Effect of Closure of Anterior Abdominal Wall Layers on Early Postoperative Findings at Cesarean Section: A Prospective Cross-sectional Study

Abstract Objective To investigate the effect of closure types of the anterior abdominal wall layers in cesarean section (CS) surgery on early postoperative findings. Methods The present study was designed as a prospective cross-sectional study and was conducted at a university hospital between October 2018 and February 2019. A total of 180 patients who underwent CS for various reasons were enrolled in the study. Each patient was randomly assigned to one of three groups: Both parietal peritoneum and rectus abdominis muscle left open (group 1), parietal peritoneum closure only (group 2), and closure of the parietal peritoneum and reapproximation of rectus muscle (group 3). All patients were compared in terms of postoperative pain scores (while lying down and during mobilization), analgesia requirement, and return of bowel motility. Results The postoperative pain scores were similar at the 2nd, 6th, 12th, and 18th hours while lying down. During mobilization, the postoperative pain scores at 6 and 12 hours were significantly higher in group 2 than in group 3. Diclofenac use was significantly higher in patients in group 1 than in those in group 2. Meperidine requirements were similar among the groups. There was no difference between the groups' first flatus and stool passage times. Conclusion In the group with only parietal peritoneum closure, the pain scores at the 6th and 12th hours were higher. Rectus abdominis muscle reapproximations were found not to increase the pain score. The closure of the anterior abdominal wall had no effect on the return of bowel motility.

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Effect of the Cut-Off Level for Thyroid-Stimulating Hormone on the Prevalence of Subclinical Hypothyroidism among Infertile Mexican Women

Diagnostics ◽

10.3390/diagnostics11030417 ◽

2021 ◽

Vol 11 (3) ◽

pp. 417

Author(s):

Lidia Arce-Sánchez ◽

Salvatore Giovanni Vitale ◽

Claudia Montserrat Flores-Robles ◽

Myrna Souraye Godines-Enriquez ◽

Marco Noventa ◽

...

Keyword(s):

Insulin Resistance ◽

Subclinical Hypothyroidism ◽

Thyroid Autoimmunity ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Mexican Women ◽

Cross Sectional ◽

Group 3 ◽

Group 2 ◽

Group 1

The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, n = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, n = 390; and Group 3, women with TSH ≥4.1 mIU/L n = 220. SCH prevalence was 40.7% (CI 95%: 38.3–43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7–16.5%) with TSH cut-off ≥ 4.1 mIU/L, (p = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 (p < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.

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Depression, anxiety levels and sleep quality indexes among the spouses of people with epilepsy

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0207 ◽

2021 ◽

Author(s):

Halil ONDER ◽

Ersin Kasim ULUSOY ◽

Caner BAYDAR ◽

Mustafa KIRAZ ◽

Muhammet Okay ORUN ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Demographic Data ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

History Of ◽

Group 3 ◽

Group 2 ◽

Psychiatric Problems

ABSTRACT Background: Psychiatric problems and sleep disturbances are comorbidities that are frequently encountered among people with epilepsy. However, their presence among the spouses of peoples with epilepsy remains to be elucidated. Objective: The objective of this study was to evaluate the spouses of people with epilepsy (PWE), with and without a history of seizures during sleep, in terms of depression, anxiety and sleep quality. Methods: This prospective, cross-sectional study was conducted in three groups of 18 to 65-year-olds. Group 1 consisted of healthy spouses of 127 healthy volunteers without any known neurological disease; group 2 comprised spouses of 63 PWE who had no history of seizure during sleep; and group 3 consisted of spouses of 63 PWE who had a history of at least one seizure during sleep in the course of the previous year. Questionnaires seeking demographic data and the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory and Beck Anxiety Inventory were applied to all participants. Results: The depression scores of the group of spouses of PWE were higher than those of the control group and were higher in group 3 than in group 2 (p = 0.017). The anxiety scores of the group of spouses of PWE were significantly higher than those of the control group, but no difference in anxiety scores was found between group 2 and group 3 (p = 0.170). The mean PSQI score of group 3 was higher than that of group 2 (p = 0.029). However, regression analyses did not show any difference between these groups. Conclusion: We found that the PSQI scores, which reflected sleep quality, were higher among the spouses of PWE who had seizures during sleep and who had more severe epilepsy.

