scholarly journals Possibilities of a Combined Biophysical Non-Invasive Fetal Monitoring During Labour in Reducing the Frequency of Operative Deliveries – A Randomized Study

2013 ◽  
Vol 13 (2) ◽  
pp. 20-25
Author(s):  
K Dokus ◽  
K Matasova ◽  
J Visnovsky ◽  
S Dokusova ◽  
J. Danko

Abstract Objective. The aim of the study was to test the performance and safety of fetal pulse oximetry (FPO) in the management of non-reassuring CTG patterns in labour. Materials. A randomized controlled trial was conducted in 648 women in active labour and pregnancies > 36 weeks with reassuring admission CTG followed by non-reassuring patterns. All women were divided into 2 groups according to the mode of fetal intrapartum monitoring used. In the study group (n=324), women received a combined biophysical fetal monitoring with CTG plus FPO (n=324), while the control group of women had CTG alone monitoring. Main outcome measures were rates of operative deliveries and neonatal outcome. Results. The analysis showed a significant reduction of Caesarean deliveries in the study group receiving a combined fetal monitoring compared to controls (45/324 vs. 67/324; P=0.022). The total operative delivery rate was also lower, but not significantly (92/324 vs. 104/324, P=0.302). No comparative differences were observed in neonatal outcomes, except for 2 controls-group neonates born with pH-UA < 7.1, however completely normal further postnatal course. No such case was encountered in the study group neonates, and no perinatal deaths occurred during the study. Conclusions. A combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry enables safe reduction in Caesarean rate for non-reassuring CTG patterns, however it could not decrease a total operative delivery rate. Condensation: Fetal pulse oximetry safely reduces a Caesarean rate for non-reassuring patterns, but not the overall Caesarean rate.

1996 ◽  
Vol 14 (2) ◽  
pp. 68-70 ◽  
Author(s):  
J Andrzejowski ◽  
D Woodward

The efficacy of acupressure and acupuncture at the Pericardium 6 (PC.6) point in relieving post-operative nausea and vomiting (PONV) is well known. Lengthy manual stimulation of the needles, or electrostimulation, is inconvenient and incurs extra costs. The aim of this study was to test the effectiveness of the antiemetic action of semi-permanent acupuncture needles (SPANs), a cheap and convenient method of administering acupuncture, in the first 48 hours following gynaecological surgery. Patients (n = 36) having total abdominal hysterectomy were studied in a randomised, placebo controlled trial. Study group patients had SPANs inserted in PC.6 on both wrists. The control group had SPANs inserted into sham points on their forearms. There was no difference in the median nausea scores between the groups; however six patients suffered moderate or severe nausea during the second 24 hours in the control group, with none in the study group (p < 0.05). In addition, the nausea score between 8 and 24 hours in patients who had previously experienced PONV, was lower in the study group (median score 2) compared to the control group (median score 4) (p < 0.05). We conclude that the use of SPANs does not reduce the overall incidence of nausea and vomiting but does appear to reduce the severity of nausea in the second 24 hours, and has a greater effect on patients who had had nausea and vomiting after a previous anaesthetic.


2018 ◽  
Vol 37 (2) ◽  
pp. 129-133
Author(s):  
Chetak Kadbasal Basavaraj ◽  
Shyamala Gowri Pocha ◽  
Ravi Mandyam Dhati

Introduction: Fever is the most common presenting complain for which children are brought to the paediatrician.Physical methods are widely used in treating febrile children, tepid sponging being commonly practiced in hospitals along with antipyretics. The objectives of this study were to compare the effectiveness of tepid sponging and antipyretic drug versus antipyretic drug alone in febrile children.Material and Methods: This was a Randomized controlled trial done in JSS Medical College and Hospital. All children under the age of 6 months to 12 years, admitted with axillary temperature of >99oF were included in the study. A total of 500 children were included over two years study period. Children with recorded axillary temperature of >990F were randomized into control and study group by computer generated randomisation. Children in the control group received only paracetamol (15mg/kg) at 5 minutes and combined group received paracetamol and tepid sponging at five minutes. Axillary temperature was monitored every 15 minutes for a period of 2 hours in both the groups.Results: There is no significant difference in reduction of temperature between the two groups by the end of two hours. Children in combined group had a higher level of discomfort than those in only antipyretic group.Conclusion: Tepid sponging does not add to the efficacy of paracetamol in antipyresis and that addition of tepid sponging to antipyretic, results in additional discomfort for the child. This study, therefore, endorses the view that antipyretic alone without tepid sponging should be the modality of therapy in children with fever.  


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Apisada Chumkam ◽  
Densak Pongrojpaw ◽  
Athita Chanthasenanont ◽  
Junya Pattaraarchachai ◽  
Kornkarn Bhamarapravatana ◽  
...  

