ABSTRACT
Background: The amniotic fluid encloses and protects the fetus within the amniotic cavity in uterus. Amniotic fluid allows room for fetal growth, movement and development. The abnormal amniotic fluid either high or low volumes helps to diagnose the reduced fetal outcomes. This fluid is an important predictive tool for assessing the development of pregnancy.Methods: The present study is done to assess the effectiveness of intravenous (IV) hypotonic saline fluid maternal hydration on oligohydramnios. This study was conducted in department of obstetrics and gynecology, CHRI for 18 months. About 30 participants of third trimester with amniotic fluid index (AFI)<8 cm with the gestational age of 34-40 weeks were included. The study was done on pregnant mothers with AFI<8 cm and gestational age of 34-40 weeks. Measurement of AFI was done for all participants. The patients received 2 liters of hypotonic saline fluid over 4 hours. AFI was measured again 24 hours after baseline measurement. Treatment with IV infusion of hypotonic saline fluid is resulted in better increase in AFI in oligohydramnios.Results: After hypotonic saline infusion, the patient抯 AFI level was 7.14�31 with the p=0.000*** and it was statistically significant.Conclusions: The blood parameters and the electrolytes showed no notable changes before and after the infusion of hypotonic saline with regular antenatal visits, oligohydramnios can be detected early by clinical examination and routine ultrasonography and the proper treatment will help in preventing the complications of oligohydramnios.
ABSTRACT
Resumo Fundamento Não houve evidência científica sobre o tratamento inicial com solução salina hipertônica (SSH) na insuficiência cardíaca agudamente descompensada (ICAD). Objetivos Este estudo avaliou o impacto do uso de SSH junto com um diurético de alça (DA) como o primeiro tratamento diurético para ICAD, com foco na função renal, níveis de eletrólitos e resultados clínicos. Métodos Neste estudo retrospectivo de caso-controle, 171 pacientes adultos (93 mulheres/78 homens) com ICAD foram incluídos entre 1º de janeiro de 2022 e 31 de dezembro de 2022. Os pacientes foram alocados em dois grupos: combinação inicial de SSH+DA e DA padronizada. O desfecho primário foi piora da função renal (PFR). A hospitalização por IC e a mortalidade por todas as causas foram avaliadas durante 6 meses de acompanhamento. O nível de significância adotado na análise estatística foi de 5%. Resultados Os grupos exibiram semelhanças nas características basais. Diurese significativamente maior no 1º dia (3975 [3000-5150] vs. 2583 [2000-3250], p=0,001) e natriurese na 2ª hora (116,00 [82,75-126,00] vs. 131,75-140,00] vs. 94,00-103,25] vs. 99,00 [96,00-103,00], p=0,295), TFG (48,50 [29,75-72,50 vs. 50,00[35,50-63,50, p=0,616) e creatinina (1,20 [0,90-1,70] vs. 1,20 [1,00-1,50], p=0,218) permaneceu estável no grupo SSH combinado inicial quando comparado ao grupo DA padronizado (Cl-: 102,00[99,00-106,00] vs. 98,00[95,00-103,00], p=0,001, TFGe: 56,00 [41,00-71,00] vs. 55,00[35,00-71,00], p=0,050, creatinina: 1,10[0,90-1,40] vs. 1,20 [0,90-1,70], p=0,009). A piora da função renal (16,1% vs. 35,5%, p = 0,007) e o tempo de internação hospitalar (4 dias [3-7] vs. 5 dias [4-7], p = 0,004) foram menores na combinação inicial SSH+DA em comparação com o DA padronizado. A mortalidade hospitalar, a hospitalização por IC e a mortalidade por todas as causas foram semelhantes entre os dois grupos. Conclusão SSH como terapia inicial, quando combinada com DA, pode proporcionar uma diurese segura e eficaz sem prejudicar a função renal na ICAD. Portanto, a SSH pode levar a um menor tempo de internação hospitalar para esses pacientes.
