scholarly journals Use of Oral Misoprostol for the Treatment of Incomplete Abortion

2014 ◽  
Vol 8 (2) ◽  
pp. 30-33
Author(s):  
S Kayastha ◽  
H Tuladhar ◽  
S Gurung ◽  
S Jaishe
Keyword(s):  
Side Effects ◽  
College Teaching ◽  
First Trimester ◽  
Medical College ◽  
Medical Evacuation ◽  
Obstetrics And Gynaecology ◽  
Incomplete Abortion ◽  
Surgical Evacuation ◽  
To Come

Aims: This study was done to assess the feasibility and acceptability of use of Misoprostol 600 mcg orally for treatment of incomplete abortion. Methods: A hospital based prospective study was carried out in the Department of Obstetrics and Gynaecology of Nepal Medical College Teaching Hospital from 1st November 2010 to 30th May 2013. All cases of first trimester incomplete abortion diagnosed clinically or by ultrasonogram were included in the study. They were given 600 mcg of Misoprostol orally. They were sent home, with advice to come for follow up after one week. Routine Ultrasound was carried out on follow up visit to confirm complete abortion. The side effects, complications and patient satisfaction was assessed and recorded. Results: Out of 86 patients, 8.1% (7) had to undergo surgical evacuation. So the success rate was 91.9% (79 cases). All the cases which needed evacuation were of higher gestation, that is, nine weeks or more. The commonest side effect was severe abdominal pain (81.4%). Three cases required emergency surgical evacuation within 24 hours due heavy bleeding.Conclusions: It is feasible and acceptable to use Misoprostol orally for medical evacuation, especially in earlier gestation of first trimester incomplete abortion. Side effects were common but were acceptable and tolerable by the patients. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 30-33 DOI: http://dx.doi.org/10.3126/njog.v8i2.9766  

scholarly journals Early Pregnancy Failure: Medical versus Surgical Management

2021 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Nasima Begum ◽  
Shahnaz Akhter ◽  
Luna Laila
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Early Pregnancy ◽  
Randomized Study ◽  
First Trimester ◽  
Patient’S Satisfaction ◽  
Medical Evacuation ◽  
Early Pregnancy Failure ◽  
Surgical Evacuation ◽  
Treatment Use

Introduction: Misoprostol is increasingly used to treat women who have a failed pregnancy may be due to blighted ovum (anembryonic gestation), incomplete abortion, missed abortion, inevitable abortion in the first trimester. Medical treatment with Misoprostol is an alternative to conventional surgical treatment. Use of Misoprostol is simple, highly acceptable, noninvasive and preferred by women. In addition to surgical risk and patient's preference, medical evacuation reduces the need for hospital stay and the overall management cost. Objective: To determine the efficacy and safety of Misoprostol for evacuation of uterus in early pregnancy loss and to compare the result with surgical evacuation. Materials and Methods: It was a prospective randomized study conducted on 50 patients at the department of Obstetrics and Gynaecology, Border Guard Hospital, Dhaka during the period from February 2018 to July 2019. Here 25 patients received Misoprostol as medical treatment and 25 patients received surgical treatment. Results: Of the 25 women assigned to receive Misoprostol, 19(76%) had complete expulsion by 24 hours and 22(88%) by 7 days. Complete evacuation after 1st dose was 68% and after 2nd dose 88%. Misoprostol treatment failed in 3(12%) cases and required surgical evacuation. Among the respondents 80% women stated that they would use Misoprostol again if the need arises. Conclusion: Medical treatment with Misoprostol is a cheaper alternative to surgery. Given its success rate near about 88% with mild side effects controllable with additional medication and above all patient’s satisfaction, it should be prioritized over the evacuation curettage in patients who meet the treatment criteria. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 63-67

scholarly journals Vaginal misoprostol versus vaginal surgical evacuation of first trimester incomplete abortion: Comparative study

2014 ◽  
Vol 19 (2) ◽  
pp. 96-101 ◽  
Author(s):  
Mahmoud Shokry ◽  
Mohamed Fathalla ◽  
Mostafa Hussien ◽  
Ashraf A. Eissa
Keyword(s):  
Comparative Study ◽  
First Trimester ◽  
Incomplete Abortion ◽  
Surgical Evacuation ◽  
Vaginal Misoprostol

scholarly journals Dermatological manifestations in PLHIV visiting link ART centre at rural medical college hospital in Western Tamilnadu, India

