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Background: Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labor and prevent prolonged labor. Objective: To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labor in primigravida's. Methods: A double-blind, placebo-controlled randomized trial of 246 primigravida's in active phase of labor at term was conducted. They were randomly (1:1 ratio) administered intravenous 2 ml (40mg) of drotaverine hydrochloride or 2 ml of Vitamin B complex as placebo. The primary outcome measure was the duration of active phase of labor. The secondary outcome measures were cervical dilatation rate, oxytocin augmentation rate, incidence of prolonged labor, labor pain scores, mode of delivery, maternal and neonatal outcomes. Results: The mean duration of active phase of labor (hour) was significantly lower in the drotaverine group compared to the control (drotaverine; 6.22 ± 2.41 vs placebo; 8.33 ± 3.56; p <0.001). Also, the cervical dilatation rate (cm/hr) was significantly faster in the drotaverine arm (drotaverine; 1.68 ± 1.02 versus placebo; 1.06 ± 0.53, p <0.001). There was a significantly higher probability of faster delivery among women who were given drotaverine (log-rank test, p < 0.001). The oxytocin augmentation rate, incidence of prolonged labor, labor pain scores, mode of delivery, maternal and neonatal outcomes were not significantly different among the groups. Conclusions: Drotaverine hydrochloride is effective in shortening the duration of active phase of labor without adverse maternal and neonatal outcomes. However, more evidence is needed to explore its role in active phase of labor among primigravid women. Trial registration number: PACTR201810902005232
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Parasympatholytics , Placebos , Clinical Laboratory Techniques , Duration of Therapy , Telomere Shortening , NigeriaABSTRACT
This article discusses the definition of the indeterminate phase of chronic hepatitis B and summarizes the proportion of patients in the indeterminate phase of chronic hepatitis B among patients with chronic HBV infection, as well as their risk of hepatocellular carcinoma and related treatment recommendations.
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Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.
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Introduction: The modified WHO partograph is aninexpensive but valuable tool that provides a continuouspictorial overview of progress of labor. It helps to detectany deviance from normal progress of labor. It guides theobstetrician to decide about the need for early diagnosis ofcomplications like prolonged labour and timely intervention.Study objectives were to study the course of normal andabnormal labour, to evaluate the fetomaternal outcome and tostudy abnormalities of active phase of labour.Material and Methods: A prospective observational studywas carried out in RIMS labour room over a period of 6months from 1st October 2017 to 31st March 2018. 100Cases admitted in labour room were randomly selected andmonitored using Modified WHO Partograph.” Pregnantwomen with uncomplicated full term pregnancies (37-40weeks) with vertex presentation in labour were included andwomen with medical complications like anemia, pregnancyinduced hypertension, gestational diabetes, Abnormal lie orpresentation, diagnosed cases of CPD were excluded fromthis study. Various parameters like progress of labor, need foraugmentation, mode of delivery, perinatal outcome etc. werestudied.Results: Out of 100 women, 83 delivered vaginally without anyoperative intervention, out of which 20 cases (24%) requiredaugmentation with oxytocin, diue to inadequate uterinecontractions. Instrumental delivery rate was 02 percent. Thecaesarean section rate was 15 percent. Commonest indicationfor caesarean section was fetal distress. (9 out of 15 caesareansections accounting for 60%).Conclusion: From the observations of the present study,we conclude that routine use of partogram during labourmanagement help in early detection of deviation from normalprogress of labour, guiding timely intervention.
