scholarly journals Could application of epinephrine improve hemostatic efficacy of hemoclips for bleeding peptic ulcers? A prospective randomized study

2013 ◽  
Vol 70 (9) ◽  
pp. 824-829 ◽  
Author(s):  
Sasa Grgov ◽  
Biljana Radovanovic-Dinic ◽  
Tomislav Tasic
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Randomized Study ◽  
Limiting Factors ◽  
Prospective Randomized Study ◽  
Peptic Ulcers ◽  
Endoscopic Method ◽  
Group I ◽  
Bleeding Peptic Ulcers ◽  
Group Ii

Background/Aim. Bleeding from peptic ulcers can be effectively and safely treated with endoscopic hemoclips therapy. However, due to certain limiting factors of hemoclips, application of combination with another endoscopic method may give better results. The aim of this study was to examine the efficacy and safety of endoscopic hemoclips therapy and to evaluate potential benefits of this therapy combined with epinephrine in the treatment of bleeding peptic ulcers. Methods. This prospective randomized study included 70 patients with bleeding gastric or duodenal ulcer. In 34 of the patients endoscopic hemoclips therapy was applied (group I), and in 36 of them a combined therapy of hemoclips and epinephrine (group II). Results. Initial hemostasis was achieved in most patients treated with endoscopic hemoclips therapy (94.1%) as well as in the patients treated with combination therapy (97.2%). After initial hemostasis achieved rebleeding occurred in 3 (9.3%) patients treated with hemoclips and in 2 (5.7%) patients treated with combination therapy, but this difference was not statistically significant (p > 0.05). The difference in the achieved final hemostasis between the group I (91.1%) and the group II (94.4%) was not statistically significant. Also, the differences between the two groups of patients in the need for blood transfusions, length of hospital stay, need for surgery and mortality were not statistically significant (p > 0.05). Conclusion. Endoscopic hemoclips therapy is effective and safe in treatment of bleeding peptic ulcers. Combination therapy of hemoclips and epinephrine has no advantage over hemoclips monotherapy.

scholarly journals Comparison of haemostatic efficacy for endoscopic injection therapy of epinephrine and combination therapy of epinephrine and hemoclips for bleeding peptic ulcers

2012 ◽  
Vol 140 (5-6) ◽  
pp. 299-304 ◽  
Author(s):  
Sasa Grgov ◽  
Perica Stamenkovic ◽  
Dejan Janjic
Keyword(s):  
Combination Therapy ◽  
Surgical Intervention ◽  
Randomized Study ◽  
Injection Therapy ◽  
Peptic Ulcers ◽  
Endoscopic Injection ◽  
Epinephrine Injection ◽  
Group I ◽  
Bleeding Peptic Ulcers ◽  
The Difference

Introduction. Endoscopic injection therapy of epinephrine is safe and effective in the treatment of bleeding peptic ulcer, but with high risk of rebleeding. The combination therapy of epinephrine and hemoclips could lead to a reduction of rebleeding and a potential reduction in mortality. Objective. To investigate the efficacy and safety of epinephrine injection therapy and combination therapy with epinephrine and hemoclips in treating bleeding peptic ulcers. Methods. A prospective randomized study included 58 patients with bleeding gastric or duodenal ulcer. In 30 patients endoscopic injection therapy with diluted epinephrine was applied (group I), while in 28 patients combination therapy of epinephrine and hemoclips was applied (group II). Results. Initial haemostasis was achieved in most patients treated with epinephrine injection therapy (93.3%) and patients treated with combination therapy of epinephrine and hemoclips (96.4%). After initial haemostasis was achieved rebleeding was significantly more frequent in the patients treated with epinephrine (28.5%) than in the patients treated with combination therapy (3.7%, p<0.05). Two patients treated with epinephrine injection therapy were subjected to surgical intervention, whereas no patient treated with combination therapy needed surgery. Lethal ending occurred in one patient treated with epinephrine and in one patient treated with combination therapy. The difference between the two groups of patients in need for surgical intervention and mortality was not statistically significant. Conclusion. Combination therapy with epinephrine and hemoclips is more efficient than epinephrine alone in the treatment of bleeding peptic ulcers.

scholarly journals Spinal Anaesthesia for Infra-umbilical Surgeries - A Prospective Randomized Study to evaluate the effectiveness of Dexmedetomidine as an adjuvant to Bupivacaine.

