scholarly journals Effectiveness of Traditional Japanese Herbal (Kampo) Medicine, Daiobotanpito, in Combination with Antibiotic Therapy in the Treatment of Acute Diverticulitis: A Preliminary Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Keiko Ogawa ◽  
Koji Nishijima ◽  
Fumio Futagami ◽  
Takashi Nakamura ◽  
Genichi Nishimura
Keyword(s):  
Acute Diverticulitis ◽  
Statistical Significance ◽  
Kampo Medicine ◽  
Double Blind Study ◽  
Open Label ◽  
Double Blind ◽  
Patient Demographics ◽  
Intravenous Antibiotics ◽  
Group 2 ◽  
Group 1

In traditional Japanese herbal (Kampo) medicine, daiobotanpito (DBT) or Da Huang Mu Dan Tang in Chinese has been used in medical treatment of acute diverticulitis for many years based on the experience. Our aim was to investigate whether the treatment of acute diverticulitis can be treated with intravenous antibiotics plus orally administrated DBT than intravenous antibiotics alone. A retrospective nonrandomized open-label trial was established to compare patients with acute diverticulitis who received oral DBT associated with intravenous antibiotics with those who received intravenous antibiotic alone. We included 34 patients, eleven patients in group 1 with DBT and 23 patients in group 2 without DBT. Both groups were comparable in patient demographics and clinical characteristics. There was a significantly better outcome in the group treated with DBT than in the group without DBT when comparing duration of fever, abdominal pain, and antibiotics administration. A trend toward a day shorter mean hospital stay and fasting was seen in group 1, although this did not reach statistical significance. In conclusion, most patients with acute diverticulitis can be managed safely with oral DBT. Although randomized, double-blind study must be done, we could show the possibility to use daiobotanpito as an additional option in treating acute diverticulitis.

Adding herbal extracts to silicone gel on post-sternotomy scar: a prospective randomised double-blind study

2020 ◽  
Vol 29 (Sup4) ◽  
pp. S36-S42
Author(s):  
Palakorn Surakunprapha ◽  
Kengkart Winaikosol ◽  
Bowornsilp Chowchuen ◽  
Kriangsak Jenwitheesuk ◽  
Kamonwan Jenwitheesuk
Keyword(s):  
Aloe Vera ◽  
Median Sternotomy ◽  
Centella Asiatica ◽  
Herbal Extract ◽  
Double Blind Study ◽  
Herbal Extracts ◽  
Double Blind ◽  
Silicone Gel ◽  
Group 2 ◽  
Group 1

Objective: Silicone gel has been shown effective in improving healing post-sternotomy scars. It remains to be determined whether adding herbal extracts to the gel would augment the healing effect. Method: After median sternotomy, patients were randomised into two groups. Group 1: topical silicone gel plus herbal extract gel (Allium cepa, Centella Asiatica, Aloe vera and Paper Mulberry) and Group 2: silicone gel. Patients were treated for six months. The postoperative scars were assessed at three and six months by plastic surgeons using the Vancouver Scar Scale (VSS) and the patient assessment scar scale. Results: Each group comprised 23 patients (n=46 in total). The VSS was significantly lower in Group 1 than in Group 2 (p=0.018 and p=0.051, respectively). In Group 1, the four differences from baseline were vascularity scores at three and six months (–0.391, p=0.025; –0.435, p=0.013, respectively), and pigmentation scores at three and six months (–0.391, p=0.019; –0.609, p=0.000, respectively). In Group 2, differences from baseline were the pigmentation and vascularity score at six months (–0.6609, p=0.000; –0.348, p=0.046, respectively). Conclusion: Our results suggest, post-sternotomy scars trend to have better vascularity and pigmentation when treated with silicone gel plus herbal extracts.

scholarly journals Prevention of Delayed Nausea: A University of Rochester Cancer Center Community Clinical Oncology Program Study of Patients Receiving Chemotherapy

