Efficacy of Per Rectal Non-Steroidal Anti-inflammatory Drugs to Prevent Post Endoscopic Retrograde Cholangiopancrea-tography Pancreatitis: A Comparative Study

2021 ◽  
Vol 32 (2) ◽  
pp. 99-106
Author(s):  
Bimal Chandra Shil ◽  
Md Mamun Ur Rashid ◽  
Shasanka Kumar Saha ◽  
Ranjit Kumar Banik ◽  
ANM Saifullah ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Outcome ◽  
Comparative Trial ◽  
History Of ◽  
Group A ◽  
Inflammatory Drugs ◽  
Prophylactic Use ◽  
Group B ◽  
Upper Abdominal ◽  
Rectal Indomethacin

Background and aims: Acute pancreatitis is the most common major post-ERCP complication ranging as high as 10% to 40%. Rectal NSAIDS (Indomethacin or Diclofenac) seem to be the most promising drugs to prevent post ERCP pancreatitis. We performed a trial to investigate the efficacy of indomethacin or diclofenac. Methods: A prospective randomized comparative trial was performed at Dhaka from January 2013 to June 2019. Patients undergoing ERCP were randomly selected to group-A and group-B. Diclofenac 50mg suppository was given to group-A patients and Indomethacin 100mg suppository was given to group-B patients during or just after ERCP. The primary outcome was acute pancreatitis following the procedure which was defined by new upper abdominal pain, elevation of pancreatic lipase to at least 3 times the upper limit of normal level 24 hours after ERCP and hospitalization for 02 nights. Retrospective analysis of data of 122 patients who had undergone ERCP in 2012 but had no history of rectal NSAIDS (group C) was done. Results: Total 613 patients were included in this study and followed up. Post ERCP pancreatitis developed in 21(8.5%) patients of group-A (n=247), in 19(7.78%) patients of group-B (n=244) and in 20(17.85%) patients of group-C (n=122)(p=0.02). Moderate to severe pancreatitis was found in 08(3.23%) patients of group-A, in 06(2.45%) patients of group-B and in 12(9.83%) patients of group-C(p= 0.01). Administration of these NSAIDS showed clear benefit to reduce occurrence of Post ERCP pancreatitis when compared with no drug group (P=0.01). The efficacy of indomethacin compared with diclofenac was similar (P=0.874). Conclusions: Prophylactic use of rectal indomethacin or diclofenac during or just after ERCP significantly reduces the incidence of post ERCP pancreatitis. These NSAIDs are inexpensive, safe and should be used routinely in each patient undergoing ERCP. Bangladesh J Medicine July 2021; 32(2) : 99-106

Appreciation of the importance of pregravid preparation and reproductive attitudes of women of childbearing age in the city of Omsk

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 48-52
Author(s):  
E N Kravchenko ◽  
R A Morgunov
Keyword(s):  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Perinatal Center ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Complicated Pregnancy ◽  
The Relationship ◽  
The City

The aim of the study. Assess the importance of pregravid preparation and outcomes of pregnancy and childbirth, depending on the reproductive attitudes of women in the city of Omsk. Materials and methods. The study included 92 women who were divided into groups: group A (n=43) - women whose pregnancy was planned; group B (n=49) - women whose pregnancy occurred accidentally. Each group was divided into subgroups depending on age: from 18 to 30 and from 31 to 49 years. For each patient included in the study, a specially designed map was filled out. These patients were interviewed at the City Clinical Perinatal Center. Results. Comparative analysis revealed the relationship between the reproductive settings of women of childbearing age and the peculiarity of the course of pregnancy and childbirth in these patients. Summary. The majority of women of fertile age are married: in subgroup AA - 25 (96.2%), AB - 13 (76.5%), BA - 25 (92.6%), BB - 20 (91.0%). The predominant number of women of fertile age have one or more abortions: in subgroup AA - 12 (46.2%), AB - 6 (35.3%), in subgroups of comparison BA - 8 (29.6%), BB - 6 (27.3%). More than half of the women of fertile age surveyed have a history of untreated cervical pathology (from 40.8% to 64.7%). The course of pregnancy in women planning pregnancy in most cases proceeded without complications: in subgroup AA - 13 (50.0%), AB - 11 (64.7%). The most common cause of complicated pregnancy in women whose pregnancy occurred accidentally is the threat of spontaneous miscarriage: in subgroup BA - 15 (55.6%), BB - 16 (72.7%). The uncomplicated course of labor more often [subgroup AA - 19 (73.0%), AB - 12 (70.6%)] was observed in women whose pregnancy was planned and they were motivated to give birth to a healthy child.

