Pub Date : 2023-10-01DOI: 10.21608/ijma.2023.236794.1815
Ahmed Abdelhakim, Alsayed Hamdy, Ahmed Ahmed, Ahmed Abo Elfottoh
Article information Background: The routine uses of intraoperative cholangiography [IOC] is still controversial. Some authors support routine IOC, while others favor selective IOC. The operative ultrasonography [OUS] probe provides a new modality for evaluating biliary anatomy and detection of Choledocholithiasis during laparoscopic cholecystectomy. It is considered a faster, safer, and non-invasive technique. Aim of the Study: This study aims to compare the accuracy of operative ultrasonography [OUS] and IOC in the detection of common bile duct stones during laparoscopic cholecystectomy. Patients and Methods: This prospective comparative study included 50 patients who underwent laparoscopic cholecystectomies with or without bile duct exploration, which was done at El-Hussein University Hospital in the period from March 2018 to December 2019. Operative laparoscopic ultrasonography was performed followed by an operative cholangiogram. Bile ducts were explored if CBD stones were seen and the patients were followed up by clinical evaluation, laboratory investigations, and abdominal ultrasound within one month from surgery. Results: The IOUS timing which was the time after identification of the cystic duct and artery till the start of IOC, was significantly lower than the IOC Timing which was the time After IOUS till clipping of the proximal part of the cystic duct. The sensitivity and specificity of IOUS for detection of CBD stone was 100%, and 94.4% respectively in comparison to 100% sensitivity and specificity in the IOC. Conclusion: During the exploration of the CBD stones, the IOUS is just as sensitive and specific as the IOC. It's less invasive than IOC and can be done quickly by any skilled surgeon, so during a laparoscopic cholecystectomy, IOUS can reliably replace IOC.
文章信息 背景：术中胆管造影术（IOC）的常规应用仍存在争议。一些学者支持常规术中胆管造影，而另一些学者则支持选择性术中胆管造影。术中超声探头（OUS）为腹腔镜胆囊切除术中评估胆道解剖结构和检测胆总管结石提供了一种新的模式。它被认为是一种更快、更安全、无创的技术。研究目的：本研究旨在比较腹腔镜胆囊切除术中手术超声波检查[OUS]和 IOC 检测胆总管结石的准确性。患者和方法：这项前瞻性比较研究纳入了 2018 年 3 月至 2019 年 12 月期间在侯赛因大学医院接受腹腔镜胆囊切除术并进行或不进行胆管探查的 50 名患者。在进行手术腹腔镜超声检查后，再进行手术胆管造影。如果看到CBD结石，则对胆管进行探查，并在手术后一个月内通过临床评估、实验室检查和腹部超声对患者进行随访。结果IOUS 时间是指确定胆囊管和胆囊动脉后到开始 IOC 的时间，明显低于 IOC 时间，后者是指 IOUS 后到剪断胆囊管近端部分的时间。IOUS检测CBD结石的敏感性和特异性分别为100%和94.4%，而IOC的敏感性和特异性均为100%。结论：在CBD结石的探查过程中，IOUS与IOC具有同样的敏感性和特异性。与 IOC 相比，IOUS 的创伤更小，任何熟练的外科医生都能快速完成，因此在腹腔镜胆囊切除术中，IOUS 可以可靠地取代 IOC。
{"title":"A Comparative Study between Operative Ultrasonography and Perioperative Cholangiography in Screening of The Common Bile Duct for Stones During Laparoscopic Cholecystectomy","authors":"Ahmed Abdelhakim, Alsayed Hamdy, Ahmed Ahmed, Ahmed Abo Elfottoh","doi":"10.21608/ijma.2023.236794.1815","DOIUrl":"https://doi.org/10.21608/ijma.2023.236794.1815","url":null,"abstract":"Article information Background: The routine uses of intraoperative cholangiography [IOC] is still controversial. Some authors support routine IOC, while others favor selective IOC. The operative ultrasonography [OUS] probe provides a new modality for evaluating biliary anatomy and detection of Choledocholithiasis during laparoscopic cholecystectomy. It is considered a faster, safer, and non-invasive technique. Aim of the Study: This study aims to compare the accuracy of operative ultrasonography [OUS] and IOC in the detection of common bile duct stones during laparoscopic