Duration Of Bleeding Research Articles

RELATIONSHIP BETWEEN MENSTRUAL PAIN AND QUALITY OF LIFE

Menstrual pain is a common socially significant problem that leads to discomfort and absence from work, with a negative impact on health status, improvement of life, and personal and public finances. The review of the scientific literature aimed at the concepts in world research related to menstrual pain and its impact on a better life. The current study aimed to investigate the relationship between menstrual pain and quality of life. The study contingent is physically active women of reproductive age. 125 physically active female students at the Vasil Levski National Sports Academy, Sofia, Bulgaria, were studied. The contingent was characterized by age, duration of bleeding in days, amount of menstruation, degree of menstrual pain, and self-assessment of the effect of menstrual pain on workability. We use the Brunnsviken Brief Quality of Life scale (BBQ) in the study. A study conducted by us demonstrated a high prevalence of dysmenorrhea among young women. We consider it necessary to compile and approve a PROGRAM of physical exercises for personal and professional use by women with menstrual pain and specialists. Any effort in this direction will have an indirect benefit for personal and public finances, by preserving the working capacity of the women concerned.

The Duration of Menstrual Blood Loss: Historical to Current Understanding

Most published research focuses on the amount of menstrual blood loss and, to a lesser extent, on cyclicity. Little attention has been paid to the duration of bleeding, the factors that enable its cessation within a ‘normal’ timeframe, or to patterns that entail interruption and resumption of blood loss. The definition of what constitutes normal remains arbitrary and there is no therapy specifically designed to shorten the duration of bleeding. Here, we critically review the literature that addresses the duration of bleeding and the factors that trigger endometrial breakdown and repair. Available reports used population averages which mask inter- and intra-individual variations. The duration of bleeding is not necessarily linked to the amount of loss but may be influenced by age, ethnicity, habitus, region and altitude of residence, dieting and stress. The onset of bleeding has been linked to declining steroid production by the corpus luteum. There remains considerable controversy around the extent of endometrial shedding at menstruation. This is likely to vary within and between women. The significance of a change from previous patterns, very short or prolonged bleeding, days of light loss or spotting before or after days of bleeding, or of bleed-free days that punctuate flow, remain poorly understood.

Hubungan Aktivitas Fisik dengan Dismenore Primer pada Remaja Putri: Systematic Review

The prevalence of dysmenorrhea in adolescents worldwide ranges from 41.7% -94%. This is caused by age at menarche, genetic, BMI, diet, duration of menstrual bleeding, smoking, coffee consumption and physical activity. Physical activity produces short-term non-specific analgesics thereby reducing pain. To determine the relationship between physical activity and primary dysmenorrhea in young women. This study used a systematic review by searching the literature from four e-databases namely Pubmed, Sciencedirect, Scopus, and Web of science. The inclusion criteria in this study were articles in the last 5 years (2018-2022), English literature, full text, open access literature, originalresearch and described physical activity with the incidence of primary dysmenorrhea in adolescents, while the exclusion criteria for this study were literature originating from non-research study, adolescents with secondary dysmenorrhea. Literature quality assessment uses a quality assessment tool from EPHPP (Effective Public Health Practice Project). From the 9 (nine) articles reviewed, it was found that all articles had a relationship between physical activity and primary dysmenorrhea. Physical activity is associated with primary dysmenorrhea in female adolescents.

Incidence and reasons for conversion of laparoscopic cholecystectomy to open cholecystectomy

Introduction: Cholelithiasis is one of the most common problems affecting the gastrointestinal tract. The objective of the study was to find the incidence of cases converted to open cholecystectomy from laparoscopic cholecystectomy and find the association with other intra-operative and preoperative findings. Methods: This is a prospective observational study. One hundred elective laparoscopic cholecystectomy cases in the institution of the study were the study sample. Pre-operative and intra-operative findings were noted. Conversion in surgery from laparoscopic cholecystectomy to open cholecystectomy was also recorded and the association was tested through Fisher’s exact test. Results: The rate of conversion from laparoscopic cholecystectomy to open cholecystectomy was 5%. which was significantly related to sex, time duration of the surgery, bleeding, and anatomical difficulties. Conclusions: The conversion rate is only 5% which was significantly associated with sex, time duration of surgery, intraoperative bleeding, and anatomical difficulties.

P-530 Which evacuation method for missed abortion is preferred by women with recurrent pregnancy loss?

