scholarly journals Efficacy of Preoperative Misoprostal in Reducing Hemorrhage during Abdominal Myomectomy

2021 ◽  
Vol 15 (6) ◽  
pp. 1934-1936
Author(s):  
Irum Batool Hashmi ◽  
Asim Shafi ◽  
Ayesha Choudhary ◽  
Wasim Ahmad ◽  
Muhammad Hamayun Khan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Body Mass ◽  
Intraoperative Blood Loss ◽  
Abdominal Myomectomy ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
Double Blinded

Objective: The aim of this study is to determine the efficacy of preoperative misoprostal in reducing hemorrhage during abdominal myomectomy. Study Design: Prospective comparative randomized double blinded Place and Duration: Conducted at DHQ Zanana hospital Dera Ismail Khan for one year duration from January 2019 to December 2019. Methods: Total 100 patients underwent abdominal myomectomy were presented in this study. Patients were aged between 18-45 years of age. Patients’ detailed demographics including age, body mass index and parity were recorded after taking informed written consent. Patients were categorized equally into two groups, I and II. Group I had 50 patients and received single dose 400 micrograms of misoprostol transrectally one hour preoperatively and group II had 50 patients and received 2-tablets of placebo preoperatively. Outcomes intraoperative blood loss, blood transfusion, hysterectomy and complications among both groups were assessed. Complete data was analyzed by SPSS 23.0 version. Results: Mean age of the patients was 32.16±9.44 with mean BMI 26.07±10.44 kg/m2. There were no significantly difference among age and body mass among both groups. 60 Patients had 0 parity, 30 patients had parity 1 and the rest were had parity 2. Mean pre-operative hemoglobin in group I was 13.64±8.55 and post-operative was 9.88±8.55 and in group II mean pre-operative hemoglobin was 13.55±8.55 and post-operative was 9.12±5.55. Mean intraoperative blood loss in group I was 388.17±37.18 ml and in group II was 501.16±17.64 ml. Post-operatively blood transfusion in group I was among 2(4%) cases and 3 (6%) in group II. Mean hospital stay in group II was greater as compared to group I. Nausea, vomiting and shivering were the complications found in this study. Conclusion: We concluded in this study that the use ofmisoprostol preoperatively during abdominal myomectomy was effective safe and useful in reduction of intraoperative blood loss and post-operatively blood transfusion among patients. Keywords: Abdominal myomectomy, Misoprostol, Placebo, Intraoperative, Blood loss

scholarly journals A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

2017 ◽  
Vol 6 (10) ◽  
pp. 4230
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Operative Time ◽  
Pressure Effects ◽  
Control Group ◽  
Group Iii ◽  
Abdominal Myomectomy ◽  
Octreotide Acetate ◽  
Group I ◽  
Group Ii

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

scholarly journals Pulmonary Function Test of Forced Vital Capacity and Slow Vital Capacity Using Spirometry in Young Adults With Respect to Body Mass Index: A Normative Study

2020 ◽  
Vol 5 (8) ◽  
pp. 1094-1111
Author(s):  
Jyothy Anthraper ◽  
Dr. Reeny Roy
Keyword(s):  
Body Mass Index ◽  
Pulmonary Function ◽  
Body Mass ◽  
Lung Volume ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Management Tool ◽  
I 18 ◽  
Group I ◽  
Group Ii

Objectives: To determine the effect of Age, Gender and its correlation on pulmonary functions of Forced Vital Capacity and Slow Vital Capacity in Group I (18-24 years) and Group II (25-30 years) with respect to Body Mass Index.  Methodology: Sixty healthy adults between 18-30 years were included in the study. Participants were subdivided into Group I (18 to 24 years) and Group II (25 to 30 years) each group having 15 males and 15 females. The parameters considered were expiratory reserve volume, tidal volume, inspiratory capacity, forced vital capacity and slow vital capacity. Spirometer RMS HELIOS 401 was used. Procedures were explained to each participant; best values from 3 maneuvers were documented and were subjected to analysis.  Results: It is noticed a significant difference in various parameters of pulmonary function. As age increases there was an increase in body mass index and the lung volume also increased. Overall males had higher pulmonary function compared to females, males in Group II (25-30 years) was better compared to males in Group I (18-24 years). With an increase in body mass index, pulmonary function was increased in males compared to females. Age, gender, age, and gender interaction effect with respect to Body Mass Index was seen.  Conclusion: Values obtained can be used as reference standard for estimation of lung volume for age group 18-30 years. In future, Spirometry can be used as a clinical assessment and management tool in the field of speech language pathology, by modifying respiratory patterns to control lung volumes, phonations and the flow of speech.

