Duration Of Blood Flow Research Articles

Assessment Clinical Association of Thyroid Function in Women of Reproductive Age Group with Abnormal Uterine Bleeding

Background: Abnormal Uterine Bleeding occurs when the frequency and quantity of menstrual bleeding in females is significantly altered. It is the most prevalent clinical presentation in gynecology, affecting more than 20% of the female population, and is characterized by variations from normal menstruation in terms of irregularity in periods, frequency, duration of blood flow, amount of blood loss, and cyclicity. Thyroid hormones had significant effects on the female reproductive system, such as delayed puberty, infertility, premature menopause, recurrent abortions, and AUB. The AUB is significantly associated with thyroid secretions, and any patient who complains of AUB or irregular menstruation must have thyrotoxicosis ruled out. Objectives: This study was conducted at the Department of Obstetrics and Gynecology, Nishtar Hospital, Multan, Pakistan, (2021-22) in order to evaluate the clinical association between thyroid function and AUB in women of different reproductive age groups. Methods: This cross-sectional study was conducted in the outpatient department of Obstetrics & Gynecology, Nishtar Hospital, Multan, from 1st December 2021 to 31st May 2022. 320 patients participated in the study and were examined clinic-pathologically and were allocated into three groups based on their thyroid profile (euthyroid, hyperthyroid and hypothyroid, respectively) and further predisposition risk factors were recorded and analyzed. Results: It was discovered that extreme age groups of adolescence and pre-menopause phase significantly (p<0.05) increased the incidence of AUB. The incidence of AUB was also elevated (p<0.05) among patients with an abnormal BMI, women with multiple pregnancies, and married women. The menstrual bleeding pattern was also studied in females, with polymenorrhea (131/320) being the most prevalent (p<0.05), followed by menorrhagia (79/320), metrorrhagia (59/320), oligomenorrhea (42/320), and amenorrhea (9/320) having a significantly lower incidence (p<0.05). The incidence rate of thyroid disorders was 28.12% (90/320), with hypothyroidism affecting 77(24.06%) and hyperthyroidism affecting 13(4.06%) patients (p<0.05). Practical implication: AUB is significantly associated (p<0.05) with thyroid hormones, therefore for early diagnosis of the underlying etiology and treatment of the patients by preventing hysterectomy and other serious surgical interventions, all patients presenting to OPD clinics with the complaint of AUB or irregular menstruation must be ruled out for a thyroid profile in the first instance. Conclusion: It was concluded that thyroid disorders directly affected the BMI, fertility and menstrual cycle of gynecology patients and increased the incidence of AUB along with the medical and gynecological complications. Keywords: Amenorrhea; Hyperthyroidism; Hypothyroidism; Polymenorrhea; Thyrotoxicosis.

Prevalence and Risk Factors of Anaemia among Adolescent Girls in Selected Schools

To assess the prevalence and risk factors which contribute to anemia among adolescent girls in selected
 Introduction: ‘Anemia is a disease in which, because of one or more vital nutrient deficiencies, the blood hemoglobin content is lower than average, irrespective of the cause of such deficiency. In Maharashtra, according to District Level Household Survey (DLHS) 2002-2006, the prevalence of moderate anemia in adolescent girls was estimated to be 53%, whereas severe anemia was 29%.
 Aims: To assess the Prevalence and risk factors which contribute to anemia among adolescent girls in selected Schools.
 Research Methodology: A cross sectional study was carried in 150 adolescent girls age between 10 to 15 years. Quantitative research approach was used. Non-probability convenience sample technique was used.
 Results: The data obtained to describe the sample characteristics including demographic variables (age of adolescent girls, education, mother education, type of family, monthly family income and type of diet), prevalence of anemia among adolescent girls, menstrual factors and dietary factors. The levels of anemia were seen into 4 categories, normal Hb% level, mild anemia, moderate anemia and severe anemia. In demographic variables, Type of family of adolescent girls (p=0.04) is statistically associated with prevalence of anemia. In menstrual factors, duration of blood flow is found to be statistically associated with menstrual factors of adolescent girls (p=0.0001). In dietary factors, it is interpreted dietary factors of adolescent girls is statistically not associated with their prevalence of anemia.
 Conclusion: The prevalence of anemia is more in adolescent girls. A statistically significant was found between nuclear family but not with the other socio-demographic factors. No association was found between status of menstrual factors except duration of blood flow.

Role of ormeloxifene, a selective estrogen receptor modulator in heavy menstrual bleeding (abnormal uterine bleeding)

Background: During women’s reproductive years, heavy menstrual bleeding (HMB) (abnormal uterine bleeding; AUB) is the most common reason for abnormal vaginal bleeding. Evidence is lacking for medical management of HMB (AUB). Ormeloxifene a selective estrogen receptor modulator (SERM) has emerged as one of the safe and effective candidates for the management of HMB (AUB). Objectives: The objectives of this study were to study the efficacy and safety of SERM, ormeloxifene in the treatment of HMB (AUB). Material and Methods: A total of 65 patients of HMB (AUB) were studied in the Department of Obstetrics and Gynecology, GR Medical College, Gwalior, from September 2011 to December 2013. Detailed history, clinical examination, and laboratory investigations including hemoglobin percentage, blood sugar, pap’s smear, transvaginal ultrasonography, and dilatation and curettage were recorded for each patient. Tablet containing 60 mg of ormeloxifene was given for twice a week for first 12 weeks then 60 mg once a week for next 12 weeks. All the patients were followed up for 6 months till the 6 months. Results: Maximum patients had age between 31 and 40 years (46.5%). The most common parity was one to three (53.4%). Most of the cases complained of menorrhagia (41.8%). Majority of the cases showed proliferative endometrium (49.18%). Of 65, 5 could not be followed up due to various reasons. At 12 weeks of treatment, most of the cycles exceeded their pretreatment cycle length; improvement in duration of blood flow and dysmenorrhea (from 76.7% case to 19%) was observed; spotting and passage of clots were not observed in 58% by 12 weeks and 96% patients by 24 weeks. Most frequent side effects complained by patients were prolonged cycle beyond 35 days (50%). Conclusion: Ormeloxifene is a good choice for the treatment of HMB (AUB) due to its excellent efficacy and safety profile.