Abstract Background There was no scientific evidence about the initial treatment of hypertonic saline solution (HSS) in acutely decompensated heart failure (ADHF). Objectives This study assessed the impact of using HSS along with a loop diuretic (LD) as the first diuretic treatment for ADHF, focusing on renal function, electrolyte levels, and clinical outcomes. Methods In this retrospective case-control study, 171 adult patients (93 females/78 males) with ADHF were included between January 1, 2022, and December 31, 2022. Patients were allocated into two groups: upfront combo HSS+LD and standardized LD. The primary endpoint was worsening renal function (WRF). Hospitalization for HF and all-cause mortality were evaluated during 6 months of follow-up. The significance level adopted in the statistical analysis was 5%. Results The groups exhibited similarities in baseline characteristics.A significantly higher diuresis on the 1st day (3975 [3000-5150] vs. 2583 [2000-3250], p=0.001) and natriuresis on the 2nd hour (116.00 [82.75-126.00] vs. 68.50 [54.00-89.75], p=0.001) in the initial upfront combo HSS+LD were found in comparison with the standardized LD.When compared to the standardized LD, the utilization of HSS led to an increase in serum Na+ (137.00 [131.75-140.00] vs. 140.00 [136.00-142.25], p=0.001 for upfront combo HSS, 139.00 [137.00-141.00] vs. 139.00 [136.00-140.00], p=.0470 for standardized LD), while chloride (99.00 [94.00-103.25] vs. 99.00[96.00-103.00], p=0.295), GFR (48.50 [29.75-72.50 vs. 50.00 [35.50-63.50, p=0.616), and creatinine (1.20 [0.90-1.70] vs. 1.20 [1.00-1.50], p=0.218) remained stable in the upfront combo HSS group when compared to standardized LD group (Cl-: 102.00 [99.00-106.00] vs. 98.00 [95.00-103.00], p=0.001, eGFR: 56.00 [41.00-71.00] vs. 55.00 [35.00-71.00], p=0.050, creatinine:1.10 [0.90-1.40] vs. 1.20 [0.90-1.70], p=0.009). Worsening renal function (16.1% vs 35.5%, p=0.007), and length of stay in the hospital (4 days [3-7] vs. 5 days [4-7], p=0.004) were lower in the upfront combo HSS+LD in comparison with the standardized LD. In-hospital mortality, hospitalization for HF, and all-cause mortality were similar between the two groups. Conclusion HSS as an initial therapy, when combined with LD, may provide a safe and effective diuresis without impairing renal function in ADHF. Therefore, HSS may lead to a shorter length of stay in the hospital for these patients.
ABSTRACT
Endotoxin contamination is a threat to the safety of pharmaceutical products, especially parenteral drugs. Any sterile and/or pyrogen-free pharmaceutical product requires regulatory specifications to ensure safe patient use. This study covers the performance evaluation study of an endotoxin quantitation commercial kit by recombinant Factor C (rFC), Endozyme II® Go, for 0.9% sodium chloride injection. The samples were spiked with endotoxin solutions between 0.0005 and 10 EU/mL and tested by the rFC kit to evaluate precision, accuracy, detection and quantification limits, linearity, and robustness. Each of the six points was assayed at least five times.The relative standard deviation for precision testing ranged from 1.9 to 8.3%. The recovery accuracy values of endotoxin were between 61% and 125% for the range from 0.005 to 10 EU/mL. The results demonstrated that the rFC method allows endotoxin quantification with accuracy, precision, specificity, and linearity for the range of 0.005 and 10 EU/mL for 0.9% sodium chloride injection. (AU)
