scholarly journals Clinical profile and fetal outcome in women with preterm labor pains

2019 ◽  
Vol 8 (11) ◽  
pp. 4309
Author(s):  
Shweta Gupta ◽  
Sunil K. Juneja ◽  
Himanti Salhan ◽  
Parminder Sandhu
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Fetal Outcome ◽  
Vaginal Swab ◽  
Cervical Length ◽  
Clinical Profile ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Preterm labor is a potential cause of preterm birth. Certain demographic and presenting features in pregnant women may correlate to the severity of the problem and progression to delivery. The aim of the study was to find out the clinical profile and fetal outcome in women with preterm labor pains in a tertiary care hospital of North India.Methods: 83 women with preterm labor were included in the study. Antenatal corticosteroids and tocolytic therapy were given. Women who delivered preterm comprised of Group A and who delivered at term were Group B. Clinical profile and fetal outcome was compared and statistically analyzed.Results: 39 (47.0%) women had preterm delivery (Group A) and 44 (53.0%) women delivered at term (Group B). 23.1% women in group A and 4.5% in group B had a previous preterm birth (p=0.021). 16 (41%) women in group A and 4 (9.1%) in group B had a positive microbial growth on high vaginal swab (p=0.001). The odds of having a preterm birth with cervical length of <2 cm was calculated to be 5.281 (p=0.000). A statistically significant difference was observed in the mean birth weight, Apgar score and nursery admissions in both the groups (p=0.000).Conclusions: A prior history of preterm birth, a positive growth on high vaginal swab and a cervical length of less than 2 cm were found to be significantly associated with preterm birth.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

2018 ◽  
Vol 7 (3) ◽  
pp. 824 ◽  
Author(s):  
Manoj Kumar Sah ◽  
Saraswati M. Padhye
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Human Reproduction ◽  
Cervical Ripening ◽  
Birth Canal ◽  
Significant Difference ◽  
Group A ◽  
Pass Through ◽  
Group B

Background: The cervix has to play dual role in human reproduction. During pregnancy, it should remain firm and closed allowing the fetus to grow in utero until functional maturity is attained while during labour it should soften and dilate, allowing the fetus to pass through the birth canal. Objective of present study was to know and compare the effect of oral Mifepristone with intracervical dinoprostone gel for cervical priming prior to induction of labour at term in an unfavorable cervix of primigravida.Methods: This was prospective randomized comparative study. 100 primigravid patients were included, 50 were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical dinoprostone gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction. Mode of delivery and induction to delivery interval in both the groups were studied.Results: After induction with Mifepristone 76% women had successful cervical ripening as compared to 56% with dinoprostone. Rate of vaginal delivery was 70% with Mifepristone and 58% with dinoprostone. There was no significant difference in induction to delivery interval between the groups. Ten percent and 2% belonging to mifepristone and dinoprostone group respectively, required NICU admissions.Conclusions: Mifepristone is more effective than dinoprostone for preinduction cervical ripening as it has high success rate of achieving cervical ripening, however there is no significant difference in the vaginal delivery rate and other maternal and fetal outcome.

scholarly journals Diagnostic Potential of Evaluation of SDF-1αand sRAGE Levels in Threatened Premature Labor

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Rafał Rzepka ◽  
Barbara Dołęgowska ◽  
Aleksandra Rajewska ◽  
Daria Sałata ◽  
Marta Budkowska ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Latency Period ◽  
Neonatal Morbidity ◽  
Diagnostic Value ◽  
Cervical Length ◽  
Ultrasound Measurement ◽  
Premature Labor ◽  
Diagnostic Potential ◽  
Group A ◽  
Group B

Preterm birth remains the most prevalent cause of neonatal morbidity. This study aimed to evaluate the diagnostic value of SDF-1α, resistin, secretory RAGE (sRAGE), and endogenous secretory RAGE (esRAGE) in preterm labor. A total of 211 pregnant women participated in the study. Group A contained 72 women between 22 and 36 weeks of gestation, with premature labor, who finally had preterm birth. Group B contained 66 women in labor between 37 and 41 weeks of gestation. Women in group A had lower SDF-1αand sRAGE levels than those in group B. Moreover, in group A, SDF-1αand sRAGE levels were correlated with the latency period from the occurrence of premature labor symptoms until delivery. Sensitivity and specificity of studied parameters for prediction of preterm birth were 95% and 40% for SDF-1αand 51.3% and 93.5% for sRAGE, respectively. The prognostic value of plasma SDF-1αand sRAGE levels was comparable with that of cervical length ultrasound measurement and serum C-reactive protein levels. We conclude that SDF-1αand sRAGE appear to play a major role in the diagnosis of preterm birth and its evaluation could be convenient and useful for predicting preterm birth.

scholarly journals CHOLECYSTECTOMY;

