scholarly journals EARLY VERSUS DELAYED ORAL INTAKE IN PATIENTS AFTER CESAREAN SECTION UNDER REGIONAL ANESTHESIA

2021 ◽  
Vol 71 (5) ◽  
pp. 1559-62
Author(s):  
Laiqa Hassan ◽  
Shazia Tufail ◽  
Farheen Aslam ◽  
Nilofar Mustafa ◽  
Arub Ahmed ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Regional Anesthesia ◽  
Bowel Movement ◽  
Oral Intake ◽  
Elective Cesarean Section ◽  
Time Interval ◽  
Duration Of Surgery ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Objective: To compare the outcome in early versus delayed oral intake in patients after cesarean section under regional anesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital Lahore, from Dec 2017 to May 2018. Methodology: A total of 352 women undergoing elective cesarean section under regional anesthesia, nil by mouth for at least 8 hours before surgery were divided in 2 groups. In group 1, patients were given sips of clear oral fluid (water) <5 hours after cesarean section and in group 2, patients received sips of water 8 hours following surgery. Bowel motility was assessed after surgery on hourly basis. Data about time interval to first bowel movement and ileus were noted. Results: Mean age of patients was 32.329 ± 3.44 years and 33.051 ± 3.64 years in group 1 and 2 respectively. Mean gestational age and body mass index was 38.50 ± 0.93 weeks and 29.824 ± 4.97 kg/m2 in group-1 versus 37.937 ± 0.98 weeks and 27.779 ± 2.81 kg/m2 in group 2. Mean duration of surgery was 47.096 ± 6.65 minutes in group-1 and 47.647 ± 8.76 minutes in group 2. Ileus was seen in 17% patients in group-1 and 34.1% in group-2 (p<0.001). Mean time interval for first bowel movement was 8.323 ± 1.20 hours in group-1 and 13.034 ± 2.54 hours in group 2 (p<0.001). Conclusion: Early feeding after an uncomplicated cesarean section has reduced rate of ileus symptoms and mean time interval for bowel......

scholarly journals Evaluation of Metachronous Breast and Endometrial Cancers: Preroutine and Postroutine Adjuvant Tamoxifen Use

2016 ◽  
Vol 26 (8) ◽  
pp. 1440-1447 ◽  
Author(s):  
Kassondra S. Grzankowski ◽  
J. Brian Szender ◽  
Chandra L. Spring-Robinson ◽  
Shashikant B. Lele ◽  
Kunle O. Odunsi ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Adjuvant Tamoxifen ◽  
Time Interval ◽  
Primary Tumors ◽  
Previous Diagnosis ◽  
Clinicopathologic Factors ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

BackgroundThe time interval between diagnoses of breast cancer (BC) and endometrial cancer (EC) is not well established in women with metachronous primary tumors. We sought to examine this interval and identify associations with treatment-related and clinicopathologic factors.MethodsWe identified 141 patients who developed both cancers during 1966 to 2013. Patients were divided into 2 groups: group 1, BC first, and group 2, EC first. Subanalysis performed of group 1 (59 patients) stratified around adjuvant tamoxifen use: pre-1990 BC diagnosis and post.ResultsFifty-nine and 82 patients were in groups 1 and 2, respectively. The mean time interval was comparable (76 vs 74 months,P= 0.861). Subanalysis divided group 1 into pre- (n = 27) and post- (n = 32) 1990 and resulted in different mean time intervals between diagnosis of metachronous cancers (106 vs 50 months, respectively [P= 0.042]). Median progression-free survival (PFS) and overall survival (OS) for EC were longer in the pre group (PFS, 51 vs 26 months [P= 0.169]; OS, 59 vs 27 months [P= 0.190]). Median PFS and OS for BC were also longer in this group (PFS, 147 vs 109 months [P= 0.005]; OS, 166 vs 114 months [P< 0.001]).ConclusionsOur data indicate the mean time interval between the diagnosis of EC and BC was approximately 6 years. Disease-specific EC survival was worse for patients with a previous diagnosis of BC. Stratification around implementation of tamoxifen use shows comparable grade and stage but different time interval and survival, suggesting resulting effects from adjuvant therapy for BC. These results are useful in counseling women at risk.

scholarly journals The Safty Profile of Blood Salvage Applied for Collected Blood With Amniotic Fluid During Cesarean Section

