scholarly journals A Study of Ormeloxifene in Case of Dysfunctional Uterine Bleeding

Author(s):  
S. Grover ◽  
A. Chhabra ◽  
S. Bindu

<strong>Background:</strong>Menorrhagia accounts for 12% of all gynaecology consultations and is one of the most common causes of iron deficiency anaemia in females after nutritional anaemia.<p><strong>Objectives:</strong> To evaluate the efficacy and side effects of ormeloxifene in cases of dysfunctional uterine bleeding.</p><p><strong>Material and Methods:</strong> 30 women aged 28-46 years who attended the outpatient gynaecology department in a tertiary care hospital with complaint of heavy menstrual flow were recruited for the study. Two pretreatment baseline cycles were compared to the treatment cycles of ormeloxifene. The main outcomes measured were menstrual blood, blood haemoglobin levels and endometrial thickness in proliferative phase as studied by TVS. Data thus collected was compared and analysed statistically.</p><p><strong>Results:</strong> Total number of bleeding days per year decreased by 76%. Total no. of pads soiled per cycle decreased by 76.3%. All the patients reported disappearance of clots, 66.66% within 1 month of the treatment only. Dysmenorrhoea was relieved in 62.5% patients. Mean increase in Hb was 0.42g%.</p><p><strong>Conclusion:</strong> Ormeloxifene is very effective in improving all the parameters of blood loss in DUB including the no. of days of bleeding, no. of pads soiled and the passage of clots. Ormeloxifene has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule. In the peri-menopausal age group, drug is protective against breast malignancy and osteoporosis. Ormeloxifene has the potential to be an effective treatment for DUB and should always be considered amongst the treatment options.</p>

Author(s):  
Dr. Yogesh C. Parmar

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of dysfunctional  uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders. Methods: A retrospective study of randomly selected 70 cases of dysfunctional  uterine bleeding admitted during October 2006 to September 2007, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. Only cases of AUB due to non-structural causes were included. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months. Results: Most common age group presenting with DUB was 40–50 years  and mostly  belonged to low socioeconomic status. Most of the women were multiparous.  Polymenorrhagia and menorrhagia was most common presentation. Size of uterus is normal in 44 patients. Dilatation and curratage was  having the cure rate of 65.6% .Maximum number of patients (85%) was treated surgically and 15% got medical treatment. Conclusions: Dysfuntional uterine bleeding (DUB) now termed as Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.   Keywords   Menorrhagia, Dysfunctional uterine bleeding,Abnormal uterine bleeding Perimenopausal women, Endometrium


2018 ◽  
Vol 17 (1) ◽  
pp. 88-92
Author(s):  
Pal Subrata ◽  
Chakrabarti Srabani ◽  
Sinha Anuradha ◽  
Phukan Jyoti Prakash ◽  
Bose Kingshuk ◽  
...  

Introduction: Hysterectomy is the most commonly performed gynaecological surgery in India as well as in abroad. It is frequently done in myometrial and endometrial pathologies and rarely for other causes. Hysterectomy is definitive management for diseases like fibroid, adenomyosis, dysfunctional bleeding, prolapsed uterus and malignant lesions of uterus and adenexa. We aimed our study to observe incidence of different pathologies of uterus and other reproductive organs in hysterectomy specimens and retrospective correlation between clinical diagnosis and histopathological finding of hysterectomy cases.Materials and Methods: Retrospective data were collected from our routine histopathological laboratory. Detailed history, clinical examination and operative findings and provisional diagnosis of all 950 hysterectomy cases were recorded during study period of 2 years. Histopathological diagnosis was correlated with clinical and preoperative diagnosis.Observations: Abdominal hysterectomy (734 cases, 77.26%) was the most common route of approach during surgery. Common pre-operative diagnoses were fibroid uterus (32%), dysfunctional uterine bleeding (28.95%), uterine prolapsed (22.74%). Other causes included uterine polyps (1.6%), complications of pregnancy (2.74%), ovarian tumours (8.42%), cervical carcinomas (2.97%) etc. Common pathologies on histology were leiomyoma (32%), adenomyosis (20.32%), atrophic endometrium (17.26%) and endometrial pathology (8.95%).Discussion: Our study has been correlated with other studies of India and other south Asian countries. Most common indication of hysterectomy in our study is dysfunctional uterine bleeding (32%) but Gupta et al and Jha R et al found utero-vaginal prolapse as most common indication. Leiomyoma was the most common histology diagnosed in the present series. Clinical diagnosis was possible in 67.57% cases in our study similar to Khan et al (70.51%).Conclusions: Histopathological examination of hysterectomy specimens helps to detect the exact causes and underlined pathology.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.88-92


Author(s):  
Nikita Gandotra ◽  
Preeti Sharma ◽  
Abhinav Sharma ◽  
Syed Masuma Rizvi

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


2016 ◽  
Vol 20 (1) ◽  
pp. 11-15
Author(s):  
Jadab K Phukan ◽  
Gautom K Saharia ◽  
Rohini Goswami

ABSTRACT Background Dysfunctional uterine bleeding (DUB) is a major form of abnormal uterine bleeding, seen in at least 10% of all new outpatient department patients. The thyroid gland is known to play an important role in maintaining a healthy menstrual cycle. Aims To assess the thyroid hormone status in apparently euthyroid patients with DUB and to correlate it with incidence of DUB. Materials and methods Fifty DUB patients were selected on the basis of clinical history, examination, and relevant investigations. Equal numbers of age-matched women with normal menstrual cycle were taken as controls. Thyroid hormones, viz., thyroid-stimulating hormone, total triiodothyronine and tetraiodothyronine, were estimated by radioimmunoassay. Statistical analysis of the data was performed by using Microsoft Excel software. Results The most common menstrual abnormality was menorrhagia (48%) followed by metrorrhagia and polymenorrhea (14% each). Hypothyroidism was more prevalent among cases (85.7%) as compared with controls (14.3%). In patients with menorrhagia, 33.3% of patients had hypothyroidism. Conclusion Hypothyroidism occurs in DUB patients commonly. There is a need for mandatory thyroid screening in all patients with menstrual irregularities to help in early detection of the cause and treatment of DUB patients to avoid surgery. How to cite this article Phukan JK, Saharia GK, Goswami R. Thyroid Status in Patients with Dysfunctional Uterine Bleeding in a Tertiary Care Hospital of Assam. Indian J Med Biochem 2016;20(1):11-15.


