A CLINICAL STUDY TO EVALUATE THE EFFECT OF SPHATIKAYUKTHA RASA SINDOORA WITH LODHRA KASHAYA IN DYSFUNCTIONAL UTERINE BLEEDING

Work Capacity ◽

Uterine Bleeding ◽

Rank Test ◽

Signed Rank Test

Dysfunctional Uterine Bleeding is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic and iatrogenic cause. The prevalence varies widely but an incidence of 10% amongst new patients attending the outpatient seems logical. Along with increased susceptibility to iron deficiency, heavy menstrual bleeding can negatively impact physical, emotional and social quality of life and reduce work capacity of females. Objective: A clinical study was conducted to evaluate the effect of Sphatikayuktha Rasa Sindoora with Lodhra Kashaya in Dysfunctional Uterine Bleeding. Design: This pre-post interventional study was conducted among 20 females in the age group 20-45 years who had the symptoms of Dysfunctional Uterine Bleeding for the past 3 cycles. Drug administration started on the 3rd day of menstruation and was continued till bleeding stopped or upto a maximum of 7 days for 3 consecutive cycles. Follow up was done in the next cycle. The condition of the patient after drug administration in the first, second and third months were separately compared with the condition of the patient before treatment. Outcome measures: Outcome variables were change in the amount, duration and frequency of bleeding. Results and Discussion: Results were analysed statistically using Wilcoxon signed rank test and Paired t-test. The treatment was effective in reducing the amount of bleeding during treatment period and the follow up period. It was effective in reducing the duration of bleeding during the treatment period as compared to the follow up period and in controlling the cycle interval during the treatment period.

EFFECT OF COMBINATION OF FRUIT OF BADARA [Ziziphus jujuba (L). Lam] AND PALM JAGGERY IN DYSFUNCTIONAL UTERINE BLEEDING

International Journal of Research in Ayurveda and Pharmacy ◽

10.7897/2277-4343.1206166 ◽

2022 ◽

Vol 12 (6) ◽

pp. 32-36

Author(s):

Subha K Nampoothiri ◽

Asha Sreedhar ◽

A Shahul Hameed

Keyword(s):

Side Effects ◽

Study Drug ◽

Uterine Bleeding ◽

Rank Test ◽

Hormonal Imbalance ◽

Signed Rank ◽

Signed Rank Test ◽

Ziziphus Jujuba

Dysfunctional uterine bleeding (DUB) is a state of abnormal uterine bleeding. It is a diagnosis of excluding any clinically detectable organic, systemic and iatrogenic cause. Current treatments available have many side effects, including hormonal imbalance. So there exists a lacuna for a safe and effective treatment without side effects for this condition. The present study is an effort to evaluate the combined effect of fruit of Badara [Ziziphus jujuba(L). Lam] with Palm jaggery in Dysfunctional uterine bleeding. The study design is interventional with a sample size of 15 subjects within the age group of 16-50 years. The study drug was administered in 6gm in the morning and the evening before food for 90 days. The following 30 days was follow up period without medication. The effect was assessed on subjective and objective parameters before treatment and on the 31st, 61st, 91st and 121st days. The results were statistically analyzed using Paired t-test and Wilcoxon Signed Rank test. The study drug showed the statistically significant result in DUB as reducing the amount and duration of bleeding, an interval of menstruation, number of clots, pain, fatigue, and increasing the Haemoglobin percentage.

A PROSPECTIVE ANALYTICAL STUDY OF PATIENTS WITH DYSFUNTIONAL UTERINE BLEEDING.

10.36106/gjra/8500174 ◽

2021 ◽

pp. 1-2

Author(s):

Mangal Supe ◽

Anup Arun Gundecha

Keyword(s):

