scholarly journals COMPARISON OF MANUAL VACUUM ASPIRATION UNDER LOCAL ANESTHESIA AND SUBLINGUAL MISOPROSTOL IN MANAGEMENT OF INCOMPLETE MISCARRIAGE IN GMC TEACHING HOSPITAL, NEPAL

2018 ◽  
Vol 6 (1) ◽  
pp. 52-55
Author(s):  
Malati Tripathi ◽  
Kripa Sherchan
Keyword(s):  
Success Rate ◽  
Local Anesthesia ◽  
Teaching Hospital ◽  
P Value ◽  
Vacuum Aspiration ◽  
Group I ◽  
Sublingual Misoprostol ◽  
Manual Vacuum Aspiration ◽  
Group Ii ◽  
Incomplete Miscarriage

Introduction: To compare the efficacy of using sublingual misoprostol and manual vacuum aspiration under local anesthesia in the treatment of spontaneous incomplete miscarriage (of up to 6 to 12 weeks of pregnancy).MATERIALS AND METHODS: This is a prospective study performed in Gandaki Medical College (GMC) Teaching Hospital, Pokhara on 150 patients with spontaneous incomplete miscarriage between 6 to 12 weeks of pregnancy. Patients were divided into two groups: group (I) patient who took 400 μg misoprostol every four hourly for maximum of three doses, group (II) patient who underwent manual vacuum aspiration (MVA) under local anesthesia. Only 68 patients in group I and 64 patients in group II completed their follow up and were included in this study.RESULTS: The success rate of MVA under local anesthesia was 100% and misoprostol was 67.7% (p-value <0.05). Both misoprostol and MVA under local anesthesia are effective for treatment of incomplete miscarriage.CONCLUSION: Although success rate of MVA under local anesthesia is more than misoprostol, both MVA and misoprostol can be used, as an effective method of uterine evacuation in incomplete abortion of <12 weeks.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 52-55

Comparison of Adverse Outcomes in Cirrhotic and Non-Cirrhotic Patients with Covid-19 Disease

2021 ◽  
Vol 15 (7) ◽  
pp. 2289-2291
Author(s):  
Jahangir Anjum ◽  
Talal Safdar ◽  
Muhammad Imran ◽  
Muazzam Fuaad ◽  
Waheed Iqbal ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Teaching Hospital ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
Group I ◽  
Cirrhotic Patients ◽  
Group Ii ◽  
Disease Study

Objective: The aim of this study is to determine the comparison of adverse outcomes in cirrhotic and non-cirrhotic patients presented with coronavirus disease. Study Design: Place and Duration: The department of Medicine of Divisional Headquarters Teaching Hospital Mirpur Azad Kashmir and Mohiuddin Teaching Hospital, Mirpur AJK for six months during the period from October 2020 to March 2021. Methodology: Total 80covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were aged between 20-55 years. Patients were divided in to two groups. Group I (with cirrhosis 40 patients) and group II (without cirrhosis 40 patients). Outcomes in term of mortality between both groups were examined. All the data was analyzed by SPSS 26.0 version. Results: There were 24 (60%) males and 16 (40%) were females with mean age 44.19±7.65 years in group I while in group II 27 (67.5%) and 13 (32.5%) patients were males and females with mean age 43.62±5.34 years. We found that mortality rate among patients of group I (cirrhotic) had high mortality rate13 (32.5%) as compared to patients without cirrhosis 5 (12.5%) in group II with p-value 0.0003. Conclusion: We concluded in this that frequency of adverse outcomes was significantly high among cirrhotic patients with coronavirus disease as compared to non-cirrhotic patients. Keywords: Corvid-19, Mortality, Chronic Liver Disease

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

Incomplete miscarriage during the first trimester: a comparison of indoor versus outdoor procedure

2020 ◽  
Vol 24 (3) ◽  
pp. 235-239
Author(s):  
Faiza Iqbal ◽  
Sadia Azmat ◽  
Rabia Jamshaid ◽  
Zunaira Arshad ◽  
Anum Saqib
Keyword(s):  
Controlled Trial ◽  
First Trimester ◽  
P Value ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Group A ◽  
First Trimester Of Pregnancy ◽  
The Mean ◽  
Group B ◽  
Incomplete Miscarriage