2017 ◽  
Vol 5 (3) ◽  
pp. 901
Author(s):  
Mohankumar Vedhanayagam ◽  
Rajesh Rajagopalan ◽  
Srinivasahan Karatupalyam Govindan ◽  
Balamurgan Bhavani Rajendran
Keyword(s):  
Side Effects ◽  
Highly Active Antiretroviral Therapy ◽  
Skin Diseases ◽  
Medical College Hospital ◽  
People Living With Hiv ◽  
College Hospital ◽  
Early Management ◽  
Medical College ◽  
Wide Range

Background: Ever since the early reports of human immuno deficiency infection, it presented as wide range of infectious and non-infectious dermatoses which correlate with the degree of immunodeficiency. Skin assessment remains a vital tool in the diagnosis and management of HIV infection due to relative easiness of examination. Most of skin diseases are amenable to diagnosis by inspection and biopsy. In this descriptive study, we have enumerated in detail the dermatological manifestations of Link ART centre clients.Methods: To analyze the dermatological manifestations in people living with HIV, we undertook a prospective observational study of all PLHIV on ART visiting IRT Perundurai Medical College Hospital link anti- retroviral therapy centre (LAC) during July 2015 to August 2016 with focus to skin manifestations.Results: Among the 140 clients, 22 in 2010, 12 in 2011, 6 in 2012, 51 in 2013, 36 in 2014, and 9 in 2015, 3 up to June 2016 enrolled for follow up. 31 were transferred to nearby ART, Link ART centres during this period as per their request, 4 lost for follow up and 6 deceased after enrolment, finally ninety-nine (39 male; 60 female) were utilizing our centre during the study period. Majority of participants were on ZLN (zidovudine, lamivudine, and nevirapine) regimen, hailing from rural zones, belonged to low or low middle income group, were undertaking farming, cattle rearing. CD4 counts of the asymptomatic clients in the ZLN group noted increase and decrease in the ZLE (zidovudine, lamivudine, and efavirenz), TLN (tenofovir, lamivudine, and nevirapine) group.  In the symptomatic clients, decline in the individual and the mean counts except in female ZLN subset. 70% were clinically asymptomatic and 30 % were having some dermatological manifestations. Multiple manifestations were seen in 5 clients during the study period. Dermatological manifestations observed commonly were fungal and viral infections, xerosis/ichthyoses, adverse drug reactions like lipodystrophy, and discoloration of nails.Conclusions: Skin manifestations observed in this study were due to aging and long term cosmetic side effects of highly active antiretroviral therapy  (HAART). Lipodystrophy posed significant aesthetic distress in HAART clients. Hence, early management would decrease the most offending cosmetolgical side effects of the disease and drugs. Therapy yields the declining trend in the inflammatory, infectious dermatoses.

scholarly journals Comparative evaluation of two commonly administered regimens of mifepristone and misoprostol for first trimester abortion

2018 ◽  
Vol 7 (7) ◽  
pp. 2759
Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar
Keyword(s):  
Side Effects ◽  
Tertiary Care Hospital ◽  
Randomized Study ◽  
Tertiary Care ◽  
First Trimester ◽  
Family Welfare ◽  
Care Hospital ◽  
Trimester Abortion ◽  
Misoprostol Group

