scholarly journals Preoperative sonographic prediction of intra-abdominal adhesions using sliding sign at repeat caesarean section at the University of Maiduguri Teaching Hospital, Nigeria: a prospective observational study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e046334
Author(s):  
Mohammed Bukar ◽  
Asta Umar Mana ◽  
Nasiru Ikunaiye
Keyword(s):  
Prospective Observational Study ◽  
Abdominal Adhesions ◽  
Third Trimester ◽  
North East ◽  
Preoperative Prediction ◽  
Ultrasound Findings ◽  
The Mean ◽  
Transabdominal Sonography ◽  
The University

ObjectiveTo determine if the presence or absence of sonographic sliding sign preoperatively is a good predictor of the presence and type of intra-abdominal adhesions; and to determine the time taken to demonstrate this sign.DesignA prospective, observational, triple-blind study using tests of diagnostic accuracy.SettingSingle-centre tertiary health institution in north-east Nigeria.Participants67 women in the third trimester scheduled for repeat elective caesarean sections (CS) had transabdominal sonography to determine the absence or presence and degree of sliding sign. The time taken to make these decisions were noted. Surgeons blinded to the ultrasound findings graded adhesions intraoperatively and comparison between sonographic and intraoperative findings made. Women who were scheduled for emergency CS were excluded.Main outcome measuresAccuracy of preoperative ultrasound to determine no/mild, moderate and severe adhesions. Secondary outcomes were interobserver correlations and time taken to determine sliding.ResultsWhen classified as adhesion and no adhesion, the sliding sign demonstrated a sensitivity of 100.00% (CI95 85.18% to 100.00%), specificity of 100.00% (CI95 92.13% to 100.00%). In predicting presence of moderate intra-abdominal adhesions, a sensitivity of 65.0% (CI95 40.78% to 84.61%) and specificity of 82.98% (CI95 69.19% to 92.35%) was found. For predicting severe intra-abdominal adhesions, it had a sensitivity of 25.00% (CI95 0.63% to 80.59%) and specificity of 98.41 (CI95 91.47 to 99.96). Disease prevalence for mild, moderate and severe adhesions was 33.82% (CI95 22.79% to 46.32%), 29.85% (CI95 19.28% to 42.27%) and 5.97% (CI95 1.65% to 14.59%), respectively. Interobserver Cohen’s kappa coefficient and PPA were 0.58 (CI95 0.39 to 0.76) and 58.82 (CI95 52.82 to 64.82), respectively. The mean duration to determine sliding sign was 7.56±2.86 s.ConclusionThis study supports the role of transabdominal sliding sign in preoperative prediction of intra-abdominal adhesions in women with previous CS without significant increase in sonography duration. This information can encourage planning for CS by ensuring that surgeons of appropriate seniority are deployed to undertake anticipated complex operations.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

scholarly journals The Influence of CLL on EFL Learners’ Speaking Skill

2018 ◽  
Vol 5 (2) ◽  
pp. 48-56
Author(s):  
Muhammad Ilyas
Keyword(s):  
Foreign Language ◽  
Language Learning ◽  
Teaching And Learning ◽  
English Language ◽  
Efl Learners ◽  
Post Test ◽  
Speaking Skill ◽  
The Mean ◽  
The University

Some students in the university got some difficulties to express their ideas, especially expressing in foreign language such as English. How to start comunication and interaction sometime need someone to stimulate. The phenomenon often encountered in various levels of education even to the students college. The students tended to be very subjective towards topics, their peer or even partner. In the teaching and learning process, the teacher not only transfer the information to the students but also facilitate the students, stimulate to learn English and provide the technique suitable with the students’ need. Teaching English language might be carried out through several techniques, one of them was CLL (Community Language Learning). In this technique, students were treated as clients who could express their problems to the counselor as well as in the community. In addition, the teacher played the role of translator to help students express themselves using English. This means that learners had enough opportunities to speak without worrying about their limitations in using English. The results showed that CLL helped students to express ideas systematically. The ideas were organized well, understandable, and standardized. In addition, CLL improved the result of students’ score in speaking skill. The mean score increased from 54.74 in pre-test to 72.86 in post-test. It means that CLL gave good influence on students’ speaking skill.