Introduction: Miscarriage is defined as the natural death of a fetus inside the uterus. To remove complete conception material after a miscarriage, vacuum aspiration or dilatation & curettage are methods to remove uterine contents. Controversies exist regarding both procedures. So we conducted this study to confirm the more successful method. Objective: To compare the effectiveness of manual vacuum aspiration versus traditional evacuation and curettage (E & C) among females presenting with incomplete miscarriage during the first trimester of pregnancy Materials and Methods: This randomized controlled trial was done at the Department of Obstetrics & Gynecology, Shalamar Hospital, Lahore for 6 months. Then the selected females were divided randomly into 2 equal groups. In group A, females had manual vacuum procedure while in group B, females had evacuation & curettage under general anesthesia. After 12 hours of the procedure, ultrasonography was done to confirm complete evacuation. Results: The mean age of the patients was 29.87 ± 6.71 years, the mean gestational age was 8.06 ± 2.82 weeks. The effectiveness was noted in 248 (91.85%) patients. Statistically, manual vacuum showed significantly more effective as compared to evacuation & curettage procedure in the management of incomplete miscarriage i.e. p-value = 0.008. Conclusion: It has been proved that manual vacuum aspiration is more effective than traditional evacuation & curettage in the management of incomplete miscarriage.

scholarly journals COMPARATIVE STUDY OF MANUAL VACUUM ASPIRATION AND DILATATION & EVACUATION IN TERMS OF THEIRS ACCEPTABILITY AND COMPLICATIONS FOR THE SURGICAL MANAGEMENT OF EARLY PREGNANCY LOSS

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
B S Meena ◽  
Narendra Kumar
Keyword(s):  
Success Rate ◽  
Surgical Management ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Early Pregnancy Loss ◽  
Missed Abortion ◽  
Medical College ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Incomplete Miscarriage

Background: To compare efficacy and complication of manual vacuum aspiration and dilatation and evacuation as the method for early pregnancy loss surgical management. Methods: This study was conducted in the Department of Obstetrics and Gynaecology, SMS Medical College & Associated group of Hospitals, Jaipur during this study, 200 pregnant women with below 12 weeks gestational age having a confirmed diagnosis of incomplete miscarriage and missed abortion were included. All selected cases divided into MVA group and D&E group randomly. Results: MVA group 98% cases were successful and failure was in 2% which required re-procedure. In D&E group 94% cases were successful and failure was in 6% cases which required re-procedure. Success rate was founded more in MVA group than D&E group. Conclusion: On comparison of the two, in our study MVA was seen to be having an edge over D&E, regarding complication and success rate. Keywords: MVA, D&E, Complication, Success rate.

Endoscopic Dacryocystorhinostomy without Probing: Surgical Outcome

2010 ◽  
Vol 3 (2) ◽  
pp. 77-80
Author(s):  
Rijuneeta LNU ◽  
Ashok K Gupta
Keyword(s):  
Success Rate ◽  
Surgical Outcome ◽  
Nasolacrimal Duct ◽  
Stent Insertion ◽  
P Value ◽  
Duct Obstruction ◽  
Group Iii ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Group Ii

Abstract Ninety-eight cases of nasolacrimal duct obstruction including 6 bilateral cases were included in the study done at Postgraduate Institute of Medical Research, Chandigarh. All the cases had been divided into three groups with Group I including cases in which 12 endoscopic dacryocystorhinostomy (DCR) with dilatation and probing and stent insertion were performed. In Group II, 23 Endo DCR performed with intraoperative dilatation and probing but no stent insertion. Group III included 69 cases of Endo DCR without dilatation and probing and no stent insertion. Overall success rate was found to be 94.3% with Group III cases having a success rate of 97.1% and was found statistically significant on comparing with that of Group II (p value: 0.03).

scholarly journals A comparison of manual vacuum aspiration with medical method of abortion in termination of pregnancy up to 9 weeks of gestational age

2017 ◽  
Vol 6 (9) ◽  
pp. 3813
Author(s):  
Pramod Garhwal ◽  
Lata Rajoria ◽  
Manju Sharma
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
Termination Of Pregnancy ◽  
P Value ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Surgical Evacuation ◽  
Group A ◽  
Group B

