AB0814 PREGNANCY COURSE ASSESSMENT IN PATIENTS WITH RHEUMATIC DISEASES COMPARED TO CONTROLS

Background:Rheumatic diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SA) may occur among women of childbearing age. Adverse events during pregnancy including disease flare, preterm delivery, and neonatal or fetal death have been reported.Objectives:Our aim was to assess the impact of rheumatic diseases on the course of pregnancy.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria) (study group) as well as healthy controls (control group) matched by age and gender. All women included had at least one pregnancy. Data were collected through telephonic interviews. We used the Student t test to compare the study group and the control group.Results:We enrolled 57 patients (30 RA and 27 SA) and 57 controls. The mean age in the study and the control groups were respectively 43.2 ± 8.2 years [26-48] and 37.5 ± 6 years. The mean chronic inflammatory rheumatisms duration was 13.81 ± 6.2 years. A history of primary sterility was found in 3 patients (1 RA and 2 SA) and none in the control group. The mean age during the first pregnancy was significantly higher in the study group (28 ± 6.2 years versus 24 ± 7 years in the control group) (p=0.01). Eight patients (5 RA and 3 SA) had a history of spontaneous miscarriage. A terminated pregnancy was noted in 3 patients (1 RA and 2 SA). Complications during pregnancy in the study group were gestational diabetes (0.3%), premature delivery (0.3), premature rupture of membranes (0.3%), abortion threat (0.3%) and pre-eclampsia (6%). Pregnancy was more associated with complications in the study group (p=0.05). Cesarean section was more used in the study group (28 patients versus 9 in the control group; p= 0.00). The main indications of cesarean section in the study group were macrosomia (11 patients), scar uterus (6 patients), sacroiliitis (4 SA patients), twin pregnancy (2 patients), and undetermined reasons (6 patients). Fetal presentation in the study group was the seat presentation (3%), top presentation (4%), face (2%), and forehead presentation (0.3%) with no significant difference with the control group. Complications of childbirth in the study group were hemorrhage of delivery (10.3%), cord widening (6.6%), perinatal asphyxia (4.9%), and dystocia (1.9%). However, no statistically significant differences were found between the two groups in the prevalence of complications of childbirth. During pregnancy, 5 patients were on salazopyrine, 2 on corticosteroids and, 1 on non-steroidal anti-inflammatories.Conclusion:Our study showed that pregnancies with rheumatic diseases were at increased risk of having maternal complications and adverse neonatal outcomes.Disclosure of Interests:None declared

Download Full-text

Impact of Whatsapp in improving learning among 9th semester MBBS students

Medpusle International Journal of Surgery ◽

10.26611/1061917 ◽

2021 ◽

Vol 19 (1) ◽

pp. 27-30

Author(s):

Y Satish Reddy ◽

Keyword(s):

Undergraduate Students ◽

Control Group ◽

P Value ◽

Study Group ◽

Opinion Poll ◽

Didactic Teaching ◽

Significant Difference ◽

Group A ◽

The Mean ◽

The Impact

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students

Download Full-text

Do Large Uterine Fibroids Impact Pregnancy Outcomes?

Oman Medical Journal ◽

10.5001/omj.2021.93 ◽

2021 ◽

Vol 36 (4) ◽

pp. e292-e292

Author(s):

Ruqaiya Al Sulaimani ◽

Lovina Machado ◽

Munira Al Salmi

Keyword(s):

