scholarly journals Targeted treatments for dysfunctional uterine bleeding based on endometrial thickness

2020 ◽  
Vol 9 (3) ◽  
pp. 900
Author(s):  
Thi Thi Htwe ◽  
Hla Hla Yi ◽  
Saw Kler Ku
Keyword(s):  
Endometrial Thickness ◽  
Hormonal Treatment ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Common Presentation ◽  
Targeted Treatments ◽  
One Year ◽  
The One

Background: Dysfunctional uterine bleeding is a common presentation to both general practitioner and gynaecologists which can have a significant effect on a woman’s quality of life. The aim of this study is to assess the effectiveness of treating dysfunctional uterine bleeding according to endometrial thickness.Methods: This study was a hospital based prospective study undertaken in gynecology outpatient clinic of Central Women’s Hospital, Mandalay, Myanmar for one-year period (2016). A total of 60 patients were recruited and divided into 3 groups based on endometrial thickness and offered targeted hormonal treatments. At the end of the one-month treatment, patients were asked to return for a follow-up visit and from their menstrual diaries, the number of bleeding days and bleeding scores were assessed and calculated.Results: Among sixty women with dysfunctional uterine bleeding, 55% of patients had endometrial thickness less than 6 mm, 25% had endometrial thickness 6-11 mm, with 20% of patients having endometrial thickness more than 11 mm. After one month of study period, treatment was found to be effective in 86.6% of the patients according to bleeding days and in 70% of the patients according to bleeding score.Conclusions: In women presenting with dysfunctional uterine bleeding, increased endometrial thickness was found to be associated with increased BMI. In the treatment of dysfunctional uterine bleeding, when the endometrial thickness of the patient was assessed and hormonal treatment was given according to the endometrial thickness, treatment was proven to be effective.

scholarly journals Intensive Care Patients from the First COVID-19 Wave: One-Year Survival after Tocilizumab Treatment

2021 ◽  
Vol 11 (11) ◽  
pp. 1234
Author(s):  
Gabriele Melegari ◽  
Enrico Giuliani ◽  
Chiara Dallai ◽  
Lucia Veronesi ◽  
Elisabetta Bertellini ◽  
...  
Keyword(s):  
Treated Group ◽  
Cytokine Storm ◽  
Icu Patients ◽  
Intensive Care Patients ◽  
One Year ◽  
The One ◽  
Mortality Hazard Ratio ◽  
New Onset

Introduction: An infection by COVID-19 triggers a dangerous cytokine storm, so tocilizumab has been introduced in Italy as an agent blocking the cytokine storm. This paper aims to describe the one-year survival of ICU patients treated with tocilizumab. Methods: This observational study enrolled all patients confirmed to be infected by COVID-19 who were admitted to the ICU in our center. We offered tocilizumab to all non-septic patients if they did not present any contraindications. Results: We enrolled 68 ICU patients in our center on 72 occasions during the enrollment period; we excluded four patients due to study criteria. The one-year mortality hazard ratio of treated patients was 0.64, with a confidence interval of 0.31 to 1.19, with p = 0.169. Among the survivors, 32 of 35 patients answered the phone interview (14 patients in the treated group and 18 in the untreated group); overall, the effect of COVID-19 on quality of life was 58.14%. These effects were lower in the tocilizumab group, with p = 0.016 *. Conclusions: Our observational data follow the most relevant largest trial. Patients treated with tocilizumab had lower rates of new-onset symptoms later COVID-19 ICU hospitalizations. As reported by recent medical literature, the presence of these symptoms suggests that a follow-up program for these types of patients could be useful.

scholarly journals Comparison between Ormeloxifene and Norethisterone in reducing menorrhagia in dysfunctional uterine bleeding

2018 ◽  
Vol 7 (12) ◽  
pp. 4966
Author(s):  
Swati Gett ◽  
Shruti Singh
Keyword(s):  
Endometrial Thickness ◽  
Mean Value ◽  
Uterine Bleeding ◽  
The Other ◽  
P Value ◽  
Loss Assessment ◽  
Dysfunctional Uterine Bleeding ◽  
Significant Difference ◽  
Before And After

