scholarly journals A randomized control study of titrated and oral misoprostol solution for induction of labor at term

2021 ◽  
Vol 10 (11) ◽  
pp. 4206
Author(s):  
Barbie Sharma ◽  
Tapasya Dhar ◽  
Sunita Goyal
Keyword(s):  
Controlled Trial ◽  
Tertiary Care ◽  
Induction Of Labor ◽  
Drop Out ◽  
Secondary Outcome ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Oral Misoprostol ◽  
Group A ◽  
Group B

Background: Quest for an induction method with safety, efficacy, feasibility, low cost, and patient preference is a constant pursuit for all obstetricians. Oral misoprostol is one such method which has been shown to be effective in achieving vaginal birth and has been recommended by WHO (2011) and FIGO (2012) for induction of labor. This study aimed to evaluate effectiveness and safety of hourly titrated oral misoprostol solution in comparison with two hourly static-dose oral misoprostol solution for induction of labor at term.Methods: Single centre interventional single-blinded randomized controlled trial conducted in a tertiary care centre in Ludhiana. 264 term pregnant women were randomly given titrated (group A) or static oral misoprostol solution (group B) till the onset of active labor. Induction to delivery time was the primary outcome measure while the secondary outcome measures pertained to efficacy and safety of the regimens.Results: 268 women were randomized, 4 patients were excluded from analysis because of drop out, leaving 264 women for intention to treat analysis. The mean interval between induction and delivery was 16.19±10.48 hours in group A and 15.28±8.34 hours in group B (p>0.10, NS). 71 women (53.8%) in group A and 72 women (54.5%) in group B had vaginal delivery within 24 hours (p>0.10, NS). 40.9% women in group B required more than 8 hours to receive the required number of doses as compared with 8.3% women in dose group A (p<0.01, SS). Oxytocin requirement was significantly higher in group A (76.5%) as compared to group B (59.8%) (p<0.05, SS). Incidence of fetal and maternal complications, rate of cesarean section and instrumental delivery was comparable between the two groups (p>0.10, NS).Conclusions: Titrated oral misoprostol, considering its efficacy, safety and time saving is comparable to WHO recommended static oral misoprostol.

A COMPARATIVE STUDY OF SAFETY & EFFICACY OF ORAL MISOPROSTOL VERSUS OXYTOCIN IN PREVENTION OF POSTPARTUM HAEMORRHAGE

2021 ◽  
pp. 73-74
Author(s):  
Dipali Maurya ◽  
Anju Sharma ◽  
Megha Agrawal
Keyword(s):  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Low Risk ◽  
Tertiary Care Centre ◽  
Oral Misoprostol ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVE: To compare oral misoprostol with intramuscular oxytocin in prevention of postpartum haemorrhage in low risk vaginal birth in a tertiary care centre. METHOD: In a prospective , open label controlled trial, 60 women were randomly allocated to 2 groups. Gr A – 10 units oxytocin i.m Gr B - 600µg misoprostol orally within 1 minute of delivery. The outcome measured was blood loss within 1 hour and 24hrs of delivery. RESULTS: The mean blood loss in 1 hour post delivery was 151.14 ±12.40ml in Group A and 149.82±10.36 ml in Group B. The mean blood loss within 24hrs after delivery was 218.59 ±33.63 ml in Group A and 230.11±31.82 ml in Group B. There was no signicant difference between the groups in terms of blood loss within1 hr and 24 hrs of delivery. CONCLUSION: oral misoprostol 600μg is as effective as intramuscular oxytocin 10IU in the prevention of PPH in low risk vaginal delivery.

scholarly journals Induction of Labor Using Misoprostol With or Without Mifepristone in Intrauterine Deat

2014 ◽  
Vol 52 (194) ◽  
pp. 785-790 ◽  
Author(s):  
Ajay Agrawal ◽  
Pritha Basnet ◽  
Achala Thakur ◽  
Pappu Rizal ◽  
Rubina Rai
Keyword(s):  
Fetal Death ◽  
Controlled Trial ◽  
Induction Of Labor ◽  
Intrauterine Fetal Death ◽  
Secondary Outcome ◽  
Group A ◽  
Pre Treatment ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Rapid Expulsion

