scholarly journals A prospective clinical trial to evaluate the role of very low dose mifepristone 10 mg in medical management of uterine leiomyoma in tertiary care hospital from North West India

2020 ◽  
Vol 9 (4) ◽  
pp. 1632
Author(s):  
Swati Kochar ◽  
Neha Suthar ◽  
Shweta Chaudhary ◽  
Shahnaj Chandad
Keyword(s):  
Low Dose ◽  
Tertiary Care ◽  
Smooth Muscles ◽  
Prospective Clinical Study ◽  
Care Hospital ◽  
Initial Visit ◽  
North West ◽  
Group I ◽  
Significant Difference

Background: Uterine leiomyomas are the most common benign tumours of the uterus and also the most common benign solid tumor in female. It arises from the uterine smooth muscles (myometrium) but contain varying amount of fibrous connective tissue. Aim of study was to evaluate the efficacy of very low dose Mifepristone (10 mg) on leiomyoma volume and its related symptoms.Methods: This was a prospective clinical study. 30 women met with the inclusion criteria and giving informed consent for the study.Results: Mean myoma volume was 60.32±51.89 at initial visit and 36.13±48.54 at 3 months follow up visit with 40.1% reduction which was statistically significant difference (p < 0.001). Mean PBAC score in Group I was 155.53±21.70 at initial visit and 0.97±2.97 at 3 months follow up visit with 99.3% reduction which was statistically significant (p < 0.001).Conclusions: Mifepristone 10 mg is efficacious in term of control of bleeding, alleviation of pain related symptoms with few side effects. So low dose mifepristone can be used as a suitable option for women with symptomatic fibroids in perimenopausal periods or patients not willing or fit for surgery.

Does Teaching Clinical Ethics to Medical Students Improve Knowledge, Attitude, and Practice of Medical Ethics Among Clinicians? An Observational Study in a Tertiary Care Hospital in Nepal.

2020 ◽  
Author(s):  
Carmina Shrestha ◽  
Jasmin Joshi ◽  
Ashma Shrestha ◽  
Shuvechchha Karki ◽  
Sajan Acharya ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Ethics ◽  
Clinical Ethics ◽  
Core Curriculum ◽  
Tertiary Care ◽  
Medical Schools ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The importance of doctors being aware of medical ethics has been highlighted in a number of studies. Our first study (Study-1) aims to assess the knowledge, attitude, and practices of medical ethics among clinicians at Patan Academy of Health Sciences (PAHS). We then follow up with the effect of teaching clinical ethics to medical students (Study-2). The purpose of this study is to assess the awareness regarding appropriate ethical principles, application of medical ethics and the effect of teaching medical ethics to students. Methods: There are two studies presented: Study-1 is a cross-sectional questionnaire-based study. A total of 72 participants, selected by simple random sampling, included doctors working as interns, medical officers and consultants in six departments of PAHS. Study-2 was a follow-up, cross-sectional online questionnaire-based comparative study conducted at PAHS to compare KAP of medical ethics among medical officers with and without formal medical ethics training. We used the validated questionnaire from our previous study. All graduates of PAHS 2016 and all medical officers employed at PAHS at the time of study who had graduated from other medical schools that did not include Medical Ethics in their core curriculum were included. Results: Study-1: A positive correlation between Knowledge(p = 0.088), Attitude (p = 0.002), Practice of medical ethics(p = 0.000), and years of practice was found. No significant difference in KAP of medical ethics between MBBS graduates from Nepal and abroad (p = 0.190) was found. The majority scored poorly in issues concerning autonomy. The follow-up study found a statistically significant difference (p = 0.000) in the knowledge between the doctors who were taught medical ethics and those who were not. Conclusions: Doctors find it easier to discuss ethical dilemmas with their colleagues rather than department heads. The KAP of the consultants were found to be better than that of the interns and medical officers. Autonomy is the least understood ethical principle. ‘Medical Ethics’ as a part of the core curriculum in medical schools would improve ethical practice.

scholarly journals The effect of ladder approach on development of preterm low birth weight infants with HIE-2