A study on menstruation of Indian adolescent girls in an urban area of South India.

Background:Menstrual cycle is an important indicator of women's reproductive health. However, menstruation has a different pattern within a few years after menarche, which might not be well understood by many adolescent girls.Materials and Methods:A cross-sectional study was conducted on 536 healthy menstruating females aged 10–19 years. Standardized self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square or Fisher's exact test.Results:Mean age of menarche was 13 ± 1.1 years with wide variations, i.e., 10–17 years. 73.1% had cycle duration of 21–35 days. More than half of them reported 5–6 days’ duration of menstrual blood flow and 12% of the participants had >7 days of flow. Long blood flow duration was more prevalent in early than in late adolescence. 30.1% reported abundant blood loss. 66.8% had dysmenorrhea and no difference was observed between early and late adolescents. Menstrual cycles tend to be shorter in early adolescence period.Conclusion:A comprehensive school education program on menarche and menstrual problems may help girls to cope better and seek proper medical assistance.

Efficacy of Geru (red ochre) in controlling the bleeding in patients of Adolescent menorrhagia

Adolescent menorrhagia is defined as excessive menstrual bleeding from menarche to adolescents. It is a distressing condition both for the patient as well as for her parents. If it is not managed in time itmay pose significant health problems that may leads to blood transfusion. We determined the efficacy of Geru (Red ochre) in controlling the amount and duration of blood flow in patients of Adolescent menorrhagia. This study included 40 teenage girls, who presented with heavy bleeding during menstruation to Outpatient Department, Sameena Maternity Nursing Home, Hyderabad during the year of 2013. Assessment of each case was done by history and Pictorial Blood loss Assessment Chart (PBAC) score. Geru powder was given for 2 cycles and results were assessed. The data was analyzed statistically. The mean PBAC score before treatment was <TEX>$497.04{\pm}389.92$</TEX> and after trial in <TEX>$1^{st}$</TEX> and <TEX>$2^{nd}$</TEX> it was found to be <TEX>$471.13{\pm}162.18$</TEX> and <TEX>$310.13{\pm}142.15$</TEX> respectively. On basis of results it was concluded that single unani drug Geru is enough in controlling bleeding and was found effective by its astringent and styptic properties.

Evolution and Scaling of Atrioventricular Conduction Time in Mammals: Part 2

This review in The American Heart Hospital Journal is published in two parts. Part 1 deals with the role of scaling in (patho)physiology and anatomy, or the function and structure of organs and organ systems in relation to body size of mammalian species. An intriguing aspect of scaling is the relation between heart size and the duration of atrioventricular (AV) conduction (Winter 2006 issue-Am Heart Hosp J. 2006;4:53-57.). Part 2 offers a simple mathematic explanation of AV conduction time scaling based on AV hemodynamics in mammalian species of different sizes. Changes of the PR interval (atrioventricular delay) in relation to changes of heart size in mammalian species (scaling) confront us with a perplexing lack of understanding of an essential function of the heart. The PR interval controls the duration of late diastolic blood flow from the atria to the ventricles. There is good evidence that blood flow velocity is fairly constant in all mammalian species, meaning it does not scale. Also, in all mammalian species, the mitral orifice does not offer any resistance to atrioventricular blood flow. It follows that blood flow duration is directly dependent on the distance between the atria and the ventricles. Although the heart is not a cube, this distance is defined as the third root of heart mass. The third root of any value changes little in relation to the value itself. This simple mathematic fact is an easy explanation for PR interval behavior in relation to heart and/or body size. However, the atrioventricular intranodal electrophysiology of this behavior is not known.

The Bleeding Time May Be Longer in Children Than in Adults

The bleeding time, the most frequently performed test reflecting in vivo platelet function, is the duration of blood flow from a standardized incision on the volar surface of the forearm. Normal values have been determined in adult subjects, but with the exception of neonates, data on the range of bleeding time values in pediatric patients are unavailable. Standard hematology textbooks imply that bleeding time values in children are similar to those of adults. We have reviewed our 9 years of experience with 137 children (mean age 6.5 years) who were referred for diagnostic evaluation of a bleeding disorder but whose history and physical examination were felt by us to be inconsistent with an abnormality of hemostasis. Bleeding time values in these individuals (mean 6.0 min, 95th percentile 9.0 min) were compared with those of 85 normal adult volunteers (mean 4.4 min, 95th percentile 6.5 min). The Simplate-I disposable device and vertical (perpendicular to elbow crease) incision direction were used in both groups. This difference between the pediatric and adult bleeding time values is statistically significant (p less than 0.0001). Neither age nor sex had a significant effect on the pediatric bleeding time measurements. We conclude that the bleeding time, when performed as described, is longer in children than in adults and that pediatric standards for bleeding time should be used in order to avoid a spurious diagnosis of a primary hemostatic disorder in some normal children.