The Efficacy of Physical Therapy in Treatment of Pelvic Floor Distress in Women of Reproductive Age

Study Objective: To compare the efficacy of two physical therapy techniques in the treatment of pelvic floor distress (PFD). Study Design: This was a prospective, randomized, double-blind, controlled study. Materials and Methods: Health information about ninety-five women who had had vaginal delivery and suffered from PFD was reviewed in the study. In Group I (n = 50) patients were treated using high-intensity focused electromagnetic (HIFEM) technology, and in Group II (n = 45) electrical stimulation therapy was delivered via an intracavity sensor. Assessments in the study included physical examination, instrumental investigations, and a discussion with patients (completion of a questionnaire and a scale-based assessment). To establish reference values for the parameters used in the study, a control group was made up of 30 apparently healthy women who had had a vaginal delivery. Study Results: Ultrasound of the pelvic floor showed that in Groups I and II the anteroposterior diameter of the levator hiatus (LH) decreased by 3.12 mm and 1.16 mm, respectively (2.7-fold difference), and the transverse diameter of the LH decreased by 3.04 mm and 1.04 mm (2.9-fold difference). The area of the LH decreased by 1.38 cm2 in Group I and 0.08 cm2 in Group II. After treatment the mean Pelvic Floor Distress Inventory (PFDI-20) score was 1.9 times lower (p<0.001) in Group I and the number of women who reported a feeling of looseness in the vagina and urinary incontinence using a bimodal scale for complaint assessment was 1.5 and 1.9 times lower, respectively, than in Group II. Conclusion: Electromagnetic stimulation demonstrated higher efficacy than stimulation via an intracavitary sensor in the treatment of PFD. Keywords: pelvic floor distress, genital prolapse, high-intensity focused electromagnetic stimulation.

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Effect of the Low Molecular Heparin Therapy on Foetal DNA Level in Non-Invasive Prenatal DNA Screening

Doctor Ru ◽

10.31550/1727-2378-2021-20-8-19-22 ◽

2021 ◽

Vol 20 (8) ◽

pp. 19-22

Author(s):

I.Yu. Barkov ◽

◽

N.K. Tetruashvili ◽

Yu.S. Bulatova ◽

L.V. Kim ◽

...

Keyword(s):

Pregnant Women ◽

Heparin Therapy ◽

Nucleotide Polymorphisms ◽

Perinatal Medicine ◽

Cross Sectional ◽

Study Objective ◽

Non Invasive ◽

Group I ◽

Study Results ◽

Group Ii

Study Objective: To evaluate the effect of low molecular heparin (LMH) therapy on non-invasive prenatal DNA screening (NIPS) for chromosomal pathologies. Study Design: cross-sectional study. Materials and Methods. We have examined two groups of pregnant women: group I included 49 patients with constantly low foetal DNA (twice lower than 4%) selected out of 1,505 women examined at Kulakov National Medical Scientific Centre of Obstetrics, Gynaecology and Perinatal Medicine of the Ministry of Health of Russia during the last 2 years. 17 women were administered LMH and 32 women did not receive it. Group II included 113 pregnant women with a normal foetal DNA fraction (at least 4%), that were selected randomly out of patients who were examined during the same period. 56 pregnant women were administered LMH and 57 were not. Next Generation Sequencing was used as an NIPS method. In order to determine the foetal DNA level, we amplified DNA loci with single nucleotide polymorphisms. Study Results. In group I (low foetal DNA fraction), where no LMH therapy was initiated, median values were 3.5% (3.2–3.8%); if LMH was administered, these values made 3.6% (3.4–3.9), while in group II — 7.7% (6.1–9.5%) and 7.9% (6.0–10.5%), respectively; no significant differences (p = 0.29 and p = 0.7, respectively) were recorded in both cases. Conclusion. Use of LMH does not affect NIPS; therefore, it is not necessary to adjust the LMH therapy in pregnant women prior to NIPS. Keywords: non-invasive prenatal DNA screening, heparin, anticoagulants, low molecular heparins, habitual abortion, pregnancy complications.