2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Patient Population ◽  
P Value ◽  
Care Hospital ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Eye Opening ◽  
Group B

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.

scholarly journals Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

2020 ◽  
Vol 24 (4) ◽  
pp. 339-343
Author(s):  
Tanveer Hussain ◽  
Misbah Sattar ◽  
Sara Mustafa ◽  
Uzma Batool ◽  
Shafqat Iqbal ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Local Population ◽  
Tertiary Care ◽  
Simple Random Sampling ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after  start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

scholarly journals THE EFFECT OF INTRAVENOUS MAGNESIUM SULFATE ON CHILDREN ADMITTED WITH ACUTE BRONCHIOLITIS IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (6) ◽  
pp. 2148-51
Author(s):  
Andaleeb Ara ◽  
Farooq Ikram ◽  
Hidayat Ullah ◽  
Shakila Asmat ◽  
Nadia Tareen
Keyword(s):  
Magnesium Sulfate ◽  
Conventional Treatment ◽  
Clinical Severity ◽  
Military Hospital ◽  
Care Hospital ◽  
Acute Bronchiolitis ◽  
Intravenous Magnesium ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To assess the efficacy of using intravenous Magnesium Sulfate along with the conventional treatment in the management of acute bronchiolitis Study Design: Quasi-experimental study. Place and Duration of Study: Pediatrics department in Sandeman Provincial Hospital, Quetta, from Jan to Jul 2019. Methodology: The study was approved by institutional ethical committee of Combined Military Hospital, Peshawar. Children, 2 months to 2 years of age, with acute bronchiolitis having clinical severity score of ≥5, presenting to the OPD and emergency department were enrolled in the study after getting informed consent from the guardian. They were randomly assigned group A receiving intravenous Magnesium Sulfate and group B receiving placebo along with the conventional treatment for both. Data was analysed with SPSS-21. Results: Total 108 patients were included in the study with 54 (50%) in group A and 54 (50%) in group B. Mean age in the study was 12.02 ± 6.421 months. Mean age in group A and B was 11.17 ± 6.40 and 12.87 ± 6.38 months respectively. Out of 108 patients 50 (46.3%) were males while 58 (53.7%) were females. There was statistically significant difference in the efficacy of treatment between two groups with values being 48 (88.9%) and 37 (68.5%) for Magnesium Sulfate and control groups respectively (p=0.01). Conclusion: From a clinical point of view, intravenous Magnesium Sulfate combined with conventional treatment is more effective than conventional treatment alone in the management of acute bronchiolitis.

scholarly journals Management of Neglected Achilles Tendon Division: Assessment of Two Novel and Innovative Techniques

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Pradeep Jain ◽  
Parthapratim Dutta ◽  
Prabal Goswami ◽  
Amol Patel ◽  
Shammi Purwar ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tertiary Care ◽  
Tendon Graft ◽  
Care Hospital ◽  
Plantaris Tendon ◽  
Significant Difference ◽  
Group A ◽  
And Gender ◽  
Group B ◽  
Innovative Techniques

Objective. Repair of injured Achilles tendon in neglected cases is one of the difficult and challenging procedures for surgeon. Here, we share our experience with the use of two innovative techniques for repair of chronic rupture of Achilles tendon. Design. Prospective Study. Setting. Tertiary care hospital. Patients. Twelve patients with chronic Tendo Achilles rupture were followed up over a period of three to five years. Intervention. Patients were divided in two groups, A and B. In Group A, the repair was done with Gastroc-soleus turndown flap and weaving with Plantaris tendon graft and in Group B, with modified Kessler’s technique strengthened with the free plantaris tendon graft. Outcome Assessment. Clinically and by Modified Rupp Scoring system. Results. At an average follow-up of 4 years (Group A, 3.7 and Group B, 4.4 years), the majority of the patients had excellent to good results as assessed with Modified Rupp Scoring with few minor complications in both the groups. There was no significant difference in the baseline variables such as age and gender and also in the Rupp’s score between the two groups. Conclusion. The two techniques are novel and simple and have been found to be useful for repair of chronically ruptured Achilles tendon.

Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

2021 ◽  
Vol 15 (10) ◽  
pp. 2699-2700
Author(s):  
M. Waseem Anwar ◽  
M. Faheem Anwer ◽  
Wasif Majeed Chaudhry ◽  
Farhana Anwar ◽  
M. Usman Aslam ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Tertiary Care ◽  
Care Hospital ◽  
Oral Antibiotics ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Complicated Acute Appendicitis

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.

scholarly journals A Comparative Study of Endoscopic Versus Navigation Guided Microscopic Transsphenoidal Pituitary Surgery at Tertiary Care Centre in India