cholecystectomy. Patients and Methods: This prospective comparative study included 50 patients who underwent laparoscopic cholecystectomies with or without bile duct exploration, which was done at El-Hussein University Hospital in the period from March 2018 to December 2019. Operative laparoscopic ultrasonography was performed followed by an operative cholangiogram. Bile ducts were explored if CBD stones were seen and the patients were followed up by clinical evaluation, laboratory investigations, and abdominal ultrasound within one month from surgery. Results: The IOUS timing which was the time after identification of the cystic duct and artery till the start of IOC, was significantly lower than the IOC Timing which was the time After IOUS till clipping of the proximal part of the cystic duct. The sensitivity and specificity of IOUS for detection of CBD stone was 100%, and 94.4% respectively in comparison to 100% sensitivity and specificity in the IOC. Conclusion: During the exploration of the CBD stones, the IOUS is just as sensitive and specific as the IOC. It's less invasive than IOC and can be done quickly by any skilled surgeon, so during a laparoscopic cholecystectomy, IOUS can reliably replace IOC.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139329779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Article information Background: Silver nanoparticles [AgNPs] are commonly used nanomaterials, and they are considered more hazardous than other metal nanoparticles. Aim of the work: The current work aimed to assess the toxic impacts of AgNPs on the kidneys of adult male albino rats through biochemical, GADD45A gene expression, and histological studies. Additionally, the study aimed to evaluate the potential therapeutic effects of Platelet-rich plasma [PRP] and the recovery of these impacts after discontinuation of AgNPs intake without any treatment Materials and Methods: This controlled clinical trial study comprised 28 rats divided into four groups: control, AgNPs [10 mg/kg/day] for 28 days, AgNPs for 28 days followed by PRP administration [0.5 ml/kg] twice weekly for three weeks, and AgNPs for 28 days with a subsequent three-week period of auto-recovery after the last dose of AgNPs. The treatment was administered intraperitoneally. Serum levels of creatinine, urea, uric acid, Tumor Necrosis Factor-α, and Interleukin 6, kidney tissue levels of superoxide dismutase, reduced glutathione, and malondialdehyde, GADD45A gene expression, histological changes of the kidney, and an immunohistochemical study of an apoptotic marker [Bax] were assessed. Results: The findings of the current study revealed that administration of Ag-NPs produced toxic effects on the rats’ kidney. These effects were indicated by disturbances in kidney functions, oxidative stress markers, inflammatory markers, and GADD45A gene expression, relative to the control group. Histologically, there was observed distortion of renal structure, and renal tubular cells and glomeruli showed strong positive immunoexpression of Bax compared to the control group. However, these effects improved after the administration of PRP. In the auto-recovery group, where Ag-NPs administration was ceased, there was a slight improvement compared to the Ag-NPs toxic group. Conclusion: Ag-NPs have toxic effects on the kidney, but the use of PRP led to the improvement of this toxicity. The auto-recovery group showed only minimal improvement.
