scholarly journals Comparison of Tamoxifen and Clomiphene Citrate for Ovulation Induction in Women with Polycystic Ovarian Syndrome: A Prospective Study

2021 ◽  
Author(s):  
Sangita Sharma ◽  
Manisha Choudhary ◽  
Vikas Swarankar ◽  
Vaibhav Vaishnav
Keyword(s):  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
P Value ◽  
Ovulatory Cycle ◽  
Chi Square ◽  
Once Daily ◽  
Induction Of Ovulation ◽  
Group A ◽  
Group B ◽  
Estradiol Levels

Background: The purpose of this study was to compare the efficacy of tamoxifen and clomiphene citrate in induction of ovulation in women with PCOS and anovulation. Methods: In this prospective cohort study, 104 women with PCOS and primary infertility were enrolled after fulfilling the inclusion and exclusion criteria. The patients were allocated in two groups; group A (n=54) received tamoxifen 40 mg once daily (Days 3-7) and group B (n=50) received clomiphene citrate 100 mg once daily (Days 3-7). Serial ultrasounds were done till the administration of human chorionic gonadotropin (hCG). The ovulation and pregnancy rates in both groups were compared. The number of dominant follicles, estradiol levels, and endometrial thickness were also studied. Comparison was done using chi-square and student’s t-test and a p-value of less than 0.05 was considered statistically significant. Results: The number of dominant follicles and serum estradiol levels were significantly higher in group B (p<0.05), whereas the endometrial thickness was significantly more in group A (p<0.05). The ovulation rates were similar in both groups (66.6% vs. 70%, p=0.715). Pregnancy rate per treatment cycle and per ovulatory cycle was marginally higher in group A (14.81% and 22.22%, respectively), as compared to group B (14% and 20%, respectively), but the difference was not statistically significant (p>0.05). Conclusion: Tamoxifen and clomiphene citrate are both equally effective in induction of ovulation and achieving a pregnancy in women with PCOS.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

scholarly journals COMPARISON OF EFFICACY BETWEEN LETROZOLE AND CLOMIPHENE CITRATE IN FEMALES PRESENTED WITH INFERTILITY DUE TO POLYCYSTIC OVARIES.

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Sumreen Anjum ◽  
Afshan Ambreen ◽  
Munazzah Bashir ◽  
Asiya Nawaz Alvi ◽  
Aasma Hanif ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Local Population ◽  
P Value ◽  
Polycystic Ovaries ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a genetically heterogeneous syndrome in which females often have to confront with the issue of infertility. Medical management of PCOS is aimed at the treatment of anovulation and menstrual irregularity. Letrozole and clomiphene citrate are two successful drugs for management of PCOS but contradiction is present in literature that which drug is more effective. So we conducted this study to find more successful drug to be implemented in future in local population. Objective: To compare the efficacy of oral Letrozole versus Clomiphene Citrate in females diagnosed with infertility due to polycystic ovaries Subjects & Methods: This randomized control trial was conducted at department of Gynaecology & Obstetrics, Fatima Memorial Hospital, Lahore for 6 months (May to November 2020). The non-probability, consecutive Sampling was used. Informed consent and demographic data was noted. Then females were randomly divided in two group by using lottery method. Females in Letrozole group were prescribed 2.5-7.5 mg daily from Day 2-Day 6 of menstruation and females in clomiphene citrate group was prescribed 50-150 mg daily from Day 2-Day 6 of menses. Females were advised to visit after every cycle till 3months. On every visit transvaginal ultrasonography was done to assess presence of follicles and number and size of follicles and endometrial thickness. All the data was entered on SPSS version 20. Results: The mean age of the patients was 26.13±5.07 years in group A and 27.17±5.95 years in group B. After 3rd month, the mean endometrial thickness in group A was 8.45±0.58 mm and in group B was 7.45±0.58 mm, the mean follicle was 23.75±4.253 in group A while 20.38±6.154 in group B. The ovulation occurred in 48 cases in group A and in 29 cases in group B. The efficacy was achieved in 36 cases in group A and 16 cases in group B and the difference in both groups was statistically significant i.e. p-value=0.000. Conclusion: Thus the Letrozole has significantly higher efficacy as compared to Clomiphene citrate. So from the results of our study we recommend letrozole as first line treatment for the management of PCOS. Keywords: Polycystic ovarian syndrome, PCOS, Letrozole, Clomiphene Citrate, Efficacy, Infertility