Background: The objective of this study was to compare and evaluate the efficacy of two commonly administered regimens as per existing guidelines of Ministry of Health and Family Welfare for Outpatient MTP services. This study is aimed at evaluation of subjective and objective stastical benefits and side effects in performance of first trimester abortion on OPD basis in popularly used drugs as advised by MOHFW by different routes of administration. The drugs used were Tab Mifepristone (RU – 486) and Tab Misoprostol.Methods: This prospective randomized study was conducted in Out Patient Department of Obstetrics and Gynaecology in a tertiary care hospital over a period of 1 year after due clearance was obtained from Ethical Committee. This was prospective study involving 400 ladies reporting for Outpatient MTP services within the given time period as per existing guidelines at a tertiary care hospital. Patients were assessed at the end of 7, 15and 56 days, the mean age of the patients was 24.5±0.5 and 33±1 years and treatment duration was an average of 3 days with follow up for 15 days post administration. Few cases of failure required a follow up of approximately 56 days. All patients were on follow up for a period of 3 months for determination of menstrual irregularities and contraception management.Results: Between the 2 groups, in the sublingual Misoprostol group 100% aborted successfully at the end of 56 days. Whereas in the vaginal Misoprostol group 99% aborted successfully at the end of 56 days, only two patients requiring MVA as an OPD procedure.Conclusions: Patients were assessed at the end of 7, 15 and 56 days and between both the groups; Mifepristone with administration of misoprostol sublingually showed better success rate in completion of procedure, quicker action with better patient satisfaction and acceptance compared to conventional administration of Mifepristone and vaginal administration of misoprostol. Misoprostol administered sublingually under medical supervision is a superior, faster abortificient and has lesser incidence of Retained Products of Conception (RPOC) or need for Suction & Evacuation (S&E) as compared to vaginal route. Side effects observed need more evaluation with larger sample size to be statistically significant.

scholarly journals Comparison Intra Articular Steroid vs. Hydraulic Distention for the Treatment of Frozen Shoulder

2013 ◽  
Vol 1 (1) ◽  
pp. 3-9 ◽  
Author(s):  
GP Singh
Keyword(s):  
Pain Relief ◽  
Teaching Hospital ◽  
Frozen Shoulder ◽  
College Teaching ◽  
Muscle Relaxants ◽  
Medical College ◽  
Group I ◽  
Normal Sleep ◽  
Group Ii

Background Frozen shoulder is a chronic fibrosing condition of the capsule of the shoulder joint. OBJECTIVE The objective of the study was to compare the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra articular steroid alone. Sample Size: 60 patients were taken in this study and were divided into two groups. Duration and Setting: The study was conducted in 2005-2006 treated in the department of orthopaedic, Janaki medical college Teaching Hospital, Janakpur. Materials and Methods: It was a prospective, observational, comparative and clinical study. Sixty patients were selected from Dhanusha District of Janakpur, Nepal. They were divided into two groups. Since January 2005 to January 2006 periods in the department of orthopedics surgery, Janaki Medical College & Teaching Hospital, Janakpur. The Group I was treated by hydraulic distention of glenohumeral joint with 50ml normal saline with steroid, oral medicines (analgesics and muscle relaxants) and exercises. Patients in group II were treated by intra-articular steroid followed by oral medicines (analgesics and muscle relaxants) and exercises. Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 23 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions: Hydraulic distension technique is quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8415   Journal of Universal College of Medical Sciences Vol.1(1) 2013: 3-9

scholarly journals A COMPARATIVE STUDY OF MATERNAL OUTCOME IN FIRST-TRIMESTER VAGINAL BLEEDING IN THE DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Savita Meena ◽  
Suniti Verma ◽  
R N Sehra ◽  
Suman Choudhary
Keyword(s):  
Gestational Age ◽  
Vaginal Bleeding ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Control Group ◽  
Case Group ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: The outcome of ongoing pregnancies after first trimester vaginal bleeding is of relevance to women and obstetricians for planning antenatal care and clinical interventions in pregnancy. Hence, this study was conducted to identify the risks associated with first trimester bleed which may facilitate decision making regarding mode, place and timing of delivery during management, which may improve maternal and neonatal outcome. Methods: Hospital based comparative prospective study conducted at Department of Obstetrics and Gynaecology, SMS Medical College & associated Hospitals, Jaipur. Results: APH was found in 4 (8.00%) patients of case group and nil in control group. So, APH was found to be more in the case group than control group but was statistically not significant. Pre-eclampsia was found in 4 (8.00%) in case group and 3 (6.00%) in control group with statistically insignificant difference between the two groups.  26 (52.00%) delivered at the gestational age of ?37 weeks, whereas only 8 (16%) of control group delivered at ?37 weeks. So, the gestational age at delivery of control group subjects was found to be higher as compared to case group subjects and the difference was statistically significant (p=0.001). Conclusion: Threatened miscarriage in early pregnancy increases the risk of adverse pregnancy outcome. In our study, these patients were found to be at an increased risk of preterm delivery, PPROM. Keywords: PROM, Miscarriage, Gestational age

MEDICAL METHODS OF ABORTION (MMA), HOW SAFE?

