scholarly journals Clinical and Ultrasonographic Evaluation of the Pelvic Floor in Primiparous Women after Normal Vaginal Delivery with Episiotomy and without Episiotomy

2020 ◽  
Vol 7 (1) ◽  
pp. 4-8
Author(s):  
Nora H. K. Elabady ◽  
◽  
Ahmed M. Awara ◽  
Amr M. El-Badry ◽  
Nareman El-Hamamy ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Levator Ani ◽  
Clinical Findings ◽  
University Hospital ◽  
Normal Vaginal Delivery ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Primiparous Women

Objective The aim of this prospective study is clinical and ultrasonographic evaluation of the pelvic floor in primiparous women after normal vaginal delivery with episiotomy and without episiotomy. Methods This is a cross-section study of primiparous women with a history of delivery at Tanta University Hospital from August 2018 to August 2019. The sample power was calculated based on avulsion (major and minor) in two groups (vaginal delivery with episiotomy and without episiotomy) of total forty-primiparous women with an interval after delivery (20 cases after normal vaginal delivery with episiotomy and 20 cases after normal vaginal delivery without episiotomy). Results Twenty-four hours of delivery there was a highly significant difference between group A (with episiotomy) and group B (without episiotomy) regarding to ultrasound abnormalities, degree of tear, blood loss, hemoglobin concentration and clinical findings, while no difference regarding levator ani weakness. Two months later from delivery there was no significant difference between group A and group B regarding to ultrasound abnormalities and levator ani weakness while there was a difference between the two groups in regarding with clinical findings. Conclusion Normal vaginal delivery without episiotomy in primiparous women is better than normal vaginal delivery with episiotomy as there is no perineal tenderness, no dyspareunia. Low incidence of urinary, rectal incontinence, tear and perineal infection.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

scholarly journals Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

2018 ◽  
Vol 7 (3) ◽  
pp. 824 ◽  
Author(s):  
Manoj Kumar Sah ◽  
Saraswati M. Padhye
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Human Reproduction ◽  
Cervical Ripening ◽  
Birth Canal ◽  
Significant Difference ◽  
Group A ◽  
Pass Through ◽  
Group B

Background: The cervix has to play dual role in human reproduction. During pregnancy, it should remain firm and closed allowing the fetus to grow in utero until functional maturity is attained while during labour it should soften and dilate, allowing the fetus to pass through the birth canal. Objective of present study was to know and compare the effect of oral Mifepristone with intracervical dinoprostone gel for cervical priming prior to induction of labour at term in an unfavorable cervix of primigravida.Methods: This was prospective randomized comparative study. 100 primigravid patients were included, 50 were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical dinoprostone gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction. Mode of delivery and induction to delivery interval in both the groups were studied.Results: After induction with Mifepristone 76% women had successful cervical ripening as compared to 56% with dinoprostone. Rate of vaginal delivery was 70% with Mifepristone and 58% with dinoprostone. There was no significant difference in induction to delivery interval between the groups. Ten percent and 2% belonging to mifepristone and dinoprostone group respectively, required NICU admissions.Conclusions: Mifepristone is more effective than dinoprostone for preinduction cervical ripening as it has high success rate of achieving cervical ripening, however there is no significant difference in the vaginal delivery rate and other maternal and fetal outcome.

Safety and feasibility of laparoscopic surgery for colorectal cancer in elderly patients (YSURG1401 study).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 725-725
Author(s):  
Yosuke Atsumi ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Naoto Yamamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Surgical Outcomes ◽  
Operation Time ◽  
University Hospital ◽  
Age Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

725 Background: The safety and feasibility of laparoscopic surgery (LAP) for colorectal cancer has not yet been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAP and evaluate the safety and feasibility of LAP in colorectal cancer patients aged > 75 years. Methods: This retrospective study enrolled consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (≧75 years of age: group A) and non-elderly patients ( < 75 years of age: group B). Surgical outcomes and postoperative complications were compared between the two groups. The severity of complications was evaluated using the Clavien–Dindo classification. Results: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6 % vs 5.2 %, P = 0.751), median operation time (232 min vs 232 min, P = 0.318), median blood loss (20 ml vs 12 ml, P = 0.353). There was no significant difference in the surgical outcomes. Although the incidence of Japanese D3 dissection was significantly lower in Group A (56 % vs 69.3 %, P = 0.047), the incidences of postoperative surgical complications of grade ≧ Ⅱ were similar between two groups (15.5 % vs 11.8 %, p = 0.427). The length of postoperative hospital stay was also similar (10days vs 10days, p = 0.347). Conclusions: The present study suggested that laparoscopic surgery for colorectal cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colorectal cancer surgery.

