scholarly journals MISSED MISCARRIAGE

2016 ◽  
Vol 23 (06) ◽  
pp. 736-740
Author(s):  
Bushra Saeed ◽  
Musrat Akhtar ◽  
Muhammad Akram
Keyword(s):  
Controlled Trial ◽  
First Trimester ◽  
Medical Group ◽  
Missed Abortion ◽  
Safe Alternative ◽  
Medical Termination ◽  
Products Of Conception ◽  
Significant Difference ◽  
The Difference ◽  
Surgical Group

Objectives: The aim of this study was to compare the medical treatment withsurgical evacuation of uterus in the management of first trimester missed miscarriage. StudyDesign: Randomize controlled trial: Place and Duration of Study: The study was conductedin the Obstetrics and Gynecology department civil hospital Bahawalpur from 1st January 20114to 31 December; 2014. Material and Methods: Total 120 patients were included in the studydiagnosed as a case of first trimester missed abortion. Patients were randomly assignedeither medical or surgical group. In the surgical group (controlled group) dilatation and theevacuation was performed. In the medical group misoprostol was used for medical termination.The criteria for success was complete expulsion of products of conception. Results: Therewas no statistically significant difference regarding demographic and clinical characteristicsbetween the two groups .Complete expulsion of the conceptus was less in medical group(83.3%) than the surgical group (88.3%) but the difference was not significant. Almost 16.7%patients in the medical group had failure of expulsion and underwent surgical evacuation.Duration of bleeding after the procedure was 9±2.6 days in surgical group and 12±3.4 inmedical group. Conclusion: Medical termination of first trimester missed miscarriage usingMisoprostol (800mcg initial dose followed by 400mcg 4 hourly 3 doses if need) is an efficaciousand safe alternative to the surgery.

scholarly journals A double-blind randomized controlled trial of topical Curcuma xanthorrhiza Roxb. on mild psoriasis: clinical manifestations, histopathological features, and K6 expressions

2018 ◽  
Vol 27 (3) ◽  
pp. 178-84 ◽  
Author(s):  
Githa Rahmayunita ◽  
Tjut N.A. Jacoeb ◽  
Endi Novianto ◽  
Wresti Indriatmi ◽  
Rahadi Rihatmadja ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Clinical Manifestations ◽  
Effective Treatment Option ◽  
Psoriasis Area Severity Index ◽  
Double Blind ◽  
Old Patients ◽  
Mean Values ◽  
Significant Difference ◽  
Curcuma Xanthorrhiza ◽  
The Difference

Background: Curcuma xanthorrhiza Roxb. exerts its anti-inflammatory effects by reducing the concentration of IL-6, IL-8, and phosphorylase kinase, which has role in keratinocyte proliferation. Our study aimed to evaluate the efficacy of C. xanthorrhiza in psoriasis.Methods: From 18 to 59 year-old patients with mild psoriasis, 2 similar lesions were selected. The severity assessment was based on the psoriasis area severity index (PASI), Trozak score, and K6 expression. Using a double-blinded randomized method, lesion was treated with 1% C. xanthorrhiza ointment vs placebo for 4 weeks. The results were analyzed by the chi-square test using STATATM V.12 software (Stata Corp.).Results: The study was conducted in 2010 to 2012 with 17 subjects participated. The median of PASI score were reduced significantly in both lesions, either treated with 1% C. xanthorrhiza ointment vs placebo; however when compared between the group, it was not significant (p=0.520). The Trozak score were reduced in lesions treated with 1% C. xanthorrhiza ointment; but it was not significant (p = 0.306). In lesions treated with placebo, the Trozak score was increased significantly. The difference of Trozak score between lesions treated with C. xanthorrhiza and placebo was significant (p=0.024). There was no significant difference of K6 expression in lesions treated with 1% C. xanthorrhiza ointments or placebo as well as on the difference of mean values of K6 expression between the group (p=0.827).Conclusion: Based on the results, 1% C. xanthorrhiza ointment is effective treatment option for mild psoriasis, but longer follow-up period is suggested to confirm this results. C. xanthorrhiza ointment is safe for topical administration as there were no side effects reported in this study.

scholarly journals A Randomized Controlled Trial Comparing Novel Triple-Cuffed Double-Lumen Endobronchial Tubes with Conventional Double-Lumen Endobronchial Tubes for Lung Isolation

