Role of l-arginine in the prevention of pre eclampsia in high-risk pregnancies.

Objective: To compare the efficacy of L-Arginine versus placebo in the prevention of pre eclampsia in high-risk pregnancies. Study Design: Randomized Control Trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period: November 2019 to February 2019. Material & Methods: A total of 130 women were included in the study. 65 patients were in L-arginine group or Group A while 65 patients were in placebo group or Group B. In group A, women were prescribed L-arginine 300 grams (Amino Whey Sachet) once a day until delivery and in group B; women were given homologated placebo (starch) once a day until delivery. Efficacy (no preeclampsia occurs during pregnancy) was noted from both groups and recorded. Mean ±SD was presented for quantitative variables like age, gestational age, parity, duration of chronic hypertension, weight, height and BMI. Variables such as age, parity, hypertension, body mass index, gestational age and duration of hypertension were stratified to assess their effect on efficacy. Chi square test was used to make comparison of the efficacy in both groups as well as for post-stratification for both groups. A p value of less than or equal to 0.05 was taken as significant. Results: In L-arginine group efficacy was 92.3% as compared to 69.2% in placebo group (p< 0.000) Table-IV. Conclusion: It can be concluded that L-arginine when given orally at the dose of 300g daily has a considerable role in prevention of pre-eclampsia in pregnant patients with high risk and also has a role in reduction of severity of pre-eclampsia.

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Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

Polish Journal of Surgery ◽

10.1515/pjs-2015-0075 ◽

2015 ◽

Vol 87 (8) ◽

Cited By ~ 2

Author(s):

Santosh Kumar ◽

Rajesh Roat ◽

Swati Agrawal ◽

Kumar Jayant ◽

Ravimohan S. Mavuduru ◽

...

Keyword(s):

Erectile Dysfunction ◽

Combination Therapy ◽

Erectile Function ◽

T Test ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

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Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i54b33789 ◽

2021 ◽

pp. 296-302

Author(s):

Obaid Ul Haseeb ◽

Haris Rashid ◽

Afrin Ahmed ◽

Mir Arsalan Ali ◽

Shakil Alam ◽

...

Keyword(s):

Controlled Trial ◽

P Value ◽

Open Approach ◽

Chi Square ◽

Closed Technique ◽

Chi Square Test ◽

Group A ◽

Classic Technique ◽

Group B ◽

Surgery Department

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

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Perbandingan Insidensi Hipotensi Saat Induksi Intravena Propofol 2 Mg/Kg Bb Pada Posisi Supine dengan Perlakuan dan Tanpa Perlakuan Elevasi Tungkai

Jurnal Kesehatan Andalas ◽

10.25077/jka.v5i1.476 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Beni Indra ◽

Untung Widodo ◽

Yunita Widyastuti

Keyword(s):

Randomized Control Trial ◽

Elective Surgery ◽

P Value ◽

Chi Square ◽

Parametric Data ◽

Chi Square Test ◽

Group A ◽

Randomized Control ◽

American Society ◽

Group B

Abstrak Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol. Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance caused by combination of venous and arterial vasodilatation. It will produce a shifting of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group B (27,2%) at the first minute after propofol injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation

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2ND TRIMESTER PREGNANCY

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.04.350 ◽

2018 ◽

Vol 25 (04) ◽

pp. 577-581

Author(s):

Sobia Tabassum ◽

Arshia Sabir ◽

Hafiz Muhammad Anwar ul Haq ◽

Hafiz Muhammad Ejaz ul Haq

Keyword(s):

