scholarly journals Effect of zinc therapy in remission of pediatric nephrotic syndrome

2017 ◽  
Vol 4 (6) ◽  
pp. 2036
Author(s):  
Dinesh Kumar ◽  
Priyanka Arya ◽  
Indra Kumar Sharma ◽  
Mukesh Vir Singh
Keyword(s):  
Nephrotic Syndrome ◽  
Hospital Stay ◽  
Steroid Therapy ◽  
Primary Outcome ◽  
Total Duration ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Duration Of Hospital Stay ◽  
Randomized Control

Background: Zinc has been used in diarrhea since long but their efficacy in nephrotic syndrome still requires evidences. The objectives of this study were to determine the effect of Zinc in nephrotic syndrome among the children in rural population.Methods: Randomized control trial. We included 60 children of age group 6 months - 15 years diagnosed as nephrotic syndrome and fulfilling the inclusion criteria. All children were given standard steroid therapy for duration depending on initial or relapse cases while intervention arm (n=30) were given zinc syrup at the dose 10 mg for less than 1 year and 20 mg for more than 1 year for 14 days apart from standard steroid therapy. Duration of remission in both the groups was measured as primary outcome while secondary outcome was duration of hospital stay in both control and study group.Results: Mean number of days taken in remission in study group was 11.8±3.96 days and in control group 18.3±5.14 days (p <0.001). Total duration of study in hospital in study group was 13.07±4.86 days and in control group was 20.50±7.06 days (p <0.001).Conclusions: Zinc significantly reduced the duration of hospital stay and remission in children suffering from nephrotic syndrome. 

scholarly journals Evaluating efficacy of oral zinc as adjuvant therapy in acute diarrhea in children.

2020 ◽  
Vol 27 (08) ◽  
pp. 1626-1630
Author(s):  
Nathumal Maheshwari ◽  
Nadeem Noor ◽  
Adnan Bashir ◽  
Bilawal Hingorjo ◽  
Arshad Ali ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Acute Diarrhea ◽  
Control Group ◽  
Study Group ◽  
Once Daily ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Control Study ◽  
Stool Volume

Objectives: To evaluate the efficacy of oral zinc as adjuvant therapy in acute diarrhea comparing frequency and volume of stool and duration of diarrhea in children. Study Design: Case Control study. Setting: Department of Paediatrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital, Karachi. Period: September 2017 to August 2018. Material & Methods: A sample of 200 children, age 5- 15 years, suffering from acute diarrhea was divided into control and cases (study group). Oral zinc therapy (20 mg once daily) was given 14 days and its efficacy was observed in terms of stool frequency, stool volume and duration of diarrhea. Variables were noted at 24 hours and 48 hours and on 7th day of hospitalization. Data was analyzed on SPSS statistical software (version 22.0) at 95% confidence interval (P≤ 0.05). Results: Mean ± SD age in control and study group was noted as 9.1± 5.43 years and 9.5±6.02 years respectively (P=0.053). 89% of children of study group were discharged on 3rd day of hospitalization compared to only 45% from control group.  Zinc treated study group shows significant decrease in frequency of loose stools, stool volume and lesser duration of hospital stay. Conclusion: Oral zinc therapy was effective in decreasing the frequency of loose stools and volume and lesser duration of hospital stay in children.

Economic and workload impact of therapeutic interchange of inhaler medications and nebulizer solutions

