scholarly journals Haemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study

2021 ◽  
Author(s):  
P. V. Tsarkov ◽  
M. A. Popovtsev ◽  
Yu. S. Medkova ◽  
A. V. Alekberzade ◽  
N. N. Krylov
Keyword(s):  
Patient Satisfaction ◽  
Clinical Symptoms ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Treatment Results ◽  
Artery Ligation ◽  
Haemorrhoidal Disease ◽  
Anal Bleeding

Aim. To evaluate the efficacy of haemorrhoidal artery ligation (HA) with a preliminary palpatory determination of its localization supplemented by mucopexy of haemorrhoids as a new surgical method in the treatment of haemorrhoidal disease (HD) and to compare it with HAL-RAR technology.Materials and methods. The randomized controlled clinical trial included patients over 18 years old with Goligher’s grade II, III or IV symptomatic HD. We operated on patients in the study group (n = 75) using palpatory determination of the localization of HA and subsequent mucopexia. In the control group (n = 75) we used HAL-RAR. The primary endpoint (25–30 days after surgery): recurrence rate of HD symptoms. Secondary endpoints: postoperative complication rate, pain intensity on a visual-analogue scale from 1 to 10 points, patient satisfaction with the treatment results on a 10-point scale.Results. According to the initial characteristics (age, gender, body mass index, stage of HD, frequency of clinical symptoms), the groups did not differ. Anal bleeding relapse developed: study group – 11%, control group –14%; relapse of haemorrhoids prolapse: 3% and 5% respectively (p > 0.05). Postoperative complications were noted in 6 (8%) in the study group and 4 (5%) in the control group (p > 0.05). The intensity of pain on the 2nd and 25–30 days after surgery was 6.3 [4.8; 7.4] and 1.2 [0.6; 2.5] points in the study group and 6.5 [4.9; 7.3] and 2.1 [1.9; 4.1] in the control group, respectively (p > 0.05). Patient satisfaction with the treatment results after 12 months was estimated at 8.7 [7.9; 9.2] and 9.4 [8.2; 9.6] in the study and control groups, respectively (p > 0.05).Conclusion. HA ligation with a preliminary palpatory determination of its localization and supplemented with mucopexy of haemorrhoids is no less effective than HAL-RAR in preventing haemorrhoidal bleeding and prolapse of the nodes.

scholarly journals Prophylactic Hypogastric Artery Ligation during Placenta Percreta Surgery: A Retrospective Cohort Study

2018 ◽  
Vol 08 (02) ◽  
pp. e142-e145
Author(s):  
Theresa Kuhn ◽  
Kristina Martimucci ◽  
Abdulla Al-Khan ◽  
Robyn Bilinski ◽  
Stacy Zamudio ◽  
...  
Keyword(s):  
Blood Loss ◽  
Retrospective Cohort ◽  
Placenta Percreta ◽  
Control Group ◽  
Study Group ◽  
Distributed Data ◽  
Hypogastric Artery ◽  
Blood Products ◽  
Artery Ligation ◽  
Cesarean Hysterectomy

Objective To evaluate if prophylactic hypogastric artery ligation (HAL) decreases surgical blood loss and blood products transfused. Study Design This is a retrospective cohort study comparing patients with placenta percreta undergoing prophylactic HAL at the time of cesarean hysterectomy versus those who did not. Data were presented as means ± standard deviations, proportions, or medians with interquartile ranges. Demographic and clinical data were compared in the groups using Student's t-test for normally distributed data or the Mann–Whitney U test for nonnormally distributed data. Fisher's exact test was used for proportions and categorical variables. Data are reported as significant where p was <0.05. Results There were 26 patients included in the control group with no HAL and 11 patients included in the study group. Estimated blood loss for the study group was 1,000 mL versus 800 mL in the control. Units of PRCBs transfused were 4.5 units in the study group versus 2 units for the control group. None of these measures were found to be statistically significant. Conclusion Our data suggest there was no benefit in the use of prophylactic HAL in decreasing surgical blood loss or amount of blood products transfused in patients who had a cesarean hysterectomy performed for placenta percreta. Précis Prophylactic HAL does not decrease blood loss during surgery for placenta percreta.