EXPERT study: Randomized phase III trial of radical surgery and postoperative mFOLFOX6 versus perioperative mFOLFOX6 plus cetuximab in patients with KRAS wild-type resectable colorectal liver metastases (CLMs).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 652-652 ◽  
Author(s):  
Yoshihiro Mise ◽  
Kiyoshi Hasegawa ◽  
Masaru Oba ◽  
Kensei Yamaguchi ◽  
Hiroyuki Uetake ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Medical Information ◽  
Radical Surgery ◽  
University Hospital ◽  
Phase Iii ◽  
Wild Type ◽  
Phase Iii Trial ◽  
Significant Difference ◽  
Group A ◽  
Group B

652 Background: Up-front radical surgery and adjuvant chemotherapy were regarded as one of the standard-of-care (SOC) in patients with resectablecolorectal liver metastases (CLMs), while perioperative chemotherapy plus surgery is also accepted. We conducted a multicenter randomized phase III trial to compare radical surgery and post-operative mFOLFOX6 with peri-operative mFOLFOX6 plus cetuximab in patients with KRAS wild-type resectable CLMs. Methods: Patients who had KRAS wild-type resectable CLMs having one to eight liver nodules without extrahepatic disease, were randomly assigned to groups: Group A (reference), hepatectomy and 12 cycles of post-operative mFOLFOX6: Group B (experimental), six cycles of preoperative mFOLFOX6 plus cetuximab (loading dose with 400mg/m2and thereafter 250mg/m2weekly), hepatectomy and six cycles of postoperative mFOLFOX6 plus cetuximab. Primary endpoint was progression-free survival (PFS). We hypothesized that 3-year PFS in Group B would be 25% with the hazard ratio (HR) being 0.75. Considering 3 year follow-up period with 5% of two-sided alpha error and 80% of power, target number were set as 500 (250 each). Study was registered in the University Hospital Medical Information Network (UMIN000007787). Results: This study was initiated since June 2012. However, the enrollment was terminated according to the recommendation from the monitoring committee on 2015 due to a slow accrual. A total of 77 patients (Group A 37 vs. Group B 40) were analyzed. Baseline characteristics were well-balanced between groups. Median numbers of liver mets were two each, ranging from one to eight. The HRs for PFS and overall survival (OS) showed no significant difference (PFS, HR = 1.18 [0.69-2.01], p = 0.54: OS, HR = 1.03 [0.46 – 2.29], p = 0.95). There were 3-year PFS of 35% in Group A vs. 30% in Group B, and 3-year OS: 86% vs. 74%, respectively. Conclusions: No additional survival benefits adding on peri-operative cetuximab were indicated, of which findings is consistent with the previous clinical studies, although there were small number of enrolled patients. Clinical trial information: UMIN000007787.

scholarly journals Outcome of thyroid lobectomies undergone with and without drains

2020 ◽  
Vol 8 (8) ◽  
pp. 2919
Author(s):  
Sahrish Bachani ◽  
Shahid N. Memon ◽  
Muhammad R. Pathan ◽  
Rehmat Sehrish Shah ◽  
Aneeta Kumari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Pain Score ◽  
Thyroid Nodules ◽  
University Hospital ◽  
P Value ◽  
Thyroid Lobectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.

