scholarly journals COMPARISON OF DURATION OF LABOUR BETWEEN PRIMIGRAVIDAS WITH AND WITHOUT AMNIOTOMY

1969 ◽  
Vol 3 (2) ◽  
pp. 379-382
Author(s):  
NAZIA LIAQAT ◽  
SAADIAYASMEEN ◽  
FARHAT NASIR ◽  
REHANA RAHIM.

BACKGROUND: Amniotomy is a common and routine obstetrical procedure in many labour wards. It ismostly performed with the intention of accelerating the process of labour. The procedure is not risk free andthe results of various studies performed on the subject are diverse. The rationale of this study was to obtainconclusive evidence on the effect of amniotomy on the duration of labour and to establish protocols forlabour wards in the light of thatevidence.OBJECTIVES: To compare the duration of labour between primigravidas with and without amniotomy.METHODOLOGY: The total number of patients was 50 in each group; A and B who were subjected toamniotomy and no amniotomy respectively. Duration of First and Second stage of labour were noted andStudent T- test was applied to find the significance of difference in the duration of First and Second stages oflabour of the two groups. Data was analyzed using SPSS version 17.0.Results:: The mean ages of patients in Group A and B were 22.6+ 2.66 and 23± 2.03 years respectively (pvalue 0.647). The mean duration of gestation of Group A was 38.8+0.50 weeks and of Group B was 39.16 ±0.52 weeks (p value 0.0634). The duration of First Stage was 169+77 min in Group Aand 205+105 minutesin Group B (p value 0.2877). The Second stage duration was 78.6+45 in Group A and 72 ±32 minutes inGroup B (p value 0.6434).CONCLUSION: Amniotomy has no significant effect in shortening the duration of labour inprimigravidas.KEYWORDS: Amniotomy, Primigravidas, Labour

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi

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.


2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.


Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...


2016 ◽  
Vol 5 (2) ◽  
pp. 32-36
Author(s):  
Azam Mahmood ◽  
Saad Saleem ◽  
Muhammad Usman Khan

OBJECTIVE To compare the effects of trigger point (TrP) pressure release with ultrasound therapy to reduce rhomboid pain due to TrP. STUDY DESIGN Experimental study STUDY SETTINGS Outpatient department of Ziauddin Hospital, Clifton campus, Karachi, Pakistan. SAMPLE SIZE 50 patients SAMPLING TECHNIQUE Simple random sampling. The patients were divided into two groups of 25. Group A were given TrP pressure release treatment with exercise and group B were given ultrasound (u/s) treatment with exercise. OUTCOME MEASURES The outcome measures were visual analog scale (VAS) for pain and functional rating index (FRI) for functional performance RESULTS In group A, mean pain score on VAS before the treatment were 5.88±1.130 and after treatment were 1.80±1.041 with a p-value of <0.006. Group B, mean pain score on VAS before treatment were 6.56±1.446, after treatment were 2.72±1.208, with a p-value of <0.006. The mean FRI in group A before treatment was 39.92 ± 2.691 and after treatment was 29.60 ± 5.454, with a p-value of 0.002. The mean FRI in Group B before treatment was 41.12 ± 2.505 and after treatment was 35.92 ± 4.183, with a p-value of 0.002.


