scholarly journals Use of Intravenous Dexamethasone for Cervical Ripening and Labor Induction in Term Pregnancies with Pre-labour Rupture of Membranes: Randomized control trial

2021 ◽  
Vol 4 (2) ◽  
pp. 01-08
Author(s):  
Sarah safwat
Keyword(s):  
Vaginal Delivery ◽  
Intravenous Administration ◽  
Randomized Control Trial ◽  
Active Phase ◽  
Maternity Hospital ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Control Group ◽  
Dexamethasone Group ◽  
Randomized Control

Abstract Background: During the first 36 to 38 weeks of normal gestation, the myometrium is in a preparatory yet unresponsive state. Concurrently, the cervix begins an early stage of remodeling yet maintains structural integrity. Induction of labour is a complex process involving cervical ripening which undergo extensive remodeling and dynamic changes controlled by hormonal, inflammatory changes, and other biological processes. Aim of the Work: to assess the effect of intravenous administration of dexamethasone on the induction delivery interval in term patients with prelabour rupture of membranes undergoing induction of labor. Patients and Methods: This randomized control trial was conducted at department of Obstetrics and Gynecology at Ain Shams University Maternity Hospital (ASUMH) in the period between August 2020 and January 2021. Participants of this study were 80 full term pregnant women with pre-labor rupture of membranes attended the labor ward in El Demerdash Maternity Hospital and scheduled for induction of labor by 8 mg dexamethasone IV before starting induction by PGE1, after 4 hours oxytocin was added by 1 IU/hr with the dose increasing by 1 IU every 30 minutes till optimal contractions were reached which were three uterine contractions in 10 minutes and each lasting for 40-50 seconds. Results: Fetal distress, arrest of delivery and indications of CS delivery were non-significantly less frequent among Dexamethasone group. Induction-active phase and active phase durations were significantly shorter among dexamethasone group than among control group. Second and third stages durations were non-significantly shorter among dexamethasone group than among control group. Total induction-delivery duration was significantly shorter and rate of vaginal delivery was significantly higher among dexamethasone group than among control group. Postpartum hemorrhage (PPH), postpartum endometritis, chorioamnionitis were not reported among the studied groups. No significant difference between Dexamaethasone and Control groups regarding neonatal condition Conclusion: Intravenous administration of dexamethasone in addition to labor induction protocol shortened the induction - active phase and active phase durations. It shortened the total induction-delivery duration and increased the rate of successful vaginal delivery. It has no effect on second and third stages durations with no increase in incidence of intrapartum, postpartum nor neonatal complications.

scholarly journals Sublingual Misoprostol versus Foley catheter for cervical ripening in women with preeclampsia or gestational hypertension: A randomized control trial

2019 ◽  
Author(s):  
Sedigheh Ayati ◽  
Elahe Hasanzadeh ◽  
Leila Pourali ◽  
Mohammadtaghi Shakeri ◽  
Atiye Vatanchi
Keyword(s):  
Vaginal Delivery ◽  
Randomized Control Trial ◽  
Gestational Hypertension ◽  
Pregnancy Termination ◽  
Foley Catheter ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Significant Difference ◽  
Sublingual Misoprostol ◽  
Randomized Control

Background: Delivery is the only definite cure for hypertensive disorders. Therefore, cervical ripening and labor induction are important to achieve favorable outcomes. Objective: This Randomized Control Trial (RCT) is aimed to compare the effects of sublingual misoprostol and Foley catheter in cervical ripening and labor induction among patients with preeclampsia or gestational hypertension. Materials and Methods: A total number of 144 women with preeclampsia or gestational hypertention with indication of pregnancy termination, who were referred to academic hospitals of the University of Medical Sciences in Mashhad, Iran, between March 2015 and December 2016, were randomly divided into two groups. In group one (n = 72), 25 μg of misoprostol tablet was administrated sublingually every 4 hr up to six doses. In group two (n = 72), a 16F Foley catheter was placed through the internal cervical os, inflated with 60 cc of sterile saline. Results: There were no significant differences between groups regarding the demographic characteristics, primary bishop score, and pregnancy termination indication. The cervical ripening time (primary outcome) (8.2 vs 14.2 hr, p < 0.00), induction to delivery interval (15.5 vs 19.9 hr, p < 0.00), and vaginal delivery before 24 hr (63.9% vs 40%, p = 0.03) were significantly different between the two groups. There was no significant difference between groups in view of oxytocin requirement (p = 0.12), neonatal Apgar score (p = 0.84), or neonatal intensive care unit admission (p = 78). Conclusion: This trial showed that the application of sublingual misoprostol, compared to the Foley catheter, can reduce cervical ripening period and other parameters related to the duration of vaginal delivery. This misoprostol regimen showed inconsiderable maternal complications.