Introduction: Rapid expulsion of fetus in intrauterine fetal death is usually requested without any medical grounds for it. So an efficient, safe method for induction of labor is required. The objective of this study is to determine if pre-treatment with mifepristone followed by induction of labor with misoprostol in late intrauterine fetal death is more efficacious. Methods: We conducted a randomized controlled trial in 100 patients in B.P.Koirala Institute of Health Sciences, Nepal from June 2011 to May 2013. Group A women received single oral dose of 200 mg mifepristone, followed by induction with vaginal misoprostol after 24 hours. Group B women were induced only with vaginal misoprostol. In each group, five doses of misoprostol was used four hourly. If first cycle was unsuccessful, after break of 12 hour, second course of misoprostol was started. The primary outcome was a measure of induction to delivery time and vaginal delivery within 24 hours. Secondary outcome was to measure need of oxytocin and complications. Results: Maternal age, parity and period of gestation were comparable between groups. Number of misoprostol dose needed in group A was significantly less than group B. Mann Whitney U test showed, women in group A had significantly earlier onset of labor, however total induction to delivery interval was not significant. In group A, 85.7% delivered within 24 hours of first dose of misoprostol while in group B 70% delivered within 24 hours (p=0.07). More women in Group B required oxytocin. Conclusions: Pretreatment with mifepristone before induction of labor following late intrauterine fetal death is an effective and safe regimen. It appears to shorten the duration of induction to onset of labor.  Keywords:  induction of labor; intrauterine fetal death; mifepristone; misoprostol. 

scholarly journals Role of medical expulsive therapy in lower ureteral calculus

2018 ◽  
Vol 5 (10) ◽  
pp. 3234
Author(s):  
Rohit G. Rangaiah ◽  
Ananth J. Kamath ◽  
Ashok Kumar Saini
Keyword(s):  
Controlled Trial ◽  
Tertiary Care ◽  
Control Group ◽  
Ureteral Calculus ◽  
Tertiary Care Centre ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Group A ◽  
Group B

Background: Urolithiasis is a chronic disease with a significant burden on the healthcare system. The aim of this study was to evaluate the role of medical expulsive therapy (tamsulosin alone or in combination with deflazacort) in the treatment of lower ureteric calculi.Methods: This was a prospective, randomized, controlled trial conducted at a tertiary care centre between November 2015 and October 2017. Patients aged more than 18 years solitary ureteral calculus 5-10 mm in size, located at distal ureter were randomized (1:1:1) to receive tamsulosin 0.4 mg once-daily (OD), deflazacort 6 mg twice-daily (BD) and analgesic OD (Group A); tamsulosin 0.4 mg and analgesic OD (Group B); or only analgesic OD (Group C, control Group) for 7 days. The treatment duration was extended to 28 days or until the expulsion of stone. Patients were followed-up weekly during the treatment period.Results: A total of 105 patients were enrolled in the study. Overall, 51.5% of patients in Group A, 48.5% of patients in Group B and 54.3% of patients in Group C had calculus size 7-10 mm. Patients allocated to Group A (80%) and Group B (74.3%) showed higher stone expulsion rate as compared to those in Group C (48.6%).  The mean time taken for stone expulsion was around 12 days in Group A, whereas around 15 days in Group B and C.Conclusions: The combination of tamsulosin and deflazacort resulted in higher stone expulsion rate in patients with lower ureteral calculus.

scholarly journals Assessment of postoperative analgesia after intraperitoneal instillation of lornoxicam in laparoscopic appendectomy: a randomized study

2018 ◽  
Vol 5 (8) ◽  
pp. 2846
Author(s):  
Anil Kumar ◽  
Rekha Kumari ◽  
Sushil Kumar ◽  
Pragati Raj
Keyword(s):  
Postoperative Pain ◽  
Normal Saline ◽  
Controlled Trial ◽  
Preoperative Evaluation ◽  
Randomized Study ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Intraperitoneal Instillation ◽  
Group A ◽  
Group B

Background: The laparoscopic surgeries though results in less postoperative pain it is not a pain-free procedure and early postoperative pain is the most dominant complaint which requires strong analgesia. This study assessed post-operative analgesia after intraperitoneal instillation of lornoxicam in laparoscopic appendicectomy.Methods: This single blind randomized controlled trial was done in a tertiary care Centre of Patna from January 2016 to December 2016. A total of 60 patients scheduled for laparoscopic appenticectomy were randomly assigned into two groups of 30 each (Group A and B) using computer generated random numbers. Patients in group A received intraperitoneal instillation of 8 mg lornoxicam (Diluted in 100 ml of normal saline) and in group B patients received 100 ml of intraperitoneal normal saline. During the post-operative period pain and requirement of analgesia were assessed.Results: The demographic characteristics, clinical presentation and preoperative evaluation for vitals was comparable in group A and B. The mean VAS score was significantly low in group A compared to group B at fourth, sixth, eight and twelfth hour interval (p<0.050). In patients with group B, the requirement of analgesia was high (53.33%) compared to group A (33.33%) (p=0.118).Conclusions: The intraperitoneal instillation of lornoxicam is simple analgesic technique that reduces the pain without adverse effects compared to normal saline.