scholarly journals The functional state of the system of immunological protection in traumatic disease in patients with an increased body mass index

2019 ◽  
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Body Mass ◽  
Functional State ◽  
Adaptation Mechanism ◽  
Group Iii ◽  
Functional Relationships ◽  
Group I ◽  
Group Ii ◽  
Immunological Protection

Introduction. An important reserve that provides adaptation processes in the immunoregulation system is the possibility of its various subsystems to redistribute structural and functional relationships between them. The approach from the perspective of systemic multivariate analysis will allow us to determine the main functional relationships that arise or are violated at different periods of traumatic disease in patients with an increased body mass index (IBMI) during polytrauma in the immune response as a whole. Aim. The aim of this study was to analyze the functional state of the immunological protection system for traumatic disease in patients with IBMI. Materials and methods The integral indicators of immunogenesis were determined using a systematic multivariate analysis on the basis of a dynamic study of 1344 complex immunograms in 224 patients with IBMI with polytrauma and a different initial value of BMI. Patients were divided into 3 groups: group I - 88 patients with BMI of up to 29.9 (26.1 ± 3.1); group II - 84 patients with BMI of up to 30.0 - 39.9 (35.2 ± 3.8 ), group III - 52 patients with BMI > 40.0 (46.2 ± 5.8). The study was conducted on the 1st, 3rd, 7th, 14th, 30th and 360th days from the moment of receiving a polytrauma. Results. In the functional state of the immune system as a whole, certain regularities were identified in patients with IBMI with polytrauma: impairment of immunoreactive processes was prolonged for 1 year or more from the time of polytrauma, regardless of BMI, their nature is regular and unidirectional, have periods of decline and increase in activity; the degree of damage, the ability of compensatory possibilities and the ability to restore them depending on BMI, since the initial deviations of the integral indicator are almost identical in all groups of patients; the immune mechanisms at all times are most determined by the state of the cell link and complement system for patients of I and III groups. Moreover, the development mechanism of secondary post-traumatic immunodeficiency, which is associated with the inclusion of extended T-suppression and a decrease in IgA concentration for more than 14 days, depends on BMI; a clear cooperation of cellular and humoral relationships, which is aimed at compensating for its consequences, was determined in patients of group II as well as active participation in the immune reactions of HLA-DR + lymphocytes as a delicate adaptation mechanism. The development of functional instability of the system occurred mainly due to the T-cell link a year after the case of polytrauma. Conclusion. Our analysis made it possible to prove objectively on mathematical models that traumatic disease is a long process. Clinical and pathogenetic aspects of immune disorders are beyond question and provide the basis for the application of the proposed treatment algorithms and changes in stereotypes regarding the treatment approach as a whole.

scholarly journals Acute hypervolemic hemodilution combined with controlled hypotension to minimize blood loss during operations of spine fusion: remifentanil versus magnesium sulfate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Khaled Mohammed Elnaghy ◽  
Ibrahimabd-Elsalam Nasr ◽  
Eman Mohamed Kamal
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Magnesium Sulfate ◽  
Spine Fusion ◽  
Controlled Hypotension ◽  
Group Iii ◽  
Group I ◽  
Estimated Blood Loss ◽  
Hypervolemic Hemodilution ◽  
Group Ii