2018 ◽  
Vol 32 (3) ◽  
pp. 443-457
Author(s):  
Anurag Sahu ◽  
Sharad Pandey ◽  
Kulwant Singh ◽  
Vivek Sharma
Keyword(s):  
Operative Time ◽  
Tertiary Care ◽  
Pituitary Surgery ◽  
Controlled Study ◽  
Complication Rates ◽  
Care Hospital ◽  
Significant Difference ◽  
Transsphenoidal Pituitary Surgery ◽  
Group A ◽  
Group B

Abstract Introduction: The transsphenoidal route for pituitary surgery is considered the standard treatment for pituitary adenomas. The disadvantage of the smaller exposure of this route is partially compensated for by the introduction of the microscope with its coaxial illumination, stereoscopic view, adequate magnification, and microsurgical instruments. However, there are only few reports about the outcome of endonasal endoscopic transphenoidal technique. Aims & Objectives: Current study has been conducted to compare the efficacy, advantages and dis advantages of endoscopic versus navigation guided microscopic transsphenoidal Pituitary surgery. Material and methods: A controlled study was done in the department of neurosurgery, at tertiary care hospital in India, from the period of August 2012 to December 2017 prospectively. In Group A- 30 patients in whom endoscopic transnasal trans Sphenoidal pituitary surgery and in Group B - 30 patients, intraoperative neuronavigation was used. Observations and Results: Both the groups were similar in demographic variables. The most common age group of pituitary tumor patients was 30-40 years. Fourteen (46.6 %) patients in group A and fifteen (50 %) of the patients in group B had tumor volume less than 5 ml. In group A, thirteen (43%) patients had intrasellar tumors with no suprasellar extension, while in group B, fifteen (50%) patients had intrasellar tumors with no extension. Operative time was noted from incision to closure and average time taken in both the groups was compared. Twenty five (83%) cases of group A took between 2-3 hours and only four cases (13%) took more than 3 hours. While in group B, twenty (66%) cases took between 4-5 hours. This shows a significant difference by fisher extact test (p<0.001) in the operative time required in both the groups. Eighteen (60%) patients in group B had a residual volume between 1-1.5 ml while only two patients in group A had so. This difference is also significant Fischer Exact test (p<0.001). Four (13.3%) patients in group A had diabites insipidus while only half of this, i.e. two (6.6%) had so in group B. however this difference in postoperative complication rate is not statistically significant between two groups. Conclusion: The results of our study correlate with many previous studies to compare endoscopic and microscopic transsphenoidal surgery. These two approaches are equally efficacious in oncological outcomes and the complication rates are comparable.

scholarly journals Optimized Clustering Algorithm for Comparative Analysis of Different Prenatal Corticosteroid Neurological Deficits in Premature Infants through Magnetic Reasoning Imaging (MRI)

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shu Zhao
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Clustering Algorithm ◽  
Neurological Deficits ◽  
Antenatal Corticosteroids ◽  
Maternal Complications ◽  
Significant Difference ◽  
Group A ◽  
Threatened Preterm Labor ◽  
Group B

Objective. This study aimed to explore the application of different prenatal corticosteroids in the assessment of neurological deficits and prognosis in premature infants through Magnetic Reasoning Imaging (MRI) under optimized cluster algorithm. Methods. 100 pregnant women with threatened preterm labor were retrospectively analyzed, in which 38 pregnant women with lasting threatened preterm labor (group A) were treated with multiple courses of antenatal corticosteroids (dexamethasone treatment) and 62 cases of pregnant women with threatened preterm labor (group B) were treated with single course of dexamethasone treatment. Craniocerebral MRI images based on optimal clustering algorithm were used to examine neonates. Neonatal hypoxic-ischemic encephalopathy (HIE) rate, serum neuron-specific enolase (NSE) concentration, neonatal behavioral neurological score (NBNA), respiratory distress syndrome (RDS) rate, perinatal mortality, neonatal birth weight, and maternal complications rate of two groups were compared. Results. Compared with other traditional image segmentation algorithms, this algorithm had the best segmentation effect, the shortest running time (1.43 s), the least number of iterations (5 times), and the highest segmentation accuracy (97.98%). There was no significant difference in the HIE rate, serum NSE concentration, NBNA score, RDS score, and perinatal mortality in group A and group B ( P > 0.05 ). Compared with group B, neonates’ body weight in group A was decreased, while the maternal complication rate in group A was increased ( P < 0.05 ). Conclusion. MRI images based on optimized clustering algorithm can be used in the diagnosis of neonatal hypoxic-ischemic encephalopathy. There is no significant difference in the application of different antenatal corticosteroids affecting premature nerve function defect and prognosis, but multiple courses of antenatal corticosteroids can affect neonatal body mass and increased maternal complications to a certain extent; therefore, before threatened premature delivery treatment, the pros and cons of multiple courses of antenatal corticosteroids should fully be considered and in the treatment, measures should be actively taken to alleviate the side effect.

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