Pharmacotherapy in Anaemia of Pregnancy: Comparison of Oral Ferrous Sulphate, Intravenous Iron Sucrose

Aim: To analyse the outcome of oral and intravenous therapy of iron preparations in treating anaemia in pregnant women. Study Design: Prospective Study. Place and duration of study: Department of Pharmacology and department of Gynaecology and obstetrics, Khawaja Muhammad Safdar Medical College, Sialkot from May 2020 to July 2021. Methods: Between May 2020 and July 2021; A total of 1200 patients presenting to obstetric department with anaemia were included in the study after fulfilling inclusion criteria. Pregnant patients with haemoglobin level 7-8gm/dl at 24th week of gestation were included in the study. The therapy was started on 24th week of gestation. The haemoglobin levels were determined at 24th week and then at 37th week of gestation. The increase in the haemoglobin level was then determined. Serum ferritin levels were done at 37th week of gestation. Results: It was observed that there was an increase in the haemoglobin level after all the treatment regimes. The increase in haemoglobin in the group B and C was statistically significant with P value of < 0.001 when compared with the group A. However, no statistical significant difference was observed between group B and group C. Conclusion: The haemoglobin and serum ferritin level were significantly increased in the subjects after oral ferrous sulphate, however parenteral formulation are more effective in noncompliant patient where quick improvement in haemoglobin levels are to be achieved. Keywords: Anaemia, pregnancy, iron deficiency, pharmacotherapy

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Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

10.53350/pjmhs211551134 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1134-1135

Author(s):

M. A. Chhutto ◽

A. H. Mugheri ◽

A. H. Phulpoto ◽

I. A. Ansari ◽

A. Shaikh ◽

...

Keyword(s):

Liver Disease ◽

Chronic Liver Disease ◽

Adverse Outcomes ◽

Chronic Liver ◽

P Value ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

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Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

10.53350/pjmhs211551024 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1024-1027

Author(s):

Asma Samreen ◽

Aamir Waseem ◽

Muhammad Azam ◽

Itrat Hussain Kazmi ◽

Aamir Bashir ◽

...

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Recovery Time ◽

Controlled Trial ◽

P Value ◽

Time Data ◽

Endoscopic Retrograde ◽

Intravenous Anesthetic ◽

Significant Difference ◽

Group A ◽

Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

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Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

Polish Journal of Surgery ◽

10.1515/pjs-2015-0075 ◽

2015 ◽

Vol 87 (8) ◽

Cited By ~ 2

Author(s):

Santosh Kumar ◽

Rajesh Roat ◽

Swati Agrawal ◽

Kumar Jayant ◽

Ravimohan S. Mavuduru ◽

...

Keyword(s):

Erectile Dysfunction ◽

Combination Therapy ◽

Erectile Function ◽

T Test ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

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A Comparative Study on Efficacy of Polymyxin B, Neomycin and Polymyxin B, Neomycin, Hydrocortisone in the Treatment of Otitis Externa at Nepal Medical College and Teaching Hospital, Kathmandu

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i2.18516 ◽

2017 ◽

Vol 2 (2) ◽

pp. 162-167

Author(s):

Mayuri Gupta ◽

S Aryal

Keyword(s):

Teaching Hospital ◽

Otitis Externa ◽

Clinical Signs ◽

Polymyxin B ◽

Medical College ◽

Significant Difference ◽

Group A ◽

Group B ◽

Cure Rates

IntroductionAcute otitis externa (AOE) is a common but preventable ear condition. Tenderness with movement of the tragus or pinna is a classic feature of otitis Externa. Polymyxin B, neomycin, hydrocortisone preparations are the choice for first-line therapy when the tympanic membrane is intact. This study atiempted to compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.ObjectiveTo compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.MethodologyTo evaluate the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa, a hospital based, randomized, prospective study was conducted in Nepal Medical College and Teaching Hospital (NMCTH), Atiarkhel, Kathmandu from August 2012 to May 2014. 70 outpatients suffering from otitis Externa who met the inclusion and exclusion criteria were included. Patients were randomized into group A and group B with lotiery system. Odd number patients were included in group A and even number patients in group B. Group A patients received pack soaked with ribbon gauge in polymyxin B, neomycin ointment and Group B patients received pack soaked with ribbon gauge in polymyxin B, neomycin, hydrocortisone ointment. The patients were called for follow up after 48 hours and 96 hours to assess the improvement on the basis of tragal and circumduction tenderness either present or absent (present 1 or absent 2). A decrease in the clinical signs and symptoms (i.e. tragal and circumduc_on tenderness) was noted. Absence of pain was considered as clinically cured.ResultsIn comparison to polymyxin B, neomycin group, hydrocortisone group exhibited statistically significant effectiveness after 48 hours of treatment (p<0.05), but in cure rates after 96 hours, no statistical significant difference was observed between two groups (p>0.05).ConclusionPolymyxin B, neomycin, hydrocortisone group showed higher and faster cure rates than polymyxin B, neomycin group in the treatment of otitis Externa at 48 hours follow up. Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 162-167