A contaminação por endotoxinas é uma ameaça à segurança dos produtos farmacêuticos, especialmente dos medicamentos parenterais. Qualquer produto farmacêutico estéril e/ou livre de pirogênios requer especificações regulatórias para garantir a segurança de uso para o paciente. Este estudo abrange o estudo de avaliação de desempenho empregando o kit comercial Endozyme II® Go para quantificação de endotoxina, por Fator C recombinante (FCr), em amostras de cloreto de sódio 0,9% para uso parenteral. As amostras foram fortificadas com cinco concentrações distintas de soluções de endotoxina na faixa entre 0,0005 e 10 UE/mL. Cada um dos cinco níveis foi testado pelo menos cinco vezes para avaliação dos critérios de precisão, exatidão, limites de detecção e quantificação, linearidade e robustez. O desvio padrão relativo para os testes de precisão variou de 1,9 a 8,3%. Os valores de recuperação de endotoxina para o parâmetro exatidão estiveram compreendidos entre 61% e 125%. Os resultados demonstraram que o método por FCr permite a quantificação de endotoxinas com exatidão, precisão, especificidade e linearidade para a faixa de 0,005 e 10 UE/mL em amostras de cloreto de sódio 0,9% para uso parenteral. (AU)
Subject(s)
In Vitro Techniques , Endotoxins , Saline Solution , Sodium ChlorideABSTRACT
Objective To explore the dilution conditions and standards in detecting the semen samples with high sperm concentration using computer-aided sperm analysis(CASA)systems.Methods CASA systems with 10 μm depth disposable counting chambers were used for the examination.The samples were divided into undiluted group(Group 1∶sperm concentration＜50×106/mL)and diluted groups(Group 2∶50×106/mL≤ sperm concentration＜100× 106/mL;Group 3∶sperm concentration≥100× 106/mL).When sperm concentration＜50×106/mL,no dilution was performed.When sperm concentration≥50× 106/mL,the samples were diluted with saline at 1∶n/(50×106)ratio(n=sperm concentration,n/[50×106]rounded down)to＜50×106/mL of sperm concentration.The sperm concentration,progressive motility(PR),non-progressive motility(NP),total motility(PR+NP)and immotile sperm percent-age(IM)were analyzed before and after dilution.The consistency of results pre-and post-dilution was compared.ROC curve was used to analyze the optimal dilution threshold.Results The differences in the parameters pre-and post-dilution gradually rosed with the increased sperm concentration.ROC curve analysis showed optimal dilution thresholds were 133.05 × 106/mL,101.75 × 106/mL,118.60×106/mL,90.90×106/mL,111.83×106/mL for the sperm concentration,PR+NP,PR,NP and IM respectively.Considering sperm concentration and NP were most affected the undiluted high concentration samples,the optimal comprehensive dilution threshold was determined as 125.08× 106/mL.Conclusion When sperm concentration exceeds 125×106/mL,it is recommended to dilute semen sample with normal saline.
ABSTRACT
Objective:To investigate the appropriate cut-off for diagnosis of primary aldosteronism (PA) by seated saline suppression test (SSST) based on liquid chromatography with tandem mass spectrometry (LC-MS/MS).Methods:In this cross-sectional study, patients who underwent SSST for suspected PA in the First Affiliated Hospital of Chongqing Medical University from January 2018 to March 2022 were evaluated. Briefly, 300 patients with PA and 119 with essential hypertension (EH) were included. Plasma aldosterone concentration (PAC) after SSST was determined by LC-MS/MS. Primary aldosteronism confirmatory testing (PACT) score was used as the reference standard for diagnosis of PA, and receiver operating characteristic (ROC) curve was used to explore the cut-off value.Results:The average age of the PA group was (50.8±10.5) years, and males accounted for 53.00% ( n=159); the average age of the EH group was (49.4±11.2) years, and males accounted for 26.89% ( n=32). The area under the ROC curve of PAC post-SSST was 0.819 (95% CI 0.775-0.862). When 40 pg/ml (110.8 pmol/L) was selected as the appropriate cut-off for diagnosis of PA, the sensitivity was 83.67% (95% CI 78.88%-87.56%) and specificity was 60.50% (95% CI 51.10%-69.21%). Thus, 95.09% (155/163) of patients with unilateral PA could be identified. Conclusion:PAC after SSST determined by LC-MS/MS has high efficacy for diagnosis of PA, and 40 pg/ml is recommended as the appropriate cut-off value.
