scholarly journals PENGARUH PEMBERIAN ASAM TRANEKSAMAT TERHADAP JUMLAH PERDARAHAN PASCASALIN PADA KELAHIRAN VAGINAL

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Laili Chilmawati ◽  
Heru Pradjatmo ◽  
H.R. Siswosudarmo

PENGARUH PEMBERIAN ASAM TRANEKSAMAT TERHADAP JUMLAH PERDARAHAN PASCASALIN PADA KELAHIRAN VAGINALLaili Chilmawati1 , Heru Pradjatmo2, H.R. Siswosudarmo3 ABSTRACT Background: Maternal mortality is the great problem in developing countries and postpartum hemorrhage is the main cause. Obstetrics intervention and uterotonics agents have been used to control postpartum hemorrhage, but the use of hemostatic agent is still in the study.Objective: To compare the effect of tranexamic acid on postpartum hemorrhage and its potential side effects compared with placebo in vaginal deliveryMethods: A Double blindrandomized controlled Trial (RCT). We conducted a total of 198 subjects who met the inclusion criteria were recruited. The treatment group was those who got one gram tranexamic injection and the the control group those who got placebo. Independent sample t-test, chi-square and linear regression were used for statistical in treatment group analysis.Results and Discussion: A total of 198 subjects met the inclusion criteria, consisting of 99 subjects and 99 in the control group. No significant difference was found on the amount of postpartum hemorrhage (102.13±67.34 ml vs.110.58±73.57 ml;p=0.40), nor on the difference of hemoglobin level (0.99±1.13 g/dLvs.1.05 ± 0.93 g/dLp=0.66), and of hematocrit level (4.06 ± 3.73 vs.4.58±4.18%;p=0.36). The use of other uterotonics gave the significant difference at the decrease of hemoglobin level (p=0,02). Side effect of nausea and vomiting at tranexamic acid group didn’t differ from placebo (p=1,00).Conclusion: There was no difference between the use of tranexamic acid and placebo in terms of number of bleeding the decrease of haemoglobin and hematocrit. Keywords: tranexamic acid; postpartum hemorrhage; hemoglobin and hematocryte level, vaginal delivery. ABSTRAK Latar belakang: Kematian ibu merupakan masalah yang besar di negara sedang berkembang. Perdarahan pascasalin merupakan penyebab paling utama kematian ibu. Intervensi obstetrik dan obat-obat uterotonika telah digunakan secara optimal untuk mengatasi perdarahan pascasalin, tetapi obat hemostatik masih dalam kajian.Tujuan: Mengetahui pengaruh asam traneksamat terhadap jumlah perdarahan pascasalin pada persalinan vaginal dan efek samping yang mungkin terjadi.Metode Penelitian: Metode penelitian ini adalah Randomized Controlled Trial (RCT). Subyek penelitian adalah pasien dengan persalinan vaginal yang memenuhi kriteria inklusi dan eksklusi. Kelompok penelitian adalah mereka yang mendapat injeksi asam traneksamat 1 gram intravena sedang kelompok control adalah mereka yang mendapat plasebo. Independent t-test, chi-square dan regresi linier digunakan untuk analisis statistika.Hasil dan Pembahasan: Sebanyak 198 subyek memenuhi memenuhi kriteria kelayakan, terdiri atas 99 subyek masuk ke dalam kelompok perlakuan dan 99 subyek yang masuk dalam kelompok kontrol. Tidak didapatkan perbedaan secara bermakna pada jumlah perdarahan kala IV (102,13±67,34 ml vs 110,58±73,57 ml, p=0,40), penurunan kadar hemoglobin (0,99±1,13 g/dLvs.1,05±0,93 g/dL, p=0,66) dan penurunan kadar hematokrit (4,06±3,73 vs.4,58±4,18%, p=0,36). Penggunaan uterotonika lain memberikan perbedaan secara signifikan terhadap penurunan kadar hemoglobin (p=0,02). Kadar hemoglobin awal dan kadar hematokrit awal memberikan perbedaan secara signifikan terhadap penurunan kadar hematokrit (p=0,006 dan 0,01). Kejadian efek samping mual dan muntah pada pemberian asam traneksamat tidak berbeda dibandingkan dengan plasebo (p=1,00).Kesimpulan: Jumlah perdarahan kala IV, penurunan kadar hemoglobin dan penurunan kadar hematokrit tidak berbeda antara kelompok yang mendapat asam traneksamat dibanding yang mendapat placebo. Kata kunci: asam traneksamat, perdarahan pascasalin, kadar hemoglobin, hematokrit. 1 PPDS 1 Obstetri dan Ginekologi, Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