2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Post Intervention ◽  
Low Birth Weight Infants ◽  
Significant Difference

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.

scholarly journals Incidence of dry eye after radiotherapy for head and neck tumours: a tertiary Care Hospital North West Rajasthan

2021 ◽  
Vol 9 (8) ◽  
pp. 2339
Author(s):  
Kalpna Jain ◽  
Vinod Sagar ◽  
Sarita Maharia ◽  
H. S. Kumar
Keyword(s):  
Head And Neck ◽  
Dry Eye ◽  
Critical Role ◽  
Tertiary Care ◽  
Care Hospital ◽  
Protective Mechanisms ◽  
North West ◽  
Neck Tumors ◽  
Total Radiation Dose

Background: Radiotherapy plays a critical role in the management of many patients with head-and-neck (H&N) cancer. To study the incidence of dry eye associated with radiotherapy and correlate them with dose of radiation.Methods: This Hospital based prospective study comprises of 100 patients of head and neck tumors who received radiotherapy by linear accelerator from 2015 to 2017. Ocular examination was done prior to the start of therapy, 1st follow up at 15th day of therapy, 2nd at last day of therapy (23-35 fraction), 3rd at 3 months after completion of therapy for side effects, 4th at 6 months, 5th at 12 month and 6th at 18 months after completion of therapy for assessing dry eye.Results: 59% patients developed dry eye. 44 patients received dose 45-55 Gy and out from these 13 (29.50%) patients developed dry eye, 40 patients received dose 56-65 Gy and out from these 33 (78.00%) patients developed dry eye and 16 patients received dose 66-70 Gy and out from these 13 (95.00%) patients developed dry eye.Conclusions: We concluded that the incidence of dry eye increased with increased total radiation dose. The current study suggests the importance of total dose as well as dose per fraction despite advancement of radiotherapy techniques and using protective mechanisms for eye complications developed.

scholarly journals Efficacy of Low Dose Topiramate and Propranolol in Migraine Prophylaxis

2018 ◽  
Vol 9 (2) ◽  
pp. 49-54
Author(s):  
Muhammad Abdul Momen Khan ◽  
Jannatul Ferdous ◽  
AKM Golam Kabir ◽  
Md Mamnur Rashid ◽  
Md Enayet Ul Islam ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Migraine Prophylaxis ◽  
Drop Out ◽  
Group I ◽  
Significant Difference ◽  
Propranolol Group ◽  
Baseline Information ◽  
Group Ii

Background: Migraine, the second most common cause of headache that can significantly impair the lives of people. Various drugs are available for migraine prophylaxis but all of which have varying degrees of adverse effects that may significantly limit their use.Objectives: To observe whether low dose topiramate is more effective compared to propranolol in migraine prophylaxis.Methods: Total 120 patients the age range of 18 to 50 years were recruited as study population of migraine in the Out Patient Department (OPD) & Headache Clinic,BSMMU.60 patients were administered by Tab.Topiramate 50 mg/ day named as group-I and rest of 60 patients were administered by Tab. Propranolol 80 mg /day named as group-II. Out of them in total 96 patients had completed the study. 47 patients had completed study in group-I and 49 patients in group-II. During trial, three follow up visits were taken for both groups, 1st follow up after 4 weeks of baseline information, 2nd follow up after 4 weeks of treatment, 3rd follow up after 8 weeks of treatment. Efficacy of treatment was measured by frequency, duration and severity of headache as measured by the visual analogue scale (VAS).Results: The mean (SD) age of group-I (topiramate) and group-II (propranolol) group were found 29.72±9.58 years and 30.96±10.11 years respectively. Female sex was found predominant in both groups. At final follow up, there was statistically significant difference in mean (SD) value of frequency of migraine between topiramate and propranolol group (4.72±2.80 vs. 3.48±2.20; p=0.024]. Propranolol appeared statistically significant than topiramate [TPM 5.53±2.98 vs. PRO 4.36±1.55; p=0.047].Regarding severity of headache, better results also were observed in the propranolol group than topiramate (p< 0.05). Both drugs appeared significant in efficacy measurement (p<0.001). Patient drop out was more in the topiramate group than the propranolol group (21.68 % vs. 18.34%). Furthermore, in the topiramate group, patients complained of more adverse effects than propranolol group (23.4% vs. 14.3%), which was statistically significant.Conclusion: The present study suggests that low dose topiramate and propranolol are effective for migraine prophylaxis in reduction of frequency, severity and duration of migraine individually and propranolol appears more effective compared to that of topiramate.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 49-54

scholarly journals Study of prevalence of raised IOP in post cataract patients following topical steroid usage