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Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000400009 ◽

2011 ◽

Vol 48 (4) ◽

pp. 265-269 ◽

Cited By ~ 5

Author(s):

Sthela Maria Murad-Regadas ◽

Francisco Sergio P Regadas ◽

Lusmar Veras Rodrigues ◽

Débora Couto Furtado ◽

Ana Cecília Gondim ◽

...

Keyword(s):

Pelvic Floor ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Obstructed Defecation ◽

Delivery Mode ◽

Obstructed Defecation Syndrome ◽

Group I ◽

Vaginal Deliveries ◽

Grade Ii ◽

Group Ii

CONTEXT: The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. OBJECTIVES: To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. METHODS: Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (<50y x >50y) and stratified by mode of delivery and parity: group I (<50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). RESULTS: Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group <50y and in the nulliparous and vaginal groups >50y. No correlation was found between rectocele and the number of vaginal deliveries. CONCLUSION: Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

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Bridging the gap between perioperative pelvic floor training and urologic surgeries with risk of incontinence by digital technologies: a survey. (Preprint)

10.2196/preprints.25324 ◽

2020 ◽

Author(s):

Jan Niclas Mumm ◽

Lucas Bohn ◽

Lennert Eismann ◽

Alexander Buchner ◽

Theresa Vilsmaier ◽

...

Keyword(s):

At Risk ◽

Pelvic Floor ◽

Digital Technologies ◽

Preventive Treatment ◽

Final Analysis ◽

Chi Square ◽

Group Iii ◽

Pelvic Floor Training ◽

Group I ◽

Group Ii

BACKGROUND Pelvic floor training (PFT) is the gold standard for conservative treatment of male stress urinary incontinence. OBJECTIVE To evaluate patients´ perspective at risk of incontinence on PFT and application of digital technologies for PFT. METHODS Patients undergoing transurethral surgery of the prostate (group I), radical prostatectomy (group II) or treatment at a specialized incontinence outpatient clinic (group III) were surveyed anonymously. Chi-Square test and Kruskal-Wallis-analysis were used for statistical analysis. RESULTS 180 patients were included in the final analysis. In group I (n=35) no patient underwent PFT prior to transurethral surgery. 23.5% of patients in group II (n=51) and 95.7% of patients in group III (n=94) performed PFT. 11.4% in group I, 80.4% in group II and 91.5% in group III have been advised to perform PFT by their urologist. Regarding the information level on PFT, patients from group I (median 1, range 0-5) are less satisfied than patients from group II (median 3, 0-9) or group III (median 5, range 0-10, p<0.001). 88.6% of patients from group I are willing to perform PFT as preventive treatment or to avoid incontinence surgery, 100% from group II and 68.4% from group III (p<0.001). The likelihood to use digital PFT is higher in group I (median: 9, range 0-10) and II (median: 9, range 0-10) than in group III (median: 4, range 0-10, p<0.001). CONCLUSIONS Patients at risk of incontinence currently have limited access to PFT, although they are willing to perform PFT. Digital PFT is highly accepted by patients preoperatively and might be a valuable tool to increase PFT participation.

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To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

10.53350/pjmhs211561227 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1227-1229

Author(s):

R. Farooqi ◽

T. Iqbal ◽

M. S. Mehmood ◽

Z. Y. Bhatti ◽

F. Liaquat

Keyword(s):

General Anesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Normal Saline ◽

Controlled Study ◽

Control Group ◽

Chi Square ◽

Group I ◽

Chi Square Test ◽

Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

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The results of use of myoplasty for closure of the pelvic floor defect after extralevator abdominoperineal excision of the rectum

Siberian Journal of Oncology ◽

10.21294/1814-4861-2018-17-6-35-40 ◽

2019 ◽

Vol 17 (6) ◽

pp. 35-40

Author(s):

N. A. Domansky ◽

V. V. Semiglazov ◽

A. M. Karachun ◽

K. K. Lebedev ◽

D. V. Samsonov ◽

...

