Frequency of Postpartum Haemorrhage after Administration of Per-Rectal Misoprostol in Females Undergoing Vaginal Delivery

Abstract | This study was designed to determine the frequency of postpartum hemorrhage after administra-tion of per rectal misoprostol in females undergoing normal vaginal delivery. The study was conducted at the Department of Obstetrics and Gynaecology, Teaching Hospital, Lahore from 02-09-2014 to 03-03-2015.Non-probability and purposive sampling techniques were used. A total of 220patients undergoing normalvaginal delivery at term after administration of per rectal misoprostol were enrolled with 95% confidenceinterval (C.I). The error margin was 5% and the prevalence of postpartum haemorrhage was 16.5%. Datawas entered and analyzed through SPSS 17. In this study, the mean age of study participants was found tobe 29.89±5.89 years while the mean gestational age was 38.86±1.38 weeks. Postpartum haemorrhage wasobserved in 35.45% cases. Blood loss was recorded in patients with a mean of 374±134.91 mL. Statistically,a highly significant difference was observed between the blood loss and postpartum haemorrhageamong the patients (i.e. p-value=0.000). A low frequency of postpartum hemorrh agein women experiencing normal vaginal delivery after misoprostol was administered. The blood loss was recorded to be very low among females.

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Efficacy of balloon tamponade in control of primary postpartum haemorrhage (PPH).

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.04.3423 ◽

2020 ◽

Vol 27 (04) ◽

pp. 717-720

Author(s):

Kashfa Tasnim Akhtar ◽

Sobia Tabassum ◽

Shazia Siddique

Keyword(s):

Blood Loss ◽

Gestational Age ◽

Postpartum Haemorrhage ◽

Ease Of Use ◽

P Value ◽

Balloon Tamponade ◽

Products Of Conception ◽

Estimated Blood Loss ◽

Increased Risk ◽

Significant Difference

Objectives: Primary postpartum haemorrhage (PPH) refers to excessive blood loss (>500ml) during 3rd stage of labour in the 1st 24 hours after delivery, thereafter, significant bleeding is referred to as secondary PPH. Its incidence is about 5% of deliveries. This study was conducted to note the efficacy of balloon tamponade in the control of PPH. Study Design: Experimental study. Setting: Department of Obstetrics and Gyne, Civil Hospital, Bahawalpur. Period: 1st January 2018 to 30th June 2018. Material & Methods: A total of 80 cases with Primary PPH after vaginal delivery were considered for this study. Cases with Bleeding disorders, ruptured uterus, retained products of conception, genital tract injuries or on anticoagulant therapy were excluded. All patients received balloon tamponade. Failure of control of bleeding was observed amongst all the patients. Results: Mean age, gestational age and parity were 24.54 years, 37.88 weeks and 3.17 respectively. Mean estimated blood loss was found to be 1125+320 ml, SBP 90.10+20.6 mmHg, DBP 57+7.2 mmHg and pulse 106+9.2 bpm. As far efficacy of balloon tamponade is concerned, it was noted in 71 (88.8%) women. When women were analyzed for maternal age, gestational age and parity status, no significant difference was found (P value > 0.05). Conclusion: Balloon tamponade has good efficacy (88.8%) in controlling PPH. Its ease of use in cases at increased risk of PPH makes it a suitable option.

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Role of Perineal Length Estimation in The Prediction of Maternal and Fetal Outcomes

Evidence-Based Nursing Research ◽

10.47104/ebnrojs3.v2i1.92 ◽

2020 ◽

Vol 2 (1) ◽

pp. 11

Author(s):

Sabah R. H. Ahmed ◽

Hala A. Ali

Keyword(s):