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Talib Khan ◽  
Ubaid Ahmad Sheikh ◽  
Shaqul Qamar Wani ◽  
Zarka Sarwar
Keyword(s):  
Postoperative Analgesia ◽  
Randomized Study ◽  
Sensory Block ◽  
University Teaching ◽  
Prospective Randomized Study ◽  
P Value ◽  
Maximum Height ◽  
Duration Of Action ◽  
Group I ◽  
Group Ii

Background: Spinal anesthesia is commonly used anesthetic modality worldwide but with the limitation of relatively short duration of action and complain of post-operative pain. However, the addition of adjuvants have intensified and increased the duration of sensory block with concommitent prolongation of the duration of postoperative analgesia. Study design and settings: This prospective randomized study was conducted in the Department of Anesthesia, Pain and Critical Care at the University Teaching Hospital. Methods: 60 patients irrespective of their age and gender were randomized equally into two groups, and received 3ml of total drug volume intrathecally (IT) viz 2.5 ml of hyperbaric bupivacaine 0.5% mixed with 0.5 ml of normal saline in Group I and 0.5 ml of 5 mcg of Dexmedetomidine in Group II respectively. Results: The maximum height of sensory block achieved were dermatomes T 6.5 ± 1.43 in Group I, and T 6.20 ± 1.28 in Group II (P value, 0.794 > 0.05) with time required to reach T10 sensory block level was 6.70 ± 0.98 min. in Group I and 5.50 ± 1.00 min. in Group II (P value, 0.001) The time to reach Bromage scale 3 was   15.70 ± 2.56 min. in Group I and 8.55 ± 1.67min. in Group II (P value, < 0.001) The time of first rescue dose requested by patient was 196.75 ± 15.16 min. in Group I, and 359.50 ± 49.79 min. in Group II (P value,  0.01)                                           Conclusions: Dexmedetomidine in doses of 5 µg as adjuvants to hyperbaric 0.5% bupivacaine intrathecally produced a significantly quick onset and longer duration of motor and sensory block with benefit prolonged postoperative analgesia. JMS 2018: 21 (2):95-100

scholarly journals A prospective randomized study of arthroscopic ACL reconstruction with adjustable- versus fixed-loop device for femoral side fixation

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Naiyer Asif ◽  
Mohammad Jesan Khan ◽  
K. P. Haris ◽  
Shah Waliullah ◽  
Anubhav Sharma ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Pivot Shift ◽  
Randomized Study ◽  
Graft Fixation ◽  
Prospective Randomized Study ◽  
Pivot Shift Test ◽  
Lachman Test ◽  
Group I ◽  
Group Ii ◽  
Femoral Side

Abstract Purpose Suspensory devices are extensively used in the management of anterior cruciate ligament (ACL) tear. They include fixed- and adjustable-loop devices. There are only a few studies comparing the efficacy of these two devices in the available literature. Therefore, the aim of this study is to compare clinical outcomes between the adjustable-loop device (group I) and fixed-loop device (group II). Materials and methods This was a prospective randomized study. Both groups were equivalent in demographic, preoperative, and intraoperative variables. Twenty-three patients underwent femoral side graft fixation with adjustable-loop and 20 with fixed-loop devices. Four patients were lost to follow-up. Assessment of clinical outcome was done with International Knee Documentation Committee (IKDC) score, Lysholm score, and knee stability tests (Lachman test and pivot shift test). Patient evaluation was performed preoperatively and finally postoperatively 2 years after surgery. Results Postoperative IKDC scores of group I and II were 91.9 ± 3.6 and 91.5 ± 3.6, respectively, and Lysholm scores were 91.0 ± 3.6 and 91.4 ± 3.5, respectively, after 2 years; however, the difference in the outcomes was statistically insignificant (p > 0.05). Twenty patients (87%) in group I and 17 patients (85%) in group II had a negative Lachman test (p = 0.8). Twenty-two patients (95.7%) in group I and 19 patients (95%) in group II had a negative pivot shift test (p = 0.9). Conclusion ACL reconstruction with fixed- and adjustable-loop suspensory devices for graft fixation gives equivalent and satisfactory clinical results. Level of evidence 1.