ABSTRACT
ABSTRACT BACKGROUND: Hyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes. OBJECTIVES: This study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma. DESIGN AND SETTING: This retrospective cohort study was conducted at a tertiary university hospital in Turkey. METHODS: Data were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors. RESULTS: The mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma. CONCLUSIONS: In pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.
ABSTRACT
ABSTRACT Purpose: This clinical study compared autologous serum eye drops diluted with 0.5% methylcellulose and 0.9% saline solution. The subjective criteria for symptom improvement and the objective clinical criteria for response to therapy were evaluated. Methods: This longitudinal prospective study enrolled 23 patients (42 eyes) with persistent epithelial defects or severe dry eye disease refractory to conventional therapy who had been using autologous serum 20% prepared with methylcellulose for > 6 months and started on autologous serum diluted in 0.9% saline solution. The control and intervention groups consisted of the same patients under alternate treatments. The subjective criteria for symptom relief were evaluated using the Salisbury Eye Evaluation Questionnaire. The objective clinical criteria were evaluated through a slit-lamp examination of the ocular surface, tear breakup time, corneal fluorescein staining, Schirmer's test, rose Bengal test, and tear meniscus height. These criteria were evaluated before the diluent was changed and after 30, 90, and 180 days. Results: In total, 42 eyes were analyzed before and after 6 months using autologous serum diluted with 0.9% saline. No significant differences were found in the subjective criteria, tear breakup time, tear meniscus, corneal fluorescein staining, or rose Bengal test. Schirmer's test scores significantly worsened at 30 and 90 days (p=0.008). No complications or adverse effects were observed. Conclusions: This study reinforces the use of autologous serum 20% as a successful treatment for severe dry eye disease resistant to conventional therapy. Autologous serum in 0.9% saline was not inferior to the methylcellulose formulation and is much more cost-effective.
RESUMO Objetivo: Este estudo comparou o colírio de soro au tólogo manipulado com metilcelulose a 0,5% com solução salina 0,9%. Critérios subjetivos de melhora dos sintomas e critérios clínicos objetivos para resposta à terapia foram avaliados. Métodos: Este estudo prospectivo longitudinal envolveu 23 pacientes (42 olhos) com defeitos epiteliais persistentes ou doença de olho seco grave refratária à terapia convencional que usavam colírio de soro autólogo 20% preparado com metilcelulose por mais de 6 meses e iniciaram soro autólogo diluído em solução salina 0,9%. Os grupos controle e intervenção consistiam dos mesmos pacientes sob tratamentos alternados. Os critérios subjetivos para o alívio dos sintomas foram avaliados usando o Salisbury Eye Evaluation Questionnaire. Os critérios objetivos foram avaliados por meio de exame em lâmpada de fenda incluindo: tempo de ruptura da lágrima, coloração da córnea com fluoresceína, teste de Schirmer, coloração com rosa bengala e altura do menisco lacrimal. Esses critérios foram avaliados antes da troca do diluente e após 30, 90 e 180 dias. Resultados: Um total de 42 olhos foram analisados antes e após 6 meses usando soro autólogo diluído com solução salina 0,9%. Nenhuma diferença significativa foi encontrada nos critérios subjetivos, tempo de ruptura da lágrima, menisco lacrimal, coloração com fluoresceína ou rosa bengala. Os resultados dos testes de Schirmer pioraram significativamente em 30 e 90 dias (p=0,008). Não foram observadas complicações ou efeitos adversos. Conclusões: Este estudo reforça o uso do colírio de soro autólogo 20% como um tratamento de sucesso para a doença do olho seco grave resistente à terapia convencional. O soro autólogo diluído em solução salina a 0,9% não foi inferior à formulação de metilcelulose.
