scholarly journals A prospective randomized comparative study of the efficacy of sustained release vaginal insert versus intracervical gel in primigravidae at term pregnancy

2020 ◽  
Vol 9 (4) ◽  
pp. 1532
Author(s):  
Thejaswi R. Thupakula ◽  
Bela Makhija ◽  
Arpana Haritwal
Keyword(s):  
Sustained Release ◽  
Dropout Rate ◽  
Cold Chain ◽  
Clinical Effects ◽  
Term Pregnancy ◽  
Duration Of Action ◽  
Successful Induction ◽  
Group A ◽  
Consecutive Term ◽  
Group B

vBackground: Induction of labour is the intentional initiation of labour before spontaneous onset for the purpose of delivery of fetoplacental unit. Failure of induction is responsible for increased incidence of caesarean delivery. This study performed to assess and compare the clinical effects of sustained release vaginal insert versus intracervical gel in primiparous women with term pregnancy in terms of improvement of Bishop’s score, Induction delivery interval, incidence of hyperstimulation, maternal and neonatal outcomes.Methods: A total 100 consecutive term pregnant women who underwent labor induction for fetal or maternal indications were divided randomly into two groups. Group A - sustained release Vaginal insert and Group B - Intracervical gel. Informed consent was taken from each patient.Results: Statistically significant increase in final Bishop’s score (p=0.008) and hyperstimulation (p=0.04) was seen in Vaginal insert group as compared to Intracervical gel group, while there were no statistically significant differences in maternal outcomes, neonatal outcomes and need for oxytocin augmentation in both groups.Conclusions: In this study we found that insert did not improve the induction delivery interval or rate of successful induction, nor did it have any advantage in terms of neonatal outcome although it did improve the Bishops score – Its advantage was in terms of single application, few prevaginal examinations, longer duration of action and immediate retrieval in case of hyperstimulation. Its main drawback remained the maintenance of cold chain without which its efficacy decreases. Another significant observation was the dropout rate of insert (16%).

scholarly journals The effect of cold-chain re-introduction on the molecular integrity of rocuronium bromide

2021 ◽  
Author(s):  
D Vermeulen ◽  
M Wooding ◽  
K Outhoff ◽  
T Dippenaar
Keyword(s):  
Degradation Products ◽  
Rapid Sequence Induction ◽  
Vital Role ◽  
Cold Chain ◽  
Clinical Effects ◽  
Rocuronium Bromide ◽  
Onset Of Action ◽  
Duration Of Action ◽  
Significant Difference ◽  
Temperature Exposure

Introduction: This study aimed to examine the effect of breakages and re-introduction into cold chain on the rocuronium bromide compound. Rocuronium bromide is frequently used in routine theatre lists and plays a vital role in modified rapid sequence induction and intubation for emergency patients who have contraindications to the primarily used muscle relaxant, succinylcholine. With the current practice of removing the drug from, and then reintroducing it into the cold chain, unpredictable clinical effects, including delayed onset of action and shortened duration of action have been observed. This may pose significant risks to the patient. Methods: Rocuronium bromide was subjected to different clinically applicable storage and temperature scenarios, after which the compound was analysed for integrity and quantities of the active compound, including detection of possible degradation products, by mass spectrometry, and compared to cold chain control samples. Results: There were no significant differences between any of the temperature exposure groups (18 °C or 24 °C) or between single or double exposures at these temperatures. No statistically significant difference could be demonstrated between the two control groups (cold chain preserved and room temperature controlled) with testing done at weeks one and six. However, week twelve analysis revealed a statistically significant result which translates to a 26 μg/ml difference, which clinically would have no effect. Substantial results were obtained with a secondary exposure to air; which lead to a 20% decrease in rocuronium concentration (p = 0.02). Conclusion: Practice should be adapted by keeping careful documentation as to when cold-chain was broken, and when the recommended 12 week period will lapse. Vial sharing as a standard is not recommended. If small quantities are repeatedly withdrawn from the vial during a prolonged case, the unused contents should be discarded after eight hours.

scholarly journals A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

2020 ◽  
Vol 9 (9) ◽  
pp. 3660
Author(s):  
Priyanka . ◽  
Shashi Bala Arya ◽  
Mirdu Sinha ◽  
J. K. Goel
Keyword(s):  
Pregnant Women ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Misoprostol Group ◽  
Successful Induction ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.