2021 ◽  
Author(s):  
Xiaoying Rong ◽  
Xiangyang Guo ◽  
Hong Zeng ◽  
Jun Wang ◽  
Mi Li ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Venous Blood ◽  
Fetal Hemoglobin ◽  
Elective Cesarean Section ◽  
Suction Device ◽  
Increased Risk ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background: The guidelines of National Health Service(NHS) also recommended for use in obstetrics at increased risk of bleeding, requiring two sets to reduce amniotic fluid contamination, however, when comes to massive hemorrhage, it is may difficult to operate because the complex operation may delay time. The aim of the study was to detect the effect of amniotic fluid recovery on intraoperative cell salvage in obstetrics and provide evidence for clinical applications.Method: Thirty-four patients undergoing elective cesarean section were randomly divided into two groups. In group 1, the cumulative blood from the operation field, including the amniotic fluid, was collected using a single suction device for processing. In group 2, after suctioning away the amniotic fluid using another suction device for the cumulative blood from the operation field. From each group, four samples were taken, including maternal venous blood (sample I), blood before washing (sample II), blood after washing (sample III) and blood after filtration with a leukocyte filter (sample IV) , to detect serum potassium (K+), hemoglobin (Hb), white blood cell (WBC), fetal hemoglobin (HbF), alpha fetoprotein (AFP) and squamous cell (SC) levels.Results: The AFP, K+ and WBC levels of sample III and sample IV were significantly lower than sample I in group 1 and group 2 (P<0.05). Significantly more SCs were found in sample III than in sample I in group 1 and group 2 (P<0.05), but SCs of sample IV had no statistical difference compared to sample I in group 1 and group 2 (P>0.05). There was no significant difference in the K+, Hb, WBC, AFP and SC levels of sample IV between group 1 and group 2 (P>0.05). The HbF levels of sample III and sample IV were significantly higher in group 1 than in group 2 (P<0.05).Conclusion: There is little or no possibility for AF contamination to enter the re-infusion system when used in conjunction with a leucodepletion filter. In future, one set of suction device can be considered in obstetric emergency.Trial registration: ChiCTR1800015684, 2018.4.15

Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial

2018 ◽  
Vol 46 (7) ◽  
pp. 786-790 ◽  
Author(s):  
Magdy Refaat Ahmed ◽  
Waleed Ali Sayed Ahmed ◽  
Rasha Elsayed Khamess ◽  
Manar S. Youwakim ◽  
Khaled Mohamed EL-Nahas
Keyword(s):  
Cesarean Section ◽  
Randomized Trial ◽  
Bowel Movement ◽  
Oral Intake ◽  
Bowel Function ◽  
Elective Cesarean Section ◽  
Regular Diet ◽  
Elective Cesarean ◽  
Group A ◽  
Group B

Abstract Aim: To compare the efficacy of three postoperative feeding regimens on bowel function recovery after term elective cesarean section (CS). Methods: Women recruited for this randomized trial were allocated into three groups. Women in group (A) were instructed to chew sugarless gum for 10 min every 2 h after surgery. Group (B) mothers received IV fluids for 6 h followed by sipping fruit juices sweetened with honey. Group (C) had oral intake of clear fluids after passage of flatus and regular diet with the passage of bowel movement. The main outcome measures were the timing of first return to bowel movement and initiation of regular diet. Results: The mean times to first hearing of bowel sounds, to first flatus passage and to first defecation were significantly lower in group A (10, 17.5 and 28.1 h, respectively) compared to groups B and C [15.1, 24.9 and 36 h (B) and 21.6, 38.8 and 49.4 h (C)]. Initiation of regular diet was significantly earlier in group A compared to groups B and C (21 vs. 27.5 and 40.3 h, respectively). Conclusion: Chewing gum appears to be more advantageous than early or traditional feeding regimens after term elective CS resulting in rapid recovery of bowel function.

Clinical and Radiological Changes after use of Alpha-1 Blocker Therapy in Patients of Posterior Urethral Valve with Bladder Neck Hypertrophy

JMS SKIMS ◽  
2009 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Aejaz A Baba ◽  
Bajpai Minu
Keyword(s):  
Bladder Neck ◽  
Posterior Urethral Valve ◽  
Posterior Urethral Valves ◽  
Blocker Therapy ◽  
Urethral Valve ◽  
Novel Method ◽  
Radiological Changes ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Background: We evaluated the effects of alpha-1 blocker therapy on clinical and radiological abnormalities in patients of posterior urethral valve with bladder neck hypertrophy. Materials and Methods: A total of 74 patients with posterior urethral valves were seen at our department between 2003 and 2007. Out of these 24 had radiological evidence of bladder neck hypertrophy. Those patients with bladder neck hypertrophy who were seen before June 2006 and did not receive alpha-1 blocker (prazocin) therapy after valve ablation were assigned to group 1 (n=10). Group 2 consisted of 14 age matched patients with bladder neck hypertrophy and comparable prognostic factors who received alpha-1 blocker therapy after valve ablation (n=14). Micturating cystourethrography (MCU) was done periodically and a novel method used to calculate bladder neck hypertrophy. Trends in symptoms and radiological changes were evaluated throughout follow-up. Results: Mean patient age at presentation was 3.02±2.68 years in group 1 and 3.12±3.4 years in group 2. Bladder neck hypertrophy decreased from 2.3±1.0 to 2.0±0.5 in a mean time of 52.0 (34-52) weeks in group 1 where as it decreased from 2.2±0.5 to 1.6±0.3 in a mean time of 32.0 (22-52) weeks. Symptomatically patients in group 2 who received alpha-1 blocker therapy after valve ablation were better and had quick resolution of bladder neck hypertrophy. Conclusions: Use of alpha-1 blocker therapy in patients of posterior urethral valve with bladder neck hypertrophy helps in quick resolution of bladder neck hypertrophy. J Med Sci 2009;12(1):3-7.