Abstract Study question Is medical or surgical evacuation for missed abortion (MA) preferred by women with recurrent pregnancy loss (RPL)? Which factors are determining for the women’s preference? Summary answer Sixty-seven percent of the participants preferred surgical evacuation. Side effects and a history of unsuccessful medical evacuation in their first MA were determining factors. What is known already Guidelines currently recommend medical rather than surgical evacuation after MA. The success rates defined as adequate evacuation of the uterine cavity after MA without further intervention are reported to be 80% and 97% for medical and surgical evacuation, respectively. Medical evacuation is associated with heavier and longer duration of bleeding and higher intensity of pain. Surgical evacuation increases the risk of uterine perforation and Asherman’s syndrome. Studies have found that women are more satisfied and have better subsequent mental health when they can decide themselves which method they would choose. Study design, size, duration An online questionnaire was sent October 5th, 2022, to 157 RPL patients who had experienced both medical and surgical evacuation for MA admitted to a center for RPL between January 2016 and September 2022. Eighty-seven (55.4%) patients completed the survey before deadline after being sent reminders. Sixty (69%) of the women had received a medical evacuation and 27 (31%) surgical evacuation for their first MA. Participants/materials, setting, methods The mean age of the respondents was 37 years (SD ± 0.5) and they had had at least three pregnancy losses. The questionnaire featured questions regarding the women’s experiences with medical and surgical evacuation, preferred evacuation method if they would have another MA, and determining factors for their preference. Categorical variables were compared using χ2 test and Wilcoxon Signed Rank Test. Analyses were conducted to determine associations between potential determining factors for preferred evacuation method. Main results and the role of chance A significantly higher intensity of pain was experienced, and analgesics were required for a significantly longer period after a first medical evacuation compared to a first surgical evacuation (p < 0.001 and p = 0.006). Bleeding, pain, sick leave, and mental discomfort had a significant impact on the choice of another evacuation method at the time of next MA in women who experienced a medical abortion first. As many as 40% had experienced failure of the first medical evacuation with need for subsequent surgical evacuation for complete evacuation; this was confirmed by consulting the patient’s medical records. The odds ratio (OR) for preferring medical evacuation at next MA was 3.3 if the women had given birth before (p = 0.011). The OR for preferring medical evacuation at next MA was 0.3, if the women had received medical evacuation for their first MA (p = 0.015). There were no statistically significant associations between preferring medical evacuation and the following factors: BMI, age at first evacuation and menstrual pain. Two thirds (66.7%) of the women would prefer surgical evacuation for their next MA, while the remaining women (33.3%) would prefer medical evacuation. Limitations, reasons for caution The response rate of 55.4% was lower than expected 70% which implicates a risk of sampling bias such as a predominance of patients with a history of complicated evacuations responding to the questionnaire. Due to the retrospective design, recollection bias could also impact the results. Wider implications of the findings In this study population, medical evacuation was associated with a stronger experience of side effects and a higher failure rate than expected, which may explain why more women preferred surgical evacuation for their next MA. This may suggest current evacuation recommendations for MAs should become more individualized than currently. Trial registration number Not applicable

Effectiveness of endometrial biopsy and diagnostic dilatation and curettage aiming adequate specimen collection for histopathology for the diagnosis of endometrial carcinoma in patients with abnormal vaginal bleeding.

Objective: To compare the effectiveness of endometrial biopsy and diagnostic dilatation and curettage (D&C) in terms of adequate specimen collection for histopathology for diagnosing endometrial carcinoma in patients with abnormal vaginal bleeding. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynecology, Bahawalpur Medical & Dental College, Bahawalpur. Period: October 2022 to March 2023. Material & Methods: A total of 172 peri and post-menopausal women with abnormal uterine bleeding of more than 6 months were analyzed. Randomization was 1:1 for biopsy group (n=86) and D&C group (n=86). Patients in biopsy group underwent biopsy endometrial sampling while those in D&C group underwent diagnostic D&C for endometrial sampling. In biopsy group pipelle suction curette was used to collect the specimen. In D&C group, procedures were done employing general anesthesia. Obtained samples were sent for histopathology examination. Results: In a total of 172 women, the mean duration of abnormal vaginal bleeding were 9.267±2.37 months and 9.174±2.33 months in in biopsy and D&C groups respectively. Adequate specimen collection was noted in 93% women in biopsy group as compare to 97.7% in D&C group (p=0.147). Conclusion: Diagnostic dilatation and curettage as well as endometrial biopsy were effective in terms of adequate specimen collection for histopathology. Endometrial sampling using Pipelle was safe and accurate procedure conducted in outpatient department that avoided general anesthesia.