scholarly journals Complete Thoracoscopic Segmentectomy and Pulmonary Lobectomy in the Treatment of Small Pulmonary Nodules

2021 ◽  
Vol 5 (6) ◽  
pp. 57-60
Author(s):  
Yu Zhou
Keyword(s):  
Clinical Effect ◽  
Pulmonary Nodules ◽  
Clinical Effects ◽  
Pulmonary Lobectomy ◽  
Significant Difference ◽  
Postoperative Drainage ◽  
Group A ◽  
Treatment Safety ◽  
Group B ◽  
Small Pulmonary Nodules

Objective: To compare the clinical effect of complete thoracoscopic segmentectomy and pulmonary lobectomy for pulmonary nodules. Methods: In this study, 176 patients with pulmonary nodules were treated in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine from January 2019 to June 2021; according to the type of surgery, the patients were divided into group A (complete thoracoscopic segmentectomy) and group B (complete thoracoscopic pulmonary lobectomy), and the clinical effects were analyzed. Results: The intraoperative blood loss, postoperative drainage volume, postoperative hospitalization days, and lung function of patients in group A were significantly better than those in group B (P < 0.05), while there was no significant difference in the number of dissected lymph nodes. Conclusion: The clinical effect of complete thoracoscopic segmentectomy for patients with small pulmonary nodules is more significant; it does not only ensure lymph node dissection, but also improve surgical-related indicators and treatment safety as well as speed up the recovery of pulmonary function. Its clinical application value is worthy of key analysis by medical institutions.

scholarly journals Comparison of sublingual buprenorphine and intravenous morphine in reducing bone metastases associated pain in cancer patients

2019 ◽  
Vol 29 (2) ◽  
Author(s):  
Seyed Mohammad Jamalian ◽  
Mohammad Sotodeh ◽  
Fathollah Mohaghegh
Keyword(s):  
Bone Metastases ◽  
Cancer Patients ◽  
Metastatic Cancer ◽  
Common Symptom ◽  
Duration Of Action ◽  
Sublingual Buprenorphine ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
Group A ◽  
Group B

Bone metastases is one of the most common causes of pain in cancer patients and have a significant effect on their quality of life. The most common symptom of bone metastases is pain that gradually develops. Morphine is used to relieve pain in these patients, but poorly accepted due to its adverse events. Therefore, the current study was aimed to compare the effect of sublingual buprenorphine, with certainly lower complications with morphine. Fourth patients were divided into 2 groups. In group A, metastatic cancer patients received 2.5 mg of intravenous morphine. Furthermore, in group B, sublingual tablet of buprenorphine (one-fourth of a 500 μg tablet) was administered sublingually. Pain was measured 15, 30, and 45 minutes after the onset of pain using visual analog scale ruler. Based on the obtained data, two groups A and B were compared using SPSS 23 software. There was a significant difference between the patient's pain intensity after 15 and 30 minutes from the onset of pain in both groups. Due to the fact that the duration of the effect of morphine is 3-4 hours and the duration of the effect of sublingual buprenorphine is 6-8 hours, morphine showed fast acting forms of opioids (P= 0.001). The required dose level on the first day was similar in both groups and there was no statistically significant difference between the two groups. While on the second and third days, the median dose in group A (morphine) was greater than group B (buprenorphine), indicating prolonged duration of action for buprenorphine compared with morphine, thus requiring lower subsequent doses. The results of this study suggested that sublingual buprenorphine is a higher effective drug compared to intravenous morphine during and after operation. With regard to easy and painless administration, it seems that its use can be useful in controlling pain due to bone metastases in cancer patients.

scholarly journals Effect of microscopically assisted decompression with micro-hook scalpel in the surgical treatment of ossification of the posterior longitudinal ligament

2019 ◽  
Vol 47 (10) ◽  
pp. 5120-5129 ◽  
Author(s):  
Sheng Yang ◽  
Jianmin Lu ◽  
Dapeng Fu ◽  
Depeng Shang ◽  
Fei Zhou ◽  
...  
Keyword(s):  
Recovery Rate ◽  
Spinal Canal ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Clinical Effects ◽  
Posterior Surgery ◽  
Vas Score ◽  
Group A ◽  
Group B