Assessment of Omentin- 1 AS AN Adipokine in obese male and females with and without fatty liver disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Ali Marei Makhlouf ◽  
Gina Gamal ◽  
Ahmad Magdy ◽  
Amal Muatafa Ali Mustafa Eid
Keyword(s):  
Fatty Liver ◽  
Protective Factor ◽  
University Hospital ◽  
Significant Difference ◽  
Hospital Patients ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
Obese Male ◽  
Control Study

Abstract Background Omentin-1 (intelectin-1) “a new adipokine described in 2003,” acts centrally to modulate the insulin resistance, body weight, and inflammation. However, its role in the liver pathogenesis and in the metabolic consequences of the liver disorders is not fully elucidated. Aim and objectives the aim of the study was to assess the relation of serum omentin1 with fatty liver in obese and non-obese Subjects and methods This was a comparative case control study was conducted at Ain Shams university hospital. Patients were divided in to two group: Group1: 40 patient 20 patient with fatty liver 10 of them obese and 10 non-obese compared with 20 not have fatty live 10obese and 10 non-obese, group 2. The duration of the study ranges from 6-12 months. Results There was statistically significant difference between the four studied subgroups as regard Omentin1 and Apelin. There was statistically significant difference between group A and group B in obese as regard Omentin1 and Apelin. Conclusion Omentin-1 might be considered as a protective factor in the evaluation of occurrence of NAFLD, especially in central obese patients. Thus, the measurement of these novel adipokines may contribute to the evaluation of NAFLD occurrence.

scholarly journals Comparison of Misoprostol With Tranexamic Acid in Preventing Post-Partum Hemorrhage

2021 ◽  
Vol 15 (5) ◽  
pp. 914-916
Author(s):  
Maryam Matloob ◽  
Zille Hyder Syed ◽  
Rubina Qasim ◽  
Wafa Najeeb
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Controlled Trial ◽  
Normal Vaginal Delivery ◽  
Third Stage ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: To compare the amount of average blood loss in transamine and misoprostol groups in patients undergoing spontaneous vaginal delivery in third stage of labour. Method: We conducted the randomized controlled trial from July 26th 2016 to 25th of January 2017. Results: In my study the mean age of the patients undergoing normal vaginal delivery was 28.47 years, parity wise, 31%, 33%, 24% and 11% of participants were para 1, para 2, para 3 and para 4 respectively. Mean blood loss in group A was 224.08 +/- 20.81mls and in group B 331 +/- 398 mls. Conclusion: This study has demonstrated that the blood loss in transamine group (group A) is less than the mean blood loss in misoprostol group (group B). Keywords: Transamine, misoprostol, normal vaginal delivery

scholarly journals Comparative study between transcervical extra-amniotic Foley’s bulb and prostaglandin E2 gel for pre-induction cervical ripening

2020 ◽  
Vol 10 (1) ◽  
pp. 119
Author(s):  
Prajakta Goswami ◽  
Kapil Annaldewar ◽  
Deepali Giri ◽  
Sachin Giri
Keyword(s):  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Normal Vaginal Delivery ◽  
Bishop Score ◽  
Group A ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labor is an artificial initiation of uterine activity before the spontaneous onset of labor with the aim of achieving vaginal delivery. Various pharmacological and non-pharmacological methods have been studied for the purpose.Methods: This randomized prospective study conducted in the Department of Obstetrics and Gynaecology at the Seth V. C. Gandhi & M. A. Vora Municipal General Hospital (Rajawadi Hospital), Mumbai from June 2019 to April 2020. It included pregnant patients admitted to the labor ward for induction of labor. A total 200 women were recruited and randomly allocated to the two study groups fulfilling the following selection criteria. Of these, 100 women were included in Foley's catheter group (group A) and 100 in (group B) prostaglandin E2 (PGE2) group.  Results: The subjects included mainly were of 24-28 years age group. The period of gestation was 37-42 weeks in majority of the women in both the groups. Maximum numbers of women in both groups were primigravidae, being 66% in group A and 70% in group B. Foley catheter proved to be a highly effective pre-induction ripening agent for unfavorable cervix, compared to PGE2 gel, as evident by the mean Bishop score at 12 hours (p<0.05) and by the difference in change of Bishop score over 12 hours (p<0.05) in both groups A and B. Women in both the groups had a high rate of normal vaginal delivery, rate being significantly more in Foley’s group.Conclusions: This study concludes that extra-amniotic Foley’s catheter balloon is an effective, safe, simple, low cost, reversible, non-pharmacological mechanical method of pre-induction cervical ripening.

