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Ozone Decreases Biomarkers of Inflamation (C-Reactive Protein and Erytrocyte Sedimentation Rate) and Improves Pain, Function and Quality of Life in Knee Osteoarthrtitis Patients: A Before-and-After Study and Review of the Literature 臭氧降低炎症生物标志物(C-反应蛋白和红细胞沉积率)并改善膝骨关节炎患者的疼痛、功能和生活质量:前后研究和文献综述
Q4 Medicine Pub Date : 2018-04-17 DOI: 10.5812/MEJRH.64507
M. E. Fernández-Cuadros, O. Pérez-Moro, M. Albaladejo-Florín, Ruben Algarra-López
Objectives: Theaimof thisstudywastoevaluateif ozoneiscapableof decreasingbiomarkersof inflammation(CRP/ESR)andpain, and to improve function and quality of life in knee osteoarthrtitis (OA) patients. Methods: Aprospectivequasiexperimental(before-and-afterstudy)researchwasperformedtoinvestigatetheeffectof Ozonether-apyprotocol. Theinterventionincluded4sessions(1session/week)of anintra-articularinfiltrationof amedicalmixtureof Oxygen-Ozone (95% to 5%) at 20 ug/mL concentration. Biochemical evaluation (CRP and ESR), pain VAS, and WOMAC scales were evaluated before and after the treatment. Results: Overall, 33 patients were evaluated. Mean age was 68.18 ± 8.43 years. Female patients accounted for 75.7% (n = 25) and male patients corresponded to 24.3% (n = 8). Female: male ratio was 3:1. The most frequent radiological KL grade was 2º (n = 22, 66.7%), followed by3º (n = 8, 24.2%), and 4º (n = 3, 9.1%). Biomarkersof inflammation decreased significantly. C-reactive protein (CRP) diminished from 0.33 ± 0.32 mg/dL to 0.25 ± 0.23 mg/dL (P = 0.0456). Erythrocyte sedimentation rate (ESR) decreased from 15.06 ± 12.09 mm/h to 11.81 ± 8.32 mm/h (P = 0.01). Before treatment, pain measured by VAS was 7.33 ± 1.31 points and decreased to 2.84 ± 1.76(P=0.0000). TheWOMAC-painsubscalewas14.84 ± 2.77pointsanddiminishedto5.96 ± 3.53(P=0.0000), WOMACstiffness subscale was 3.06 ± 1.95 points and ameliorated to 1.15 ± 1.3 (P = 0.0000), WOMAC-function subscale was 41.15 ± 12.58 points and decreased to 22.3 ± 11.64 (P = 0.000). Conclusions: Ozoneiscapableof bothdecreasingpainandstiffnessandimprovingfunctionandqualityof lifeinkneeOApatients, yet decreases biomarkers of inflammation, such as CRP and ESR. inflammation hypothesized stiff-nessandQoL,andmanystudiessuggestthatozoneiscapa- bleof amelioratinginflammation(5). Therationaletoeval-uateCRP/ESRisthatinflammationbiomarkersmaypredict outcomes in OA. Elevated hs-CRP predicts loss of cartilage in knee OA and poor results after total knee arthroplasty. acute phase
目的:本研究的目的是评估臭氧是否能够降低炎症生物标志物(CRP/ESR)和疼痛,并改善膝关节骨性关节炎(OA)患者的功能和生活质量。方法:采用前瞻性准实验(前后对照)研究臭氧-apyprotocol的作用。干预包括4次(1次/周)关节内浸润浓度为20 ug/mL的医用氧-臭氧混合物(95%至5%)。治疗前后分别进行生化评价(CRP、ESR)、疼痛VAS、WOMAC评分。结果:总共评估了33例患者。平均年龄68.18±8.43岁。女性占75.7% (n = 25),男性占24.3% (n = 8),男女比例为3:1。最常见的放射学KL分级为2º(n = 22, 66.7%),其次为3º(n = 8, 24.2%)和4º(n = 3, 9.1%)。炎症生物标志物显著降低。c反应蛋白(CRP)由0.33±0.32 mg/dL降至0.25±0.23 mg/dL (P = 0.0456)。红细胞沉降率(ESR)由15.06±12.09 mm/h降至11.81±8.32 mm/h (P = 0.01)。治疗前疼痛评分由7.33±1.31分降至2.84±1.76分(P=0.0000)。womac -疼痛亚量表由14.84±2.77分降至5.96±3.53分(P=0.0000), womac -僵硬亚量表由3.06±1.95分降至1.15±1.3分(P=0.0000), womac -功能亚量表由41.15±12.58分降至22.3±11.64分(P=0.000)。结论:臭氧既能减轻疼痛和僵硬,又能改善新患者的功能和生活质量,同时还能降低炎症的生物标志物,如CRP和ESR。炎症假设僵硬和生活质量,许多研究表明臭氧具有改善炎症的作用(5)。研究表明,炎症生物标志物可以预测OA的预后。hs-CRP升高可预测膝关节OA患者软骨丢失及全膝关节置换术后不良结果。急性期
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引用次数: 14