2016 ◽  
Vol 5 (1) ◽  
pp. 20-25
Author(s):  
Sofiyetti Sofiyetti ◽  
Edi Dharmana ◽  
M. Zen Rahfiludin ◽  
Nyoman Suci W ◽  
Diana Nur Afifah

Background: Zinc supplementation decrease the risk of malaria parasitaemia, increasing ferritin serum level and hemoglobin in patients with malaria. Zinc influence the activity of aminolevulinic acid dehydratase (ALAD) an enzymes that catalizes heme synthesize. Vitamin B6 in pyridoxal 5-phosphate (PLP) from has a role in alpha-aminolevulinic acid (ALA) formation, which is the precursor of heme in hemoglobin. PLP also inhibit the growth of the malaria parasite.Objective: The objective was to analyze the effect of zinc and vitamin B6 supplementation on hemoglobin level, hematocrit and erythrocyte indexs (MCV, MCH and MCHC) of anemic Plasmodium vivax malaria patients.Methods: Double Blind Randomised Controlled Trial with pre and post test design. 30 subjects were divided into two groups: the suplementation group were given zinc 1x10 mg/day with vitamin B6 1x5 mg/day and the control group were given a placebo for 30 days. Data analysis by paired t-test, independent t-test and Mann Whitney.Results: There was an increase in Hb levels in the suplementation group (p=0.0001), the control group (p=0.001) and there was a significant difference on the increase between the two groups (p=0.020). Hematocrit significant increase only in the suplementation group (p=0.0001). There were no differences on erythrocyte index parameter in both groups.Conclusion: Zinc and vitamin B6 supplementation of for 30 days increase the hemoglobin level, hematocrit and there were no effect on erythrocyte indexs of anemic Plasmodium vivax malaria patients.


Author(s):  
Muhammad Kashif ◽  
Nosheen Manzoor ◽  
Rimsha Safdar ◽  
Hafsa Khan ◽  
Maryam Farooq ◽  
...  

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.


PEDIATRICS ◽  
1964 ◽  
Vol 34 (4) ◽  
pp. 558-562
Author(s):  
ROBERT MCDONALD ◽  
SHEILA R. MARSHALL

As doubt had been cast upon the reputed efficacy of iron in the treatment of pica, a double blind controlled trial was carried out in an endeavor to establish a firmer conclusion in the matter. One group of children received intramuscular iron and a control group of equal mean age were given intramuscular injections of normal saline. Three to 4 months later nearly all of those given iron had lost their pica, but it was still present in three-quarters of the controls. After 5 to 6 months there was no significant difference between the two groups and this failure of maintenance of cure may have been related to a fall in mean hemoglobin level which occurred. Five children who initially received saline and in whom pica was still present were given iron at 6 months and all lost their pica. Our experience is that pica can be cured by iron in nearly all cases, but that permanent cure may be dependent upon the maintenance of adequate hemoglobin levels.


2020 ◽  
Author(s):  
Saeideh Shahsavari ◽  
Sakineh dadipoor ◽  
Mohtasham Ghaffari ◽  
Ali Safari-Moradabadi

Abstract Background: The aim of the present study was to assess readiness to become or stay physically active according to the Stages of Change Model.Methods: The present quasi-experimental study was conducted on 100 women working in the healthcare centres of Bandar Abbas, Iran. The sampling method is clustering in type. The subjects were assigned into two groups of intervention and control. The collected data were analysed by SPSS-16 software using descriptive and inferential statistics, including independent-sample t-test, paired-sample t-test and Chi-square test.Results: Before the educational intervention, 19 subjects (0.38%) from the intervention group showed to have regular physical activity (4-5 stages). This number changed to 29 (0.58%) and 25 (0.50%) after three months and six months of intervention. A statistically significant difference was found before the intervention and 3 and 6 months afterwards (P˂.001). In the control group, no statistically significant difference was found between the pre-intervention and post-intervention (three months (P=.351) and six months (P=.687).Conclusion: The educational intervention based on the stages of behaviour change model showed to be effective in promoting the physical activity of employed women. These findings may benefit health education researchers and practitioners who tend to develop innovative theory-based interventions and strategies to increase the level of physical activity in women.


2019 ◽  
Vol 133 (12) ◽  
pp. 1033-1037 ◽  
Author(s):  
A Das ◽  
S Mitra ◽  
D Ghosh ◽  
S Kumar ◽  
A Sengupta

AbstractObjectiveTo assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.MethodsFifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.ResultsThe Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.ConclusionTranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Jing-Hao Zhang ◽  
Chao Zheng ◽  
Xiao-Jun Zhu ◽  
Xin Zhang ◽  
Zhi-Jun Hou ◽  
...  

