scholarly journals Complications following use of single rod etonogestrel implant (Implanon).

2019 ◽  
Vol 26 (11) ◽  
pp. 1947-1951
Author(s):  
Sadia Bashir ◽  
Sajilah Karim ◽  
Bushra Khan ◽  
Sadia Faiz ◽  
Madeeha Riaz ◽  
...  
Keyword(s):  
Side Effects ◽  
Reproductive Health ◽  
Insertion Site ◽  
Case Series ◽  
Antenatal Clinic ◽  
Health Clinic ◽  
Menstrual Disturbance ◽  
Irregular Bleeding ◽  
Continuous Bleeding ◽  
Etonogestrel Implant

Objectives: To determine the frequency of complications and side effects of single rod etonogestrel implant (implanon). Study Design: Descriptive case series. Setting: At Contraceptive clinic, (Reproductive Health Clinic (Contraception), antenatal clinic of the Department of Obstetrics & Gynaecology, Nishtar Hospital Multan. Period: From November 2014 to November 2016. Material & Methods: The sample included 72 healthy active women. The final outcome in this study was efficacy. Results: Client mean age was 28.07±4.88 years. Usually clients 57 (79.2%) were 1-4 para. 5 (6.9%) clients complain of pain, out of which only 4 had pain at insertion site and 1 had pain at insertion site and also in stomach. No side effects were observed 55 clients (67.4%) main complains about menstrual disturbance like 26 (36.1%) having amenorrhea. Continuous bleeding was the main complain in 9 clients (12.5%), heavy menstruation was found in 7 (9.7%), 10 (13.9%) had irregular bleeding. Prolonged bleeding was present in 2 clients (2.8%), 7 (9.7%) complain of spotting, 10 (13.9%) had no menstruation problem. Conclusion: The results of this study showed that majority of the clients had amenorrhea.

scholarly journals Contemporary use of Selexipag in pulmonary arterial hypertension associated with congenital heart disease: a case series

2020 ◽  
Author(s):  
Sarah Blissett ◽  
David Blusztein ◽  
Vaikom S Mahadevan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Side Effects ◽  
Arterial Hypertension ◽  
Exercise Capacity ◽  
Congenital Heart ◽  
Pulmonary Veins ◽  
Case Series ◽  
Pulmonary Arterial

Abstract Background There are significant risks of parenteral prostacyclin use in patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD), which may limit their use. Selexipag is an oral, selective prostacyclin analogue that has been shown to reduce disease progression and improve exercise capacity in patients with PAH-CHD. Administering Selexipag in patients with PAH-CHD could potentially overcome some of the risks of parenteral therapy while improving clinical outcomes. Case summary We report five cases highlighting the clinical uses of Selexipag in patients with PAH-CHD. In the first two cases, Selexipag was initiated as part of a Treat-to-close strategy. In the third case, initiation of Selexipag improved symptoms and objective exercise capacity in a patient with Eisenmenger syndrome. In the fourth and fifth cases, rapid cross-titration protocols were used to transition from parenteral prostacyclins to Selexipag. In the fourth case, Selexipag was initiated in the context of significant side effects limiting parenteral prostacyclin use. In the fifth case, Selexipag was used to down-titrate from parenteral prostacyclins following closure of a sinus venosus atrial septal defect and redirection of anomalous pulmonary veins. Discussion Selexipag is a promising oral therapy for patients with at various stages of the spectrum of PAH-CHD to improve symptoms, exercise capacity and, in some cases, haemodynamics. Our cases also highlight practical aspects of Selexipag use including targeting the individualized maximally tolerated dose for each patient, managing side effects and managing dose interruptions.

scholarly journals Opioid-free anesthesia for patients with joint hypermobility syndrome undergoing craneo-cervical fixation: a case-series study focused on anti-hyperalgesic approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Carlos Ramírez-Paesano ◽  
Albert Juanola Galceran ◽  
Claudia Rodiera Clarens ◽  
Vicenҫ Gilete García ◽  
Bartolomé Oliver Abadal ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Discharge ◽  
Case Series ◽  
Ehlers Danlos Syndrome ◽  
Painful Condition ◽  
Discharge Data ◽  
Gastrointestinal Complications ◽  
Case Series Study ◽  
Series Study