Background: Dysfunctional Uterine Bleeding (DUB) is a condition that affects nearly every woman at some point in her life. This study aims to compare the efficacy of Ormeloxifene and Norethisterone in reducing menorrhagia in such patients.Methods: This prospective study was done on 100 women presenting with dysfunctional uterine bleeding, of 20-50 years of age, who were ready for follow-up and were allocated into two equal groups, one was given Ormeloxifene and the other was given Norethisterone for a period of 3 months. Haemoglobin levels, endometrial thickness on ultrasound and Pictorial Blood loss Assessment Chart (PBAC) scores were assessed before and after the treatment.Results: It was found that both Ormeloxifene and Norethisterone reduced menorrhagia, with a significant difference in PBAC scores (p value <0.05). There was a notable reduction in PBAC scores in Ormeloxifene group (66.53% change from pretreatment mean value) as compared to Norethisterone group (31.38% change from pretreatment mean value); and same holds true for the change in haemoglobin levels as well as endometrial thickness. Ormeloxifene was found to have a greater effect on heavy menstrual bleeding in comparison to Norethisterone.Conclusions: Ormeloxifene is a new modality and is found to be a better option in reducing menorrhagia in DUB in respect to a greater success rate, better compliance and cost effectiveness.

THE DYSFUNCTIONAL UTERINE BLEEDING (DUB) DUE TO ENDOMETRIAL HYPERPLASIA WITH BULKY UTERUS IN AYURVEDIC VIEW – CASE STUDY

2020 ◽  
Vol 8 (06) ◽  
Author(s):  
Dr DIVYA PAWAR ◽  
Sameer Gholap
Keyword(s):  
Endometrial Hyperplasia ◽  
Treatment Protocol ◽  
Hormonal Treatment ◽  
Uterine Bleeding ◽  
The Body ◽  
Dysfunctional Uterine Bleeding ◽  
The Subject ◽  
Special Health

ABSTRACT :- Endometrial is inner lining of uterus. Hyperplasia is excessive growth of cells. Endometrial Hyperplasia is excessive cell growth or thickness of inner lining of uterus. Endometrial hyperplasia is excessive or abnormal thickening of the lining of the uterus, which is most probable cause of Dysfunctional Uterine Bleeding (DUB). In most of the cases, it is benign in nature. The treatment of endometrial hyperplasia of uterus is mainly done by hormonal treatment (especially by progesterone) and by surgical treatment such as hysterectomy, which are having their own side effects. Ayurveda is a health care system sensitive to women’s special health needs. Women are far more sensitive to the rhythms and cycles of nature, Ayurveda is founded on the principle of keeping the body toned in time with nature, and naturally, women find Ayurveda very suitable. In Ayurveda, Endometrial hyperplasia of uterus can be correlated with Lohitakshara Yonivyapada. The present case revealed the Raktastambhaka, Shothhara evum Tridoshahara properties of some Ayurvedicmedicines viz. Pushyanuga Churna, Ashokarishta and Dashamoola Kashaya in a known case of DUB due to endometrial hyperplasia with Bulky Uterus. After 3 months of treatment sonography report showed no hyperplasia of uterus. AIMS AND OBJECTIVES To evaluate the efficacy of Shamana Aushadhi in the management of Dysfunctional Uterine Bleeding (DUB) due to Endometrial Hyperplasia MATERIALS AND METHODS It is a case study of the subject of 35 yrs age with Dysfunctional Uterine Bleeding (DUB) due to Endometrial Hyperplasia who has been treated with Shamana Chikitsa. RESULTS AND DISCUSSION The subject is on follow up and without any medicine on normal cyclic rhythm till date with overall feeling of wellbeing. There is improvement and no evidence recurrence of Dysfunctional Uterine Bleeding and Endometrial Hyperplasia. CONCLUSION The selected treatment protocol i.e. Shamana Aushadha is very effective in the management of Endometrial Hyperplasia KEYWORDS –​ Ayurveda, Lohitakshara Yonivyapada, Endometrial Hyperplasia, Raktastambhaka Drugs

scholarly journals Impact of Endovascular Treatment on Clinical Status and Health-Related Quality of Life