2021 ◽  
pp. 51-52
Author(s):  
Anita Pathak
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Unsafe Abortion ◽  
Self Administration ◽  
Mortality And Morbidity ◽  
Incomplete Abortion ◽  
Referral Practices ◽  
Maternal Mortality And Morbidity ◽  
Insight Into

Unsafe abortion is important and preventable cause of maternal mortality and morbidity. Medical method of abortion is a safe efcient and affordable method of abortion. However incomplete abortion is known side effect. An insight into the referral practices in cases of incomplete abortion following medical method of abortion will give an idea of the safety prole of medical methods of abortion. 150 women with incomplete abortion following medical method of abortion were administered a questionnaire which included information regarding onset of bleeding, treatment received, use of medication for abortion, its prescription, and administration. 90% of incomplete abortion following medical method of abortion were due to self-administration or prescription by unregistered practitioners, lack of examinations and lack of follow up. Complications such as collapse, blood requirement and fever were signicantly higher in these patients. The side effects of incomplete abortion following medical method of abortion can be minimized by following the standard guidelines.

scholarly journals Neurological Sequelae in Acute Encephalitis Syndrome one month post discharge from the hospital in the Children Aged 1-14 years

2016 ◽  
Vol 5 (2) ◽  
pp. 43-46
Author(s):  
Arun Giri ◽  
Vijay Kumar Sah ◽  
Raju Sedhain ◽  
Romia Chimoriya
Keyword(s):  
Local Level ◽  
Fatal Outcome ◽  
College Teaching ◽  
Post Discharge ◽  
Behavioral Impairment ◽  
Neurological Sequelae ◽  
Medical College ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Introduction Encephalitis is a complex clinical syndrome of the central nervous system (CNS) associated with fatal outcome or severe permanent damage including cognitive impairment, behavioral impairment and epileptic seizures. It is important to understand the clinical spectrum and outcome of acute encephalitis syndrome(AES) at local level to better define problem and to draw inferences for management and policy formulation.Material and Methods: This study was a hospital based observational, longitudinal and descriptive study conducted at Department of Pediatrics; Nobel Medical College Teaching Hospital, Biratnagar. Seventy cases with a diagnosis of AES (irrespective of the underlying etiology), were studied over a period of one year. All cases from 1 to 14 years of age fulfilling the standard WHO case definition of AES were included in the study. A pre-designed semistructured questionnaire was being used to obtain the clinical profile and investigations. The cases were followed after one month post discharge from the hospital and the outcomes were recorded.Results: On follow up of the cases at the end of 1 month, 35 (50.7%) cases were found to have complete cure and were labelled as cured. Neurological sequelae were seen in 8(11.6%) cases and were labeled as not cured. Total death was documented in 26(37.7%) of the cases.Conclusion: Despite of early diagnosis and aggressive treatment neurological sequelae is not uncommon in AES. So, regular follow up and early rehabilitative efforts should be instituted for all cases of AES post discharge from the hospital.Journal of Nobel Medical College Vol.5(2) 2016; 43-46

scholarly journals Impact of Antenatal Care on Maternal and Perinatal utcome: A Study at Nepal Medical College Teaching Hospital

2012 ◽  
Vol 6 (2) ◽  
pp. 37-43 ◽  
Author(s):  
H Tuladhar ◽  
N Dhakal
Keyword(s):  
Cesarean Section ◽  
Antenatal Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
First Trimester ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Medical College ◽  
Antenatal Visits

Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome. Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu. Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin / Chhetri caste were more likely to attend ? 4 visits, while those living further than 6 km. from a health facility were less likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), only 21.9% had first ANC visit during first trimester. Overall Cesarean section rate was 17.4% and with increased rates in women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions: Although attendance of ANC is quite encouraging, the proportion of women attending ANC from first trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities.NJOG 2011 Nov-Dec; 6 (2): 37-43 DOI: http://dx.doi.org/10.3126/njog.v6i2.6755

scholarly journals Role of methotrexate in ectopic pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 84
Author(s):  
Munjal J. Pandya ◽  
Neha V. Ninama ◽  
Chirag V. Thummar ◽  
Meet K. Patel
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Intervention ◽  
Cost Effective ◽  
First Trimester ◽  
Medical College ◽  
Beta Human Chorionic Gonadotropin ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

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