Intravenous Dexamethasone Versus Vaginal Misoprostol in Enhancing Cervical Ripening and Labor Induction

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Mahmoud Salman ◽  
Fekria Ahmed Salama ◽  
Mina Yacoub
Keyword(s):  
Total Duration ◽  
Active Phase ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Time Interval ◽  
Vaginal Misoprostol ◽  
Mean Time

Abstract Background Induction of labor is one of the most common procedures performed in the world of Obstetrics. Traditionally, labor induction is performed using prostaglandin and oxytocin. However, usage of corticosteroids nowadays is gaining a lot of interest regarding its effects on cervical ripening and shortening the physiological process of labor. Aim of work to evaluate the efficacy of intravenous dexamethasone versus vaginal misoprostol in enhancing cervical ripening and labor induction. Patients and Methods A randomized controlled clinical trial was carried out at Ain Shams University Maternity Hospital on (60) full term pregnant women between 39 – 42 weeks undergoing induction of labor, during a period from April 01, 2019 to November 30, 2019. Pregnant women were divided into two groups; vaginal misoprostol (control) group and intravenous dexamethasone (experimental) group (30 cases each). Results Our study showed that the mean time interval (hours) from initiation of labor induction to initiation of active phase was statistically significantly shorter among the dexamethasone (experimental) group 7.36 ± 2.23 versus 12.20 ± 4.92 hours among the vaginal misoprostol (control) group (p value &lt; 0.001). Also, the mean time interval of the total duration between the induction of labor to successful vaginal delivery was statistically significantly shorter among the dexamethasone group 10.90 ± 4.17 versus 19.20 ± 5.62 hours among the vaginal misoprostol group (p value &lt; 0.001). The results of this study showed the rate of initiation of active phase and rate of successful vaginal delivery were more in the experimental dexamethasone group than the control vaginal misoprostol control group. Conclusion Intravenous injection of 8 mg of dexamethasone before induction of labor is found to shorten the duration of labor induction by reducing the time interval between the initiation of labor induction and onset of active phase and the total duration from initiation of labor induction to delivery with no marked maternal or fetal complications. Recommendations Intravenous Dexamethasone can help cervical ripening and accelerate induction of labor. Further research should be taken in consideration with more population for more global evaluation.

scholarly journals Role of Dexamethasone in Induction of Labor: (A Randomized Clinical Trial)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Elsayed ◽  
A M Bahaa ◽  
A A Alanwar ◽  
K M Mohamed
Keyword(s):  
Pregnant Women ◽  
Statistical Difference ◽  
Active Phase ◽  
Maternity Hospital ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Control Group ◽  
Significant Statistical Difference ◽  
Phase Interval ◽  
Group D

Abstract Background Labor induction is a common obstetric procedure which is done for many indications. Ripening of the cervix is a complex process involving hormonal, vasodilatory and inflammatory changes. There are broad range of methods for cervical ripening and induction of labor. Aim of the study: to assess the efficacy of intramuscular administration of dexamethasone on the induction delivery-interval in full term women undergoing induction of labor. Patients and Methods This study was carried out between July 2018 and January 2019, at the labor ward of Ain Shams university maternity hospital, a double bind randomized control trial of 80 pregnant women undergoing induction of labor after obtaining the approval of the local ethical committee and a fully-informed written consent. They were randomized into two groups: group D (Dexamethasone group n = 40) and group C (control group n = 40). Results Of 80 pregnant women undergoing induction of labor there were no statistically significant differences between the two groups as regard their age, body mass index, gestational age and bishop score at time of intervention. There was significant statistical difference between the two groups as regard induction-active phase interval (P &lt; 0.05), mean induction-active phase interval in group D was (4.91±.85 hours) while in group C was (5.44±.83 hours). There was no significant statistical difference between the two groups as regard duration of active phase of labor, mean duration of active phase in group D was (4.10±.97 hours) and in group C (4.47±1.20 hours). There was significant statistical difference between the two groups as regard induction-delivery interval (P &lt; 0.05), mean induction-delivery interval in group D was (9.73±.1.52hours) while in group C was (10.70±1.87 hours). There were no statistically significant differences between the two groups as regard duration of 2nd and 3rd stages of labor. Conclusion Single intramuscular injections of 2 ml. (8mg) of dexamethasone before induction of labor seems to shorten induction-delivery interval by shortening the induction-active phase interval.