{"title":"Auto-Recovery from Silver Nanoparticles Toxic Effects on The Kidney and Possible Curative Role of Platelet Rich Plasma in Adult Male Albino Rats","authors":"Rehab Megahed, Asmaa El-sheikh, Asmaa Yousuf, Shaymaa Mohammed, Fattoma El- Mashad, Mohammed Morsy","doi":"10.21608/ijma.2023.222301.1735","DOIUrl":"https://doi.org/10.21608/ijma.2023.222301.1735","url":null,"abstract":"Article information Background: Silver nanoparticles [AgNPs] are commonly used nanomaterials, and they are considered more hazardous than other metal nanoparticles. Aim of the work: The current work aimed to assess the toxic impacts of AgNPs on the kidneys of adult male albino rats through biochemical, GADD45A gene expression, and histological studies. Additionally, the study aimed to evaluate the potential therapeutic effects of Platelet-rich plasma [PRP] and the recovery of these impacts after discontinuation of AgNPs intake without any treatment Materials and Methods: This controlled clinical trial study comprised 28 rats divided into four groups: control, AgNPs [10 mg/kg/day] for 28 days, AgNPs for 28 days followed by PRP administration [0.5 ml/kg] twice weekly for three weeks, and AgNPs for 28 days with a subsequent three-week period of auto-recovery after the last dose of AgNPs. The treatment was administered intraperitoneally. Serum levels of creatinine, urea, uric acid, Tumor Necrosis Factor-α, and Interleukin 6, kidney tissue levels of superoxide dismutase, reduced glutathione, and malondialdehyde, GADD45A gene expression, histological changes of the kidney, and an immunohistochemical study of an apoptotic marker [Bax] were assessed. Results: The findings of the current study revealed that administration of Ag-NPs produced toxic effects on the rats’ kidney. These effects were indicated by disturbances in kidney functions, oxidative stress markers, inflammatory markers, and GADD45A gene expression, relative to the control group. Histologically, there was observed distortion of renal structure, and renal tubular cells and glomeruli showed strong positive immunoexpression of Bax compared to the control group. However, these effects improved after the administration of PRP. In the auto-recovery group, where Ag-NPs administration was ceased, there was a slight improvement compared to the Ag-NPs toxic group. Conclusion: Ag-NPs have toxic effects on the kidney, but the use of PRP led to the improvement of this toxicity. The auto-recovery group showed only minimal improvement.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135926363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-21DOI: 10.21608/ijma.2023.223411.1741
Mohammed Mohammed, Mostafa Abdelsalam, Mona Tawfik, Mona Mostafa, Zenat Mohammed
ABSTRACT
{"title":"Impact of Intraoperative Degrees of Hypotensive Anaesthesia Using Dexmedetomidine on Perioperative Renal Injuries in Patients Undergoing Endoscopic Sinus Surgery","authors":"Mohammed Mohammed, Mostafa Abdelsalam, Mona Tawfik, Mona Mostafa, Zenat Mohammed","doi":"10.21608/ijma.2023.223411.1741","DOIUrl":"https://doi.org/10.21608/ijma.2023.223411.1741","url":null,"abstract":"ABSTRACT","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136237959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.21608/ijma.2023.189805.1608
Emad Atallah, Abdel-Monsef Moustafa, Ahmed Eltabakh
Article information Background: Numerous bacteria live in the human vagina; because of this, it has been discovered that the vaginal microbiome is directly related to both vaginal and overall health. Aim of the work: In this study, we sought to evaluate the vaginal microbiomes of premenopausal and post-menopausal women. Patients and Methods: This was a comparative cross section study, was carried out on 120 patients who divided in to two groups as regard menopausal state in to Group A: 60 women in Premenopausal group and Group B: 60 women in Post-Menopausal group, vaginal samples were obtained from all studied women. Results: As regard bacterial distribution according to Phylum; there was a significant difference between two groups regarding Firmicutes and Proteobacteria which were higher among premenopausal women. Conclusion: Women in each study group had different vaginal ecosystems in terms of the relative quantity and composition of the dominating bacterial species. While species diversity greatly increased in postmenopausal women, species richness significantly declined. After menopause, the most significant difference between the two groups was caused by a decline in Lactobacillus taxa, which are represented by all taxon ranks of the vaginal microbiome.