Prevalence of Depression Among Primary Caregivers of Stroke Survivors in Nigeria 尼日利亚脑卒中幸存者初级护理人员中抑郁症的患病率
Q4 Medicine Pub Date : 2018-04-17 DOI: 10.5812/MEJRH.65080
Umeonwuka Chuka Ifeanyi, Fatimah Sa'ad, Ogbueche Chukwudi Martin, Maduagwu Stanley Monday, Nwachukwu Juliet Onyinyechukwu
Background: Stroke has a great adverse effect not only on the lives of stroke survivors but also on the informal caregivers, as they provide care ranging from assistance in activities of daily living, leading to a high risk of depression and other psychological morbidities. Objectives: This study explored the prevalence of depression and associated factors among primary caregivers of stroke survivors in Nigeria. Methods: A cross sectional survey on the prevalence of depression among primary caregivers of stroke survivors was conducted at selected hospitals in Maiduguri, Nigeria. A sample of convenience was used to recruit participants in this study. The Beck depression inventory was used to screen for depression. Data form and patients folders were used to obtain socio-demographics and clinical characteristics of participants and stroke survivors. Result: A total of 115 primary caregivers participated, out of which 53% were male and 47% were female. The mean age and overall beck depression inventory score were 30.78 ± 9.66 and 15.42 ± 7.84, respectively. The overall prevalence of depression was found to be 46.1%. Type of stroke (P = 0.03) and post stroke duration (P = 0.02) of stroke survivors cared for was found to be associated with depression among caregivers of stroke survivors. Conclusions: Caring for the patients with stroke presents increased in the psychological impact of caregiving for stroke survivors, it is therefore recommended that information, education, and support should be provided to primary caregivers as they are key in sustaining rehabilitation gains and long term overall well-being of stroke survivors.
背景:中风不仅对中风幸存者的生活有很大的不利影响,而且对非正式的照顾者也有很大的负面影响,因为他们提供的照顾包括日常生活活动的帮助,导致抑郁症和其他心理疾病的高风险。目的:本研究探讨了尼日利亚中风幸存者主要照顾者中抑郁症的患病率及其相关因素。方法:在尼日利亚迈杜古里选定的医院对中风幸存者的主要照顾者的抑郁症患病率进行了横断面调查。在这项研究中,使用了一个方便的样本来招募参与者。贝克抑郁量表被用来筛查抑郁症。数据表和患者文件夹用于获得参与者和中风幸存者的社会人口统计和临床特征。结果:共有115名主要照顾者参与,其中53%为男性,47%为女性。平均年龄和贝克抑郁量表总分分别为30.78±9.66和15.42±7.84。抑郁症的总患病率为46.1%。在中风幸存者的护理人员中,中风类型(P=0.03)和中风后持续时间(P=0.02)与抑郁症有关。结论:照顾中风患者会增加照顾中风幸存者的心理影响,因此建议向主要照顾者提供信息、教育和支持,因为他们是维持中风幸存者康复成果和长期整体健康的关键。
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引用次数: 3
Evaluation of a New Method for Biological Activity Analysis of Recombinant Human Parathyroid Hormone-Related Protein 重组人甲状旁腺激素相关蛋白生物活性分析新方法的评价
Q4 Medicine Pub Date : 2018-04-16 DOI: 10.5812/MEJRH.65828
D. Nasrabadi, Siamak Rezaeiani, Ali Sayadmanesh, M. Gharaati, M. B. Eslaminejad, A. Shabani
Background: BaParathyroid hormone-related protein (PTHrP) is a multi-functional protein with a sequence “aa 1-34” similar to that of parathyroid hormone (PTH). In spite of growth factor activity, there is no standardized analytical method to determine the biological activity of recombinant PTHrP. Methods: The current study isolated the cDNA encoding 141 N-terminal amino acid sequence of PTHrP, cloned it in plasmid vec-tor pET32a, and produced recombinant PTHrP in Escherichia coli . The biological activity analysis of the recombinant protein