Glanzmann’s thrombasthenia: a rare case presented with recurrent nasal bleeding

A rare congenital condition of platelet aggregation known as Glanzmann's thrombasthenia is caused by mutations in the Glycoprotein IIb or Glycoprotein IIIa gene, which leads to platelet malfunction. Glanzmann’s thrombasthenia is difficult to diagnose on basis of routine physical examination and is usually mis diagnosed because platelet morphology is normal as well as the platelet counts are in normal range, but bleeding duration is noticeably longer. The most prevalent signs of Glanzmann’s thrombasthenia include numerous types of bleeding, such as menorrhagia in females, recurrent nasal bleeding, mucocutaneous haemorrhage, continuous bleeding after injury or surgery, etc. Recurrent severe intractable causes of massive nasal epistaxis are relatively less common, particularly in cases where local causes do not explain the findings, then haematological causes should be suspected. Here we present a case of a 3 years old Indian boy who presented with recurrent massive epistaxis, fatigue, severe anaemia, and breathlessness who was diagnosed with Glanzmann’s thrombasthenia upon undergoing various investigations such as genetic testing and platelet assays. The patient was immediately started with supportive treatment and progress was made by the patient. Counselling was done to the patient’s family that it is a lifelong disorder and upon taking prescribed treatment bleeding episodes will be reduced. Overall Glanzmann’s thrombasthenia is a lifelong disorder which is difficult to diagnose, and misdiagnosis is very common regarding this disease, hence the clinician should remain alert regarding this rare congenital disorder and appropriate lab investigations should be done and treatment must be started in due time.

The Utility of Pelvic Ultrasounds in Adolescents Presenting to the Emergency Department with Abnormal Uterine Bleeding

To analyze what factors influence a provider's decision to order a pelvic ultrasound (PUS) in the emergency department (ED) for adolescents with abnormal uterine bleeding (AUB), to determine if endometrial stripe (EMS) measurements are used in treatment decisions, and to evaluate if treatment outcomes differ based on EMS thicknesses. Retrospective chart review of patients aged 11-19 presenting to the ED with AUB from 2006 to 2018. Those receiving a PUS were divided into three EMS groups: ≤5 mm, 6-9 mm, and ≥10 mm. Outcomes were evaluated in admitted patients by progress notes indicating resolution of bleeding. Cross-tab, χ2, and logistic and linear regression analysis were performed. Of 258 adolescents meeting study criteria, 113 (43.8%) had a PUS. None had an abnormality. A PUS was more likely to be performed in patients with lower hemoglobin values (P < .003). Provider decision to order a PUS did not differ by age or bleeding duration (P > .1). Among those with a PUS, 67 (59%) received hormonal therapy (pill, progestin-only, IV estrogen). There were no significant differences in treatment choices based on EMS (P < .061) or, among the 44 admitted patients (17%), in the time it took bleeding to stop after initiating treatment (pill: P=.227, progestin-only: P=.211, IV estrogen: P=.229). In adolescents with AUB in the ED, performing a PUS was more common in those with low hemoglobin. EMS thickness did not appear to affect treatment decisions or inpatient outcomes. Larger studies are needed to confirm the current findings and determine if PUS is needed in the evaluation of AUB.

Medical Management of Incomplete Abortion Using Pervaginal Misoprostol in Chittagong Medical College Hospital

Background: A miscarriage is a pregnancy that ends before the baby can survive outside the womb because it has not yet reached viability. A miscarriage may be early - during the first 14 weeks of pregnancy, or late. Objective of the study was to see the outcome of pervaginal misoprostol in the medical management of incomplete abortion.&#x0D; Methods: This cross-sectional study was performed between July and December 2015 on patients with incomplete abortion, who wanted to undergo medical management at the Department of Gynecology and Obstetrics, Chittagong Medical College Hospital. 100 consecutive incomplete abortion cases, who fulfilled the inclusion and exclusion criteria were enrolled for the study. Information about management with per vaginal misoprostol, possible side effects and success rate was given to the women. 600 microgram misoprostol was given per vaginally. Interval between administration of misoprostol and expulsion of product of conception was recorded.&#x0D; Result: The mean age was found 25.0±6.4 years and the mean gestational age was found 10.2±2.0 weeks. The mean duration of bleeding was found 8.6±10.9 days. No side effect was found in 86 (86%), nausea in 7(7%), vomiting in 5 (5%) and cramping in 2 (2%) patients. For majority (76%) of the patients, single dose of Misoprostol was enough to achieve the goal. However, 24 patients didn’t respond and received a second dose. The mean induction expulsion interval was 10.83±5.45 hours. Retained product of conception was found in 14 patients. Medical management failed in these 14 patients and ultimately Dilatation &amp; Curettage (D &amp; C) was done.&#x0D; Conclusion: Pervaginal Misoprostol is as effective as method of treating incomplete abortion at uterine size of &lt;12 weeks. Treatment with misoprostol can reduce the demand for surgical evacuation in cases of incomplete abortion. The acceptability of misoprostol appears higher. Pervaginal Misoprostol appears suitable for the treatment of incomplete abortion in the developing countries.&#x0D; Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 42-48