Development and Validation of the Questionnaire of Satisfaction with Perioperative Anesthetic Care for General and Regional Anesthesia in Taiwanese Patients

2011 ◽  
Vol 114 (5) ◽  
pp. 1064-1075 ◽  
Author(s):  
Wui-Chiu Mui ◽  
Chia-Ming Chang ◽  
Kong-Fah Cheng ◽  
Tak-Yu Lee ◽  
Kwok-On Ng ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Patient Satisfaction ◽  
Regional Anesthesia ◽  
Anesthetic Care ◽  
Anesthesia Group ◽  
Confounding Variables ◽  
Group 3 ◽  
Group 2 ◽  
Nomological Validity ◽  
Group 1

Background To fulfill the increasing demand of service quality improvement in recent years, it is imperative to develop a proper instrument to evaluate patient satisfaction with perioperative anesthetic care for many institutes in Taiwan. Methods We used a six-factor 32-item pilot questionnaire developed in our previous study as our starting point in this study. Exploratory factor analysis of the pilot questionnaire for factor structure generation was performed in general anesthesia patients (group 1, n = 320) and resulted in the generation of the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq). Confirmatory factor analysis of the PSPACq in general anesthesia (group 2, n = 565) and regional anesthesia (group 3, n = 225) patients was performed for validation and cross-validation of the PSPACq model, respectively. The confounding variables and the patient loyalty effects on PSPACq scores were analyzed to evaluate the nomological validity of the PSPACq. Result Exploratory factor analysis of the pilot questionnaire in group 1 resulted in the development of the PSPACq (a seven-factor 30-item model). The standardized coefficients and indexes for the assessment of fit of the PSPACq model in group 2 (validation) and group 3 (cross-validation) patients revealed a well-fitting model. The results of the loyalty scores and confounding variables support the nomological validity of the PSPACq. Conclusions A valid and reliable questionnaire (PSPACq) with Taiwanese culture characteristics was developed and is suitable for testing of patient satisfaction with perioperative anesthesia care for patients receiving general or regional anesthesia for their surgery.

scholarly journals Sealing ability of two commonly used root canal sealers with and with out smear layer

2014 ◽  
Vol 2 (4) ◽  
pp. 327
Author(s):  
Nazish Fatima ◽  
Mehwish Hussain
Keyword(s):  
Smear Layer ◽  
Repeated Measure ◽  
Time Interval ◽  
Sealing Ability ◽  
Nail Polish ◽  
Ah Plus ◽  
Time Periods ◽  
Group 2 ◽  
Crown Roots ◽  
Group 1

AIM: The aim of current research was to find out the sealing ability of two commonly used sealers in the presence and absence of smear layer at different time interval. MATERIAL AND METHODS: Total of 180 single rooted vital teeth were used. Transversal section was made with the help of digital slow speed cutting saw to divide the root and crown part. After removal of crown roots part was instrumented and prepared. The 180 teeth were randomly divided into two equal groups (n=90) 1 and 2. In group 1 the smear layer was kept intact but it was removed from group 2 with EDTA (17%). Group 1 was then divided into two sub-groups, A1, A2. Group 2 was again separated into two sub-groups, B1 and B2. Each sub-group contained of 45 samples. In sub-groups A1 and B1, AH Plus sealer, in sub-groups A2 and B2, Ketac-endo sealer and cold lateral condensation technique was used for obturation with gutta percha. All samples were kept in an incubator at 37°C for 24 hours, with help of nail polish/varnish all samples root surfaces was painted only excluding apical area after words each sub group were further divided in to three groups of 15 to represent immersion periods of 7,15 and 30 days. All samples were then kept in 5 % methylene blue dye solution at 37o c for their respective time periods. After specific time period, the roots of every group were cut longitudinally and evaluate under a stereomicroscopes to evaluate apical micro leakage in millimeter. Data was subjected to Repeated measure ANOVA with post-hoc analysis using Tukey and bonferroni tests. RESULTS: Overall analysis indicated significant reduction in sealing ability canals in with and without smear layer over different time periods (p <0.0001). CONCLUSION: Current study has concluded that AH plus sealer provides significantly better seal in the absence of smear layer than in the presence of smear layer in addition it gave better seal than Ketac-Endo sealer in the absence and presence of smear layer.

