A comparative study of tranexamic acid and ethamsylate in menorrhagia

Background: Menorrhagia interferes with the woman’s physical, social, emotional, and/or material quality of life. Antifibrinolytic drugs are effective in decreasing excessive menstrual bleeding. The objective of this study was to compare the effects of tranexamic acid and ethamsylate on quality of life in women with menorrhagia.Methods: The 50 women with menorrhagia were randomised to receive either tranexamic acid or ethamsylate. Twenty five patients were allocated to receive tranexamic acid 500 mg six hourly, and 25 patients to receive ethamsylate 500 mg six hourly. Among the parameters measured by the MIQ were impairment in social activities, work performance, physical activities, productivity, hygienic condition, psychological condition. Health-related quality-of-life question scores (MIQ scores) at baseline and after treatment were calculated as mean for tranexamic acid group and ethamsylate group.Results: Tranexamic acid and ethamsylate treatment groups showed mean improvement in MIQ scores compared to baseline. However, the total mean score was higher in tranexamic acid group compared to ethamsylate group after three treatment cycles (21 Vs 17).Conclusions: Use of tranexamic acid and ethamsylate improved health-related quality of life in patients with menorrhagia. Tranexamic acid showed better improvement in health-related quality of life compared to ethamsylate in patients with menorrhagia

Correlation between changes in placental morphological features with abnormal Doppler flow in pregnancy induced hypertension

Background: Placenta is one of the most challenging organs; it is an instrument of transfer of essential elements, i.e. nutrients and oxygen from mother to fetus and waste product of metabolism in reverse manner.Methods: Cases of PIH between 20-36 weeks of gestation will be studied over a peri-od of 2 years having B.P ≥140/90mm Hg and protienuria ≥1+ in this prospective analytical study having color Doppler scanner with PI, RI of umbilical, uterine artery and middle cerebral artery PI along with placental morphological changes are observed.Results: In present study where, placental weight was 1 group. While 78% placental infarction, 57% calcification and 69% retroplacental clots be-longed to uterine artery RI > 0.6 group. Infarction were 77.50%, calcification were same as infarction 77.50% while retroplacental clots 80% in group having MCA PI 1.3.Conclusions: In recent years placenta has drawn attention as valuable indicator for maternal and fetal diseases in preeclampsia. Decreased circulation in placenta reflects on its morphological features and these changes causes alterations in Doppler flow velocities of uterine, umbilical and middle cerebral vessels pregnancy induced hyper-tension

The prediction of pregnancy induced hypertension from umbilical and uterine Doppler flow study

Background: Hypertensive disorder along with hemorrhage and infection contribute greatly to maternal mortality and morbidity. Pregnancy induced hypertension remains among the most significant and intriguing unsolved problems in obstetrics.Methods: In this prospective analytical study investigations and color doppler findings 0f umbilical artery PI, RI and end diastolic flow in same, uterine PI, RI and persistent diastolic notch in uterine artery recorded. Total 100 Cases of PIH between 20-36 weeks of gestation in 2 years with B.P ≥ 140/90 mm hg and protienuria ≥ 1+ were observed.Results: In this study, out of 100 cases, there were 58 cases of mild PIH (58%) and 42 cases of severe PIH (42%). Umbilical artery PI was elevated in 43(43.0%) patients and was normal in  57(57.0%) patients. Umbilical  artery RI was more than and equal to 0.7 in 77 patients  (77%) and was below of 0.7 in 23 (23%) pa-tients.9(9.0%)  fetuses showed  absence  and  14 (14.0%) fetus  had  reversal and 46 (46.0%) had reduced  end diastolic umbilical artery flow with total 69 out of 100  fetuses  having  abnormal  waveforms.65 (65%)  mothers  had  an  elevated  uterine  artery  PI   and  35(35%)  patients   had  normal uterine  artery PI. in observation 69 (69%)  patients  were  having  RI more  than 0.6, while 31 (31%) were having less than 0.6 out of 100 patients. In this study, 65 (65.0%) women were having persistent diastolic notch.Conclusions: This study was to evaluate arterial flow velocities as a predictor of impending pregnancy induced hypertension with raised RI and PI along with umbilical ab-sent or reverse end diastolic flow velocities and elevated RI and PI in the presence of a diastolic notch are considered as abnormal uterine doppler findings doppler finding with unfavorable outcome

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension.Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period.Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h.Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure

Comparison of the efficacy and safety of norethisterone vs. combined oral contraceptive pills for the management of puberty menorrhagia