Preterm Delivery ◽

Postpartum Hemorrhage ◽

Uterine Fibroids ◽

Neonatal Outcomes ◽

Control Group ◽

Study Group ◽

Significant Difference ◽

History Of ◽

The Mean ◽

Cesarean Myomectomy

Objectives: We sought to assess the prevalence of fibroids complicating pregnancy among Omani women who delivered and were followed-up at Sultan Qaboos University Hospital (SQUH) and correlate the presence of large fibroids (> 5 cm) with maternal and neonatal outcomes. Methods: This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, SQUH, from 1 January 2011 to 31 December 2016. Demographic data included maternal age, gravidity, parity, body mass index (BMI), and history of preterm delivery. Ultrasonographic data included the total number of fibroids, number of fibroids > 5 cm in diameter, and location. The main outcomes measured were preterm delivery, preterm premature rupture of membranes (PPROM), malpresentation, intrauterine growth restriction (IUGR), mode of delivery, postpartum hemorrhage, retained placenta, and cesarean myomectomy. Fetal outcomes included birth weight and Apgar score. We used the chi-square test and t-test to calculate significant outcomes. Results: The total number of deliveries over the study period was 24 800. Among these, 62 women had fibroids complicating pregnancy, giving an overall prevalence of 0.3%. Of the 62 women with documented uterine fibroids, 41 had fibroids > 5 cm in diameter and formed the study group, while the control group included 88 women with no fibroids and normal singleton pregnancies. The mean age, parity, BMI, and history of preterm delivery were comparable. The mean age of the study group was 32.6 years. There was no statistically significant difference in obstetric outcomes between the study and control group in terms of preterm labor (p =0.381), PPROM (p =0.536), malpresentation (p =0.237), IUGR (p =0.059), and retained placenta (p =0.296). Postpartum hemorrhage was significantly higher in the study group (p =0.018), the commonest cause was uterine atony (p =0.007). Women with large fibroids had a significantly increased cesarean section rate (p =0.002), the main indications were obstructed labor and failure to progress (62.5%). Five of the 44 women in the study group (12.8%) underwent cesarean myomectomy. Regarding neonatal outcomes, a statistically significant difference was noted in the Apgar scores. Conclusions: Fibroids measuring > 5 cm in diameter are more likely to cause obstetric complications and are associated with higher cesarean rates. Pre-conception myomectomy is recommended for women with large fibroids.

Download Full-text

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2019-0221 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Divya Raj ◽

Subramaniam Santhi ◽

G. J. Sara Sapharina

Keyword(s):

Old Age ◽

Depression Scale ◽

Exercise Program ◽

The Elderly ◽

Control Group ◽

Study Group ◽

Significant Difference ◽

The Mean ◽

Interventional Group ◽

Old Age Homes

AbstractObjectivesThis study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes.MethodsThe non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique.ResultsThe neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found.ConclusionsThe findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

Download Full-text

The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽

10.1093/qjmed/hcaa056.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K M Diab ◽

R M Mohamed ◽

A G Abdelhay

Keyword(s):

Blood Loss ◽

Cesarean Section ◽

Tranexamic Acid ◽

Maternal Mortality ◽

Vaginal Delivery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Significant Difference ◽

And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

Download Full-text

The impact of outpatient clinical care on the survival and hospitalisation rate in patients with alcoholic liver cirrhosis

Radiology and Oncology ◽

10.1515/raon-2017-0056 ◽

2017 ◽

Vol 52 (1) ◽

pp. 75-82

Author(s):

Dejan Majc ◽

Bojan Tepes

Keyword(s):