Keyword(s):

Pelvic Floor ◽

Perineal Wound ◽

Abdominoperineal Excision ◽

Early Postoperative Period ◽

Wound Complications ◽

Pelvic Floor Reconstruction ◽

Group Iii ◽

Group I ◽

Perineal Wound Complications ◽

Group Ii

Background. Extralevator abdominoperineal excision is associated with a high incidence of perineal wound complications. There is no uniform standard for choosing the method for pelvic floor reconstruction after extralevator abdominoperineal excision.The purpose of the study was to compare the results of extralevator abdominoperineal excisions of the rectum using various methods of perineal wound closure.Materials and Methods. Between 2014 and 2018, 120 patients underwent extralevator abdominoperineal excisions of the rectum using various options for closure of the pelvic floor. The patients were divided into 3 groups. Group I patients (n=64) underwent simple plasty of the peritoneal wound. Group II patients (n=43) underwent myoplasty using the gluteus maximus muscle. Group III patients (n=13) underwent myoplasty using the rectus abdominis muscle. The incidence of perineal wound complications in the early postoperative period was assessed.Results. The total number of perineal wound complications in Group I, II and III was 33 (51.5 %), 13 (30.2 %), and 6 (46.1 %), respectively. Grade IIIA-IIIB complications according to the Clavien-Dindo classification were observed in 25 % of Group I patients, in 18.6 % of Group II patients and in 7.7 % of Group II patients. Postoperative perineal wound complications occurred more often in Group I patients after simple plasty than in Group II and III patients after myoplasty (51.5 % versus 30.2 %). However, perineal wound complications were observed more often in Group III than in Group II (46.1 % versus 30.2 %, respectively). No significant differences in the frequency of complications between 3 groups were found.Conclusion. Using various options for closure of the pelvic floor after extralevator abdominoperineal excisions of the rectum, there was a tendency to reduction in the incidence of grade IIIA-IIIB perineal wound complications.

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Evaluation and Comparison of Formocresol and Sodium Hypochlorite as Pulpotomy Medicaments in Treatment of Mandibular Primary Molars - A Randomized Controlled Study

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20211017 ◽

2021 ◽

Vol 6 (4) ◽

pp. 105-110

Author(s):

Nadia Irshad Wani ◽

Navneet Kour ◽

Manju Verma

Keyword(s):

Sodium Hypochlorite ◽

Primary Teeth ◽

Main Idea ◽

Permanent Teeth ◽

Controlled Study ◽

Primary Tooth ◽

Second Molar ◽

Randomized Controlled ◽

Group I ◽

Group Ii

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite

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Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.31 ◽

2020 ◽

Vol 5 (1) ◽

pp. 153-155

Author(s):

Sanjay Melville Masih ◽

Rakesh Kumar Gupta

Keyword(s):

Vaginal Delivery ◽

Group Iv ◽

Normal Vaginal Delivery ◽

Secondary Outcome ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Multiparous Women ◽

Group Ii ◽

Intrathecal Analgesia

Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.

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Lack of Effect of GnRH Agonists on Final Height in Girls with Advanced Puberty: A Randomized Long-Term Pilot Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.84.10.6032 ◽

1999 ◽

Vol 84 (10) ◽

pp. 3575-3578 ◽

Cited By ~ 41

Author(s):

C. Bouvattier ◽

J. Coste ◽

D. Rodrigue ◽

C. Teinturier ◽

J. C. Carel ◽

...