2020 ◽  
Vol 78 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Elizabeth Gonzalez ◽  
Jason Alan Glick ◽  
Guogen Shan ◽  
Jeffery N Talbot
Keyword(s):  
Hospital Stay ◽  
Community Hospital ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Medication Costs ◽  
Metered Dose ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Purpose To examine the financial impact of automatic formulary substitution of nebulization solutions for pressurized metered dose inhalers and dry powder inhalers and the effect of the automatic substitution initiative on respiratory care practitioner (RCP) workload at a community hospital. Methods A retrospective observational study was conducted in a 326-bed nonacademic community hospital. Adult patients who received respiratory medications and had an inpatient stay, were admitted for observation, or had an emergency room visit from December 2016 through February 2017 (the control group) or from December 2017 through February 2018 (the study group) were included in the analysis. The primary outcomes were the cost of respiratory medications per hospital stay and the number of RCP visits per hospital stay. The secondary outcome was the cost of wasted doses per hospital stay. Results A total of 3,766 patients were included in the study: 2,030 in the study group and 1,736 in the control group. The mean cost of respiratory medications per hospital stay was significantly lower in the study group vs the control group ($13.29 vs $36.48, P &lt; 0.001). The mean number of RCP visits per hospital stay was also statistically lower in the study group vs the control group (11.6 vs 12.9, P = 0.04). The mean cost of wasted doses was significantly lower in study group vs the control group ($0.25 vs $22.91, P &lt; 0.001). Conclusion Automatic formulary substitution of nebulization solutions for inhaler medications significantly decreased medication costs without increasing the average number of RCP visits per hospital stay.

Low Bacterial Diet in Patients with Cytopenia after Intensive Chemotherapy for Hematological Malignancy: A Study of Efficacy and Costs.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5548-5548
Author(s):  
Harry C. Schouten ◽  
Peter Terporten ◽  
Maartje Harbers ◽  
Riette van Boxtel ◽  
Alphons Kessels ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Preventive Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Risk Of Infection ◽  
Outcome Parameter ◽  
Societal Costs ◽  
Gram Negative ◽  
To Receive

Abstract Patients with hematological malignancies who receive intensive chemotherapy usually develop a period of cytopenia, during which there is an increased risk of infection. In order to reduce the risk of infection several preventive measures have been adopted. Fundamentally, all of these measures were designed to prevent either acquisition of Gram negative rods or fungal pathogens from the environment, or the translocation of these potential pathogens across the mucosal barrier of the gut. The evidence for the necessity of low bacterial diet as an infection preventive measure is weak. Therefore, in this randomized, controlled study the question whether normal hospital diet is equivalent in efficacy to low bacterial diets, given as an infection preventive measure during treatment of cytopenic patients, was addressed. Intestinal colonization by aerobic Gram negative rods and yeasts has been chosen as primary endpoint. In addition, the occurrence of infections and the total costs of hospital care have been documented, in order to identify potential cost savings by the use of either diet. The patients were randomized into two groups: one group (Study group) to receive antimicrobial prophylaxis (AP) and low-bacterial diet, the other (Control group) to receive the same AP and normal hospital diet. The primary outcome parameter is colonization of faeces with Gram-negative rods or Candida species. Degree of colonization was calculated as [∑ 10log (CFU/g feces)] x [duration of episode] /[number of days on which feces culture were taken]. Next, an analysis of variance was performed taking several factors into account, such as the use of antibiotics. As secondary outcome parameters all infections, and therapeutic use of antibiotics were registered; moreover, total societal costs were calculated for each patient starting at first hospitalization until 28 days after the last discharge. In the study group 10 patients were included and evaluable, in the control group 10 patients were included and 9 evaluable. The number of cycles studied, defined as the period from starting antibiotic prophylaxis until leukocyte counts had recovered to 1000 /mm3 or higher, was 21 in the study group, and 18 in the control group. The median number of days per cycle was 28 (range 17–43) days for the study group, and 34 (range 19–60) days for the control group (NS). Regarding the primary outcome parameter, gut colonization by yeasts or Gram negative rods, no statistically significant differences between treatment groups were observed. With respect to infections as secondary outcome parameter, neither the number of days with fever nor the number of days, during which antibiotics were administered therapeutically, was different between the study and control group of patients. The numbers of fungal infections were no cases of invasive aspergillosis (IA) in the study group, 2 episodes of possible aspergillosis in the control group, and in both groups one episode of candidemia. Regarding the total societal costs no statistically significant differences were measured between normal diet and low-bacterial diet. The results indicate that low-bacterial diet and normal hospital diet are equivalent regarding colonization with yeasts and Gram negative rods, infections and total societal costs.

scholarly journals Role of probiotics in clinical course and outcome of preterm neonates