Abstract Background Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation (CCF). The secondary aim was to assess the needs of opioids at hospital-discharge, incidence of gastrointestinal complications and the requirement of anxiolytic. Methods A retrospective, consecutive case series study was designed. 42 patients with EDS-HT/JHS undergoing CCF were enrolled in two groups: an OFA-plus Group that received opioid-free anesthesia with propofol, lidocaine, ketamine and dexmedetomidine, and OP Group, opioid-based anesthesia-analgesia. The main variables: Preoperative Visual Analogue Score (VAS), postoperative VAS on the 1st, 2nd, 4th and 6th days, sufentanil or morphine requirements, need for methadone rescue, and VAS at hospital-discharge. Data was presented by mean ± SD, percentage, median or interquartile range. Chi-squared or Fisher’s test. 95% C.I and P values < 0.05. Results Nineteen patients in OFA-plus, and 23 patients in OP group. VAS was lower in OFA-plus on the postoperative days evaluated (p < 0.001).VAS at hospital-discharge was lower in OFA-plus: 4.96 (4.54–5.37) vs. OP 6.39 (6.07–6.71) (p < 0.001). Methadone requirement was lower in the OFA-plus (p < 0.001). 78% of patients in OFA-plus didn’t need methadone rescue. 95% in OP group needed methadone rescues at high doses(> 15 mg/day). No differences regarding equivalent doses of sufentanil or morphine consumption on the 2nd, 4th, and 6th postoperative days were found. OFA-plus decreased ileus, nausea and vomiting (p < 0.001). 60.9% in OFA-plus group decreased opioid requirements at hospital-discharge compared with preoperative values. A 77% reduction of anxiolytics requirements was shown. Conclusion OFA-plus management for patients undergoing CCF with EDS-HT/JHS shows significant reduction in postoperative pain and at hospital-discharge compared with opioid-based anesthesia. OFA-plus management decreases the total doses of methadone rescues, reduces anxiolytic requirements and gastrointestinal side-effects, except for constipation. OFA-plus management is a feasible option to improve postoperative pain control, reducing the opioids’ use and their postoperative side-effects in patients undergoing CCF with EDS-HT/JHS.

scholarly journals Quick and collaborative response to teenage pregnancies in a poor semi-rural area of Belgium

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Déom ◽  
L Ben Abdelhafidh ◽  
N Annez ◽  
C Glorie ◽  
M Roland
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Rural Areas ◽  
Sexual And Reproductive Health ◽  
Health Clinic ◽  
Local Health ◽  
Reproductive Health Services ◽  
Sexually Transmitted ◽  
Victims Of Violence ◽  
The City

Abstract Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate. Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus. In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week. In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services. The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas. Key messages Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.

scholarly journals Anaesthesia and Postoperative Analgesia Performed by Insertion of a Perineural Catheter at the Brachial Plexus Site - Case Series

2015 ◽  
Vol 61 (3) ◽  
pp. 241-244
Author(s):  
Lazar Alexandra ◽  
Szederjesi Janos ◽  
Copotoiu Sanda Maria ◽  
Simon Noemi Szidonia ◽  
Badea Iudita ◽  
...  
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Case Series ◽  
Postoperative Pain Management ◽  
Perineural Catheter ◽  
Plexus Block ◽  
Systemic Drug

Abstract Postoperative pain management is of major importance and the existence of a device that ensures a good analgesia in the immediate postoperative period and also removes the side effects of the systemic drugs, is becoming a necessity. Objectives: The goal was to obtain a good quality anaesthesia and also a good postoperative analgesia by inserting a perineural catheter at the brachial plexus site. Material and method: This study included adult patients who underwent brachial plexus anaesthesia through a perineural catheter inserted at the brachial plexus site. The perineural catheter was introduced by ultrasound guidance with neurostimulation control. After insertion, a quantity of a an-aesthetic admixture of 0.4mg/kg is administered. The anaesthetic admixture contained Ropivacaine and Lidocaine, equimolar concentration of 0.5% In the postoperative period, the analgesia was ensured trough the already installed catheter. The analgesic mixture contained Ropivacaine and Lidocaine, equivalent concentrations of 0.25%. The administration rate was 5 ml every 4 hours, starting 6 hours postoperatively. Results: The anaesthesia, obtained through the perineural catheter, was a good quality anaesthesia ensuring both, good sensory and motor block. The feedback regarding postoperative analgesia was positive, this type of pain management being efficient and without the systemic drug side effects. This approach of brachial plexus block was accepted easily by the patients and was rated as a very satisfactory method. Conclusions: The insertion of a perineural catheter for anaesthesia and postoperative analgesia represents a safe and efficient method of achieving both analgesia and anaesthesia.

Use hormonal contraception in women with overweight

2017 ◽  
pp. 120-122
Author(s):  
N.V. Avramenko ◽  
◽  
I.B. Gridina ◽  
Keyword(s):  
Side Effects ◽  
Reproductive Health ◽  
Key Words ◽  
Mucous Membrane ◽  
Clinical Supervision ◽  
Hormonal Contraception ◽  
Negative Influence ◽  
Modern Medicine ◽  
Excessive Weight ◽  
Important Direction

Maintenance of reproductive health and decision of problem of safe contraception women with excessive weight have the issue of the day of present time and it is confessed by important direction of modern medicine. The objective: to define influence of hormonal contraception on the mucous membrane of neck of uterus for women with surplus mass of body. Patients and methods. In 90 women with excessive weight influence of hormonal contraception is studied on the mucous membrane of neck of uterus. Results. It is set that a modern hormonal contraception does not have a negative influence on the state of mucous membrane of neck of uterus for women with surplus mass of body. Conclusion. Women with excessive weight and can effectively and safely to use a modern hormonal contraception. But it is necessary to carry out a clinical supervision for the step of that additional elucidations are possible about the features of application of hormonal contraception for patients with excessive mass of body. Key words: contraception, overweight, side effects.