was evaluated using a precise and practical method that measured PTHrP-mediated cell proliferation of a breast cancer cell line MCF7. Additionally, to investigate the accuracy and precision of MCF-7 method used, chondrogenic differentiation condition of PTHrP treated mesenchymal stem cells (MSCs) was evaluated. Results: DNAsequencingand protein massspectrometryanalysisconfirmedtheaccuracy of clonedcDNAsequenceandexpressed the protein. Biological activity analysis showed the increasing effect of recombinant PTHrP on cell proliferation of cancer cell line MCF-7. Alkaline phosphatase and gene expression analysis validated the anti-hypertrophy effects of recombinant PTHrP on chondrogenic differentiation of MSCs. Conclusions: The current study method removed potential challenges and errors in comparability and reproducibility studies focusing on stem cell differentiation and pathogenesis of breast cancer arising from PTHrP biological activity analysis.
背景:甲状旁腺激素相关蛋白(PTHrP)是一种多功能蛋白,其序列“aa 1-34”与甲状旁腺激素(PTH)相似。尽管存在生长因子活性,但没有标准化的分析方法来确定重组PTHrP的生物活性。方法:本研究分离了PTHrP的141个N端氨基酸序列的cDNA,将其克隆到载体pET32a中,并在大肠杆菌中制备了重组PTHr P。使用测量PTHrP-介导的乳腺癌症细胞系MCF7的细胞增殖的精确且实用的方法来评估重组蛋白的生物活性分析。此外,为了研究所用MCF-7方法的准确性和精密度,评估了PTHrP处理的间充质干细胞(MSCs)的软骨分化条件。结果:DNA测序和蛋白质质谱分析证实了克隆的cDNA序列的准确性,并对蛋白质进行了测序。生物活性分析表明,重组PTHrP对癌症细胞系MCF-7细胞增殖的作用增强。碱性磷酸酶和基因表达分析证实了重组PTHrP对MSCs软骨分化的抗肥大作用。结论:目前的研究方法消除了PTHrP生物活性分析引起的关注干细胞分化和癌症发病机制的可比性和再现性研究中的潜在挑战和错误。
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引用次数: 1
Optimized Storage Methods of RNA Extraction from Formalin Fixed Paraffin Embedded Tissue 福尔马林固定石蜡包埋组织RNA提取的优化保存方法
Q4 Medicine Pub Date : 2018-04-16 DOI: 10.5812/MEJRH.63356
Mehdi Barati, M. S. Barough, F. Pak, V. Semnani, Mehrnoosh Pashaei, P. Kokhaei
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引用次数: 0
Chronic Low Back Pain in Young Population: An MRI Study 年轻人慢性腰痛的MRI研究
Q4 Medicine Pub Date : 2018-03-14 DOI: 10.5812/MEJRH.64143
E. Ekin, M. E. Altunrende
Background: Low back pain is a common health problem in the younger population. Spinal degeneration is the most common cause of low back pain. Objectives: The purpose of this study was to investigate the most common causes of low back pain with MRI in young people under the age of 40 and to determine gender differences, if any. Methods: This is a retrospective study on 200 consecutive patients between the ages of 17 39 who had lumbar MRI (1.5 T MRI). Patients were included in the study based on the information collected from the radiological database system and neurosurgical clinical archives between September October 2017. Spinal mass, spondylolisthesis, disc degeneration, multifidus muscular atrophy, and congenital anomalies were investigated. Studied parameters were compared in male and female patients. Results: Disc degeneration or hernia was observed in 132 patients (66%) and no gender difference was found for a disc hernia (P = 0.376 Chi-Square test). The most frequent disc hernia was detected at the level L5 S1. Multifidus muscular atrophy was identified in 54 (27%) of all patients and it was higher in women (P < 0.001, Chi-Square test). Accepted change of lumbar lordosis was detected only in 10 patients. Conclusions: Disc herniation is the most common causes of low back pain in young people under the age of 40 and there are no gender differences.