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Objective:To observe clinical efficacy of Taohua Tang and Buzhong Yiqi Tang on Crohn's disease (CD) at active phase (deficiency-cold in spleen and stomach), in order to observed its effect on Th1 and Th17 cytokines. Method:According to random number table, 86 patients with CD were divided into control group (42 cases) and observation group (44 cases). The control group (mild) was given SASP, 3-4 g·d-1, Po, tid. The control group (moderate or poor efficacy of SASP) was given prednisone acetate, 0.75 mg·kg-1·d-1, Po, tid. Observation group was given Taohua Tang and Buzhong Yiqi Tang in addition to therapy of the control group, 1 dose·d-1. The course of treatment was 12 weeks. Before and after treatment, Best CDAI, SES-CD, IBDQ and deficiency syndrome were scored, and levels of CRP, ESR, ALB, HB, PLT, IFN-γ, TNF-α, IL-2 and IL-17 were measured before and after treatment. Result:After treatment, the effect of traditional Chinese medicine(TCM) syndromes in the observation group was better than that in the control group (Z=2.058, PPPPZ=2.112, PZ=2.288, PPPγ, TNF-α, IL-2 and IL-17 levels in the observation group were lower than those in the control group (PConclusion:In addition to the therapy of conventional western medicine, Taohua Tang and Buzhong Yiqi Tang in treatment of deficiency syndrome of Crohn's disease (CD) can control the activity degree of the disease, reduce the degree of illness and inflammation, and improve the remission rate and the quality of life, with a better clinical efficacy than the pure western medicine therapy.
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Background: The management of labour and its complication is an issue of great importance worldwide. Still it is unclear from available information that when to admit a Women in labour in order to achieve maximum maternal and fetal benefit. The present study was an attempt to assess how the outcome of woman changed with timing of admission either in active or latent phase of spontaneous labour in a tertiary care hospital. Aim: 1) To determine and compare the rate of intervention among low risk women admitted in latent and active phase of labour. 2) To determine and compare the rate of complications among them. 3) To determine and compare the foetal APGAR Scores and admission to NICU. Methods: It’s a cross-sectional observational study, conducted at NIMS Hospital, Jaipur from a period between October 2015 to July 2016 with Sample Size of 180 low risk term women presenting during latent or active phase of labour. Result: Out of 180 patients, 96 patients (53.3%)were admitted during latent phase (group I) and 84 patients (46.7%) during active phase of labour (group II). Duration of labour was significantly greater in-group I compared to group II (mean± SD 17.0 ± 2.1 vs 12.7 ± 3.2). Caesarean was more in group I compared to group II (62.5% vs 28.5%) which was significant. Most common indication of caesarean was dystocia followed by fetal distress. Augmentation with oxytocin was required in 66 cases (68.75%) in group I and 42 cases (50.0%) in group II and the difference was not significant. Although PPH, cervical and perineal tear,fetal distress was more in group I but the difference was insignificant.
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[Objective]Discussion on academic ideas and clinical experience of Professor XIE Jingri in treatment of ulcerative colitis(active phase). [Method] From the disease affiliation, etiology and pathogenesis,syndrome differentiation, clinical adding and subtracting, disease aftercare to expound the academic viewpoints and clinical experience of Prpfessor XIE Jingri in treating ulcerative colitis(active phase), summarize his prescription regularity and treatment characteristics,and put an example to exemplify that.[Results]Professor XIE Jingri thinks that spleen deficiency is its fundamental pathogenesis,dampness-heat is the key factor of attack, the liver is closely related to the lung, spleen and large intestine,it could adjust the emotions and circulation of Qi, blood and body fluid.Therefore,we shuold take the method of strengthening spleen and nourishing Qi and dampness-heat clearing simultaneously as basic therapy, and pay more attention to the treatment lying in regulating the liver, use the method of regulating qi activity and activating circulation to remove blood stasis, focus on disease aftercare at the same time,the clinical therapeutic effect is satisfied.[Conclusion]The clinical experience of Professor XIE Jingri in treatment of ulcerative colitis(active phase) could effectively alleviate symptoms and reduce relapse rate,it is worth to be summarized and popularized.