scholarly journals Effect of Different Volumes on Pain Relief in Patient Receiving Fluoroscopic Guided Interlaminar Lumbar Epidural Steroid Injection

2018 ◽  
Vol 1 (21;1) ◽  
pp. 243-249 ◽  
Author(s):  
Jeetinder Kaur Makkar
Keyword(s):  
Pain Relief ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
Double Blind ◽  
Iodinated Contrast ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Background: Epidural steroids injections (ESI) are frequently used to treat lumbar radicular pain. Although different volume have been used for interlaminar ESI in adults, there is no controlled trial comparing the effect of different volumes on pain relief for the same dose of steroid . Objective: To compare the effect of increase in volume of epidural drug on pain relief in lumbar ESI . Study design: Randomized double blind trial Settings: Pain OR of a tertiary care centre Methods: Sixty patients were randomly allocated to 1 of 3 groups: Group A (4 mL), Group B (6 mL), and Group C (8 mL). Pain was evaluated using visual analog scale (VAS) and improvement in disability using modified Oswestry Disability Questionnaire scores (MODQS) at 2, 4, 8, 12, and 24 weeks. Patients having less than 50% pain relief from baseline received an additional epidural injection of the same volume with a maximum of 3 injections at least 15 days apart. The primary objective of the study was incidence of patients attaining more than 50% pain relief at 6 months. Secondary outcome included MODQS and pattern of spread of iodinated contrast on fluoroscopy. Results: At the end of 6 months, there was no significant difference in the effective pain relief between the 3 groups (Group A-16/22 (72.7%), Group B-15/20 (75%), Group C-13/18 (72.2%); P = 0.98, chi- square test). All groups demonstrated a significant reduction in mean VAS scores. There was no significant intergroup difference in VAS sores and MODQS at all the time intervals. The pattern of contrast spread did not differ between the 3 groups. Limitation: Not a placebo controlled trial Conclusions: An increase in volume of the injectate from 4 mL to 8 mL did not increase the efficacy of interlaminar ESI. Key words: Epidural steroid, volume, low back pain, interlaminar:

scholarly journals Utility of Gastric Lavage in Vigorous Neonates Delivered with Meconium Stained Liquor: A Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jatin Garg ◽  
Rupesh Masand ◽  
Balvir Singh Tomar
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Gastric Lavage ◽  
Secondary Outcome ◽  
Randomized Controlled ◽  
Group A ◽  
Feed Intolerance ◽  
Group B

Objective. To determine the incidence of feed intolerance in vigorous babies with meconium stained liquor (MSL) who received prophylactic gastric lavage as compared to those who were not subjected to this procedure.Design. Randomized controlled trial.Setting. Tertiary care teaching hospital.Participants/Intervention. 330 vigorous babies delivered with MSL and satisfying the predefined inclusion criteria were randomized either to receive gastric lavage (group A,n=165) or to not receive gastric lavage (group B,n=153). Clinical monitoring was subsequently performed and recorded in prestructured proforma.Results. There was no significant statistical difference (P>0.05) in incidence of feed intolerance in “lavage” and “no lavage” groups.Secondary Outcome. There was no evidence of secondary respiratory distress in either group. None of the patients in the lavage group exhibited adverse effects owing to the procedure.Conclusions. There is no role of prophylactic gastric lavage in neonates born with MSL.

scholarly journals A study of effect of oral PGE1 and cervical PGE2 on induction of labor and mode of delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2160
Author(s):  
Sukanya Mukherjee ◽  
H. Valson ◽  
Balaji K.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
P Value ◽  
Singleton Pregnancy ◽  
Outcome Indicators ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Induction of labor is one of the most important procedures done by the Obstetricians. Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium.Methods: 200 pregnant women with singleton pregnancy both nulliparous and multiparous, were included in the study at term gestation (>39weeks) with Bishop’s score <6, and reactive NST. The subjects were divided in to two groups Group A including patients who were given oral PGE1 - 50 mcg Tab, and Group B with cervical PGE2, 0.5 mg, gel. The outcome indicators were recorded in both Group A and Group B and analyzed. The mean time taken from induction to vaginal delivery in Group A was 628±67 minutes and in Group B was 839±118 minutes. Incidence of LSCS in Group B when compared to Group A (p value <0.005).Results: Incidence of LSCS in Primi’s in Group B compared to Primi’s in Group A was statistically significant (p value 0.009). Non-progression of labor was observed to be the major indication for LSCS in Group B. Meconium stained labor was found to be the major indication for LSCS in Group A.Conclusions: The study concludes that using 50 mcg oral misoprostol, is an effective and safe mode of induction of labor in comparison to PGE2 gel. Vaginal deliveries are more with the use of oral misoprostol and the induction to delivery interval is also lesser than that in cervical PGE2 use.