Background: Objective of present study was to compare efficacy and complications of medical method versus manual vacuum aspiration in early pregnancy termination and to determine whether medical method of termination of pregnancy represent a reasonable alternative to surgical method (MVA) in terms of complete evacuation of products of conception and their side effects.Methods: A comparative study was carried out on 184 pregnancies in women who were willing for termination of pregnancy up to 9 weeks (63 days) of gestational age, in Group A: women who opted for medical method for termination, Group B: women who opted for manual vacuum aspiration for termination.Results: Mean age of Group A was 27.63±3.60 years and Group B was 26.87±3.83 years. Majority 169 (92%) of women were Hindu. 165 (90%) of the patients lived in urban area and 176 (96%) were married women. Majority 130 (71%) of them were para 2 and more. Average age of gestation at which termination was performed was 46.79±6.29 days in Group A and 49.13±6.67 days in Group B. Average duration of vaginal bleeding among Group A was found to be 8.9±3.5 days (p value<0.05) and in Group B was 6.837+2.928 days which was significantly longer in Group A. 72 (78.3%) patients considered vaginal bleeding to be heavier than their normal period in Group A where as in Group B 8 (8.7%)perceived it to be heavier (p value <0.001). Incidence of pain, nausea, vomiting, diarrhea and incomplete abortion (78.26%, 32.60%, 16.3%, 19.56% and 4.43%) in group A and (52%, 7.6% ,4.3%, nil and 2.17%) in group B which were found to be higher in Group A as compare to Group B. Patient satisfaction was 95.65% in medical method and 84.78% in MVA group. Success rate was 95.65% for medical and 97.82% for MVA group.Conclusions: Duration and amount of bleeding per vaginum is more in medical method as compare to surgical method. Side effects like pain, nausea, vomiting and diarrhea were more in medical group, but majority of these symptoms were self-limiting. There was high satisfaction rate (95.65%) among medical abortion group because less surgical and anaesthetic complication, offer them more privacy and treatment is taken at home. The effectiveness of medical method of abortion in present study was 95.65% and success rate in MVA was 97.82%. Medical method of abortion for first trimester termination of pregnancy upto 9 weeks of gestation can be better alternative method to surgical evacuation. Medical method of abortion proves to be more effective, safe and economical method that avoid complication associated with surgical evacuation like uterine perforation, cervical laceration and anaesthtic complication. The only disadvantage with medical method of abortion is lack of predictability and variable success rate.

Comparison of Outcome of Lateral Pinning Versus Medial and Lateral Cross Pinning in Childhood Supracondylar Fractures of Humerus

2021 ◽  
Vol 15 (9) ◽  
pp. 2873-2875
Author(s):  
Mudassar Nazzar ◽  
Muhammad Adeel-Ur- Rehman ◽  
Rizwan Anwar ◽  
Omer Farooq Tanveer ◽  
Muhammad Abdul Hanan ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
P Value ◽  
Supracondylar Fractures ◽  
Group I ◽  
Pin Fixation ◽  
Group Ii ◽  
Carrying Angle ◽  
Ulnar Nerve Injury

Objectives: To compare the complications and outcomes of lateral entry pin fixation with medial and lateral pin fixation for Gartland type III supracondylar fractures of humerus. Methodology: This prospective comparative study involving 190 patients of Gartland type III close supracondylar fractures were included. from March-2019 to Dec-2020. In all patients, initially the elbow was mobilized using the splint placed above the elbow joint at 30 to 45 degrees’ flexion. After closed reduction, lateral pinning was applied in group I and in group II lateral and medial cross pinning was applied using the standard protocol. Patients were followed for iatrogenic ulnar nerve injury, radiologic and function outcomes in-terms of loss of reduction, elbow range of motion, loss in carrying angle and functional outcomes. Results: The two groups were comparable for loss of elbow range of motion, loss of carrying angle and loss of Bauman's angle. On clinical examination, immediate post-operative ulnar nerve injury was diagnosed in 4 (4.2%) cases in group II and in no patient in group I (p-value 0.12). Satisfactory functional outcomes were achieved in 85 (89.5%) patients in group I and in 88 (92.6%) patients in group II (p-value 0.44). Conclusion: Lateral pinning provided stable fixation clinically and radiologically as compared to lateral and medial cross pinning. Keywords: Supracondylar fracture of Humerus, Iatrogenic ulnar nerve injury, Lateral pin entry, lateral and medial cross pin entry.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals The prognostic role of inflammatory markers in COVID 19 patients – A retrospective analysis.

2021 ◽  
Author(s):  
Shivkumar Gopalakrishnan ◽  
sangeetha kandasamy ◽  
S.Malini ◽  
S.Peer Mohamed ◽  
k.velmurugan
Keyword(s):  
Inflammatory Markers ◽  
Severe Disease ◽  
Radiation Hazard ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
D Dimer

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.

scholarly journals Results of modern tuboperitoneal infertility treatment

2009 ◽  
Vol 66 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Drenka Turjacanin-Pantelic ◽  
Dragana Bojovic-Jovic ◽  
Biljana Arsic ◽  
Eliana Garalejic
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Infertility Treatment ◽  
P Value ◽  
Modern Approach ◽  
Vitro Fertilization ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

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