scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY COMPARING CLINICAL OUTCOME OF IUGR NEONATES WITH NORMAL AND ABNORMAL UMBILICAL ARTERY FLOW DOPPLER

2020 ◽  
pp. 1-3
Author(s):  
Aarti Panchal ◽  
Sucheta Munshi ◽  
Halak Chauhan
Keyword(s):  
Umbilical Artery ◽  
Outcome Measure ◽  
Perinatal Asphyxia ◽  
Secondary Outcome ◽  
Control Group ◽  
Case Group ◽  
Secondary Outcome Measure ◽  
Perinatal Complications ◽  
Umbilical Artery Doppler ◽  
Artery Flow

Background: Intrauterine growth restriction (IUGR) is one of the causes of perinatal mortality and morbidity which affects approximately 9.65% of pregnancies worldwide. Doppler indices from the fetal circulation can reliably predict adverse perinatal outcome. Aims &objectives: To compare perinatal complications and outcome between term and preterm IUGR neonates having normal and abnormal umbilical artery flow Doppler. Methodology: 140 IUGR Neonates with abnormal and normal antenatal umbilical artery Doppler scan admitted in NICU of Civil Hospital, Ahmedabad were included in the study. Amongst them 52 were preterm and 88 were term neonates. Study was conducted between October 2019 to December 2019. Primary outcome measure is neonatal mortality and secondary outcome measure is neonatal morbidities like perinatal asphyxia, hypoglycemia, NEC, hyperbilirubinemia etc. Results: Amongst140 IUGR neonates Preterm were more in case group 36(51.4%) compared to control group 16(22.8 %.) Hypoglycaemia and NEC was observed more in preterm 19 (36.5%) and 14(26.9%) compared to 16(18.2%) and 11(12.5%) in term respectively. Birth asphyxia was observed more in term 26(29.5%) than preterm 7(13.5%). At birth perinatal asphyxia was observed more in case group, 27 out of 70 (38.5%), as compared to 6 out of 70 (8.5%) in control group (P <0.05). Hypoglycemia and NEC was noticed in 30(42.8%) and 24(34.2%) neonates in case group, as compared to 5(7.1%) and 2(2.8%) neonates in control group respectively. (P < 0.05) Conclusion: Neonates with abnormal Umbilical Artery Doppler flow are at increased risk of perinatal complications and needs extra care during this period.

scholarly journals To compare the perinatal outcome of IUGR infants with abnormal and normal antenatal umbilical artery Doppler flow in the immediate neonatal period

2017 ◽  
Vol 6 (4) ◽  
pp. 1449 ◽  
Author(s):  
Shivaprasad B. ◽  
Devendrakumar Sharma
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Outcome Measure ◽  
Perinatal Asphyxia ◽  
Secondary Outcome ◽  
Control Group ◽  
Case Group ◽  
Secondary Outcome Measure ◽  
Doppler Flow ◽  
Umbilical Artery Doppler

Background: Intrauterine growth restriction (IUGR) is one of the cause of perinatal mortality and morbidity and affects approximately 7-15% of worldwide pregnancies. IUGR is the failure of the fetus to achieve intrinsic growth potential, due to disorders and diseases in the feto–placental–maternal unit. Doppler indices from the fetal circulation can reliably predict adverse perinatal outcome. Aim of the study was to determine perinatal outcome of IUGR infants with abnormal antenatal umbilical artery Doppler flow versus IUGR infants with normal Doppler flow.Methods: All Preterm and term IUGR infants with abnormal and normal antenatal umbilical artery Doppler scan admitted in NICU of St Martha’s Hospital were included in the study. 30 in each group with total sample size of 60. Study was conducted from March 2015 to February 2016. Primary outcome measure will be neonatal mortality and secondary outcome measure will be neonatal morbidities like perinatal asphyxia, hypoglycemia, NEC, polycythemia, sepsis, hyperbilirubinemia etc.Results: IUGR infants with abnormal antenatal umbilical artery Doppler scan were included as cases and those with normal antenatal umbilical artery Doppler scan as control. At birth resuscitation rate and therefore perinatal asphyxia was observed more in case group, 11 out of 30 (36.6%), compared to 1 out of 30 (3.3%) in control group, statistically significant (P <0.05). Hypoglycemia was noticed in 19 infants in case group (63.3%) compared to 2 infants (6.6%) in control group, statistically significant. NEC, polycythemia, sepsis was noticed more in case group, but statistically not significant.Conclusions: Infants with abnormal antenatal Doppler flow are at increased risk of perinatal complications than infants with normal antenatal umbilical artery Doppler and needs extra care during this period.