Objective This study was performed to investigate the effect of microscopically assisted decompression using a micro-hook scalpel on ossification of the posterior longitudinal ligament (OPLL). Methods Sixty-one patients with OPLL were divided into Group A (posterior surgery with laminectomy of the responsible segment and lateral mass screw fixation) and Group B (anterior cervical corpectomy with intervertebral titanium cage fusion). Neurological function was assessed by the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and recovery rate. The fixation status and the result of spinal canal decompression were radiographically assessed. Results In Groups A and B, the JOA score was significantly higher and the VAS score was significantly lower at 1 week postoperatively and at the final follow-up than during the preoperative period. The mean recovery rate in Group A and B was 59.92% ± 13.46% and 62.28% ± 14.00%, respectively. Postoperative radiographs showed good positioning and no damage to the internal fixation materials. The spinal canal was also fully decompressed. Conclusions Microscopically assisted decompression with a micro-hook scalpel in both anterior and posterior surgeries achieved good clinical effects in patients with OPLL.

scholarly journals Effects of intramuscular and vaginal progesterone supplementation on frozen-thawed embryo transfer

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lei Jiang ◽  
Zhuo-Ye Luo ◽  
Gui-Min Hao ◽  
Bu-Lang Gao
Keyword(s):  
Sustained Release ◽  
Embryo Transfer ◽  
Intramuscular Injection ◽  
Abortion Rate ◽  
Vaginal Progesterone ◽  
Group A ◽  
Progesterone Supplementation ◽  
Group B ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract This study was to investigate effects of progesterone vaginal sustained-release gel and intramuscular injection of progesterone on frozen-thawed embryos transfer in 3013 patients receiving vaginal progesterone sustained-release gel and progesterone injection in artificial cycle for frozen-thawed embryo transfer. All patients were divided into two groups: group A with progesterone intramuscular injection (60 mg/d) plus dydrogesterone (10 mg tid) and group B with progesterone vaginal sustained-release gel of progesterone (90 mg/d) plus dydrogesterone (10 mg tid). There were 1988 women in group A treated with progesterone injection and 1025 women in group B with progesterone vaginal sustained-release gel. There were no statistically (P > 0.05) significant difference between the two groups in age, years of infertility, body mass index, endometrial thickness at transfer time, the average numbers of embryo transferred, cause of infertility, number of cycles, pregnancy rate and ectopic pregnancy rate. No significant (P > 0.05) differences existed in the clinical pregnancy (52.5% vs. 56.0%) and ectopic pregnancy (2.2% vs. 3.0%) rate between groups A and B. However, group B with vaginal progesterone supplementation had significantly (P < 0.05) greater implantation (37.0% vs 34.4%), delivery (45.1% vs. 41.0%) and live birth (45.0% vs. 40.8%) rate than group A with intramuscular progesterone injection, whereas group A had significantly (P < 0.05) greater early abortion rate (19.4% vs. 15.3%) than group B. This study showed that vaginal gel progesterone supplementation has good effects on frozen-thawed embryo transfer and can significantly increase the rate of implantation, delivery and live birth but decrease the abortion rate compared with intramuscular progesterone injection.

scholarly journals High-Volume Spinal Anaesthesia. A Dose-Response Study of Bupivacaine 0.125%

1992 ◽  
Vol 20 (4) ◽  
pp. 443-447 ◽  
Author(s):  
D. H. B. Tay ◽  
S. M. Tay ◽  
E. Thomas
Keyword(s):  
Spinal Anaesthesia ◽  
High Volume ◽  
Sensory Block ◽  
Complete Recovery ◽  
Sensory Level ◽  
Clinical Effects ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Dose Response Study