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Health-related quality of life and work productivity in UK patients with HER2-positive breast cancer: a cross-sectional study evaluating the relationships between disease and treatment stage

Health and Quality of Life Outcomes ◽

10.1186/s12955-020-01603-w ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Mark Verrill ◽

Andrew M. Wardley ◽

Jenny Retzler ◽

Adam B. Smith ◽

Catherine Bottomley ◽

...

Keyword(s):

Work Productivity ◽

Cross Sectional Study ◽

Her2 Positive ◽

Activity Impairment ◽

Cross Sectional ◽

Related Quality ◽

Health Related ◽

Group 3 ◽

Group 2

Abstract Background The impact of different disease stages and treatment for human epidermal growth factor 2 positive (HER2-positive) breast cancer (BC) on work productivity and health-related quality of life (HRQoL) is poorly understood. Methods This was a UK cross-sectional study of 299 adult patients with HER2-positive early or metastatic BC (NCT03099200). Productivity was assessed using the work productivity and activity impairment scale; HRQoL was measured using EuroQol-5 Dimensions-5 levels (EQ-5D-5L), and Functional Assessment of Cancer Therapy Breast (FACT-G and -B) instruments. Three balanced patient groups were recruited: (1) early BC on treatment post-surgery, (2) early BC after completion of adjuvant treatment, (3) during metastatic BC treatment. Between-group comparisons were performed using an analysis of variance. Results Group 1 comprised 89 patients, Group 2, 108 and Group 3, 102. Age, ethnicity and comorbidities were similar across groups. Patients in Group 3 reported more often being unable to work (significant Bonferroni adjusted p < 0.003). Proportions of employed patients were 50.6%, 50.9% and 27.5% in Groups 1, 2 and 3, respectively. For patients in part-time employment, the number of hours worked was significantly higher in Group 2 patients versus Group 3 (p = 0.002). Group 2 also had significantly lower levels of work absenteeism and overall work impairment compared with Group 1 (p < 0.001). Patients in Group 3 reported worse health utility scores (p ≤ 0.002), moderate or worse problems in the EQ-5D-5L self-care and usual activity domains (p ≤ 0.001), and lower HRQoL as assessed by FACT summary scores (p < 0.001 for FACT-B and -G) than Groups 1 and 2. Poorer HRQoL was significantly associated with higher work impairment (p < 0.001), with the strongest relationships being observed between activity impairment and HRQoL (Pearson’s r: 0.67). Conclusions Metastatic disease and treatment of HER2-positive BC adversely impacted on work productivity and HRQoL. The results of this study support the idea that being able to delay or prevent the metastatic recurrence of BC, for example by extending the time patients are in remission or at early stage of BC, has wider benefits in terms of patient productivity and HRQoL.

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Sensitivity and Specificity of Belin Ambrosio Enhanced Ectasia Display in Early Diagnosis of Keratoconus

Journal of Ophthalmology ◽

10.1155/2020/7625659 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Shahram Bamdad ◽

Mohammad Reza Sedaghat ◽

Masoud Yasemi ◽

Aliraza Vahedi

Keyword(s):

Early Diagnosis ◽

Sensitivity And Specificity ◽

Study Groups ◽

Cross Sectional Study ◽

Cross Sectional ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Normal Thickness

Purpose. Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative evaluations of refractive surgery (RS).The aim of this study was to investigate the correlation between findings of Belin Ambrosio enhanced ectasia display (BAD) software and conventional corneal imaging (Orbscan and topography) in the early diagnosis of KCN. Methods. For conducting this cross-sectional study, a total of 1000 eyes were selected from 500 patients that underwent the myopic photorefractive keratectomy surgery and were compared in four study groups during the years 2017–2018. In group 1, all topography, Orbscan, and BAD criteria were normal (65.8%).In contrast, in Group 2, at least one of the topography or Orbscan criteria as well as at least one BAD criterion (12.6%) were abnormal. In Group 3, the eyes had normal Orbscan and topography criteria with at least one abnormal BAD criterion (18.5%). Also, in Group 4, the patients had at least one abnormal Orbscan or topography criterion, but all BAD criteria (3.1%) were normal. Thickness of the thinnest point (TP) of cornea was compared in Pentacam and topography. Data analysis was done by SPSS software (version 21). Results. BAD criteria were normal in 78.5% of all eyes with normal topography and Orbscan criteria (specificity). BAD criteria were also abnormal in 80.2% of eyes (sensitivity). There was also no significant difference between TP in Orbscan and Pentacam. Conclusions. BAD criteria had a relatively acceptable sensitivity and specificity, compared with conventional Orbscan and topography criteria. Thus, BAD criteria can be more effective in the early diagnosis of KCN.