Pediatric Equestrian Injuries: Assessing The Impact of Helmet Use

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 487-489
Author(s):  
G. Randall Bond ◽  
Richard A. Christoph ◽  
Bradley M. Rodgers
Keyword(s):  
Emergency Department ◽  
Prospective Observational Study ◽  
Injury Severity ◽  
Head Injuries ◽  
University Of Virginia ◽  
Severity Scale ◽  
Helmet Use ◽  
The Mean ◽  
The University ◽  
The Impact

Objective. To assess the impact of helmet use on the pattern, and severity of pediatric equestrian injuries. Design. A prospective observational study of all children less than 15 years of age who were brought to the University of Virginia children's Emergency Department with horse-related injuries. Results. During the two-year period of the study, 32 children were evaluated. Two children were injured when a horse stepped on them. Thirty children fell from or were thrown from a horse. Of these, 20 were wearing a helmet. Head injuries were more frequent in those patients not wearing helmets. The mean Modified Injury Severity Scale (MISS) score for riders without a helmet (12.9) was significantly higher (more severe) than that for helmeted riders (2.8). All three patients with a Glascow Coma Score &lt;15 on arrival were not wearing a helmet at the time of injury. The frequency of hospitalization was significantly higher for those not wearing a helmet. Compared with other common mechanisms of childhood injury the mean Modified Injury Severity Scale score of injured riders was exceeded only by that of pedestrians struck by a car. Conclusion. Equestrian injuries are more severe than those suffered from other common pediatric mechanisms. Helmet use is associated with decreased frequency and severity of central nervous system injury.

Plasma Iron Indices in Pregnant Women Referred to the University of Abuja Teaching Hospital, Nigeria

2020 ◽  
Author(s):  
Amos Dangana ◽  
Anthony Uchenna Emeribe ◽  
Sanusi Musa ◽  
Lugos D. Moses ◽  
Christopher Ogar ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Teaching Hospital ◽  
Binding Capacity ◽  
First Trimester ◽  
Iron Binding ◽  
Third Trimester ◽  
Plasma Iron ◽  
The Mean ◽  
Iron Binding Capacity ◽  
The University

Background and Aims: Iron Deficiency (ID) is a common obstetric problem and nutritional disorder that occurs mostly in developing countries. Hence, nutritional studies are required every few years to determine the necessary healthcare interventions for pregnant women. This cross-sectional study evaluated the plasma iron, ferritin, transferrin, total iron-binding capacity (TIBC), and unsaturated iron-binding capacity (UIBC) levels of pregnant women referred to the University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. Materials and Methods: Blood samples were collected from 58 non-pregnant women, 22 pregnant women in the first trimester, 52 in second, and 44 in the third trimester. The plasma ferritin concentration of these samples was measured by chemiluminescence assay, while the plasma transferrin, TIBC, and iron concentrations were measured by enzyme-linked immunosorbent assay. Plasma ferritin levels <15μg/L were considered ID. Results: The overall prevalence of ID in pregnant women was 33.1%. However, the prevalence of ID was 29.3%, 22.7%, 34.6%, and 36.4% among non-pregnant women, women in the first trimester, second and third trimester, respectively. The mean±SEM iron levels were significantly higher among pregnant women compared to non-pregnant women (p=0.004). There was no significant difference in the mean±SEM of plasma ferritin, transferrin and TIBC concentrations between pregnant and non-pregnant women (p>0.05). Nevertheless, the mean±SEM plasma iron, ferritin, and UIBC significantly differed across the gestational ages of pregnant women (p<0.05). Conclusions: This study revealed a high prevalence of ID during pregnancy, which increases with the trimester of affected women. Healthcare interventional measures that can address ID are recommended.

scholarly journals Safety and Efficacy of Medical Cannabis in Fibromyalgia

2019 ◽  
Vol 8 (6) ◽  
pp. 807 ◽  
Author(s):  
Iftach Sagy ◽  
Lihi Bar-Lev Schleider ◽  
Mahmoud Abu-Shakra ◽  
Victor Novack
Keyword(s):  
Odds Ratio ◽  
Prospective Observational Study ◽  
Response Rate ◽  
Gastrointestinal Symptoms ◽  
Intensity Scale ◽  
Medical Cannabis ◽  
Safety And Efficacy ◽  
The Mean