ABSTRACT
Salinity stands out as a crucial abiotic stress factor that significantly impacts both crop yield and quality. Wheat, considered a moderately salt-tolerant crop, offers a wealth of variability and diversity within its species, presenting an accessible avenue for enhancing wheat's salt tolerance. Consequently, this study investigated the extent of genetic diversity for salt tolerance among sixty Triticum dicoccum germplasm accessions. In both saline and control condition, the genotypes were divided into three and nine separate clusters respectively, showing that there was a significant level of genetic variability among the genotypes by multivariate analysis. It was observed that biomass was the largest contributor (85.19 %) to the divergence in the saline situation. Among the yield parameters under saline condition, tillers per meter followed by thousand-grain weight and spike length were observed to be important. Thirteen genotypes were salt-tolerant, according to the Stress susceptibility index (SSI). The stress tolerance index (STI) was defined as a useful tool for determining the high yield and potential stress tolerance of genotypes. Based on the stress tolerance index, only eight genotypes were said to be tolerant.
ABSTRACT
Salinity is one of the most important abiotic stresses affecting crop yield and quality. Wheat is regarded as a moderately salt tolerant crop; wheat species exhibit high variability that can be conveniently explored to improve wheat species for salt tolerance. Hence, the magnitude of variability for salt tolerance was studied in dicoccum wheat germplasm accessions. High phenotypic and genotypic coefficients of variance were observed for grain yield and yield attributes like tillers per meter, biomass, spikelets per spike and harvest index. The heritability and genetic advance over mean were moderate to high for grain yield, thousand grain weight, tillers per meter, biomass, spikelets per spike, harvest index, plant height, days to 50 per cent flowering and days to maturity. Character association studies revealed that harvest index and SPAD at anthesis stage exhibited a positive significant correlation under both saline and control condition. Path coefficient analysis revealed that traits like harvest index, biomass, tillers per meter and days to 50 per cent flowering were showing a high direct effect on grain yield under both saline and control condition. Thus, the present study provides valuable genetic resources for grain yield and yield parameters improvement which are associated with the salt tolerance in wheat species.
ABSTRACT
Background: This study, conducted from August 2014 to August 2015, investigated hyponatremia in 228 in-hospital patients, aiming to discern its clinical and biochemical features and compare the efficacy of vaptans against standard treatments. The null hypothesis assumed no significant disparity in outcomes, while the alternate hypothesis posited otherwise. Methods: Using an open-label, non-blinded, observational, prospective comparative design, we assessed 228 hyponatremia patients. We scrutinized their clinical and biochemical profiles and made comparisons between moderate and profound hyponatremia cases, along with different treatment approaches. Results: Our findings revealed that patients aged 61-80, primarily females, dominated the cohort. Moderate hyponatremia occurred in 56.6% of cases, with severe hyponatremia in 43.4%. Common symptoms included drowsiness, nausea, and vomiting. Euvolemic hyponatremia was predominantly due to SIADH, while heart failure led to most hypervolemic cases. Various treatments were employed, with fluid restriction and normal saline being common. Tolvaptan and 1.6% hypertonic saline significantly increased serum sodium levels at 24 and 48 hours. Hospital stay duration didn’t significantly differ, and no osmotic demyelination cases emerged. Mortality stood at 10.5%, notably higher in profound hyponatremia cases. Conclusions: This study provides insights into hyponatremia’s clinical and biochemical aspects and compares vaptans to standard treatments. Tolvaptan and hypertonic saline displayed promise in raising serum sodium levels. Nevertheless, further research is warranted to validate these findings and explore additional factors impacting hyponatremia treatment outcomes.
ABSTRACT
Climate change, in spite of attempts at mitigation, is becoming much more serious. Wide spectrum major mitigation efforts are now necessary including removing CO2 from the atmosphere, reducing fossil energy use and increasing the planet albedo. Halophytes, salt plants grown on deserts and wastelands using saline and seawater are uniquely suitable to rapidly and profitably, at the tremendous scale of the climate problem, using inexpensive land and water, remove CO2 and produce major amounts of biofuels and food while returning up to 70% of the fresh water to direct human use. This article examines the extraordinary possibilities of halophytes to significantly mitigate the major societal issues involving land, water, food, energy and climate.