Sampling Technique ◽

P Value ◽

Chi Square ◽

Prostaglandin F2a ◽

Oxytocin Infusion ◽

Successful Induction ◽

Chi Square Test ◽

Group A ◽

Test Of Significance ◽

Group B

Objectives: To compare the effectiveness of prostaglandin F2á by extra amnioticroute and I/V oxytocin infusion for induction of labor in 24 hours. Study Design: This wasa randomized control study. Place and Duration of the Study: This study was conductedat the department of Obstetrics & Gynaecology, Civil Hospital, Bahawalpur from March 2017to October 2017. Materials and Methods: A total number of 104 patients (52 given PGF2áand 52 increasing infusion rate of I/V oxytocin) between 13 to 26 weeks of gestation wereenrolled using non-probability purposive sampling technique. Two groups ‘A’ and ‘B’ wereformed having patients of comparable age, parity and gestational age to minimize the effectof confounders. Both the groups were compared for induction delivery interval (hours), andcomplications. Chi square test was used as test of significance and any value <0.05 was takenas statistically significant. Results: The ages of patients ranged from 16-45 years (28.93 + 8years). Gestational ages were between 13-26 weeks (mean 16.48 + 6.43 weeks). The parityranged from 0-9 (mean 3.9 + 2.87). Missed abortion was the major reason for TOP, seen in 71(68.3%). In Gorup-A, all patients aborted / delivered within 28 hours from the start of the infusionso got successful induction in 100% patients whereas 5 (9.6%) patients failed in Group B. InGroup A, successful induction of delivery was done in significantly less interval (11.27+6.2hours) as compared to Group B (18.4+10.8 hours) with a statistically significant p value of0.016.There were 3 (5.8%) patients in Group A and 10 (19.2%) in Group B who developed oneor more complications and this difference turned out to be statistically significant (p=0.038).No major complications developed in any of the groups. Conclusion: Extra amniotic PGF2á ismore effective than I/V Oxytocin for termination of pregnancy.

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Comparison of Ovulation Induction with Letrozole with Metformin Versus Letrozole Alone in Females Presenting with Polycystic Ovarian Syndrome

Esculapio ◽

10.51273/esc20.2516412 ◽

2021 ◽

Vol 16 (4 (oct 2020 - dec 2020)) ◽

Author(s):

Zubda Aiman ◽

Amna Khanam ◽

Mahliqa Maqsood ◽

Mehwish ayyaz ◽

Miss Alia ◽

...

Keyword(s):

Ovulation Induction ◽

Polycystic Ovarian Syndrome ◽

Controlled Trial ◽

P Value ◽

Chi Square ◽

Induction Rate ◽

Chi Square Test ◽

Group A ◽

Group B ◽

Ovarian Syndrome

Objective: To compare the frequency of Ovulation Induction after administration of Letrozole with metformin versus Letrozole alone in females presenting with Polycystic Ovarian Syndrome Methods: This Randomized Controlled Trial was done in unit 5 of Lady Aitchison Hospital Lahore for 6 months. Total 200 females fulfilling the inclusion criteria were recruited from OPD. Lottery method was used for randomization of study subjects. Females in group A were given Letrozole 2.5mg once a day for five days (from third to seventh day)of the cycle for three consecutive months and metformin 1500mg (500mg 3 times a day) daily for three months, while females in group B were given Letrozole 2.5mg once a day for five days (from third to seventh day) le for three consecutive months. Then they were followed up in OPD for 3 cycles. In all 3 cycles TVS was done on day 12 to access the number of follicles and to measure the size of largest follicle, and on day 21 of cycle progesterone level will be assessed for confirmation of ovulation induction. The data was entered and analyzed through SPSS version 20. Mean and standard deviation was calculated for age and BMI. Frequency and percentage was calculated for Ovulation induction. Both groups were compared by using chi-square test taking p-value<0.05 as significant. Data was stratified for BMI (Normal, overweight and Obese).After stratification chi-square test was applied keeping a p value < 0.05 as significant. Results: In Group-A mean age of women was 28.18±6.58 years. In Group-B mean age of women was 27.08±5.15 years. In Group-A ovulation induction rate was much higher as compared to that of Group-B women. i.e. (89% vs. 60%). p-value=0.000. Ovulation induction rate was significantly higher with Letrozole+ Metformin in women who were having normal BMI, overweight & obese as compared to that of Letrozole alone. Conclusion: Letrozole with metformin is more effective for the ovulation Induction females presenting with polycystic ovarian Syndrome as compared to letrozole alone.() Key Words: Polycystic Ovarian Syndrome, Management, Ovulation Induction, Letrozole, Metformin How to Cite: Aiman Z, Khanam A, Maqsood M, Ayyaz M, Alia, Kanwal K. Comparison of ovulation induction with letrozole with metformin versus letrozole alone in females presenting with polycystic ovarian syndrome. Esculapio.2020;16(04):54-58.