scholarly journals Early Use of Corticosteroid May Prolong SARS-CoV-2 Shedding in Non-Intensive Care Unit Patients with COVID-19 Pneumonia: A Multicenter, Single-Blind, Randomized Control Trial

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Xiao Tang ◽  
Ying-Mei Feng ◽  
Ji-Xiang Ni ◽  
Jia-Ying Zhang ◽  
Li-Min Liu ◽  
...  
Keyword(s):  
T Cells ◽  
Randomized Control Trial ◽  
Corticosteroid Treatment ◽  
Clinical Deterioration ◽  
Control Group ◽  
Number Of Patients ◽  
Early Use ◽  
Randomized Control ◽  
And Control ◽  
Single Blind

<b><i>Background:</i></b> There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia. <b><i>Objective:</i></b> To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia. <b><i>Methods:</i></b> This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization. <b><i>Results:</i></b> We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, <i>p</i> = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6–16 days), which was significantly longer than that in the control group (8 days [2–12 days], <i>p</i> = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3<sup>+</sup> T cells, CD8<sup>+</sup> T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia. <b><i>Trial Registration:</i></b> ClinicalTrials.gov, NCT04273321.

EFFECT OF ACCUPRESSURE PEN ON DISTANCE VARIABLE IN SCIATICA PATIENTS -A RANDOMIZED CONTROL TRIAL

2021 ◽  
pp. 28-31
Author(s):  
Urja S. Vaidya ◽  
Roshani S. Patel
Keyword(s):  
Randomized Control Trial ◽  
Stride Length ◽  
Step Length ◽  
Control Group ◽  
Exclusion Criteria ◽  
Parametric Test ◽  
Group A ◽  
Randomized Control ◽  
Experimental Group ◽  
Distance Variable

Background: Sciatica is a radiating pain which is treated with manual accupressure and after a time electro accupressure came into introduction. Aim And Objective: Aim: To nd out the effectiveness of accupressure pen to improve the distance variable To nd out the effect of Objective: accupressure pen on pain and distance variable in sciatica patient To compare the experimental group to the control group On the basis of Method: inclusion and exclusion criteria 30 participants were selected. They were treated with electro accupressure pen for 3 alternative days / week for 3 weeks, after that re-assessment was taken with NPRS, Slump and Distance variables. The data was analyzed using SPSS Version Results: 21.Parametric test was used .In Group A improvement was seen Accupressure Conclusions: pen is effective to reduce pain and improve step length and stride length in Sciatica Patients

scholarly journals Effects of Nutrition Education on Improving Knowledge and Practice of Complementary Feeding of Mothers with 6- to 23-Month-Old Children in Daycare Centers in Hawassa Town, Southern Ethiopia: An Institution-Based Randomized Control Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Selam Deksiyous Muluye ◽  
Tefera Belachew Lemma ◽  
Tona Zema Diddana
Keyword(s):  
Nutrition Education ◽  
Randomized Control Trial ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Southern Ethiopia ◽  
Control Group ◽  
Feeding Practice ◽  
Daycare Centers ◽  
Randomized Control ◽  
Knowledge And Practice