Background: Chronic pain may be treated by medical cannabis. Yet, there is scarce evidence to support the role of medical cannabis in the treatment of fibromyalgia. The aim of the study was to investigate the characteristics, safety, and effectiveness of medical cannabis therapy for fibromyalgia. Methods: A prospective observational study with six months follow-up period based on fibromyalgia patients who were willing to answer questionnaire in a specialized medical cannabis clinic between 2015 and 2017. Results: Among the 367 fibromyalgia patients, the mean age was 52.9 ± 15.1, of whom 301 (82.0%) were women. Twenty eight patients (7.6%) stopped the treatment prior to the six months follow-up. The six months response rate was 70.8%. Pain intensity (scale 0–10) reduced from a median of 9.0 at baseline to 5.0 (p < 0.001), and 194 patients (81.1%) achieved treatment response. In a multivariate analysis, age above 60 years (odds ratio [OR] 0.34, 95% C.I 0.16–0.72), concerns about cannabis treatment (OR 0.36, 95% C.I 0.16–0.80), spasticity (OR 2.26, 95% C.I 1.08–4.72), and previous use of cannabis (OR 2.46 95% C.I 1.06–5.74) were associated with treatment outcome. The most common adverse effects were mild and included dizziness (7.9%), dry mouth (6.7%), and gastrointestinal symptoms (5.4%). Conclusion: Medical cannabis appears to be a safe and effective alternative for the treatment of fibromyalgia symptoms. Standardization of treatment compounds and regimens are required.

scholarly journals Influence of biochemical markers of pregnancy on vitelline sac diameter

2002 ◽  
Vol 55 (5-6) ◽  
pp. 201-206
Author(s):  
Anita Mitreski
Keyword(s):  
Biochemical Markers ◽  
Placental Tissue ◽  
Serum Levels ◽  
Control Group ◽  
Elisa Method ◽  
Third Trimester ◽  
Vaginal Sonography ◽  
Human Chorionic Gonadotropin Hormone ◽  
The Mean

Introduction Recent research has revealed that vitelline sac and extraembryonal membranes play an important role in embryo development as well as those assigned to placental tissue in the second and third trimester. Material and methods This study analyzed levels of human chorionic gonadotropin hormone (hCG), estradiol (E2), progesterone (PRG) and prolactin (PRL) and their influence on vitelline sac diameter in uncomplicated pregnancies and complicated pregnancies with symptoms of imminent miscarriage. Serum levels of analyzed hormones were evaluated by ELISA method and women were examined by vaginal sonography. Correlation between analyzed parameters was evaluated using regression and correlation (Pearsons) tests. Results Levels of estradiol, progesterone and prolactin were lower in patients with symptoms of imminent miscarriage, than in patients with uncomplicated pregnancies, and the mean diameter of vitelline sac was higher than in control group of patients with uncomplicated pregnancies. Discussion The influence of biochemical markers of pregnancy on the role of vitelline sac was discussed. Conclusion Hormonal status in pregnancy determines the progression of pregnancy and the diameter of vitelline sac. The diameter of vitelline sac, in early pregnancy, correlates with embryonic heart rate.

scholarly journals PEDIATRIC ABDOMINAL PAIN;

2014 ◽  
Vol 21 (03) ◽  
pp. 556-558
Author(s):  
Ejaz Hussain Siddiqui ◽  
Saad Siddiqui ◽  
Romana Ayub ◽  
Noreen Shah
Keyword(s):  
Abdominal Pain ◽  
High Frequency ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Determine Role ◽  
Study Results ◽  
Ultrasound Findings ◽  
The Mean

Objectives: To assess common presenting features of children with abdominalpain and to determine role of High frequency & Doppler Ultrasound in evaluation of thesepatients. Material and Methods: This is a cross sectional study conducted from August 2012 toDecember 2012. Data from patients presenting for evaluation of abdominal pain was analyzed forpresenting complaints and ultrasound findings according to objectives of the study. Results: Intotal 262 cases were included in the study. The mean age of patients was 6.3 years with a male tofemale ratio of 1.47:1. Dysuria followed by Diarrhoea and vomiting were most commonassociated complaints, Urological pathologies were most common ultrasound findings uponevaluation of patients. Conclusions: Abdominal pain is a frequent presenting feature inpeadiatric population, Urological pathologies were most common examination findings.Ultrasound is a useful and safe modality in evaluation of abdominal pain in children.

Circulating Platelet Aggregates in Normal Pregnancy and Rpeeclampsia

1979 ◽  
Author(s):  
I. Rákóczi ◽  
F. Tallián ◽  
I. Cseh ◽  
I. Gáti
Keyword(s):  
Pregnant Women ◽  
Platelet Activation ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
The Third ◽  
Platelet Aggregate ◽  
Circulating Platelet Aggregates ◽  
Platelet Aggregates ◽  
The Mean

Circulating platelet aggregates have been observed in various thromboembolic states. It is known that severe preeclamsia is associated with features of intravascular coagulation. To evaluate the role of platelets in this disorder we have determined circulating platelet aggregates in 10 patients with severe preeclampsia, in 30 patients in the third trimester of uncomplicated pregnancies and in 35 healthy nonpregnant volunteers. Platelet aggregate ratio /P.A.R./ was measured by a modification of a method described by Wu and Hoak, The mean P.A.R. of severe preeclamptic patients /0.732 ± 0,063 SEM/ was significantly lower than that of the uncomplicated pregnant women /0,860 ± 0,052 SEM/ and of the nonpregnant volunteers /0.880 ± 0,061 SEM/.The results indicate that severe preeclamptic patients have increased levels of circulating platelet aggregates and platelet activation is a feature of preeclampsia.