Comparison of single-layer continues or two-layer interrupted pancreatojejunal suture in Frey procedure for treatment of chronic pancreatitis: a prospective randomized study

2019 ◽  
Vol 91 (5) ◽  
pp. 1-5
Author(s):  
Audrius Šileikis ◽  
Saulius Jurevičius ◽  
Mykolas Butvila ◽  
Kęstutis Strupas
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Randomized Study ◽  
Single Layer ◽  
Prospective Randomized Study ◽  
Complex Method ◽  
Frey Procedure ◽  
Group I ◽  
Duration Of Surgery ◽  
Group Ii

Background Many patients with chronic pancreatitis are elected for surgery when endoscopic interventions are ineffective. Duodenum preserving pancreatic head resection introduced by Charles F. Frey is the most common procedure used for surgical treatment of chronic pancreatitis. However, technical aspects of this procedure have not been studied extensively. Goal Our prospective randomized study is aimed to compare usage of single-layer continuous (I group) and two-layer interrupted sutures (II group) in constructing pancreatojejunostomy after Frey procedure. Methods and materials In a period between 2009 and 2016, a total of 103 patients, diagnosed with chronic pancreatitis and determined medical indications for surgical treatment were included into the study and randomized into group I (52 patients) and group II (51 patients). Preoperative, intraoperative patient characteristics and postoperative results were compared between both groups. Results Mean duration of surgery was statistically shorter in group I - 210 min., while in group II - 240 min (p =0,004). Pancreatojejunoanastomosis construction time was shorter in group I - 19 (±6) min versus 51 (±18) min in group II, p <0,001. No statistically relevant differences were observed in postoperative morbidity: group I - 51,9 % and group II - 45,1 % (p = 0,177) and mortality: group I - 3,8 % and group II - 2 % (p = 0,636). Conclusions Frey procedure using single-layer continuous pancreatojejunostomy is safe, fast and less complex method in surgical treatment of chronic pancreatitis.

Comparison of Topical, Systemic, and Combined Therapy with Steroids on Idiopathic Granulomatous Mastitis: A Prospective Randomized Study

2019 ◽  
Vol 43 (11) ◽  
pp. 2865-2873 ◽  
Author(s):  
Kenan Çetin ◽  
Hasan E. Sıkar ◽  
Nuri E. Göret ◽  
Günay Rona ◽  
Nagehan Ö. Barışık ◽  
...  
Keyword(s):  
Combined Therapy ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis

scholarly journals A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

2019 ◽  
Vol 5 (4) ◽  
pp. 668
Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu
Keyword(s):  
Combination Therapy ◽  
Hair Loss ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Female Pattern Hair Loss ◽  
Group I ◽  
Topical Minoxidil ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>

Sublingual Misoprostol vs Intravenous Tranexamic Acid in reducing Blood Loss during Cesarean Section: A Prospective Randomized Study

2017 ◽  
Vol 9 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Deepak Bose ◽  
Rasheeda Beegum
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Randomized Study ◽  
Operation Time ◽  
Prospective Randomized Study ◽  
Cord Clamping ◽  
Group I ◽  
Sublingual Misoprostol