Undernutrition and hidden hunger threaten the survival, growth, and development of children, young people, economies, and nations. Inappropriate complementary feeding practice due to poor maternal knowledge and awareness in combination with low income and infectious disease is the contributing factor for child undernutrition. Hence, this study was aimed at determining the effect of nutrition education on improving the knowledge and practice of complementary feeding of the mothers with 6- to 23-month old children in daycare centers of Hawassa Town, Southern Ethiopia. An institution-based randomized control trial design was employed. Daycare centers were randomly allocated for the intervention group and the control group. Among the total daycare centers in the town, five were assigned to receive nutrition education and the rest five for the control group (CG). The simple random sampling technique used to select individual participants from each daycare center. Two hundred (200) mother-child pairs (100 for each group) were recruited. Sociodemographic and economic variables were collected by the structured questionnaire. Knowledge of appropriate complementary feeding was assessed by seven knowledge questions. Appropriate complementary feeding practice was assessed by adapting Alive and Thrive Infant and Young Child Feeding (IYCF) practice guidelines. Nutrition education was given for four consecutive months by using Alive and Thrive IYCF guidelines. Data were analyzed by the SPSS software program version 20. The chi-squared test was used to test the significant differences in the proportion of good knowledge and good practice of complementary feeding and good dietary diversity between two groups. The independent t test was used to test the significant differences in mean dietary diversity between two groups. At 95% confidence interval, p<0.05 was considered statistically significant. The results revealed that the proportion of mothers with good knowledge of appropriate complementary feeding was increased from 59% at pretest to 96% at posttest and the appropriate complementary feeding practice was improved from 54% at pretest to 86% at posttest in IG. There was no change in the knowledge and practice of complementary feeding practice in CG after four months. The proportion of mothers with good complementary knowledge was 54% both at pretest and at posttest and good complementary feeding practice was 51% and 52% at pre- and posttest in CG, respectively. There was no significant difference (p>0.05) on complementary feeding knowledge and practice between two groups at pretest, while the difference was highly significant (p<0.05) at the posttest. In conclusion, providing nutrition education improved the appropriate complementary feeding knowledge and practice of mothers. In recommendation, government and other partners working on sustainable child nutrition reduction should focus on the nutrition education to improve the knowledge and appropriate complementary feeding practice including daycare centers.

scholarly journals Efektivitas Klinis Ofloksasin Topikal Dibanding Ciprofloksasin Oral Pada Terapi Otitis Media Supuratif Kronik Aktif

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Deasy Mediawaty ◽  
Pujo Widodo ◽  
Dian Ayu Ruspita
Keyword(s):  
World Health Organization ◽  
Otitis Media ◽  
Randomized Control Trial ◽  
World Health ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Randomized Control ◽  
Health Organization ◽  
Per Oral

Latar belakang : Otitis media kronik atau sering disebut Otitis Media Supuratif Kronik (OMSK) adalah otitis media yang berlangsung > 12 minggu. Prevalensi OMSK di seluruh dunia sebanyak 65-330 juta dan 60% di antaranya menderita kurang pendengaran yang signifikan. Angka kejadian OMSK aktif mencapai 3,8% dari pasien THT-KL. Gejala OMSK aktif berupa banyaknya discaj, kurang pendengaran, nyeri, pusing berputar, telinga tidak nyaman. Tanda OMSK aktif berupa discaj di liang telinga, perforasi membran timpani, dan gangguan pendengaran. World Health Organization (WHO) mencanangkan strategi untuk mengatasi OMSK secara serius berkaitan dengan komplikasi yang dapat disebabkan. Pilihan terapi medikamentosa yang tepat diperlukan untuk mengatasi OMSK aktif. Ofloksasin topikal dan ciprofloksasin oral adalah antibiotik golongan fluorokuinolon yang banyak digunakan. Efektivitas diantaranya dibuktikan dengan perbaikan gejala dan tanda klinis. Tujuan : Membuktikan efektifitas ofloksasin topikal, ciprofloksasin oral dan efektifitas ofloksasin topikal dibanding ciprofloksasin oral terhadap perbaikan gejala dan tanda klinis. Metode :  Penelitian intervensi dengan rancangan pretest and posttest control group design, randomized control trial Klinik THT-KL BKIM Semarang pada bulan Juni-Agustus 2016. Penderita OMSK aktif dilakukan anamnesis lalu dilakukan pemeriksaan fisik dan pemeriksaan pendengaran dilanjutkan randomisasi. Penderita diberi ofloksasin topikal 10 tetes/12 jam atau ciprofloksasin tablet 500 mg/12 jam per oral. Hari ke 4, 10 dan 14 setelah terapi penderita kontrol. Analisis uji komparatif menggunakan uji parametrik dan non parametrik. Hasil : Jumlah subyek penelitian 108 orang ; ofloksasin topikal 54 orang (50%) dan ciprofloksasin oral 54 orang  (50 %). Gejala dan tanda klinis setelah terapi lebih rendah dibanding sebelum terapi pada kelompok ofloksasin topikal dan ciprofloksasin oral dengan nilai kemaknaan p < 0,05. Gejala klinis kelompok ofloksasin lebih baik dibanding ciproloksasin secara bermakna (p<0,05). Tanda klinis kedua kelompok terdapat perbedaan yang tidak bermakna (p>0,05). Simpulan : Ofloksasin topikal dan ciprofloksasin oral terbukti efektif memperbaiki gejala dan tanda klinis penderita OMSK aktif. Ofloksasin topikal efektif memperbaiki gejala klinis dibandingkan ciprofloksasin oral. Kata kunci : Otitis media supuratif kronik, ofloksasin, ciprofloksasin, gejala dan tanda klinis

scholarly journals Efficacy of Single Pre-Operative Dose of Glucocorticoid (125mg of Solumedrol Intravenous) in Terms of Seroma Formation in Patients Undergoing Mastectomy with Axillary Clearance For Breast Cancer: A Randomized Control Trial