2021 ◽  
Vol 7 (2) ◽  
pp. 436-441
Author(s):  
Kavitha Mohankumar ◽  
Abhay Amrit Lune ◽  
Rakesh Goud ◽  
Chaitali Chandrashekhar Desai ◽  
Namratha Judith Cardoza
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Topical Steroid ◽  
Prednisolone Acetate ◽  
Topical Steroids ◽  
Care Hospital ◽  
Group I ◽  
Iop Elevation

To evaluate the rise in intraocular pressure (IOP) in post cataract surgery patients who received topical steroids.Patients in the age group of 50-75 years and both sexes who were coming to ophthalmology OPD at a tertiary care hospital of Western Maharashtra were studied. 500 subjects who underwent uncomplicated cataract surgery were taken into consideration; both age and sex matched. All patients were screened for raised intraocular pressure by Perkin’s tonometer preoperatively and at 5th day, 2nd week, 4th week, 6th week and 8th week postoperatively. Patients were allocated into two groups: either topical Prednisolone acetate e/d (1%) (Group I) or Dexamethasone e/d (0.1%) (Group II) started six times for 1st week (considering the cells in anterior chamber &#60;2+) & then tapered off subsequently in the following weeks for a period of 5 weeks (starting with six times for 1st week, then tapering to 4 times for the next week, 3 times for the next week, 2 times for the next week, 1 time for the next week and then stopped).In our study group, the prevalence of steroid-responders was 3.6% with 0.8% showing mild rise, 2.8% showing moderate rise in IOP on the fourth week of topical steroid usage. There was no difference in the mean IOP rise with the usage of two different topical steroids (E/d Prednisolone acetate (1%) and E/d Dexamethasone(0.1%)) in our study. The highest mean IOP was noted at the 5th postoperative day (20.26 mmHg) which was due to inflammation & there was a gradual decrease in IOP in the subsequent weeks of follow-up till 8th week. While as duration after cataract surgery progress till 8th week of follow up, moderate rise in IOP occurs which gradually comes down to mild rise till 8th week of follow-up.Steroid-induced IOP elevation typically occurs after 4 weeks of beginning steroid therapy and the prevalence of steroid responders in post cataract surgery patients was established.

scholarly journals A Prospective Comparative Study of Efficacy and Pleiotropic Effect of Telmisartan versus Enalapril in Hypertensive Patients with Dyslipidaemia in a Tertiary Care Hospital in Visakhapatnam

2021 ◽  
Vol 8 (23) ◽  
pp. 1915-1921
Author(s):  
Supriya Sanke ◽  
Chitra Karuppiah ◽  
Hema Sundar Rao Dumpala ◽  
Sai Vishnu Vardhan Allu ◽  
Syamala Shanthi Kumari Bonela
Keyword(s):  
Blood Pressure ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Tertiary Care ◽  
Density Lipoprotein ◽  
Blood Levels ◽  
Care Hospital ◽  
Significant Difference ◽  
Enalapril Group