Objective. To examine the effectiveness of cryotherapy for reducing postoperative pain in patients who underwent exploratory laparotomy for gynecologic surgery. Materials and Methods. Patients who had indication for an exploratory laparotomy gynecologic procedure were selected by attending physicians to undergo abdominal surgery via low transverse skin incision. The participants were randomized into study and control groups with simple random sampling methods. Cold packs were applied at two hours after operation for 6 hours. The visual analog scale (VAS) score was recorded at two, 6, and 12 hours after operation. Result. One hundred cases were recruited and then divided into study and control groups equally. The mean age of both groups was 43 years. There was no difference in demographics data of both groups. Half of the participants in both groups underwent hysterectomies. At two hours after surgery, both groups had similar VAS scores. The study group had a lower VAS score at 6 and 12 hours after surgery than the control group with statistical difference. Morphine consumption within 24 hours after surgery in both the study and control groups was 2.8±3.4 and 3.0±4.4 mg, respectively, with no statistical difference. However the registration time of the first morphine requirement in the study group was statistically more prolonged than that of the control group. The lengths of hospital stay in both groups were similar. There was no complication reported in this study. Conclusion. Cryotherapy can reduce postoperative pain. In this presented study the patients who underwent gynecologic surgery had improved pain relief and prolonged time for the first dose of the analgesic drug.


2019 ◽  
Vol 10 (1) ◽  
pp. 67
Author(s):  
Hrønn Thorn ◽  
Lisbeth Uhrenfeldt

Background and objective: Preoperative anxiety among gynecological patients is well-known and has a direct correlation with postoperative pain. By minimizing preoperative anxiety, the level of postoperative pain may decrease.  The purpose of this study was to evaluate the effect of preoperative structured information and dialogue on patients' anxiety and postoperative pain.Methods: A single-center non-blinded randomized controlled trial. Forty-six women scheduled for hysterectomy were allocated either to the study group or the control group.  The study group was given individual information at a preoperative consultation while the control group was given information at admittance. The main outcome was anxiety level and postoperative pain.Results: Forty participants (study group = 20; control group = 20) were analyzed. No statistically significant difference was found in anxiety level within the first 24 h postoperatively or in postoperative pain within four weeks between the groups.Conclusions: Preoperative individual information and dialogue did not result in significant effects in reducing anxiety level nor did it result in lower postoperative pain score.


2017 ◽  
Vol 9 (2) ◽  
pp. 84-87 ◽  
Author(s):  
Imam Bano ◽  
Pramod R Gade ◽  
Yasir Alvi

ABSTRACT Objective To assess the effectiveness of discontinuation of magnesium sulfate (MgSO4) infusion in patients with severe preeclampsia immediately postdelivery. Materials and methods In a prospective-randomized study, women with severe preeclampsia attending the Jawaharlal Nehru Medical College, Aligarh, India, between January 2013 and September 2014 were enrolled. The inclusion criteria were blood pressure of at least 160/110 mm Hg after 24 weeks and either of the following: Proteinuria (dipstick value. 1), platelet <100,000, and serum transaminase levels twice as normal. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received MgSO4 loading dose (4 gm intravenously), followed by maintenance doses (1 gm/hour) until delivery (study group) and 24 hours (control group). The primary outcome was occurrence of convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses. Results Analyses included 48 patients in the study group and 43 patients in the control group. No convulsions occurred in either group after the completion of treatment. Conclusion: For women with severe preeclampsia, discontinuing MgSO4 immediately after delivery could effectively prevent convulsions. How to cite this article Anjum S, Gade PR, Garg N, Bano I, Alvi Y. Maternal Outcome with Discontinuation of Magnesium Sulfate immediately Postpartum in Severe Preeclampsia. J South Asian Feder Obst Gynae 2017;9(2):78-81.


2020 ◽  
Author(s):  
Ziyan Li ◽  
Yanzhe Ning ◽  
Pei Chen ◽  
Yi Zhang ◽  
Dongqing Yin ◽  
...  

Abstract BackgroundAt present, the focus and difficulty of schizophrenia (SCZ) treatment is to improve cognitive function and negative symptoms. Jie-du-qing-nao granules(JQG) , a traditional Chinese medicine(TCM) prescription , has a good clinical effectiveness in enhancing the cognition and negative symptoms of patients with SCZ. However, its clear effectiveness and safety have not been adequately supported by clinical studies. The main objective of this study is to explore the efficacy and safety of JQG for first-episode schizophrenics.Methods/designThis trial is a prospective, randomized, single-centered, parallel-controlled clinical study with double-blind design. A total of 96 eligible participants will be randomly assigned to either the study group or the control group in a ratio of 1:1. Participants allocated to the study group will receive JQG and aripiprazole, control group will receive placebo and aripiprazole. The treatment course will last 12 weeks, with follow-up every 4 weeks. Outcome measurements include Positive and Negative Syndrome Scale (PANSS), self face test , MATRICS Consensus Cognitive Battery (MCCB), TNFα, IL-6, IL-1β, BDNF, vital signs, complete blood count, liver and kidney function tests, urinalysis, and electrocardiograph. Adverse reactions will be evaluated using the Treatment Emergent Symptom Scale (TESS).DiscussionThis study will provide evidence for the efficacy and safety of JQG as a complementary approach, which can be initiated following with antipsychotics therapy. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR1900028250 . Registered on December 16, 2019, http://www.chictr.org.cn/edit.aspx?pid=41880&htm=4 .