2020 ◽  
pp. 1-5
Author(s):  
Aliya Ishaq ◽  
Abida Parveen ◽  
Aliya Ishaq ◽  
Mariya Ishaq ◽  
Muhammad Jamshaid Hussain Khan ◽  
...  
Keyword(s):  
Single Dose ◽  
Randomized Control Trial ◽  
Removal Rate ◽  
Fluid Collection ◽  
Study Groups ◽  
Seroma Formation ◽  
Control Group ◽  
Drain Removal ◽  
Randomized Control ◽  
And Control

Objective: The study aimed to determine the efficacy of single dose of glucocorticoid (125 mg of Solumedrol intravenous) in terms of seroma formation after mastectomy in patient with carcinoma of breast. Study Design: Randomized control trial. Place and Duration of Study: Study was conducted in the Department of General Surgery, Liaquat National Hospital Karachi, Pakistan from july 1 to dec 31, 2010. Patients and Methods: Patients were randomly divided in two groups (study and control) each group consisting of 30 patients. Randomization was done by opening of a sealed envelope which had a slip bearing the name of study medication (solumederol or saline as placebo) to be administered. The study group received a single dose of inj 125mg solumedrol IV half an hour prior to surgery by resident scrub in surgery. A similar procedure was applied to the control group and patients in controlled group were administered an equal volume of saline intravenously. After drain removal patients in both groups were observed for a duration of 2 weeks for sermoa formation. Detection of seroma formation was based on clinical grounds by absence of any fluid collection at mastectomy bed as detected by manual palpation. SPSS 10 was used for analysis. Results: Seroma formation was observed in 66.7% (40/60) women 2 weeks post drain removal. Rate of seroma formation was significantly low in study groups than control groups (33.3% vs. 100%; p=0.0001). Conclusion: Single dose of steroid is efficacious in reducing the post mastectomy seroma formation.

Effects of thoracic spine manipulation on pressure pain sensitivity of rhomboid muscle active trigger points: a randomized control trial

2021 ◽  
pp. 1-12
Author(s):  
Bibi Haleema ◽  
Huma Riaz
Keyword(s):  
Thoracic Spine ◽  
Randomized Control Trial ◽  
Rating Scale ◽  
Trigger Points ◽  
Control Group ◽  
Pressure Sensitivity ◽  
Myofascial Trigger Points ◽  
Pain Pressure Threshold ◽  
Significant Difference ◽  
Randomized Control

Abstract Objective: The objective of study was to determine the effects of thoracic spine manipulation on interscapular pain and pain pressure sensitivity, thoracic mobility and disability due to active myofascial trigger points in rhomboid muscle. Methods: A randomized control trial was conducted at Women Institute of Rehabilitation Sciences Abbottabad, from July to December 2019.Ethical permission was taken fromResearch ethical committee of Riphah international university Islamabad. Participants were selected through non-probability purposive sampling technique as per inclusion criteria. It consisted of 60 participants with forward head posture having active trigger points in rhomboid muscle, with age ranging from 18 to 30 years. The participants were randomly allocated through sealed envelope method into two groups that are experimental and control. Experimental group has received thoracic manipulation along with conventional physical therapy (CPT) whereas control group has only received CPT including manual pressure release and therapeutic exercise. Intervention was applied with 2 sessions / week with 3 weeks in total. Pre and Post assessment was done with outcome measurement tools comprised of Numeric pain rating scale (NPRS) for pain severity, Algometry for pain pressure threshold(PPT), Inclinometer for Range of movement(ROM) and Neck disability index (NDI) for associated disability. Data analysis was done using SPSS-20 version. Results: Between group analysis has shown significant improvement of pain & pain pressure sensitivity with p value <0.01 and <0.05 respectively. All outcome measures have shown significant difference in pre post treatment (p<.000) in both groups. Continuous...

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