2008 ◽  
Vol 97 (1) ◽  
pp. 50-55 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
L. Keski-Nisula ◽  
P. Apuli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Status ◽  
Critical Limb Ischaemia ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
The One

Background and Aims: Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI). Material and Methods: 61 patients and 64 limbs underwent a primary PTA (30 claudication and 34 CLI cases). Clinical status was graded according to Ahn and Rutherford and ankle/brachial index (ABI). Quality of life was assessed using the Nottingham Health Profile (NHP) preoperatively, one month and one year after the procedure. Triplex scan evaluation of the treated arterial segment was carried out postoperatively and one year after the procedure. Results: Claudication: 24/27 patients underwent one-year follow up, after which 20/24 had no claudication. In triplex evaluation 17 (63.0%) treated segments were open with 0–50% restenosis, 9 (33.3%) with 51–99% restenosis and one (3.7%) was occluded. CLI: 13/34 (38.2%) patients underwent one-year follow-up after which eight patients (61.5%) were asymptomatic and five (38.1%) had claudication. In triplex evaluation there was 0–50% restenosis in 6 (46.2%) segments treated with PTA and 51–99% restenosis in 7 (53.8%) segments. 21 (61.8%) patients did not conclude the one year follow up: 7 had died, 5 had undergone bypass surgery and 6 an amputation and 3 did not attend the follow-up up for unknown reasons. Quality of life: For CLI patients, improvement was observed in the domain of pain, which continued throughout the follow-up period. Among the claudicants, the domain of physical mobility was improved at one month's follow-up, but this effect disappeared during the following year and could not be seen at one the one- year follow-up. Conclusions: Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.

scholarly journals Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Yanyi Wang ◽  
Charlie Changli Xue ◽  
Robert Helme ◽  
Cliff Da Costa ◽  
Zhen Zheng
Keyword(s):  
Controlled Trial ◽  
Sham Acupuncture ◽  
Manual Acupuncture ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
One Year ◽  
The One

Objectives. This study aimed to evaluate the efficacy and safety of manual acupuncture as a prophylaxis for frequent migraine.Methods. Fifty frequent migraineurs were randomly allocated to receive 16 sessions of either real acupuncture (RA = 26) or sham acupuncture (SA = 24) during 20 weeks. The primary outcomes were days with migraine over four weeks, duration, and intensity of migraine and the number of responders with more than 50% reduction of migraine days. The secondary outcomes were the relief medication, quality of migraine, quality of life, and pressure pain thresholds.Results. The two groups were comparable at baseline. At the end of the treatment, when compared with the SA group, the RA group reported significant less migraine days (RA: 5.2 ± 5.0; SA: 10.1 ± 7.1;P=0.008), less severe migraine (RA: 2.18 ± 1.05; SA: 2.93 ± 0.61;P=0.004), more responders (RA: 19 versus SA: 7), and increased pressure pain thresholds. No other group difference was found. Group differences were maintained at the end of the three-month follow-up, but not at the one-year follow-up. No severe adverse event was reported. Blinding was successful.Discussion. Manual acupuncture was an effective and safe treatment for short-term relief of frequent migraine in adults. Larger trials are warranted.

scholarly journals O42 SURGICAL REPAIR OF DIASTASIS RECTI ABDOMINIS (DRA) PROVIDES LONG-TERM IMPROVEMENT OF ABDOMINAL CORE FUNCTION AND QUALITY OF LIFE: A THREE-YEAR FOLLOW-UP