Anterior approach levator plication for congenital ptosis, absorpable versus non absorpable sutures

2021 ◽  
pp. 112067212110053
Author(s):  
Moustafa Salamah ◽  
Ashraf Mahrous Eid ◽  
Hani Albialy ◽  
Sherif Sharaf EL Deen
Keyword(s):  
Randomized Study ◽  
Early Postoperative Period ◽  
Polyglactin 910 ◽  
Exclusion Criteria ◽  
Congenital Ptosis ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Over Time

Purpose: To compare the efficacy of two different suture types in levator plication for correction of congenital ptosis. Subjects and methods: Prospective comparative interventional randomized study involving 42 eyes of 42 patients aged more than 6 years with congenital ptosis and good levator action. The exclusion criteria were as follows: bilateral ptosis, history of previous surgery, fair or poor levator action, and associated other ocular diseases. Patients were randomized into group A, in which double-armed 5/0 polyester Ethibond were used, and group B, in which double-armed 5/0 Coated Vicryl® (polyglactin 910) suture material we used. Outcomes including eyelid height and stability of eyelid height over time were compared with follow-up data. The MRD was 4.05 ± 0.36 mm and 3.95 ± 0.34 after 1 week for both groups A and B, respectively. At the end of study follow up period (24 weeks), the MRD was 3.60 ± 0.42 mm in group A, and 2.52 ± 0.85 mm in group B. Conclusion: No difference in eyelid height between two groups in early postoperative period, but the postoperative eyelid height was more stable over time in the 5/0 polyester Ethibond group (group A) than in the 5/0 Coated Vicryl® (polyglactin 910) group (group B).

scholarly journals Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanyu Yang ◽  
Zefei Zhu ◽  
Hongyu Zheng ◽  
Shifeng He ◽  
Wanyue Zhang ◽  
...  
Keyword(s):  
Thermal Insulation ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Laparoscopic Hysterectomy ◽  
Control Group ◽  
Prospective Randomized Controlled Trial ◽  
Warming Blanket ◽  
Group A ◽  
Insulation Effect ◽  
Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

scholarly journals Can Co-enzyme Q10 improve the chances of conception after the age of 35?

2017 ◽  
Vol 6 (7) ◽  
pp. 2729
Author(s):  
Eman Ali Abd El Fattah
Keyword(s):  
Chromosomal Abnormalities ◽  
Normal Pregnancy ◽  
Metabolic Energy ◽  
Secondary Outcome ◽  
Slowing Down ◽  
Ovulation Stimulation ◽  
Before And After ◽  
History Of ◽  
Group A ◽  
Group B

Background: ovarian follicular quality diminishes with age, Free radicals and oxidative stress begin to accumulate in cells, aging or slowing down the metabolic energy production centers in the cell- the mitochondria. When the mitochondria cannot generate a certain amount of energy, it slows growth and proper development of the follicle making it more prone to DNA damage, including chromosomal abnormalities resulting in poor fertilization patterns, and early miscarriage. Co-enzyme Q10 (CoQ10) is a major cellular antioxidant. its tissue levels gradually decrease with age. We attempt to evaluate its protective effect on ROS-induced ovarian damage, which is one of the most important and widely accepted patho- mechanisms underlying cell ageing.Methods: 40 Participants   from El Shatby hospital infertility clinic 35 to 38 years old, with history of bad response to ovulation stimulation, were divided into two equal groups (group A given (CoQ10) 3mg|kg body weight for three cycles prior to stimulation Serum anti- mullarian hormone level was measured before and after CoQ10 administration, group B= twenty cases as control). Participants were given gonadotrophins (150 IU to 375 IU). Follicular growth was monitored by trans- vaginal ultra- sonography and serum estradiol level (E2). Ovulation trigger was achieved using 10,000 IU of human chorionic gonadotrophin.Results: The primary outcome was occurrence of normal pregnancy; secondary outcome was good response to stimulation (at least one mature follicle 18-22mm).Conclusions: CoQ10 has no significant effect on response to ovulation stimulation or on pregnancy rates.