Background: The most common cause of puberty menorrhagia is immaturity of the hypothalamic pituitary ovarian axis. Treatment is directed towards stabilizing the endometrium and treating the hormonal alterations. The objective of this study was to compare the efficacy and safety of norethisterone and combined oral contraceptive (COC) pills for the management of puberty menorrhagia.Methods: A total of 60 young girls from age of menarche to 19 years with menorrhagia were randomized to receive either norethisterone or COC pills. The end points included change from baseline in health-related quality-of-life parameters, estimation of blood loss and effect on hemoglobin level. Health-related quality-of-life question scores at baseline and after treatment were calculated as mean for norethisterone group and COC pills group.Results: Norethisterone and COC pills treatment groups showed mean improvement in Menorrhagia Impact Questionnaire (MIQ) scores compared to baseline. However, the total mean score was higher in norethisterone group compared to COC pills group after three treatment cycles (21 Vs 17). The treatment failure was less in norethisterone group compared to COC pills group.Conclusions: Use of norethisterone was more effective and better tolerated compared to combined oral contraceptive pills for the management of puberty menorrhagia

Renal arteriovenous malformation presenting with massive hematuria

AbstractRenal arteriovenous malformations are abnormal communications between the intrarenal arterial and venous systems. They are a rare cause of hematuria. Color Doppler ultrasonography, multislice CT angiography, and DSA are important tools for making the diagnosis. We describe the case of a 62-year-old man with renal arteriovenous malformation who presented with gross hematuria

A comparative analysis of upper airway space with lateral cephalogram and cone beam computed tomography in north Gujarat population

Objective : The Aim and objective of this study is to evaluate the accuracy of upper airway measurement using with lateral cephalogram , CBCT lateral reconstruction and CBCT axial planes as well as to correlates these finding with area measurements acquired with the latter imaging methods. Methods : In this study , 44 subject (22 males & 22 females) included from north Gujarat adults . Landmark were defined for measurement of naso and Oropharynx , for different planes , using linear antero-posterior measurement and the corresponding area. Result : Analysis of variance shows linear measurement in nasopharynx and oropharynx area wise distribution and Inter Group Wise Distribution in Nasopharynx , all three group have significant different value. In inter Group Wise Distribution in Oropharynx, there is statistically no significant difference between Lateral Reconstruction Group and Lateral Cephalogram Manual Tracing Group. Statistically, no significant difference between Lateral Reconstruction Group and Axial Slice Group & also Statistically, no significant difference between Lateral Cephalogram Manual Tracing Group and Axial Slice Group. Conclusion : The linear measurements of the airway space obtained using the different techniques correlated positively with the respective area measurements, which demonstrate the reliability of the investigated techniques

Renal arteriovenous malformation presenting with massive hematuria

Renal arteriovenous malformations are abnormal communications between the intrarenal arterial and venous systems. They are a rare cause of hematuria. Color Doppler ultrasonography, multislice CT angiography, and DSA are important tools for making the diagnosis. We describe the case of a 62-year-old man with renal arteriovenous malformation who presented with gross hematuria

Study on water and gas permeation characteristics with ZIF-8 mixed matrix membranes

The membrane separation process lacks intrinsic permeation characteristics to compete with other separation technologies like adsorption, sedimentation, coagulation, skimming, and distillation. A mixed matrix membrane (MMM) is one of the strategies to improve the separation characteristics with embedded nanofillers particles. Zeolite imidazolate framework (ZIF) has a new subclass of inorganic–organic hybrid materials that are being introduced as new fillers for incorporation into the polymer matrix for various applications such as oily wastewater separation, wastewater treatment, natural gas dehydration, landfill gas upgrading, and mixed gas separation. In this experimental work, a metal-organic framework called ZIF-8 was synthesized and used as a filler for modification of MMMs and characterized with FTIR and SEM. ZIF-8 nanoparticles up to 5 wt% loading were added to PSF casting solution then the permeation characteristics of MMMs showed an improved result like the pure water flux of the modified membrane at 2.5 bar was increased up to 456.38 L/m2h. In the case of pure gas separation, at 5 wt% ZIF-8 loading in PSF, the pure gas CO2 permeability at 9 bar pressure had increased to 10.54 barrer. HIGHLIGHTS We have studied water and gas permeation characteristics incorporated with ZIF-8 containing mixed matrix membranes.; ZIF-8 was made as a gateway for quick transport of CO2 gas molecules and water molecules through the polymer matrix.; As per the observed results, higher permeability of the MMMs can be possible with higher loading of ZIF-8.