ABSTRACT Introduction The increasing incidence of cesarean sections in India has caused a rise in the incidence of postpartum hemorrhage (PPH). There has been expanding interest in the role of misoprostol and tranexamic acid (TXA) in preventing and managing PPH during lower (uterine) segment cesarean section (LSCS). However, the lack of a published study comparing the efficacies of these drugs prompted us to conduct this study. Aims and objectives To compare the efficacies of sublingual misoprostol (600 μg) and intravenous TXA injection (500 mg) in reducing blood loss during LSCS by assessing intraoperative blood loss, perioperative hemoglobin (Hb) fall, and need for additional uterotonic agents. Materials and methods A total of 163 pregnant patients undergoing emergency/elective LSCS during the study period from 2013 to 2014 were randomly assigned to two groups — group I (82) received sublingual misoprostol 600 μg and group II (81) intravenous TXA 500 mg at cord clamping. Visual estimation of blood loss was done and 48 hours postoperative Hb and packed cell volume were measured to compare with preoperative values. Need for added uterotonics, blood transfusion, and adverse effects of drugs was assessed. The two groups were again subgrouped based on presence or absence of risk factors for PPH. Results The TXA significantly reduced blood loss compared with misoprostol (416 vs 505 mL) in patients without high-risk factors for PPH. Misoprostol caused significantly higher minor side effects while TXA reduced operation time. Conclusion The TXA can be routinely used after cord clamping along with oxytocin in patients undergoing elective/emergency LSCS to reduce perioperative blood loss, especially in those without risk factors for PPH. How to cite this article Bose D, Beegum R. Sublingual Misoprostol vs Intravenous Tranexamic Acid in reducing Blood Loss during Cesarean Section: A Prospective Randomized Study. J South Asian Feder Obst Gynae 2017;9(1):9-13.

scholarly journals Prophylactic Intramyometrial Oxytocin before Placenta Delivery during Cesarean Section Prevents Postpartum Hemorrhage: A Prospective Randomized Study of 150 Women

2012 ◽  
Vol 4 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Divya Mangla ◽  
JK Goel ◽  
Ruchica Goel
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Normal Saline ◽  
Postpartum Hemorrhage ◽  
Uterine Contraction ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Group Iii ◽  
Group I ◽  
Oxytocin Infusion

ABSTRACT Objectives To compare efficacy of intramyometrial oxytocin vs intravenous oxytocin infusion in reducing blood loss during cesarean section. Materials and methods A prospective randomized controlled trial of 150 women undergoing cesarean section was done. Women undergoing cesarean section were randomly divided into three groups according to method of administration of oxytocin. In group I (n = 50): 20 units of oxytocin in 500 cc of ringer lactate as continuous infusion I/V after separation of placenta was given. In group II (n = 50): 5 units of oxytocin is diluted in 10 cc of normal saline and 5 cc injected in each cornu of uterus after separation of placenta. In group III (n = 50): 5 units of oxytocin is diluted in 10 cc of normal Saline and 5 cc injected in each cornu of uterus before separation of placenta. Blood loss was calculated by number of mops soaked and amount of blood in suction jar. Results Average blood loss was found to be more in group I 606 cc, while in group II average blood loss was 460 ml which further decreased to 412 cc in group III. There was an additional observation that the 6% cases where I/V oxytocin infusion could not prevent uterine atony while immediate uterine contraction was achieved with intramyometrial oxytocin. Conclusion Intramyometrial injection of oxytocin when given before separation of placenta was found to be most effective method to increase uterine contraction, reducing incidence of postpartum hemorrhage and thus decreasing cesarean morbidity. How to cite this article Mangla D, Goel JK, Goel R. Prophylactic Intramyometrial Oxytocin before Placenta Delivery during Cesarean Section Prevents Postpartum Hemorrhage: A Prospective Randomized Study of 150 Women. J South Asian Feder Obst Gynae 2012;4(2):93-96.

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