scholarly journals Study of the efficacy of ormeloxifene in abnormal uterine bleeding

2020 ◽  
Vol 9 (12) ◽  
pp. 4941
Author(s):  
Priyanka B. Varwatte ◽  
Michelle Fonseca
Keyword(s):  
Medical Management ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Hemoglobin Concentration ◽  
Abnormal Uterine Bleeding ◽  
Significant Rise ◽  
Uterine Bleeding ◽  
Duration Of Treatment ◽  
Significant Difference

Background: Abnormal uterine bleeding (AUB) is a diagnosis that does not apply to menorrhagia only, but also includes (menometrorrhagia) excessively prolonged and frequent bleeding. Ormeloxifene (also known as centchroman) is a selective estrogen receptor modulator. This study was conducted to assess the efficacy, safety and compliance of ormeloxifene in the medical management of AUB.Methods: This quasi experimental, one group pre and posttest research design study was conducted among 30 participants in a tertiary care institute in a metropolitan city during January 2016 to June 2017. Patients with AUB were administered with ormeloxifene were advised to follow up one monthly for the first three months and then three monthly follow up for 6 months.Results: The mean age of all the patients was 35.96±5.62 years. There was statistically significant difference of mean hemoglobin, mean endometrial thickness and mean pregnancy-associated breast cancer (PABC) score observed between pre-treatment and 3 months and 6 months of post treatment. Mean hemoglobin concentration was increased while mean endometrial thickness and mean PABC score was decreased as the duration of treatment was increased from 3 months to 6 months.Conclusions: Ormeloxifene is quick acting, effective and appears to be a promising option for the medical management of dysfunctional uterine bleeding. It leads to a significant reduction in menstrual blood loss, a significant rise in hemoglobin concentration and a significant decrease in endometrial thickness with very minimal side effect.

scholarly journals Comparison of saline instillation sonography with trans vaginal sonography in abnormal uterine bleeding: a prospective study

2018 ◽  
Vol 7 (12) ◽  
pp. 4819
Author(s):  
Banishree Pati ◽  
Rupa Vani K. ◽  
Gowri A. L. ◽  
Debendra Kumar Tripathy
Keyword(s):  
Diagnostic Accuracy ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Outpatient Basis ◽  
Significant Difference ◽  
Vaginal Sonography ◽  
Sensitivity Specificity ◽  
Saline Instillation

Background: Abnormal vaginal bleeding may be caused by an extensive spectrum of disorders, both gynecologic and non-gynecologic. Diagnostic accuracy of abnormal uterine bleeding is important for the management.  Trans vaginal sonography (TVS) is one of the commonest investigation used for the diagnosis, but the diagnosis is not always accurate for all clinical conditions. Saline instillation sonography (SIS) has been shown to improve the diagnosis. Authors aimed to compare the TVS and SIS diagnosis with the final histopathological diagnosis.Methods: Seventy-five patients with the complained of abnormal uterine bleeding attending outpatient department of a tertiary care institute were enrolled for the study. Trans vaginal sonography (TVS) and saline instillation sonography (SIS) was done on outpatient basis. The diagnosis was compared with final histopathological diagnosis, in term of diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value.Results: Seventy-five patients who were enrolled for the study. Sixty-four patients underwent surgery and final histopathological diagnosis was established. Four patients SIS was not possible, data was analysed for sixty patients.Conclusions: In SIS abnormal uterus diagnosis confidence was significantly improved (p value 0.001) when compared to TVS. The diagnosis of submucous myoma significantly improved (p=0.015) by SIS when compared to TVS. There was no significant difference between TVS and SIS diagnosis of Myoma remote from the endometrium (p=0.522), Adenomyosis (p=1), Focal endometrial abnormality (p=0.654) and Diffuse endometrial abnormality (p=1). The SIS sensitivity, specificity, PPV and NPV were either improved or same, when compare to TVS for all the diagnosis except for the diagnosis of focal endometrial abnormality.

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.

scholarly journals The role of Sevista (ormeloxifene) in the management of dysfunctional uterine bleeding

2016 ◽  
Vol 6 (1) ◽  
pp. 219 ◽  
Author(s):  
Nikita Gandotra ◽  
Preeti Sharma ◽  
Abhinav Sharma ◽  
Syed Masuma Rizvi
Keyword(s):  
Side Effects ◽  
Outcome Measures ◽  
Medical Management ◽  
Endometrial Thickness ◽  
Hemoglobin Concentration ◽  
Uterine Bleeding ◽  
Secondary Outcome ◽  
Dysfunctional Uterine Bleeding ◽  
The Mean