Skin Side Effects Due To Vortioxetine Case Series

2021 ◽  
Vol 11 (4) ◽  
pp. 284
Author(s):  
Mehmet Gunes ◽  
Ezgi Inan
Keyword(s):  
Side Effects ◽  
Case Series ◽  
Skin Side Effects

Efficacy of ultra-low-dose (0.1 mg) ranibizumab intravitreal injection for treatment of prethreshold type 1 retinopathy of prematurity: A case series

2018 ◽  
Vol 30 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Islam SH Ahmed ◽  
Ahmed MA Hadi ◽  
Hassan H Hassan
Keyword(s):  
Side Effects ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Large Scale ◽  
Low Dose ◽  
Case Series ◽  
Results Of Treatment ◽  
Case Series Study ◽  
Systemic Side Effects

Aim: To report the results of treatment of type 1 prethreshold retinopathy of prematurity using intravitreal injection of ultra-low dose of ranibizumab (0.1 mg in 0.01 mL). Design: A retrospective observational case series study. Methods: Review of files of eligible infants who received this form of treatment to determine the outcome of treatment and any associated ocular or systemic side effects. Results: The study included 24 eyes of 12 preterm infants with mean gestational age of 29.75 ± 1.54 weeks and mean birth weight of 1074.58 ± 320.59 g. A total of 22 eyes (91.67%) had zone II disease while 2 eyes of one infant (8.33%) had zone I disease. All cases showed regression of the signs of the active retinopathy of prematurity with complete retinal vascularization. None of the cases required retreatment. Three eyes developed ocular complications. Apart from mild feeding intolerance that lasted for 24 h after injection in one infant, none of the cases developed systemic side effects. Conclusion: Intravitreal injection of ultra-low-dose ranibizumab showed promising efficacy and good ocular safety. However, further large-scale studies are required to give stronger evidence about the efficacy and safety of ultra-low-dose ranibizumab.

scholarly journals Efavirenz induced gynecomastia, hidden reality: a case series

2020 ◽  
Vol 7 (11) ◽  
pp. 1747
Author(s):  
Dnyanesh N. Morkar ◽  
Ankita Aneja ◽  
Rishabh Agarwal
Keyword(s):  
Side Effects ◽  
Hiv Infection ◽  
Side Effect ◽  
Case Series ◽  
Drug Adherence ◽  
Resource Limited Settings ◽  
Hiv Patients ◽  
Highly Active ◽  
Resource Limited ◽  
Haart Therapy

The prognosis of HIV infection has considerably improved following the introduction of highly active anti-retroviral therapy by reducing AIDS related morbidity and mortality. At the same time, ART drugs are well known for their side effects. Gynaecomastia is a lesser known side effect of a commonly used anti-retroviral drug efavirenz. There are very few reports of HAART-induced gynaecomastia in resource-limited settings. The current study presents a series of three cases that developed ultrasound confirmed gynaecomastia following efavirenz containing HAART. Initial reports of gynaecomastia related to HAART were in HIV patients with lipodystrophy, they were termed as pseudogynaecomastia. Gradually, few reports of efavirenz related gynaecomastia were published wherein other causes of gynaecomastia were ruled out. Several hypothesis have been suggested for the pathophysiology of development of gynaecomastia related to efavirenz consumption. All other causes were ruled out in our patients too. The incidence of gynaecomastia is increasing in men with HIV on HAART therapy, proper identification and management will promote better drug adherence.

scholarly journals Effect of Placenta Previa on fetal & maternal morbidity / mortality

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Bushra Sehr Zaman ◽  
Asma Zubair ◽  
Sher Zaman Bhatti ◽  
Muhammad Zubair Saeed Malik
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Case Series ◽  
Antenatal Clinic ◽  
Case Series Study ◽  
Severe Hemorrhage ◽  
Year 2000 ◽  
Series Study

Objective: To see the effect of placenta previa on fetal and maternal mortality/ morbidity. This was a case series study. Study was conducted in Gynecology unit BV Hospital Bahawalpur during year 2000 to 2003. All the patients presenting with or with out painless bleeding in antenatal clinic & proved to be due placenta previa were included in the study. Patients presenting with pain less bleeding in the antenatal clinic due to other reasons were excluded from the study. In all the patients` history along with the risk factors clinical and sonography finding, any intervention needed and final out come was recorded. SPSS was used for data collection & analysis. Results: Total 50 patients were studied Out of these 84% of patients were symptomatic a t admission the symptoms found were Bleeding, shock & Pain. Strong associations o f risk factors like Age, Parity, ERCP, Smoking and previous C. Section was found in our study. Severe hemorrhage, prematurity, stillbirths and ENND was associated with Placenta Previa. Conclusion: Placenta previa is not an uncommon but underestimated, under reported & preventable condition. Prevention is possible in case of Known risk factors. Early diagnosis is necessary as the delay in some cases may end up in disaster

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