scholarly journals COMPARATIVE STUDY OF SUBLINGUAL AND VAGINAL MISOPROSTOL TABLET IN MISSED ABORTION

2021 ◽  
Vol 9 (06) ◽  
pp. 623-629
Author(s):  
Raxita Patel ◽  
◽  
Ami Patel ◽  
Debshree a ◽  
Vaishali Panchal ◽  
...  
Keyword(s):  
Side Effects ◽  
P Value ◽  
Missed Abortion ◽  
Significant Incidence ◽  
Sublingual Misoprostol ◽  
Group A ◽  
The Difference ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Abortion Case

Introduction: Management of missed abortion is matter of concern for obstetrician in terms of its methods and complications. Objectives: To compare efficacy, side effects and complications of sublingual and vaginal misoprostol tablet in missed abortion case of less than 20 weeks of gestation. Methods: Total 300 cases were taken, and out of those 300 cases, group A (150cases) included cases who were given sublingual misoprostol tablet, and group B (150 cases) included cases who were given vaginally misoprostol tablet. Observation: Mean gestational age is 7.9 and 8 weeks in Group A and Group B respectively. P value is 0.94. (Not significant). Mean induction abortion interval is 11.6 hours and 12.9 hours in Group A and Group B respectively i.e., the induction abortion interval is slightly short in the Group A. P value is 0.9, means the difference is not statistically significant. Mean dose of misoprostol was 1004.6 microgm and 1080 microgm for group A and group B respectively. P value is 0.029 is significant. Incidence of side effects (nausea, vomiting, unpleasant taste) was higher in group A than group B. P value is <0.05 is significant. Success rate was 86% in group A and 80% in group B. Conclusion: Sublingual and vaginal misoprostol tablet are both equally effective for medical management of missed abortion. Mean dose required for abortion is more in vaginal misoprostol but side-effects are more associated with sublingual misoprostol tablets.

scholarly journals Randomized comparison of vaginal and sublingual misoprostol with mifepristone priming in termination of second trimester pregnancy

2019 ◽  
Vol 7 (10) ◽  
pp. 3869
Author(s):  
Shrikrushna Vasant Chavan ◽  
Niraj Nilkanth Mahajan ◽  
Arundhati Gundu Tilve
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
Medical Abortion ◽  
P Value ◽  
Second Trimester ◽  
Open Label ◽  
Sublingual Misoprostol ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: Sublingual Misoprostol 200 ug 4 hrly is as effective or less effective than vaginal Misoprostol 200ug 4hrly with 200mg oral Mifepristone in termination of second trimester pregnancy.To compare effectiveness, side-effects, and patient satisfaction of sublingual vs vaginal misoprostol administration.Methods: It was prospective randomized open label study. 60 women 13-20 weeks of gestation with a valid legal indication for termination of pregnancy as per MTP act in INDIA were enrolled for study, randomly divided into Group A- Sublingual (n=30) group B-Vaginal (n=30). For group A, 200 mg of Mifepristone was given, 48h later Misoprostol 200 µg was given sublingually 4hrly up to a maximum of 5 doses. If abortion does not occur, the pregnancy was terminated with vaginal misoprostol, in group A. Same procedure repeated in group B. If abortion fails to occur after 5 doses, then second course of vaginal misoprostol was given in group B. Failure of procedure was defined as failed expulsion of foetus at 48 hrs. Results: Mean induction-abortion interval in vaginal group was 12.8±4.38h and 11.47±4.42h in sublingual group was comparable with insignificant p value (p=0.136). All the side effects were comparable in both groups. The overall success rate was 93.3% in the sublingual group while it was 100% in the vaginal group.Conclusion: Vaginal misoprostol with oral mifepristone priming in second -trimester medical abortion has a shorter time to pregnancy termination compared with a sublingual regimen. However, both the routes are equally effective for induction of abortion.

scholarly journals Comparison of efficacy of buccal versus vaginal misoprostol in first trimester induced abortion