2012 ◽  
Vol 30 (27) ◽  
pp. 3389-3395 ◽  
Author(s):  
Joseph A. Roscoe ◽  
Charles E. Heckler ◽  
Gary R. Morrow ◽  
Supriya G. Mohile ◽  
Shaker R. Dakhil ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Cancer Center ◽  
Double Blind ◽  
Group 4 ◽  
Community Clinical Oncology Program ◽  
Delayed Nausea ◽  
Group 3 ◽  
Group 2 ◽  
Mean Differences ◽  
Group 1

Purpose We conducted a double-blind randomized clinical trial of the following four regimens for controlling delayed nausea (DN): group 1: palonosetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 2: granisetron + dexamethasone on day 1 with prochlorperazine on days 2 and 3; group 3: aprepitant + palonosetron + dexamethasone on day 1 with aprepitant + dexamethasone on days 2 and 3; and group 4: palonosetron + dexamethasone on day 1 with prochlorperazine + dexamethasone on days 2 and 3. Patients and Methods Chemotherapy-naive patients received doxorubicin, epirubicin, cisplatin, carboplatin, or oxaliplatin. The primary end point was average nausea assessed four times daily on days 2 and 3. Primary analyses were whether nausea control would be improved by using palonosetron versus granisetron on day 1 (group 1 v group 2); by adding dexamethasone on days 2 and 3 (group 1 v group 4); and by using aprepitant versus prochlorperazine (group 3 v group 4). Statistical significance was set at P = .017. Results Two hundred thirty-four, 234, 241, and 235 evaluable patients were accrued to groups 1, 2, 3, and 4, respectively. Adjusted mean differences for the three planned analyses were as follows: palonosetron versus granisetron: −0.01 (95% CI, −0.23 to 0.20; P = .72); adding dexamethasone on days 2 and 3: 0.20 (95% CI, −0.02 to 0.41; P = .01); and using aprepitant versus prochlorperazine: −0.03 (95% CI, −0.24 to 0.19; P = .56). Conclusion The addition of dexamethasone on days 2 and 3 reduced DN. Palonosetron and granisetron have similar effects on DN. The beneficial effect of adding aprepitant for control of DN was the same as adding prochlorperazine.

scholarly journals Daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Keiko Ogawa-Ochiai ◽  
Kenichi Yoshimura ◽  
Akiko Shirai ◽  
Seisho Sakai ◽  
Hideki Moriyama ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Acute Diverticulitis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Open Label ◽  
Double Blind ◽  
Abdominal Abscesses ◽  
Intravenous Antibiotics

Abstract Background: Colonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics with placebo. Methods: This is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT for moderate to severe diverticulitis patients treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be the rate of fever reduction within 3 days or/and abdominal pain relief within 4 days. Secondary endpoints will include hospitalization days, changes in inflammatory response (CRP, WBC, neutrophil count), thermal type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration. Discussion: This study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence regarding the efficacy and safety of DBT in the recurrence of acute diverticulitis. Trial registration: UMIN000027381, registered on April 27th, 2017; https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377.

scholarly journals Daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Keiko Ogawa-Ochiai ◽  
Keinichi Yoshimura ◽  
Akiko Shirai ◽  
Seisho Sakai ◽  
Hideki Moriyama ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Acute Diverticulitis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Open Label ◽  
Double Blind ◽  
Abdominal Abscesses ◽  
Intravenous Antibiotics

Abstract Background: Colonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics with placebo. Methods: This is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT for moderate to severe diverticulitis patients treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be the rate of fever reduction within 3 days or/and abdominal pain relief within 4 days. Secondary endpoints will include hospitalization days, changes in inflammatory response (CRP, WBC, neutrophil count), thermal type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration. Discussion: This study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence regarding the efficacy and safety of DBT in the recurrence of acute diverticulitis. Trial registration: UMIN000027381, registered on April 27th, 2017 https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377, and changed to jRCTs041180063, registered on July 30th, 2019; https://jrct.niph.go.jp/en-latest-detail/jRCTs041180063

scholarly journals Effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy: A prospective, double blind study