The Application Value of Contrast-Enhanced Ultrasonography in Assessing the Efficacy of Ultrasound-Guided Lauromacrogol Injections in Cesarean Scar Pregnancies.

To investigate the application value of contrast-enhanced ultrasonography (CEUS) in ultrasound-guided lauromacrogol injections in patients with cesarean scar pregnancies (CSP). A total of 31 patients diagnosed with CSP, who underwent an ultrasound-guided lauromacrogol injection + curettage in our hospital between February 2019 and December 2020 and had a complete recovery confirmed by a postoperative ultrasound review and serum β-human chorionic gonadotropin (β-hCG) assay, were enrolled as the study subjects. According to the volume of intraoperative blood loss and the duration of postoperative vaginal bleeding, the patients were divided into two groups, with 19 in the significantly effective group (Group A) and 12 in the effective group (Group B). The recorded clinical data, including age, duration of amenorrhea, number of pregnancies, number of deliveries, time since last cesarean delivery, number of cesarean deliveries, and preoperative serum β-hCG levels, were retrospectively analyzed. The morphological indicators in CEUS before the lauromacrogol injection, as well as immediately and 12-24 hours after the injection, were compared between the groups. In Group A, the post-injection CEUS showed no enhancement, single strip enhancement, and sparse punctate enhancement, while in Group B, it showed a more irregular ring and local patch enhancement. In addition, the number of cases where the CEUS showed no enhancement 12-24 hours after the injection was more than that of the immediate CEUS after the injection. In Group A, four (21.1%) cases showed a single strip-like blood flow on the immediate postoperative CEUS, four (21.1%) cases showed a sparsely dotted blood flow on the immediate postoperative CEUS, and three cases turned into no enhancement 12-24 hours after the injection. A total of four cases in Group B showed that the contrast enhancement range 12-24 hours after the injection was reduced compared with that of the immediate contrast after the injection. Contrast-enhanced ultrasonography can guide the location selection of the lauromacrogol injection in patients with CSP, and its postoperative morphological indicators can adequately predict the therapeutic effect after curettage and guide clinical management.

PRIMARY DYSMENORRHEA AND ASSOCIATED RISK FACTORS AMONG FEMALE ADOLESCENTS LIVING IN WEST BENGAL, INDIA

Primary dysmenorrhea is a gynecological problem of women in their reproductive age which adversely affect quality of life. This study was designed to determine the prevalence of dysmenorrhea and associated risk factors for incidence of primary dysmenorrhea among adolescent females. Further this study attempted to determine the factors associated with degree of primary dysmenorrhea. This is a cross sectional questionnaire based study conducted among 1646 adolescent female having age limit 14-19 years. Only unmarried adolescent females were included in the study however, females with gynecological, psychological or other medical problems were excluded from the study. We used Visual analogue scale (VAS) for pain rating. Socio-demographic, life style and behavior and menstrual characteristics were obtained through interviews with the help of pretested questionnaire. The descriptive data analysis, chi-square test and multivariate logistic regression analysis was done. The signicance level of the tests were considered at a signicance level of 0.05. Prevalence of dysmenorrhea was 88.94%. Among dysmenorrhea 22.40% was under severe category. There was no signicant difference of prevalence of dysmenorrhea between Hindu and Muslim. Family history of dysmenorrhea strongly increase the risk of dysmenorrhea and its pain intensity. Among lifestyle characteristics skipping breakfast and frequency of junk food intake signicantly increase the risk of dysmenorrhea and degree of menstrual pain. Among reproductive characteristics irregularity of menstrual cycle, bleeding duration and release of clot blood during menstruation are signicantly associated with primary dysmenorrhea. In conclusion the results of our study suggested that primary dysmenorrhea is a signicant for a large proportion of adolescent females. Positive family history of dysmenorrhea, Junk food intake, Skipping breakfast, irregular menstruation, release of clot blood during menstruation and duration of menstrual bleeding are signicantly associated with risk of primary dysmenorrhea and its pain intensity.

