scholarly journals Comparative feasibility of two World Health Organization partographs to predict prolonged labour: a randomized control trial

2019 ◽  
Vol 6 (4) ◽  
pp. 167
Author(s):  
Mohini Rajoriya ◽  
Ruchi Kalra
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Randomized Control Trial ◽  
Controlled Trial ◽  
World Health ◽  
P Value ◽  
Obstructed Labor ◽  
Prolonged Labor ◽  
Randomized Control ◽  
Latent Phase

<p class="abstract"><strong>Background:</strong> One of the major causes of maternal mortality is obstructed labor. Identification of abnormal labor at earliest and timely management can prevent prolonged labor and significantly reduce its sequel. Partograph is a useful tool in hands of labor care givers to monitor labor course. The study was done to compare feasibility of two WHO partographs a composite partograph including the latent phase with a simplified one without the latent phase to predict prolonged labor in randomized control trial.</p><p class="abstract"><strong>Methods:</strong> A randomized controlled trial, with parallel arm design was conducted. Sample size was calculated as 404 pregnant women .They were randomly categorized in two groups, each group having 202 participants.</p><p class="abstract"><strong>Results:</strong> labor had crossed the alert line in 108 (53.4%) cases monitored by composite partograph and 38(18.8%) cases monitored with simplified partograph. The calculated P value was &lt;0.0001. The odds ratio calculate was 4.95 and 95% confidence interval was 3.16 to 7.76. Labor crossing the action line was found in 16 (7.9%) in composite partograph whereas in simplified partograph, labor had crossed the action line in 18 cases in simplified group. Calculated P value was 0.72 (&gt;0.05). The odds ratio was 0.8793 and 95% confidence interval 0.43 to 1.77 which was not significant statistically .Most participants (70%) experienced difficulty with the composite partograph, but no participant reported difficulty while plotting the simplified partograph.</p><p class="abstract"><strong>Conclusions: </strong>WHO simplified partograph was found to be as good as WHO composite partograph in identifying maternal and perinatal outcomes and was more user friendly.</p>

A Comparative Study of e-Partogram with Conventional Partogram

2016 ◽  
Vol 8 (4) ◽  
pp. 319-323
Author(s):  
Priyanka H Krishnaswamy ◽  
Achal Shetty ◽  
Padmalatha Venkatraman
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Apgar Score ◽  
Statistical Tests ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
World Health ◽  
P Value ◽  
Obstructed Labor ◽  
Secondary Outcomes

ABSTRACT Introduction Obstructed labor remains an important cause of not only maternal death but also short- and long-term disability. Even though the partogram serves to assist in effective monitoring of the progress of labor and the condition of the mother and baby, its use in developing countries is limited. Aim To compare the reliability of mobile application-based e-partogram for feto-maternal monitoring in labor with the conventional World Health Organization (WHO) partogram. Setting A total of 40 patients in the delivery suite at Rangadore Memorial Hospital, Shankarapuram, Bengaluru. Design A randomized controlled trial. Materials and methods Study population was randomized into two groups of 20 patients each. Labor events, delivery, and baby details were randomly filled either in the modified WHO partogram or in the e-partogram app. Outcome measures The primary outcomes analyzed were regularity of monitoring of maternal and fetal parameters, consultant supervision of labor, and retrospective filling of data. Secondary outcomes studied were the mode of delivery, blood loss up to 24 hours of delivery, 1 and 5 minutes neonatal APGAR score. Statistical analysis used Averages and proportions were calculated for the study and appropriate statistical tests like chi-square test, Fisher's exact test, Z-test, and Levene's test for equality of variances were done using MiniTab version 16. Results The regularity of monitoring maternal parameters (p-value of 0.001) and consultant supervision (p-value of 0.000) was significantly higher using the e-partogram compared with those whose labor was monitored using the paper partogram. Retrospective filling of the partogram was higher in the modified WHO (on-paper) partogram (p-value of 0.000). The secondary outcomes — mode of delivery, blood loss up to 24 hours of delivery, 1 and 5 minutes neonatal APGAR score — were not significantly different between the two groups (p-value > 0.05). Conclusion The e-partogram can provide safe births by increasing the quality and regularity of important observations on the progress of labor and early detection of problems by consultants, which can lead to better decision-making and earlier referrals. It also makes remote monitoring of labor possible, promotes logical human resource allocation, supports recordkeeping, and is thus a pragmatic way to reduce both maternal and newborn mortality and morbidity. How to cite this article Krishnaswamy PH, Venkatraman P, Shetty A. A Comparative Study of e-Partogram with Conventional Partogram. J South Asian Feder Obst Gynae 2016;8(4):319-323.