The clinical effects of high-volume spinal anaesthesia with bupivacaine 0.125% were studied in 30 patients presenting for postpartum sterilisation. Group A, B and C patients received 6, 8 and 10 ml of bupivacaine 0.125% respectively. Onset, duration and regression of sensory block and motor blockade, haemodynamic parameters and postoperative complications were studied. A sensory level of T10 was reliably obtained in Group B and C but not in Group A. Similarly motor blockade was unreliable in Group A compared with Group B (P < 0.05) and Group C (P < 0.05). Two segment regression times were similar in all three groups. L1 regression times were 4 7.9, 94.3 and 99.0 minutes in Groups A, B and C respectively. The corresponding times for complete recovery of motor power were 120, 212.3 and 182.7 minutes respectively (P < 0.01 when Group A compared to B and C). A significant incidence of high spinal anaesthesia occurred when 10 ml bupivacaine 0.125% was administered (P < 0.05 when compared with Group A). No patient experienced respiratory discomfort in spite of sensory levels of up to T1. Hypotension responded readily to intravenous fluids and small doses of ephedrine (three patients). Only one patient (Group A) developed a postdural puncture headache. In this study, high-volume spinal anaesthesia with bupivacaine 0.125% was found to be satisfactory for postpartum tubal ligation. The optimal volume of bupivacaine 0.125% was 8 ml.

scholarly journals Clinical effect analysis of laminectomy alone and laminectomy with instrumentation in the treatment of TOLF

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhi-Wei Wang ◽  
Zheng Wang ◽  
Yan-Hong Zhou ◽  
Jia-Yuan Sun ◽  
Wen-Yuan Ding ◽  
...  
Keyword(s):  
Clinical Effect ◽  
Clinical Effects ◽  
Cross Sectional ◽  
Improvement Rate ◽  
Duration Of Symptoms ◽  
Residual Rate ◽  
Score Improvement ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background To explore the clinical effect of laminectomy alone and laminectomy with instrumentation in the treatment of TOLF. Methods A retrospective study was conducted on the clinical data of 142 patients with TOLF and laminectomy who underwent spine surgery at XXX Medical University from January 2003 to January 2018. According to whether the laminectomy was combined with instrumentation, the patients were divided into two groups: group A (laminectomy alone (LA), n = 77) and group B (laminectomy with instrumentation (LI), n = 65). Comparisons of possible influencing factors of demographic variables and operation-related variables were carried out between the two groups. In this study, the clinical effects of LA and LI in the treatment of TOLF were discussed. Thus, we explored the clinical effect of LA and LI in the treatment of TOLF. Results In terms of demographics, there was a statistically significant difference in BMI between group A and group B (P < 0.05). The differences in age, sex, smoking, drinking, heart disease, hypertension and diabetes were not statistically significant (P > 0.05). In terms of preoperative symptoms, there was a significant difference in gait disturbance, pain in the LE, and urination disorder between group A and group B (P < 0.05), but there was no significant difference in other variables between the two groups (P > 0.05). In terms of operation-related variables, there was a significant difference in the preoperative duration of symptoms, intramedullary signal change on MRI, dural ossification, residual rate of cross-sectional spinal canal area on CT, shape on the sagittal MRI, operation time, pre-mJOA, post-mJOA at 1 year, and leakage of cerebrospinal fluid between group A and group B (P < 0.05), but there was no significant difference in other variables between the two groups (P > 0.05). The preoperative average JOA score of group A was 6.37 and that of group B was 5.19. In group A, the average JOA score at 6 months, 1 year and 2 years after surgery was 7.87, 8.23 and 8.26, respectively, and the average JOA score improvement rate was 32.79 %, 38.32 and 38.53 %, respectively. In group B, the average JOA score at 6 months, 1 year and 2 years after surgery was 7.74, 8.15 and 8.29, respectively, and the average JOA score improvement rate was 39.15 %, 46.86 and 47.12 %, respectively. Conclusions Currently, there is no consensus on whether instrumentation is needed after laminectomy for TOLF. We found that for patients with a long duration of gait disturbance, urination disorder, preoperative duration of symptoms, intramedullary signal change on MRI, dural ossification, residual rate of cross-sectional spinal canal area on CT less than 60 %, and shape on the sagittal MRI being beak and low, pre-mJOA had better clinical effects after LI as compared to those after LA, and the incidence of perioperative complications was lower.

scholarly journals Comparative evaluation of the clinical effects of high Air-Through soft diaper and standard diaper in Indian babies with diaper rash