Social Life ◽

Analytical Study ◽

Systemic Disease ◽

Study Data ◽

Uterine Bleeding ◽

Age Group ◽

Endometrial Pattern ◽

Considerable Morbidity

Background: Dysfunctional uterine bleeding is dened as abnormal uterine bleeding not caused by any pelvic pathology, medications, pregnancy related complications or any systemic disease. It is the most common cause of abnormal uterine bleeding. It affects pubertal adolescents and perimenopausal women and is associated with considerable morbidity and affects patient’s family, personal and social life. Patient presents as menorrhagia, polymenorrhea, metrorrhagia or intermenstrual bleeding. It has great variations in endometrial patterns each deciding treatment modality. Objective: To determine frequency of various types of abnormal uterine bleeding and analyze the histopathology of endometrial curettage samples. Method: A prospective analytical study was conducted from Jan 2018 to Dec 2019 on sample of 650 patients between 20-70 years of age with symptoms of dysfunctional uterine bleeding presenting to medical college and hospital, Pimpri. Their endometrial samples were obtained by dilatation and curettage. To have a broader analysis the endometrial histopathology on hysterectomy specimens where the clinical diagnosis was DUB were also included in the study. Data obtained was tabulated and analyzed. Conclusion: The age group 31-40 and 41-50 years was the most common age group presenting with DUB. The predominant pattern of presentation was menorrhagia. The most common endometrial pattern on histopathology was proliferative type.

Histopathological evaluation of endometrial sampling in perimenopausal women with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212977 ◽

2021 ◽

Vol 10 (8) ◽

pp. 3180

Author(s):

Bhavani L. Nair ◽

Lency S. Kuriakose

Keyword(s):

Endometrial Cancer ◽

Uterine Bleeding ◽

Menstrual Bleeding ◽

Endometrial Sampling ◽

Medical College ◽

Perimenopausal Women ◽

Proliferative Endometrium ◽

Secretory Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the common symptoms in the gynaecology outpatient department. About one third of women are affected at some time in their lives. The perimenopausal women show significant number of underlying organic pathology. The evaluation of endometrium and/or organ histopathology has the dual advantage of finding the cause of AUB and to rule out endometrial cancer or the potential for cancer in future like endometrial hyperplasia with atypia. The aim of the study was to determine the histopathological pattern of endometrial sampling in perimenopausal women with AUB and to follow them up for a period of six months after the procedure.Methods: The prospective observational study was conducted at the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, Kerala, for a period of one year from December 2019 to December 2020. The study was conducted on 116 perimenopausal women 41-52 years who presented with AUB and had undergone endometrial sampling. These ladies were subsequently followed up for six months post procedure to assess the response to medical treatment or the need for any surgical intervention like hysterectomy.Results: A total 39.65% patients had heavy and prolonged menstrual bleeding and 18.16% patients had irregular bleeding. 14.65% patients had prolonged flow, 8.6% had heavy flow, 6.8% had infrequent with prolonged flow, 6% had prolonged, infrequent with heavy bleeding. Non-structural (COEIN) causes contributed to about 60.4% of AUB in perimenopausal women and 39.6% had structural (PALM) causes. 49% cases were secretory endometrium. 29.3% had disordered proliferative endometrium, 4.3% had proliferative endometrium, 5.2% each had polyp or hyperplasia without atypia. 18 (15.5%) cases underwent hysterectomy, 3 patients who had adenocarcinoma underwent staging laparotomy, 2 patients had LNG IUS insertion and 40 patients were on follow up requiring either no treatment and 53 (45.68%) patients were given antifibrinolytics or hormonal therapy.Conclusions: Heavy and prolonged menstrual bleeding was the most common presenting symptom. COEIN contributed to about 60.4% of cases. Evaluation of the endometrium showed that, secretory endometrium was commonest (49%) followed by disordered proliferative endometrium (29.3%). On follow up for six months, 15.5% patients underwent hysterectomy, 2 patients had insertion of levonorgestrel IUD, 45.68% patients had medical management with antifibrinolytics or hormones and were on follow up. The responsibility of gynaecologist in the management of AUB in perimenopausal women is to exclude hyperplasia of endometrium and endometrial cancer.

Pre and Post test Clinical study to evaluate the Immunomodulatory effect (IgE) of Virecana followed by Citrakaharitaki Leha in Allergic Asthma

International Journal of Ayurvedic Medicine ◽

10.47552/ijam.v12i1.1743 ◽

2021 ◽

Vol 12 (1) ◽

pp. 53-61

Author(s):

Jyotish S Jayandan ◽

James Chacko ◽

Devipriya Soman ◽

Mahesh C Kundagol

Keyword(s):