scholarly journals Efficacy of two-week therapy with doxycycline-based quadruple regimen versus levofloxacin concomitant regimen for helicobacter pylori infection: a prospective single-center randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marouf Alhalabi ◽  
Mohammed Waleed Alassi ◽  
Kamal Alaa Eddin ◽  
Khaled Cheha
Keyword(s):  
Clinical Trial ◽  
Helicobacter Pylori ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Helicobacter Pylori Infection ◽  
First Line ◽  
Link Type ◽  
Syrian Population

Abstract Background Antibiotic-resistance reduces the efficacy of conventional triple therapy for Helicobacter Pylori infections worldwide, which necessitates using various treatment protocols. We used two protocols, doxycycline-based quadruple regimen and concomitant levofloxacin regimen. The aim was to assess the effectiveness of doxycycline-based quadruple regimen for treating Helicobacter Pylori infections compared with levofloxacin concomitant regimen as empirical first-line therapy based on intention-to-treat (ITT) and per-protocol analyses (PPA) in Syrian population. Settings and design An open-label, randomised, parallel, superiority clinical trial. Methods We randomly assigned 78 naïve patients who tested positive for Helicobacter Pylori gastric infection, with a 1:1 ratio to (D-group) which received (bismuth subsalicylate 524 mg four times daily, doxycycline 100 mg, tinidazole 500 mg, and esomeprazole 20 mg, each twice per day for 2 weeks), or (L-group) which received (levofloxacin 500 mg daily, tinidazole 500 mg, amoxicillin 1000 mg, and esomeprazole 20 mg each twice per day for two weeks). We confirmed Helicobacter Pylori eradication by stool antigen test 8 weeks after completing the treatment. Results Thirty-nine patients were allocated in each group. In the D-group, 38 patients completed the follow-up, 30 patients were cured. While in the L-group, 39 completed the follow-up, 32patients were cured. According to ITT, the eradication rates were 76.92%, and 82.05%, for the D-group and L-group respectively. Odds ratio with 95% confidence interval was 1.371 [0.454–4.146]. According to PPA, the eradication rates were 78.9%, and 82.05% for the D-group and L-group respectively. The odds ratio with 95% confidence interval was 1.219 [0.394–3.774]. We didn’t report serious adverse effects. Conclusions Levofloxacin concomitant therapy wasn’t superior to doxycycline based quadruple therapy. Further researches are required to identify the optimal first-line treatment for Helicobacter-Pylori Infection in the Syrian population. Trial registration We registered this study as a standard randomized clinical trial (Clinicaltrial.gov, identifier-NCT04348786, date:29-January-2020).

Translational delivery of Cool Little Kids to prevent child internalising problems: Randomised controlled trial

2017 ◽  
Vol 52 (2) ◽  
pp. 181-191 ◽  
Author(s):  
Jordana K Bayer ◽  
Ruth Beatson ◽  
Lesley Bretherton ◽  
Harriet Hiscock ◽  
Melissa Wake ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Controlled Trial ◽  
Secondary Outcomes ◽  
Randomised Controlled ◽  
Internalising Problems

Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.

scholarly journals Hypoxic Status Is Associated With The Intensity Of Hypoxia Inducible Factor (Hif)-1α Expression In A Premature Placenta

2021 ◽  
Vol 17 (1) ◽  
pp. 1-11
Author(s):  
Kartini Edwin
Keyword(s):  
Confidence Interval ◽  
Premature Birth ◽  
Odds Ratio ◽  
Critical Role ◽  
Hypoxia Inducible Factor ◽  
Biological Materials ◽  
P Value ◽  
Live Births ◽  
Infant Morbidity ◽  
The Relationship

Prematurity refers to live births before 37 weeks of gestation and associated with infant morbidity/mortality. Activation of HIF during the final pregnancy phase is believed to play a critical role in the pathogenesis of premature birth and other pregnancy disorders. This study aimed to analyze the relationship between hypoxicstatus and the intensity of HIF-1α expression in a premature placenta.Stored biological materials premature placenta (paraffin blocks) was used in this study. Thirtyone samples of placental hypoxia (H) and 28 samples of premature placental non-hypoxia (N) as controls, were selected non-random consecutively. Subsequently, immunohistochemistry was performed to analyze HIF-1α expression. TheChi-square testwas used to analyze the data and a p-value <0.05 was considered statistically significant.Moderate to strong intensity of HIF-1α expressionwas observed in 58% of hypoxic placenta samples, whereas most of non-hypoxic placental samples(86%) did not expressed or expressed weaklyHIF-1α.There was a significant correlation between the intensity of HIF-1α expression and placental hypoxia (p <0.05) and Odds Ratio (OR) value was 8.31 with a 95% confidence interval (2.32-29.77). The conclusion shows that hypoxic status is associated with intensity of hypoxia inducible factor (HIF)-1α expression in a premature placenta.