2021 ◽  
Vol 7 (4) ◽  
pp. 353-359
Author(s):  
Salvi Anjali N ◽  
Rajiv Joshi ◽  
Amit Bhawe ◽  
Rinko Takagi ◽  
Haruko Toyoshima ◽  
...  
Keyword(s):  
Clinical Effect ◽  
Clinical Effects ◽  
Diaper Dermatitis ◽  
Treatment Groups ◽  
Randomized Controlled ◽  
Change In The Mean ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

The incidence of diaper dermatitis (rash) in India is reported to be in the range of four to thirty-five per cent in children up to 2 years of age. To evaluate the clinical effect of using High Air-Through Soft Diaper and babies’ favourite diaper (Standard diaper) on Indian babies’ skin. This was a single-blinded, randomized, controlled, cross-over study. Eligible babies were randomized in two treatment groups. Babies in Group A used High Air-Through Soft Diaper for the first two weeks and then used standard diaper for the next 2 weeks. Babies in Group B used a standard diaper for the first two weeks and then used a High Air-Through Soft Diaper for the next 2 weeks. The study was completed with 105 babies. Theevaluation of the skin using the scoring system and photographs for representative purposes. At baseline, the mean total diaper rash scores were comparable in both Group A and Group B viz. 3.04 ± 1.00 and 3.30 ± 1.04 respectively and the difference was not statistically significant (p = 0.195). After 2 weeks, the mean total diaper rash score increased significantly from the baseline in both Group A and Group B (5.05 ± 1.97; p = 0.001 and 6.16 ± 2.22, p = 0.001 respectively); the rise in the mean total diaper rash score was significantly more in Group B than that in Group A (p = 0.045). After 4 weeks, a significant increase in the mean total diaper rash score (1.31 ± 2.69; p =0.001) was observed from what it was at 2 weeks in the Group A and there was an insignificant decrease in the mean total diaper rash score (-0.52 ± 2.54; p =0.153) in Group B from what it was at 2 weeks; the change in the mean total diaper rash score was significantly more in Group A than that in Group B (P = 0.001). Both High Air-Through Soft Diaper and standard diaper in babies caused a significant increase in mean total diaper rash score. However, the extent and the degree of rash induced with the use of High Air-Through Soft Diaper was significantly less than that during the usage of the standard diaper. Thus, High Air-Through Soft Diaper due to technologies used in it appears to be superior to the standard diaper in reducing the mean total diaper rash score.

scholarly journals Efficacy of Drotaverine in Comparison to Hyoscine Butylbromide in Augmentation of Labour

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 39-43
Author(s):  
Sameena Ashraf Kirmani ◽  
Mohammad Sadiq Malla ◽  
Farkhand Mohi-ud-din Regoo
Keyword(s):  
Active Phase ◽  
Cervical Dilatation ◽  
Term Pregnancy ◽  
Hyoscine Butylbromide ◽  
Rectal Suppository ◽  
Active Labour ◽  
Products Of Conception ◽  
The World ◽  
Group A ◽  
Group B

BACKGROUND: Contractility of the myometrium is usually diminished during pregnancy to accommodate and protect the growing products of conception; drugs like Hyoscine butylbromide and Drotaverine are used to shorten the duration of labor in many hospitals all over the world. OBJECTIVE: To compare the effect of intravenous Drotaverine and Hyoscine Butylbromide rectal suppository on duration of labour and rate of cervical dilatation. METHODS: Three hundred pregnant women with term pregnancy in active labour were selected by simple randomization and were divided into three groups: Group A, where injection Drotaverine intravenous was given; Group B, where Hyoscine Butylbromide rectal suppository was instilled; and in Group C, where no drug was given. RESULTS: Mean duration of first stage of labour was 179.1 min, 159.3 min and 299.0 min in groups A, B and C, respectively. Rate of cervical dilatation in groups A, B and C was 2.6, 2.9 and 2.0 cm/hr, respectively. Most of the subjects delivered vaginally. No serious side effects were noted in both the drug groups. CONCLUSION: Hyoscine Butylbromide is more effective than Drotaverine in reducing the duration of active phase of labour. There is a significant improvement in the rate of cervical dilatation with Hyoscine Butylbromide when compared to Drotaverine. JMS 2012;15(1):39-43.

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