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Objective To evaluate the clinical effect and safety of intravenous administration of phloroglucinol combined with delivery of ball-assisted free position in parturient women during labor.Methods One hundred and fifty-two primiparous women who were treated by vaginal delivery from June 2015 to August 2016 in Beijing Navy General Hospital were selected as the study subjects.They were given 80 mg of phloroglucinol diluted in saline injection intravenous injection.Observation group were treated with childbirth.Control group treated with traditional supine or lateral body.Results The rate of descending of the observed group was longer than that of the control group((1.09±0.22) cm/h vs.(0.83±0.15) cm/h),the first labor time,the second labor time and the total labor time of the observation group were shorter than the control group((9.57±1.71) h vs.(12.13±2.64) h,(35.75±8.68) min vs.(61.21±10.03) min,(11.34±1.96) h vs.(14.66±2.70) h),the difference between the two groups was statistically significant(t=3.611,4.204,3.307,3.456,P0.05).The percentage of vaginal delivery in the observation group was 89.47%(68/76),significantly higher than that in the control group(73.68%(56/76)),the difference was statistically significant(χ2=4.514,P<0.05).The incidence of vaginal midwifery was 1.32%(1/76) and that of cesarean section was 9.21%(7/76) of observation group,significantly lower than that in control group(5.26%(4/76),21.05% (16/76)),the difference was statistically significant(χ2=5.323,4.376,P<0.05).Observation group 24 h postpartum hemorrhage was (273.12±58.23) ml,significantly less than the control group((385.42±70.13) ml),the difference between the two groups was statistically significant(t=3.744,P<0.05).The observation group had postpartum hemorrhage of 1.32%(1/76),urinary retention of 2.63%(2/76),and the percentage of neonatal asphyxia of 2.63%(2/76),were lower than that of the control group(5.26%(4/76),10.53%(8/76),9.21%(7/76)),the difference between the two groups was statistically significant(χ2=4.103,4.925,4.421,P<0.05).Conclusion The delivery of ball-assisted free-body delivery in active stage of delivery can promote natural childbirth.The medical staff should update the concept of delivery and raise awareness to encourage the use of phloroglucinol combined with free-body delivery.
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Objective To investigate the effect of Doula delivery ball apparatus combined with correct occipitoposterior.Methods Four hundred primiparas whose dilatation of cervix of 3 cm and position of foetus was occipitopostenor position, were randomly divided into observation group and control group according their wishes, and each group of 200 cases.Doula delivery ball was used for the observation group,while the free body position, the traditional delivery mode was the control group.The vaginal delivery rate, degree of pain, postpartum 2 h bleeding volume and neonatal asphyxia rate were compared between the two groups.Results The degree of pain Ⅲ degree was 4.0％ (8/200) ,lower than the control group(50.0％ (100/200), x2 =11.55,P＜0.01).The vaginal delivery rate in observation group was 84.5％ (169/200), higher than that in control group (60.5％ (121/200);x2 =28.905,P=0.001).Postpartum 2H bleeding was (156.3±53.2) ml, lower than the control group((268.1±54.6) ml, t =20.70, P＜0.01).The Postpartum bleeding rate was 0.5％ (1/200), lower than that in control group (4.0％ (8/200) ,P =0.018).Conclusion Doula delivery ball is applied to the first active stage of labor can effectively relieve pain, promote the safety of natural childbirth.
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OBJECTIVE:To investigate the effects of anisodamine combined with oxytocin on labor process of lying-in women with prolonged active phase in the first labor process and related indicators of newborns. METHODS:216 lying-in women with pro-longed active phase in the first labor process were randomly divided into control group(108 cases)and observation group(108 cas-es). All lying-in women were artificially ruptured,based on it,control group was given 2.5 u Oxytocin for injection,adding into 500 ml 5% Glucose injection by intravenous infusion,the drip rate was appropriately adjusted based on contractions;observation group was additionally given 10 mg raceanisodamine hydrochloride,adding into 10 ml 5% Glucose injection by intravenous infu-sion by 5 min slow intravenous injection. The fetal heart was warded to closely observe the labor process during medication. The cervical maturity,labor process time,delivery mode and postpartum situation of lying-in women,Apgar score,body mass and inci-dence of adverse reactions of newborn in 2 groups were observed. RESULTS:The lying-in women cases with no less than 9 cervi-cal maturity,natural delivery rate and 5 min newborn Apgar score in observation group were significantly higher than control group, lying-in women cases with 7-9 scores and less than 7 scores,cesarean section rate,perineal/ straight cut rate and 24 h postpartum hemorrhage were significantly lower than control group,the second,the third and total labor process were significantly shorter than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Anisodamine combined with oxytocin can accelerate the cervical dilation of lying-in women with pro-longed active phase,shorten labor process,reduce cesarean section rate and improve prognosis,it did not affect the body mass of newborns,with good safety.