2019 ◽  
Author(s):  
Karishma Bansal ◽  
Maharishi Markandeshwar ◽  
Utkarsh Garg ◽  
Kritesh Goel ◽  
Divya Vijay ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Magnesium Sulphate ◽  
Hemodynamic Response ◽  
Blind Study ◽  
P Value ◽  
Double Blind Study ◽  
Double Blind ◽  
Intravenous Magnesium ◽  
Group 2 ◽  
Group 1

Background and Aim: Pneumoperitoneum (PP) for laparoscopic surgery is known to induce a pressor response. It can be attenuated by drugs, like opioids, vasodilators, beta blocking agents and alpha-2 agonists, but these drugs have their side effects. This study investigated the efficacy of magnesium sulphate to attenuate hemodynamic response associated with pneumoperitoneum in patients undergoing laparoscopic cholecystectomy.Methodology: This randomized, double blind, prospective study was carried out at Department of Anesthesiology, Maharishi Markandeshwar University, Mullana, Haryana (India). A total of 60 patients of ASA grade I or II, aged 20-60 y, of either sex, undergoing laparoscopic cholecystectomy, were randomly allocated into one of the two groups of 30 each. Standardized general anesthesia was administered to all patients. Group 1 patients received magnesium sulphate (30 mg/kg) intravenously as a bolus before induction of PP and Group 2 patients received same volume of 0.9% normal saline. Hemodynamic variables, e.g. heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial pressures (MAP) were recorded from the start of surgery till extubation. Statistical analysis: SPSS version 17.0 for windows was used and p value of < 0.05 was considered significant.Results: Mean HR was 81.50 ± 8.44 vs. 93.03 ± 6.93/min, SBP was 126.37 ± 13.03 vs. 150.20 ± 10.45 mmHg, DBP was 82.50 ± 11.20 vs. 94.73 ± 8.33 mmHg, and MAP 98.43 ± 10.29 vs.113.27 ± 9.16 mmHg in Group 1 and Group 2, respectively, at 10 min after PP. Statistically significant fall in HR, SBP, DBP, MAP was seen in Group 1 at 10 min after PP till extubation. (p < 0.05).Conclusion: Intravenous magnesium sulphate effectively attenuates the hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy under general anesthesia.Citation: Bansal K, Santpur MU, Garg U, Goel K, Vijay D, Tatineni Bansal. Effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum in laparoscopic cholecystectomy: A prospective, double blind study. Anaesth pain & intensive care 2019;23(3):290-294

scholarly journals Spinal and intravenous midazolan anesthetic effects on fentanyl/ ligdocaine regional anesthesia following back minor orthopedic surgery

2010 ◽  
Vol 9 (1) ◽  
pp. 30-34
Author(s):  
Gabriela Rocha Lauretti ◽  
Anita L. Mattos
Keyword(s):  
Orthopedic Surgery ◽  
Concentration Level ◽  
Statistical Significance ◽  
Intrathecal Injection ◽  
Control Group ◽  
Sensory Level ◽  
Double Blind Study ◽  
Double Blind ◽  
Effective Analgesia ◽  
Group 1

OBJECTIVES: the present study was designed to evaluate the usefulness of intravenous and intrathecal midazolan as an adjunct to intrathecal ligdocaine, with or without intrathecal fentanyl. METHODS: double-blind study, institutional approval and informed consent; 40 patients scheduled for minor lumbar orthopedic surgery were randomly assigned to one of five groups (n=8). Patients were premedicated with a 4 mL final intravenous volume (saline or midazolan). Spinal anaesthesia was administered to a 3 mL final volume - 75 mg of lidocaina plus either 33 mg fentanyl or 500 mg midazolan diluted in saline (0,9%) - with the patient in sitting position. The latency time for onset of the block (LT), time to progress to T10 sensory level (TT10), duration of the block (Bl), duration of effective analgesia (An), the subjective degree of intraoperative sedation, level of alertness, concentration level and degree of anxiety were specifically measured. P<0.05 was considered significant. RESULTS: the addition of midazolan to the intrathecal injection in the absence of fentanyl was the only procedure which caused a statistically significant reduction in LT (p<0.002) and TT10 (p<0.001). Intrathecal midazolan increased the blockade time both with (p<0.05) and without (p<0.02) intrathecal fentanyl, but, when given intravenously, this effect failed to reach statistical significance (p>0,05). Both intrathecal fentanyl and midazolan increased the duration of analgesia (p<0.01). With respect to the subjective measures, group 1 served as the control group, demonstrating an alert, fully awake patient who was able to concentrate but showed some anxiety. CONCLUSIONS: while all additional treatments resulted in a relaxed patient, only those given intrathecal midazolan remained fully awake, alert and able to concentrate. Intrathecal fentanyl with saline premedication or intravenous midazolan premedication resulted in decreased alertness and inability to concentrate, as well as sleepiness, which was more extreme in the case of those patients given intravenous midazolan.

