scholarly journals COMPARISON OF DELAYED CORD CLAMPING AND CORD MILKING EFFECTS ON NEONATAL APGAR SCORE AND HAEMATOCRIT

2021 ◽  
Vol 71 (5) ◽  
pp. 1811-15
Author(s):  
Ghulam Sabir ◽  
Ayesha Raja ◽  
Saira Mahboob ◽  
Saima Shoukat ◽  
Ali Kashif ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Apgar Score ◽  
Ventilatory Support ◽  
Study Groups ◽  
Military Hospital ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Quasi Experimental ◽  
Group B

Objective: To assess the feasibility of umbilical cord milking as an alternative to delayed cord clamping during caserean section by comparing neonatal outcomes. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital, Okara, from Mar to Oct 2018. Methodology: A total of 384 cases (n=192 in each group) were included in our study. In group A, the half-length of umbilical cord was milked thrice by the operating surgeon before clamping and cutting it. In group B the umbilical cord was cut 90 second after delivery of the baby. The outcomes were: APGAR score at one and five minutes after delivery, haemglobin and haematocrit 4 hours after delivery of baby. Requirement of oxygen and ventilatory support during the 24 hours after birth were also noted. Results: Our two study groups didn’t vary in their demographic profile. The difference between the APGAR score at one and five minutes was not statistically significant, (p>0.05). The diffrence in haemoglobin and haematocrit levels of the neonates 4 hours after delivery were insignificant (p-value 0.27 and 0.14 respectively). Conclusion: Milking of the umbilical cord can be used as an alternative to the recommended technique of delayed umbilical cord clamping, especially when immediate resuscitation of the newborn is needed.

scholarly journals COMPARISON OF THE EFFICACY OF ANTIBIOTIC-STEROID AND ICHTHAMMOL GLYCERINE WICK IN TREATMENT OF ACUTE OTITIS EXTERNA

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  
Keyword(s):  
Experimental Study ◽  
Otitis Externa ◽  
The Other ◽  
Military Hospital ◽  
P Value ◽  
Similar Response ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.

scholarly journals Comparison of 4% Topical Hydroquinone versus Combination of Oral Tranexamic Acid and 4% Topical Hydroquinone in the Treatment of Epidermal Melasma

2021 ◽  
Vol 15 (10) ◽  
pp. 3406-3409
Author(s):  
Sarah Riaz ◽  
Najia Ahmed ◽  
Ayesha Anwar ◽  
Moizza Tahir ◽  
Farrah Yousaf ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Topical Therapy ◽  
Military Hospital ◽  
Ethical Review ◽  
P Value ◽  
Treatment Groups ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: comparison of efficacy of topical 4% hydroquinone monotherapy with combination of oral tranexamic acid and topical 4% hydroquinone in the treatment of epidermal melasma Study design: Quasi experimental study Study period and place: Dermatology OPD, Pak Emirates Military Hospital Rawalpindi from July 2018 to January 2019. Methodology: Total 80 patients presenting with epidermal melasma were selected from outdoor patient department after applying the inclusion criteria and consent was taken from selected patients. Study was started after getting permission from hospital ethical review board. Two treatment groups were made after dividing patients by using alternate method. Treatment with topical 4% hydroquinone alone was started for group A patients and combination of capsule tranexamic acid (250 mg two times a day) along with topical 4% hydroquinone were started for group B patients for the next 6 months. Evaluation of patients through detailed history, clinical and wood’s light examination before starting therapy and after of 24 weeks of treatment was done for both groups. Efficacy of treatment was assessed via Modified MASI score. Results: Hydroquinone monotherapy was effective in 21 (52.5%) patients among group A while in group B patients, combination treatment i.e. oral tranexamic acid and topical hydroquinone, was effective in 31 (77.5%) patients (p value= 0.01). Conclusion: Effectiveness of Hydroquinone 4% topical therapy combined with oral tranexamic acid for epidermal melasma is better than topical 4% hydroquinone alone. Key words: Epidermal melasma, oral tranexamic acid, topical 4% hydroquinone.