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PARA UMBILICAL HERNIAS

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.01.531 ◽

2018 ◽

Vol 25 (01) ◽

pp. 21-25

Author(s):

Muhammad Kalim ◽

Saeed Khan ◽

Asad Ali ◽

Rafi Ullah ◽

Mazhar Khan

Keyword(s):

Mesh Repair ◽

Controlled Trial ◽

P Value ◽

Chi Square ◽

Mild Pain ◽

Surgical Department ◽

Chi Square Test ◽

Group A ◽

Group B ◽

Repair Group

Background: Para-umbilical hernias are the common hernias among ventralabdominal hernias constituting about 85% of the overall abdominal wall hernias. Due to theirhigh risk of complications, adult paraumbilical hernias needs surgical repair. Objectives: Tocompare effectiveness of mesh versus mayo’s repair of para umbilical hernias in terms of postoperativepain. Study Design: Randomized controlled trial. Setting: Surgical Department,Hayatabad Medical Complex, Peshawar. Period: 12 months. Materials and Methods: A totalof 162 patients with paraumblical hernia were repaired. They were equally divided into 2 groupswith mesh repair (group A) and Mayo’s repair (Group B). The intervention effectiveness of meshversus mayo’s repair of para umbilical hernias was measured in terms of post-operative painby Visual Analogue Scale at the end of 3rd month. Data was analyzed by using SPSS version17. Chi Square Test was used p Value < 0.05 was significant. All the results were presentedin the form of tables and charts. Results: Mean age in (Mesh repair) was 30 years ± 2.1SDwhereas mean age in (Mayos repair) was 28 years ± 1.71SD. In Group A (Mesh repair), 73(90%)patients had mild pain (VAS 0-3), 8(10%) patients had moderate pain (VAS 4-6). In Group B(Mayos repair), 63(78%) patients had mild pain (VAS 0-3), 16(20%) patients had moderate painscore (VAS 4-6), 2(2%) patients had severe pain score (VAS 7-10). Mesh repair was effective in73(90%) patients whereas Mayos repair was effective in 63 (78%) patients. Conclusion: Meshrepair is more effective in terms of post-operative pain than Mayos repair.

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Role of Dermaroller and Prp In Post-Traumatic Facial Scar Treatments

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2605 ◽

2020 ◽

Vol 11 (3) ◽

pp. 4061-4067

Author(s):

Alpesh ◽

Jumale V P

Keyword(s):

Statistical Significance ◽

T Test ◽

P Value ◽

Chi Square ◽

Chi Square Test ◽

Group A ◽

Post Traumatic ◽

Group B

In the present study follow up kept on immediate post-operative day and at one week to evaluate pain, bleeding and inflammation. Final follow up at two months for assessment of aesthetic score by three independent personnel. Pain and inflammation were more associated with Group B compared to Group A, but there are no statistical significance differences among this groups (P value- 0.074 and 0.136 for pain and inflammation respectively on immediate post-operative day. Chi-square test). Final follow up assessment of aesthetic scores at two months calculated by Chi- square test and comparisons of two groups for aesthetic scores done by Independent t-Test. All three personnel gave higher aesthetic score to Group B but statistically this was not significant (P-value 0.287, 0.129 and 0.400 by Observer 1, 2 and patients respectively. Chi-square test). The mean aesthetic score given by Observer 1, 2 and patient was higher associated to Group B but statistically this was not significant (P=0.526, 0.055 and 0.232 independent t-Test).

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Resorbable Collagen Barrier Impeding the Extrusion of Obturating Material in Primary Molars Undergoing Resorption – A Randomized Clinical Trial

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-45.5.4 ◽

2021 ◽

Vol 45 (5) ◽

pp. 312-316

Author(s):

Mishra Neha Sanjeev ◽

Harsimran Kaur ◽

Sandeep Singh Mayall ◽

Rishika ◽

Ramakrishna Yeluri

Keyword(s):

Test Group ◽

Primary Molars ◽

Control Group ◽

Chi Square ◽

Significance Level ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B ◽

And Control

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p < 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p>0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.

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Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.12.4728 ◽

2020 ◽

Vol 27 (12) ◽

pp. 2541-2547

Author(s):

Muhammad Arif ◽

Sabih Nofal ◽

Ahsan Khan ◽

Mariam Tariq Awana ◽

Anum Arif

Keyword(s):

Glyceryl Trinitrate ◽

Controlled Trial ◽

P Value ◽

Chi Square ◽

Male Predominance ◽

Internal Sphincterotomy ◽

Open Hemorrhoidectomy ◽

Group A ◽

Group B ◽

Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

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ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

10.36106/ijsr/3520656 ◽

2020 ◽

pp. 9-11

Author(s):

Madhu Kumari ◽

Kumari Bibha ◽

Abha Sinha ◽

Debarshi Jana

Keyword(s):

Cesarean Section ◽

Gestational Age ◽

Statistical Significance ◽

P Value ◽

Chi Square ◽

Medical College ◽

Chi Square Test ◽

Uterine Scar ◽

Age Range ◽

The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

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