ABSTRACT
High salt concentrations and high pH occur simultaneously in nature, however, presently most of the studies have mainly focused on only salinity, the research on salt-alkali combined stress are comparatively very limited. Hydrogen peroxide is an important signaling molecule. However, the role of exogenously applied hydrogen peroxide (H2O2) under saline–alkaline stress is not known. The main objectives of present study was to assess role of exogenously applied H2O2 as seed priming in mitigating the harmful effect of saline–alkaline stress on differentially tolerant mungbean genotypes (TMB-37 and MH-1314). Saline-alkaline stress significantly decreased the chlorophyll content, leaf relative water content (RWC) and yield while enhanced malondialdehyde (MDA), proline and antioxidant enzyme activity in root and leaf samples of both mungbean cultivars. Seeds priming were done with 0.01% H2O2 and distilled water. Seed priming with 0.01% H2O2 significantly improved the yield and yield attributes along with increment in leaf chlorophyll content, RWC as well as accumulation of osmolytes. The activities of antioxidant enzymes, viz., SOD, CAT and POX were also significantly increased in both mungbean genotypes and especially the CAT activity both in root and leaf tissue. However, relatively higher improvement was observed in genotype TMB-37. In conclusion, exogenously applied 0.01% H2O2 improved the saline–alkaline tolerance, which was reflected in terms of enhanced photosynthetic pigments, RWC, proline accumulation, and antioxidant enzyme activity of root as well shoot tissues and yield.
ABSTRACT
FINCA (fibrosis, neuro-degeneration, cerebral angiomatosis) syndrome is a rare autosomal recessive early onset fatal disorder characterised by progressive cerebropulmonary symptoms, malabsorption, progressive growth failure, recurrent infection, chronic haemolytic anaemia and transient liver dysfunction. A 5 year old female baby born as a preterm 33 weeks (2nd twin of dichorionic diamniotic twin) to nonconsanguineous parents via intra-cytoplasmic sperm injection and surrogacy, delivered by emergency caesarean section (indication- pre-eclampsia in mother) with a birth weight of 1.8 kg. She had a stormy neonatal period and had anaemia requiring blood transfusion. Developmental delay was noted from early infancy which was not responding to developmental therapy, along with recurrent episodes of aspiration pneumonia. Her twin on the other hand had normal mile stones without any remarkable medical history. Examination and evaluation revealed features of chronic hemolysis. In view of constellation of developmental delay, recurrent infection, chronic hemolytic anaemia and cerebral atrophy beyond documented perinatal issues and dysmorphism, clinical exome sequencing was done which revealed missense variation in exon of NHLRC2 gene on chromosome 10 suggestive of FINCA syndrome. This case emphasized the need of genetic testing to resolve uncertainty in etiology and accurate prognostication.
ABSTRACT
Laparoscopy has many advantages over open surgery including less post-operative pain, earlier return of normal bowel function, shorter hospital stay, and earlier recovery. Bowel injury is a serious complication of gynecological laparoscopy. The most common site of bowel injury is the small bowel, followed by the large bowel and stomach. This is in agreement with a recent systematic review which has shown that the incidence of bowel injury in gynecologic laparoscopy is 1 in 769.3. Air saline test performed to check bowel integrity by inserting the rectal probe and filling the cavity with normal saline. After performing total laparoscopic hysterectomy with bilateral salphingoopherectomy with retroperitoneal lymphnode dissection done initially after pushing air from rectal probe into the bowel, no bubble was noted but after pushing sigmoid into the pool of saline, escape of air was seen. After suction, a 2×2 cm incidental sigmoidal injury was detected. Bowel injury is a serious complication in laparoscopic surgeries and routine intraoperative checking of bowel integrity by air saline test with the help of rectal probe is a useful modality of intraoperative bowel repair.