Liver Cirrhosis ◽

Alcohol Consumption ◽

Clinical Care ◽

Hospitalisation Rate ◽

Control Group ◽

Study Group ◽

Alcoholic Liver Cirrhosis ◽

Significant Difference ◽

A Prospective Study ◽

The Impact

AbstractBackgroundIn the study, we aimed to determine whether regular outpatient controls in patients with alcoholic liver cirrhosis have an impact on their survival and hospitalisation rates.Patients and methodsWe included patients with liver cirrhosis and regular outpatient controls as a prospective study group and patients with liver cirrhosis who were admitted to hospital only in cases of complications as a retrospective control group. The study was conducted between 2006 and 2011.ResultsWe included 98 patients in the study group and 101 patients in the control group. There were more outpatient controls in the study group than in the control group (5.54 examinations vs. 2.27 examinations, p = 0.000). Patients in the study group had 25 fewer hospitalisations (10.2%; p = 0.612). The median survival rate was 4.6 years in the study group and 2.9 years in the control group (p = 0.021). Patients with Child A classification had an average survival of one year longer in the study group (p = 0.035). No significant difference was found for Child B patients. Patients with Child C classification had longer survival by 1.6 years in the study group (p = 0.006). Alcohol consumption was lower in the study group than in the control group (p = 0.018).ConclusionsWe confirmed that patients with regular outpatient controls had lower alcohol consumption, a lower hospitalisation rate and significantly prolonged survival time. We confirmed the necessity for the establishment of regular outpatient controls in patients with alcoholic liver cirrhosis.

Download Full-text

The Impact of Strengthening Exercise on Dynamic Balance in Patients with Knee Osteoarthritis

10.53350/pjmhs2115103429 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3429-3431

Author(s):

Shenbaga Subramanian Sundaram ◽

Makesh Babu Subramanian ◽

Riziq Allah Mustafa Gaowgeh ◽

Mikhled Falah Maayah ◽

Ziyad Neamatallah ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Dynamic Balance ◽

Mean Value ◽

Control Group ◽

P Value ◽

Strengthening Exercise ◽

Significant Difference ◽

The Mean ◽

The Impact ◽

Experimental Group

Background: Knee osteoarthritis is characterised clinically by usage-related pain and/or functional limitation. OA that is associated with physical dysfunction and decline in health-related quality of life caused the main disability worldwide and is expected to increase due to aging and obesity rates and further load on the population and health system. The strengthening exercises that normally used is knee flexion and extensions, isometric quadriceps exercise, isometric hamstring exercise, and sit to stand to improve the balance. Objectives: is to find out the impact of Strengthening exercise on Balance in patients with knee Osteoarthritis Study Design: Quasi experimental study Methods: Fifty-six (n=56) of knee OA patients were involved in this study by judgemental sampling design. Researcher will first demonstrate and explain the Y-balance tools testing procedure based on Plisky and colleagues study. Participants are given to practice six trials before the formal testing, stated that SEBT have a significant learning effect and found that the reaching distances reached the longest distance after six trials and then will be constant. Results: Independent t-test shows significant difference in only anterior direction. In the experimental group the mean value is 69.83 with a SD of 11.62 while in the control group the mean value is 63.51 with a SD of 11.36; p-value of .045 and t-value of 2.056. In postero-lateral directions result shows there is no significant difference, experimental group the mean value is 91.10 with a SD of 9.74 while in control group mean value is 90.88 with SD value of 12.68; p-value of .947 and t-value of .067. Result of postero-medial shows no significant difference too, in experimental group the mean value of 95.16 with SD of 10.92 while in control group the mean value is 93.40 with SD of 8.20; p=value of .501 and t-value of .678. Conclusion: This study has proven strengthening exercise using YBT improved only anterior direction of YBT but no significant difference in postero-lateral and postero-medial direction. Key Words: Knee Osteoarthritis, Strengthening exercise, Dynamic Balance, Star excursion test

Download Full-text

Effect of Foetal Movement Counting on Prenatal Attachment and Maternal Worries among Primigravidas- A Longitudinal Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48870.15394 ◽

2021 ◽

Author(s):

Jignya Vinodbhai Asari ◽

Anjali Pushkar Tiwari

Keyword(s):

