Efficacy of Endosampler in Endometrial Sampling for Diagnosis of Endometrial Cancer

Objective: To evaluate the efficacy and operator satisfaction of Endosampler in endometrial sampling for the diagnosis of endometrial cancer. Study Design: A Non Randomized Experimental Trial. Place and Duration of Study: The Department of Obstetrics and Gynecology Bahawal Victoria Hospital, Bahawalpur.  From 15 July 2015 to 10 December 2017 Methodology: overall 300 patients were selected for study. Data was collected regarding demographic informations like age, parity and outcome variable as operator satisfaction, positive and negative sampling. Collected data information was entered in SPSS version 24 for mean ± SD calculation of numerical data (age and parity) frequency percentages of categorical variables operator satisfaction, positive and negative sampling was calculated. Student t test was applied on data and p value ≤0.05 was considered as significance. Results: Among studied patents operative satisfaction score (ranged 1-5) was 1-2 73.7% well accepted. While, Operative satisfaction score was ranged 3-5, 26.3% poorly accepted. Positive sampling was 82.7%.While negative sampling was 17.3%. No association was found between operative satisfaction score and sampling. Conclusion: Our results revealed that Endosampler is a useful device for endometrial sampling for the diagnosis of endometrial cancer with high rate of operator satisfaction. Keywords: Endosampler, Endomatrial cancer, Hystrectomy, Gynaecology

A PROSPECTIVE OBSERVATIONAL STUDY ON THE ASSESSMENT OF POTENTIAL DRUG-DRUG INTERACTIONS AND MANAGEMENT OF POST-COMPLICATIONS IN STROKE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

Objective: The objective of the study is to determine the occurrence, frequency, and severity of significant drug-drug interactions in stroke patients, with an emphasis on post complications and their symptomatic management. Methods: A prospective observational study was carried out for 6 mo at Osmania General Hospital, a Tertiary Care Teaching Hospital. The prescriptions taken by stroke patients throughout their hospital stay were analyzed for possible interactions using-Micromedex-2 (Thomson Reuters) × 2.0. Results: A total of 130 prescriptions was analyzed in the study in which 141 drug-drug interactions were found with a male predominance of 85.4%. The majority of interactions were of moderate severity (74.46%) and pharmacokinetics (67.37%) in nature. Among the clinical consequences, decreased atorvastatin efficacy (49.10%) was found to be the highest. The class of drugs most commonly involved in drug-drug interactions was found to be anti-epileptics and statins. 60.15% of the study population were identified with one complication, among which seizures account for 15% of patients. All the complications allied with the condition were treated with drug classes in the study population. Conclusion: This study highlighted the exigency for screening prescriptions of cerebrovascular accident patients for potential drug-drug interactions (pDDIs). Brain edema and seizure were the most accountable complications identified in the study population. The early detection of these problems can improve stroke outcomes and can reduce the mortality or disability rate

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A Comparative Study of the Treatment Efficiency of Floating and Constructed Wetlands for the Bioremediation of Phenanthrene-Contaminated Water

Employing floating treatment wetlands (FTWs) and constructed wetlands (CWs) is one of the most eco-friendly strategies for the bioremediation of water contaminants. Here, the efficiency of FTWs and CWs was compared for the degradation of phenanthrene-contaminated water for the first time. The FTWs and CWs were established by vegetated Phragmites australis in phenanthrene (1000 mg L−1)-contaminated water. Both wetlands were augmented with a bacterial consortium of four bacterial strains: Burkholderia phytofirmans PsJN, Pseudomonas anguiliseptica ITRI53, Arthrobacter oxydans ITRH49, and Achromobacter xylosoxidans ITSI70. Overall, the wetlands removed 91–93% of the phenanthrene whilst the augmentation of the bacterial strains had a synergistic effect. In comparison, the CWs showed a better treatment efficiency, with a 93% reduction in phenanthrene, a 91.7% reduction in the chemical oxygen demand, an 89% reduction in the biochemical oxygen demand, and a 100% reduction in toxicity. The inoculated bacteria were found growing in the shoots, roots, and water of both wetlands, but were comparatively better adapted to the CWs when compared with the FTWs. Similarly, the plants vegetated in the CWs exhibited better growth than that observed in the FTWs. This study revealed that the FTWs and CWs vegetated with P. australis both had promising potential for the cost-effective bioremediation of phenanthrene-contaminated water

A Comparative Study of the Treatment Efficiency of Floating and Constructed Wetlands for the Bioremediation of Phenanthrene-Contaminated Water

Employing floating treatment wetlands (FTWs) and constructed wetlands (CWs) is one of the most eco-friendly strategies for the bioremediation of water contaminants. Here, the efficiency of FTWs and CWs was compared for the degradation of phenanthrene-contaminated water for the first time. The FTWs and CWs were established by vegetated Phragmites australis in phenanthrene (1000 mg L−1)-contaminated water. Both wetlands were augmented with a bacterial consortium of four bacterial strains: Burkholderia phytofirmans PsJN, Pseudomonas anguiliseptica ITRI53, Arthrobacter oxydans ITRH49, and Achromobacter xylosoxidans ITSI70. Overall, the wetlands removed 91–93% of the phenanthrene whilst the augmentation of the bacterial strains had a synergistic effect. In comparison, the CWs showed a better treatment efficiency, with a 93% reduction in phenanthrene, a 91.7% reduction in the chemical oxygen demand, an 89% reduction in the biochemical oxygen demand, and a 100% reduction in toxicity. The inoculated bacteria were found growing in the shoots, roots, and water of both wetlands, but were comparatively better adapted to the CWs when compared with the FTWs. Similarly, the plants vegetated in the CWs exhibited better growth than that observed in the FTWs. This study revealed that the FTWs and CWs vegetated with P. australis both had promising potential for the cost-effective bioremediation of phenanthrene-contaminated water