背景:腰痛是年轻人群中常见的健康问题。脊柱变性是引起腰痛的最常见原因。目的:本研究的目的是通过MRI调查40岁以下年轻人腰痛的最常见原因,并确定性别差异(如果有的话)。方法:这是一项对200名年龄在17-39岁之间的连续腰椎MRI(1.5T MRI)患者的回顾性研究。根据2017年9月至10月期间从放射学数据库系统和神经外科临床档案中收集的信息,将患者纳入研究。研究了脊柱肿块、脊椎滑脱、椎间盘退变、多裂肌萎缩和先天性畸形。对男性和女性患者的研究参数进行了比较。结果:132例(66%)患者观察到椎间盘退变或疝,椎间盘疝无性别差异(P=0.376卡方检验)。最常见的椎间盘疝发生在L5 S1水平。54例(27%)患者发现多发性肌萎缩,女性患者多发性肌肉萎缩率更高(P<0.001,卡方检验)。仅在10例患者中检测到腰椎前凸的可接受变化。结论:椎间盘突出症是40岁以下年轻人腰痛的最常见原因,且无性别差异。
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引用次数: 2
Reliability and Validity of Sedentary Behavior Questionnaire in Turkish Population: Evaluation of Psychometric Properties 土耳其人群久坐行为问卷的信度和效度:心理测量特性的评估
Q4 Medicine Pub Date : 2018-03-12 DOI: 10.5812/MEJRH.63576
Y. Bakar, A. Tuğral, A. Ozel, Y. D. Altuntaş, Y. Yakut
Background: Inactivityandsedentarylifestyleareawell-knownriskfactorsforhealtheffects. Manyquestionnairesevaluatephysi-calactivity(PA)level;however,theevaluationof sedentarybehaviorneedsmoreattention. Sedentarybehaviorquestionnaire(SBQ) isareliable,valid,andeasy-to-administertool. Thecurrentstudyaimedatcross-culturallyadaptingandassessingthereliabilityand validity of the Turkish version of SBQ. Methods: SBQ consists of 9 items related to sedentary lifestyle both on weekdays and weekends. SBQ was administrated to 235 participantswiththeattritionrateof 24%,followedbyarepeatedadministrationafter7daystoassessitsreliability. Criterion-related validitywasanalyzedwiththeinternationalphysicalactivityquestionnaire-shortform(IPAQ-SF)withintheconstructvalidityof the SBQ.Test-retestreliabilitywasassessedbytheintraclasscorrelationcoefficient(ICC),whiletheSpearmanrhowasusedforcriterion-related validity. Results: The ICC scores for each parameter ranged from 0.388 to 0.771. The obtained results showed moderate to good test-retest reliability. The validity results of SBQ somewhat violated the standards, which are generally accepted. Items of SBQ “watching TV (includingvideosonVCD/DVD)”,“sittingandtalkingonthephoneorbeingbusyonthephone”,and“doingpaperworkorcomputer work (office work, e-mails, paying bills, etc.)” correlated significantly with body mass index (BMI) (r = -0.138 to 0.247, P < 0.05). Conclusions: The SBQ had good reliability and acceptable validity to assess sedentary behaviors in a Turkish population.