{"title":"Comparison of The Vaginal Microflora in Relation to The Menopausal Status","authors":"Emad Atallah, Abdel-Monsef Moustafa, Ahmed Eltabakh","doi":"10.21608/ijma.2023.189805.1608","DOIUrl":"https://doi.org/10.21608/ijma.2023.189805.1608","url":null,"abstract":"Article information Background: Numerous bacteria live in the human vagina; because of this, it has been discovered that the vaginal microbiome is directly related to both vaginal and overall health. Aim of the work: In this study, we sought to evaluate the vaginal microbiomes of premenopausal and post-menopausal women. Patients and Methods: This was a comparative cross section study, was carried out on 120 patients who divided in to two groups as regard menopausal state in to Group A: 60 women in Premenopausal group and Group B: 60 women in Post-Menopausal group, vaginal samples were obtained from all studied women. Results: As regard bacterial distribution according to Phylum; there was a significant difference between two groups regarding Firmicutes and Proteobacteria which were higher among premenopausal women. Conclusion: Women in each study group had different vaginal ecosystems in terms of the relative quantity and composition of the dominating bacterial species. While species diversity greatly increased in postmenopausal women, species richness significantly declined. After menopause, the most significant difference between the two groups was caused by a decline in Lactobacillus taxa, which are represented by all taxon ranks of the vaginal microbiome.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135109084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.21608/ijma.2023.228728.1769
Waleed Gaber, Abd Al Shakour Abd Al Wahed, Mohamed Kamel
Article information Background: A multitude of treatment options have been used in dealing with enlarged facial pores. However, there is a lack of studies assessing the effectiveness of oral isotretinoin, which is commonly used to treat acne, as a treatment option for enlarged facial pores in such patients. Aim of the work: To assess the effectiveness of oral isotretinoin in reducing the size of enlarged facial pores in patients with moderate and severe acne vulgaris. Patients and Methods: Forty cases with moderate and severe acne vulgaris, characterized by the presence of multiple to numerous inflammatory papules, pustules, nodules, and scarring, as well as enlarged facial pores, were prescribed oral isotretinoin. The daily dosage ranged from 0.5 to 1.0 mg/kg/day, with a total cumulative dose of 120 mg/kg administered over a 6-month treatment period. For each patient, dermoscopic photos were taken of the enlarged facial pores located on the tip of the nose, where sebum production is high and the pores are clinically visible. These photos were captured both before and after the 6 months of treatment. The total surface area of all facial pores was measured using Fiji software, and a comparison was made between the measurements before and after treatment to determine any differences. Results: All of the treated patients exhibited a statistically significant decrease in the size of their facial pores after treatment [0.46 ± 0.2 mm 2 ], as compared to the size of their facial pores before treatment [0.67 ± 0.3 mm 2 ], with a p-value < 0.05. Conclusion: In our study, Isotretinoin has been demonstrated to be a safe and effective treatment modality for managing enlarged facial pores in patients with moderate and severe acne vulgaris.
{"title":"Efficacy of Isotretinoin in The Management of Enlarged Facial Pores in Moderate and Severe Acne Vulgaris Patients","authors":"Waleed Gaber, Abd Al Shakour Abd Al Wahed, Mohamed Kamel","doi":"10.21608/ijma.2023.228728.1769","DOIUrl":"https://doi.org/10.21608/ijma.2023.228728.1769","url":null,"abstract":"Article information Background: A multitude of treatment options have been used in dealing with enlarged facial pores. However, there is a lack of studies assessing the effectiveness of oral isotretinoin, which is commonly used to treat acne, as a treatment option for enlarged facial pores in such patients. Aim of the work: To assess the effectiveness of oral isotretinoin in reducing the size of enlarged facial pores in patients with moderate and severe acne vulgaris. Patients and Methods: Forty cases with moderate and severe acne vulgaris, characterized by the presence of multiple to numerous inflammatory papules, pustules, nodules, and scarring, as