Abstract Background Blood loss is one of the major problems during operations of spine fusion. Several blood-conservative measures were applied to reduce the incidence of blood loss—among them, acute hypervolemic hemodilution (AHH) and controlled hypotension (CH). This study was designed to detect the effect of combination of AHH with CH induced by remifentanil versus magnesium sulfate on the volume of blood loss, allogeneic blood transfusion, hemodynamics, coagulation, and electrolytes during operations for spine fusion which are risky operations with high incidence of blood loss and blood transfusion. Sixty patients scheduled for posterior fusion of the spine were randomly allocated into three groups of 20 patients each (group I (AHH), group II (AHH combined with remifentanil-based CH), and group III (AHH combined with magnesium sulfate-based CH)). Estimated blood loss and total volume of packed red blood cells (PRBCS) transfused were recorded. Arterial blood pressure (ABP) and heart rate (HR) measures were recorded. Blood samples were obtained for the detection of hemoglobin (Hb) and hematocrit (HCT). Results Estimated blood loss, percentage blood loss, and intraoperative RBC transfusion units were significantly high in group I in relation to group II and group III (Table 2). Cardiac output was significantly higher in group I in relation to group II and group III at 10, 15, 30, 45, and 60 min after start of AHH. MBP and HR results were significantly high in group I in comparison with group II and group III at 30, 45, 60, and 90 min and 2 and 3 h after start of study drugs. CVP results were significantly high in group I in relation to group II and group III at 15, 30, 45, 60, and 90 min after start of AHH. PTT was significantly increased in the three study groups in comparison with baseline inside each group after AHH. Conclusion Combination of AHH with CH induced by remifentanil or magnesium sulfate was associated with reduction in estimated blood loss, and total volume of PRBCS transfused. There was no significant difference between hemodynamic parameters with the use of remifentanil or magnesium sulfate except that SBP, DBP, and MBP results were significantly high with magnesium sulfate at 15 min after drug infusion. There was significant increase in PT and PTT after AHH that was not reflected by significant blood oozing from the operative field, or by difficulty in hemostasis.

scholarly journals Study on the relationship between menopausal age, body mass index and total number of teeth

2021 ◽  
Vol 67 (1) ◽  
pp. 29-34
Author(s):  
Ioana Madalina Lescai ◽  
◽  
Laurenta Lelia Mihai ◽  
Monica Mihaela Cirstoiu ◽  
◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
The Body ◽  
Entire Group ◽  
Number Of Teeth ◽  
Group I ◽  
Average Body Mass ◽  
Group Ii ◽  
The Relationship ◽  
Average Body

Objectives. The objective of this study is to assess the state of oral health, from the perspective of the number of teeth present, according to the body mass index as a representative element of health. Materials and methods. This study consists of 180 patients from a private dental practice. All 180 patient records were reviewed for an assessment of the number of teeth present and the body mass index at menopausal age. The cohort of patients was divided into two groups, a group of women aged 40 to 54.9 years and the second group, which included women aged 55 and over. The 2 groups were divided based on premenopausal (group I) and postmenopausal (group II) age. Results. The average number of present teeth (based on radiographs) for the entire population of 180 patients is 22.02 teeth. In group I, for the 109 women in the premenopausal group, the average number of teeth is 23.94. The total number of teeth for the 71 women in the postmenopausal group is 19.07. The average BMI for the entire group of patients is 27.24 kg/m2, with a lower value in group I, 26.25 kg/m2, compared to group II, 28.78 kg/m2. Discussions. The average number of teeth in the premenopausal group is higher than in the postmenopausal group. The average body mass index places the whole series of patients in the overweight category. Conclusions. This study shows that the relationship between BMI and the number of lost teeth is positive and proportional, BMI increases with increasing number of teeth lost at premenopausal age.

Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Interventions

2017 ◽  
Vol 10 (1) ◽  
pp. 31-39
Author(s):  
Mohammad Khalilur Rahman Siddiqui ◽  
STM Abu Azam ◽  
Pradip Kumar Karmakar ◽  
Shaila Nabi ◽  
Pranob Karmaker ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Obese People ◽  
Hospital Outcomes ◽  
Hospital Outcome ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Background: Obesity, measured on the basis of body mass index (BMI), is an independent cardiovascular risk factor. However, some studies have reported the “obesity paradox” after percutaneous coronary intervention (PCI). The relationship between BMI and clinical outcomes after PCI has not been thoroughly investigated, especially in Bangladesh.Method: This cross sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e” 23.0 kg/m2). In-hospital outcomes were observed and recorded after PCI.Results: The mean BMI of study population was 23.9 ± 1.9 kg/m2. The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean duration of hospital stay after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in-hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 – 2.24 and 1.16 – 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with adverse in-hospital outcome after PCI (OR = 0.95; 95% CI = 0.91 – 0.98; p = 0.007).Conclusion: BMI is inversely associated with adverse in-hospital outcomes after PCI. The underweight and normal weight people are at greater risk to experience in-hospital adverse outcomes than overweight and obese people following PCI.Cardiovasc. j. 2017; 10(1): 31-39

True insulin and intact proinsulin levels in acromegalic patients

1996 ◽  
Vol 134 (5) ◽  
pp. 549-553 ◽  
Author(s):  
Edelweiss F Tavares ◽  
Ivaldir S Dalbosco ◽  
Julio Abucham ◽  
Ewaldo MK Russo
Keyword(s):  
Body Mass Index ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Body Mass ◽  
Control Group ◽  
Immunoreactive Insulin ◽  
Oral Glucose ◽  
Group I ◽  
Active Acromegaly ◽  
Group Ii