scholarly journals Effect of umbilical cord milking versus delayed cord clamping on preterm neonates in Kenya: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246109
Author(s):  
Mandeep Sura ◽  
Alfred Osoti ◽  
Onesmus Gachuno ◽  
Rachel Musoke ◽  
Frank Kagema ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Neonatal Jaundice ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
The Mean ◽  
Neonatal Polycythaemia ◽  
Umbilical Cord Milking

Background Delayed cord clamping (DCC) is a placental to new-born transfusion strategy recommended by obstetric and gynaecological societies. Though not widely adopted, umbilical cord milking (UCM) may achieve faster transfusion when DCC cannot be performed such as when a neonate requires resuscitation. Methods Pragmatic, two-arm, randomized clinical trial in which consenting women in spontaneous labour or provider-initiated delivery at 28 to less than 37 weeks at Kenyatta National Hospital in Nairobi, Kenya, were enrolled. At delivery, stable preterm infants were randomized to UCM (4 times) or DCC (60 seconds). Neonatal samples were collected for analysis at 24 hours after delivery. Maternal primary PPH (within 24 hours) and neonatal jaundice (within 1 week) were evaluated clinically. The primary outcome was the mean neonatal haemoglobin level at 24 hours after birth. Modified Intention to treat analysis was used for all outcomes. P-value was significant at p<0.05. Results Between March 2018 to March 2019, 344 pregnant women underwent screening, and 280 eligible participants were randomized when delivery was imminent. The intervention was not performed on 19 ineligible neonates. Of the remaining 260 neonates, 133 underwent UCM while 128 underwent DCC. Maternal and neonatal baseline characteristics were similar. The mean neonatal haemoglobin (17.1 vs 17.5 grams per decilitre, p = 0.191), haematocrit (49.6% vs 50.3%, p = 0.362), anaemia (9.8% vs 11.7%, p = 0.627), maternal PPH (2.3% vs 3.1%, p = 0.719) were similar between UCM and DCC respectfully. However, neonatal polycythaemia (2.3% vs 8.6%, p = 0.024) and neonatal jaundice (6.8% vs 15.6%, p = 0.024) were statistically significantly lower in UCM compared to DCC. Conclusion UCM compared to DCC for preterm neonates resulted in similar outcomes for neonatal haemoglobin, haematocrit, anaemia and maternal primary PPH and a lower proportion of neonatal polycythaemia and clinical jaundice. UCM offers a comparable method of placental transfusion compared to DCC and may be considered as an alternative to DCC in preterm neonates at 28 to <37 weeks’ gestation.

scholarly journals Early Versus Delayed Umbilical Cord Clamping on Physiologic Anemia of the Term Newborn Infant

2018 ◽  
Vol 6 (8) ◽  
pp. 1399-1404 ◽  
Author(s):  
Fatma Alzaree ◽  
Ahmed Elbohoty ◽  
Mohamed Abdellatif
Keyword(s):  
Umbilical Cord ◽  
Positive Pressure ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Chi Square ◽  
Positive Correlation ◽  
Cord Clamping ◽  
Group 2 ◽  
Labour Suite ◽  
Group 1

AIM: Our study aims to make a comparison between the effects of milking of umbilical cord versus delayed cord clamping on Hemoglobin level at 6 weeks from delivery among term neonates and which method is more beneficial for them.DESIGN: It was a randomised control study. Participants were randomised into 2 groups; Group 1: 125 women were assigned to delay cord clamping; Group 2: 125 women were assigned to milking of the umbilical cord 5 times before cutting. Student t-test was used to compare between the two groups for quantitative data, for qualitative data chi-square test and the Correlation coefficient was done to test the association between variables.SETTING: This study was at El-Galaa Teaching Hospital, labour suite. Cairo, Egypt.PARTICIPANTS: A group of 250 pregnant women starting from ≥ 37 weeks’ gestational age.INTERVENTION: In this study, we searched if the mechanism of milking or delayed cord clamping could give some of the positive benefits for neonates or not.RESULTS: In this study, we found that milking of the umbilical cord five times as in group 1 was associated with higher hemoglobin levels at 6 weeks after birth, at physiological anemia of the fetus and significant but clinically there was no difference between the two groups (10.4 ± 0.5 and 10.6 ± 0.5 respectively, P < 0.001). Also, there was a positive correlation between haemoglobin of the mother and the newborn during the first day and after 6 weeks with r = 0.349 and 0.283 respectively and a P value < 0.001. Furthermore, there was a positive correlation between the haemoglobin of the fetus after the first day and fetus at 6 weeks with r = 0.534 and a P value < 0.001. For most other outcomes (including APGAR score, positive pressure ventilation, poor neonatal outcomes such as respiratory distress syndrome there were no significant differences between the two groups. Our study may recommend the use of umbilical cord milking in term babies when delayed cord clamping is unavailable.CONCLUSION: Umbilical cord blood milking after its clamping improves some important haematological parameters for newborns, especially in countries with high incidence of anaemia in newborns and children.