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Comparative Study of Efficiency between Povidone Iodine and Normal Saline Lavage in the Treatment of Acute Peritonitis

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v4i1.37675 ◽

2018 ◽

Vol 4 (1) ◽

pp. 15-20

Author(s):

Haridas Saha ◽

Mohammad Ibrahim Khalil ◽

Aminul Islam ◽

Abdullah Al Mamun ◽

Md Margub Hossain

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Normal Saline ◽

Povidone Iodine ◽

Medical College ◽

Acute Peritonitis ◽

Significant Difference ◽

Group A ◽

Group B ◽

Saline Lavage

Background: Control of the primary site of sepsis is the main determinant of good surgical outcome. Objective: The purpose of the present study was to compare the efficiency between povidone iodine and normal saline lavage in the treatment of acute peritonitis. Methodology: This was a randomized clinical trial conducted in the Department of Surgery at Dhaka Medical College & Hospital, Dhaka, Bangladesh. Patients with acute peritonitis due to gastrointestinal causes who were admitted in the different units of Dhaka Medical College Hospital during the study period were selected as study population. Among them patients who were treated with povidone iodine were enrolled in the present study in group A and patients who were treated with conventional normal saline were in group B. Results: A total number of 1050 patients were recruited for this study. Among them 100 patients were enrolled in the present study of which group A (50 patients) for povidone iodine and group B (50 patients) for conventional normal saline. On 7th POD wound infection was found in Group A and Group B were 11(22.4%) and 21(44.7%) respectively. Statistically significant difference in post operative complication of wound infection was observed on 7th POD between the groups (p<0.05). Post operative hospital stay in Group A and Group B were 11.50 ± 4.48 and 13.46 ± 5.13 days respectively. There is statistically significant difference in post operative hospital stay between the groups (p<0.05). Conclusion: Statistically significant difference observed in post operative complication of wound infection and burst abdomen on 7th POD between the groups. The present study there is statistically significant difference in post operative hospital stay between the groups also observed. Bangladesh Journal of Infectious Diseases 2017;4(1):15-20

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A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb Orthopaedic surgery

Journal of Chitwan Medical College ◽

10.3126/jcmc.v4i1.10842 ◽

2014 ◽

Vol 4 (1) ◽

pp. 19-21

Author(s):

NR Sharma ◽

U Rai ◽

S Panthee ◽

P Shrestha

Keyword(s):

Epidural Anaesthesia ◽

Lower Limb ◽

Orthopaedic Surgery ◽

Epidural Morphine ◽

P Value ◽

Medical College ◽

Group A ◽

Group B ◽

Good Patient Satisfaction

Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post operative analgesia with good patient satisfaction has been observed with this technique. The objective of this study was to assess the duration of postoperative analgesia and complications in patients receiving epidural anesthesia with morphine, midazolam and pethidine in combination with bupivacaine. We prospectively studied 75 Patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia. This study was conducted from March 2010 to March 2012 at Lumbini Medical College Palpa. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural pethidine (3 ml) with 0.5 % bupivacaine 13 ml. Group ‘ B’ (BM) received 5 mg (3 ml) epidural morphine with 13 ml of 0.5% bupivacaine and Group’ C’ (BMM) received 5 mg (1 ml) epidural morphine with 13 ml 0.5% bupivacaine and 2 mg (2 ml) epidural midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea vomiting, and pruritus. Data were analysed by SPSS-16.0 software. The result of the study shows the duration of analgesia was prolonged in BMM group than BM, and BP group and was statistically significant (P value <0.001). Incidence of nausea and vomiting in BMM group was lower than that of BP and BM group but was statistically insignificantly (P value 0.489). Pruritus was absent in BP group and was more with BM and BMM group (P value 0.007). In conclusion the use of epidural morphine and midazolam in combination with bupivacaine is the satisfactory method of post operative analgesia. By adding midazolam, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10842 Journal of Chitwan Medical College 2014; 4(1): 19-21

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HYPERLIPIDEMIC PATIENTS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.3241 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Marium Shoukat ◽

Hijab Batool ◽

Faiza Javaid

Keyword(s):