Tavares EF, Dalbosco IS, Abucham J, Russo EMK. True insulin and intact proinsulin levels in acromegalic patients. Eur J Endocrinol 1996;134:549–53. ISSN 0804–4643 To determine whether proinsulin (PI) contributes significantly to the immunoreactive insulin (IRI) concentrations in acromegalics, we measure PI, "true insulin" and IRI in a group of acromegalics compared with a control group. Serum PI was determined by the immunofluroimetric assay (IFMA). Insulin was also determined by an IFMA that measures true insulin and by a radioimmunoassay (RIA). We performed an oral glucose tolerance test (OGTT) in a total group of 46 subjects: 10 controls with normal OGTT and body mass index <25 kg/m2 (control group I), 10 controls with normal OGTT and body mass index > 25 kg/m2 (control group II), 15 patients with active acromegaly and normal OGTT and 11 patients with active acromegaly and IGT. Plasma glucose, serum GH, insulin and proinsulin were measured in all OGTT samples. Basal levels of insulin-like growth factor I (IGF-I) were measured in acromegalics. Mean body mass index in acromegalics with normal and impaired glucose tolerance were significantly higher compared with control group I and similar when compared with control group II. Proinsulin increased during OGTT in acromegalics with impaired glucose tolerance compared to control group I, and only fasting proinsulin compared to control group II. In normal OGTT acromegalics, only fasting proinsulin was increased. The RIA insulin during OGTT was significantly higher for both acromegalic groups compared to control group I and only at fasting when compared with control group II. This difference was not evident when insulin was measured by IFMA. These results suggest that in acromegalics, hyperinsulinism measured by RIA was at least in part due to hyperproinsulinism. Ewaldo MK Russo, PO Box 20266, CEP 04034-970, Sáo Paulo, SP, Brazil

Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 941-948 ◽  
Author(s):  
Jiaping Li ◽  
Shenming Wang ◽  
Chishing Zee ◽  
Jianyong Yang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Carotid Body ◽  
Operation Time ◽  
Class Ii ◽  
Preoperative Embolization ◽  
Intraoperative Blood Loss ◽  
Class Iii ◽  
Group I ◽  
Group Ii

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

scholarly journals Endoscopic interlaminar lumbar discectomy: How to decrease the learning curve

2020 ◽  
Vol 11 ◽  
pp. 401
Author(s):  
Sherif Elsayed Elkheshin ◽  
Ahmed Y. Soliman
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Operative Time ◽  
Lumbar Disc ◽  
Standard Technique ◽  
Intraoperative Blood Loss ◽  
Modified Technique ◽  
Group I ◽  
Herniated Lumbar Disc ◽  
Group Ii

Background: Herniated lumbar disc is a common cause of lumbosacral pain. Endoscopic interlaminar lumbar discectomy (ILD) is a well-established technique that provided comparable results to micro-discectomy. The aim of the study is to describe the learning curve of endoscopic ILD and explore measures that could improve effectiveness and decrease blood loss and operative time with accumulation of reasonable experience. Methods: This retrospective cohort study included 65 patients presenting with symptomatic herniated lumbar disc who underwent endoscopic ILD. Patients were divided into two groups: Group I (standard technique) and Group II (modified technique). Collected data included patients’ age, gender, preoperative manifestations, visual analog score (VAS) for pain, Oswestry Disability Index (ODI), disc level, operative time, intraoperative blood loss, complications, and follow-up data at 1, 6, and 12 months postoperatively. Primary outcomes included total operative time, amount of intraoperative blood loss, and post-operative improvement in pain. Secondary outcomes included intraoperative complications, rate of conversion to open surgery, and recurrence. Results: Post-operative VAS and ODI improved significantly in both groups. Mean total surgical time and intraoperative blood loss were significantly lower in Group II compared to Group I (P < 0.001). The learning curves for operative time and intraoperative blood loss were shallow in Group I, and almost flattened in Group II. Complications were recorded in only three cases, and no symptomatic recurrences were reported. Conclusion: The learning curve of endoscopic ILD was shallow with standard technique, indicating difficulties in mastering the procedure. The proposed modified technique helped reaching the required level of proficiency in the early phase of the curve, providing a significant reduction in operative time and blood loss, with comparable effectiveness and safety as the standard technique.

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