scholarly journals Effect of Intravenous Phloroglucinol Injections upon duration of Active First Stage of Labor

2020 ◽  
Vol 4 (2) ◽  
pp. 69-71
Author(s):  
Bilqees Akhtar Malik ◽  
Ambreen Shabbir ◽  
Zeb-Un-Nisa ◽  
Asma Ambreen
Keyword(s):  
Controlled Trial ◽  
Military Hospital ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Uterine Contractions ◽  
Multiparous Women ◽  
History Of ◽  
Group A ◽  
Group B ◽  
First Stage Of Labor

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

scholarly journals EFFECTIVENESS OF LUMBAR MANIPULATION (HIGH VELOCITY LOW AMPLITUDE) FOR THE TREATMENT OF LOW BACK PAIN IN COMPARISON TO BACK STRETCHING EXERCISES

2012 ◽  
Vol 1 (1) ◽  
pp. 23-27
Author(s):  
Syed Abid Mehdi Kazmi ◽  
Nabiha Mujahid Faruq ◽  
Sumaira Imran Farooqui ◽  
Jharna Devi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
High Velocity ◽  
Low Back ◽  
Before And After ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Low Amplitude ◽  
Stretching Exercises

OBJECTIVES To assess the effectiveness of lumbar manipulation (high velocity low amplitude) for the treatment of low back pain in comparison to back stretching exercises. Randomized Control Trial (Experimental Study) The study was conducted on 200 patients at the Physiotherapy Department of Ziauddin Hospital among patients with history of low back pain of acute, sub acute or chronic origin. In this study, patients were divided into two groups, group A and group B equally. Group A of 100 patients received Lumbar Manipulation (High Velocity Low Amplitude) and at the same time Group B of 100 patients were treated by back stretching exercises. A pre tested and structured questionnaire was used to collect data. Data was entered and analyzed by using SPSS. Pain was measured on Visual Analogue Scale before and after the given treatment. The study showed significant results for both the interventions in the treatment of low back pain but Lumbar Manipulation has been more effective in different types of low back pain while stretching exercises are less effective. On the basis of this study, we are very confident that lumbar manipulation is more effective for the treatment of low back pain compared to back stretching

scholarly journals Clinical, Surgical Characteristics and Long-Term Outcomes of Lumbar Hernia.

2020 ◽  
Author(s):  
Chaoyong Shen ◽  
Guixiang Zhang ◽  
Sen Zhang ◽  
Yuan Yin ◽  
Bo Zhang ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Lumbar Hernia ◽  
Consecutive Series ◽  
Long Term Outcomes ◽  
Anesthesia Group ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Background/AimLumbar hernia is extremely rare which resulting from a defect in the abdominal wall. Due to its rarity, there is no established optimal treatment available for lumbar hernia yet. Thus, we here investigated the clinical, surgical characteristics and outcomes of lumbar hernia by collecting 28 such patients in our hospital. MethodsPatients diagnosed with lumbar hernia from our institution between April 2011 and August 2020 were retrospectively collected in this study. Demographics, clinical characteristics and surgical information were recorded. ResultsA consecutive series of 28 patients with lumbar hernia were retrospectively collected, including 13 males (46.4%) and 15 females (53.6%). The ages of the patients ranged from 5 to 79 years (median: 55 years), with a mean age of 55.6±14.9 years. A total of 7 cases had a history of previous lumbar trauma or surgery. There were 11 (39.3%), 15 (53.6%) and 2 (7.1%) cases had right, left and bilateral lumbar hernia, respectively. Superior and inferior lumbar hernia were found in 25 (89.3%) and 3 (10.7%) patients. General anesthesia was applied in 16 cases (group A), whereas 12 patients received local anesthesia (group B). Patients in the group B had a shorter hospital stay than that of the group A (3.5±1.3 days vs. 7.1±3.2 days, p=0.001), as well as total hospitalization expenses between the two groups (8309.3±1467.1 CNY vs. 19117.3±8116.1 CNY, p<0.001). ConclusionsLumbar hernia is a relatively rare entity, and inferior lumbar hernia is rarer. It is feasible to repair lumbar hernia under local anesthesia, and it may be more suitable than general anesthesia in some selected cases.