BACKGROUND Hypertension is a silent killer, an asymptomatic chronic disorder if left untreated which results in major health problems. Goal of treatment is to decrease the morbidity and mortality associated with cardiovascular and cerebrovascular complications of hypertension when it is associated with dyslipidaemia. The renin angiotensin system plays an important role in the regulation of blood pressure and in the pathogenesis of hypertension. Telmisartan is an ARB (angiotensin receptor blocker) and Enalapril is an ACE inhibitor. The purpose of this study is to compare the efficacy of Telmisartan with Enalapril in patients of essential hypertension with dyslipidaemia, and to observe the effects of Telmisartan and Enalapril on blood lipid levels of these patients. METHODS This is a prospective, randomized, comparative and open label study conducted among 70 patients who were included in the study and were divided in to two groups. Group A - consisting of 35 patients receiving Telmisartan 40 mg, and Group B receiving Enalapril 5 mg orally once a day. Informed consent was obtained from all the patients. Follow up was done after 4, 8 and 12 weeks. Blood pressure was recorded at every visit and lipid profile was done at the time of enrolment and after 12 weeks of study period. RESULTS Baseline demographic attributes were comparable between both the groups including total cholesterol and low-density lipoprotein (LDL). The mean reduction in systolic and diastolic blood pressure (BP) after 12 weeks was highly significant (P value < 0.001) in both the groups but when mean reduction in SBP & DBP was compared, there was no significant difference (P > 0.05) between the drugs. Blood levels of total cholesterol, LDL, triglyceride had significantly reduced (P < 0.05) in Telmisartan group compared to Enalapril group after 12 weeks of follow up and mean high density lipoprotein (HDL) level significantly increased in Telmisartan group (P < 0.05) but no increment was seen in Enalapril group. CONCLUSIONS Telmisartan and Enalapril had comparable antihypertensive effect and significant reduction in blood pressure was seen after 12 weeks of therapy in both the groups. In addition, Telmisartan showed more beneficial effects on lipid profile when compared to Enalapril. KEYWORDS Hypertension, Dyslipidemia, Lipid Profile, Telmisartan, Enalapril

scholarly journals Progesterone only pills: an effective contraceptive option for lactating women

2017 ◽  
Vol 6 (10) ◽  
pp. 4399
Author(s):  
Michelle Fonseca ◽  
Prasad Yeshwant Deshmukh ◽  
Deepali Kharat
Keyword(s):  
Low Dose ◽  
Tertiary Care Hospital ◽  
Post Partum ◽  
Tertiary Care ◽  
Lactation Period ◽  
Care Hospital ◽  
Lactating Women ◽  
Effective Contraceptive ◽  
Spacing Method

Background: Progesteone only pills (POP) are the most suitable for breastfeeding women as they have no effect on quality and quantity of breast milk in lactating women or on infant growth as well.Methods: A study was conducted on post partum lactating women over a period of 6 months at a tertiary care hospital in Mumbai. Post partum women were called for follow up in the post natal OPD and were counseled about temporary and permanent spacing methods.Results: Progesterone only pills are an acceptable and convenient means of temporary contraception / spacing during lactation period in motivated patients who do not want IUCDs or Injectables or are undecided about permanent methods of family planning.Conclusions: Low Dose progesterone only minipill is both effective and acceptable to breast feeding women. It may be used as a temporary spacing method in women who do not prefer an IUD but who are motivated to be complaint with its use.

scholarly journals Trail without Catheter after Transurethral Resection of Prostate: Clamp It or Not?

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Vikash Talreja ◽  
Aun Ali ◽  
Summaya Saeed ◽  
Kiran Rani ◽  
Sunil Sadruddin Samnani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Transurethral Resection ◽  
Foley Catheter ◽  
Tertiary Care ◽  
Transurethral Resection Of Prostate ◽  
Care Hospital ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Study Participants

Background.There has been argument between clinical practitioners about clamping catheter or not prior to its removal after transurethral resection of prostate (TURP). We conducted a clinical trial to assess whether clamping has any role in early bladder tone recovery particularly in patients who undergo TURP.Methods.Randomized clinical trial was conducted at a tertiary care hospital, Karachi from January 2014 to July 2015. Eighty-six study participants who underwent TURP were randomly allocated into two groups of 43 participants each. In Group I, patient’s Foley catheter was not clamped prior to its removal and in Group II Foley catheter was clamped. Data of all subjects were analyzed using SPSS version 20.Results.There was no significant difference in age and weight of resected tissues between two groups. Among 4 patients in Group I who required recatheterization, 1 patient was discharged with catheter as compared to Group II in which 2 patients were discharged with catheter (P=0.99). Only 1 patient (2.3%) in Group II had bleeding which required recatheterization. Length of stay was significantly affected by early and free removal of Foley catheter (P<0.001).Conclusion.The results of current study identified that clamping whether done or not had no significant impact on urinary retention.