scholarly journals Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

2020 ◽  
Vol 27 (12) ◽  
pp. 2541-2547
Author(s):  
Muhammad Arif ◽  
Sabih Nofal ◽  
Ahsan Khan ◽  
Mariam Tariq Awana ◽  
Anum Arif
Keyword(s):  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Male Predominance ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
Group B ◽  
Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Erectile Function ◽  
T Test ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

scholarly journals A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

2019 ◽  
Vol 8 (6) ◽  
pp. 2487
Author(s):  
Ashok Verma ◽  
Shivani Sharma ◽  
Suresh Verma ◽  
Pankaj Sharma ◽  
Tenzin Tsamo Tenga ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Human Menopausal Gonadotropin ◽  
Multiple Gestation ◽  
Group A ◽  
Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle.  Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

scholarly journals Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

2021 ◽  
pp. 296-302
Author(s):  
Obaid Ul Haseeb ◽  
Haris Rashid ◽  
Afrin Ahmed ◽  
Mir Arsalan Ali ◽  
Shakil Alam ◽  
...  
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Open Approach ◽  
Chi Square ◽  
Closed Technique ◽  
Chi Square Test ◽  
Group A ◽  
Classic Technique ◽  
Group B ◽  
Surgery Department

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

scholarly journals HEMORRHOIDECTOMY;

2017 ◽  
Vol 24 (09) ◽  
pp. 1316-1321
Author(s):  
Shibber Ahmed ◽  
Ishtiaq Ahmad ◽  
Humayun Amjid ◽  
Aamir Furqan
Keyword(s):  
Hospital Stay ◽  
Severe Pain ◽  
Conventional Technique ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Post Operative Pain ◽  
Group A ◽  
And Gender ◽  
Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

scholarly journals COMPARISON OF OVULATION INDUCTION LETROZOLE AND CLOMIPHENE CITRATE IN SUBFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

2021 ◽  
Vol 71 (5) ◽  
pp. 1844-47
Author(s):  
Amna Shafiq ◽  
Rabiya Akbar ◽  
Uzma Urooj ◽  
Sadaf Zohra ◽  
Shazia Afzal ◽  
...  
Keyword(s):  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Military Hospital ◽  
P Value ◽  
Polycystic Ovaries ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome ◽  
Fertile Women

Objective: To compare the ovulation induction of letrozole and clomiphene citrate in sub-fertile women with polycystic ovarian syndrome. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jun 2018 to Aug 2019. Methodology: A total of 116 married sub-fertile women with polycystic ovarian syndrome, 16-40 years of age were included. Patients with previous surgery related to genital tract, hypothyroidism and chronic renal failure were excluded. Letrozole 5.0mg daily from Day 5-9 of menstruation was prescribed to group A women and clomiphene citrate 100 mg daily from Day 5-9 of menses was given to group B women. Results: In group A and in group B, mean age was 29.78 ± 4.71 years and 29.95 ± 4.22 years respectively. Most of the patients 59 (50.86%) were between 18-30 years of age. Mean duration since marriage was 4.23 ± 1.42 years. Mean body mass index was 29.71 ± 2.65 kg/m2. Frequency of ovulation of clomiphene citrate and letrozole in sub-fertile women with polycystic ovaries was 28 (42.28%) versus 42 (72.41%) respectively (p-value=0.008). Conclusion: This study concluded that ovulation induction of letrozole is better than clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.

scholarly journals Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
P Value ◽  
Chi Square ◽  
Vas Score ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

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