2021 ◽  
Vol 8 (5) ◽  
pp. 854
Author(s):  
Ram Mohan G. ◽  
Majaz Ahmed Khan ◽  
Seshagiri G. ◽  
Pavithra V. ◽  
Ramya C.
Keyword(s):  
Breast Milk ◽  
Hospital Stay ◽  
Test Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Control Groups ◽  
Duration Of Hospital Stay ◽  
Randomized Control ◽  
And Control

Background: In a quest to improve the outcome of preterm neonates and to reduce neonatal mortality a lot of research has been done in the field of neonatology; one such intervention is the use of probiotics. We evaluated the role of probiotics in reducing the incidence and severity of NEC, sepsis, hyperbilirubinemia and in improving enteral feeds in preterms.Methods: A prospective randomized control trial was conducted in preterm neonates <37 weeks of gestation from December 2017 to November 2019. They were randomized into test and control groups. The neonates in the test group were fed with probiotics with breast milk twice daily till they reach full feeds. Babies in the control group were fed with breast milk alone. Various parameters were compared between two groups like incidence of NEC, sepsis etc.Results: Sixty preterm neonates were enrolled, 30 in the test group and 30 in the control group. The demographic and clinical variables were similar in both groups. The incidence of NEC and sepsis in the test group is less compared to the control group. Duration of phototherapy was less in test group (1.10.3 days) compared to control group (1.90.9 days). Duration of hospital stay in test group was less (8.92.1 days) compared to the control group (11.43.7 days).Conclusions: Prophylactic probiotics have a beneficial role in prevention of NEC and sepsis, reducing duration of phototherapy and duration of hospital stay in preterm neonates.

scholarly journals Randomized Control Trial of Kangaroo Mother Care in Low Birth Weight Babies at a Tertiary Level Hospital

2014 ◽  
Vol 34 (1) ◽  
pp. 18-23 ◽  
Author(s):  
N Acharya ◽  
RR Singh ◽  
NK Bhatta ◽  
P Poudel
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Hospital Stay ◽  
Randomized Control Trial ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Tertiary Level ◽  
Duration Of Hospital Stay ◽  
Randomized Control ◽  
Level Hospital

Introduction: This study was conducted to compare the effect of Kangaroo Mother Care (KMC) and conventional methods of care on weight gain, occurrence of hypothermia and apnea and duration of hospital stay among Low Birth Weight (LBW) babies. Materials and Methods: It was a randomized control trial conducted at a tertiary level hospital for a period of one year from June 2009 to May 2010. Total 126 stable LBW babies weighing less than 2000 gm and fulfilling inclusion criteria were included in the study. Neonates enrolled for the study were allocated to either KMC or control group using random number table. KMC group was subjected to Kangaroo mother care of at least six hours per day in not more than four sittings. In control group, babies were adequately clothed, covered and kept with their mother and if required were kept under radiant warmer. Recording of temperature in KMC group was done before, during and after KMC. In control group temperature was taken every 4 hours. Weighing of baby was done twice daily on electronic weighing scale. Results: Median daily weight gain (IQR) was 10 (6- 20) gm in KMC group as compared to 7 (0-10) gm in control group (p<0.001). Mean weight gain was 12.11±9.04 gm in KMC group as compared to 3.29±15.81 gm in control group (p<0.001). Incidence of hypothermia was more in control group (12.6%) as compared to KMC group (3.1%) (p=0.048). Duration of hospital stay was less in control group as compared to KMC group (p=0.015). Conclusion: LBW babies less than 2000 gm who receive KMC show better weight gain and have less incidence of hypothermia than those who do not receive KMC. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8960   J Nepal Paediatr Soc 2014;34(1):18-23

Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology

2021 ◽  
pp. neurintsurg-2021-017341
Author(s):  
Devin V Bageac ◽  
Blake S Gershon ◽  
Jan Vargas ◽  
Maxim Mokin ◽  
Zeguang Ren ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Anterior Circulation ◽  
Guide Catheter ◽  
Catheter Failure ◽  
Catheter Technology ◽  
Intracranial Vasculature

BackgroundMost conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.MethodsThis is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.ResultsEach study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0–2%, and 10.26% were deceased.ConclusionsTracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.