Cesarean Section ◽

Apgar Score ◽

Normal Vaginal Delivery ◽

P Value ◽

Fetal Outcomes ◽

Second Stage Of Labor ◽

Second Stage ◽

Significant Difference ◽

The Mean

Context: Female perineum is a significant part of females because perineal tears and episiotomy habitually happen in childbirth with first-time deliveries. Aim: This study aimed to explore the role of perineal length (PL) estimation in the prediction of maternal and fetal outcomes. Methods: A prospective cohort observational design used to collect data from the Department of Obstetrics and Gynecology, Laboring room, Kafrelsheikh General Hospital, Kafrelsheikh City, Egypt. A purposive sample of 139 parturient women recruited during the period from the first of December 2018 to the end of August 2019. Six tools used to conduct this study. Maternal and newborn characteristics questionnaire, disposable standardized paper tape for measuring PL in centimeters, a standardized scale for measuring maternal height by meters, and body weight in kilograms to calculate Body Mass Index (BMI) (k/m2), REEDA scale, partograph for labor process and Apgar score. Results: There were statistically significant differences regarding the mean age, previous episiotomy and cesarean section of both studied groups (PL less than or equal to 4 cm and more than 4 cm) at p-value <0.001. Out of 139 parturient women, the two groups of PL less than or more than 4 cm had 16.7% versus 56.9%, respectively had normal vaginal delivery, with a statistically significant difference between both groups, while 46.7% versus 6.3% respectively had an episiotomy. However, the mean duration of the second stage of labor had statistically significant differences between both studied groups, with 116.7 ± 44.3 versus 85.1 ± 42.0, respectively. Additionally; Mean birth weight/grams, cephalohematoma, caput succedaneum, and mean APGAR score after 5 minutes had a statistically significant difference between the two groups. Conclusions: Short perineum accompanied by increased duration of the second stage of labor. Cesarean section delivery and perineal trauma are associated with primigravida with short perineum. Regarding the mean APGAR score after 5 minutes, there were statistically significant differences between both studied groups. Maternity and newborn health nursing need to improve the illustration of the risk factors that can lead to undesirable consequences

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Comparison of Misoprostol With Tranexamic Acid in Preventing Post-Partum Hemorrhage

10.53350/pjmhs21155914 ◽

2021 ◽

Vol 15 (5) ◽

pp. 914-916

Author(s):

Maryam Matloob ◽

Zille Hyder Syed ◽

Rubina Qasim ◽

Wafa Najeeb

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Post Partum ◽

Controlled Trial ◽

Normal Vaginal Delivery ◽

Third Stage ◽

Misoprostol Group ◽

Group A ◽

The Mean ◽

Group B

Aim: To compare the amount of average blood loss in transamine and misoprostol groups in patients undergoing spontaneous vaginal delivery in third stage of labour. Method: We conducted the randomized controlled trial from July 26th 2016 to 25th of January 2017. Results: In my study the mean age of the patients undergoing normal vaginal delivery was 28.47 years, parity wise, 31%, 33%, 24% and 11% of participants were para 1, para 2, para 3 and para 4 respectively. Mean blood loss in group A was 224.08 +/- 20.81mls and in group B 331 +/- 398 mls. Conclusion: This study has demonstrated that the blood loss in transamine group (group A) is less than the mean blood loss in misoprostol group (group B). Keywords: Transamine, misoprostol, normal vaginal delivery

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A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164814 ◽

2016 ◽

Vol 3 (1) ◽

pp. 122 ◽

Cited By ~ 1

Author(s):

Nithya V. ◽

Angshuman Dutta ◽

Sabarigirish K.

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Postoperative Period ◽

P Value ◽

Intraoperative Blood Loss ◽

Pain Scores ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean ◽

Cold Dissection

Background: The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.Methods: A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups. Results: Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value <0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant. Conclusions: This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period.

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Obstetric outcome of floating head in primigravida at term

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175854 ◽

2017 ◽

Vol 7 (1) ◽

pp. 242

Author(s):

