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Mohammadi B, Nazari Robati L, Tavakol Z, Movahhed M. Evaluation of the effect of Nigella sativa oil on the outcome of missed abortion in women: A randomized double-blind clinical trial. Health Sci Rep 2024; 7:e2029. [PMID: 38633734 PMCID: PMC11022303 DOI: 10.1002/hsr2.2029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/07/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Background and Aim Due to the concern about the side effects of chemical drugs and their ineffectiveness, the use of natural compounds as alternatives or complementary therapies has received increasing attention. The purpose of this study was to investigate the effect of Nigella sativa oil on the outcome of missed abortion. Methods In this double-blind clinical trial, 70 nulliparous pregnant women referred to Hajar Hospital and Imam Ali clinics of Shahrekord and had missed abortion before the 12-week gestational age were selected and randomly divided into two interventions and control groups. The intervention group received 5 g of Nigella sativa oil alone daily for up to 3 days and the control group received a placebo. In case of nonresponse, 3 days after the last dose of medication or placebo, 800 μg of misoprostol (vaginal) were used. Data were analyzed by SPSS software. The chi-square test, Fisher's exact test, independent t-test and paired t-test were used for analytical statistics. Results According to the results, 18 cases (51.4%) in the intervention group and seven cases (20%) in the control group showed complete evacuation of uterine contents which had a significant difference (p < 0.05). The frequency of vagina physical examination and type of hemorrhage did not show any significant difference between the two groups before and after the intervention. After the intervention, human chorionic gonadotropin (HCG) was significantly decreased in the intervention group but did not change in the control group (p < 0.05). The frequency of adverse events in the intervention group was three (8.6%) and in the control group was one (2.9%) which had no significant difference. Conclusion Nigella sativa improves the outcome of missed abortion by reducing HCG and facilitating cervix dilatation and delivery of uterine contents.
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Affiliation(s)
- Belgheis Mohammadi
- Clinical Research Development Unit, Hajar HospitalShahrekord University of Medical SciencesShahrekordIran
| | | | - Zeinab Tavakol
- Community‐Oriented Nursing Midwifery Research Center, Nursing and Midwifery SchoolShahrekord University of Medical SciencesShahrekordIran
| | - Mina Movahhed
- Department of Traditional Medicine, School of Traditional MedicineShahid Beheshti University of Medical SciencesTehranIran
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Zorilă GL, Căpitănescu RG, Drăgușin RC, Istrate-Ofițeru AM, Bernad E, Dobie M, Bernad S, Craina M, Ceaușu I, Marinaş MC, Comănescu MC, Zorilă MV, Drocaș I, Berbecaru EIA, Iliescu DG. Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review. Diagnostics (Basel) 2023; 13:diagnostics13020331. [PMID: 36673141 PMCID: PMC9858542 DOI: 10.3390/diagnostics13020331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management and the outcome. METHODS A systematic literature search was conducted on PubMed, PubMed Central and Scopus using uterine perforation, D&C, abortion and omentum as keywords. The exclusion criteria included the presence of the uterus or placenta's malignancy and uterine perforation following delivery or caused by an intrauterine device. RESULTS The review included 11 articles from 133 screened papers. We identified 12 cases that three evaluators further analysed. We also present the case of a 32-year-old woman diagnosed with uterine perforation and omentum involvement. The patient underwent a hysteroscopic procedure with resectioning the protruding omentum into the uterine cavity, followed by intrauterine device insertion. CONCLUSION This paper highlights the importance of a comprehensive gynaecological evaluation following a D&C procedure that includes a thorough clinical examination and a detailed ultrasound assessment. Healthcare providers should not overlook the diagnosis of omentum involvement in the presence of a history of intrauterine procedures.