Keyword(s):

Final Height ◽

Bone Age ◽

Age And Growth ◽

Controlled Study ◽

Gnrh Agonists ◽

Clear Cut ◽

Group I ◽

Group Ii ◽

Predicted Height

Abstract GnRH agonists improve final height in girls with “true” precocious puberty. To test if a comparable effect can be obtained in older girls, we performed a long-term controlled study in 30 caucasian girls whose puberty started between 8.4 and 10 yr (9.4 ± 0.1 yr), a variant of normal called “advanced” puberty. At entry into trial, these girls had clinical, biological, and sonographic manifestations of puberty and a bone age greater than 10.9 yr. They were randomized 2:1 to receive 3.75 mg triptorelin im every 4 weeks for 2 yr (n = 20, group I) or no treatment (n = 10, group II). Mean height at inclusion was 135.2 ± 4.3 cm (+0.6 sds) in group I, 136.1 ± 4.2 cm (+0.8 sds ) in group II, with target height 157.6 ± 4.3 cm (group I) and 157.8 ± 4.7 cm (group II), and predicted height (Bayley-Pinneau) 154.1 ± 3.9 cm and 155.2 ± 3.7 cm. Although GnRH agonists transiently delayed sexual maturation as well as bone age and growth rate, they had no clear-cut long-standing effect, and final height was comparable in treated (157.6 ± 4.0 cm) and untreated girls (156.1 ± 5.3 cm) (NS).

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Bilateral Hegu Acupoints Have the Same Effect on the Heart Rate Variability of the Healthy Subjects

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/106940 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Wang Guangjun ◽

Tian Yuying ◽

Jia Shuyong ◽

Zhou Wenting ◽

Zhang Weibo

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Healthy Subjects ◽

Scientific Evidence ◽

The Body ◽

Acupuncture Points ◽

Group I ◽

Study Results ◽

Group Ii ◽

The Time Domain

Background. The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Acupoint laterality is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, namesake acupoint located on opposite sides of the body. Our previous study results suggest that Neiguan acupoint (PC6) has the laterality. The aim of this study was to investigate whether Hegu (LI4) also has laterality from the perspective of heart rate variability.Methods. A total of twenty-eight healthy female volunteers were recruited for this study and were randomly separated into the group I (n=14) and the group II (n=14) according to the register order. In the group I, left LI4 was stimulated in the first epoch and the right LI4 was stimulated in the second epoch. In the group II, right LI4 was stimulated in the first epoch and left LI4 was stimulated in the second epoch. Electrocardiogram was recorded and heart rate variability was analyzed.Results. The results show that there were no significant differences of heart rate variablity between the group I and the group II in the time domain and in the frequency domain.Conclusions. Bilateral Hegu acupoints have the same effect on the heart rate variability of the healthy subjects.

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The Value of Ozone in CT-Guided Drainage of Multiloculated Pyogenic Liver Abscesses: A Randomized Controlled Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/1236974 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Bing Li ◽

Chuan Liu ◽

Lang Wang ◽

Yang Li ◽

Yong Du ◽

...

Keyword(s):

Clinical Symptoms ◽

Pyogenic Liver Abscess ◽

Nonparametric Test ◽

Controlled Study ◽

Success Rates ◽

Catheter Drainage ◽

Ct Guided ◽

Group I ◽

Significant Difference ◽

Group Ii

Objective. This study was designed to compare the effects of catheter drainage alone and combined with ozone in the management of multiloculated pyogenic liver abscess (PLA). Methods. The prospective study included 60 patients diagnosed with multiloculated PLA. All patients were randomly divided into two groups: catheter drainage alone (group I) and catheter drainage combined with ozone (group II). Drainage was considered successful when (1) the abscess cavity was drained and (2) clinical symptoms were resolved. Kruskal-Wallis nonparametric test was used to compare the success rates, length of stay (LOS), and need for further surgery of the two groups. P<0.05 indicates significant difference. Results. All patients’ catheters were successfully placed under CT guidance. Group I was treated with catheters alone and group II was treated with catheters and ozone. The success rates of groups I and II were 86% and 96%, respectively (P<0.05). And compared with group II, the duration of fever in group I was longer (P<0.05), and the LOS was also longer (P<0.05). Conclusion. Catheter drainage combined with ozone is an effective and safe treatment in multiloculated PLA. The Clinical Registration Number is ChiCTR1800014865.

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