Role of Combined Mifepristone and Misoprostol Verses Misoprostol Alone in Induction of Labour in Patients with Intrauterine Foetal Death - a Randomized Comparison Between their Outcome

Background: Intrauterine fetal death is means- intrapartum death after the fetus has reached the age of viability8. As in IUFD journey, labor pain will be fruitless. So, it is of utmost importance to search for the method which can reduce hours of pain in labor of IUFD cases.Metarials Methods: In this research work patients divided in two groups. Induction of labour in one group was given by combination of mifepristone and misoprostol other group by misoprostol only and we try to find out the best method. To compare the effectiveness, induction to delivery interval, safety and side effects of combination of mifepristone and misoprostol versus conventional use of misoprostol alone in induction of labour in patients with intrauterine fetal death. It is a Prospective randomized comparative study in Anwer Khan Modern Medical College Hospital and Dhaka Medical College Hospital among 70 patients with IUFD after 28 weeks of gestation during January 2014- January 2016.Result: We allowed the patients up to third gravid and after 28 weeks of gestation. Patients were grouped as Group A(35) & Group B (35). In Group A Induction was given by single oral dose of 200 mg mifepristone, and after 48 hours, tab. Misoprostol in post. fornix started if <34 weeks-100 ?gm dose and >34 weeks-50 ?gm dose. Doses were repeated every 6 hourly intervals if required. In Group B Induction was given by 100 ?gm misoprostol at 6 hourly interval in post. Fornix. In both groups we allowed misoprostol maximum 600 ?gm. Oxytocin was given for augmentation if needed. The two study groups did not differ demographically. Induction to delivery time was shorter with combined regimen group (P<0.001). Induction to delivery interval ranges from 10-12 hours in mifepristone plus misoprostole group.In only misoprostol group it was about 24-26 hours. Doses of misoprostol was lower in combined group (P<0.001). 4 patients need Oxytocin for augmentation in only misoprostol group. In combined group oxytocin was not needed. The two groups did not differ as regards complications experienced during labour and delivery significantly. In overall out come 2 failed induction in misoprostol only group but not in combinedgroup.Conclusion: In Induction of IUFD mifepriston plus misoprostol is an effective combined group. It is safe, non invasive, easily tolerable, highly cost effective, had less induction to delivery interval, required less dose of misoprostol and no need of augmentation with oxytocin. So,the combined group is more effective than conventional regimen of misoprostol alone.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 50-54

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Role of Phonophoresis in Management of Adhesive Capsulitis (Frozen Shoulder)

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i2.21057 ◽

2014 ◽

Vol 13 (2) ◽

pp. 21-27

Author(s):

Sunam Kumar Barua ◽

Sohely Rahman ◽

Prashanta Kumar Chakrabarti ◽

Zahangir Alam

Keyword(s):

External Rotation ◽

Adhesive Capsulitis ◽

Frozen Shoulder ◽

Medical College Hospital ◽

Physical Medicine ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Group A ◽

Group B

This prospective study was performed in the department of Physical Medicine, Dhaka Medical College Hospital (DMCH), Dhaka for a period of 6 months to see the effect of phonophoresis (Ultrasound therapy with Naproxen gel) on adhesive capsulitis. During this period 240 (4% of total patients) patients were diagnosed as adhesive capsulitis of shoulder in outpatient department, Physical Medicine, Dhaka Medical College Hospital. Sixty patients were selected for the study and divided them into two groups. In group A, patients were treated with phonophoresis and exercises in contrast with group B patients who were treated with same exercises without phonophoresis for same duration. Patients in both groups were followed up weekly for consecutive six weeks. The mean age of the patients in this study was 51.73 ± 10.01 year, with a range of 35 to 70 years. Out of sixty patients 31 (51.7%) were male and 29 (48.3%) were female. The male: female ratio was 1.07: 1. Among 60 patients, 27 (45%) were housewives, 20 (33.3%) service holders (official job), 4 (6.7%) businessmen, 1 (1.7%) teacher and 8 (13.3%) retired persons. In this study 53.3% patients had right shoulder involvement and rest of them (46.7%) had left sided involvement. Pain was improved just after initiation of treatment and it was completely alleviated in group A patients after 6th week, on the contrary although pain was increased after 1st week of treatment thereafter it was gradually decreased but it was not completely alleviated in group B patients at the end of the study. All sorts of range of motions (abduction, internal rotation on abduction, external rotation on abduction) of affected shoulder were improved more rapidly in group A compared to group B patients. Shoulder pain and disability index (SPADI) were significantly reduced in group A compared to group B patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21057