ABSTRACT
Background: The intentional commencement of cervical ripening and uterine contraction for the purpose of achieving delivery prior to the onset of spontaneous parturition is known as induction of labour. When the benefits to the mother or the foetus surpass the benefits of extending the pregnancy, it is indicated. The purpose of this study was to assess the efficacy of a transcervical foley's catheter with extra amniotic saline infusion against intra cervical prostaglandin E2 gel for inducing labour in term pregnant women.Methods: From January 2020 to June 2021, a comparative study was undertaken at R.L. Jalappa Hospital and Research Centre. The study enrolled a total of 72 individuals. After obtaining informed consent from the patients who were admitted, and meeting the inclusion criteria, detailed history was collected, baseline investigations were done. After clinical examination of the patient, by using the simple lottery method, patients were divided into group A (Extra amniotic saline infusion group with Foley’s catheter) and group B (Dinoprostone (PGE2 gel) group).Results: Prolonged gestational age, hypertensive disorders in pregnancy, and oligohydramnios were the most frequent causes for induction in the EASI group, accounting for 38.89%, 38.89%, and 22.22%, respectively. The dinoprostone group has 36.11%, 33.33%, and 25%, respectively. After induction, the majority of patients in the EASI group had a modified Bishop's score of 2.Conclusions: Our research found that PGE2 and EASI were equally effective in inducing labour.
ABSTRACT
Background: This study aimed to evaluate and compare the diagnostic utility of hysteroscopy and saline infusion sonography in patients presenting with abnormal uterine bleeding, using the International Federation of Gynaecology and obstetrics classification system.Methods: The study included 97 women with menorrhagia attending the department of obstetrics and gynaecology, R. D. Gardi Medical College, Ujjain, from September 2011 to February 2013. All the participants underwent hysteroscopy, saline infusion sonography (SIS), and endometrial histopathology. The sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method was calculated and compared.Results: Both hysteroscopy and SIS demonstrated high sensitivity and specificity in detecting structural lesions from the PALM group of abnormal uterine bleeding (AUB) aetiologies. For endometrial polyps, hysteroscopy had a sensitivity of 89.47% with a specificity of 87.17%, while SIS had a sensitivity of 100% and specificity of 88.46% (p<0.01). For submucous fibroids, hysteroscopy had a sensitivity of 82.35% and specificity of 91.25%, while SIS had a sensitivity of 88.23% and specificity of 88.75% (p<0.01). However, neither method was as effective for endometrial hyperplasia and the COEIN group. Hysteroscopy-guided biopsy could improve the sensitivity and specificity of hysteroscopy in detecting endometrial hyperplasia.Conclusions: Hysteroscopy and SIS are valuable tools in the diagnosis and management of AUB, with both methods demonstrating significant efficacy in detecting structural lesions, such as endometrial polyps and submucous fibroids. Further research is needed to refine these techniques and determine their optimal use in clinical practice, especially for the detection of endometrial hyperplasia and conditions within the COEIN group.