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Affiliation(s)
- George Lucian Zorilă
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
| | - Răzvan Grigoraș Căpitănescu
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
| | - Roxana Cristina Drăgușin
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
| | - Anca-Maria Istrate-Ofițeru
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
- Research Centre for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Elena Bernad
- Department of Obstetrics and Gynaecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square no 2, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynaecology, “PiusBrinzeu” County Emergency Hospital, 300723 Timisoara, Romania
- Correspondence:
| | - Mădălina Dobie
- Lugoj Municipal Council, Medical Assistance-Education Service Romania, 305500 Lugoj, Romania
| | - Sandor Bernad
- Romanian Academy Timisoara Branch, Mihai Viteazul Avenue, 24, 300275 Timisoara, Romania
| | - Marius Craina
- Department of Obstetrics and Gynaecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square no 2, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynaecology, “PiusBrinzeu” County Emergency Hospital, 300723 Timisoara, Romania
| | - Iuliana Ceaușu
- Department of Obstetrics and Gynaecology, “Carol Davila” University of Medicine and Pharmacy, “Dr I. Cantacuzno” Hospital, 020021 Bucharest, Romania
| | - Marius Cristian Marinaş
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
- Department of Anatomy, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Maria-Cristina Comănescu
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
- Department of Anatomy, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Marian Valentin Zorilă
- Department of Forensic Medicine, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Ileana Drocaș
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Elena Iuliana Anamaria Berbecaru
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
| | - Dominic Gabriel Iliescu
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, University Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynaecology, Medgin, GINECHO Clinic, 200333 Craiova, Romania
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Cesnjevar R, Purbojo A, Haake C, Laas J. Significant adhesion reduction and time saving in pediatric heart surgery with 4DryField PH: A retrospective, controlled study. PLoS One 2022; 17:e0277530. [PMID: 36395120 PMCID: PMC9671326 DOI: 10.1371/journal.pone.0277530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 10/30/2022] [Indexed: 11/19/2022] Open
Abstract
Adhesions formation after surgery for congenital heart defects can complicate follow-up procedures due to bleeding from detached adhesion bands, injury to cardiac structures or large vessels, all of which do prolong operation times. The problem is enhanced by the fact that detached adhesions are predilection sites for new adhesions setting off a downward spiral. 4DryField® PH gel barrier has demonstrated high efficacy in reducing postoperative adhesions in general surgical and gynecological studies. This retrospective controlled study of 22 patients evaluates whether these positive results can be confirmed in pediatric cardiac surgery. Adhesions were scored from photographs of follow-up interventions by an independent cardiac surgeon blinded to group assignment. The publication provides not only score numbers but also original photographs of all sites for better traceability and transparency. In addition, timesaving due to reduced adhesions was evaluated. Results show a significantly reduced adhesion score for the 4DryField® group. Importantly, this resulted in a significantly shorter period between skin incision and start of cardiopulmonary bypass. In addition, timesaving due reduced adhesion formation was evaluated. The use of 4DryField® was safe, although higher doses per kg were used than in adults.
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Affiliation(s)
- Robert Cesnjevar
- Department for Heart Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Ariawan Purbojo
- Department for Pediatric Heart Surgery, University Clinic Erlangen, Erlangen, Germany
| | | | - Joachim Laas
- PlantTec Medical GmbH, Lüneburg, Germany
- Centre Surgery, Hanover Medical School, Hanover, Germany
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Ziegler N, De Wilde RL. Reduction of adhesion formation after gynaecological adhesiolysis surgery with 4DryField PH - a retrospective, controlled study with second look laparoscopies. J OBSTET GYNAECOL 2021; 42:658-664. [PMID: 34392782 DOI: 10.1080/01443615.2021.1928030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adhesions are a common consequence of abdomino-pelvic surgery. Efficacy of available adhesion prevention agents is discussed controversially. Here, we used the adhesion barrier 4DryField PH: a powder, which is transformed into a barrier gel with saline solution. The study includes 40 consecutive patients with surgeries for adhesiolysis, endometriosis and other gynaecological pathologies and subsequent second look interventions. The intervention group (n = 17) received 4DryField PH gel while control patients (n = 23) did not receive any adhesion prevention. Severity and extent of adhesion formation were scored during both interventions using an established score. Direct comparison between first and second interventions showed that extent and severity of adhesions could be reduced significantly using 4DryField PH gel. In contrast, in the control group, extent was not reduced and severity was even significantly higher. Direct comparison of second look laparoscopies revealed that adhesion extent and severity were significantly lower in the 4DryField PH than in the control group.Impact StatementWhat is already known on this subject? Adhesion formation after gynaecologic surgeries is known to be frequent and highly problematic as it directly induces complications and additionally makes subsequent surgeries more difficult. The effectiveness of established adhesion barriers is not sufficient to tackle these problems adequately.What the results of this study add? This is the first controlled study using the relatively new adhesion barrier 4DryField PH. It yields a significant reduction of extent as well as severity of adhesions, while adhesiolysis surgery alone does not solve the problem.What the implications are of these findings for clinical practice and/or further research? Usage of 4DryField PH gel seems to be a good approach to solve the adhesion problem of gynaecologic surgery in general and the reformation problem of adhesiolysis surgery specifically. The results should be confirmed in a larger prospective randomised controlled trial.
