STUDY TO EVALUATE EFFECTS OF MIFEPRISTONE 25mg IN MANAGEMENT OF UTERINE FIBROIDS

2021 ◽  
pp. 26-27
Author(s):  
Nidhi Johri ◽  
Priti Kumar
Keyword(s):  
Social Sciences ◽  
Side Effects ◽  
Uterine Leiomyoma ◽  
Uterine Fibroids ◽  
Cost Effective ◽  
Once Daily ◽  
Common Indication ◽  
Perimenopausal Women ◽  
Effective Option ◽  
Progesterone Antagonist

Background: In India, the uterine broid is a common indication of hysterectomy. An effective option for medical treatment may decrease the morbidity associated with hysterectomy. Objectives: We aimed to evaluate the effect of mifepristone (25 mg), progesterone antagonist, on uterine broids in perimenopausal women. Material And Methods: Fifty perimenopausal women having symptomatic uterine broids were selected from Gynaecology OPD and given 25 mg mifepristone once daily continuously for 2–4 cycles of 3 months each. Variables such as baseline broid size, position, and haemoglobin were measured and followed at 3, 6, 9, and 12 months. The data were entered in MS EXCELspreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. APvalue of <0.05 was considered as statistically signicant. Results: Majority were intramural broids (70%) followed by submucosal in 18%. Size of broids ranged from 7 cm; the majority of broids were in 5–7 cm size. No signicant association of location with the size of broid was found. Out of 50 cases included in the study, change in size in uterine broids was observed in 95.14% cases. There was an increase in haemoglobin, from 8.6 g% at baseline to 9.5 g% at 12 months. Conclusion: Mifepristone resulted in a reduction in uterine broids size and an increase in haemoglobin at the end of 12 months. It may be an option for uterine leiomyoma treatment, as it is given orally, cost-effective and has minimal side effects.

scholarly journals Effectiveness of Mifepristone in the Treatment of Uterine Leiomyomata

2013 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Mayurika Sinha ◽  
A Kyal ◽  
P Mukhopadhay
Keyword(s):  
Side Effects ◽  
Uterine Leiomyoma ◽  
Endometrial Hyperplasia ◽  
Lower Abdominal Pain ◽  
Simple Type ◽  
Age Group ◽  
Uterine Leiomyomata ◽  
Obstetrics And Gynaecology ◽  
Perimenopausal Women ◽  
A Prospective Study

Aims: The goal of this study was to determine the effects of mifepristone in perimenopausal women with leiomyomas, thereby to see a decrease in severity of symptoms and a decrease in size of the leiomyomas. Methods: This was a prospective study conducted at Eden HospitalMedical College and Hospital, Kolkatafrom July 2010 to June 2011. Fifty patients received 20-25mg mifepristone daily and comparison was made between pre and post treatment symptoms and leiomyoma volume. Results: All patients became amenorrhoeic after treatment, relieving heavy menstrual flow most complained of. Lower abdominal pain improved by > 80% in most patients and volume of leiomyoma decreased appreciably. The drug did not have any major side effects. Endometrial hyperplasia detected by ultrasound in 42% patients was only of simple type on biopsy. Conclusions: Mifepristone can be useful in treating symptomatic women with uterine leiomyoma in perimenopausal age group, in those awaiting surgery to stop bleeding and improve anaemia and to reduce size of tumor to make surgery technically easier, making it a cheaper alternative to GnRH agonists and without any major side effects. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 22-25 DOI: http://dx.doi.org/10.3126/njog.v8i1.8856

Evaluation of the effectiveness of skin preparation methods for the reduction of Cutibacterium acnes (formerly Propionibacterium acnes) in shoulder surgery: a systematic review

2021 ◽  
pp. 175857322110325
Author(s):  
Maria Sagkrioti ◽  
Stephen Glass ◽  
Georgios Arealis
Keyword(s):  
Systematic Review ◽  
Hydrogen Peroxide ◽  
Side Effects ◽  
Cost Effective ◽  
Shoulder Surgery ◽  
Skin Preparation ◽  
Preparation Methods ◽  
Cutibacterium Acnes ◽  
Surgery Outcomes ◽  
Positive Effect