2020 ◽  
Vol 9 (4) ◽  
pp. 977
Author(s):  
Namo Kim ◽  
Hyo-Jin Byon ◽  
Go Eun Kim ◽  
Chungon Park ◽  
Young Eun Joe ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Fiberoptic Bronchoscopy ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lung Isolation ◽  
Significant Difference ◽  
Initial Placement ◽  
The Difference ◽  
Double Lumen Endobronchial Tube

Placing a double-lumen endobronchial tube (DLT) in an appropriate position to facilitate lung isolation is essential for thoracic procedures. The novel ANKOR DLT is a DLT developed with three cuffs with a newly added carinal cuff designed to prevent further advancement by being blocked by the carina when the cuff is inflated. In this prospective study, the direction and depth of initial placement of ANKOR DLT were compared with those of conventional DLT. Patients undergoing thoracic surgery (n = 190) with one-lung ventilation (OLV) were randomly allocated into either left-sided conventional DLT group (n = 95) or left-sided ANKOR DLT group (n = 95). The direction and depth of DLT position were compared via fiberoptic bronchoscopy (FOB) after endobronchial intubation between the groups. There was no significant difference in the number of right mainstem endobronchial intubations between the two groups (p = 0.468). The difference between the initial depth of DLT placement and the target depth confirmed by FOB was significantly lower in the ANKOR DLT group than in the conventional DLT group (1.8 ± 1.8 vs. 12.9 ± 9.7 mm; p < 0.001). In conclusion, the ANKOR DLT facilitated its initial positioning at the optimal depth compared to the conventional DLT.

scholarly journals Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Dan-Viorel Nistor ◽  
Nicolae Ciprian Bota ◽  
Sergiu Caterev ◽  
Adrian Todor
Keyword(s):  
Physical Therapy ◽  
Controlled Trial ◽  
Direct Anterior Approach ◽  
Lateral Approach ◽  
Total Hip ◽  
Significant Difference ◽  
Postoperative Physical Therapy ◽  
Muscle Sparing ◽  
The Difference ◽  
Therapy Sessions

The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach’s main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.

A Sham-Controlled Trial of Acupuncture as An Adjunct in Migraine Prophylaxis

2014 ◽  
Vol 32 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Mohsen Foroughipour ◽  
Amir Reza Golchian ◽  
Mohsen Kalhor ◽  
Saeed Akhlaghi ◽  
Mohammad Taghi Farzadfard ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Sham Acupuncture ◽  
Migraine Prophylaxis ◽  
Acupuncture Group ◽  
Migraine Headaches ◽  
Prophylactic Drugs ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Sham Acupuncture Group

Background Migraine is one of the most common types of headache, with significant socioeconomic effects. Prophylactic drugs are used to prevent migraine headaches but are unpromising. Objective To assess the effects of adding acupuncture to conventional migraine prophylaxis. Methods One hundred patients with migraine (41 male, 59 female), in whom prophylactic drugs had not produced a fall of at least 50% in the number of attacks, entered the study. The patients were randomised into two groups, sham and true acupuncture. The patients in both groups continued their prophylactic treatment and received 12 sessions of either true or sham acupuncture. Each session was 30 min and was repeated three times a week. The number of headaches in the two groups was compared at baseline, and at the end of four successive months. Results There was no significant difference in the frequency of attacks between the two groups before intervention. After 1 month, the frequency of attacks each month decreased from 5.1 (0.8) to 3.4 (1.2) in the true acupuncture group, and from 5.0 (0.8) to 4.4 (1.1) in the sham acupuncture group (a significant difference, p<0.001). The frequency continued to decrease in month 2 but increased in months 3 and 4; however, it was still significantly lower than baseline, and the difference remained significant after month 4. Conclusions Acupuncture is applicable as an adjunct to prophylactic drugs in migraineurs in whom the number of attacks does not fall with prophylactic medication.

scholarly journals Adverse Effects of Carbetocin versus Oxytocin in the Prevention of Postpartum Haemorrhage after Caesarean Section: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
D. Mannaerts ◽  
L. Van der Veeken ◽  
H. Coppejans ◽  
Y. Jacquemyn
Keyword(s):  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Caesarean Section ◽  
Blood Loss ◽  
Controlled Trial ◽  
Hypotensive Effect ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Effect Difference ◽  
The Difference