Relationship between covid-pandemic anxiety and sleep disorder with menstrual disorders among female medical workers

BackgroundIt has been more than 2 years since the 2019 novel coronavirus disease (COVID-19) pandemic destabilized the world, adversely affecting not only physical health, but also mental health. During this time, frontline medical workers were at a greater health risk, especially female medical workers. Changes or abnormalities in the menstrual cycle—an important indicator of women’s health—may jeopardize female reproductive functioning. Considering that emotional health and sleep status may be related to the menstrual cycle, this study aimed to investigate the association between menstrual cycle changes, anxiety, sleep dysfunction, and other factors among female medical workers during the COVID-19 pandemic.MethodsA cross-sectional survey was conducted by distributing online questionnaires to female medical workers in China from February to May 2022. The study included 160 women aged 18–45 years old. The questionnaires covered data related to the participants’ sociodemographic characteristics, medical and reproductive history, and lifestyle. The Rating Scale for Clinical Manifestations of Menopathy (SCMM), Self-Rating Anxiety Scale (SAS), and Sleep Dysfunction Rating Scale (SDRS) were utilized. Data were analyzed using chi-square tests, t-tests, and linear regression analysis.ResultsA total of 160 female medical staff were randomly selected in this research, of whom seven scored less than 3 points, 85 scored 3–11 points, and 68 scored more than 11 points on the total score of the SCMM. Compared to pre-pandemic scores, scores of dizziness and tinnitus were significantly higher during the COVID-19 pandemic. Scores corresponding to the following clinical symptoms were also higher during the pandemic: Menopathy, including hypaphrodisia, dim complexion, abnormal urination, languidness, dim menstruation, thin menstruation, dysmenorrhea, and empty or saggy lower abdomen (p < 0.05). However, pre-pandemic scores of vaginal bleeding quantity were significantly higher than those found during the COVID-19 pandemic (p < 0.05). Scores of vaginal bleeding quantity were significantly lower in cabin hospitals than other types of hospitals, and a similar finding was observed for vaginal bleeding duration (all p < 0.05). Moreover, the findings of the univariable and multivariable linear regression analysis revealed a link between consistent exercise, the underlying illness, the SDRS score, the SAS score, and the total score of SCMM (p < 0.05).ConclusionsIn this study, we found that menstruation in female medical workers was affected by the COVID-19 pandemic. Furthermore, regular exercise and good physical condition were protective factors, while anxiety and insomnia were risk factors for menstrual abnormalities.

Comparative study between Asokarista and Pradarantak Lauha in the treatment of Asrigdara

Asrigdara is a disease of excessive and prolonged blood loss per vagina during menstrual and inter menstrual period. In modern era, Asrigdara is similar just like a Menorrhagia. In my comparative study I had chosen to evaluate the role of both drugs that was “Asokarista” and “Pradarantak Lauha”which was the best in the treatment of Asrigdara. I had taken sixty (60) patients which were divided into two equal group’s i.e., Group-A and Group- B with clinical features of excessive menstrual bleeding in amount, long duration of menstrual bleeding in day, bodyache, pain in the uterus. Gr-A was treated with Asokarista for 3 menstrual cycles and Gr-B was treated with Pradarantak Lauha for 3 menstrual cycles. This comparative study was conducted to evaluation of efficacy of the drugs in both groups. This study was a prospective, comparative and observative. This study observes good reduction in mean scores of clinical feature and overall compliance to the treatment was good in the both groups and p value of &lt; 0.001 was considered highly significant.