Background: Dysfunctional uterine bleeding (DUB) is a common gynaecological disorder that usually ends up in hysterectomy and causes psychological and physiological stress. Medical management with hormones and NSAIDS has inherited side effects. Ormeloxifene, a selective estrogen receptor modulator, is emerging as a safe and effective agent for dysfunctional uterine bleeding. The objective of the study was to evaluate the role of ormeloxifene in medical management of dysfunctional uterine bleeding.Methods: 30 patients, on whom diagnosis of dysfunctional uterine bleeding was made, were included in the study. Patients were given ormeloxifene 60mg twice a week for 12 weeks and then once a week for 12 weeks. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were acceptability and side effects of ormeloxifene.Results: There was a significant reduction in mean PBAC score from 316 to 52 after six months of treatment. The mean hemoglobin concentration increased significantly from 8.4 to 9.8 gms/dl with a rise of 1.4gm/dl (p <0.05). The mean pretreatment endometrial thickness was 10.8mm and it decreased significantly to 8.1mm after 6 months of treatment with ormeloxifene (p < 0.05). 76.7% of the women showed marked subjective improvement in symptoms. The most common side effect reported was amenorrhea (13.3%).Conclusions: Ormeloxifene can be considered as an effective and safe therapeutic option for the medical management of dysfunctional uterine bleeding.

Endometrial biopsy in women with abnormal uterine bleeding: inadequate and unassessable categorisation is not clinically relevant

2014 ◽  
Vol 67 (8) ◽  
pp. 673-677 ◽  
Author(s):  
Ayman A A Ewies ◽  
Kadry A A Shaaban ◽  
Reena Merard ◽  
Ulises Zanetto
Keyword(s):  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Median Number ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Initial Finding ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Records

AimsInadequate endometrial biopsy comprises a dilemma for gynaecologists and histopathologists alike. This study was conducted to assess the clinical merit of classifying scant endometrial biopsy into inadequate and unassessable using McCluggage criteria.MethodsWe retrospectively classified 268 endometrial biopsies, initially reported as inadequate, into inadequate (n=74) and unassessable (n=174) using McCluggage criteria after excluding 20 cases; all taken from patients aged ≥50 years with abnormal uterine bleeding attending Sandwell and West Birmingham Hospitals, UK from 1 January 2007 until 30 September 2012. The electronic clinical records were reviewed to find out the consequent clinical decisions and final outcomes. The follow-up period was 15 months after including the last patient.ResultsThe median age was 57 years (range: 50–97), and the median number of visits to hospital till the diagnosis was achieved was 2 (range: 1–4). The final diagnosis of endometrial hyperplasia or cancer was reported in 9 cases; 5 (7.1%) with an initial finding of inadequate and 4 with unassessable (2.4%); the difference was statistically insignificant (p=0.13). More patients in the inadequate category (82.4%) underwent further investigations when compared with the unassessable category (68.4%); the difference was statistically significant (p=0.029). There was no statistically significant difference in the inadequate to unassessable ratio when the endometrial thickness was ≥5 mm or <5 mm within the Pipelle group (p=0.46) or the curettage group (p=0.34).ConclusionsOur findings suggest that categorising scant endometrial specimens into inadequate or unassessable has no clinical implications. The gynaecologist should interpret the histopathology report in the light of clinical scenario.

scholarly journals Ormeloxifene versus Tranexamic acid in dysfunctional uterine bleeding comparative evaluation

2018 ◽  
Vol 7 (2) ◽  
pp. 566
Author(s):  
Kaliki Hymavathi ◽  
Malini Devi Gottipati ◽  
Prasuna . ◽  
Sudha V.
Keyword(s):  
Tranexamic Acid ◽  
Endometrial Thickness ◽  
Hemoglobin Concentration ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Double Blind Study ◽  
Loss Assessment ◽  
Dysfunctional Uterine Bleeding ◽  
Double Blind ◽  
Beneficial Effects

Background: Dysfunctional Uterine bleeding (DUB) is the most common cause of abnormal uterine bleeding (AUB). Medical therapy being the first line of management, an ideal drug should be able to block the estrogenic effects on the Endometrium without interfering with its beneficial effects on other tissues. Both Ormeloxifene - a selective estrogen receptor modulator (SERM) and Tranexamic acid-an anti fibrinolytic inhibitor is important in the treatment of DUB. The aim of this study is to assess the efficacy and safety of Ormeloxifene v/s Tranexamic acid in the treatment of DUB.Methods: This is a prospective double blind study conducted for 2 years in 200 women presenting with DUB attending to the Gynaecology outpatient department (OPD) of Narayana Medical College and Hospital, Nellore, AP, India. Two hundred women presenting with DUB were recruited into this study (after fulfilling inclusion and exclusion criteria) with informed consent and randomly divided into two equal groups (Group-A and Group-B) after obtaining college ethical committee approval.Results: The reduction in the mean pictorial blood loss assessment chart (PBAC) score with Ormeloxifene (from 278 to 97.6) was significantly more than that of Tranexamic acid (from 261 to 134.5) at six months (p <0.0001). The rise in Hemoglobin concentration (8.4g% to 11.15g% vs. 8.5 to 9.7gm%; p <0.008) and reduction in Endometrial thickness (from 10.57mm to 6.5mm v/s 9.96mm to 7.24mm p <0.0001) were also significantly more with Ormeloxifene than with Tranexamic acid. Relief from dysmenorrhoea and subjective improvement were also found to be considerable with Ormeloxifene.Conclusions: Both Ormeloxifene and Tranexamic acid can be considered for DUB treatment but Ormeloxifene is found to be superior to Tranexamic acid in various aspects.

