scholarly journals Urinary Effects of Routine Urethral Catheterisation during Elective Caesarean Section in Enugu, Nigeria: A Randomised Controlled Study

2021 ◽  
Author(s):  
Elijah Nduka Onwudiwe ◽  
Hyginus Uzo Ezegwui ◽  
Cyril Chukwudi Dim ◽  
Chibuike Ogwuegbu Chigbu ◽  
Chinyere Florence Onwudiwe ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Urinary Bladder ◽  
Urinary Retention ◽  
Elective Caesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Catheter Group ◽  
Urethral Catheterisation ◽  
Significant Bacteriuria ◽  
Randomised Controlled

Introduction: Routine urinary catheterisation during elective caesarean section is a common practice. However, this practice involves some urinary bladder morbidities. Aim: To determine the effect of non-catheterisation of the urinary bladder on the incidence of significant bacteriuria and other perioperative urinary bladder morbidities during elective caesarean section in Enugu, Nigeria. Materials and Methods: A multicentre, non-inferiority randomised controlled study was conducted. The study centres were the University of Nigeria Teaching Hospital (UNTH), Mother of Christ Specialist Hospital (MOCSH), and Blessed Assurance Specialist Hospital (BASH), all in Enugu State, Southeast Nigeria. A total of 264 eligible consenting term pregnant women who had a caesarean section in these three specialist centres in Enugu, Nigeria over a one-year period were recruited and they completed the study and their results were analysed. Study group (A) did not receive urethral catheterisation while the control group (B) had urethral catheterisation on the operating table and the catheters were removed 24 hours after the surgery. Clean catched urine samples were collected from each participant 72 hours after the surgery for urine microscopy and culture. The primary outcome measure was the incidence of significant bacteriuria 72 hours postoperatively while the secondary outcome measures included incidence of intraoperative bladder injury (accidental cystostomy), primary postpartum haemorrhage and urinary retention. Results: Nine (6.8%) women in the non-catheter group (n=132) had significant bacteriuria as against 17 (12.9%) women in the catheter group (n=132), (Relative Risk (RR)=0.5 (95% CI: 0.24-1.14) p=0.098). Urinary retention was observed in 10.6% (14/132) of the non-catheter group while there was no case of urinary retention in the control group (p<0.001). There was neither a case of accidental cystostomy nor postpartum haemorrhage in either group. Conclusion: Non-catheterisation of the urinary bladder during elective caesarean section had no significant relationship with the incidence of significant bacteriuria in Enugu, Nigeria. Rather, it was associated with postoperative urinary retention when compared to women who had a urinary catheter.

Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: a single-blind, randomised, controlled study

2021 ◽  
pp. 1-4
Author(s):  
E Ocak ◽  
S Mulazimoglu ◽  
D Kocaoz ◽  
E Mirici ◽  
E Dagli ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Isotonic Saline ◽  
Sodium Hyaluronate ◽  
Controlled Study ◽  
Control Group ◽  
Clearance Time ◽  
Nasal Irrigation ◽  
Persistent Allergic Rhinitis ◽  
Randomised Controlled

Abstract Objective To investigate the effects of nasal irrigation with sodium hyaluronate and surfactant solutions on mucociliary clearance time in patients with mild persistent allergic rhinitis. Methods A total of 120 patients diagnosed with mild persistent allergic rhinitis were enrolled in this prospective study. The patients were allocated randomly to the surfactant, sodium hyaluronate or isotonic saline (as a control) nasal irrigation group. The mucociliary clearance times and improvements in mucociliary clearance times were compared. Results Improvements in mean mucociliary clearance time were significantly greater in the surfactant and sodium hyaluronate groups than in the control group (p < 0.01). The mean post-treatment mucociliary clearance time of the surfactant group was significantly lower than that of the control (p < 0.001) and sodium hyaluronate groups (p = 0.03). Conclusion Surfactant and sodium hyaluronate nasal irrigation solutions may both be used as adjunctive treatments for allergic rhinitis. Surfactant nasal irrigation resulted in better mucociliary clearance times.

Hysteroscopic management of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hatem Hussein El-Gamal ◽  
Walid El-Basuony Mohammad ◽  
Ahmed Samir Mohamed Zeerban
Keyword(s):  
Quality Of Life ◽  
Caesarean Section ◽  
Controlled Trial ◽  
Intervention Group ◽  
Expectant Management ◽  
Control Group ◽  
Randomised Controlled ◽  
Caesarean Scar Defect ◽  
Interventional Group

Abstract Background Long-term complaints after caesarean section, such as postmenstrual spotting, dysmenorrhea, dyspareunia, or chronic pelvic pain, are frequently described in relation to the presence of a niche. A post-caesarean niche is defined as an indentation in the myometrium at the site of the uterine scar. Two independent prospective cohort studies reported that the presence of a niche after caesarean section increases the risk of postmenstrual spotting for more than 2 days from 15 to 30%. Postmenstrual spotting may be caused by a mechanical outflow problem, with the retention of menstrual blood in a niche, or by the accumulation of blood because of impaired uterine contractions at the site of the niche. Additionally, newly formed fragile vessels in the niche may play a role in the formation of blood or fluid in the niche and uterine cavity. Objective The aim of this study was to compare the effectiveness of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting and a uterine caesarean scar defect. Methods This trial is a randomised controlled trial that provides evidence for the (cost) effectiveness of hysteroscopic resection of a niche versus expectant management in women with niche related postmenstrual spotting. It was carried out on 28 cases divided into two equal group. The study was conducted at Ain Shams University on the women reporting postmenstrual spotting after a caesarean section. The primary outcome was the number of days of postmenstrual spotting 6 months after randomization. Secondary outcomes were spotting at the end of menstruation, intermenstrual spotting, dysuria, sonographic niche measurements, quality of life, women’s satisfaction, sexual function, and additional therapy. Outcomes were measured at 3 months and, also at 6 months after randomization. Results The results of this study show a significant improvement in interventional group after 3 months more than the control group in bleeding micturition characteristics which includes total days of spotting, spotting end of menstruation, intermenstral spotting, discomfort from spotting, dysmenorrhea and daily pain during micturition, after 6 months the two group improved but the interventional group was significantly higher than control group. Regarding the radiological assessment it was found that there was a significant improvement in intervention group more than the control group after 3 months, also the control group improved after 6 months also, but the intervention groups was significantly higher than the control group. The quality of life show a significant increasing in intervention group more than the control group after 3 months of intervention, at the end of follow up the intervention group was significantly higher in quality of life more than the control group. Conclusion A hysteroscopic niche resection reduces postmenstrual spotting, and the discomfort from spotting, compared with expectant management after 3 months of follow-up in women with a niche with a residual myometrium of at least 3 mm.

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Breast Feeding ◽  
Local Anesthetic ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Cesarean Section Delivery ◽  
Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

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