Evaluation of Applications of Intrauterine Progesterone Versus Oral Progesterone in the Treatment of Dysfunctional Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is a common gynecological problem that affects the women of all ages. It is defined as any irregular or excessive bleeding from the uterus that is not related to the woman’s normal menstrual cycle. It can be caused by a many of underlying factors such as hormonal imbalance, fibroids, polyps or endometriosis. Study design: It is a randomized controlled study conducted at Divisional Headquarters Teaching Hospital Mirpur Azad Kashmir and Lady Willingdon Hospital Lahore for the duration of six months from June 2022 to November 2022. Material and Methods: The study was carried out for two groups. Intrauterine group included the patients that received intrauterine dose of progesterone and oral group patients had progesterone orally. The study was approved by the review board committee of the hospital. The use of pads for both groups was studied and it was found that oral group used the most pads 18.7 and 12.9 before and after the study respectively. Results: Duration of bleeding was examined. The patients in intrauterine group stated about bleeding for 7.8 days before the study and 5.9 days after the study. In case of oral group participants, they bled for 8.9 days before the study and 6.7 days after the study. Standard deviation and p value was calculated and results were statistically significant. Conclusion: The investigation of oral and intrauterine progesterone for patients suffering from dysfunctional uterine bleeding was studied and it was found that the rate of bleeding was more in case of oral group. Keywords: Intrauterine progesterone and oral progesterone.

Randomized single blind controlled clinical study to evaluate the efficacy of Ashok ghrita in the management of Raktapradara with special reference to Menorrhagia

Raktapradara is most common gynaecological problem found in women. According to Acharya charaka, Raktapradara is also known as Asrugdara. According to modern, Raktapradara can be correlated with Menorrhagia. Ashok acts as a uterine tonic and improve the muscular tone of uterine musculature which is important to control bleeding. Most of the drugs in Ashok ghrita having rasayan property and can improve nourishment of all the dhatus and reduce the duration of bleeding. Aim: To study the efficacy of Ashok ghrita in the management of Raktapradara. Materials and Method: A total 80 patients of the age group 16-45 years presenting with signs and symptoms of Raktapradara w.s.r to Menorrhagia were selected randomly from OPD of the department of Stree rog Prasutitantra. The 40 patients of trial group were treated with Ashokghrita and 40 patients of control group were subjected to Ashok ksheerpak. Conclusion: Ashok Ghrita was found to be more effective than Ashok ksheerapak in the management of Raktapradara with special reference to Menorrhagia.

MP34-16 RANDOMIZED PHASE II STUDY OF ANTIBIOTIC PROPHYLAXIS WITH ORAL 3 GR FOSFOMYCIN TROMETHAMINE VS PREOPERATIVE AMIKACIN 1 GR I.V. IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE BLADDER

You have accessJournal of UrologyCME1 Apr 2023MP34-16 RANDOMIZED PHASE II STUDY OF ANTIBIOTIC PROPHYLAXIS WITH ORAL 3 GR FOSFOMYCIN TROMETHAMINE VS PREOPERATIVE AMIKACIN 1 GR I.V. IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE BLADDER Adrian Garza-Gangemi, David Gomez-Ortiz, Guillermo Martinez-Delgado, Renata Duarte-Valdes, Ricardo Tinoco-Betancourt, Francisco Rodriguez-Covarrubias, and Ricardo Castillejos-Molina Adrian Garza-GangemiAdrian Garza-Gangemi More articles by this author , David Gomez-OrtizDavid Gomez-Ortiz More articles by this author , Guillermo Martinez-DelgadoGuillermo Martinez-Delgado More articles by this author , Renata Duarte-ValdesRenata Duarte-Valdes More articles by this author , Ricardo Tinoco-BetancourtRicardo Tinoco-Betancourt More articles by this author , Francisco Rodriguez-CovarrubiasFrancisco Rodriguez-Covarrubias More articles by this author , and Ricardo Castillejos-MolinaRicardo Castillejos-Molina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003268.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary tract infections are one of the most common complications following transurethral resection of the bladder (TURBT). Antibiotic prophylaxis is indicated in every patient, however recommendations are essentially empiric and based on older studies. An adequate prophylaxis should be tailored on local microbiological data to minimize postoperative infectious complications. The aim of this study was to compare preoperative oral 3 gr Fosfomycin tromethamine vs intravenous 1 gr amikacin administration in patients undergoing TURBT. METHODS: Between January 2020 and November 2022, a double blind, phase II randomized clinical trial was conducted in a tertiary center in Mexico City. Patients undergoing TURBT were randomly assigned to two groups; oral Fosfomycin Tromethamine 3 gr (one day before) vs. preoperative amikacin 1 gr I.V. (control group). The primary endpoints were the development of urinary tract infection (UTI), asymptomatic bacteriuria (AB) and sepsis 30 days after surgical resection. Every patient had a negative preoperative urine culture, absence of urinary symptoms, no use of antibiotics 15 days prior to surgery and no indwelling catheters. Baseline and perioperative characteristics were compared between study groups. Relative risk and independent risk factors for the development of UTI and/or AB were calculated. Every patient had a postoperative midstream urine culture 1 month after surgical resection. This study was IRB approved and was registered in ClinicalTrials.gov, NCT 04209192. RESULTS: Seventy five patients were included in the study and 71 completed follow up (control group n=37) and were further analyzed. There were no significant differences in baseline characteristics between study groups (age, sex, comorbidities, smoking status, ECOG score, ASA score) and no differences in perioperative characteristics (surgical time, number of tumors, tumor size, bleeding, and postoperative catheter duration). There were no differences in postoperative UTI (11.8% vs 5.4% in control group, p=0.42) and AB (2.9% vs. 8.1% in control group, p=0.62) between study groups. No patient developed postoperative sepsis. No adverse effects related to antibiotic use were reported in this study. CONCLUSIONS: There were no significant differences in the development of infectious complications following TURBT between study groups. Oral 3 gr Fosfomycin tromethamine may be a reasonable alternative for prophylaxis in these patients. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e465 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adrian Garza-Gangemi More articles by this author David Gomez-Ortiz More articles by this author Guillermo Martinez-Delgado More articles by this author Renata Duarte-Valdes More articles by this author Ricardo Tinoco-Betancourt More articles by this author Francisco Rodriguez-Covarrubias More articles by this author Ricardo Castillejos-Molina More articles by this author Expand All Advertisement PDF downloadLoading ...