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TO COMPARE THE FETOMATERNAL OUTCOME OF ORAL MISOPROSTOL SOLUTION AND VAGINAL MISOPROSTOL TABLET FOR INDUCTION OF LABOUR AT TERM IN THE DEPARTMENT OF OBSTETRICS & GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i6.1245 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Neelam Bhardwaj ◽

Parveen . ◽

Prerna . ◽

Neeta Meena ◽

Prem .

Keyword(s):

Controlled Trial ◽

Meconium Aspiration Syndrome ◽

Induction Of Labour ◽

Medical College ◽

Oral Misoprostol ◽

Misoprostol Group ◽

Group A ◽

Nicu Admission ◽

Vaginal Misoprostol ◽

Group B

Background: Induction of labour is a common intervention, required in situations where continuation of pregnancy may be lifethreatening for the mother and/or fetus. In industrialized countries, the induction rate ranges from 10-25%. Methods: Randomized controlled trial was conducted at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: APGAR score at 1 min and 5 minutes was 6.64 and 6.84 in oral misoprostol and vaginal misoprostol group respectively, while at 5 minutes it is 6.7 oral group and 7 of vaginal misoprostol group. 34% of cases need NICU admission in Group-A (Oral misoprostol) and 14% in Group-B (Vaginal misoprostol) group. Meconium aspiration syndrome which is present 10% of patients in Group-A (Oral Misoprostol) while it is present in 6% of patients in Group-B (Vaginal misoprostol). Conclusion: The lesser incidence of meconium-stained liquor and NICU admissions and fewer caesareans with better neonatal outcome in women induced with oral misoprostol outweigh its advantages over the vaginal misoprostol Keywords: Misoprostol, Labor, Induction, Fetomaternal outcome.

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A COMPARATIVE STUDY OF MIFEPRISTONE AND MISOPROSTOL VERSUS MISOPROSTOL ALONE IN INDUCTION OF LABOUR IN LATE INTRAUTERINE FETAL DEATH

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1756 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Shivpal Moond ◽

K.P. Banerjee ◽

Rakhi Arya

Keyword(s):

Single Dose ◽

Comparative Study ◽

Fetal Death ◽

Induction Of Labour ◽

Labour Induction ◽

Intrauterine Fetal Death ◽

P Value ◽

Group A ◽

The Mean ◽

Group B

Objective: To compare efficacy, safety and tolerance of combination of Mifepristone and Misoprostol versus Misoprostol alone in induction of labour in late intrauterine fetal death (>24 weeks). Methods: This prospectively study included 160 women with late intrauterine fetal death (IUFD) after 24 weeks of gestation and divided the women randomly into two groups each containing 80 women. In Group-A : Mifepristone 200 mg single dose was given and after 24 hrs Tab Misoprostol (intravaginally) administered and repeated 4 hourly upto a maximum of 5 doses, while in Group-B : Only Tab Misoprostol administered intravaginally 4 hourly upto maximum 5 doses. Induction-delivery interval and number of doses of Misoprostol was calculated. Results: The mean induction-delivery interval in Group-A was 13.02 ± 3.74 hours and in Group-B was 16.09 ± 2.99 hours (p-value <0.0001). Mean doses of Misoprostol required in Group-A was 3.36 ± 1.08 hours and in Group-B was 4.32 ± 0.65 hours (p-value <0.0001). Conclusion: Combination of Mifepristone and Misoprostol is more effective as comparison to Misoprostol in terms of induction-delivery interval and number of doses of misoprostol required. Keywords: IUFD, mifepristone, misoprostol, induction of labour, induction-delivery interval.