scholarly journals Multinodular goitre surgery complications and directly observed surgeons’ skills: a prospective double-blind observational cohort study

2021 ◽  
Author(s):  
Hafiz Naweed Ahmad ◽  
Fayyaz Ahmad ◽  
Admin
Keyword(s):  
Surgical Technique ◽  
Direct Observation ◽  
Real Life ◽  
University Hospital ◽  
Double Blind Study ◽  
Multinodular Goitre ◽  
Double Blind ◽  
Group 2 ◽  
The One ◽  
Group 1

Objective: To study multinodular goitre patients’ surgery by direct observation of surgical technique, and to compare complications with surgeons’ skills and experience, for improved training of future thyroid surgeons. Methods: Based on positivist epistemology and analytical observational design, this prospective double-blind study of a cohort of multinodular goitre patients operated upon by variedly experienced surgeons, was conducted at Bahawal Victoria Hospital Bahawalpur and Nishtar Medical University Hospital Multan, Pakistan, from December 2016 to April 2019. Patients were admitted through outpatient department and operated upon in routine operation lists. The surgeons were specialists/senior registrars, assistant professors, associate professors and professors. The patients were divided into two virtual groups: the one operated upon by surgeons with >3 years of post-fellowship experience and the other operated upon by surgeons with <3 years of post-fellowship experience. Surgeries were directly observed and differences in surgical technique and complications were recorded for respective groups. Data was analysed using SPSS 20. Results: Of the 134 patients, there were 73(54.5%) in group 1 and 61(45.5%) in group 2. Overall, there were 119(88.8%) females and 15(11.2%) males. The overall mean age was 37.17+/-13.41 years (range: 14-80 years). Of the 25 surgeons, 13(52%) were in group 1 and 12(48%) in group 2. Group 1 had fewer complications compared to group 2, which on certain parameters was statistically significant (p<0.05). Conclusion: Surgeons’ experience and technique were found to have significant relationship with the rate of complications. Direct observation of surgeries is significant for real life evaluation and training of junior surgeons.

scholarly journals Pregabalin Effect on Acute and Chronic Pain after Cardiac Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Aik Bouzia ◽  
Vassilios Tassoudis ◽  
Menelaos Karanikolas ◽  
George Vretzakis ◽  
Argyro Petsiti ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cardiac Surgery ◽  
Sleep Disturbances ◽  
Median Sternotomy ◽  
Double Blind Study ◽  
Double Blind ◽  
Elective Cardiac Surgery ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Group 1

Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative pregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind study. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral pregabalin 75 mg, and Group 3 received oral pregabalin 150 mg. Data were collected 8 hours, 24 hours, and 3 months postoperatively. Results. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2, p=0.000) and had lower pain scores at 8 hours (4 versus 3 versus 3, p=0.001) and 3 months (3 versus 2 versus 2, p=0.000) and lower morphine consumption at 8 hours (14 versus 13 versus 12 mg, p=0.000) and 24 hours (19.5 versus 16 versus 15 mg, p=0.000). Percentage of patients with sleep disturbances or requiring analgesics was lower in the pregabalin group and even lower with higher pregabalin dose (16/31 versus 5/31 versus 3/31, p=0.000, and 26/31 versus 16/31 versus 10/31, p=0.000, resp.) 3 months after surgery. Conclusion. Preoperative oral pregabalin 75 or 150 mg reduces postoperative morphine requirements and acute and chronic pain after cardiac surgery.