scholarly journals Evaluation of therapeutic effectiveness of vitamin D3 injections in common warts in a tertiary care centre

2019 ◽  
Vol 5 (3) ◽  
pp. 462
Author(s):  
Sushmalatha Banoth
Keyword(s):  
Vitamin D3 ◽  
Normal Saline ◽  
Tertiary Care ◽  
Treatment Session ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Multiple Modalities ◽  
Common Warts ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Warts or verrucae are the benign cutaneous manifestations caused by human papilloma virus. The treatment of wart possess a therapeutic challenge, as a result multiple modalities are existing for the treatment of cutaneous warts, which is cumbersome and may result in cosmetic disfigurement, chances of recurrences. The aim of the present study was to determine the resolution of common warts in response to vitamin D3 injections and to compare the resolution of common warts in the group receiving vitamin D3 with placebo group receiving normal saline.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were enrolled and divided into Group A- received lesional injection of 0.2 ml vitamin D3 every 3 weeks for 3 months for the improvement in the size of warts. Group B- received 0.2 ml of normal saline injections as a control. The maximum of three sessions were carried in both groups. Clinical assessment was done by photographic evaluation at baseline, before each treatment session, and after completion of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A, 76.92% (10) of the patients showed complete clearance of wart with vitamin D3 injection, while in group B 8% (1) of patients with normal saline showed partial response. This therapy was well tolerated except for the minimal side effects like pain, redness and swelling at the site of injection.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional Vit D3 injections may be a treatment option for warts, which has a good cosmetical acceptance and simple, well tolerated easily administrated in outpatient clinic rather than conventional treatment.</p>

scholarly journals EFFECTIVENESS OF NEURAL MOBILIZATION AND STRETCHING EXERCISE FOR THE MANAGEMENT OF SCIATICA

2014 ◽  
Vol 3 (2) ◽  
pp. 11-15
Author(s):  
Sidra Zahid ◽  
Ghazala Noor Nizami
Keyword(s):  
Conventional Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Tertiary Care ◽  
P Value ◽  
Below The Knee ◽  
Pain Disability ◽  
Before And After ◽  
Group A ◽  
Group B

OBJECTIVE To find out the effectiveness of neural mobilization and stretching exercise for the management of sciatica BACKGROUND Sciatica is described as pain, radiating to the leg below the knee joint and caused by irritation of the sciatic nerve or nerve trunk. There are many treatment options for the management of sciatica, including stretching exercise and neural mobilization. MATERIAL AND METHODS This study was a Randomized Controlled Trial. 94 patients from physical therapy OPD of tertiary care hospitals, were participated in this study. Hence, 47 patients were randomly allocated into each group A and B. Before and after the nine treatment sessions, both groups were assessed with VAS, SLR ROM and Quebec back pain disability scale. In group A, neural mobilization with conventional therapy (heat and TENS) was applied, while stretching exercise with same conventional therapy was applied to group B. RESULTS It was observed that both treatments were helpful in reducing the symptoms. The analysis showed significant improvement (p-value <0.05) in the SLR to 60.851o±6.86oand Quebec score to 23.617±3.125, after the stretching exercise. Hence, both treatments were equally effective in reducing pain (p-value >0.05). CONCLUSION Stretching exercise is more effective in the improvement of SLR and disability. Furthermore, both techniques are helpful in the management of pain. KEY WORDS Sciatica, Stretching, Neural Mobilization, Straight Leg Raising, Visual Analogue Scale, TENS.

scholarly journals A comparative study of efficacy and safety of glucosamine plus chondroitin sulphate versus rosehip as add on therapy to NSAIDs in patients suffering from osteoarthritis

2018 ◽  
Vol 7 (11) ◽  
pp. 2254
Author(s):  
Kiranpreet Kaur ◽  
Anjleen Kaur ◽  
Prabhsimran Singh ◽  
Amandeep Singh Bakshi
Keyword(s):  
Comparative Study ◽  
Chondroitin Sulphate ◽  
Tertiary Care ◽  
Efficacy And Safety ◽  
Tertiary Care Centre ◽  
Open Label ◽  
Significant Difference ◽  
Group A ◽  
Efficacy Parameters ◽  
Group B

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.

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