scholarly journals Oral Hygiene in a Sample of Children/Adolescents Living in Family-Homes from the Province of Milan (Italy): A Pilot Study

2020 ◽  
Vol 8 (2) ◽  
pp. 33 ◽  
Author(s):  
Alessandro Nota ◽  
Floriana Bosco ◽  
Shideh Ehsani ◽  
Francesca Giugliano ◽  
Giulia Moreo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Oral Hygiene ◽  
Clinical Results ◽  
Plaque Index ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Significant Difference ◽  
And Gender ◽  
Oral Hygiene Instructions

Objective: This pilot study is a prospective controlled clinical trial, designed to evaluate the short-term clinical results (the plaque index) of an educational/motivational program for home oral hygiene, directed to children and adolescents who live in family-homes. Methods: The setting of the project was the province of Milan (Italy), where two family-homes were selected. The study group included 26 children (16 females and 10 males) aged between 7 and 15 years, of Italian nationality, from the family-home communities. The control group included 26 children (15 females and 11 males, aged between 7 and 15 years) of Italian nationality, matched for age and gender distribution with the study group, that were not in a socially disadvantaged condition. Collection of the plaque index (PI) was performed at t0. Then, all basic oral hygiene instructions were given to all children/adolescents and their educators. Education and motivation were repeated in the same way after 4–7 weeks (T1), and after 10–12 weeks (T2). The PI was taken also at T1 and T2. Results: An improvement in the PI was generally found in both groups, but there was no statistically significant difference between the two groups over time. Multivariate analysis of variance (MANOVA) revealed a statistically significant effect of time [F (1, 52) = 90.73, p < 0.001], regardless of the assignment group, in consequence of which the plaque index presented a moderate and significant improvement. Conclusion: The present data confirm the validity of the educational/motivational program to improve oral hygiene in children/adolescents, regardless of the assignment group.

scholarly journals The Efficacy of Once-Daily Dose of Phenobarbital in Children with Generalized Tonic-Clonic Epilepsy

2018 ◽  
Vol 35 (7-8) ◽  
pp. 172-9
Author(s):  
Amril A. Burhany ◽  
Sofyan Ismael ◽  
Hardiono Pusponegoro
Keyword(s):  
Clinical Trial ◽  
Plasma Concentrations ◽  
Serum Levels ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Once Daily ◽  
Daily Dose ◽  
Plasma Measurements ◽  
Better Than

In spite of its long half life, phenobarbital is still given twice-daily in the treatment of generalized tonic-clonic epilepsy. This study aims to determine if daily dose of phenobarbital given once differs to that given twice daily. Subjects of this unblinded controlled clinical trial were generalized tonic-clonic epilepsy patients ranging in age from 1-15 years. There were 40 study cases and 42 controls. We gave phenobarbital 4-6 mg/kg/day once-daily for study group and twice-daily dose for control group. History, physical and EEG examination and phenobarbital plasma measurements were obtained a t the beginning of the study and four weeks later. The ratio of the second to first phenobarbital plasma concentrations in the study group was 0.99 while in the control group it was 1.02. The proportion of seizure-free patients in the study group increased from 70% at the beginning to 85% at the end of study, and in the control group from 64.3% to 83.3%. Hyperactivity and irritability increased in both groups, and there were no significant differences in mean serum levels, seizures control, hyperactivity and irritability in both groups. Drowsiness was found in 50% of cases, but statistically significant decrease were found in study group. The compliance of the study group (92.5%) was significantly better than that of the control group (71.4%).