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Evaluation of static and dynamic pupil characteristics in hyperopic anisometropic amblyopia

European Journal of Ophthalmology ◽

10.1177/1120672118803514 ◽

2018 ◽

Vol 29 (5) ◽

pp. 486-493

Author(s):

Esat Yetkin ◽

Kemal Tekin ◽

Hasan Kiziltoprak ◽

Mehmet Ali Sekeroglu ◽

Veysel Cankurtaran ◽

...

Keyword(s):

Pupil Diameter ◽

Cross Sectional Study ◽

Pupil Dilation ◽

Cross Sectional ◽

Anisometropic Amblyopia ◽

Contraction Velocity ◽

Contraction Duration ◽

Group 3 ◽

Group 2 ◽

Fellow Eyes

Purpose:The aim of this study is to perform a comparison of static and dynamic pupillometry measurements in patients with hyperopic anisometropic amblyopia and age-matched controls.Methods:This prospective cross-sectional study consisted of 38 patients with hyperopic anisometropic amblyopia and 80 control subjects. A quantitative pupillometry system was used to evaluate the pupil characteristics of higher hyperopic eyes (Group 1), the fellow eyes (Group 2), and healthy eyes (Group 3). Static pupillometry measurements were taken including scotopic pupil diameter, mesopic pupil diameter, low-photopic pupil diameter, and high-photopic pupil diameter. Subsequently, dynamic pupillometry measurements were taken including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation.Results:Groups 1 and 2 had statistically significantly lower scotopic and high-photopic pupil diameter values compared with Group 3 (p < 0.05). The amplitude of pupil contraction values were also statistically significantly lower in Groups 1 and 2 compared with Group 3 (p = 0.001 and p = 0.003). However, there were no significant differences between the study and the control eyes with respect to mesopic and high-photopic pupil diameter, resting diameter, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation values (p > 0.05, for all).Conclusion:Static and dynamic pupil characteristics of higher hyperopic eyes and their fellow eyes are similar. This may support that amblyopia is not a monocular disorder, but can affect both eyes.

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DIFFERENCES AMONG THE PERCEPTIONS OF ORTHODONTISTS, PROSTHODONTISTS AND CONSERVATIVE DENTISTRY SPECIALISTS REGARDING BUCCAL CORRIDOR WIDTHS

Journal of University Medical & Dental College ◽

10.37723/jumdc.v12i1.432 ◽

2021 ◽

Vol 12 (1) ◽

pp. 44-50

Author(s):

Muhammad Azeem ◽

Ali Raza ◽

Rashid Mahmood ◽

Erum Behroz

Keyword(s):

Cross Sectional Study ◽

Cross Sectional ◽

Present Cross Sectional Study ◽

Conservative Dentistry ◽

Group 3 ◽

The Subject ◽

Group 2 ◽

Post Hoc ◽

Buccal Corridor ◽

Group 1

ABSTRACT BACKGROUND & OBJECTIVE: To find out the optimal ranges of smile attractiveness on basis of different amounts of buccal corridor widths, as judged by Pakistani orthodontists, prosthodontists and conservative dentistry specialists (CDS). METHODOLOGY: Present cross-sectional study was conducted from June 2016 to June 2017. The anterior smiling image of a female model was edited to be converted to 10 images displaying different amounts of buccal corridor width. After informed consent from the subject, different buccal corridors widths images were created at following widths: 0%, 2%, 4%, 6%, 8%, 10%, 12%, 14%, 16%, and 18%. This was followed by measurement of smile attractiveness of these 10 images on a visual analogue scale by 30 evaluators in three groups. Group 1 consisted of 10 CDS, group 2 consisted of 10 prosthodontists and group 3 consisted of 10 orthodontists. The data was collected and scores of smile attractiveness were presented in form of mean and standard deviation for each group. The differences in the three groups regarding perception of smile attractiveness were found out using ANOVA test and Turkey’s post-hoc test was used for multiple comparisons. RESULTS: For group 1, the highest scoring was obtained by image showing 10% buccal corridor width. In group 2, the highest score was by image showing 14% buccal corridor width, whereas in group 3, the highest scoring was showing 12% buccal corridor width. The differences found were statistically insignificant. CONCLUSION: Dental specialty does not affect perception of smile attractiveness. Buccal corridor width greater than 14% should be avoided.