Menstrual characteristics and dysmenorrhea among Palestinian adolescent refugee camp dwellers in the West Bank and Jordan: a cross-sectional study

BackgroundWomen and girls experience menstruation throughout their reproductive years. Normal adolescent menstrual cycles gauge current and future reproductive health. Dysmenorrhea (painful menstruation) is the most prevalent menstrual disturbance in adolescents that can be debilitating. This study examines the menstrual characteristics of adolescent girls living in Palestinian refugee camps in the West Bank of the Israeli-occupied Palestinian territory and Jordan, including estimates of dysmenorrhea levels and associated factors.MethodsA household survey of 15 to 18-year-old adolescent girls was conducted. Trained field workers collected data on general menstrual characteristics and dysmenorrhea level using Working ability, Location, Intensity, Days of pain Dysmenorrhea scale (WaLIDD), in addition to demographic, socio-economic, and health characteristics. The link between dysmenorrhea and other participant characteristics was assessed using a multiple linear regression model. Additionally, data on how adolescent girls cope with their menstrual pain was collected.Results2737 girls participated in the study. Mean age was 16.8 ± 1.1 years. Mean age-at-menarche was 13.1 ± 1.2; mean bleeding duration was 5.3 ± 1.5 days, and mean cycle length was 28.1 ± 6.2 days. Around 6% of participating girls reported heavy menstrual bleeding. High dysmenorrhea levels were reported (96%), with 41% reporting severe symptoms. Higher dysmenorrhea levels were associated with older age, earlier age-at-menarche, longer bleeding durations, heavier menstrual flow, skipping breakfast regularly, and limited physical activity patterns. Eighty nine percent used non-pharmacological approaches to ease menstrual pain and 25% used medications.ConclusionThe study indicates regular menstrual patterns in terms of length, duration, and intensity of bleeding and a slightly higher age-at-menarche than the global average. However, an alarmingly high prevalence of dysmenorrhea among participants was found that tends to vary with different population characteristics, some of which are modifiable and can be targeted for better menstrual health.This research emphasizes the need for integrated efforts to assist adolescents with menstrual challenges such as dysmenorrhea and irregular periods to achieve informed recommendations and effective actions.

