scholarly journals The impact of uterine artery embolisation on fibroid volume at 43.6 months in women with symptomatic fibroids at a tertiary-level hospital

2017 ◽  
Vol 23 (3) ◽  
pp. 97
Author(s):  
R T Mogakane ◽  
Z Abdool ◽  
S Ahmad ◽  
H M Swanepoel
2020 ◽  
Vol 27 (5) ◽  
pp. 114-127
Author(s):  
Z. U. Archegova ◽  
N. K. Kasum-zade ◽  
R. I. Shalina

Background. Uterine fi broids is a highly prevalent gynaecological disease affecting 30–35% of reproductive age women and twice as many beyond this age, according to various sources. Uterine fi broids are diagnosed in 25–27% of infertile women. According to the American Society of Reproductive Medicine, this disease causes infertility in 2–3% of the cases.Objectives. A prognostic assessment of recovering fertility after treatment for uterine fi broids, outlining a comprehensive strategy for successful in vitro fertilisation after variant organ-preserving treatment for uterine fi broids.Мethods. Publication records were mined in the PubMed, Elibrary, Web of science and Cyberleninca databases under the search depth of 7 years. The query terms were: uterine fi broids, in vitro fertilisation, myomectomy, uterine artery embolisation, myomectomy and pregnancy, uterine artery embolisation and pregnancy, uterine fi broids and in vitro fertilisation.Results. We analysed 105 records and selected 32 for review. Many sources suggest that the putative pathogenetic mechanisms of a reduced in vitro fertilisation success in uterine fi broids comprise: abnormal circulation and receptor apparatus; abnormal uterine blood fl ow, venous stasis, vascular changes; local infl ammation; abnormal endometrial morphology, distortions of the uterine cavity with submucosal and large interstitial fi broids, continuity between endometrium and myometrium, subendometrial thickening; local nodal oestrogen/progesterone imbalance. Clinical data on the impact of uterine fi broids in assisted reproductive technology trials are multitude but ambiguous. Submucosal and intramural fi broids distorting the uterine cavity are commonly considered for resection due to their signifi cant negative impact on the pregnancy success rate with assisted reproductive strategies.Conclusion. Uterine fi broids pose an acute persistent challenge in gynaecology and reproductive medicine aggravated by the lack of a unifi ed strategy for patient management and reproductive life planning. Various aspects of the uterine blood fl ow diagnosis, treatment for uterine fi broids, pregravid preparation, long-term management of in vitro fertilisation protocols and pregnancy in this pathology require further detailed studies.


2020 ◽  
Vol 18 (1) ◽  
pp. 52-55
Author(s):  
Anil Kumar Das ◽  
Upama Paudel ◽  
Navjot Brar ◽  
Ashish Karn

Introduction: Most healthcare providers recognize that urticaria is frequently difficult to treat but many do not realize the substantial negative impact, chronic urticarial (CU) has on patient’s quality of life (QoL). The questionnaire specifically developed to measure health related quality of life in chronic urticaria is the Chronic Urticaria Quality of Life (CU-Q2oL) questionnaire. This questionnaire has helped to define the effects and impact on patients. Objective: To assess the impact of chronic urticaria on quality of life at tertiary level hospital in Nepal. Materials and Methods: This was a hospital based cross-sectional study conducted in the Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal, over a period of one year involving 230 patients in the study. A detailed history along with the complete cutaneous examination was carried out in all patients. Results: All the 230 patients (100%) had symptoms of wheals and pruritus while eye swelling and lip swelling was present only in 20% and 25% respectively. Highest Mean scores were seen of pruritus (4.34) and wheals (4.29). Highest mean score was achieved by domain of pruritus (4.31) followed by domain of sleep (2.31), life activities (2.22), limits (2.05), looks (1.76) and swelling (1.4). Conclusion: Chronic Urticaria impacts the quality of life by affecting various aspects in patient’s life. CU-Q2oL questionnaire could reveal the involvement of various such aspects, which were seldom realized by the patients themselves. Patients had worst quality of life with symptoms of pruritus and wheals.


2020 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Farzana Sharmin Pamela Islam

As 21st century is the era of modern technologies with different aspects, it offers us to make the best use of them. After tape recorder and overhead projector (OHP), multimedia has become an important part of language classroom facilities for its unique and effective application in delivering and learning lesson. Although in many parts of Bangladesh, a South Asian developing country, where English enjoys the status of a foreign language, the use of multimedia in teaching and learning is viewed as a matter of luxury. However, nowadays the usefulness and the necessity of it are well recognized by the academics as well as the government. The study aims to focus on the difference between a traditional classroom void of multimedia and multimedia equipped classrooms at university level by explaining how multimedia support the students with enhanced opportunity to interact with diverse texts that give them more in-depth comprehension of the subject. It also focuses on audio-visual advantage of multimedia on the students’ English language learning. The study has followed a qualitative method to get an in-depth understanding of the impact of using multimedia in an English language classroom at tertiary level. For this purpose, the data have been collected from two different sources. Firstly, from students’ written response to  an open ended question as to their comparative experience of learning  lessons with and without multimedia facilities; and secondly, through  observation of English language classes at a private university of Dhaka, the capital city of Bangladesh. The discussion of the study is limited to  the use of multimedia in English language classroom using cartoons, images and music with a view to enhance students’ skills in academic writing, critical analysis of image and critical appreciation of music. For this purpose, cartoons in English language, images from Google and music from You Tube have got focused discussion in this paper.


2019 ◽  
Vol 31 (2) ◽  
pp. 131

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.


Author(s):  
MSI Tipu Chowdhury ◽  
Khaled Md. Iqbal ◽  
Zahidul Mostafa ◽  
Md. Fakhrul Islam Khaled ◽  
Sadia Sultana ◽  
...  

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098821
Author(s):  
Md Kamrul Ahsan ◽  
Md Sariful Hasan ◽  
Md Shahidul Islam Khan ◽  
Najmus Sakeb

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.


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