Clinical Study ◽

Allergic Asthma ◽

Rank Test ◽

Drug Induced ◽

Paired Samples ◽

Management Protocol ◽

Post Test ◽

Signed Rank Test ◽

Significant Change ◽

The Difference

Allergic Asthma is one among the diseases which imposes a great burden on the subjects by hampering the quality of life of patients, reducing productivity, and causing work absence. The literary search hinted that there are no published works reporting both clinical and immunological(IgE) outcomes in Allergic Asthma. So the present study was a pre and post test clinical study to evaluate the effect of Ayurvedic line of management in inducing both immunological(IgE) and clinical outcomes in Allergic Asthma. In this study 30 patients were administered classical Virecana Karma (drug induced purgation) followed by Shamanoushadi (internal medicine) for 30 days. Statistical Analysis was done using SPSS VER. 20. Wilcoxon signed rank test was used to evaluate the Subjective parameters, in order to interpret the time of significant change. For objective parameters Paired Samples t- Test was used to evaluate the difference of significant change. The results showed improvement in the subjective criteria, objective criteria and the overall effect of the therapy with the exception of no statistically significant results in immunomodulatory (IgE) effect which proves that the particular management protocol adopted is found to be clinically efficant but not effective in inducing changes at the immune level.

Clinical and doppler monitoring of patients with Takayasu arteritis with ITAS 2010 and CDUS-K score respectively following medical intervention: a 12 months follow-up study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184415 ◽

2018 ◽

Vol 6 (11) ◽

pp. 3602

Author(s):

Debanjali Sinha ◽

Sumantro Mondal ◽

Arijit Nag ◽

Debasish Lahiri ◽

Alakendu Ghosh

Keyword(s):

Disease Activity ◽

Disease Progression ◽

Takayasu Arteritis ◽

Medical Intervention ◽

Matched Pair ◽

Rank Test ◽

Colour Doppler ◽

Signed Rank ◽

Signed Rank Test

Background: The objective of the present study was to monitor the disease activity of Takayasu arteritis clinically by the Indian Takayasu Activity Score 2010 (ITAS) and ultra sonographically by Colour Doppler Ultrasound-Kolkata (CDUS-K) Score after 12months of treatment with methotrexate and steroid, and to find the correlation between these two scores.Methods: Around 25 Angiographically proven Takayasu arteritis patients were treated with Methotrexate (15mg weekly) and Steroids (1mg/kg/day for 6weeks and then tapered) for 12months. Wilcoxon matched pair signed rank test was done to assess the change in ITAS 2010 with treatment. A correlation study was done between ITAS 2010 and change in CDUS-K scores at the end of 12months.Results: By Wilcoxon’s matched pair signed rank test, a non-significant change of ITAS 2010 (p=0.066) was observed at the end of 12months, which means that the treatment helps to control the disease progression by preventing a significant increase in ITAS 2010. Strong correlation (correlation coefficient of 0.878, 95% CI = 0.602 to 1.000) was found between the ITAS 2010 and change in CDUS-K scores at 12months follow up.Conclusions: The combination of Methotrexate and steroids helps to control the disease progression in Takayasu arteritis. Colour doppler ultrasonography may serve as a reliable and safe surrogate disease activity measure at follow up, as it avoids the radioactivity exposure and invasiveness of angiography.

Ormeloxifene in the management of dysfunctional uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181923 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1885

Author(s):

L. Thulasi Devi ◽

Ravi Nimonkar

Keyword(s):

Side Effects ◽

Medical Management ◽

Cost Effective ◽

Uterine Bleeding ◽

Brand Names ◽

Age Group ◽

Receptor Modulator ◽

One Year

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg. Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

A clinicopathological study of dysfunctional uterine bleeding

Journal of Pathology of Nepal ◽

10.3126/jpn.v4i8.11500 ◽

2014 ◽

Vol 4 (8) ◽

pp. 635-638

Author(s):

N Katuwal ◽

G Gurung ◽

A Rana ◽

A Jha

Keyword(s):

Endometrial Biopsy ◽

Uterine Bleeding ◽

University Teaching ◽

Age Group ◽

Obstetrics And Gynaecology ◽

Proliferative Endometrium ◽

One Year ◽

Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

Thyroid disorders in women with dysfunctional uterine bleeding

Journal of Pathology of Nepal ◽

10.3126/jpn.v6i12.16253 ◽

2016 ◽

Vol 6 (12) ◽

pp. 1018-1020

Author(s):

S Subedi ◽

B Banerjee ◽

C Manisha

Keyword(s):

Reproductive Function ◽

Hormonal Treatment ◽

Cross Sectional Study ◽

Uterine Bleeding ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

Cross Sectional ◽

Menstrual Pattern

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.