ENDOTHELIAL DYSFUNCTION AND NEUROHUMORAL REGULATION OF BLOOD PRESSURE IN PATIENTS WITH SYSTEMIC SCLEROSIS

2019 ◽  
Vol 57 (4) ◽  
pp. 445-451
Author(s):  
N. P. Shilkina ◽  
I. E. Yunonin ◽  
S. A. Stolyarova ◽  
A. A. Vinogradov
Keyword(s):  
Blood Pressure ◽  
Systemic Sclerosis ◽  
Endothelial Dysfunction ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Endothelial Activation ◽  
Control Group ◽  
Neurohumoral Regulation ◽  
Positive Correlations

Objective: to investigate the effect of endothelial dysfunction, catecholamines, and renin on the diurnal blood pressure (BP) profile in patients with systemic sclerosis (SS).Subjects and methods. Twenty-five patients with SS underwent determination of the blood count of desquamated endotheliocytes by the method described by J. Hladovec (1978), the plasma levels of endothelin-1 (ET-1), adrenaline, norepinephrine, and renin by enzyme immunoassay. All the patients underwent 24-hour BP monitoring with calculating the time index, daily index, the magnitude and rate of a morning rise in BP, as well as its daily variability.Results and discussion. Hypertension was detected in 8 (32%) patients with SS. All the patients with SS showed signs of endothelial dysfunction, as evidenced by considerable differences in endothelial activation measures compared with the control group: the mean level of ET-1 was 5.8±2.3 and 0.48±0.21 fmol/ml (p<0.05); the number of desquamated endotheliocytes was 4.50 [3.00; 7.00] and 2.10 [1.00; 3.20] • 104/l, respectively (p<0.05). The levels of adrenaline and norepinephrine in SS were significantly higher than those in the control. There were positive correlations between endothelial dysfunction and the degree of an increase in BP. Endothelial dysfunction was found to have a negative impact on the diurnal BP profile in the presence of pathological types of night-peaker and non-dipper. Conclusion. Two mechanisms, such as endothelial dysfunction and sympathoadrenal activation, are responsible for the pathogenesis of clinical symptoms of SS, including hypertension.

scholarly journals Role of High Dose Calcium in the Prevention of Preeclampsia

2016 ◽  
Vol 28 (2) ◽  
pp. 66-70 ◽  
Author(s):  
Aparna Khan ◽  
Susil Kumar Mandal ◽  
Amitava Pal
Keyword(s):  
Preterm Delivery ◽  
Final Analysis ◽  
Analysis Data ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
Study Group ◽  
Chi Square ◽  
The Difference ◽  
Lost To Follow Up

Objectives: To assess the effect of supplementation of high dose of calcium(2gm) in prevention of preeclampsia.Materials & Methods: A randomized controlled clinical trial on 272 healthy nulliparous woman were randomly allocated into two groups by means of a computer generation randomization list. From 20 weeks of gestation until delivery who received 2gm of oral elemental calcium per day (n=127 )were assigned to high dose calcium group or the study group and 145 women were assigned to low dose calcium or control group , receiving 500 mg of calcium per day. Ten women (3.67%) were lost to follow up after randomization (4 in the study group and 6 in the control group) . Thus a total of 123 woman in the study group and 139 in the control group were included in the final analysis. Data was collected by standard questionnaire, clinical examination and investigations and statistical analysis was performed by student’s t-test, chi square tests. P<0.05 was statistically significant.Results: Preeclampsia developed in Study Group were 5.7% and Control Group 13.7% and the difference was statistically significant (Chi-squares - 4.65, df =1, p = 0.031). There were 2.43% (3 of 123 women) preterm delivery in the study group and 7.91% (11 of 39 women) in the control group. So, there was a significantly lower risk of preterm delivery in the study group ( p = 0.049). Intrauterine growth retardation (IUGR) was found in 3.25% and 9.35% of women in the study and the control groups respectively. The incidence is higher in the control group when compared to the study group (p = 0.045).Conclusion: Calcium intake is beneficial for both pregnant women and her unborn child. Daily supplementation with 2 grams of calcium during pregnancy significantly reduced the risk of preeclampsia, preterm labor and IUGR. So, high dose calcium should be supplemented to all women during pregnancy in developing countries where preeclampsia and preeclampsia related morbidities and mortality are quite high.Bangladesh J Obstet Gynaecol, 2013; Vol. 28(2) : 66-70

scholarly journals Efficacy of minimally invasive therapy and laser therapy in the comprehensive treatment of endoperiodontal lesions