Sangeeta Pahwa ◽

Arshdeep Kaur ◽

Madhu Nagpal

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Normal Vaginal Delivery ◽

Obstetric Outcome ◽

Surgical Interventions ◽

Section 8 ◽

Significant Difference ◽

Secondary Objective ◽

The Mean ◽

Time Of Admission

Background: Engagement of head is the most important event in labor which decides obstetric outcome. Floating head in primigravida at term is considered an important obstetric risk factor. Cephalopelvic disproportion, occipito-posterior position and deflexed head should be suspected in most cases of floating head. Present study was conducted to determine the outcome of labor in primigravida with floating head at term. The primary objectives of the study was to analyse the progress of labor, need of medical and surgical interventions and fetomaternal outcome. The secondary objective was to find out the rate of caesarean section for floating head in all situations whether elective or emergency in labor.Methods: This study was conducted in department of Obstetrics and Gynaecology SGRDIMS and R, Sri Amritsar on 100 primigravida subjects with floating head at term admitted through OPD admissions for induction of labor /spontaneous labor or referred from outside directly in early labor.Results: In present study the mean age was 24.95±3.01 years. The youngest case was 19 years old and eldest being 32 yrs old. The mean height was 151±3.41. At the time of admission 21% of cases had floating head, 55% cases were at -3 station, 17% of cases had -2 station, with only 7% of cases had -1 station. 56% of women delivered by caesarean section, 8% by forceps assisted vaginal delivery and 36% by normal vaginal delivery. The mean duration of labor was more in free floating and -3 stations in comparison to -2, or -1 stations. The need for augmentation was more in higher head stations. Mean birth weight was 2.84±0.31, it was more in higher fetal stations in comparison to lower fetal stations. No significant maternal and fetal morbidity was seen. There was no significant difference in the Mean APGAR score of higher head stations in comparison to lower fetal stations.Conclusions: Primigravida with floating head at term and during labor should be managed cautiously. By proper monitoring and maintenance of partogram most of these cases deliver vaginally and without any maternal and fetal morbidity. The attitude of watchful expectancy and timely intervention will be used in all cases, especially in those appearing to be taking a protracted course.

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Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

International Journal of Modern Languages And Applied Linguistics ◽

10.24191/ijmal.v3i2.7643 ◽

2019 ◽

Vol 3 (2) ◽

pp. 1

Author(s):

Eliyas Sulaiman Mohandas ◽

Nik Mastura Nik Ismail Azlan ◽

Salwa Othman ◽

Muhammad Aizat Azhari

Keyword(s):

Short Stories ◽

Reading Comprehension ◽

P Value ◽

L2 Reading ◽

Reading Score ◽

Paired Samples ◽

Significant Difference ◽

Post Test ◽

The Mean ◽

L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

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A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183802 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3826

Author(s):

Sharmistha Sarkar ◽

Dhruba Prasad Paul ◽

Jayanta Ray

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Comparative Evaluation ◽

P Value ◽

Contraceptive Device ◽

Government Medical College ◽

Expulsion Rate ◽

Medical College ◽

Significant Difference ◽

Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

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Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽

10.1186/s12893-021-01269-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Salma S. Al Sharhan ◽

Mohammed H. Al Bar ◽

Shahad Y. Assiri ◽

Assayl R. AlOtiabi ◽

Deemah M. Bin-Nooh ◽

...

Keyword(s):

Surgical Outcomes ◽

Endoscopic Sinus Surgery ◽

T Test ◽

Sinus Surgery ◽

Symptom Improvement ◽

P Value ◽

Psychological Dysfunction ◽

Significant Difference ◽

The Mean ◽

Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value = < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value = < 0.001); ear/facial symptoms (t-test = 6.34, p-value = < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value = < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

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Emotional Bonding and Sexual Activity During COVID-19 Lockdown: A Cross-National Pilot Study

Journal of Psychosexual Health ◽

10.1177/26318318211027482 ◽

2021 ◽

pp. 263183182110274

Author(s):

Deblina Roy ◽

Sujita Kumar Kar ◽

SM Yasir Arafat ◽

Pawan Sharma ◽

Russell Kabir

Keyword(s):

Online Survey ◽

Sampling Technique ◽

Sexual Relationships ◽

Sexually Active ◽

Online Questionnaire ◽

Cross Sectional ◽

Emotional Bonding ◽

Significant Difference ◽

The Mean ◽

Study Participants

Background: The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world. Objectives: We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal). Methods: A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study. Results: A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified. Conclusion: There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.

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Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs

Biology ◽

10.3390/biology10050358 ◽

2021 ◽

Vol 10 (5) ◽

pp. 358

Author(s):

Javier Aragoneses ◽

Ana Suárez ◽

Nansi López-Valverde ◽

Francisco Martínez-Martínez ◽

Juan Manuel Aragoneses

Keyword(s):

Surface Treatment ◽

Test Group ◽

Mean Value ◽

Control Group ◽

P Value ◽

Implant Surface ◽

Bone Contact ◽

Bone Implant ◽

Significant Difference ◽

The Mean

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

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