Objective. To ascertain the efficacy and safety of Ganji Formulation (GF) for patients with Hepatocellular carcinoma (HCC) who had undergone surgery. Materials and Methods. A total of 262 HCC patients who had undergone liver resection, local ablation, or transcatheter arterial chemoembolization (TACE) were divided randomly into the treatment group and control group. The former was treated with GF and the later with placebo, both for 6 months. The primary endpoint was overall survival (OS). Second endpoints were disease-free survival (DFS) or time to disease progression (TTP). Results. OS of the treatment group was significantly longer than that of the control group (P < 0.05). Subgroup analysis showed that, for patients who received TACE, the TTP was significantly longer in the treatment group than in the control group (P < 0.05). However, for patients who underwent liver resection or local ablation, there was no significant difference in DFS between the two groups (P > 0.05). Conclusion. GF could improve postoperative cumulative survival and prolong the TTP. This clinical trial number is registered with ChiCTR-IOR-15007349.


2016 ◽  
Vol 8 (11) ◽  
pp. 11 ◽  
Author(s):  
Mahbobeh Sajadi ◽  
Mozhgan Bagheri ◽  
Davood Hekmatpou ◽  
Hamid Borsi

<p><strong>INTRODUCTION:</strong> Asthma is a prevalent disease with a multitude of complication. The present research was aimed at investigating the effects of implementing sensitization care model on medication adherence in asthmatic patients.</p><p><strong>METHODS &amp; MATERIALS:</strong> In this interventional study, 74 subjects were selected using accessibility sampling method and were randomly classified into 2 separate groups, intervention (37 subjects) and control group (37 subjects). Data were collected with questionnaire. A month later, the subjects in both groups (control and intervention) completed questionnaire again. The collected data were analyzed using SPSS software, Independent t-test, Paired t-test and Chi-Square.</p><p><strong>RESULTS:</strong> Data analysis showed that the average age of participants was 41 years (range 21-83). The most and lowest frequencies of marital status in both sexes were 66.2% married and 33.8% single, respectively. There was no significant difference before intervention between two groups. However, after the intervention, there was a significant difference between the two groups (P=0.0001).</p><p><strong>DISCUSSION:</strong> The results of the present study showed that implementing sensitization care model had a positive effect on medication adherence among asthmatic patients. Therefore, application of this model is recommended to care and treatment asthmatic patients.</p>


2018 ◽  
Vol 4 (2) ◽  
pp. 83-90
Author(s):  
I Gusti Agung Tresna Wicaksana ◽  
Teguh Wahju S ◽  
Rinik Eko K ◽  
Putu Yudara S

Background: Panti werdha in Indonesia is considered as a nursing home for elderly. However, there are still psychosocial problems occur such as loneliness, sadness, and anxiety disorders. Acceptance and Commitment Therapy (ACT) may be able to solve psychosocial problems especially for anxiety.Objective: To analyze the extent of ACT's influence on the level of anxiety of the elderly living in the PSTW Bali.Methods: This study was a quasi-experimental study with pretest posttest with control group. Sixty elderly were recruited and divided into control and treatment groups with 30 samples of each group. Paired and Independent T-test were used for data analysis.Results: The paired T-test results in the control group showed significant differences of anxiety score between pretest and posttest after given generalist therapy (p 0.05). The result of paired T-test in the treatment group showed that there was a significant difference of anxiety score between pretest and posttest after given general and ACT therapy (p 0.05). The independent T-test showed that there was a significant difference of anxiety score between control group and treatment group (p 0.05).Conclusion: ACT psychotherapy is effective in decreasing anxiety in elderly who are living in PSTW Bali. 


2021 ◽  
Vol 21 ◽  
pp. e226341
Author(s):  
Moses Okechukwu Azouru ◽  
Modupe Olufunmilayo Ashiwaju ◽  
Augustine Edomwonyi ◽  
Afolabi Oyapero ◽  
Bola Obisesan ◽  
...  

Treatment of dental caries in children still remains challenging due to lack of cooperation with conventional treatment modalities. Recently, the use of Silver Diamine Fluoride (SDF) has proved useful in addressing this challenge. Aim: This clinical trial aimed to evaluate the effectiveness of Silver Diamine Fluoride (SDF) in arresting caries in children in Lagos, Nigeria. Methods: This was a phase III balanced randomized controlled school based interventional study on 240 children. The study group was treated with SDF while GIC was used in the control group. Follow up visits in 2 weeks, 1 month, and 3 months were carried out to assess the treatment outcome. Inferential statistics with the use of Pearson Chi-square test and Independent Student t-test were used at 5% level of significance. Results: There was significant relationship between SDF and caries arrest in 2 weeks, 1 month and 3 months’ assessment period (p = 0.001). The control group showed continuous decline (71.7%, 54.3% and 50.9%) in restorative success from 2 weeks to 3 months respectively. The mean ± SD and Confidence Interval (CI) of arrested caries in the SDF group were 113± 1.24 and 113.1 – 113.5 respectively. In the control group the mean ± SD and CI of restorative success were 69.3±11.8 and 67.2 – 71.4. The effect size was 5.24. Conclusion: The result of the study showed that SDF was effective in arresting caries in children without any harm and there was statistically significant difference in the use of 38% SDF in arresting caries in children.