scholarly journals Perioperative Hemodynamic Changes During Video-Assisted Thoracoscopic Decortication for empyema

2017 ◽  
Vol 11 (1) ◽  
pp. 88-96
Author(s):  
Fang-Ting Chen ◽  
An-Hsun Chou ◽  
Chun-Yu Chen ◽  
Pei-Chi Ting ◽  
Ming-Wen Yang ◽  
...  
Keyword(s):  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
Time Interval ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Video Assisted ◽  
Lateral Decubitus ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and Objective: Hemodynamic consequences during video-assisted thoracoscopic surgery (VATS) with decortication during empyema drainage are unclear. The aim of the study was to assess the perioperative hemodynamic changes decortication during empyema drainage. Methods: A prospective study enrolled 23 patients with empyema who underwent decortication. Hemodynamic parameters were continuously obtained at 15 time points: supine two lung ventilation after induction, lateral decubitus position and two lung ventilation, lateral decubitus position and one-lung ventilation, every 5 min after decortication upto 60 minutes and at the end of surgery. We divided patients into three groups according to microorganisms, group 1: patients with no growth of organism; group 2: patients with staphylococcus aureus and pseudomonas; group 3: patients with streptococcus, yeast and fungus, gram-positive bacilli, and mycobacterium tuberculosis. The hemodynamic variables were recorded by the third-generation Vigileo/FloTracTM system and variables for each time interval were compared with the baseline by Wilcoxon Signed Ranks Test. Results: In group 1, hemodynamic parameters showed no significant changes over time. However, in group 2 and 3, both CO and CI increased 10 to 15 minutes after decortication and remained elevated during the remainder of surgery. However, SVR and SVRI decreased 10 to 15 minutes after decortication in both groups, especially, with a more significant decrease noted in group 2 than group 3. Conclusion: Close perioperative hemodynamic monitoring during decortication in empyema patients is required because of potential hemodynamic disturbances especially patients with toxic microorganisms.

scholarly journals Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

2018 ◽  
pp. 1
Author(s):  
Baris Buke ◽  
Hatice Akkaya ◽  
Cigdem Karakukcu
Keyword(s):  
Cesarean Section ◽  
Inflammatory Reaction ◽  
Operation Time ◽  
Blood Samples ◽  
Inflammatory Reactions ◽  
Tnf Α ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Group 1

<p><strong>Objectives:</strong> There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels.<br />To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.</p><p><strong>Study Desıgn:</strong> The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.</p><p><strong>Results:</strong> There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).</p><p><strong>Conclusions:</strong> The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.</p>

scholarly journals Revisiting conventional adenoidectomy using technology

2020 ◽  
Vol 6 (7) ◽  
pp. 1232
Author(s):  
Kiran Gangadhar S. ◽  
Sonee Thingujam ◽  
Jayita Poduval
Keyword(s):  
Blood Loss ◽  
Paediatric Population ◽  
Lateral View ◽  
Respiratory Pathogens ◽  
Moderate Degree ◽  
Ventilation Tubes ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most frequently applied surgical procedures in the paediatric population, either alone or in conjunction with tonsillectomy and/or insertion of ventilation tubes. The main purpose of the adenoidectomy is to eliminate the nasopharyngeal respiratory pathogens and to remove nasal airway obstruction. Aim of the study was to compare the outcomes of conventional and endoscopic assisted curettage adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> In this comparative study, 50 patients were divided into 2 groups. Group 1 (25 patients) underwent endoscopic curettage adenoidectomy and group 2 (25 patients) underwent conventional curettage adenoidectomy. Intraoperative time, complications and postoperative pain were recorded.  </p><p class="abstract"><strong>Results:</strong> 72% in group 1 and 64% in group 2 had grade 2 adenoid hypertrophy. 68% in group 1 and 64% in group 2 had a moderate degree of obstruction in lateral view of soft tissue X-ray nasopharynx. The mean time taken for surgery in group 1 was 13.29±3.28 minutes, and in group 2,6.28±2.31 minutes. Minimal loss of blood was recorded in group 1 with less than 20 ml, whereas in group 2, the blood loss was high; 30% of patients had blood loss more than 30 ml. In group 1, the mean VAS was 3.25 and 2.55 in group 2 2.55. In group 1, 4% of patients had primary haemorrhage and in group 2, 8% of patients had primary haemorrhage. No patient had velopharyngeal dysfunction in either group.</p><p class="abstract"><strong>Conclusions:</strong> More operative time but less blood loss were noted in endoscopic adenoidectomy. Intraoperative visualisation of the nasopharynx in endoscopic procedures showed no significant advantage over conventional adenoidectomy.</p>

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