2019 ◽  
Vol 8 (8) ◽  
pp. 3368
Author(s):  
Nida Khan ◽  
Anita M. Kant ◽  
Pooja C. Thukral ◽  
Mohammad Saquib
Keyword(s):  
Side Effects ◽  
Group Versus ◽  
First Trimester ◽  
Comparable Efficacy ◽  
P Value ◽  
Vaginal Route ◽  
Trimester Abortion ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: To compare the effectiveness, side effects, and patient satisfaction of buccal versus vaginal misoprostol administration in first trimester abortions.Methods: Women opting for first trimester abortion received oral Mifepristone followed 48 hours latermisoprostol. Group A received Misoprostol via buccal route whereas group B received Misoprostol vaginally. A comparative analysis using SPSS was done.Results: Giving 800µg Misoprostol by either buccal or vaginal route after oral Mifepristone have comparable efficacy in terms of complete abortion rate (96% in buccal group versus 98% in vaginal group; p value = 0.495), failure rate being statistically similar (4% versus 2%). Drug abortion interval was comparable in the two groups. (11.16 hour in buccal group and 12.32 hours in vaginal group). Few side effects like nausea and vomiting, shivering, diarrohea was significantly higher with vaginal Misoprostol while abdominal cramps, altered taste were found more with the buccal group.Conclusions: Buccal Misoprostol is comfortable and easier to administer when compared to other routes and it has potential to be developed as a self-administered regimen. Buccal Misoprostol is as efficacious as vaginal Misoprostol with significantly lesser side effects up to 7 weeks of period of gestation.

scholarly journals Efficacy of combination of tablet mifepristone and misoprostol for first trimester pregnancy termination at different gestational age

2017 ◽  
Vol 7 (1) ◽  
pp. 248
Author(s):  
Poonam Bhojwani ◽  
Pragati Meena ◽  
Gajendra Singh Verma
Keyword(s):  
Side Effects ◽  
Gestational Age ◽  
Pregnancy Termination ◽  
First Trimester ◽  
P Value ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Medical method of abortion is a safe, effective and affordable method for first trimester termination. However, nausea, vomiting, diarhoea, excess bleeding and incomplete abortion are known side effects. The aim of study was to compare the success rate of abortions in both groups, to compare the induction-abortion interval in both groups and to study the side effects of the drugs.Methods: This study was conducted in department of obstetrics and gynecology, NIMS Medical College, Jaipur, India during June 2017-August 2017. Total hundred cases were taken and divided into two groups. Group A was gestational age upto 49 days, Group B was gestational age 50-63 days. Both groups were given tab. mifepristone 200mg. followed by 48 hrs. by 4 tablets of tab misoprostol.Results: The results of the given regimen were highly successful and complete abortion was achieved in 96% and 94% in group A and group B respectively. The difference between two groups was statistically not significant (p value =0.64). Failure rates were seen in only 4% of group A and 6% of group B. Pain abdomen was seen in 16% of group A and 38% of group B patients. The difference between both groups was statistically significant (p value=0.02). Nausea was seen in 10% of group A and 30% of group B patients. The difference between both groups is statistically significant(p value=0.018).Conclusions: First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy.

scholarly journals Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 10-13
Author(s):  
Bimochan Piya ◽  
Abhishek Bhattarai
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Diclofenac Sodium ◽  
Study Groups ◽  
Ureteral Stones ◽  
Control Group ◽  
P Value ◽  
Expulsion Rate ◽  
Group A ◽  
Group B

Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones. Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group. Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively.  It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient. Conclusion:  The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.

scholarly journals Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion

2018 ◽  
Vol 7 (11) ◽  
pp. 4545
Author(s):  
Michelle N. Fonseca ◽  
Vernica Sah
Keyword(s):  
Side Effects ◽  
Foley Catheter ◽  
Medical Abortion ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Sequential Administration ◽  
Group A ◽  
Low Incidence ◽  
Vaginal Misoprostol ◽  
Group B