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Study on ABO & Rhesus Blood Groups in Rajshahi Medical College Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v17i1.3488 ◽

1970 ◽

Vol 17 (1) ◽

pp. 38-40

Author(s):

MM Hossain ◽

SFM Khyirul Ataturk ◽

ARM Saifuddin Ekram ◽

M Abul Kalam

Keyword(s):

Blood Transfusion ◽

Blood Groups ◽

Medical College Hospital ◽

Transfusion Medicine ◽

College Hospital ◽

Medicine Department ◽

Medical College ◽

Group A ◽

Group B

About fifty two thousand admitted patients in different wards & cabins of Rajshahi Medical College Hospital are grouped in the Transfusion Medicine Department for the purpose of blood transfusion during the period of July/ 1997 to June/2000. It is found that out of 51966 patients, 16928 (32.38%) are group B, 16704(32.15%) are group O 13005 (25.02%) are group A, & 5329 (10.25%) are group AB, Among those patients, 50141 (96.51%) are Rh D positive, 1828(3.49%) are negative. doi: 10.3329/taj.v17i1.3488 TAJ 2004; 17(1) : 38-40

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Epidemiology of intrauterine fetal death in Dhaka National Medical College Hospital

Bangladesh Medical Journal ◽

10.3329/bmj.v45i3.33123 ◽

2017 ◽

Vol 45 (3) ◽

pp. 131-133 ◽

Cited By ~ 1

Author(s):

Lipy Bakshi ◽

Samira Hoque ◽

Farhana Tanjin ◽

Sukla Dey ◽

Mithun Bakshi

Keyword(s):

Fetal Death ◽

Medical College Hospital ◽

Intrauterine Fetal Death ◽

College Hospital ◽

National Medical College ◽

Medical College ◽

Therapeutic Modalities ◽

National Medical ◽

Still Births ◽

Tragic Event

Intrauterine fetal death (IUFD) and still births is a tragic event for the parents and an important cause of perinatal mortality. This retrospective study study was conducted in the department of Obstetrics and Gynecology of Dhaka National Medical College Hospital from January 2015 to June 2016 with the intention to understand the incidence, socio-epidemiological and etiological factors of intrauterine fetal death (IUFD). A total of 1838 pregnancies were studied retrospectively during the study period & out of them 48 were IUFDs. Ante partum and intra partum events leading to fetal demise were recorded, socio-demographic and clinical characters were noted. there were 1838 deliveries . The incidence of prenatal loss was 26 per 1000 live births. Despite advances in diagnostic and therapeutic modalities the rate of IUD is unacceptably high. Socio-cultural background, lack of adequate antenatal care and inaccessible health care are some of the reasons that predispose women to IUFD. Majority of fetal wastage can be prevented with universal and improved antenatal care.Bangladesh Med J. 2016 Sep; 45 (3): 131-133

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Outcome of Lower Ureteric Stone Fragmentation by Laser in Comparison with Pneumatic Lithotripsy

Bangladesh Journal of Urology ◽

10.3329/bju.v23i2.50310 ◽

2020 ◽

Vol 23 (2) ◽

pp. 169-175

Author(s):

SA Anowar Ul Quadir ◽

Khan Nazrul Islam ◽

Md Mostafizur Rahman ◽

Md Shafiqul Alam Chowdhury ◽

SM Mahbub Alam

Keyword(s):