scholarly journals Latrine availability and associated factors among Religious institution in Northern Ethiopia, 2018

2019 ◽  
Author(s):  
Mulugeta Woldu Abrha ◽  
Kiros Demoz Ghebremedhin ◽  
Tesfay Teklemariam Weldeslasie
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Associated Factors ◽  
P Value ◽  
Northern Ethiopia ◽  
Religious Institutions ◽  
Religious Institution ◽  
Tigray Region ◽  
Availability Analysis ◽  
Sanitation And Hygiene

Abstract Background Religious institutions found at the community, not only uphold belief and cultural values but also as a force for positive change and development. Improved sanitation and hygiene is crucial in these institutions to decrease preventable infections due to unsanitary conditions. However, there are no studies among religious institution on availability of latrine. So this study was conducted to assess the latrine availability and associated factors among religious institution in Tigray Region, Ethiopia.Method Institution based cross – sectional study design was conducted in Tigray Region, Northern Ethiopia. Multi-stage sampling was used to sample 385 religious institutions. Data was collected using pre tested, structured questionnaire and observation checklist. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to determine the predictors of latrine availability. Analysis was carried out using SPSS 20 TM - software package.Results In this study latrine availability was 32.8%. And was significantly affected by currently saved money towards having a latrine (Adjusted Odds ratio (AOR): 0.32, 95% confidence interval (CI) [0.25, 0.42]), any messages seen, heard or received on sanitation and hygiene (AOR: 0.43, 95% CI [0.38, 0.51]) and place where messages seen, heard, received (AOR: 2.95, 95% CI [1.11, 5.55]).Conclusion Availability of latrine was very low when compared to the national target of 100% among the religious institution and was affected by the currently saved money towards having a latrine, any messages seen, heard or received on sanitation and hygiene and place where the messages receive. Information regarding latrine availability should be provided to the community visiting religious institutions through available channels and practical models promotion.

scholarly journals Efektivitas Klinis Ofloksasin Topikal Dibanding Ciprofloksasin Oral Pada Terapi Otitis Media Supuratif Kronik Aktif

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Deasy Mediawaty ◽  
Pujo Widodo ◽  
Dian Ayu Ruspita
Keyword(s):  
World Health Organization ◽  
Otitis Media ◽  
Randomized Control Trial ◽  
World Health ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Randomized Control ◽  
Health Organization ◽  
Per Oral

Latar belakang : Otitis media kronik atau sering disebut Otitis Media Supuratif Kronik (OMSK) adalah otitis media yang berlangsung > 12 minggu. Prevalensi OMSK di seluruh dunia sebanyak 65-330 juta dan 60% di antaranya menderita kurang pendengaran yang signifikan. Angka kejadian OMSK aktif mencapai 3,8% dari pasien THT-KL. Gejala OMSK aktif berupa banyaknya discaj, kurang pendengaran, nyeri, pusing berputar, telinga tidak nyaman. Tanda OMSK aktif berupa discaj di liang telinga, perforasi membran timpani, dan gangguan pendengaran. World Health Organization (WHO) mencanangkan strategi untuk mengatasi OMSK secara serius berkaitan dengan komplikasi yang dapat disebabkan. Pilihan terapi medikamentosa yang tepat diperlukan untuk mengatasi OMSK aktif. Ofloksasin topikal dan ciprofloksasin oral adalah antibiotik golongan fluorokuinolon yang banyak digunakan. Efektivitas diantaranya dibuktikan dengan perbaikan gejala dan tanda klinis. Tujuan : Membuktikan efektifitas ofloksasin topikal, ciprofloksasin oral dan efektifitas ofloksasin topikal dibanding ciprofloksasin oral terhadap perbaikan gejala dan tanda klinis. Metode :  Penelitian intervensi dengan rancangan pretest and posttest control group design, randomized control trial Klinik THT-KL BKIM Semarang pada bulan Juni-Agustus 2016. Penderita OMSK aktif dilakukan anamnesis lalu dilakukan pemeriksaan fisik dan pemeriksaan pendengaran dilanjutkan randomisasi. Penderita diberi ofloksasin topikal 10 tetes/12 jam atau ciprofloksasin tablet 500 mg/12 jam per oral. Hari ke 4, 10 dan 14 setelah terapi penderita kontrol. Analisis uji komparatif menggunakan uji parametrik dan non parametrik. Hasil : Jumlah subyek penelitian 108 orang ; ofloksasin topikal 54 orang (50%) dan ciprofloksasin oral 54 orang  (50 %). Gejala dan tanda klinis setelah terapi lebih rendah dibanding sebelum terapi pada kelompok ofloksasin topikal dan ciprofloksasin oral dengan nilai kemaknaan p < 0,05. Gejala klinis kelompok ofloksasin lebih baik dibanding ciproloksasin secara bermakna (p<0,05). Tanda klinis kedua kelompok terdapat perbedaan yang tidak bermakna (p>0,05). Simpulan : Ofloksasin topikal dan ciprofloksasin oral terbukti efektif memperbaiki gejala dan tanda klinis penderita OMSK aktif. Ofloksasin topikal efektif memperbaiki gejala klinis dibandingkan ciprofloksasin oral. Kata kunci : Otitis media supuratif kronik, ofloksasin, ciprofloksasin, gejala dan tanda klinis