Background Cutibacterium acnes ( C. acnes) is the most common pathogen responsible for post-operative shoulder infections. The purpose of this study was to evaluate the effectiveness of skin preparation methods against C. acnes in shoulder surgery. Methods A systematic review was conducted evaluating the effectiveness of skin preparation methods in the reduction of C. acnes in patients undergoing shoulder surgery. Outcomes were assessed based on the effectiveness of the method used; side effects and cost were also analysed. Results Of the 19 included studies, 9 evaluated pre-surgical home treatments: 8 assessed benzoyl peroxide (BPO) and 6 concluded it is effective in reducing C. acnes. Nine studies assessed surgical skin preparation and concluded that Chlorhexidine gluconate (CHG) was not effective; in contrast hydrogen peroxide reduced C. acnes. Finally, one study evaluated an aseptic protocol using CHG and concluded that it was not effective. Conclusions It was demonstrated that BPO as home treatment is effective in reducing C. acnes load on skin ; it rarely causes side effects and is also cost-effective. This study highlights non-effectiveness of CHG. There was some evidence that the addition of hydrogen peroxide could have a positive effect in the reduction of C. acnes skin load; however, more studies are required.

scholarly journals ANN-Based Decision Making in Station Keeping for Geotechnical Drilling Vessel

2021 ◽  
Vol 9 (6) ◽  
pp. 596
Author(s):  
Murugan Ramasamy ◽  
Mohammed Abdul Hannan ◽  
Yaseen Adnan Ahmed ◽  
Arun Kr Dev
Keyword(s):  
Decision Making ◽  
Water Depth ◽  
Business Models ◽  
Cost Benefit ◽  
Cost Effective ◽  
Station Keeping ◽  
Operational Information ◽  
Effective Option ◽  
The Cost ◽  
Cost Factors

Offshore vessels (OVs) often require precise station-keeping and some vessels, for example, vessels involved in geotechnical drilling, generally use Spread Mooring (SM) or Dynamic Positioning (DP) systems. Most of these vessels are equipped with both systems to cover all ranges of water depths. However, determining which system to use for a particular operational scenario depends on many factors and requires significant balancing in terms of cost-benefit. Therefore, this research aims to develop a platform that will determine the cost factors for both the SM and DP station-keeping systems. Operational information and cost data are collected for several field operations, and Artificial Neural Networks (ANN) are trained using those data samples. After that, the trained ANN is used to predict the components of cost for any given environmental situation, fieldwork duration and water depth. Later, the total cost is investigated against water depth for both DP and SM systems to determine the most cost-effective option. The results are validated using two operational scenarios for a specific geotechnical vessel. This decision-making algorithm can be further developed by adding up more operational data for various vessels and can be applied in the development of sustainable decision-making business models for OVs operators.

scholarly journals Damping Pressure Pulsations in a Wave-Powered Desalination System

2014 ◽  
Vol 136 (2) ◽  
Author(s):  
Brandon J. Hopkins ◽  
Nikhil Padhye ◽  
Alison Greenlee ◽  
James Torres ◽  
Levon Thomas ◽  
...  
Keyword(s):  
Constant Pressure ◽  
Low Cost ◽  
Pressure Fluctuations ◽  
Cost Effective ◽  
Coastal Communities ◽  
Pressure Pulsations ◽  
Pressure Flow ◽  
Reliable Source ◽  
Effective Option ◽  
Elastic Pipes

Wave-driven reverse osmosis desalination systems can be a cost-effective option for providing a safe and reliable source of drinking water for large coastal communities. Such systems usually require the stabilization of pulsating pressures for desalination purposes. The key challenge is to convert a fluctuating pressure flow into a constant pressure flow. To address this task, stub-filters, accumulators, and radially elastic-pipes are considered for smoothing the pressure fluctuations in the flow. An analytical model for fluidic capacitance of accumulators and elastic pipes are derived and verified. Commercially available accumulators in combination with essentially rigid (and low cost) piping are found to be a cost-effective solution for this application, and a model for selecting accumulators with the required fluidic-capacitance for the intended system is thus presented.

scholarly journals Assessment of Live Candidate Vaccines for Paratuberculosis in Animal Models and Macrophages

2009 ◽  
Vol 78 (3) ◽  
pp. 1383-1389 ◽  
Author(s):  
Gabriella M. Scandurra ◽  
Geoffrey W. de Lisle ◽  
Sonia M. Cavaignac ◽  
May Young ◽  
R. Pamela Kawakami ◽  
...  
Keyword(s):  
Side Effects ◽  
Bacterial Load ◽  
Economic Effect ◽  
Cost Effective ◽  
The Other ◽  
Murine Models ◽  
Initial Screening ◽  
Vaccine Candidates ◽  
Allelic Exchange ◽  
Potential Vaccine