2021 ◽  
Vol 29 (3) ◽  
pp. 127-131
Author(s):  
MATHEUS GARCIA LOPES MERINO ◽  
VICTOR MORALE ◽  
GUILHERME PEREIRA OCAMPOS ◽  
MARIA CÂNDIDA MIRANDA LUZO ◽  
OLAVO PIRES DE CAMARGO ◽  
...  

ABSTRACT Objective: To compare the long-term effects of a brace designed to stabilize the patellofemoral (PF) joint in comparison to a standard neoprene sleeve for the knee with patellar hole in patients with patellofemoral osteoarthritis (PFOA). Methods: 38 patients with PFOA and comorbidities received either a functional PF brace (Study Group, SG) or a neoprene sleeve for the knee (Control Group, CG). Both groups received clinical treatment to OA and comorbidities according to a program from the institution. Patients were evaluated with Western Ontario and MacMaster (WOMAC) and Lequesne questionnaires, 30-second chair stand test (30CST), Timed Up and Go (TUG), anthropometric measures and self-reported physical activity in minutes/week at inclusion, one, three and twelve months after placing the brace. X-Rays were taken to measure the angles. Results: At one year there was more abandonment in the CG without differences in weight and body mass index between groups during the study. The SG maintained improvements in Lequesne and WOMAC total and subsets during the year, whereas the CG returned to baseline values for pain, function and total (p < 0.01). TUG and 30CST results were always better in the study group without any clinically important improvement in both groups. Conclusion: Long-term use of functional brace added to self-management program improves pain and function in patients with PFOA. Level of Evidence II, Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).


2019 ◽  
Vol 8 (7) ◽  
pp. 1031 ◽  
Author(s):  
Michele Reibaldi ◽  
Teresio Avitabile ◽  
Francesco Bandello ◽  
Antonio Longo ◽  
Vincenza Bonfiglio ◽  
...  

The study purpose was to assess the efficacy of a preservative-free 0.6% povidone iodine eye drops as perioperative prophylactic treatment for reducing conjunctival bacterial load and the rate of needle contamination in patients undergoing intravitreal anti-vascular endothelial growth factor injection. Enrolled patients were randomized to either the study group (0.6% povidone iodine, three day-prophylactic treatment before the injection) or to the control group (placebo, three day-prophylactic treatment). Conjunctival swabs were obtained before and after the prophylactic treatment in both groups. Intravitreal injections were performed in a sterile fashion. The injection needle and a control needle were collected for microbiological culture. Data from 254 and 253 eyes in the study group and control group, respectively, were analyzed. Bacterial growth from conjunctival swab cultures was significantly lower after 0.6% povidone iodine prophylaxis compared to baseline and to placebo prophylaxis (p < 0.001), showing an 82% eradication rate in the study group. No injection needle showed bacterial contamination in the study group, whereas six needles were culture-positive in the control group (p = 0.015). No serious ocular and non-ocular adverse events were recorded. The 0.6% povidone iodine solution proved an effective treatment in reducing conjunctival bacterial load and risk of needle contamination.


2009 ◽  
Vol 22 (2) ◽  
pp. 204-206
Author(s):  
H Akthar ◽  
S Sultana ◽  
D Begum ◽  
Z Nahar

One hundred twenty women at 40 weeks pregnancy with singleton foetus in cephalic presentation and intact membrane were randomly assigned to receive membrane sweeping or no membrane sweeping. The aim of this study was to determine the benefit of membrane sweeping at initiation of labour induction in conjunction with other methods of labour induction. After sweeping Bishop Score was done and in sweeping group, oxytocin infusion or misoprostol was administered 6 hours later. In control group, oxytocic agent was administered after vaginal examination. Among one hundred twenty women (60 sweep and 60 non-sweep) show that swept women had higher spontaneous vaginal delivery rate (83% compared with 60%). Shorter induction to delivery interval (12 hours compared with 19 hours), fewer that required oxytocin use (15% compared with 50%), shorter duration of oxytocin infusion (2 hours compared with 4 hours). Membrane sweeping at initiation of lab our induction increased the spontaneous vaginal delivery rate, reduced oxytotic drug use, shortened induction to delivery interval.TAJ 2009; 22(1): 204-206


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