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Affiliation(s)
- Nicole Ziegler
- Pius Hospital, University Hospital for Gynaecology, Medical University Oldenburg, Oldenburg, Germany
| | - Rudy Leon De Wilde
- Pius Hospital, University Hospital for Gynaecology, Medical University Oldenburg, Oldenburg, Germany
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Lucas B, Riebau C, Mohr J, Pliske G, Walcher F, Piatek S. Effect of 4DryField® PH on blood loss in hip bipolar hemiarthroplasty following intracapsular femoral neck fracture - a randomized clinical trial. BMC Musculoskelet Disord 2021; 22:113. [PMID: 33499843 PMCID: PMC7836593 DOI: 10.1186/s12891-021-03983-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the most common complications of hip arthroplasty is excessive blood loss that could necessitate allogenic blood transfusion, which is further associated with other complications, such as infections, transfusion reactions or immunomodulation. In gynecology, 4DryField®PH, an absorbable polysaccharide-based formulation, is used for hemostasis and adhesion prophylaxis. In this study, we evaluated its hemostatic effect in patients undergoing hip bipolar hemiarthroplasty following intracapsular femoral neck fracture. METHODS We studied 40 patients with intracapsular femoral neck fractures (Garden III or IV) admitted at our institution between July 2016 and November 2017. We included patients above 60 years with simple fracture and without pathologic fractures. Patients were randomized into intervention and control groups. The intervention group received 5 g of 4DryField® PH (subfascially and subcutaneously) during wound closure. Three drainages were inserted in a standardized manner (submuscular, subfascial, and subcutaneous) and drainage volume was measured immediately before extraction. Total blood loss was calculated using Mercuriali's formula and standard hemograms upon admission and five days after surgery. Volume of postoperative hematoma was measured using point-of-care ultrasound seven days after surgery. RESULTS Volume of the postoperative hematoma was reduced by 43.0 mL. However, significant reduction of total blood loss and drainage volume was not observed. CONCLUSIONS We observed that 4DryField® PH had a local hemostatic effect, thereby reducing volume of the postoperative hematoma. However, this reduction was small and had no effect on the total blood loss. Further studies are warranted to improve the application algorithm. TRIAL REGISTRATION DRKS, DRKS00017452 , Registered 11 June 2019 - Retrospectively registered.
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Affiliation(s)
- Benjamin Lucas
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany.
| | - Christian Riebau
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
| | - Juliane Mohr
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
| | - Gerald Pliske
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
| | - Felix Walcher
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
| | - Stefan Piatek
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
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Topical hemostatic and tissue-sealing agents in gynecologic surgery. Curr Opin Obstet Gynecol 2020; 32:285-291. [PMID: 32324712 DOI: 10.1097/gco.0000000000000632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW To review current topical hemostatic agent use and how it pertains to gynecologic surgery. RECENT FINDINGS Recent literature suggests some benefit of topical hemostatic agents (THA). THAs confer reduced bleeding and shorter operating room time in women undergoing hysterectomy for cancer and in abdominal myomectomy. THA use in women undergoing ovarian cystectomy is associated with a decreased reduction in ovarian reserve. Potential complications of THA use include abscess formation, small bowel obstruction, inflammation, allergic reaction, and transmission of blood-borne pathogens. Evidence for use of THA in benign minimally invasive gynecologic surgery (MIGS) procedures is lacking. SUMMARY Although evidence exists for the efficacy of THA in reducing blood loss and operating times across surgical subspecialties, specific, appropriate, and efficacious use of THAs in gynecologic surgery remains ill-defined. Knowledge of their mechanisms of action and potential complications should enable surgeons to optimize desired effects and minimize harm.
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Lymphostasis and Hemostasis in Body-Contouring Surgery Using a Polysaccharide Based Hemostat (4DryField PH). PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2128. [PMID: 31044110 PMCID: PMC6467625 DOI: 10.1097/gox.0000000000002128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/12/2018] [Indexed: 11/25/2022]
Abstract
Background: Following liposuction, abdominoplasty is the most frequent body-contouring intervention in the world. The transection of small blood vessels in large areas and subsequent bleeding is a viable risk during this procedure. The resulting microvascular bleedings should be stopped thoroughly to reduce the probability of related complications. In this prospective, monocentric, randomized study, the efficacy of the polysaccharide-based hemostat 4DryField PH (4DF) (PlanTec Medical, Lueneburg, Germany) is examined in classic abdominoplasty and lower body lift after Lockwood. Methods: For this prospective, monocentric, randomized study, 40 patients underwent surgery for both interventions. Twenty patients received an abdominoplasty, and 20 patients underwent a body lift. In each group, 10 patients have been treated with 4DF, whereas 10 have been served as the untreated control group. Results: 4DF had neither a beneficial nor a negative effect on necessity of drainages, drainage volume and duration, length of hospital stay or frequency of postoperative seromas, wound healing disturbances, and infections, independent of surgical intervention. Patients in the 4DF group, however, had more individual risk factors, and required extended surgical interventions that might mask primary outcome results. Conclusions: This is the first prospective, monocentric, randomized study on 4DF in body-contouring surgery. The use of 4DF did not lead to a better postoperative outcome regarding hemostasis and lymphostasis. Potential benefits need further evaluation in high-volume studies.
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