ABSTRACT
Objective: Phenytoin is a medication primarily used to treat seizures, but it has been discovered to have the potential for wound healing due to its ability to increase collagen production, promote new blood vessel growth, reduce inflammation, fight infections, and encourage new skin growth. These effects are particularly useful for healing chronic wounds like pressure ulcers, diabetic ulcers, traumatic wounds, and venous ulcers.Methods: This is a two-year prospective study conducted between January 2020 and December 2022 at the Government General Hospital in Kurnool. A study was conducted on 60 patients with traumatic wounds, dividing them into two groups. One group received topical phenytoin dressing, while the other received normal saline dressing. The study compared wound surface area, granulation tissue percentage, pain ratings on the visual analog scale, and healing time between the groups on day 14 and day 21.Results: On day 0, cases and controls had similar wound surface areas (62.17±25.74 cm2 and 62.14±21.57 cm2, respectively) and VAS scores (8.81±1.22 and 8.88±1.52). By day 14, cases had significantly smaller wound surface areas (41±32.32 cm2), a higher percentage of granulation tissue (75.56±7.30%), and lower VAS scores (4.57±1.78) compared to controls (53.28±25.33 cm2, 58.45±7.01%, and 6.32±1.02, respectively). By day 21, cases had even smaller wound surface areas (28.3±31.75 cm2), a higher percentage of granulation tissue (93±3.46%), and lower VAS scores (2.78±0.42) compared to controls (40.34±34.23 cm2, 72.56±5.05%, and 4.82±1.27, respectively). The time for wound healing was significantly shorter for cases (22.76±7.28 d) compared to controls (32.64±9.31 d). On day 21, negative cultures were found in 80% of wounds in the study group and 50% of wounds in the control group, with a statistically significant difference (P-value<0.05).Conclusion: Topical phenytoin dressing had positive effects on wound healing by increasing the rate of granulation tissue formation, providing better pain relief, and shortening the healing time. It was found to be a safe, effective, and cost-effective option for wound healing due to its various mechanisms. The study highlights the significance of phenytoin in treating traumatic wounds, particularly in patients with limited access to expensive wound-healing medications.
ABSTRACT
Background: Nasal irrigation following Functional endoscopic sinus surgery (FESS) appears to be a nearly universal recommendation. FESS significantly improves the symptoms of the CRS (Chronic rhino sinusitis) and the postoperative endoscopy scores. The primarily objective of our study was to study the efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery. Methods: A total of 100 patients who underwent functional endoscopic sinus surgery were randomly divided into two groups on the basis of computerized generated random table with 50 patients in each group. In group 1 normal saline was used where as in group 2 budesonide solution was used for nasal douching. Post-operative evaluation was done using Lund Kennedy Endoscopic scoring (LKES) at the 7th and 30th postoperative day. Results: On 7th postoperative day, we found that none of our patient in the study groups had polypoidal change. There was decrease in scores of polyposis, discharge mucosal edema, scaring and crusting in both the groups. However, the reduction of discharge in the budesonide group was more significantly decreased than normal saline group (p value<0.05). We also noted that on 30th postoperative edema, scarring and crusting was significantly decreased in budesonide group as compared to normal saline group (p value <0.05). Conclusions: We concluded that the addition of budesonide in nasal irrigation resulted in improved scores of polyposis, discharge, mucosal edema, crusting and scarring and total score of LKES than normal saline alone.
ABSTRACT
Background: Nasal irrigation following Functional endoscopic sinus surgery (FESS) appears to be a nearly universal recommendation. FESS significantly improves the symptoms of the CRS (Chronic rhino sinusitis) and the postoperative endoscopy scores. The primarily objective of our study was to study the efficacy of nasal irrigation of normal saline as compared to budesonide following functional endoscopic sinus surgery. Methods: A total of 100 patients who underwent functional endoscopic sinus surgery were randomly divided into two groups on the basis of computerized generated random table with 50 patients in each group. In group 1 normal saline was used where as in group 2 budesonide solution was used for nasal douching. Post-operative evaluation was done using Lund Kennedy Endoscopic scoring (LKES) at the 7th and 30th postoperative day. Results: On 7th postoperative day, we found that none of our patient in the study groups had polypoidal change. There was decrease in scores of polyposis, discharge mucosal edema, scaring and crusting in both the groups. However, the reduction of discharge in the budesonide group was more significantly decreased than normal saline group (p value<0.05). We also noted that on 30th postoperative edema, scarring and crusting was significantly decreased in budesonide group as compared to normal saline group (p value <0.05). Conclusions: We concluded that the addition of budesonide in nasal irrigation resulted in improved scores of polyposis, discharge, mucosal edema, crusting and scarring and total score of LKES than normal saline alone.