2017 ◽  
Vol 5 (1) ◽  
pp. 49 ◽  
Author(s):  
Vigna Sai Potula

Background: This study compares the efficacy of vacuum therapy against conventional iodine povidone dressing with respect to area and time of ulcer.Methods: This study is a randomized controlled trail which was conducted in Meenakshi Medical College hospital and research institute Enathur Kanchipuram. The number of patients selected were 50, which were divided into 2 groups, Group A which consisted of 25 and received vacuum therapy, Group B which consisted of 25 and received povidone-iodine solution.Results: This study was a 16 days study, mean area of ulcer on day 0 was 11.25 cm2 in group B, 10.89 cm2 in group A. On day 6, mean area of ulcer was 10.44 cm2 in group B, 8.98 cm2 in group A. Mean area of ulcer was 10.39 cm2 in group B, 7.66 cm2 in group A on the end of the day 16. The results show that both the groups showed decrease in the area of ulcers, but patients in group A who underwent vacuum therapy have shown greater decrease in the mean area of ulcer. The decrease in surface area of ulcer was statistically significant i.e. p=0.025. There was a greater decrease in infection in group A on 16th day compared to group A on 16th day. On day 0, 48% and 60% growth of microorganisms was observed in patients of group B and group A respectively (p=0.428). On day 16, 28% and 8% growth of microorganisms was observed in patients of group B and group A respectively (p=0.034).Conclusions: Vacuum therapy was more effective compared to conventional method of povidone-iodone solution dressing in rate of healing and time of healing.


2017 ◽  
Vol 24 (09) ◽  
pp. 1331-1335
Author(s):  
Khalid Hussain ◽  
Maria Tarique ◽  
Attiq ur Rehman Khan ◽  
Asim Bukhari ◽  
Bilal Akhter ◽  
...  

Objectives: To compare Tamsulosin versus ESWL for lower ureteric stonesexpulsion. Study Design: Randomized controlled trial. Setting: Outpatient Department ofUrology at Services Hospital, Lahore. Period: January 2015 to December 2015. Material& Methods: Total 50 patients were enrolled in study. Patients were divided into 2 groups.In group A, 25 patients received daily oral treatment of 0.4mg Tamsulosin for 28 days, andin group B, 25 patients were treated with ESWL. A stone-free condition, was defined as thecomplete absence of any stone based on plain abdominal X-rays observed and during followupvisits at the time of treatment of stone was noted. Results: The mean age of the patientswere recorded as 33.20±9.23 years. There were 40(80%) males and 10(20%) females with maleto female ratio of 4:1. Out of 50 patients, 16(32%) presented with hematuria, 3(6%) had feverwhile 31(62%) appeared with no complication status. Out of 50 patients, 21(42%) presentedwith expulsion time 08-14 days in which 14(28%) were from tamsulosin group and 07(14%)were from ESWL group, similarly 19(38%) patients appeared with expulsion time of 15-28 daysin which 10(20%) were from tamsulosin group and 09(18%) were from ESWL group. Statisticallythere is insignificant difference between the groups i.e. p-value=0.28 Ns. Conclusion: Thisstudy suggests that the tamsulosin helps in the earlier clearance of stone fragments andreduces the complications as compared to ESWL.


Author(s):  
ANITA MADAN ◽  
SUJATA SHARMA ◽  
YASHASVINI YEDLA ◽  
JAGDEEP KAUR

Objectives: The objectives of the study were to compare progression of spontaneous versus induced labor in primigravida and multigravida women. Methods: Pregnant women admitted in Labor room of Bebe Nanaki mother and Child Care Centre, Amritsar during April 2019–March 2020 were selected for this study. A total of 200 pregnant women were selected and divided into two groups. Women in group A were induced while in group B were women with spontaneous onset of labor. Labor progression in both was compared. Results: In group A, the mean duration of the active phase in primigravida was 4.08±2.30 h and in multigravida was 4.02±2.20 h. In group B, the mean duration of active phase in primigravidas was 7.24±1.39 h and in multigravidas was 6.48±1.40 h. In group A, the mean duration of the second stage in a primigravida was 25.5±8.15 min and in a multigravida was 17.38±9.95 min. In group B, the mean duration of the second stage in a primigravida was 41.3±9.6 min, while in a multigravida was 22.72±6.2 h. Discussion: The mean duration of active phase in group A in the primigravida and multigravida was almost similar, showing that induction does not have any effect on the duration of active phase. The mean duration of the second stage of group A in primigravida was 25 min and multipara was 17 min showing that induction reduces the duration of the second stage. Conclusion: Induction of labor when done at the right gestational age for correct indication is beneficial to women as it reduces the complications caused due to the continuation of high-risk pregnancies.