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Anders Olsson ◽  
Olivia Kiwanuka ◽  
Sofia Wilhelmsson ◽  
Gabriel Sandblom ◽  
Otto Stackelberg
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Post Partum ◽  
Diastasis Recti ◽  
Sf 36 ◽  
Core Function ◽  
One Year ◽  
The One

Abstract Aim Diastasis Recti Abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women. Material and Methods Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the Abdominal Trunk Function Protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and Quality of Life was evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at one year and three years’ post-operatively. Results Response rate at the three-year follow-up was 86.7 % for the DRI questionnaire; and 71.7% for ATFP, the UDI-6, IIQ-7, and SF-36 questionnaires. All DRI-parameters were improved (p &lt; 0,05) after three-years of follow-up compared to preoperative values. The functional tests in the ATFP showed an improvement (p &lt; 0.05) in core muscle strength and stability, persisting back and abdominal muscle strength compared to preoperative values as well as an improvement compared to the one-year follow-up values (p &lt; 0.05). UDI-6 and IIQ-7 results were improved (p &lt; 0.05) compared to preoperative values and showed consistent values compared to the one-year follow-up. Quality of life measured with SF-36 were improved compared to preoperative values and showed consistent values compared to the one-year follow-up (p &lt; 0.05). Conclusions The functional improvement of surgical reconstruction of the DRA persisted for three years in this series of post-partum women with DRA.

Long-term quality of life evaluation of patients with total hip arthroplasty

2003 ◽  
Vol 13 (3) ◽  
pp. 167-176 ◽  
Author(s):  
K. Knahr ◽  
R. Jagsch ◽  
I. Kryspin-Exner
Keyword(s):  
Quality Of Life ◽  
Total Hip Arthroplasty ◽  
Functional Capacity ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
One Year ◽  
The One

The aim of the study was to evaluate the clinical and psychological situation of total hip arthroplasty (THA) patients before and one year and five years after surgery. Data of 101 patients were available for the one-year and of 69 patients for the five-year follow-up. Quality of Life (QoL) data were collected using the Nottingham Health Profile (NHP), functional capacity comprised patient's self-assessment (Functional Outcome Questionnaire Hannover, FFbH) and surgeon's assessment (Harris Hip Score, HHS). While all dimensions of QoL and functional capacity except social isolation showed significant improvement at the one-year follow-up, only pain scores showed further improvement at the five-year evaluation. Implantation of THA is accompanied by significant increases in QoL and functional capacity. Stabilised scores were found at the five-year evaluation while significant increases could be observed after one year.

scholarly journals Quality of life in children with atopic dermatitis: A one-year prospective cohort study

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Tatjana Gazibara ◽  
Vesna Reljic ◽  
Slavenka Jankovic ◽  
Jelena Peric ◽  
Milos Nikolic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Life Quality ◽  
Severe Atopic Dermatitis ◽  
Related Quality ◽  
Quality Of Life Index ◽  
One Year ◽  
The One

Background: Literature on the quality of life trends across time in children with atopic dermatitis are scarce. Aims: To assess factors associated with quality of life of children with atopic dermatitis after a one-year follow-up and to examine the factors contributing to greater improvement in the atopic dermatitis-related quality of life over one year. Methods: Our cohort consisted of 98 children who were treated for atopic dermatitis at the clinic of dermatovenereology. Data collection included atopic dermatitis scoring using the SCORing Atopic Dermatitis (SCORAD) index, Children’s Dermatology Life Quality Index (CDLQI) for children aged > four years and Infants’ Dermatitis Quality of Life Index (IDLQI) for children aged 0–4 years. Categorization of the impairment of quality of life score due to atopic dermatitis was as follows: mild (score from 0 to 6), moderate (score from 7 to 12) and severe (score from 13 to 30). The cohort was followed for one year after which a total of 80 children were reassessed. Results: Improvements of both CDLQI and IDLQI were observed in children whose impairment of quality of life due to atopic dermatitis after one year was ‘mild’. This was not observed in children whose atopic dermatitis caused either ‘moderate’ or ‘severe impairment’ of their quality of life. Adjusted analysis showed that lower initial SCORAD and greater improvement in SCORAD after the one-year follow-up were associated with a better quality of life at follow-up. Limitations: The size of our cohort was relatively small. Study participants were recruited from the largest urban and medical referral center in Serbia. Persons from suburban or rural regions may have had different perceptions of atopic dermatitis-related quality of life. Conclusion: Children with less severe atopic dermatitis were more likely to improve their atopic dermatitis-related quality of life. Lower SCORAD was associated with both better quality of life initially and greater improvement in quality of life after one year of follow-up.