Increased Umbilical Artery Pulsatility Index in Third-Trimester Fetuses with Trisomy 21

2015 ◽  
Vol 39 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Philipp Wagner ◽  
Jiri Sonek ◽  
Markus Hoopmann ◽  
Harald Abele ◽  
Sara Brucker ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Linear Regression Analysis ◽  
Abdominal Circumference ◽  
Third Trimester ◽  
The Third ◽  
Obstetrics And Gynaecology ◽  
The Mean ◽  
The University

Objective: To examine the umbilical arterial Doppler flow patterns in late third-trimester fetuses with trisomy 21. Methods: This is a retrospective study on fetuses with trisomy 21 that were evaluated after 33 weeks' gestation at the Department of Obstetrics and Gynaecology of the University of Tuebingen, Germany. The umbilical and the middle cerebral artery (UA and ACM) pulsatility index (PI) measurements and the abdominal circumference were transformed into z-values. Results: Forty-two fetuses met the study criteria. The mean gestational age at the time of the first and the second visit was 35.0 and 36.6 weeks, respectively. The mean UA PI was 1.31 and 1.38, which corresponds to z-values of 2.20 and 2.70. In 24 (57.1%) cases, both PI measurements were above the 95th centile. A linear regression analysis demonstrated that the mean of both UA PI was not dependent on the abdominal circumference or on any other examined maternal and pregnancy characteristics. The mean ACM PI at the first and the second visit was 1.62 and 1.48, respectively, corresponding to mean z-values of -0.59 and -0.75, and in none of the cases was it below the 5th centile. Conclusion: In half of the third-trimester fetuses with trisomy 21, the resistance in the UA is increased - even in the absence of placental insufficiency.

The role of once-weekly online hemodiafiltration with low protein diet for initiation of renal replacement therapy: A case series

2021 ◽  
pp. 039139882110498
Author(s):  
Kullaya Takkavatakarn ◽  
Piyawan Kittiskulnam ◽  
Khajohn Tiranathanagul ◽  
Pisut Katavetin ◽  
Niramon Wongyai ◽  
...  
Keyword(s):  
Urine Volume ◽  
Case Series ◽  
Protein Diet ◽  
Low Protein Diet ◽  
Low Protein ◽  
Incremental Hemodialysis ◽  
Clinical Benefits ◽  
The Mean ◽  
The University

Incremental hemodialysis (HD) has become an exciting approach according to the recognition of the importance of preserving residual kidney function (RKF). However, not all incident HD patients are suitable for this approach, particularly once-weekly HD. This is the first study which reported the effectiveness of once-weekly online-hemodiafiltration (OL-HDF) plus low protein diet (LPD) in incident HD patients. All stage 5 CKD patients who had chosen HD as their treatment modality at the HD center of King Chulalongkorn Memorial Hospital, Bangkok, Thailand, with RKF ⩾ 3 mL/min calculated by renal clearance of urea and urine output ⩾ 800 mL/day, started the treatment with once-weekly OL-HDF. Dietitians advised patients to consume LPD (0.6–0.8 g/kg/day) on non-dialysis days and a regular protein diet on the dialysis day (1.2 g/kg/day). Eleven incident HD patients were enrolled in the study. The mean RKF and urine volume at baseline were 4.56 ± 2.21 mL/min and 2,019.54 ± 743.73 mL/day, respectively. After 6 and 12 months of follow-up, the mean RKF of the patients who remained in the once-weekly OL-HDF protocol were 3.82 ± 1.68 mL/min and 3.28 ± 0.95 mL/min, respectively. The median duration of once-weekly OL-HDF before transitioning to twice- or thrice-weekly OL-HDF was 7 months (3–24 months). The most common indication for stepping prescription was too low RKF. We reported that dialysis initiation in the university-based center with once-weekly OL-HDF in carefully selected incident HD patients combined with LPD under serial monitoring is practical. Further studies on the clinical benefits of once-weekly OL-HDF are still required.

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