scholarly journals Preparing for a randomized controlled trial: Strategies to optimize the design of a cardiovascular surgical patient education intervention.

2021 ◽  
Author(s):  
Suzanne Fredericks ◽  
Terrence M. Yau
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Education ◽  
Complex Intervention ◽  
Randomized Control Trial ◽  
Controlled Trial ◽  
Surgical Patient ◽  
Education Programs ◽  
Randomized Controlled ◽  
Clinical Methods ◽  
Randomized Control

Randomized controlled trial (RCT) designs are standardized to control for bias and allow for replication. Conducting RCTs is generally straightforward when dealing with interventions that contain a single component, such as a drug. However, interventions that do not contain single components, such as a patient education programs, are more difficult to standardize, as they contain multiple elements, which may act independently or interdependently of each other. The purpose of this discursive clinical methods paper is to describe and explain a methodology that can be used to optimize the design of a complex intervention prior to its evaluation in a randomized control trial.

scholarly journals Preparing for a randomized controlled trial: Strategies to optimize the design of a cardiovascular surgical patient education intervention.

2021 ◽  
Author(s):  
Suzanne Fredericks ◽  
Terrence M. Yau
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Education ◽  
Complex Intervention ◽  
Randomized Control Trial ◽  
Controlled Trial ◽  
Surgical Patient ◽  
Education Programs ◽  
Randomized Controlled ◽  
Clinical Methods ◽  
Randomized Control

Randomized controlled trial (RCT) designs are standardized to control for bias and allow for replication. Conducting RCTs is generally straightforward when dealing with interventions that contain a single component, such as a drug. However, interventions that do not contain single components, such as a patient education programs, are more difficult to standardize, as they contain multiple elements, which may act independently or interdependently of each other. The purpose of this discursive clinical methods paper is to describe and explain a methodology that can be used to optimize the design of a complex intervention prior to its evaluation in a randomized control trial.

scholarly journals Increasing response rates to follow-up questionnaires in health intervention research: Randomized controlled trial of a gift card prize incentive

2017 ◽  
Vol 14 (4) ◽  
pp. 381-386 ◽  
Author(s):  
Amy J Morgan ◽  
Ronald M Rapee ◽  
Jordana K Bayer
Keyword(s):  
Randomized Controlled Trial ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Response Rate ◽  
Controlled Trial ◽  
Response Rates ◽  
Health Intervention ◽  
Randomized Controlled ◽  
Gift Card

Background/aims Achieving a high response rate to follow-up questionnaires in randomized controlled trials of interventions is important for study validity. Few studies have tested the value of incentives in increasing response rates to online questionnaires in clinical trials of health interventions. This study evaluated the effect of a gift card prize-draw incentive on response rates to follow-up questionnaires within a trial of an online health intervention. Method The study was embedded in a host randomized controlled trial of an online parenting program for child anxiety. A total of 433 participants were randomly allocated to one of two groups: (1) being informed that they would enter a gift card prize-draw if they completed the final study questionnaire (24-week follow-up) and (2) not informed about the prize-draw. All participants had a 1 in 20 chance of winning an AUD50 gift card after they completed the online questionnaire. Results The odds of the informed group completing the follow-up questionnaire were significantly higher than the uninformed group, (79.6% vs 68.5%, odds ratio = 1.79, 95% confidence interval = 1.15–2.79). This response rate increase of 11.1% (95% confidence interval = 2.8–19.1) occurred in both intervention and control groups in the host randomized controlled trial. The incentive was also effective in increasing questionnaire commencement (84.6% vs 75.9%, odds ratio = 1.74, 95% confidence interval = 1.07–2.84) and reducing the delay in completing the questionnaire (19.9 vs 22.6 days, hazard ratio = 1.34, 95% confidence interval = 1.07–1.67). Conclusion This study adds to evidence for the effectiveness of incentives to increase response rates to follow-up questionnaires in health intervention trials.

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

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