Protective Role ◽

Lipid Lowering ◽

Atheromatous Plaque ◽

P Value ◽

Cross Sectional ◽

Apo B ◽

Time Period ◽

Significant Difference ◽

Group A ◽

Group B

Objectives: Role of niacin in decreasing cardiovascular accidents by lowering the levels of Apo-B in hyperlipidemic patients. Background: In hyperlipidemia, there are high levels of atherogenic lipoproteins leading to higher risk of atherosclerotic cardiovascular events. Patients with dyslipidemia use statins as a mainstay of therapy over last many decades. Recent studies show that apolipoproteins play a major role in formation of atheromatous plaque, thus there is an urgent need to study the effects of lipid lowering medication on apolipoprotiens levels. Study Design: Cross sectional analytical study. Setting: Sheikh Zayed Hospital Lahore (Department of Biochemistry and Chemical Pathology). Period: 12 weeks from July to Sep 2014. Materials and Methods: Recently diagnosed hyperlipidemic patients (n=44) were selected for the study purpose and divided into two equal groups; A and B. Each group was given different medication. Group A took only statin while group B took a combination of statin and niacin. Blood samples were taken at the start of medication and then after completion of 12 week time period. Results: At the start of the treatment there was no significant difference in the Apo B cholesterol level between the two groups (p value 0.972). However, after the end of 12 week duration, there was a significant reduction in the Apo level of group B taking statin and niacin as compared to group A taking statin alone (p value 0.003). Conclusions: Niacin has cardio-protective role when used in combination with niacin.

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Stenting versus Pharmacological Therapy in Treatment of Single Vessel Intermediate Culprit Lesion Stenosis in Acute St-Segment Elevation Myocardial Infarction

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i2130699 ◽

2020 ◽

pp. 99-106

Author(s):

Hazem K. Shalaby ◽

Ayman Mohammed El Saied ◽

Hanan Kasem ◽

Mai Salama ◽

Seham Fahmy Badr

Keyword(s):

Myocardial Infarction ◽

Pharmacological Treatment ◽

P Value ◽

Culprit Lesion ◽

Acute Stemi ◽

Single Vessel ◽

St Segment ◽

Significant Difference ◽

Group A ◽

Group B

Background: Primary percutaneous coronary intervention (PCI) with stent implantation has been the standard therapy in acute ST-segment elevation myocardial infarction (STEMI) patients. Compared with medical treatment alone, stent implanting can achieve larger lumen gain and helps to reduce the re-occlusion risk of the infarct-related artery. Purpose: The aim of this study was to compare the effectiveness of stenting of single vessel intermediate culprit lesion stenosis to pharmacological treatment alone in acute STEMI patients. Methods: This study was prospective comparative interventional case series. It included 60 patients admitted to coronary care unit of our University hospital with acute STEMI. All patients were subjected to detailed history taking, clinical examination, 12 leads ECG, echocardiography and cardiac catheterization and angiography (TIMI flow and corrected TIMI frame count (CTFC) was reported. Patients selected were those with intermediate culprit lesion (40-70%) single vessel stenosis. Patients were divided into 2 groups: Group A: 30 patients who underwent stenting of the culprit lesion in addition to standard pharmacological treatment. Group B: 30 patients who received pharmacological treatment and no stenting (Glycoprotein II b/IIIa inhibitor in addition to the standard pharmacological treatment). Patients were followed up for 12 months and major adverse cardiac events (MACE) were reported (death, myocardial infarction, coronary re-vascularization, stroke and hospitalization because of heart failure). Results: 63.3% of group A patients reported complete ST segment resolution versus 30% of group B (P=0.034). TIMI Flow showed statistically significant difference in group A compared to group B regarding (P value=0.005) Group A reported slow fast blood flow (CTFC<60) in 1 patient (3.3%) while in group B it was reported in 5 patients (16%). There was a statistically significant difference between the 2 groups regarding CTFC (P value=0.029). At 12 months follow up, MACE were reported in one patient of group A versus 4 patients of group B (P value >0.05). Conclusion: Stent implantation reported better immediate efficacy and safety results among acute STEMI patients with single vessel intermediate culprit lesion stenosis and favourable effects in reducing MACE.

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A Comparative Study of 5.5mm Temporal Sclerocorneal Manual Small Incision Cataract Surgery Versus 5.5mm Temporal Clear Corneal Extended-incision Phacoemulsification with Implantation of a 5.25mm Rigid pmma Intraocular lens in the Bag

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr.03.02.01 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

Cataract Surgery ◽

Controlled Study ◽

P Value ◽

Small Incision Cataract Surgery ◽

Corneal Incision ◽

Small Incision ◽

Clear Corneal Incision ◽

Significant Difference ◽

Group A ◽

Group B

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.

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