Purpose. To compare the incidence of nausea, vomiting, and arterial hypotension between carbetocin and oxytocin to prevent haemorrhage after caesarean section (CS).Methods. A randomized controlled trial in term pregnant women undergoing planned CS. Groups were randomized to carbetocin or oxytocin. Blood pressure (BP), heart rate, presence of nausea/vomitus, and need for vasopressors were evaluated throughout surgery. Preoperative and postoperative haemoglobin and haematocrit levels were compared.Results. Fifty-eight women were randomized (carbetocinn=32; oxytocinn=26). Both medications had hypotensive effect, difference in BP for carbetocin versus oxytocin: systolic (14.4 ± 2.4 mmHg versus 8.5 ± 1.8 mmHg); diastolic (7.8 ± 1.6 mmHg versus 8.9 ± 3.0 mmHg) without significant difference between the drugs (p=0.1andp=0.7). Both groups had similar needs for vasopressors. The presence of nausea was not rare, but the difference was not statistically significant (p=0.4). Average blood loss was slightly lower in the carbetocin group but not statistically significant (p=0.8).Conclusion. In planned CS, a possible clinical significant lower incidence of nausea after carbetocin was noted but this was not statistically significant. There were no differences regarding BP, heart rate, the need for vasopressor, and blood loss. The study was registered in the International Journal of Clinical Trials (ISRCTN95504420, 2/2017).

scholarly journals Does the parental stretching programs improve metatarsus adductus in newborns?

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769032 ◽  
Author(s):  
Perajit Eamsobhana ◽  
Karn Rojjananukulpong ◽  
Thanase Ariyawatkul ◽  
Chatupon Chotigavanichaya ◽  
Kamolporn Kaewpornsawan
Keyword(s):  
Success Rate ◽  
Controlled Trial ◽  
Observation Group ◽  
Mild Degree ◽  
Significant Difference ◽  
Pediatric Foot ◽  
Lower Success Rate ◽  
Metatarsus Adductus ◽  
The Difference ◽  
Severe Degree

Background: Metatarsus adductus (MA) is a common pediatric foot deformity. Current recommendations suggest observation until 4–6 months, then casting if the deformity persists. Based on our review of the literatures, no randomized controlled trial has been conducted to study the effectiveness of parental stretching in the correction of MA in newborn. Material and methods: Ninety-four newborn feet that were diagnosed as MA by clinical examination were enrolled. Feet were randomized into two groups: observation group and stretching group. Outcome measurements were performed to compare success rate between groups. Results: According to Pearson’s χ2 test, there were no statistically significant differences between groups with regard to the overall success of the parental stretching program ( p = 0.191). There was also no significant difference between groups for mild degree or moderate-to-severe degree ( p = 0.134, p = 0.274, respectively). A more rapid success rate was observed in the stretching group at the first month follow-up, but rate of improvement then decreased. The stretching group tended to have a lower success rate compared to the observation group in moderate-to-severe feet, but the difference was not statistically significant. Conclusions: Parental stretching program found no benefit over observation group in this study. Parental stretching program should not be applied for newborn babies with moderate-to-severe MA as the result from the study appeared to have lower success rate compared to observation group. Observe until 4–6 months, then corrective casting for the persisting deformity is recommended.

scholarly journals A Brief Intervention to Increase Uptake and Adherence of an Internet-Based Program for Depression and Anxiety (Enhancing Engagement With Psychosocial Interventions): Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Philip J Batterham ◽  
Alison L Calear ◽  
Matthew Sunderland ◽  
Frances Kay-Lambkin ◽  
Louise M Farrer ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Psychosocial Interventions ◽  
P Uptake ◽  
Depression And Anxiety ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Trials Registry