scholarly journals O26 Testing an intervention to reduce fatigue impact in inflammatory arthritis: design and outcomes of a single-arm feasibility study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Susan Bridgewater ◽  
Joe Lomax ◽  
Bryan Abbott ◽  
Jo Adams ◽  
Alice Berry ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Inflammatory Arthritis ◽  
Primary Outcome ◽  
Time Frame ◽  
Secondary Outcome ◽  
Control Group ◽  
Regression To The Mean ◽  
Intervention Delivery ◽  
Cognitive Behavioural ◽  
One To One

Abstract Background/Aims  Patients with inflammatory arthritis report that fatigue can be a challenging symptom to manage, with little support available. In response, we developed a brief one-to-one cognitive-behavioural manualised intervention, delivered by rheumatology health professionals (RHPs), to help patients manage their fatigue. Methods  We designed a single-arm feasibility study called FREE-IA (Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis). Patients were eligible if they were ≥18 years, had a clinician confirmed diagnosis of inflammatory arthritis, scored ≥6/10 on the BRAF NRS Fatigue Impact with fatigue that they considered recurrent, frequent, and/or persistent, and were not accessing support for their fatigue. Following training, RHPs delivered 2-4 one-to-one sessions to participants. The initial two core sessions were delivered face-to-face in clinic; participants then had the option of up to two further sessions, either in clinic, by telephone or online. We proposed delivering sessions 1 and 2 within two weeks of each other, and sessions 3 and 4 in the following two weeks. Baseline data were collected before the first session (T0), and outcomes at six weeks (T1) and six months (T2). The primary outcome was fatigue impact (BRAF NRS Fatigue Effect), collected by telephone. Secondary outcomes included fatigue severity, fatigue coping, multi-dimensional impact of fatigue, disease impact and disability and measures of therapeutic mechanism (self-efficacy, and perceived confidence and autonomy to manage health). These outcomes were collected by post. This study allowed us to test the feasibility and acceptability of RHP training, study design and materials, intervention delivery and outcome collection, ahead of a possible RCT to determine intervention effectiveness. Results  Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Four sessions were delivered by phone and none online. Session 2 was only delivered within the two-week time frame for 37% of participants attending both core sessions. Out of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 missing primary outcome responses and 27 missing secondary outcome responses. Results indicated improvements in all measures except disability at either T1 or T2, or both, with confidence intervals supporting an interpretation of improvement. Conclusion  We were able to design and deliver FREE-IA training to RHPs, deliver FREE-IA sessions to patients, and collect outcomes at three time points with low levels of attrition. Outcomes in all measures except disability were in a direction to suggest improvement at T1, T2, or both. Study numbers were small, there was no control group and regression to the mean was a possibility. However, outcomes were in the direction to cautiously suggest benefit, and there is evidence of promise of the intervention. A definitive RCT is the next step to test clinical and cost effectiveness of the intervention. Disclosure  S. Bridgewater: None. J. Lomax: None. B. Abbott: None. J. Adams: None. A. Berry: None. S. Creanor: None. P. Ewings: None. S. Hewlett: None. L. McCracken: None. M. Ndosi: None. J. Thorn: None. M. Urban: None. E. Dures: None.

Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Katrin Brück ◽  
Kirsten Jacobi ◽  
Tobias Schmidt
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Repeated Measures ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Severity Of Illness ◽  
Chronic Neck Pain ◽  
Secondary Outcome ◽  
Control Group ◽  
Industrialized Nations

BACKGROUND: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS: Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dR⁢M= 1.14; NPAD: dR⁢M= 0.51) and for the MT (VAS: dR⁢M= 1.15; NPAD: dR⁢M= 0.72). CONCLUSION: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.

Effect of the Modified Surgeon Assisted Bilateral Transversus Abdominis Plane Block on Time Required for First Analgesic Dose after Cesarean Section under Spinal Anesthesia: Randomized placebo-control

2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Mamdouh
Keyword(s):  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Interquartile Range ◽  
Transversus Abdominis ◽  
Secondary Outcome ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Tap Block

Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632

P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Karataş ◽  
B E Temiz ◽  
S Mumusoglu ◽  
H Yarali ◽  
G Bozdag
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Mean Difference ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Drop ◽  
Mean Size ◽  
The Mean ◽  
Respective Figure

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

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