scholarly journals Endometrial Cut Off Thickness as Predictor of Endometrial Pathology in Perimenopausal Women with Abnormal Uterine Bleeding: A Cross-Sectional Study

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Prity Kumari ◽  
Harsha S. Gaikwad ◽  
Banashree Nath
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Endometrial Sampling ◽  
Group I ◽  
Significant Difference ◽  
Perimenopausal Women ◽  
Endometrial Pathology

Purpose. We aim to determine the predictive value of endometrial thickness by transvaginal ultrasonography (TVS) in diagnosing endometrial pathology and to evaluate whether Doppler complements its diagnostic efficacy in perimenopausal women with abnormal uterine bleeding. Methods. This cross-sectional observational study was conducted among 70 perimenopausal women with AUB who underwent TVS measurement of endometrial thickness (ET) and Doppler flow indices followed by endometrial sampling and histopathological examination (HPE). Results. In HPE, 51 (73%) women had normal diagnosis while 19 (27%) women had neoplastic histology either benign or malignant. They were categorised into group I and group II, respectively. There was a significant difference in age ( P = 0.001 ) and incidence of obesity ( P = 0.01 ) between the two groups. The ETs measured in group I and group II were 7.89 ± 2.62 mm and 14.07 ± 3.96 mm, respectively, with significant difference ( P < 0.001 ). A TVS-ET of 10.5 mm had the highest sensitivity and specificity of 89.5% and 86.3%, respectively, PPV of 70.68%, NPV of 95.68%, LR+ of 6.52, and LR− of 0.12. Doppler flow velocimetric study of endometrial and uterine vessels did not demonstrate a significant difference. Conclusions. Women in perimenopause with AUB should be offered to undergo endometrial sampling for histopathological examination if TVS ET ≥10.5 mm. The coexisting risk factors especially higher age (>45 years) and obesity (BMI>30) significantly escalate the chances of developing endometrial pathology.

scholarly journals Comparison of transvaginal sonography with hysteroscopy and correlation with histopathological report in case of abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 710
Author(s):  
Gunadhar Maiti ◽  
Prasad Lele ◽  
Dhananjay Borse
Keyword(s):  
Sensitivity And Specificity ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Lower Sensitivity ◽  
Age Group ◽  
Histopathological Report

Background: Abnormal uterine bleeding (AUB) is change in frequency of menses, duration of flow or amount of blood loss. The objectives of the present study were to determine and compare the diagnostic accuracy of TVUS (Transvaginal ultrasonogrphy) with hysteroscopy for diagnosis of endometrial and intramyometrial pathology in case of abnormal uterine bleeding, to study the correlation with histopathological report of endometrial biopsyMethods: It was a prospective comparative study. 200 cases of AUB were selected from June 2010 to May 2012 attending Gynaecology OPD in tertiary care level public sector teaching hospital at Mumbai, meeting the selection criteria were enrolled into the study. Complete history, detail general, systemic and local examination was performed for all patients. Two-dimensional transvaginal ultrasonography was performed to see for endometrial or intramyometrial pathology. Endometrial thickness was noted for all patients. Hysteroscopy and D&C was performed within 48 hours of ultrasonography. After hysteroscopy, curettage was performed and sent for histopathological examination.Results: TVUS detected, 19 polyps (9.5%) and 81 myomas. It was able to differentiate these myomas as 64 interstitials (32%) and 17 submucous (8.5%) hysteroscopy detected 26 submucous myomas (13%), 31 polyps (15.5%), endometrial hyperplasia detected by TVUS, 19 in premenopausal and 06 in postmenopausal age group. Hysteroscopy detected 24 in premenopausal and 06 in post-menopausal age group. Histopathology of endometrial biopsy it came positive for 13 in premenopausal and 08 in postmenopausal age group. Two cases of CA endometrium were diagnosed on HPE out of which one was diagnosed by TVUS and same was diagnosed by hysteroscopy. Conclusions: TVUS has significantly lower sensitivity but comparable specificity with hysteroscopy in diagnosing endometrial polyp and submucous fibroid, comparable sensitivity and specificity in diagnosing endometrial hyperplasia, equivalent sensitivity and specificity in diagnosing endometrial carcinoma, accuracy of TVUS for detecting pathology in AUB is comparable to hysteroscopy, suitable for developing countries as first diagnostic step for AUB.

