Is there a difference in the maternal and neonatal outcomes between patients discharged after 24 h versus 72 h following cesarean section? A prospective randomized observational study on 2998 patients

Objective: To compare the incidence of postpartum maternal and neonatal complications and hospital readmission in patients discharged 24 versus 72?h after cesarean section.

Methods: Using randomization, 1495 patients were discharged after 24?h and 1503 patients were discharged after 72?h. All patients fulfilled the discharge criteria. Patients were assessed 6 weeks after delivery, any maternal or neonatal problems or hospital readmissions during this time interval were reported.

Results: There was no difference in maternal hospital readmission between the two groups, but there was a significantly higher neonatal readmission rate in the 24-h group mainly due to neonatal jaundice. As for the complications reported after 6 weeks, the only two significant outcomes were initiating breast feeding, being significantly higher in the 72-h group [OR and 95% CI 0.77 (0.66–0.89)] and the mood swings being significantly lower in the 72-h group [OR and 95% CI 2.28 (1.94–2.68)].

Conclusion: Our recommendation is still in favor of late discharge, after cesarean delivery. Bearing in mind, that an early 24-h discharge, after cesarean delivery is feasible, but with special care of the neonate, with early visit to the pediatrician and early establishment of effective lactation.     

Comparison of the clinical efficacy of daily use of L-arginine,tadalafil and combined L-arginine with tadalafil in the treatment of elderly patients with erectile dysfunction

This study aimed to evaluate the efficacy of the daily oral administrations of L-arginine, tadalafil and combined L-arginine with tadalafil in treatments of elderly patients with erectile dysfunction (ED). It was designed as a single-blind placebo-controlled clinical trial. It was conducted on 120 male patients aged ≥60 years old with ED. Patients were randomised classified into four groups (n = 30 each). Oral daily use of L-arginine (5 g), tadalafil (5 mg), combined L-arginine (5 g) with tadalafil (5 mg) and placebo were taken for 6 weeks in each group of patients respectively. Patients were assessed before and after treatments using the Sexual Health Inventory for Men (SHIM) questionnaire and total serum testosterone. The means of Q1–5, total scores of SHIM and total testosterone, in L-arginine, tadalafil and combined L-arginine with tadalafil groups were significantly higher after treatments (p = .001). Combined L-arginine with tadalafil group had the highest SHIM scores and levels of total testosterone. This clinical trial deduced that the combined daily use of L-arginine with tadalafil therapy for elderly male patients with ED could significantly increase the SHIM scores and levels of total testosterone in comparison to L-arginine, or tadalafil alone.     

Caveolin-1 expression in hyperproliferative skin disorders: A potential predictive marker of disease severity and progression

Background

Caveolin-1 (CAV-1) is a key structural and functional membrane protein that is thought to play a role in controlling cellular proliferation and differentiation.