2021 ◽  
Author(s):  
Nurgul Zh. Zholdassova ◽  
Ainur Amanzholkyzy ◽  
Azamat I. Kaikan ◽  
Yerik S. Isbulatov ◽  
Albina M. Nurtileuova
Keyword(s):  
Minimally Invasive ◽  
Laser Therapy ◽  
Minimally Invasive Therapy ◽  
Apical Periodontitis ◽  
Solid Food ◽  
Control Group ◽  
Comprehensive Treatment ◽  
Study Group ◽  
Treatment Results ◽  
Invasive Therapy

Introduction: A strategy for comprehensive treatment of endoperiodontal lesions is discussed, depending on the severity of pathology in the endodontium and periodontium associated with mild chronic generalized periodontitis. Aim: The purpose of the study was to evaluate the efficiency of minimally invasive therapy and laser therapy in the comprehensive treatment of endoperiodontal lesions associated with chronic generalized periodontitis. Material and methods: Sixty patients with apical periodontitis were examined and received periodontal treatment using minimally invasive therapy and laser therapy in combination with endodontic stages of treatment. Results and discussion: Pain when biting down, sometimes aggravated with solid food, was reported for several days in 38% of cases in the control group. The patients of the study group did not report painful sensations; in 20% of cases, inconveniences only occurred with solid food during the first days. Conclusions: The study showed that in all clinical cases selected for this article, a comprehensive treatment including minimally invasive therapy and laser therapy was effective with both endodontic and periodontal sparing treatment.

scholarly journals Effect of a Smartphone-Based App on the Quality of Life of Patients With Heart Failure: Randomized Controlled Trial

JMIR Nursing ◽  
10.2196/20747 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e20747
Author(s):  
Mahboube Davoudi ◽  
Tahereh Najafi Ghezeljeh ◽  
Farveh Vakilian Aghouee
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Background Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. Objective The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. Methods This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. Results The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (P<.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (P<.001). Conclusions Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. Trial Registration Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434

scholarly journals Clinical Effect of Auricular Point Sticking in Patients with Lung Cancer Receiving Chemotherapy

2021 ◽  
Vol 5 (6) ◽  
pp. 73-77
Author(s):  
Xiaorui Zhu
Keyword(s):  
Lung Cancer ◽  
Stress Response ◽  
Adverse Reactions ◽  
Clinical Effect ◽  
Clinical Symptoms ◽  
Auricular Point Sticking ◽  
Jiangxi Province ◽  
Control Group ◽  
Study Group ◽  
Auricular Point

Objective: To discuss and analyze the clinical effect of auricular point sticking in lung cancer chemotherapy. Methods: Sixty-two patients with lung cancer treated with chemotherapy in Suqian Traditional Chinese Medicine Hospital of Jiangxi Province were selected for case evaluation and analysis. The time span of the research was from June 2020 to June 2021. The patients were divided into two groups: a study group (n = 31) and a control group (n = 31) based on their medical record numbers. All the patients were treated with conventional western medicine before and after chemotherapy to prevent adverse reactions; however, the patients in the study group were also treated with auricular point sticking in addition to the former. The relevant indexes of the two groups were compared. Results: The incidence of adverse reactions was significantly lower in the study group compared to the control group (P < 0.05); the rate of symptomatic relief of the patients in the study group was higher than that of the control group (P < 0.05); the stress response indexes toward chemotherapy of the study group were better than those of the control group (P < 0.05). Conclusion: Auricular point sticking for patients with lung cancer who are receiving chemotherapy can reduce the incidence of adverse reactions, alleviate clinical symptoms, such as chest distress, asthma, and poor appetite, significantly alleviate stress response caused by chemotherapy, as well as promote the treatment effect; thus, it is worthy of promotion.

scholarly journals Comparative Evaluation of the Efficacy of Hydrocortisone Suppository and Durvadi gudavarti in Raktarsha: A Management Protocol

2021 ◽  
pp. 12-18
Author(s):  
Biswas Nitin ◽  
Jajoo Suhas ◽  
Jaiswal Reena ◽  
S. R. Kapse
Keyword(s):  
Clinical Symptoms ◽  
Control Group ◽  
Haemorrhoidal Disease ◽  
Management Protocol ◽  
Objective Parameter ◽  
Common Diagnosis ◽  
Mucous Discharge ◽  
Anal Pruritus ◽  
Treatment Onset ◽  
Objective Outcomes