Author(s):  
Kurdi Syamsuri

Objective: To assess the effectiveness of vacuum and forceps extraction in prolonged second stage in Dr. Mohammad Hoesin Hospital Palembang. Methods: A retrospective study for 5 years (2005-2009) by doing a prognostic test on prolonged second stage of labor. Results: The subject age most commonly ranges from 20 to 35 years (84.8% in the forceps extraction group and 86% in the vacuum group). The common parity was nulliparity (58.1% in the forceps extraction group and 61.58% in the vacuum extraction). In the forceps extraction group, 76.7% scores >7 in the 1 minute APGAR score with the mean score of 7.14±1.62, whilst in the vacuum extraction group, 79.1% scores >7 in the 1 minute APGAR score, with the mean score of 7.16±1.78. And in the forceps extraction group, 94.2 scores >7 in the 5 minute APGAR score with mean score of 8.62±1.11, whilst in the vacuum extraction group, 93% scores >7 in the 5 minute APGAR score with the mean score of 8.65±1.08. It is concluded that there is no significant differences on both 1 and 5 minute APGAR scores (p value is 0.713 and 0.755, respectively). Maternal complication of extended episiotomy and perineal rupture were found more often in forceps extraction, but with no statistically significant difference (p=0.324). Conclusion: There is no difference of effectiveness between forceps extraction and vacuum extraction in the case of prolonged second stage. Physicians are free whether to use the vacuum or foceps according to their own desirability and skill. [Indones J Obstet Gynecol 2012; 36-1:28-31] Keywords: forceps extraction, prolonged second stage, vacuum extraction


2019 ◽  
Vol 26 (07) ◽  
pp. 1057-1061
Author(s):  
Dr. Hafiz Salman Saeed ◽  
Farhad Alam ◽  
Muhammad Yousaf ◽  
Iqra Fayyaz

The objective of this study was to compare the mean residual pain after cemented versus uncemented hemiarthroplasty of hip. Study Design: Randomized Controlled Trial. Setting: Orthopaedic Department, Allied Hospital, Faisalabad. Period: September 2016 to October 2017. Materials and Methods: Total 150 patients were admitted in orthopedic Department of Allied Hospital Faisalabad according to inclusion & exclusion criteria. After taking informed written consent, all patients were divided into two groups randomly. Cementedhemiarthroplasty was done in Group A patients and uncemented hemiarthroplasty was done in group B patient. All procedures were done by surgeon who has minimum 5yrs post fellowship experience. Monthly Follow up was done and residual pain was noticed at the end of 6th month. All the data was analyzed by using SPSS version 20.0. Results: In this study, in Group-A the patients between 65-75 years of age were 57.33% (n=43) and between 76-85 of age were 42.67% (n=32). In Group B the patients between 65-75 years of age were 56%(n=42) and between 76-85 years were 44% (n=33). The mean+sd was calculated and it is 73.49+4.99 years in Group-A patients and 73.73+4.74 years in Group-B patients. In Group A, males were 61.33% (n=46) and female were 38.67% (n=29). In Group B, males were 57.33% (n=43) and female were 42.67% (n=32). When we compared the residual pain after cemented versus uncemented hemiarthroplasty of the hip, it shows 1.69+0.35 in Group-A patients and 2.62+0.30 in Group-B patients. When we calculated p-value it was 0.0001 showing a significantdifference. Conclusion: It is concluded that residual pain in cemented hemiarthroplasty is lower than uncemented hemiarthroplasty. 


Author(s):  
Shreshth Khanna ◽  
Suman Bala ◽  
Yashpal Singh ◽  
Taruna Sharma ◽  
Juhi Kalra ◽  
...  

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.


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