BACKGROUND Psychosocial, self-guided, internet-based programs are effective in treating depression and anxiety. However, the community uptake of these programs is poor. Recent approaches to increasing engagement (defined as both uptake and adherence) in internet-based programs include brief engagement facilitation interventions (EFIs). However, these programs require evaluation to assess their efficacy. OBJECTIVE The aims of this hybrid implementation effectiveness trial are to examine the effects of a brief internet-based EFI presented before an internet-based cognitive behavioral therapy self-help program (<i>myCompass 2</i>) in improving engagement (uptake and adherence) with that program (primary aim), assess the relative efficacy of the <i>myCompass 2</i> program, and determine whether greater engagement was associated with improved efficacy (greater reduction in depression or anxiety symptoms) relative to the control (secondary aim). METHODS A 3-arm randomized controlled trial (N=849; recruited via social media) assessed the independent efficacy of the EFI and <i>myCompass 2</i>. The <i>myCompass 2</i> program was delivered with or without the EFI; both conditions were compared with an attention control condition. The EFI comprised brief (5 minutes), tailored audio-visual content on a series of click-through linear webpages. RESULTS Uptake was high in all groups; 82.8% (703/849) of participants clicked through the intervention following the pretest survey. However, the difference in uptake between the EFI + <i>myCompass 2</i> condition (234/280, 83.6%) and the <i>myCompass 2</i> alone condition (222/285, 77.9%) was not significant (n=565; <i>χ</i><sup>2</sup><sub>1</sub>=29.2; <i>P=</i>.09). In addition, there was no significant difference in the proportion of participants who started any number of modules (1-14 modules) versus those who started none between the EFI + <i>myCompass 2</i> (214/565, 37.9%) and the <i>myCompass 2</i> alone (210/565, 37.2%) conditions (n=565; <i>χ</i><sup>2</sup><sub>1</sub><0.1; <i>P=</i>.87). Finally, there was no significant difference between the EFI + <i>myCompass 2</i> and the <i>myCompass 2</i> alone conditions in the number of modules started (<i>U</i>=39366.50; <i>z</i>=−0.32; <i>P=</i>.75) or completed (<i>U</i>=39494.0; <i>z</i>=−0.29; <i>P=</i>.77). The <i>myCompass 2</i> program was not found to be efficacious over time for symptoms of depression (<i>F</i><sub>4,349.97</sub>=1.16; <i>P=</i>.33) or anxiety (<i>F</i><sub>4,445.99</sub>=0.12; <i>P=</i>.98). However, planned contrasts suggested that <i>myCompass 2</i> may have been effective for participants with elevated generalized anxiety disorder symptoms (<i>F</i><sub>4,332.80</sub>=3.50; <i>P=</i>.01). CONCLUSIONS This brief internet-based EFI did not increase the uptake of or adherence to an existing internet-based program for depression and anxiety. Individuals’ motivation to initiate and complete internet-based self-guided interventions is complex and remains a significant challenge for self-guided interventions. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12618001565235; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375839

scholarly journals A retrospective study of efficacy and cost efficiency of medical vs. surgical management of abortions in first trimester

2021 ◽  
Vol 10 (9) ◽  
pp. 3429
Author(s):  
Meetangi Agarwal ◽  
Sailatha Ramanujam ◽  
Anuradha C. Ramachandran
Keyword(s):  
Success Rate ◽  
Pregnancy Termination ◽  
Transvaginal Ultrasound ◽  
Cost Effective ◽  
Medical Abortion ◽  
First Trimester ◽  
Observational Research ◽  
Medical Termination ◽  
Significant Difference

Background: The aim of the study was to assess and comparatively evaluate the efficacy of different methods of first trimester abortions (medical, surgical) in terms of its safety, cost and effectiveness.Methods: We present a retrospective observational research study done at Chettinad hospital and research institute, Kelambakkam Chennai which included a total of 70 patients of first trimester abortions, in the period from June 2019 to June 2020. 55 patients were offered medical treatment (MTOP) and were followed up with a repeat scan after 2 weeks. In cases of failed medical abortion patient underwent curettage. Though, in some cases after an attempt at medical abortion, if the products didn’t expel at all within 48 hours, dilatation and evacuation was offered. Transvaginal ultrasound was performed to confirm the success of the treatment. In 15 cases who presented with incomplete abortion, surgical treatment (STOP) was offered. The outcomes considered were successful complete abortions, failed medical abortions, side effects and complications including blood transfusion.Results: The baseline characteristics of women were similar in both the groups like mean age, parity, history of previous termination of pregnancy (TOP). The success rate in MTOP was 67.2% and in STOP 100%.The amount of bleeding experienced was moderate to heavy in MTOP and minimal to moderate in STOP.37 women who underwent only medical termination who returned for the 2-week follow-up, the rate of complete pregnancy termination was 94% and for the remaining 2 women surgical intervention was required. In the surgical group, at the 2-week follow up, no woman underwent a repeat vacuum aspiration with an efficacy of 100%. No significant difference was found in the mean total cost for the medical and surgical groups after adding the subsequent costs (including additional manual vacuum evacuation).Conclusions: Medical termination of abortion should be preferred over surgical termination as it is safer, cost effective, with fewer complications and high success rate. 

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