背景:不活动和日常生活方式是健康影响的危险因素。许多问卷评估了自己的活动能力(PA)水平;然而,对久坐行为的评估需要谨慎。久坐行为问卷(SBQ)是一种可靠、有效且易于管理的工具。目前的研究旨在根据土耳其版SBQ的可靠性和有效性进行跨文化适应。方法:SBQ包括9个与工作日和周末久坐生活方式有关的项目。235名受试者服用SBQ,氚化率为24%,7天后再次服用,以评估其可靠性。在SBQ的结构有效性范围内,用国际物理活性调查表(IPAQ-SF)对标准相关有效性进行了分析。通过类内相关系数(ICC)评估测试的再测试可靠性,而Pearman用于标准相关的有效性。结果:各参数的ICC评分在0.388-0.771之间。所获得的结果显示出中等至良好的重新测试可靠性。SBQ的有效性结果在一定程度上违反了公认的标准。SBQ项目“看电视(包括VCD/DVD上的视频)”、“坐在手机上或在手机上聊天”、,“做文书工作或计算机工作(办公、电子邮件、支付账单等)”与体重指数(BMI)显著相关(r=-0.138-0.247,P<0.05)。结论:SBQ在评估土耳其人群久坐行为方面具有良好的可靠性和可接受的有效性。
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引用次数: 11
Utility of Ultrasound on Musculoskeletal Pathology in Hands of a Rehabilitation Specialist: A Review of the Literature 超声在康复专家手上肌肉骨骼病理学中的应用:文献综述
Q4 Medicine Pub Date : 2018-01-31 DOI: 10.5812/MEJRH.65931
M. E. Fernández-Cuadros, O. Pérez-Moro, M. Albaladejo-Florín, Carmen Ramos-Gonzalez, Laura Cabrera-Rodriguez, Ruben Algarra-López
Musculoskeletal (MSK) disorders are very prevalent in a rehabilitation setting. These disorders involve muscle, tendon, ligaments, as well as nerves, and are related to overuse due to work or sports, and degeneration due to aging. These conditions are usually diagnosedbasedonclinicalsignsandsymptoms;however,amoreaccuratediagnosisisrequired. Theimagingtechniquesfordiag-nosis include radiography, magnetic resonance imaging (MRI), and ultrasounds (US). In this review article, US is proposed to be an effective technique in diagnosing MSK pathologies, which, in hands of a Rehabilitation specialist, constitute a dynamic, accurate, economic, and cost-effective tool.
肌肉骨骼(MSK)障碍在康复环境中非常普遍。这些疾病涉及肌肉、肌腱、韧带和神经,与工作或运动导致的过度使用和衰老导致的退化有关。这些情况通常是根据临床症状和体征来诊断的;然而,需要不准确的诊断。诊断的成像技术包括射线照相术、磁共振成像(MRI)和超声波(US)。在这篇综述文章中,US被认为是诊断MSK病理的一种有效技术,在康复专家手中,它构成了一种动态、准确、经济和高效的工具。
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引用次数: 5
Effects of Walking with Aids on Walking Speed and Selected Cardiovascular Parameters in Apparently Healthy Elderly Individuals 辅助行走对表面健康老年人步行速度和某些心血管参数的影响
Q4 Medicine Pub Date : 2018-01-31 DOI: 10.5812/MEJRH.62803
C. B. Aiyejusunle, A. Akodu, Oluwadamilola Jarinat Giwa
Background: Elderly individuals make up a large part of the population, many of whom use walking aids and also tend to have a higher percentage of cardiovascular complications. There is a need to document the effects of walking with different aids on walking speed and selected cardiovascular parameters. Objectives: Thisstudyaimedatdeterminingandcomparingtheeffectsof walkingwithcane,tripod,andwalkingframeonwalking speed and selected cardiovascular parameters in apparently healthy elderly individuals. Methods: Thirty-five (35) elderly individuals participated in this study. Participants’ systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured after ambulation with and without walking aids. Walking speed (WS) was measured as each participant walked at their normal comfortable pace without aid and with 3 walking aids on separate days. Analysis of variance (ANOVA) was used to find a significant difference between variables. Results: Participants’ meanagewas74.89 ± 7.15years. Systolicbloodpressure(SBP)(138.57 ± 16.62mmHg),diastolicbloodpressure (DBP),(80.37 ± 9.57mmHg),andheartrate(HR)(75.51 ± 9.54beats/min)afterwalkingframeambulationwerehigherthanwithcane (132.91 ± 18.97 mmHg; 78.74 ± 8.59 mmHg; 75.37 ± 10.28 beats/min) and tripod (130.40 ± 16.59 mmHg; 77.31 ± 9.13 mmHg; 74.63 ± 9.92beats/min)ambulation,respectively. Walkingspeed(0.58 ± 0.21m/s)withacanewassignificantlyhigher(P=0.001)thanwith frame (0.31 ± 0.12 m/s), and tripod (0.50 ± 0.19 m/s). Conclusions: Walking frame ambulation elicited a higher blood pressure, a higher HR and a slower WS than cane and tripod ambulation, respectively. The participants walked significantly faster with a cane than tripod and walking frame.