Background: Abortions are one of the most commonly performed procedures in gynaecological departments worldwide. They are still a major problem in developing countries contributing to a significant percentage of maternal morbidity and mortality. The main objective of this study is to compare the efficacy, side effects and acceptability of intracervical Foley and oral Mifepristone both followed with sequential administration of vaginal misoprostol for second trimester medical abortion.Methods: This was a prospective randomized trial of 36 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation between 12 to 20 completed weeks. Intracervical Foley catheter with administration of misoprostol (200µg) vaginally was done for Group A. Mifepristone 200mg was administered on day one followed by misoprostol (200µg) vaginally, 48 hours later, to Group B. Both groups received misoprostol (200µg) vaginally at 4 hourly intervals. Completeness of abortion was assessed, and surgical evacuation was performed, if abortion was found to be incomplete.Results: The two groups were comparable with respect to age, parity and gestational age. 83-89% of the women in both the groups had complete abortion. The mean induction abortion interval was 20.11 hours in Group A and 54.77 hours in Group B, which was statistically significant. Side effect profile was comparable in both groups however the intensity and the duration of persistence of pain was greater among patients from Group A.Conclusions: Authors conclude that medical abortions with both methods were found to be safe, effective, inexpensive and acceptable methods. Whereas a shorter induction abortion interval was observed in the Foley induction group, induction with mifepristone was the preferred regimen in second trimester abortion because of its high efficacy, low incidence of side effects, better tolerance by the patients and due to lower dose of misoprostol required following mifepristone administration.

scholarly journals Comparison of efficacy of Misoprostol 4 hourly with Misoprostol 6 hour for Medical termination of pregnancy in second trimester.

2020 ◽  
Vol 27 (01) ◽  
pp. 46-51
Author(s):  
Shamas un Nisa ◽  
Farzana Razaq ◽  
Sadaf un Nisa
Keyword(s):  
Side Effects ◽  
Controlled Trial ◽  
Fetal Loss ◽  
Termination Of Pregnancy ◽  
Second Trimester ◽  
Medical Termination Of Pregnancy ◽  
Medical Termination ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Termination of Pregnancy (TOP), in our country is carried out only when considerable danger to a fetus due to congenital abnormalities, intrauterine fetal loss or when maternal life is under threat. The principle concerns in providing second trimester termination include safety, efficacy, simplicity, low-cost, and fast acting with minimal side effects. Objectives: To compare the efficacy in term of complete abortion within 48 hours between protocol-I (200 µg misoprostol 4 hourly) versus protocol-II (200 µg misoprostol 6 hourly) for second trimester (14-24 weeks) medical termination of pregnancy. Study Design: Randomized controlled trial. Settings: Gynecology & obstetrics unit-II, Bahawal Victoria Hospital (BVH) Bahawalpur. Period: From 1st July 2017 to 30th June 2018. Material & Method: A total of 182 patients meeting the inclusion criteria were included in study. Ninety one patients were included in group-A and 91 patients were included in group-B.  Women allocated to group-A was given misoprostol 200µg every 4 hour. Similar drug and dose were administered to women of group-B intra-vaginally, 6 hourly. Patients in both groups were monitored up to 48. If abortion occurred within 48 hours of induction, it was labeled as effective abortion otherwise it was regarded as failed abortion. Results: The mean age in group-A was 26.71 years 25.49 years in Group-B. In group-A, 89 (97.8%) patients showed efficacy (abortion within 48 hours) and in group-B, 74 (81.32%) patients showed efficacy to misoprostol. Conclusion: The regimen of using 200μg of vaginal misoprostol 4 hourly is more efficacious and quick for 2nd trimester TOP with fewer side effects when compared to 200μg of vaginal misoprostol 6 hourly.

scholarly journals Comparison of Salbutamol and Salbutamol with ipratropium bromide in children with exacerbation of Asthma in terms of peak expiratory flow rate (PEFR).