Obstetrical and neonatal factors associated with optimal public banking of umbilical cord blood in the context of delayed cord clamping

2019 ◽  
Vol 42 (3) ◽  
pp. E56-E63 ◽  
Author(s):  
Anna Munro ◽  
Daniel J. Corsi ◽  
Lisa Martin ◽  
Michael Halpenny ◽  
Nicholas Dibdin ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Delayed Cord Clamping ◽  
Factors Associated ◽  
Cell Counts ◽  
Cord Clamping ◽  
Newborn Weight ◽  
Cord Blood Banks

Purpose: To assess the association of specific newborn and maternal factors with indicators of increased blood-forming capacity in umbilical cord blood to inform strategic collection strategies that could augment the quality of units in public cord blood banks. Methods: Data regarding 268 consecutive cord blood units (CBUs) banked by Canadian Blood Services were analyzed. Multivariate analysis was performed to identify factors associated with markers of hematopoietic potency and likelihood of utilization. Results: Delayed clamping of the cord beyond 60 s was associated with reduced volume collected. Any delay in clamping of the cord was associated with reduced total nucleated cell counts. Newborn weight >4,000 g was also associated with greater blood volume in the collection but not with other measures of hematopoietic potency. Cord blood acidosis at birth (pH

scholarly journals Comparison of efficacy & safety of Blue Light vs topical application of 1% Clindamycin solution in the treatment of mild to moderate inflammatory Acne Vulgaris

2021 ◽  
Vol 15 (7) ◽  
pp. 1475-1480
Author(s):  
Saira Mohsin ◽  
Muhammad Nadeem ◽  
Shahbaz Aman ◽  
Zaib . ◽  
Shehbaz Ali
Keyword(s):  
Side Effects ◽  
Blue Light ◽  
Topical Application ◽  
Acne Vulgaris ◽  
Severity Index ◽  
Study Groups ◽  
P Value ◽  
Group B ◽  
Light Group ◽  
Efficacy Of Treatment

Aim: To compare the efficacy & safety of blue light vs topical application of 1% clindamycin solution in the treatment of mild to moderate inflammatory acne vulgaris. Study Design: Comparative interventional study done in Dermatology Outpatient Department Unit-II, KEMU/ Mayo Hospital, Lahore six months i.e. 1-06-2014 – 30-11-2014 Methodology: After an informed and written consent, 130 patients fulfilling the selection criteria were enrolled in the study and divided in two study groups A & B by balloting method. At first visit, a detailed history and clinical examination was recorded on a specially designed proforma. The acne was graded according to the acne grading scale of American Academy of Dermatology.4,13 Group A was exposed to blue light for twenty minutes twice weekly for eight weeks. Group B was given 1% clindamycin to apply twice daily for a period of eight weeks. Post- treatment follow up was done for next four weeks. Patients were assessed at 2nd, 4th, 6th, 8th, 10th, and 12th week. All findings and side effects were recorded on a predesigned proforma. To determine the efficacy of treatment, Acne Severity Index (ASI) was used.5 Result: Efficacy of treatment [≥ 50% improvement in ASI score] was seen in 39(60%) patients in blue light group while in clindamycin group it was achieved in 8 (12.3%) patients only. Blue light group had significantly less number of side effects observed in 35 (37.23%) patients while clindamycin group had a higher number of side effects observed in 59 (62.77%) patients, p-value= 0.013. Conclusion: Blue light is more efficacious and safer than topical 1% clindamycin in the treatment of mild to moderate inflammatory acne vulgaris. Keywords: Blue light, 1% Clindamycin, Acne vulgaris

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

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