The most common diagnosis for any anorectal complaint particularly of rectal bleeding in adults is haemorrhoidal disease. Regardless of grading conservative treatment is used primarily in symptomatic haemorrhoids. In Ayurveda, Sthanik Chikitsa (Local application) in the management of Arsha (Hemorrhoids) includes pralepa/pratisaran (Paste application). Instead of applying the lepa in the clinics by the clinician/proctologist, those formulations could be developed into Gudavarti (traditional suppository) & used in the management of Raktarsha (bleeding piles) for better compliance. Hence, development of ‘Durvadi Gudavarti’ using the indigenous medicinal herbs mentioned in Charaka Sanhita (Classical Ayurveda text) for pratisaran/pralepa in Raktarsha & its efficacy will be evaluated. Objectives: To study & compare the efficacy in patient treated with standard- Hydrocortisone suppository group & interventional- Durvadi Gudavarti group in the management of Raktarsha (Bleeding piles). Methodology: 130 patients of 2nd grade hemorrhoids will be selected and will be allocated into two equal groups by computer randomization. Experimental group will be treated with Durvadi Gudavarti & control group with Hydrocortisone based suppository for 2 weeks. Following Symptoms- PR Bleeding, Anal Pain, Prolapse of Pile mass/Lump, Anal pruritus, Mucous discharge & Constipation will be assessed subjectively and Size/ (Volume in cubic millimeter) of pile mass will be the objective parameter for study. Clinical evaluation will be done at Baseline and 3rd, 5th, 10th, 15th day after treatment onset. Proportion of patients that would respond clinically on 10th day will be the main end point, determined via disappearance of the clinical symptoms & more than or equal to 50 % reduction in the initial size of pile mass/lump. Time to response & need for any oral/ parenteral medication for pain, bleeding and constipation would be the secondary variables. Side effects (type, duration & severity) will be registered carefully. Expected Results: Durvadi Gudavarti contains indigenous herbs having anti-inflammatory, analgesic, haemostatic, wound healing, astringent, & laxative properties. Hence, it is expected to be as efficacious as Hydrocortisone suppository with lesser side effect in the management of Raktarsha. Results will be assessed on the basis of clinical assessment criteria using proper statistical values and tools. Changes will be observed in objective outcomes. Conclusion: Durvadi Gudavarti will be efficacious in the management of Raktarsha.

scholarly journals Omega-3 polyunsaturated fatty acids supplementation improve clinical symptoms in patients with covid-19: A randomized clinical trial

2021 ◽  
Author(s):  
Mohsen Sedighiyan ◽  
Hamed Abdollahi ◽  
Elmira Karimi ◽  
Mostafa Badeli ◽  
Reza Erfanian ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Liver Enzymes ◽  
Clinical Symptoms ◽  
Intervention Group ◽  
Clinical Signs ◽  
Control Group ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Body Pain

Objective: We hypothesized that omega-3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalized patients with covid-19 disease. Methods: This was a single-blind randomized controlled trial in Amir-Alam hospital in Tehran. Thirty adult men and women diagnosed with covid-19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of DHA+EPA) for 2 weeks. Primary outcome of the intervention including CRP, ESR as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega-3 supplementation. Clinical signs were measured using self-reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated hematology analyzer was applied. Results: In comparison to control group, patients receiving omega-3 indicated favorable changes in all clinical symptoms except for olfactory ((p<0.001 for body pain and fatigue, p= 0.03 for appetite and p=0.21 for olfactory). Reducing effects of omega-3 supplementation compared to control group were also observed in the levels of ESR and CRP after treatment (p<0.001 for CRP and p=0.02 for ESR). However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (p>0.05). Conclusion: Current observations are very promising and indicate that supplementation with moderate dosages of omega-3 fatty acids may be beneficial in the management of inflammation-mediated clinical symptoms in covid-19 patients. Key words: Covid-19, omega-3, inflammation, clinical symptoms

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