2021 ◽  
Vol 28 (11) ◽  
pp. 1611-1615
Author(s):  
Sadaf Minhas ◽  
Saqib Aslam ◽  
Muhammad Azhar Farooq ◽  
Ayesha Anwar ◽  
Farhan Zahoor ◽  
...  
Keyword(s):  
Peak Expiratory Flow ◽  
Ipratropium Bromide ◽  
Controlled Trial ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Expiratory Flow ◽  
The Difference ◽  
Group B ◽  
Trial Setting

Objective: To compare the Salbutamol alone and Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR. Study Design: Randomized Controlled Trial. Setting: Pediatrics Emergency, KRL Hospital Islamabad. Period: 1st August 2016 to 31 January 2017. Material & Methods: Group A patients were given only Salbutamol (0.15mg/kg per dose with minimum 2.5 mg, maximum 5 mg/dose). Group B was given Ipratropium Bromide supplemented Salbutamol (250 mcg/dose for <20 kg while 500 mcg/dose for >20kg of Ipratropium Bromide with same dose of Salbutamol as prescribed for Group A). Baseline spirometry was performed on each patient and after measurement of baseline peak expiratory flow. The outcome was measured by Peak flow meter and reassessed at 60 minutes. Results: Comparison of salbutamol alone and ipratropium bromide supplemented salbutamol in children with exacerbation of asthma in terms of PEFR shows that 40.5 + 4.28 in Group-A and 59.5 +4.75 in Group-B, P-value was calculated as 0.0001, showing a significant difference between the two groups while the difference in increase was recorded as 19%. Conclusion: We concluded that salbutamol alone is significantly less effective when compared with Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR.

scholarly journals Airway Clearance in Bronchiectasis: A Randomized Control Trial of N-Acetylcysteine with 3% hypertonic saline

2019 ◽  
Vol 8 (3) ◽  
pp. 146-150 ◽  
Author(s):  
Muhammad Imran Shehzad ◽  
Muhammad Atiq Ul Mannan ◽  
Masood Alam ◽  
Abdul Rauf ◽  
Muhammad Imran Sharif
Keyword(s):  
Acute Exacerbation ◽  
Hypertonic Saline ◽  
Control Group ◽  
P Value ◽  
Airway Clearance ◽  
Before And After ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: N-Acetylcysteine and 3% hypertonic saline are being used effectively for sputum clearance in chronic cases of bronchiectasis for quite some time. However, their use in acute condition of the disease seems to be underexplored. The objective of our study is to compare the role of nebulized N-acetylcysteine and 3% hypertonic saline in clearing the airway in patients with acute exacerbation of bronchiectasis. Material and Methods: A total of 136 confirmed cases of bronchiectasis were enrolled in this study. This randomized controlled trial was done in chest ward of Nishtar Hospital Multan from January 2015 to March 2017. Sampling was done by non-probability consecutive sampling and patients were divided into two groups A and B by lottery method. Verbal informed consent was taken from all participants. Group A participants received nebulization of N acetylcysteine mixed in normal saline for ten minutes, while group B participants were nebulized with 10ml of 3% hypertonic saline for ten minutes. Group B was active control group in the study. Data was collected on pre-designed Proforma, and analyzed by SPSS version 22. Numerical variables such as saturation, weight of sputum, age and blood pressure was analyzed by using t test. These were considered significant if the p value was equal or less than 0 .05. For qualitative variables chi square test was applied. Results: The mean O2 saturation of Group A, before and after treatment, was 92.11±3.07% and 94.47±2.18%, respectively. The difference was statistically significant (p value =0.001). The sputum weight of Group A, before and after treatment, was 2.63±2.39 g and 7.41±1.38 g, respectively. The difference was statistically significant (p value =0.001). The frequency of rhonchi of Group A, before and after treatment, was 52% and 76%, respectively. The difference was statistically significant (p value =0.003). While, for Group B, the mean O2 saturation, before and after treatment, was 92.36±3.13% and 93.49±2.27%, respectively. The difference was statistically significant (p value =0.012). The sputum weight, before and after treatment, was 3.11±2.01 g and 5.56±1.02 g, respectively. The frequency of rhonchi, before and after treatment, was 45% and 74% respectively. Again, the difference was statistically significant. Conclusion: Both nebulized N-acetylcysteine and 3% hypertonic saline cause airway clearance by enhancing sputum expectoration in patients with acute exacerbation of bronchiectasis equally. Both these agents also improve oxygen saturation in acute exacerbation of bronchiectasis significantly.

scholarly journals Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?