scholarly journals COMPARISON OF EFFICACY AND SAFETY OF ORMELOXIFENE AND CYCLICAL PROGESTERONE (NORETHISTERONE) IN OVULATORY ABNORMAL UTERINE BLEEDING

2020 ◽  
pp. 178-180
Author(s):  
DIVYA VARDAINI ◽  
RAKESH MISHRA ◽  
RASHMI RANJAN ◽  
SWAPNALI R BORADE
Keyword(s):  
Blood Loss ◽  
Medical Management ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Age Group ◽  
Efficacy And Safety ◽  
Reproductive Age Group

Objective-To determine the efficacy and safety  of ormeloxifene versus progesterone in controlling Ovulatory Abnormal Uterine Bleeding(AUB-O) Methods-A Prospective Randomized comparative study of total 100 females of reproductive age group 25 to 45 years with AUB-O.Patients were randomly divided in two groups of 50 each. Results-The study showed ormeloxifene was found to be more effective and safe than Norethisterone in AUB-O. Ormeloxifine as compared to norethisterone is more effective in improving Hb and reducing endometrial thickness. Hence, ORM is more superior than Norethisterone Conclusion-In this study ormeloxifene was found to be more effective in reducing blood loss,that leads to improvement in mean haemoglobin and also it had more ability to reduce endometrial thickness.As both ormeloxifene and norethisterone are very effectivebut ormeloxifene is safe , cost effective ,nonsteroidal, non hormonal drug with convenient dosage and better compliance for medical management of AUB-O.Hence, ormeloxifene canbe considered as first drugs in the management of AUB-O.

scholarly journals Evaluation of the Anxiety Level of Mothers of Children with Epilepsy during the COVID-19 Pandemic Period

2021 ◽  
pp. 1-8
Author(s):  
Halil Celik ◽  
Sadettin Burak Acikel ◽  
Fatih Mehmet Akif Ozdemir ◽  
Erhan Aksoy ◽  
Ulkuhan Oztoprak ◽  
...  
Keyword(s):  
Neurological Disease ◽  
Chronic Conditions ◽  
Care Center ◽  
Tertiary Care ◽  
Anxiety Level ◽  
Childhood And Adolescence ◽  
Routine Examination ◽  
Significant Difference ◽  
Anxiety Levels

<b><i>Background and Aim:</i></b> Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. <b><i>Methods:</i></b> The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers’ anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. <b><i>Results:</i></b> There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. <b><i>Conclusion:</i></b> Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.

scholarly journals IsHelicobacter pyloriBeing Treated Appropriately? A Study of Inpatients and Outpatients in a Tertiary Care Centre

2007 ◽  
Vol 21 (5) ◽  
pp. 285-288 ◽  
Author(s):  
Jose Nazareno ◽  
David K Driman ◽  
Paul Adams
Keyword(s):  
Tertiary Care ◽  
Gastric Biopsy ◽  
Pathology Report ◽  
Tertiary Care Centre ◽  
Delivery Of Care ◽  
Ulcer Disease ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
H Pylori

BACKGROUND:Helicobacter pyloriis causally associated with peptic ulcer disease and gastric cancer. Although effective treatment is available, studies have shown that patients withH pyloriare often not well managed. Recently, there has also been increasing awareness of patient safety concerns arising from missed follow-up of abnormal test results.OBJECTIVE: To examine whether inpatients and outpatients diagnosed withH pylorireceive appropriate treatment.PATIENTS AND METHODS: All patients who were diagnosed withH pyloriby gastric biopsy in London, Ontario between January 1, 2004, and December 31, 2004, were identified. The hospital charts of these patients were reviewed. Outpatient office charts, clinic notes, pathology reports and endoscopy reports were also reviewed.RESULTS: One hundred ninety-three patients were diagnosed withH pyloriby gastric biopsy in 2004. Of the 193 patients, 143 (74%) were outpatients and 50 (26%) were inpatients. Overall, 89% of patients received treatment forH pylori. Ninety-two per cent of outpatients were treated, while only 60% of inpatients received treatment (P<0.001). Among the inpatients, the pathology report was available in 40% of the cases before the patient was discharged from the hospital. After discharge from the hospital, 30% of inpatients received appropriate treatment and follow-up. There was no significant difference in treatment whether the patient was admitted to a medical or a nonmedical service.CONCLUSION:H pyloriis treated relatively poorly in inpatients compared with outpatients. Results of the present study reveal opportunities to improve delivery of care for inpatients on a number of different levels. More research is needed to ensure safety, effectiveness and timeliness in the test result management process.

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