ABSTRACT Mycobacterium avium subsp. paratuberculosis (basonym M. paratuberculosis) is the causative agent of paratuberculosis, a chronic enteritis of ruminants. To control the considerable economic effect that paratuberculosis has on the livestock industry, a vaccine that induces protection with minimal side effects is required. We employed transposon mutagenesis and allelic exchange to develop three potential vaccine candidates, which were then tested for virulence with macrophages, mice, and goats. All three models identified the WAg906 mutant as being the most attenuated, but some differences in the levels of attenuation were evident among the models when testing the other strains. In a preliminary mouse vaccine experiment, limited protection was induced by WAg915, as evidenced by a reduced bacterial load in spleens and livers 12 weeks following intraperitoneal challenge with M. paratuberculosis K10. While we found macrophages and murine models to be rapid and cost-effective alternatives for the initial screening of M. paratuberculosis mutants for attenuation, it appears necessary to do the definitive assessment of attenuation with a ruminant model.

P-296 Examining the link between environmental toxin exposure and uterine leiomyoma: a systematic review

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Sodhi ◽  
L Chan ◽  
R Chow ◽  
I Chen
Keyword(s):  
Systematic Review ◽  
Bisphenol A ◽  
Organic Pollutants ◽  
Uterine Leiomyoma ◽  
Phthalate Esters ◽  
Experimental Studies ◽  
Uterine Fibroids ◽  
Case Control ◽  
Environmental Toxins ◽  
Alkyl Phenols

Abstract Study question Is there an association between exposure to certain environmental toxins and the prevalence of uterine leiomyoma in women? Summary answer Some evidence was obtained to suggest an association between phthalate esters, bisphenol A, heavy metals, persistent organic pollutants and the prevalence of uterine fibroids. What is known already Environmental toxins are naturally occurring, or human made chemicals that can act as endocrine disrupting chemicals (EDCs) by binding and activating estrogen receptors in the body. Uterine fibroids, often called leiomyoma are non-cancerous growths occurring in the uterus. Though often asymptomatic, they can cause pain, infertility, pregnancy complications and are a leading cause for hysterectomy. The aetiology of leiomyoma is not fully understood but both estrogen and progesterone have been implicated in their growth. We aimed to investigate the epidemiological evidence for the association between EDCs and the prevalence of fibroids.  Study design, size, duration We undertook a systematic review and in keeping with PRISMA guidelines, a structured search of Medline, Embase, Scopus, and Web of Science was conducted (to October 2020). Case-control, cross-sectional, cohort and experimental studies were included.  Participants/materials, setting, methods The included studies analyzed the association between one or more toxins and the occurrence, or growth of leiomyoma in humans, including human cell lines. The types of toxins, patient characteristics, association and outcome, body concentration of toxin and confounding variables were extracted and analyzed. Quality assessment was performed using the Newcastle-Ottawa Scale. Main results and the role of chance In total, 34 studies were included. The majority (76%) of studies revealed a significant association between the exposure studied and the prevalence of uterine leiomyoma. In examining body burden in cases vs controls, phthalate esters showed an association with increased odds of uterine leiomyoma, except in one case where a negative association was observed. In vitro experimental studies examining the effect of alkyl-phenols such as bisphenol A (BPA), octylphenol (OP) and nonylphenol (NP) demonstrated that these environmental estrogens can act to promote the proliferation of leiomyoma cells through a number of mechanisms, typically including the estrogen receptor alpha (ERa) signalling pathway. There were conflicting results for the association between alkyl-phenols and fibroids in case-control studies. A positive association between cadmium was demonstrated in only two studies. There were conflicting results for the association between lead, mercury, arsenic and uterine fibroids. Several metabolites of organophosphate esters, alternative plasticizers, and persistent organic pollutants were associated with an increased risk of uterine fibroids.  Limitations, reasons for caution Separating these exposures from the multiple other factors that could affect the outcome of leiomyoma is challenging, but an important issue for future research.  Wider implications of the findings The link between some environmental toxins and uterine fibroids discussed is in agreement with previous literature. However, our review provides a more in depth analysis on specific dosage effects, odds ratios, and potential gene mechanisms of the exposures. This information could contribute to more accurate preventative measures. Trial registration number not applicable

Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential

2021 ◽  
Vol 14 (10) ◽  
pp. e243465
Author(s):  
Chiamaka Maduanusi ◽  
Sathiyaa Balachandran ◽  
Sahathevan Sathiyathasan ◽  
Kazal Omar
Keyword(s):  
Uterine Leiomyoma ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Haemodynamic Instability ◽  
Hypovolaemic Shock ◽  
Important Differential Diagnosis ◽  
Life Threatening ◽  
Definitive Management

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

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