scholarly journals INDUCTION OF LABOUR

2015 ◽  
Vol 22 (04) ◽  
pp. 385-389
Author(s):  
Munawar Afzal ◽  
Uzma Asif ◽  
Bushra Miraj
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
P Value ◽  
Lower Segment Cesarean Section ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Present Pregnancy

It is now widely accepted that trial for vaginal delivery should be attempted unlessa genuine indication exists for C- section. Objective: To determine the efficacy of membranesweeping for onset of labor till 41 weeks of gestation and mode of delivery in patients withprevious one cesarean section (C-Section). Study Design: Randomized control trial. Setting:Department of Obstetrics & Gynaecology, Benazir Bhutto hospital, Rawalpindi. Period: Jan2008 to Dec 2008. Methods: Pregnant women with previous one C- section were randomlyallocated to Group-A (sweeping of membrane) and Group-B (no intervention) each having 55patients. There was no absolute indication of cesarean section in present pregnancy. Aftercomplete antenatal examination, tests like CBC, urine DR, BSR, urea, creatitnine, screening forhepatitis B and C were done. In group A, digital sweeping of fetal membranes was started a37 weeks and was done every 3rd day till she went into the labor or she reached 41 weeks. At41 weeks of gestation, if she did not go into labor, induction with prostaglandin or elective Csectionwas done depending upon the bishop score. In group B, patients awaited spontaneousonset of labor till 41 weeks. After 41 weeks induction with prostaglandin or elective C- cesareansection was done. Results: In Group A, 43 (78.18%) patients had onset of labour aftersweeping of membranes while 12 (21.82%) patients had no onset of labour. In Group-B, 28patients (50.90%) had spontaneous onset of labor while 27 (49.10%) had no onset of labours.In Group-A, 34 (61.82%) patients and in Group-B only 14 (25.45%) were delivered vaginally (pValue 0.001). In Group-A, lower segment cesarean section was done in 6 (10.91%) patientswhile in Group-B, 23 (41.82%) had cesarean section (p Value 0.001). Assisted vaginal deliverywas done in 15 (27.27%) in Group-A while 18 (32.73%) patients in Group-B had assistedvaginal delivery (p Value 0.533). Conclusions: In patients with previous one cesarean section,the efficacy of membrane sweeping in terms of onset of labor and normal vaginal delivery issignificantly higher as compared to patients who had no sweeping of membranes.

scholarly journals Monitoring of labor with WHO modified partogram – A study report

2014 ◽  
Vol 3 (2) ◽  
pp. 8-11 ◽  
Author(s):  
Md Alauddin ◽  
Runa Bal ◽  
Arunangsu De ◽  
Parthajit Mondal ◽  
Mayoukh Chakraborty
Keyword(s):  
Vaginal Delivery ◽  
World Health Organisation ◽  
World Health ◽  
Cesarean Sections ◽  
Significant Difference ◽  
Group A ◽  
Live Fetus ◽  
Group B ◽  
Comparison Of The Results ◽  
Vertex Presentation

Introduction: Partogram represents labor events. World Health Organisation (WHO) had produced a partogram in the last decade and subsequently modified it to make it easier to use. The present study was conducted to note the effectiveness of the WHO modified partogram. Methods: Altogether 430 primigravida women, at term, having single live fetus in vertex presentation, were included for the study. The women were randomly subdivided into three groups: Group A (180 women) - monitoring of labor done by WHO modified partogram; Group B (150 women)- monitoring of labor done by WHO original partogram and 100 women in Group C (control), the labor would be monitored clinically. The results were noted in each group regarding the length of labor, vaginal delivery, cesarean sections, augmentation of labor etc. The results of Group A were compared with Group B and Group C. Result: The comparison of the results of the Group A and Group B did not reveal any statistically significant difference. The comparison of the results of the Group A and Group C observed that significantly less number of women in Group A (4.44%) was in labor for more than 12 hours than in Group C (18%). The number of vaginal delivery was more and cesarean section was less in Group A than Group C (p < 0.05). More number of women required augmentation of labor in Group C (p<0.001). Conclusion: WHO modified partogram, which is easier to use, gives almost the same effects as the WHO original partogram but significantly better results than clinical monitoring. DOI: http://dx.doi.org/10.3126/njog.v3i2.10824 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 8-11

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