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Objective To study the changes of pulmonary function in patients with active rheumatoid arthritis(RA).Methods Sixty patients with active RA were divided into low lung function group and normal lung function group by detecting their pulmonary function.The clinical symptoms and signs,laboratory indicators,health index(HAQ) score,disease activity score(DAS-28) and regulate T-cells(Treg) were observed.Results In 60 patients with active RA,42 cases(70%) were lower lung function and 18 cases(30%) were normal lung function.Compared with normal lung function group,Hb of low lung function group significantly lowered(P
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Objective To investigate the feature and the safety of birth process of induced labor by Propess.Methods The 380 cases of vaginal delivery women in our hospital between Sep.2006 to Dec.2007 who, were primigravida,term delivery,singleton gestation,vertex presentations and no standing contraindication, was considered as study group. The other 380 cases of women of labor spontaneous or intravenous oxyvenous in the same condition was considered as control group.The birth process,the amount of bleeding,the number of urine retention,and the prognosis of neonate were compared between the two group.Results The active phase and the second stage was abbreviated in the study group,(P0.05).Conclusion Propess was more effective and safe in shortening the active phase, the secona stage and reducing complications.
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OBJECTIVE: Despite the general information of vaginal birth after cesarean section (VBAC), little is known about the duration of active labor in women attempting VBAC. The aim of this study was to compare the time length of active labor in women attempting VBAC compared with nulliparas or multiparas, and then, provide further insight for better management of labor. METHODS: From January 1999 to December 2003, a total of 444 patients with VBAC were entered into the study. Women with two or more history of caesarean section or previous vaginal delivery were all excluded from the study. Time length of active labor in these patients was compared with 335 nulliparas and 218 multiparas consecutively visiting our unit for delivery in 2003. RESULTS: For patients with VBAC, the duration of active and second phase were 184.8+/-115.7, and 25.1+/-15.2 minutes, which was significantly shorter than nulliparas (p<0.05), but longer than multiparas (p<0.05). To eliminate confounding factors affecting the duration, 374 women without use of vacuum, oxytocin, or epidural anesthesia were selected for analysis. Consistently, the time length of active and second phase in women with VBAC was significantly shorter than in nulliparas, but longer than in multiparas (p<0.001) except for active phase compared with nulliparas (p=0.295). CONCLUSION: With regard to the time length of active labor, women attempting VBAC were in the intermediate group when compared with nulliparas or multiparas. Understanding of this unique time interval in women attempting VBAC may help in allowing an appropriate management for labor process.
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Female , Humans , Pregnancy , Anesthesia, Epidural , Cesarean Section , Oxytocin , Vacuum , Vaginal Birth after CesareanABSTRACT
OBJECTIVE: This study examined the effect of a maximal cervical dilatation prior to their primary cesarean birth on the time length of labor in women attempting vaginal birth after cesarean section (VBAC). METHODS: From January 2000 to Jun 2005, a total of 526 patients with VBAC were entered into the study. Patients were classified into 4 groups according to the maximal cervical dilatation on the prior cesarean birth: Group 1 (0~3 cm), Group 2 (4~7 cm), Group 3 (8~9 cm), and Group 4 (10 cm). RESULTS: An analysis of the duration of labor showed that the time length of active phase was significantly shorter in each of Group 3 (147.3+/-103.9 minutes) and 4 (155.2+/-104.2 minutes) than in Group 1 (192.9+/-126.0 minutes) or 2 (195.1+/-148.2 minutes) (p or =8 cm than those without. Study results indicate that prior cervical dilatation may affect the labor time of subsequent VBAC. The proper understanding of the association between prior cervical dilatation and labor time on a subsequent VBAC may be useful for better management or further intervention in the setting of VABC.