Laser Lithotripsy ◽

Medical College Hospital ◽

Ureteric Stone ◽

College Hospital ◽

Operation Theatre ◽

Medical College ◽

Pneumatic Lithotripsy ◽

Stone Fragmentation ◽

Group A ◽

Group B

Background: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. Aims: To see the outcome of lower ureteric stone fragmentation by laser in comparison with pneumatic lithotripsy. Methods: The prospective clinical study was conducted during the period from July 2012 to June 2014 in Dhaka Medical College Hospital. From the patient admitted in Dhaka medical college hospital a total of 60 patient were selected using purposive sampling methods. Selected patients were numbered chronologically and odd number group as group A (laser lithotripsy) and even number group B (pneumatic lithtripsy). Cystoscopy followed by ureterescopy with the help of guide wire was done and stone fragmentation done by either laser lithotripsy (done in general operation theatre in Dhaka Medical College Hospital) or pneumatic lithotripsy (done in Urology operation theatre in Dhaka Medical College Hospital). Collected data were processed and analyzed using computer software SPSS (statistical package for social science), version-18. Un-pair t-test, chisquare test and Fishers Exact probability test were used to analyze the data. The findings of the study showed age and sex are almost identically distributed in both groups. Results: The mean age of group A and group- B were 35.63±11.66 and 38.90±11.21 years respectively. A male predominance was observed in both groups with 70% male in group- A and 53.3% in group-B. Stone size was also observed identically in both groups. 43% of stone are larger than 10mm in group- A and 47% stone are larger than 10mm. None of other baseline variable found very between groups. Immediate stone clearance was much higher in group-A (96.7%) then that in group- B (80%). Although both the groups demonstrated 100% clearance after 1 month. Immediate complications were higher in group B then those of group- A. Ureteral perforation in group B was found 6.7% as opposed to none in group-A. Fever in group A (6.7%) was observed to be more than 3 times higher than in group- B (23.3%). Comparison of complications after 1 and 3 months shows some differences (higher in group-B) but that is not significant. Ureteral stricture developed in 3 patients in group- B compared to nil in group- A. More than 90% of patients of group-A were released from the hospital within 3 days after operation, in contrast about 40% in group-B left the hospital within 3 days. Conclusion: So, laser lithotripsy is better option for the management of lower ureteric stone by using semi rigid ureteroscope, in term of stone migration, rate of stone fragmentation and clearance, operation time, hospital stay and complication. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.169-175

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Outcome of Continuous Low Dose Antibiotic Treatment in Comparison With Periintervention Antibiotic Prophylaxsis in Double J Stenting

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49884 ◽

2020 ◽

Vol 21 (2) ◽

pp. 127-136

Author(s):

Maruf Ahmed ◽

Md Nazrul Islam ◽

Amirul Islam ◽

Md Jahangir Alam ◽

Md Mostafizur Rahman ◽

...

Keyword(s):