Clinical Effects of Sensor AR40E Intraocular Lenses in Cataract Patients with Prominent Myopia

2020 ◽  
Vol 12 (4) ◽  
pp. 461-466
Author(s):  
Wenying Wang ◽  
Zhixue Wang ◽  
Yu Liu ◽  
Yuanyuan Zou ◽  
Xiangning Ji ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Group Treatment ◽  
Outcome Measure ◽  
Acupuncture Group ◽  
Intraocular Lenses ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Clinical Effects

Cataracts are a complex group of eye disorders. Many studies suggest that blood circulation around the eyes, and a rise in intraocular pressure play important roles in glaucoma. Sensor AR40E artificial crystalline bodies can adjust intraocular pressure, improve activity in the optic nerve and increase blood flow to the eye fundus. BL1 can transport Yin and Yang. We designed a randomized, military blind, controlled clinical trial: Control group: (1) A Sensor only AR40E intraocular lens was applied to the skin of Qingming and retrobulbar acupoints on the rainy side, twice per week for 20 min every time, for two consecutive weeks; (2) acupuncture group: treatment was same as for the control group, but the eye was needled into Jingming and retrobulbar acupoints to achieve Qi; (3) Sensor AR40E intraocular lens group: treatment was the same as that for the acupuncture group, the main outcome measure was the change of intraocular pressure and the secondary outcome measure is the score change of WHOQOL ref (Taiwan version). Beneficial outcomes were realized in the right and left eye acupuncture groups and the Sensor AR40E intraocular lens group.

scholarly journals Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

2017 ◽  
Vol 4 (12) ◽  
pp. 3822
Author(s):  
Yahia Alkhateep ◽  
Abdelmieniem Fareed
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Lidocaine Group ◽  
Significant Difference ◽  
Double Blinded

Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

scholarly journals The Role of Intra-Operative Wound Irrigation with Normal Saline in Reduction of Surgical Site Infection in Gynecological Surgeries

2021 ◽  
Vol 29 (02) ◽  
pp. 115-118
Author(s):  
Uzma Urooj ◽  
Sumaira Khan ◽  
Rabia Imran
Keyword(s):  
Normal Saline ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Military Hospital ◽  
Control Group ◽  
Skin Closure ◽  
Secondary Outcome Measure ◽  
Wound Irrigation ◽  
Cohort Group ◽  
Operative Wound

Objective: To evaluate the efficacy of intra-operative wound irrigation with normal saline in reducing surgical site infections in gynaecological surgeries. Methods: It is a prospective cohort study carried out at Obstetrics and Gynaecology Department, Pak-Emirates Military Hospital, Rawalpindi from 1st November 2019 to 30th April 2020. A total of 400 patients undergoing abdominal surgery for gynecological reasons were recruited by consecutive non-probability technique. Patients with known comorbidities were excluded. Participants of study were allocated cohort and control groups at the end of the surgery after closing the abdominal fascia. In cohort group, the subcutaneous soft tissue was irrigated with 1000 ml of Normal saline solution before skin closure and sterile dressing. No intra-operative wound irrigation was performed in the control group. The primary and secondary endpoint measures (SSI up to 10th Post-Operative day) and (SSI up to 30th Post-Operative day) respectively, were assessed clinically. Results: The study included 400 patients, with 200 in the cohort group and 200 in the control group with Mean Age of (Mean ± SD) 33.6±8.1 years. Majority of the patients had Pre-Op Hemoglobin of >11 g/dl (216)54%. Most common surgeries were Caesarean section (324)81% and Hysterectomy (40)10%. Maximum surgeries were performed between 30-30 min (312)78% with mean hospital stay of (Mean ± SD) 2.9±0.5 days. Analysis of the results showed that Intra-operative wound irrigation with normal saline significantly lesser rate of postoperative SSIs in comparison to no irrigation at both primary outcome measure that was SSI at 10th Post-operative day (POD)(RR=0.417, 95 % CI [0.15;1.161]) and secondary outcome measure that was SSI at 30th POD(RR=0.286, 95 % CI [0.060;1.359]). Conclusion: Intra-operative wound irrigation with Normal Saline decreases the risk of SSI by 58.3% (AR) at 10thPOD and by 71.4% (AR) at 30th POD in otherwise healthy women with no comorbidities.

scholarly journals Non-surgical oral hygiene interventions on disease activity of Rheumatoid arthritis patients with periodontitis: A randomized controlled trial

2020 ◽  
Vol 14 (1) ◽  
pp. 26-36
Author(s):  
William Buwembo ◽  
Ian Guyton Munabi ◽  
Mark Kaddumukasa ◽  
Haruna Kiryowa ◽  
Muhammad Mbabali ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Oral Hygiene ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Das 28 ◽  
Periodontal Index

Background . Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda. Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status. Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores. Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.