scholarly journals Efficacy and Safety of Diphenylcyclopropenone in the Treatment of Multiple Warts - A Prospective Study at a Tertiary Care Hospital, Mumbai

2021 ◽  
Vol 8 (20) ◽  
pp. 1580-1585
Author(s):  
Prathyusha Yakkala ◽  
Rachita Dhurat ◽  
Meghana Phiske
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Viral Origin ◽  
Factors Affecting ◽  
Type Iv ◽  
Significant Difference ◽  
A Prospective Study

BACKGROUND Diphenylcyclopropenone (DPCP) produces type IV hypersensitivity reaction, immune response being directed against a complex of contact agent hapten bound to proteins of viral origin that enhance wart regression. We wanted to evaluate the efficacy and safety of DPCP in multiple warts along with the various factors affecting DPCP response METHODS A prospective study with 49 patients older than 5 years with 5 or more warts in any area (except genital) was conducted. Patients were sensitized with 2 % DPCP solution and examined after 48 hours. Sensitization was graded as mild, moderate, severe or no sensitization. Patients with mild / moderate sensitization were further applied DPCP; patients with severe sensitization were included after subsidence of reaction and patients with no sensitization were excluded. After sensitization, weekly applications were made on warts. Concentration causing mild reaction was selected as optimal and was applied till lesion clearance. Follow up was for 3 months for recurrences. Response was graded as complete, partial and no response. RESULTS Males outnumbered females. Mean age was 23 years. Mean duration was 12 months. Recurrent and resistant warts were seen in 15 and 6 patients respectively. Mean number of warts was 15.6. 49 patients were tested for sensitization, 1 failed sensitization and 48 were continued with weekly DPCP. 2 developed distant eczematisation and 4 were lost to follow up. Out of 42, complete clearance was seen in 35 (83.3 %), partial in 3 (7.14 %) and no response in 4 (9.52 %). Local eczematisation, lymphadenopathy, hyperpigmentation were the side effects. Response was better with increasing age. Warts less than 6 months had 100 % response. There was no statistically significant difference between site and type of warts and response to DPCP, recurrent and untreated warts in terms of response and response to sensitization and final response. CONCLUSIONS DPCP is an excellent option for multiple / resistant warts with good safety profile. KEYWORDS Diphenylcyclopropenone, Multiple Warts, Safety, Efficacy, Various Factors Affecting Response

scholarly journals Impact of Preoperative Counselling on Early Postoperative Mobilization and Its Role in Smooth Recovery

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sunil Sadruddin Samnani ◽  
Muhammad Farooq Umer ◽  
Syed Hussain Mehdi ◽  
Farah Naz Farid
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Pulmonary Complications ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Randomized Control ◽  
Preoperative Counseling

Background and Objectives. Preoperative counseling is effective to foster early postoperative mobilization that reduces pulmonary complications following abdominal surgery. This study aims at evaluating the effect of preoperative counseling regarding postoperative mobilization and its impact on reducing pulmonary complications. Design and Setting. Randomized control trial was conducted at the Department of Surgery of a tertiary care hospital, Karachi. Patients and Materials. Patients who underwent abdominal surgery and met inclusion criteria were recruited. All participants were randomly divided into two groups. Both groups received information about the surgery and Group I received additional counseling for postoperative mobilization. All patients were encouraged for postoperative mobilization. Scholes et al. criteria were used to evaluate postoperative pulmonary complications. Results. In total 232 participants were recruited and divided into two groups. There was no significant difference in participants’ age (P=0.79), duration of surgery (P=0.5), and pain score (P=0.1) of both groups. However, significant difference was identified in mobilization from bed to chair and mobilization for >10 minutes. Patients in Group I experienced less pulmonary complications in comparison with Group II.

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