КОНТРАЦЕПЦИЯ ПОСЛЕ АБОРТА: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ

It is important to choose a combined oral contraceptive (COC) after an abortion operation, since the requirements for a contraceptive prescribed during this period have their own specifics. It is necessary to stop as many negative consequences for the woman's body caused by the termination of pregnancy and, in addition, to ensure maximum safety of the prescribed drug. The relevance of this topic is due to the need to choose the safest and most effective contraceptive. A study was conducted of the effect of monophasic low-dose COCs, which is a combination of 0.15 mg levonorgestrel and 0.03 mg eeinylestradiol 0.03 mg in each tablet (PlaniGenslevo) on the state of the body and endothelial function in 22 women of reproductive age using the drug for 3 months after an artificial abortion and belonging to the first category of acceptability of COCs. As a control, the results of a test with reactive hyperemia were evaluated in 22 healthy women aged 19 to 35 years. As a result of the study, there was no increase in body mass index, blood pressure, changes in metabolic parameters in the biochemical analysis of blood, as well as an increase in the duration of menstrual bleeding, the absence of intermenstrual bleeding, as well as breast swelling, headaches, dyspeptic phenomena and other adverse events that may be caused by taking COCs in women using Women's Left within 3 months. The conducted study demonstrated the absence of adverse events on the part of the body of women taking after abortion Plani Women left. In addition, there were no statistically significant changes compared to the control group in the results of the test with reactive hyperemia, reflecting the absence of endothelial dysfunction in women using the contraceptive Plani Women left, which can serve as confirmation of the absence of a negative effect of the drug on the cardiovascular system.

Prevalence and predictors of iron deficiency anemia among pregnant women in Bolosso Bomibe district, Wolaita Zone, Southern Ethiopia Community-based cross-sectional study

: Iron-deficiency anemia is defined as anemia, a condition in which there less than the normal hemoglobin (Hb) accompanied by an indication of iron deficiency. Nearly half of all pregnant women worldwide suffer from anemia, and iron deficiency accounts for about half the world’s anemia burden. Most of the studies conducted on iron-deficiency anemia during pregnancy were conducted at the institution level and associated factors are not well studied and documented. Hence, the aim of this study is to determine the prevalence of iron-deficiency anemia and associated factors among pregnant women in Bolosso Bomibe District, Southern Ethiopia, 2019. Community-based cross-sectional quantitative study was conducted from April to June 2019. Multistage sampling was used to include 270 study participants in 6 kebeles. The structured and pretested questionnaire, middle upper arm circumference (MUAC), Hb, serum ferritin, and C-reactive protein were used as a tool to collect data. The data was compiled and entered to EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 23.00 packages for analysis. Univariate, bivariate, and multivariable logistic regression with odds ratio along with the 95% confidence intervals (CI) was computed and interpreted. p value < 0.05 was declared as statistically significant. The prevalence of iron-deficiency anemia was 11.3% (95% CI: 8.9–15.7). Factors associated with iron-deficiency anemia were ANC follow-up for the recent pregnancy (adjusted odds ratio [AOR] = 3, 95% CI: 1.15−8.9, and years b/n successive pregnancy (AOR = 4,95% CI: 1.2–12.4). Prevalence of iron-deficiency anemia was low, which is a mild public health concern among pregnant women in Bolosso Bombe District. The factors associated with iron-deficiency anemia in this study population were MUAC, ANC follow-up, birth spacing among successive pregnancy, and duration of menstrual bleeding. Thus, there should be the integration of concerned stakeholders for implementation of different interventions to solve these problems.

Characteristics of the Menstrual Cycle According to the Sports Groups of the New Generation of Female Athletes

PURPOSE To examine the characteristics of menstrual cycles in female athletes in different sports, comparison of possible deviations and changes associated with new generations of female athletes in training processes.&#x0D; METHODS The research included a total of 143 respondents (average age 17.46 ± 2.61; average training experience 8.67 ± 3.85) who were divided into three groups: sports games (n=59), martial arts (n= 16) and aesthetic sports (n= 68). An anonymous survey specially prepared for the needs of this research was conducted among the respondents. The results were processed in the IBM SPSS program, v.26. Comparisons by sports categories were made using the Chi-square test for categorical variables and Kruskal-Walis analysis of variance for ordinal variables. In the case of significant differences obtained by Kruskal - Wallis analysis, the Dunn-Bonferroni post hoc test was performed to determine between which groups there is a difference. A logistic regression analysis was performed to predict the regularity of the menstrual cycle using age, length and duration of training and sport category.&#x0D; RESULTS The groups of sports do not differ from each other with regard to cycle regularity (p=0.088). There are no differences between sports groups (p=0.935) in cycle changes. There is also no difference in duration (p=0.883) and abundance of bleeding (p=0.700). A slightly higher irregularity of menstrual cycles was observed in the martial sports group.&#x0D; CONCLUSION The examined characteristics of the menstrual cycle of the new generation of female athletes according to the sports groups in this research did not show significant changes, but they were noticeable in the martial sports group. Although there is a common difference in the training duration of individual sports groups, future research and monitoring of the menstrual cycle in female athletes should be further reduced according to the possible effects on the reproductive and general health of female athletes.