背景:老年人占人口的很大一部分,他们中的许多人使用助行器,也往往有更高比例的心血管并发症。有必要记录不同辅助工具对步行速度和选定心血管参数的影响。目的:本研究旨在确定并比较拐杖、三脚架和步行架对表面健康老年人步行速度和某些心血管参数的影响。方法:35例老年人参加本研究。在有助行器和没有助行器的情况下,测量参与者的收缩压(SBP)、舒张压(DBP)和心率(HR)。步行速度(WS)是在不同的日子里测量的,即每个参与者在没有辅助和有3个辅助的情况下以正常舒适的速度行走。方差分析(ANOVA)用于发现变量之间的显著差异。结果:参与者的平均年龄为74.89±7.15岁。步行后收缩压(SBP)(138.57±16.62mmHg)、舒张压(DBP)(80.37±9.57mmHg)、心率(HR)(75.51±9.54次/分)均高于步行组(132.91±18.97 mmHg);78.74±8.59 mmHg;75.37±10.28次/分钟)和三脚架(130.40±16.59 mmHg;77.31±9.13 mmHg;74.63±9.92次/分)。行走速度(0.58±0.21m/s)显著高于框架(0.31±0.12 m/s)和三脚架(0.50±0.19 m/s) (P=0.001)。结论:与拐杖和三脚架行走相比,步行架行走分别引起血压升高、HR升高和WS减慢。参与者使用拐杖行走的速度明显快于使用三脚架行走的速度。
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引用次数: 1
Barriers and Challenges Experienced by Seniors in Using Online Social Networks: A Phenomenological Study 老年人使用在线社交网络的障碍和挑战:一项现象学研究
Q4 Medicine Pub Date : 2018-01-31 DOI: 10.5812/MEJRH.65310
Marjan Momeni, N. Hariri, Monir Nobahar, F. Noshinfard
Background: Many studies have indicated that the use of social networks and online communication by seniors can improve their general health and social welfare as well as promote the quality of their lives. However, problems with the use of online social networks may prevent them from using the networks. This study aims to explain the experiences of older adults when facing barriers and challenges of using social networks. Methods: This qualitative study takes a phenomenological approach and was carried out in 2016 using purposive sampling. We collected the in-depth semi-structured interviews with 9 seniors) 3 males and 6 females) with an average age of 68.3 years. Subjects confirmed to be active members in at least 1 of the online social networks. The data were analyzed using Colaizzi’s 7-step method. Results: Two main themes of “preconditions of use” and “individual concerns” were extracted from the data analysis. A total of 6 relevant subthemes were as follows: “need for equipment and facilities,” “adequate income”, “need for technical knowledge”, “trust in information”, “trust in other users”, and “security and privacy”. Conclusions: People of older age reported barriers and difficulties using online social networks. It seems that the elderly can be encouraged to use these social networks and improve the quality of their lives through educational planning.