Longitudinal Study ◽

Control Group ◽

P Value ◽

Study Group ◽

Prenatal Attachment ◽

Study Results ◽

Significant Difference ◽

The Mean ◽

Foetal Movement ◽

And Control

Introduction: Pregnant woman experience various physical, emotional, and hormonal changes that may cause anxiety. The anxiety and worries can be decreased by sharing information about the developing child, like foetal body movement. Aim: To assess effect of Foetal Movement Counting (FMC) on prenatal attachment and maternal worries among primigravida mothers. Materials and Methods: A longitudinal study was carried out among primigravida mothers of selected Hospitals of Central Gujarat using proforma of Cranley’s maternal foetal attachment scale and Cambridge worry scale. The study was conducted from March 2019 to July 2020. Eighty participants were recruited by convenient sampling 40 in each study group and control group. The study group were provided with foetal movement chart and the participants were asked to record foetal movements for seven consecutive days, twice a day for 20 minutes. Post assessment of prenatal attachment and maternal worries was done using tools of data collection for both study and control group. Chi- square test was used to test the significance (p-value <0.05). Results: The study results revealed that in study group mean score for prenatal attachment was 79.43 at the start and improved to 101.25 (p-value <0.001) after seven days of FMC. In control group, the mean score for prenatal attachment did not show significant difference pre-test and post-test (74.20 vs 74.85, p-value=0.077). In study group, the mean Cambridge worry scale score was 36.55 which came down to 20.28 (p-value <0.001) after seven days, while in control group it was 41.38 at the beginning and 41.30 after seven days (p-value=0.998). Conclusion: Foetal Movement Counting was found to improve maternal foetal attachment and reduce maternal worries. FMC can be routinely and effectively promoted among the pregnant population to help them achieve a positive pregnancy experience and outcome.

Download Full-text

Outcome of using a modified surgical technique for the repair of complex vesicovaginal fistulas in Nigeria

Urogynaecologia ◽

10.4081/uij.2017.196 ◽

2017 ◽

Vol 30 (1) ◽

Author(s):

Aniefiok J. Umoiyoho ◽

Emmanuel C. Inyang-Etoh

Keyword(s):

Obstetric Fistula ◽

Conventional Technique ◽

Control Group ◽

Study Group ◽

Success Rates ◽

Modified Technique ◽

Repair Technique ◽

Significant Difference ◽

The Mean ◽

Repair Techniques

The relatively low effectiveness of available surgical repair techniques for complex obstetric fistula has justified the need for continued exploration of more effective repair techniques. Subjects who presented at a vesicovaginal fistula referral centre in Nigeria were randomized into the study group (modified technique) and the control group (conventional technique). Success rates between the two groups were compared. The study comprised 29 patients in each arm of the study. The mean age of patients in the study group was 23.9 ± 9.6 years and 24.4 ± 2.1 years among patients in the control group with the vast majority of the patients in the both groups being married, 75.9% and 86.2% respectively. In both groups, the majority were secundipara, 55.2% in the study group and 44.8% in the control group. The majority (41.4% in the study group and 44.8% in the control group) of the patients in both groups had attained primary level of education. The mean duration of the fistulas among patients in the study population was 1.1 ± 0.3 years with over half (50.0% among patients in the study group and 53.5% of patients in the control group) of the patients had their fistula for less than one year. A highly statistically significant difference in success rate between patients in the study group and patients in the control group was obtained (p=0.0004). The modified repair technique presented by this study has proved to produce superior results when compared to the conventional repair technique in the management of complex obstetric fistulas in Nigeria.

Download Full-text

Impact of Momordica Charantia (Karela) on the Proportion of Hepatocytes with Intranuclear Inclusions in the StreptozotocinInduced Diabetic Rats

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v5i2.20761 ◽

2013 ◽

Vol 5 (2) ◽

pp. 84-86

Author(s):

Shirin Mohal ◽

Md. Afzal Hossain ◽

Dulal Krishna Mondal ◽

Shamim Ara ◽

Khandaker Manzare Shamim

Keyword(s):