Author(s):  
Rambabu Chennuru ◽  
Ramkumar Potnuru

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of abnormal uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders.Methods: A retrospective study of randomly selected 200 cases of abnormal uterine bleeding between 40–55 years of age during January 2018 to January 2019, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months.Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 60% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (21%) uterus was most common. Maximum number of patients (75%) was treated surgically and 20% got medical treatment.Conclusions: Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.


2019 ◽  
Vol 10 (4) ◽  
pp. 2687-2690
Author(s):  
Kothai Ramalingam ◽  
Atheena Gigi ◽  
Anu Sara Thomas ◽  
Abdul Mohsin Mootaparambil ◽  
Arul Balasubramanian

To study the drug utilization pattern and risk factor assessment on abnormal uterine bleeding in reproductive-aged women in a tertiary care hospital at Salem district, Tamil Nadu, India. This retrospective study was carried out for a period of 6 months from November 2017 to April 2018 in which 150 prescriptions were selected for study by considering the inclusion and exclusion criteria. A total of 150 prescriptions were analyzed in reproductive-aged women. Patients of age group between 41-50 years were mostly diagnosed 75 (50%) of abnormal uterine bleeding. Considering the types of AUB, most of the patients (39.33%) which has been diagnosed as adenomyosis while 59 (32.67%) of the patient has been diagnosed leiomyoma 49 (32.67%). Anaemia 102 (68%) are the most seen co-morbid condition in our survey, along with Hypertension 28 (18.6%), Infective disorders 28 (18.6%). Our findings showed that among the drugs prescribed, that antifibrinolytics were the most often prescribed drug class for AUB, and the most prescribed drug is tranexamic acid. Perimenopause 57 (38%) is the main risk factor in abnormal uterine bleeding, along with dysfunctional uterine bleeding 47 (32.6%). From we concluded that The mostly used class of drug for abnormal uterine bleeding in our tertiary care hospital is antifibrinolytics and mostly used drug agent is tranexamic acid during the period of data collection. It is found to be that perimenopause is the main risk factor in abnormal uterine bleeding along with dysfunctional uterine bleeding.


2016 ◽  
Vol 3 (4) ◽  
pp. 244
Author(s):  
Nirmala Jaget Lakkawar ◽  
Padma Alaganandam ◽  
S. Yasodha

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Menstrual disorders are the most common gynecological condition resulting in hospital referrals.   Dysfunctional Uterine Bleeding is an abnormal uterine bleeding, in the absence of any organic, systemic or iatrogenic cause. Among women in reproductive age, one in 20 consults her general practitioner each year with menorrhagia. This condition can be managed both medically and surgically. Pharmacological treatment options available for DUB are combined oral contraceptive pills, progestogens, danazol, gonadotrophin releasing hormone (GnRH) agonists, prostaglandin synthetase inhibitor, anti-fibrinolytics and ethamsylate.  Role of ormeloxifene in dysfunctional uterine bleeding (DUB) is still in an exploring level.</span>The purpose of the study was <span lang="EN-IN">to evaluate the efficacy of ormeloxifene in the treatment of DUB and compare the effects of ormeloxifene with combined oral contraceptive pills for the control of DUB. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Sixty women presenting with DUB were randomly allocated to 2 equal groups, Group A were given ormeloxifene tablet @ 60 mg twice a week for 12 weeks, followed by 60 mg once a week for 12 weeks. Group B were given low dose combined oral contraceptive pills (OCP) containing 30 microgram ethinyloestradiol and 150 microgram levonorgestrel from day 1 to day 21st of the menstrual cycle for 6 cycles. The various parameters studied were reduction in menstrual blood loss which was measured by fall in pictorial blood loss assessment chart (PBAC) score, rise in haemoglobin (Hb) level and reduction in endometrial thickness, any drug side effects, compliance with the drug, dosage schedule and effect on quality of life after each month and at the end of trial period of 6 months. Patient’s level of satisfaction was assessed by improvement in Hb concentration, sense of wellbeing as well as overall general health, quality of life, sexual life and comfort with the continuation of the same drug.</span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Mean blood loss (PBAC score) following treatment showed significant reduction in both the groups, however this reduction was comparatively high in ormeloxifene treated group. The various parameters to assess the subjective and clinical improvement at the end 3 and 6 months post treatment showed significant improvement in both the treatment groups; however ormeloxifene group showed significantly better improvement in comparison to OCP group. Mean endometrial thickness also showed reduction in both the groups but more significant reduction was observed in ormeloxifene group as compared to OCP group following 6 months of treatment. Symptomatic relief and subjective feelings in relation to improvement of menstrual abnormalities, any undesirable side effects, about dosage compliance and any thought of discontinuing the drug by the patients indicated excellent control of menorrhagia in both the study group, which accounted for 86.66% in ormeloxifene group and 80% of individuals in OCP group.  </span></p><p class="abstract"><strong>Conclusions:</strong> ORM is effective in control of DUB and can be used as an alternative to OCP for treatment of DUB with possibly minimal side effects and better dosage compliance.</p>


2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.


2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.


Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.


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