scholarly journals Efficacy of ormeloxifene in comparison to oral contraceptive pills in medical management of dysfunctional uterine bleeding

2016 ◽  
Vol 3 (4) ◽  
pp. 244
Author(s):  
Nirmala Jaget Lakkawar ◽  
Padma Alaganandam ◽  
S. Yasodha
Keyword(s):  
Oral Contraceptive ◽  
Side Effects ◽  
Blood Loss ◽  
Endometrial Thickness ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Oral Contraceptive Pills ◽  
Combined Oral Contraceptive ◽  
Contraceptive Pills

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Menstrual disorders are the most common gynecological condition resulting in hospital referrals.   Dysfunctional Uterine Bleeding is an abnormal uterine bleeding, in the absence of any organic, systemic or iatrogenic cause. Among women in reproductive age, one in 20 consults her general practitioner each year with menorrhagia. This condition can be managed both medically and surgically. Pharmacological treatment options available for DUB are combined oral contraceptive pills, progestogens, danazol, gonadotrophin releasing hormone (GnRH) agonists, prostaglandin synthetase inhibitor, anti-fibrinolytics and ethamsylate.  Role of ormeloxifene in dysfunctional uterine bleeding (DUB) is still in an exploring level.</span>The purpose of the study was <span lang="EN-IN">to evaluate the efficacy of ormeloxifene in the treatment of DUB and compare the effects of ormeloxifene with combined oral contraceptive pills for the control of DUB. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Sixty women presenting with DUB were randomly allocated to 2 equal groups, Group A were given ormeloxifene tablet @ 60 mg twice a week for 12 weeks, followed by 60 mg once a week for 12 weeks. Group B were given low dose combined oral contraceptive pills (OCP) containing 30 microgram ethinyloestradiol and 150 microgram levonorgestrel from day 1 to day 21st of the menstrual cycle for 6 cycles. The various parameters studied were reduction in menstrual blood loss which was measured by fall in pictorial blood loss assessment chart (PBAC) score, rise in haemoglobin (Hb) level and reduction in endometrial thickness, any drug side effects, compliance with the drug, dosage schedule and effect on quality of life after each month and at the end of trial period of 6 months. Patient’s level of satisfaction was assessed by improvement in Hb concentration, sense of wellbeing as well as overall general health, quality of life, sexual life and comfort with the continuation of the same drug.</span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Mean blood loss (PBAC score) following treatment showed significant reduction in both the groups, however this reduction was comparatively high in ormeloxifene treated group. The various parameters to assess the subjective and clinical improvement at the end 3 and 6 months post treatment showed significant improvement in both the treatment groups; however ormeloxifene group showed significantly better improvement in comparison to OCP group. Mean endometrial thickness also showed reduction in both the groups but more significant reduction was observed in ormeloxifene group as compared to OCP group following 6 months of treatment. Symptomatic relief and subjective feelings in relation to improvement of menstrual abnormalities, any undesirable side effects, about dosage compliance and any thought of discontinuing the drug by the patients indicated excellent control of menorrhagia in both the study group, which accounted for 86.66% in ormeloxifene group and 80% of individuals in OCP group.  </span></p><p class="abstract"><strong>Conclusions:</strong> ORM is effective in control of DUB and can be used as an alternative to OCP for treatment of DUB with possibly minimal side effects and better dosage compliance.</p>

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