2020 ◽  
Vol 8 (4) ◽  
pp. 1282
Author(s):  
Karan Malhotra ◽  
Kallappa C. Herakal
Keyword(s):  
Growth Factors ◽  
Side Effects ◽  
Cost Effective ◽  
Androgenetic Alopecia ◽  
P Value ◽  
Common Cause ◽  
Point Evaluation ◽  
Group A ◽  
Promising Treatment ◽  
Group B

Background: Androgenetic alopecia is the most common cause of chronic hair loss. The FDA approved treatment for male androgenetic alopecia are Finasteride and Minoxidil. But many patients do not respond to these medications. Microneedling is a recent modality that releases several growth factors and enhances penetration of minoxidil, thereby promoting hair growth.Methods: 60 patients, aged 21-40 years, with androgenetic alopecia were divided into 2 groups. In group A, patients were subjected to microneedling twice monthly, immediately followed by application of topical 5% minoxidil solution over the scalp and then 1 ml twice daily. In group B, patients were treated with application of 1ml of topical 5% minoxidil solution over the scalp twice daily. The results were evaluated based on patient’s and physician’s assessment based on the standardized 7-point evaluation scale.Results: Patients in group A showed statistically significant improvement (p value<0.05) compared to group B. Headache and erythema were the most common side effects encountered in both the groups.Conclusions: Microneedling with 5% minoxidil is a safe, simple and cost-effective modality and is a promising treatment option for patients with androgenetic alopecia. It showed much better results when compared to use of topical 5% minoxidil solution alone.

scholarly journals CONTROL OF HYPERTENSION

2010 ◽  
Vol 17 (03) ◽  
pp. 425-430
Author(s):  
GHULAM RASOOL BHURGRI ◽  
HUSSAIN BUX KOREJO ◽  
MUHAMMAD ALI QURESHI ◽  
Raj Kumar ◽  
Nasrullah Aamir
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Combination Therapy ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Combined Therapy ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Age Range

Objective: To compare the efficacy and tolerability of Losartan and Atenolol in alone and combination in treatment of hypertension. Study Design: Comparative study. Setting: Medical out patients department of Jinnah Postgraduate Medical Centre Karachi from January 2007 to June 2007. Methods: There were 60 patients previously untreated with mild and moderate essential hypertensions were registered for study. The selected patients were divided into three groups. Group A was given atenolol, Group B was given Losartan, and Group C was given both drugs. The target blood pressure was 120-140/80-90 mmHg. There were 42 males and 18 females with age range 25-65 years. Results: The mean baseline score of groups A, B and C were showed systolic blood pressure 182±19, 174 ± 20 and 168 ± 12 respectively. The diastolic blood pressure was 104.5±11, 102.5±9 and 104.5±10 respectively. The difference in mean systolic and diastolic blood pressure was not significant statistically as P = 0.06 and 0.76 respectively. After 4 months of treatment with atenolol, systolic blood pressure decreased to 147±17, and diastolic blood pressure fell to 87±4. Losartan decreased systolic blood pressure 138±13 and diastolic blood pressure 87±4 in 4 months of treatment. The combined therapy decreased systolic blood pressure 115±4.6 and diastolic blood pressure 75±4.7. The effect of treatments on systolic and diastolic blood pressure was significantly different as (p < 0.001) and ( p = 0.036) respectively. Side effects observed in 2 (10%) patients from group C, 8 (40%) in group A and 4 (20%) in group B. Combination therapy proved more effective in controlling hypertension than mono therapy and also fewer side effects. Patients showed better control on combination therapy as compared to mono therapy. Losartan proved a little better in controlling hypertension then atenolol and was more expensive. Conclusion: Patients showed better results with combination therapy for hypertension compared to individual drug.

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