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Serum and Bronchoalveolar Lavage Fluid 25(OH)Vitamin D3 Levels in HIV-1 and Tuberculosis: A Cross-Sectional Study from a Tertiary Care Center in North India

Current HIV Research ◽

10.2174/1570162x16666180528112924 ◽

2018 ◽

Vol 16 (2) ◽

pp. 167-173

Author(s):

Sanjeev Sinha ◽

Kartik Gupta ◽

Dibyakanti Mandal ◽

B.K. Das ◽

R.M. Pandey

Keyword(s):

Vitamin D ◽

Lavage Fluid ◽

Cross Sectional Study ◽

P Value ◽

Vitamin D Metabolites ◽

Cross Sectional ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Vitamin D is an immunomodulator, and its deficiency is associated with Tuberculosis (TB) infection. Bronchoalveolar lavage fluid (BALF) is a rich milieu of macrophages that form the first line of defense against invading TB bacilli. As there is an increased prevalence of vitamin D deficiency in TB and human immunodeficiency virus-1 (HIV-1) subjects, we intend exploring the possibility of a localized deficiency of vitamin D metabolites in BALF of these patients. Objective: The primary objective was to assess the level of 25D3 in serum and BALF of subjects and look for a significant difference among patients and controls. The secondary objective was to find a correlation between serum and BALF 25D3 levels. Methods: We performed a cross-sectional study with subjects divided into four groups: Controls (group 1), HIV positive without active TB (group 2), active TB without HIV (group 3), and HIV-TB coinfection (group 4). BALF and serum 25D3 levels were compared between the groups. Results: Among the 149 (an immunomodulator) successive subjects enrolled, there were 40 subjects in group 1 (HIV-TB-), 48 in group 2 (HIV+TB-), 37 in group 3 (HIV-TB+), and 24 in group 4 (HIV+TB+). Females constituted 31.6% of the study subjects. In groups 3 and 4, there were significantly lower serum 25D3 levels compared to group 1 (p-value group 3: 0.002; group 4: 0.012). In groups 2, 3, and 4, there were significantly lower BALF 25D3 levels compared to group 1 (p-value group 2: 0.000; group 3: 0.000; group 4: 0.001). There was a significant correlation between serum and BALF 25D3 levels (Spearman’s rank correlation coefficient 0.318, p-value = 0.0001). Conclusion: Lower levels of serum and BALF 25D3 were observed in HIV, TB, and HIV-TB coinfected patients. Localized deficiency of vitamin D metabolites might be associated with increased vulnerability to TB infection.

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Prevalence of prediabetes in patients with metabolic risk

Sao Paulo Medical Journal ◽

10.1590/s1516-31802011000500004 ◽

2011 ◽

Vol 129 (5) ◽

pp. 300-308 ◽

Cited By ~ 1

Author(s):

Lívia Nascimento de Matos ◽

Guilherme de Vieira Giorelli ◽

Amir Saado ◽

Cristiane Bitencourt Dias

Keyword(s):

Clinical Laboratory ◽

Tolerance Test ◽

Cross Sectional Study ◽

Cross Sectional ◽

Group 4 ◽

Laboratory Variables ◽

Group 3 ◽

Group 2 ◽

Anthropometric Profile ◽

Group 1

CONTEXT AND OBJECTIVE: Early diagnosis of prediabetes should be done to avoid complications relating to diabetes mellitus (DM). The aim here was to assess the prevalence of prediabetes among individuals at high risk of developing DM, and to seek variables relating to glucose intolerance (GI) among individuals with normal fasting plasma glucose (FPG). DESIGN AND SETTING: Cross-sectional study at Hospital do Servidor Público Estadual, São Paulo. METHODS: The FPG and glucose tolerance test (GTT) were analyzed, from which the subjects were divided as follows: group 1 (FPG and GTT both normal), group 2 (normal FPG but abnormal GTT), group 3 (abnormal FPG but normal GTT), and group 4 (FPG and GTT both abnormal). The subjects' clinical, laboratory and anthropometric profile was determined. RESULTS: 138 subjects were studied: 44 in group 1, 11 in group 2, 33 in group 3 and 50 in group 4. The prevalence of prediabetes was 68.0%. Group 4 individuals were older than group 1 individuals [69.0 (55.5-74.0) versus 58.9 ± 11.8 years; P < 0.05], with greater prevalence of risk conditions for DM [5.0 (4.0-5.0) versus 4.0 (3.0-5.0); P < 0.05]. Among individuals with normal FPG, GI prevalence was 20.0%. No variables analyzed correlated with GTT. CONCLUSION: The prevalence of prediabetes was 68.0%, and 20.0% of subjects with normal FPG had GI. Although some anthropometric, clinical and laboratory variables have been correlated with DM and prediabetes, none, except for GTT, was able to screen for GI among subjects with normal FPG in the present study