well as enlarged facial pores, were prescribed oral isotretinoin. The daily dosage ranged from 0.5 to 1.0 mg/kg/day, with a total cumulative dose of 120 mg/kg administered over a 6-month treatment period. For each patient, dermoscopic photos were taken of the enlarged facial pores located on the tip of the nose, where sebum production is high and the pores are clinically visible. These photos were captured both before and after the 6 months of treatment. The total surface area of all facial pores was measured using Fiji software, and a comparison was made between the measurements before and after treatment to determine any differences. Results: All of the treated patients exhibited a statistically significant decrease in the size of their facial pores after treatment [0.46 ± 0.2 mm 2 ], as compared to the size of their facial pores before treatment [0.67 ± 0.3 mm 2 ], with a p-value < 0.05. Conclusion: In our study, Isotretinoin has been demonstrated to be a safe and effective treatment modality for managing enlarged facial pores in patients with moderate and severe acne vulgaris.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135485644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-12DOI: 10.21608/ijma.2023.229745.1778
Ghada El desouky, Abdelrahman Emam, Rashed Rashed
{"title":"Gynecologists Basic Knowledge of Electrosurgery","authors":"Ghada El desouky, Abdelrahman Emam, Rashed Rashed","doi":"10.21608/ijma.2023.229745.1778","DOIUrl":"https://doi.org/10.21608/ijma.2023.229745.1778","url":null,"abstract":"","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-12DOI: 10.21608/ijma.2023.229103.1773
Ahmed Mounir Ahmed El-Saeed, Walaa Elbassioune, Abdelrahman Emam
{"title":"Evaluating Fetal Kidney Length and Trans-cerebellar Diameter as Ultrasound Biometry Parameters for Gestational Age Estimation in the Third Trimester","authors":"Ahmed Mounir Ahmed El-Saeed, Walaa Elbassioune, Abdelrahman Emam","doi":"10.21608/ijma.2023.229103.1773","DOIUrl":"https://doi.org/10.21608/ijma.2023.229103.1773","url":null,"abstract":"","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-11DOI: 10.21608/ijma.2023.181427.1575
Essam Mohamed Elbaz, Samir El-Shoura, Mustafa Rabea, Mahmoud El Said
ABSTRACT
{"title":"Feasibility of Percutaneous Pedicle Screw Fixation in The Treatment of Thoracolumbar Fractures","authors":"Essam Mohamed Elbaz, Samir El-Shoura, Mustafa Rabea, Mahmoud El Said","doi":"10.21608/ijma.2023.181427.1575","DOIUrl":"https://doi.org/10.21608/ijma.2023.181427.1575","url":null,"abstract":"ABSTRACT","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136025378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-10DOI: 10.21608/ijma.2023.231288.1787
Rana Abou-shehata, Abdelraoof Oun, Mahmoud S. Mahmoud
Article information Background: As there is increase in cesarean section mode of delivery, growing concerns related to its negative consequences are raised and reliable diagnostic tools are of crucial importance in order to diagnose caesarean scar defect. Aim of the work: The aim of this study was to compare the efficacy of 3D ultrasound versus Hysteroscopy in diagnosis of caesarean scar defect. Patients and Methods: Three hundred cases of female patients 6-12 months after undergoing cesarean section were recruited and assessed for eligibility at the outpatient Gynecology Clinic in Al-Azhar University Hospital [Damietta]. The study cases were examined using 3D trans-vaginal ultrasound for detecting the presence of caesarean scar defect [niche] and assessing its site, depth, shape and volume and measuring the residual myometrium. Diagnostic hysteroscopy was carried out to all patients under anesthesia and compared blindly to the ultrasound findings. Results: The mean scar thickness of the study group by trans-vaginal ultrasound was 1.94±0.89 with range 0.65-3.2 cm. There was significant difference between using the trans-vaginal ultrasound and hysteroscopy regarding detecting scar ballooning, it was detected in 74 cases [24.7%] using trans-vaginal ultrasound in compare with 38 cases [12.7%] diagnosed by hysteroscopy [P<0.001]. There was no significant difference between using the trans-vaginal ultrasound and hysteroscopy regarding detecting the site of the scar [P=0.52], the continuity of scar [P= 0.24] and the vascularity of scar [P=0.33]. Conclusion: Ultrasound is of greater value in evaluating scar thickness and detecting scar defect originated after cesarean section than hysteroscopy.