背景:许多研究表明,老年人使用社交网络和在线交流可以改善他们的总体健康和社会福利,并提高他们的生活质量。然而,使用在线社交网络的问题可能会阻止他们使用网络。这项研究旨在解释老年人在使用社交网络时遇到的障碍和挑战。方法:这项定性研究采用现象学方法,于2016年使用目的性抽样进行。我们收集了9名平均年龄为68.3岁的老年人(3名男性和6名女性)的深度半结构化访谈。受试者被确认为至少1个在线社交网络中的活跃成员。使用Colaizzi的7步方法对数据进行分析。结果:从数据分析中提取了“使用的先决条件”和“个人关注”两个主题。共有6个相关分主题如下:“对设备和设施的需求”、“充足的收入”、“对技术知识的需求”,“对信息的信任”、“信任其他用户”以及“安全和隐私”。结论:老年人报告了使用在线社交网络的障碍和困难。似乎可以鼓励老年人使用这些社交网络,并通过教育规划提高他们的生活质量。
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引用次数: 6
Comparison of Sublingual Misoprostol and Intravenous Oxytocin in the Management of Postpartum Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial 舌下米索前列醇与静脉催产素治疗剖宫产产后出血的比较:一项随机对照试验
Q4 Medicine Pub Date : 2018-01-31 DOI: 10.5812/MEJRH.62025
N. Rahbar, Neda Mirjan, R. Ghorbani
Background: Postpartumhemorrhage(PPH)isoneof themostimportantcausesof maternalmorbidityandmortality. Ithasbeen accepted that an effective way for preventing PPH is active management of third stage of labor. Objectives: Thisstudyaimedatfindingtheeffectof 800 µ gofsublingualmisoprostolcomparedto60unitsofintravenousoxytocin in Ringer-lactate to reduce PPH after cesarean delivery. Methods: This single blind randomized clinical trial was conducted at Amir Al-Momenin hospital in Semnan, Iran, from June 2013 to April 2014. A total of 100 pregnant (Gravidity 1, 2) women entered the study. They were randomized into 2 groups. One group received800 µ gsublingualmisoprostol(n=50)andtheothergroupreceived60IUoxytocinintravenously(n=50)inthecesarean section under spinal anesthesia, immediately after the opening of the peritoneum. Results: The mean ± SD decline in hematocrit level after 24 hours of delivery was 2.6% ± 2.3% in misoprostol group and it was 3.2% ± 2.5% in oxytocin group, and the difference was not significant (P = 0.27). The need for the additional uterotonic drug was significantly higher in the oxytocin group (16%) than in the misoprostol group (2.1%) one hour after delivery (P = 0.031). During one hour after delivery, the incidence of shivering was significantly lower in oxytocin group (P = 0.001), but on the contrary, the incidence of hypotension in the oxytocin received patients was higher (P = 0.003). Conclusions: The effectiveness of sublingual misoprostol is similar to intravenous oxytocin in reducing cesarean section hemorrhage. Moreover,becauseshiveringasanuntreatableadverseeffectof misoprostolwasverybothersomeforthepatients,werecom-mend that sublingual misoprostol not be used in high dosage.
背景:产后出血(PPH)是导致产妇患病和死亡的最重要原因之一。人们普遍认为,预防产后出血的有效方法是积极管理第三产程。目的:本研究旨在观察在乳酸林格中使用800µgo的异丙醇与60单位的静脉注射催产素相比,对降低剖宫产后产后产后出血的效果。方法:这项单盲随机临床试验于2013年6月至2014年4月在伊朗塞姆南的阿米尔·莫梅宁医院进行。共有100名孕妇(妊娠1,2)参加了这项研究。他们被随机分为2组。一组在腹膜打开后立即接受800µg的异丙肾上腺素(n=50),另一组在脊髓麻醉下于剖宫产时接受60IU催产素(n=50。结果:米索前列醇组产后24小时红细胞压积下降平均±SD为2.6%±2.3%,缩宫素组为3.2%±2.5%,差异不显著(P=0.27)。催产素组在分娩后1小时对额外的子宫收缩药物的需求(16%)显著高于米索前列醇组(2.1%)(P=0.031)。在分娩后一小时内,催产素组的颤抖发生率显著降低(P=0.001),但相反,接受催产素治疗的患者低血压发生率较高(P=0.003)。结论:舌下米索前列醇在减少剖宫产出血方面的效果与静脉注射催产素相似。此外,由于无法治疗的米索前列醇不良反应对肝炎患者来说非常麻烦,我们建议不要大剂量使用舌下米索前列。
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引用次数: 2
期刊
Middle East Journal of Rehabilitation and Health
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