ABSTRACT
Postoperatively, early enteral feeding has been associated with I-educed protein-store depletion, improved wound healing, and a positive psychological impact, resulting in faster recovery. Thus, early oral feeding after abdominal surgery has been the goal of surgeons for several decades. To evaluate the safety and efficacy of early oral feeding as compared with those placed on a delayed feeding schedule in patients undergoing abdominal hysterectomy. This was a prospective randomized study of 80 women who were undergoing abdominal hysterectomy. They were enrolled in a randomized controlled trial and compared with delayed postoperative oral feeding. Women were divided in two groups. Patients in the early feeding group received oral diet within 6-8 hours of surgery, but those in the control group were given nothing by mouth for 18- 24 hours. They were given clear liquids, and were advanced to solid food on the second or third postoperative day. We reviewed the gastrointestinal outcomes and hospital stays eighty women were studied, with assigned 40 versus 40 to each group. Two groups were similar in age, disease and surgical length. In early-fed patients nausea was more developed [43% versus] 22.4%. p=0.006]. [Despite this, vomiting, abdominal distention, length of post-operative ileus, need of nasogastric tube use was comparable in both groups. Time to development of bowel sound] [1.7 +/- 1.1 days vs 2.2 +/- 1.1 days, p=0.007], time to initiation of solid diet] [1.8 +/- 1.2 days vs. 2.9 +/- 1.4 days, p<0.0001] and hospital stay] [2.3 +/- 1 days vs. 3.9 +/- 1.3 days, p<0.003] were significantly sooner in the early feeding group. Early postoperative feeding in abdominal hysterectomy seems to be safe, well tolerated, and may lead to earlier hospital discharge
ABSTRACT
Metfomin, a biguanide antihyperglycemic drug, has been shown in improvement ovarian function and glucose metabolism in women with polycystic ovary syndrome [PCOS], but results concerning its effects on insulin sensitivity are controversial. Oral contraceptive pills are commonly used in the treatment of PCOS; but like metformin, their influence on insulin sensitivity is not well known. The aim of this study was to compare the clinical improvement between Metformin and Diane in women with polycystic ovary syndrome. This research was a prospective randomized clinical trial study. We randomized 60 [20-49 years old] women with PCOS either to metformin [500 mg] X3 daily for 6 months or to ethinyl estradiol [35 microg] cyproterone acetate [2 mg] oral contraceptive pills [Diane] for 6 months. This study prolonged for 2 years. Results showed that metformin significantly decreased the waist to hip ratio, body mass index [BMI], serum glucose and insulin concentrations and improved menstrual cyclicily hirsutism score and Insulin sensitivity. Diane decreased hirsutism score and improvement in .the menstrual pattern but slight effect in carbohydrate metabolism and increase serum glucose. Metfomin, probably by way of its effects on adipose tissue, leads to reduction of hyperinsulinemia and concomitant improvement; in the menstrual pattern and clinical manifestation hyperandrogenism and therefore, it offers a useful alternative treatment for anovulatory women with PCOS. Dian slight increased in fasting glucose, BMI and Waist To hip ratio but it is an effective treatment for women with hyperandrogenism and hirsutism