Diabetic Rats ◽

Momordica Charantia ◽

Control Group ◽

Intranuclear Inclusions ◽

Significant Difference ◽

Vehicle Injection ◽

Streptozotocin Induced Diabetes ◽

The Mean ◽

Age Range ◽

The Impact

Background: Momordica charantia has some hypoglycemic properties.Objective: The purpose of the present study was to find out the impact of Momordica charantia (karela) on the proportion of hepatocytes in the Streptozotocin-induced diabetic rats.Methodology: This was an animal study carried out in the Department of Anatomy at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research & rehabilitation in Diabetes, Endocrine & metabolic Disorders (BIRDEM), Dhaka. Healthy young Long Evans rats of male sex weighing 150 to 280gm with an age range of 10 to 12 weeks were used in this study. The rats were divided into 4 equal groups depending upon their different sorts of dietary feedings and drug treatment. The variation of different proportion of hepatocytes with intranuclear inclusions in different groups of rat was monitored.Result: Sixty five rats were included in this study. Mean proportion of hepatocytes with intranuclear inclusions on day 51 from Streptozotocin/vehicle injection in the control group which was known as Group-A was 0. In untreated diabetic group the mean proportion of hepatocytes with intranuclear inclusions was 3.71 ± 0.82. On the other hand, in the insulin-treated diabetic rats the mean proportion of hepatocytes with intranuclear inclusions was 0 and in the karela-treated diabetic rats, the proportion of hepatocytes with intranuclear inclusions was 0. The value in the insulin-treated diabetic rats (p=0.0001) and in the karela-treated diabetic rats (p= 0.0001) were significantly lower than that of the untreated diabetic rats; however, there was no significant difference between the insulin-treated diabetic rats & the karela-treated diabetic rats (P>0.05) in this regard.Conclusion: Karela showed a tendency of acting against hyperglycemic effects of Streptozotocin-induced diabetes mellitus and also acting against the rise in proportion of hepatocytes with intranuclear inclusions in Streptozotocin-induced diabetes mellitus.DOI: http://dx.doi.org/10.3329/jssmc.v5i2.20761J Shaheed Suhrawardy Med Coll, 2013;5(2):84-86

Download Full-text

Phenylephrine Effectiveness in Handling Hypotensive Issues During Spinal Anesthesia Conductance for Cesarean Section Deliveries

Journal of Anesthesia & Pain Medicine ◽

10.33140/japm.04.03.02 ◽

2019 ◽

Vol 4 (3) ◽

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Research Group ◽

Elective Cesarean Section ◽

Control Group ◽

P Values ◽

Management Protocol ◽

Significant Difference ◽

Elective Cesarean ◽

The Impact

Background: Hypotension is frequent clinical challenge during spinal mode of anesthetic induction for cesarean delivery. Requiring an effective and prompt management mode since it has unfavorable clinical outcomes such as hemodynamic cardiovascular instability issues besides reduced uteroplacental perfusion. Aim: Investigating the impact and effectiveness of different prophylacticdosages of Phenylephrine on hypotensive issues during spinal anesthesia for cesarean section deliveries. Methodology:A prospective, randomized, clinical research study involved 184 cases That are classified as American Society of Anesthesiologists physical status I and II with term singleton pregnancies scheduled for elective cesarean section under spinal anesthesia randomized to receive 0.9% saline 2 mL (Control Group) or phenylephrine1.0 ug/kg (PHE1 research Group), 1.5 ug/kg (PHE1.5 research Group), or 2.0 ug/kg (PHE2 research Group) immediately after induction of spinal anesthesia. Results: The adverse effects of prophylactic bolus ofPhenylephrine among the research groups control, Phenylephrine 1, 1.5,2 in which there was statistically significant difference as regards hypotension, rescue Phenylephrine,lowest SBP,highest SBP,early highest SBP,mean SBP, occurrence of hypertension (p values= <0.001, <0.001, 0.002, <0.001, <0.001, <0.001, <0.001consecutively) there was no statistical significant difference as regards nausea and bradycardia (p values=0.929, 0.823consecutively). Conclusions: The research findings obtained denote and imply that a prophylactic Phenylephrine 1.5 ug/kg bolus followed by additional boluses when necessary could be an alternative management protocol to decrease the frequency of hypotensive issues occurrence during spinal anesthetic mode for cesarean deliveries.

Download Full-text