2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Desi Sarli ◽  
Masrul Masrul ◽  
Meilinda Agus

Abstrak Upaya penanganan perdarahan postpartum adalah dengan pemberian oksitosin yang mempunyai peranan penting dalam merangsang kontraksi otot polos uterus sehingga perdarahan dapat teratasi.Hormon oksitosin dapat dihasilkan melalui rangsangan pemijatan oksitosin yang akan mempercepat kerja saraf parasimpatis untuk menyampaikan perintah ke hipotalamus untuk menghasilkan oksitosin. Tujuan penelitian ini adalah untuk mengetahui pengaruh perbedaan kadar oksitosin melalui pemijatan oksitosin terhadap jumlah perdarahan pada ibu 2 jam postpartum. Penelitian menggunakan desain eksperimen. Penelitian ini dilaksanakan ± 6 bulan dengan jumlah sampel 64 orang. Pengolahan data dilakukan dengan komputerisasi. Data disajikan dalam bentuk distribusi frekuensi dan selanjutnya dilakukan uji independen t-test, uji korelasi dan regresi untuk mengetahui pengaruh hubungan kedua variabel. Hasil penelitian perbedaan kadar oksitosin pada ibu 2 jam postpartum pada kelompok intervensi mempunyai rata-rata kadar oksitosin 47.16 pg/ml dengan standar deviasi 17.583 pg/ml,sedangkan kadar oksitosin  pada kelompokkontrol 29.86 pg/ml dengan standar deviasi 17.532 pg/ml dengan nilai p<0,05.Rata-rata jumlah perdarahan pada kelompok intervensi 175.00 ml dengan standar deviasi 48.894 ml,sedangkan jumlah perdarahan  pada kelompok kontrol 247.06 ml dengan standar deviasi 72.093 ml dengan nilai p<0,05. Hasil uji korelasi didapatkan hubungan kadaroksitosin terhadap jumlah perdarahan menunjukkan hubungan sedang (r=0,482). Hasil uji statistik didapatkan ada perbedaan kadar oksitosin terhadap jumlah perdarahan (p<0,05). Terdapat perbedaan yang bermakna antara kadar oksitosin ibu 2 jam postpartum pada kelompok intervensi dan kelompok kontrol.Terdapat perbedaan yang bermaknaantara jumlah perdarahan ibu 2 jam postpartum pada kelompok intervensi dan kelompok kontrol. Semakin tinggi kadar oksitosin maka jumlah perdarahan semakin sedikit.Kata kunci: Pemijatan oksitosin, oksitosin, jumlah perdarahan 2 jam postpartumAbstract Efforts to handling postpartum hemorrhage is to give oxytocin,which it is an important role in oxytocin stimulates uterine smooth muscle contraction, so that bleeding can be resolved.The hormone oxytocin can be generated through the stimulation of oxytocin massage that will accelerate parasympathetic nerves to deliver commands to the hipotalamus to produce oxytocin. The objective of this study was to determine effect of different levels of oxytocin trough massage of oxytocin on the amount of bleeding at 2 hours postpartum. This research use experimental designthat was conducted ± 6 months to 64 people. Data processing was done by computerized. The data presented in the form of a frequency distribution and performed an independen t-test and correlation test and regression to determine the effect ofthe relationship between the two variables. There is differences the levels of oxytocin at 2 hours postpartum in the intervention group had higher median levels of oxytocin 47.16pg/ml with a standard deviation of 17.583pg/ml, whereas the levels ofoxytocin at 2 hours post partum control group 29.86 pg/ml with a standard deviation of 17.532 pg/ml with p<0.05. The average of bleeding in the intervention group was 175.00 ml with a standard deviation of 48.894 ml, while the amount of bleeding at 2 hours postpartum control group 247.06 ml with a standard deviation of 72.093 ml with p<0.05. The results obtained correlation levels of oxytocin relation to 2 hours postpartum hemorrhage showed moderate relationship (r =0.482). The results of statistical tests found differences in the levels of oxytocin on the amount of bleeding at 2 hours postpartum (p<0.05). There is differences between the levels of oxytocin 2 hours pos partum in the intervention group and the group control. There are significant difference between the hemorrhage 2 hours post partum in the intervention group and the group of high levels of oxytocin control. Keywords: massage of oxytocin, oxytocin, amount of bleeding at 2 hours postpartum


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