Antibiotic Prophylaxis ◽

Antibiotic Treatment ◽

Low Dose ◽

Treatment Regime ◽

Medical College Hospital ◽

Antibiotic Regimen ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B

Objective: To determine the outcome of antibiotic treatment regime in patient with indwelling DJ stenting having a per-interventional antibiotic prophylaxis compared with those of a continuous low-dose antibiotic treatment. Methods: A hospital based prospective experimental study was conducted in the Department of Urology of Dhaka Medical College Hospital, Dhaka from July 2012 to June 2014, to evaluate the antibiotic treatment regime in patient with indwelling DJ stenting, the benefits and disadvantages of a peri-interventional antibiotic prophylaxis compared with those of a continuous low-dose antibiotic treatment by enrolling a total number of 60 subjects in the department of Urology, Dhaka Medical College, Dhaka. Among 60 subjects 30 subjects were Group A comprised of subjects treated with continuous low dose antibiotic and Group B with 30 subjects treated with peri-interventional antibiotic. The patients would undergo temporary D J stent placement due to upper tract urolilhiasis who meet the inclusion criteria and exclusion criteria. Informed written consent would be taken from all patients. Urine samples would be analysed conventional antibiotic susceptibility and resistance was determined. All analyses was conducted at department of Microbiology, Dhaka medical college hospital. All patients who received peri-interventional antibiotic prophylaxis with 1g ceftriaxon was given l.v. at anaesthesia induction to obtain a peak concentration at the time of highest risk during the procedure.According to the pathogens profile and susceptibility, the antimicrobial agent of choice for continuous low-dose treatment was Cefixim 200mg twice daily. All stents placements were performed under sterile conditions applying a retrograde technique or antregrade in PCNL and open procedure under spinal or general anaesthesia. Patients were prescribed ketorolac (10mg) or Tramadol (50mg), while none of the patient received alpha blocker agents or anti-cholinergic drugs. Evaluations for UTI were performed before stent insertion and consecutively after 1, 2 and 4 weeks and/or at stent withdrawal. Statistical analysis of the result was obtained by using window based computer software devised with statistical packages for social science (SPSS-20 IBM) (SPSS inc, Chicago, IL, USA). The result was presented in tables, figures, and diagrams. Statistical test was done by Chi square test and Z test for qualitative data and t test for quantitative data. A p-value <0.05 is considered as level of significance. Results: To evaluate the antibiotic treatment regime in patient with indwelling DJ stenting, the benefits and disadvantages of a peri-interventional antibiotic prophylaxis compared with those of a continuous low-dose antibiotic treatment, a total number of 60 subjects were enrolled in this present study in the department of Urology, Dhaka Medical College, Dhaka. Among 60 subjects 30 subjects were Group A comprised of subjects treated with continuous low dose antibiotic and Group B with 30 subjects treated with periinterventional antibiotic only. Outcome of these two treatment techniques were studied. For urinary tract infection rate the concept of a peri-interventional antibiotic prophylaxis during DJ stent implantation is known to be better antibiotic coverage and is therefore recommended by the European Association of Urology. However, there is a lack of evidence concerning the exact antibiotic strategy for the entire stent-indwelling time. In clinical routine, it is an applied practice among urologists to continue antibiotic treatment in a low-dose fashion, even after previous uncomplicated implantations. Conclusion: In case of indwelling DJ stenting, subjects with continuous low dose antibiotic regimen had significantly less proportion of UTI, dysuria and frequency of micturition than those with peri-interventional antibiotic. So, if haematuria, skin rash and GIT disturbance is carefully managed then continuous low dose antibiotic regimen is better treatment option than peri-interventional regimen for with indwelling DJ stenting in different cases. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.127-136

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Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49882 ◽

2020 ◽

Vol 21 (2) ◽

pp. 105-110

Author(s):

Md Shawkat Alam ◽

Sudip Das Gupta ◽

Hadi Zia Uddin Ahmed ◽

Md Saruar Alam ◽

Sharif Muhammod Wasimuddin

Keyword(s):

Comparative Study ◽

Acute Urinary Retention ◽

Bladder Capacity ◽

Inclusion Criteria ◽

College Hospital ◽

Medical College ◽

High Incidence ◽

Group A ◽

Group B ◽

Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

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Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

10.53350/pjmhs211551134 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1134-1135

Author(s):

M. A. Chhutto ◽

A. H. Mugheri ◽

A. H. Phulpoto ◽

I. A. Ansari ◽

A. Shaikh ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Adverse Outcomes ◽

Chronic Liver ◽

P Value ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

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Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.6309 ◽

2021 ◽

Vol 28 (03) ◽

pp. 277-281

Author(s):

Bushra Shaikh ◽

Imamuddin Baloch ◽

Azhar Ali Shah ◽

Abdul Sami Mirani ◽

Parkash Lal Lund ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wound Infection ◽

Port Site ◽

Site Infection ◽

College Hospital ◽

Medical College ◽

Duration Of Surgery ◽

Group A ◽

Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

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