. Group A included 100 cases who were given early feeding within 6 hours of caesarean delivery. Group B included 100 control who were given the feeding after 24 hours of caesarean delivery.Results: The mean duration of postoperative hospital stay in Group A and Group B was 4.59±0.65 and 4.81±0.81 days respectively (p <0.05). The mean time to return of bowel sounds in Group A and Group B was 2.79±1.36 and 3.55±1.49 hours respectively (p <0.01). 2(2%) cases in group A had postoperative ileus symptoms, whereas 3 (3%) cases in Group B had the same. Statistically significant difference (p <0.05) was seen in terms of vomiting 1% versus 17%, nausea 5% versus 16%, abdominal distention 2% versus 7%, diarrhea 4% versus 90% in the early feeding versus conventional feeding groups.Conclusions: It can be concluded from present study that fast return to the normal diet is possible with early feeding among women undergoing cesarean section compared to the conventional feeding among women undergoing cesarean section.

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