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A Cross-Sectional Study of Serum and Urine Fluoride in Diabetes in Fluoride Exposed Population

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/171 ◽

2021 ◽

Vol 10 (11) ◽

pp. 798-802

Author(s):

Sai Deepika Ram Mohan ◽

Shashidhar Kurpad Nagaraj ◽

Raveesha Anjanappa ◽

Muninarayana Chandrappa

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Cross Sectional Study ◽

Sirtuin 1 ◽

Cross Sectional ◽

Diabetic Kidney ◽

Group 3 ◽

Group 2 ◽

Serum And Urine

BACKGROUND In addition to diet and nutrition, environmental changes may increase the incidence of diabetes mellitus and microvascular complication leading to ‘diabetic kidney disease (DKD)’. One such factor considered in this study is fluoride. Increased incidence of DKD lead to estimation of fluoride in fluoride endemic areas. Fluoride and advanced glycation end products lead to the development of microvascular complication in patients of diabetes leading to diabetic kidney disease or diabetic nephropathy which in turn leads to increase in expression of sirtuin 1; a regulatory protein mediating deacetylation of histone proteins which was analysed. METHODS Subjects recruited for this cross-sectional study were divided as - group 1 (healthy controls), group 2 (patients with type 2 diabetes) and group 3 (diabetic nephropathy patients) with 50 subjects in each group. Routine parameters were analysed in biochemistry section of central laboratory. RESULTS In patients with diabetic kidney disease, serum and urine fluoride levels were similar (0.2 and 0.28 ppm); whereas, in other two groups, urine fluoride values were more than the serum fluoride values indicating better renal function and fluoride clearance. Least sirtuin 1 median range was observed in group 1 [22.65 (11.78 - 91.10)] and 36.9 (27.38 - 56.23) in group 3 lesser than group 2 with a value of [42.7 (30.17 - 52.93)]. CONCLUSIONS Serum and urine fluoride estimation aids in assessing progression of disorder and hence helps in preventing complications. Fluoride may not be a cause of diabetes but may accelerate its microvascular complications as observed in this study. Sirtuin 1 levels in serum or plasma can be a marker for various damages caused by aging disorders. Sirtuin 1 correlation with diabetic parameters will help in health research to include it as a therapeutic target for various toxic conditions. KEY WORDS Advanced Glycation End product, Fluoride, Diabetic Kidney Disease, Sirtuin 1, Type 2 Diabetes Mellitus

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Seroprevalence of Rubella IgG in Pregnant Females

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v7i4.267 ◽

2019 ◽

Vol 7 (4) ◽

pp. 295-298

Author(s):

Huda Rana ◽

Rijja Chaudhary ◽

Saeed Alam ◽

Wajiha Mahjabeen

Keyword(s):

Cross Sectional Study ◽

Natural Immunity ◽

Cross Sectional ◽

Positive Group ◽

Group 4 ◽

Child Bearing ◽

High Prevalence ◽

Group 3 ◽

Group 2 ◽

Age Range

Objective: To find out the seropositivity of IgG rubella in pregnant women in Pakistan, to assess the prevalence of infection and to estimate the requirement of vaccination.Patients and Methods: In this retrospective cross sectional study total 730 females who visited Salma Kafeel Fertility Clinic (Rawalpindi) for antenatal checkup were inducted. Their age range was 18-45 years. The study was carried out from 2011-2016. ELISA serological testing was used to check the seroprevalence of Rubella IgG.Results: In total the 730 subjects were included in the study and divided in four groups according to their ages. The results were as follows: group 1(18-20yrs) 100% positive, group 2 (21-30yrs) 90.5% positive, group 3 (31-40yrs) 93.5% positive and lastly group 4 (>40yrs) 95%positive. Overall 92.32 % seropositivity was seen while 7.70% were found at risk of developing infection.Conclusion: There is a high prevalence of Rubella in females of child bearing age in Pakistan. This is alarming as it can result in high risk of CRS in newborns and fetal death. Therefore, women planning to become pregnant, who do not have natural immunity to rubella should be vaccinated at least 4 weeks prior to conception.

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