Cephradine and cefazolin plasma levels during cardiac surgery

Perfusion ◽  
1986 ◽  
Vol 1 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Sergio V Moran ◽  
Francisco Montiel ◽  
Guillermo Acuña ◽  
Jeanette Vergara ◽  
Manuel J Irarrazaval ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Plasma Levels ◽  
Early Postoperative Period ◽  
Good Choice ◽  
Double Blind Study ◽  
Double Blind ◽  
Postoperative Course ◽  
Group 2 ◽  
Group 1

A prospective, randomized, double-blind study was carried out to evaluate two prophylactic regimes in patients undergoing cardiac surgery with cardiopulmonary bypass. Antibiotic plasma levels were measured in fifty consecutive adult patients undergoing valve and coronary surgery. They were divided into two comparable groups of 25 patients, each matched in age, sex, type of operation and duration of cardiopulmonary bypass. Group 1 received 1 g of cephradine with the anaesthetic premedication, 1 g in the prime of the oxygenator and 1 g every six hours during the first 72 hours of the postoperative course. Group 2 received cefazolin following the same protocol except that they received 1 g every eight hours during the postoperative course. There were no allergic or toxic reactions and no infections up to two months follow-up in both groups. Antibiotic plasma levels were significantly higher (p < 0·001) in the cefazolin group in four out of five sampling periods. Antibiotic plasma levels for group 1 versus group 2 were as follows: initial level 11·7 ± 5.2 mcg/ml vs 31 4 ± 35·4 mcg/ml. During cardiopulmonary bypass 26·6 ± 9·5 mcg/ml vs 51·7 ± 21 ·1 mcg/ml. Final levels 13·6 ± 7·0 mcg/ml vs 32·2 ± 17·8 mcg/ml. Baseline levels 2·7 ± 2·3 mcg/ml vs 6·· ± 7·7 mcg/ml and peak level 44·0 ± 16·2 mcg/ml vs 51·2 ± 23·4 mcg/ml (NS). The results of this study demonstrate that cefazolin achieved significantly higher plasma levels during the different phases of the operation and early postoperative period. Also, cefazolin and cephradine levels are above the minimal inhibitory concentrations for the gram positive and gram negative susceptible bacteria, except for the basal levels obtained by cephradine. The favourable pharmacokinetic characteristics of cefazolin, makes it a good choice for prophylactic use during cardiac surgery.

scholarly journals A comparison of three different gauge Quincke’s spinal needles in patients undergoing elective surgery under spinal anaesthesia: a prospective randomized study

2019 ◽  
Vol 7 (11) ◽  
pp. 4188
Author(s):  
Kiranpreet Kaur ◽  
Suresh K. Singhal ◽  
Anu Mehla
Keyword(s):  
Success Rate ◽  
Spinal Anaesthesia ◽  
Elective Surgery ◽  
Randomized Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Male Patients ◽  
Group 2 ◽  
Traumatic Effect ◽  
Group 1

Background: The present study was conducted to compare three different Quincke’s spinal needles i.e. 23, 25 and 26 gauge in patients undergoing elective surgery under spinal anaesthesia (SA).Methods: The prospective randomized double-blind study was conducted on 150 male patients in the age group of 18-50 yrs., having physical status class I to II, scheduled for elective surgery under SA. Patients were randomly divided into three groups comprising 50 patients each. SA was administered using Quincke’s spinal needles of 23, 25 and 26 gauge in group 1, 2 and 3 respectively. Ease of insertion, number of attempts and time of appearance of CSF and incidence of PDPH was recorded in all the patients.Results: Ease of insertion was graded easy in 98%, 84% and 82% in group 1, 2 and 3 respectively. First attempt success rate was highest in group 1, (98%). Meantime for appearance of CSF beyond hub was maximum in group 3 i.e. 14.60±2.56 sec. Mild PDPH was reported in 6% and 2% patients after 24 hrs in group 1 and group 2 respectively.Conclusions: Finer spinal needle proved to be more dependable in generating less traumatic effect on the dura and preventing PDPH but are technically more difficult thus decreasing first attempt success rate.

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