Abstract 17296: Arrhythmia Recurrence and Subsequent Heart Failure Hospitalization in Atrial Fibrillation Patients Undergoing Catheter Ablation: A Landmark Analysis From the Kansai Plus Atrial Fibrillation (KPAF) Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nobuaki Tanaka ◽  
KOICHI INOUE ◽  
Atsushi Kobori ◽  
Kazuaki Kaitani ◽  
Takeshi Morimoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Large Scale ◽  
Multicenter Observational Study ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Af Recurrence

Background: Heart failure (HF) is the leading cause of death in patients with atrial fibrillation (AF). Radiofrequency catheter ablation (RFCA) of AF is effective for maintaining sinus rhythm though its impact on heart failure still remains controversial. Purpose: We sought to elucidate whether AF recurrence following RFCA was associated with subsequent HF hospitalizations. Methods: We conducted a large-scale, prospective, multicenter, observational study. A total of 4931 consecutive patients who underwent an initial RFCA for AF with longer than 1-year of follow-up in 26 centers were enrolled (average age, 64±10 years; non-paroxysmal AF, 35.7%). The median follow-up duration was 2.9 years. The primary endpoint was an HF hospitalization more than 1-year after the index RFCA. We compared the patients without AF recurrences (group A) to those with AF recurrences within 1-year post RFCA (group B). Results: The 1-year cumulative incidence of AF recurrences after a single procedure was 30.7% (group A=3418, group B=1513 patients). Group B had a lower body mass index (group A vs. group B,24.1±3.6 vs. 23.8±3.4 kg/m 2 , p=0.014), longer history of AF (1.9 vs. 3.1 years, p<0.0001), higher prevalence of non-paroxysmal AF (32.1% vs. 33.9%, p<0.0001), and valvular heart disease (5.9% vs. 7.8%, p=0.013). They also had a lower ejection fraction (63.7±9.4% vs. 62.8±9.6%, p=0.0043) and larger left atrial dimeter (39.7±6.6 vs. 40.6±7.0 mm, p<0.0001) on echocardiography. Hospitalizations for HF were observed in 57 patients (1.14%) more than 1-year after the RFCA and were significantly higher in group B than group A (group A vs. group B, 0.91% vs 1.72%, log-rank p=0.019). Conclusions: Among AF patients receiving RFCA, those with AF recurrences were at a greater risk of subsequent heart failure hospitalizations than those without AF recurrences. Recognition that AF recurrence following RFCA is a risk factor for a subsequent HF-related hospitalization is appropriate in clinical practice.

scholarly journals Low Iron Level is related to Telogen Effluvium in Women

2013 ◽  
Vol 21 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Md Manjurul Karim ◽  
Md Abdul Wahab ◽  
Lubna Khondoker ◽  
Md Shirajul Islam Khan
Keyword(s):  
Hair Loss ◽  
Control Group ◽  
Case Group ◽  
Iron Level ◽  
History Of ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Medical University ◽  
Control Study

A case-control study conducted in the Department of Dermatology and Venereology of Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2008- December 2010. A total 60 female patients of telogen effluvium attending in outpatient department (OPD) were enrolled in the study with 30 having hair loss considered as case (Group-A) and another 30 females had no history of hair loss were considered as control (Group-B). The study included 60 patients and the mean age were 25.4±7 years ranging from 18 to 42 years in group A and 24.8±5.6 years ranging from 17 to 36 years in group B. Maximum number was found in the age group of 21- 30 years in both groups and nearly three fourth (73.4%) patients were unmarried in group A and 18(60.0%) in group B. Most of the patients were student in both groups, which were 21(70.0%) and 17(56.7%) in group A and group B respectively and majority of the the patients were HSC level in both groups, 15(50.0%) and 14(46.7%) in Group A and Group B respectively. Most of the patients came from middle class, which were 20(66.7%) and 16(53.3%) in group A and group B respectively. The mean serum ferritin were 18.8±8.1 g/L ranging from 4.5 to 36.54 g/L and 36.6±9.9 mg/L ranging from 18.46 to 56.3 mg/ L in group A and group B respectively. The mean Hb level was 11.5±1.4 gm/dl ranging from 8.5 to 14.0 gm/dl in group A and 12.8±1.1 gm/dl ranging from 10.5 to 14.5 gm/dl in group B. The mean difference of Hb level was statistically significant (p<0.05) between two groups in unpaired t-test. It can be concluded that low iron level is associated with telogen effluvium in women. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13617 Bangladesh J Medicine 2010; 21: 84-89

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