Phase II trial of bevacizumab in combination with temozolomide and regional radiation therapy for up-front treatment of patients with newly diagnosed glioblastoma multiforme

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 2000-2000 ◽  
Author(s):  
A. Lai ◽  
P. Nghiemphu ◽  
R. Green ◽  
L. Spier ◽  
S. Peak ◽  
...  
Keyword(s):  
Phase Ii ◽  
Outcome Measure ◽  
Phase Ii Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Newly Diagnosed ◽  
Standard Regimen ◽  
Safety And Efficacy ◽  
Wound Breakdown

2000 Background: Bevacizumab (BV) is a humanized monoclonal antibody directed against the vascular endothelial growth factor (VEGF). Based on the promising activity of BV in the treatment of recurrent glioblastoma, we are conducting a phase II trial to determine whether up-front treatment of newly diagnosed GBM with BV may be more advantageous than withholding BV until recurrence. In this trial, we evaluate the safety and efficacy of BV combined with standard of care radiation (RT) and temozolomide (TMZ) and radiation (RT) for newly-diagnosed GBM. Methods: This is a phase II trial with a 10-patient pilot and 60-patient expansion phases. Newly-diagnosed GBM patients with no prior treatments are eligible. Primary outcome measure is overall survival; the secondary outcome measure is TTP and 12-month survival. Therapy began between 3–5 weeks of surgery with BV (10 mg/kg every 2 weeks), TMZ (75 mg/m2 daily), and external beam RT (30 x 200 Gy) on the same day. After completion of radiation, patients are then placed on a maintenance phase of BV (10mg/kg every 2 weeks) and TMZ (150–200 mg/m2 5 out of every 28 days) until progression or 24 months in which patients are then maintained on BV only. Results: 70 of 70 projected GBM patients have been enrolled between August 2006 and November 2008 at UCLA and Kaiser Permanente (KP) (Northern and Southern California). All patients had resections to ensure that frozen tissue (>200mg) was collected. The median age was 57.4 years (range 31–75). MGMT methylation analysis has been performed on 52/70 patients with ∼40% showing methylation. Severe adverse events to date have included ischemic stroke, pulmonary embolus, wound breakdown, GI bleeding/perforation, and renal dysfunction. Isolated cases of retinal detachment and optic neuropathy have also been observed. As of now, 35/70 patients are off study (26 due to progression and 9 due to SAE). Preliminary TTP by Kaplan-Meier analysis is promising compared to that of a UCLA/KP control group of patients that received the conventional RT/TMZ regimen. Conclusions: Addition of BV to the standard regimen of TMZ and RT for newly-diagnosed GBM is well-tolerated and shows promising efficacy. More detailed analysis of safety and efficacy will presented. [Table: see text]

Impact of Guideline Implementation on Patient Care: a Cluster RCT

2009 ◽  
Vol 89 (1) ◽  
pp. 71-76 ◽  
Author(s):  
T.G. Mettes ◽  
W.J.M. van der Sanden ◽  
E. Bronkhorst ◽  
R.P.T.M. Grol ◽  
M. Wensing ◽  
...  
Keyword(s):  
Patient Care ◽  
Outcome Measure ◽  
Guideline Implementation ◽  
Intervention Group ◽  
Implementation Strategies ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Relevant Effect ◽  
Dental Practitioners

In Western European countries, dentists use standardized procedures, rather than individualized risk assessment, for routine oral examinations. The predictive hypothesis was that guideline implementation strategies based on multifaceted interventions would be more effective in patient care than the dissemination of guidelines only. A cluster-randomized trial was conducted, with groups of general dental practitioners (GDPs) as the unit of randomization. Patients were clustered within practices and prospectively enrolled in the trial. Patient data were collected from registration forms. The primary outcome measure was guideline-adherent recall assignment, and a secondary outcome measure was guideline-adherent bitewing frequency. The interventions consisted of online training, guideline dissemination, and educational sessions. For low-risk patients, guideline-adherent recall increased in the intervention group (+8%), which differed from the control group (−6.1%) (p = 0.01). Guideline-adherent bitewings showed mixed results. We conclude that multifaceted intervention had a moderate but relevant effect on the performance of GDPs, which is consistent with other findings in primary care.

scholarly journals Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2161
Author(s):  
Jae Yun Sung ◽  
Ju Mi Kim ◽  
Jae Yul Hwang ◽  
Kyoung Nam Kim ◽  
Jae Young Kim ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Surgical Outcomes ◽  
Timing Of Surgery ◽  
Secondary Outcome ◽  
Control Group ◽  
Optimal Timing ◽  
Secondary Outcome Measure ◽  
Success Rates ◽  
Endoscopic Dacryocystorhinostomy ◽  
And Gender

Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery. Methods: A retrospective review of medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and an age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were the surgical outcomes at the final follow-up examination. The secondary outcome measure was the clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing the outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days). Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery, respectively. In the subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stays, and the duration of antibiotic treatments were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the two groups (p = 1.000). Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR performed within 3 days leads to faster recovery and shortens the course of antibiotic treatment.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

scholarly journals A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

2018 ◽  
Vol 7 (11) ◽  
pp. 4706
Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Perinatal Complications ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

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