{"title":"Three-dimensional Ultrasound versus Hysteroscopy in Diagnosis of Cesarean Scar Defect","authors":"Rana Abou-shehata, Abdelraoof Oun, Mahmoud S. Mahmoud","doi":"10.21608/ijma.2023.231288.1787","DOIUrl":"https://doi.org/10.21608/ijma.2023.231288.1787","url":null,"abstract":"Article information Background: As there is increase in cesarean section mode of delivery, growing concerns related to its negative consequences are raised and reliable diagnostic tools are of crucial importance in order to diagnose caesarean scar defect. Aim of the work: The aim of this study was to compare the efficacy of 3D ultrasound versus Hysteroscopy in diagnosis of caesarean scar defect. Patients and Methods: Three hundred cases of female patients 6-12 months after undergoing cesarean section were recruited and assessed for eligibility at the outpatient Gynecology Clinic in Al-Azhar University Hospital [Damietta]. The study cases were examined using 3D trans-vaginal ultrasound for detecting the presence of caesarean scar defect [niche] and assessing its site, depth, shape and volume and measuring the residual myometrium. Diagnostic hysteroscopy was carried out to all patients under anesthesia and compared blindly to the ultrasound findings. Results: The mean scar thickness of the study group by trans-vaginal ultrasound was 1.94±0.89 with range 0.65-3.2 cm. There was significant difference between using the trans-vaginal ultrasound and hysteroscopy regarding detecting scar ballooning, it was detected in 74 cases [24.7%] using trans-vaginal ultrasound in compare with 38 cases [12.7%] diagnosed by hysteroscopy [P<0.001]. There was no significant difference between using the trans-vaginal ultrasound and hysteroscopy regarding detecting the site of the scar [P=0.52], the continuity of scar [P= 0.24] and the vascularity of scar [P=0.33]. Conclusion: Ultrasound is of greater value in evaluating scar thickness and detecting scar defect originated after cesarean section than hysteroscopy.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136073561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.21608/ijma.2023.214270.1696
Khaled Elsheshtawy
Article information Background: The outcome of spontaneous vaginal birth is improved using analgesics during the three phases of labour. Both pharmaceutical and non-pharmaceutical approaches have been tried. Therefore, this study aimed to compare parenteral ketamine and tramadol regarding their analgesic effect and maternal and labor outcome. Patients and Methods: This randomized clinical trial was conducted on 100 primigravida and multigravida women. The study population was randomized into two equal groups; ketamine group: received low dose ketamine 0.4 mg/kg body weight intravenous [IV] slowly over 30-60 seconds with maintenance dose at the rate of 1 mg/min in normal saline after 30 min of induction dose using an infusion pump and the tramadol group: 1 mg/kg iv slowly for 5-10 minutes then after 30 min we start maintenance by IV Tramadol 0.3 mg /kg/hr. Results: Ketamine significantly decreased the time of onset analgesia [p=0.036] and VAS [p=0.002] than tramadol. Ketamine has a significant advance in patient satisfaction than tramadol. The duration of all 3 stages of labor, Apgar score after 1 min, Apgar score after 5 min, and the percentage of maternal complications did not exhibit any significant change between both groups. Conclusion: In spontaneous vaginal delivery, ketamine and tramadol are considered safe drugs with low complications and similar Apgar scores after 1 min and also after 5 min with superiority of ketamine than tramadol regarding the earlier time of onset analgesia, lower VAS score and better patient satisfaction.
{"title":"Ketamine versus Tramadol for Analgesia in Spontaneous Vaginal Delivery: A Randomized Clinical Trial","authors":"Khaled Elsheshtawy","doi":"10.21608/ijma.2023.214270.1696","DOIUrl":"https://doi.org/10.21608/ijma.2023.214270.1696","url":null,"abstract":"Article information Background: The outcome of spontaneous vaginal birth is improved using analgesics during the three phases of labour. Both pharmaceutical and non-pharmaceutical approaches have been tried. Therefore, this study aimed to compare parenteral ketamine and tramadol regarding their analgesic effect and maternal and labor outcome. Patients and Methods: This randomized clinical trial was conducted on 100 primigravida and multigravida women. The study population was randomized into two equal groups; ketamine group: received low dose ketamine 0.4 mg/kg body weight intravenous [IV] slowly over 30-60 seconds with maintenance dose at the rate of 1 mg/min in normal saline after 30 min of induction dose using an infusion pump and the tramadol group: 1 mg/kg iv slowly for 5-10 minutes then after 30 min we start maintenance by IV Tramadol 0.3 mg /kg/hr. Results: Ketamine significantly decreased the time of onset analgesia [p=0.036] and VAS [p=0.002] than tramadol. Ketamine has a significant advance in patient satisfaction than tramadol. The duration of all 3 stages of labor, Apgar score after 1 min, Apgar score after 5 min, and the percentage of maternal complications did not exhibit any significant change between both groups. Conclusion: In spontaneous vaginal delivery, ketamine and tramadol are considered safe drugs with low complications and similar Apgar scores after 1 min and also after 5 min with superiority of ketamine than tramadol regarding the earlier time of onset analgesia, lower VAS score and better patient satisfaction.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136193626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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