Frequency of Mortality in Patients with Post-Partum Eclampsia-A Study at Liaquat
University Hospital, Hyderabad, Sindh, India

Postpartum preeclampsia is the occurrence of hypertension and proteinuria after delivery. Preeclampsia plus seizures after delivery is defined as postpartum eclampsia. Objective: To determine the frequency of mortality in patients with post-partum eclampsia; To determine the obstetrical factors leading to maternal mortality in patient with postpartum eclampsia. Methodology: The descriptive case series study was carried out in the department of Department of obstetrics and gynecology LUMHS Hospital Hyderabad from 1st January 2018 to 30 June 2018. All patients who fulfilled the inclusion criteria were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. All patients of postpartum eclampsia with increase blood pressure and proteinuria admitted through out-patient department or emergency within 48 hours of delivery will be included in the study. Patient will be followed for 10 days. All the collected data were entered into the proforma attached at the end. Results: Mean ± SD of age was 27.88±7.77 with C.I (27.02…….28.74) years. Mean ± SD of systolic B.P and urine protein was 161.46±22.09 mmhg and 1432.59±967.33 mg respectively. Out of 369 was occurred mortality in 190 (60%) women. Conclusion: It is to be concluded that mortality is most in eclampctic women followed by patients with Pre-eclampsia. However a study design comprising multiple centers, and a higher number of patients over a longer period of time will be more representative.

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Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions

Internal and Emergency Medicine ◽

10.1007/s11739-020-02586-8 ◽

2020 ◽

Author(s):

Giada Crescioli ◽

Valentina Brilli ◽

Cecilia Lanzi ◽

Andrea Burgalassi ◽

Alessandra Ieri ◽

...

Keyword(s):

Adverse Drug Reactions ◽

Case Series ◽

University Hospital ◽

Drug Reactions ◽

Case Evaluation ◽

Hospitalised Patients ◽

Number Of Patients ◽

Case Series Study ◽

Caucasian Patients ◽

Series Study

AbstractDue to the need of early and emergency effective treatments for COVID-19, less attention may have been paid to their safety during the global emergency. In addition, characteristics of drug–drug interaction (DDI)-related adverse drug reactions (ADRs) in COVID-19 patients have not yet been studied in depth. The aim of the present case-series study is to describe clinical and pharmacological characteristics of SARS-CoV-2 hospitalised patients, focusing on ADRs, particularly those related to DDIs. We evaluated all reports of COVID-19 medication-related ADRs collected within the COVID-19 Units of Careggi University Hospital, Florence (Italy), between January 1st and 31st May 2020. Information regarding COVID-19 medications, patients’ demographic and clinical characteristics, concomitant drugs, ADRs description and outcome, were collected. Each case was evaluated for the causality assessment and to identify the presence of DDIs. During the study period, 23 Caucasian patients (56.5% males, mean age 76.1 years) experienced one or more ADRs. The majority of them were exposed to polypharmacy and 17.4% presented comorbidities. ADRs were referred to cardiovascular, psychiatric and gastrointestinal disorders. The most frequently reported preferred term was QT prolongation (mean QT interval 496.1 ms). ADRs improved or resolved completely in 60.8% of cases. For all patients, a case-by-case evaluation revealed the presence of one or more DDIs, especially those related to pharmacokinetic interactions. Despite the small number of patients, our evidence underline the clinical burden of DDIs in SARS-CoV-2 hospitalised patients and the risk of unexpected and uncommon psychiatric ADRs.

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Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study

Journal of Clinical Medicine ◽

10.3390/jcm10040880 ◽

2021 ◽

Vol 10 (4) ◽

pp. 880

Author(s):

Caterina Caminiti ◽

Giuseppe Maglietta ◽

Tiziana Meschi ◽

Andrea Ticinesi ◽

Mario Silva ◽

...

Keyword(s):

Hospital Admissions ◽

Case Series ◽

Communicable Diseases ◽

University Hospital ◽

Negative Consequences ◽

Non Communicable Diseases ◽

Case Series Study ◽

And Gender ◽

Long Term Impact ◽

Series Study

Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.

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Endoscopic Harmonic Midline Partial Glossectomy in Obstructive Sleep Apnea

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i130800 ◽

2021 ◽

pp. 98-104

Author(s):

A. I. Elkawa ◽

Y. I. Aglan ◽

M. A. Hagras

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Case Series ◽

University Hospital ◽

Obstructive Sleep ◽

Case Series Study ◽

Prospective Case Series ◽

Series Study ◽

Partial Glossectomy ◽

Posterior Midline

Aim: Our study was done to evaluate the role of Endoscopic posterior midline partial glossectomy as a surgical modality for the hypopharyngeal collapse in obstructive sleep apnea patients. Study design: Prospective case series study. Place and Duration of Study: Tanta university hospital, otolaryngology department, from October 2017 till March 2019. Methodology: This was a prospective case series study, conducted on 10 patients from 2017 -2019 with tongue base collapse and normal craniofacial angles, the patients were evaluated preoperative and 6 months postoperative subjectively by Epworth sleepiness scale (ESS) and objectively by polysomnography and lateral cephalometry. Results: Our study included 10 patients with age (mean ± SD48.70±4.08), BMI( mean ±SD24.45±1.56), 5 patients showed a significant reduction in AHI with a success rate of 50% with a significant change in ESS and the non-significant changes in cephalometric parameters. Conclusion: Transoral endoscopic posterior midline partial glossectomy can improve the surgical outcomes of obstructive sleep apnea patients.

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Outcome of Plaster Splintage in the Management of Closed Extraarticular Fracture of Distal Radius

10.53350/pjmhs211592382 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2382-2383

Author(s):

Akbar Shah ◽

Shaheryar Aziz ◽

Muhammad Usman Aslam ◽

Syed Wasif Ali Shah

Keyword(s):

Informed Consent ◽

Visual Analogue Scale ◽

Distal Radius ◽

Orthopaedic Surgery ◽

Analogue Scale ◽

Case Series ◽

Inclusion Criteria ◽

Case Series Study ◽

Series Study ◽

Fracture Of Distal Radius

Aim: To determine the outcome of extra-articular distal radius fracture treated with plaster splintage. Methodology: This descriptive case series study was done in the Department of Orthopaedic Surgery, at Jinnah Hospital, Lahore from 01-08-210 to 31-01-2011 which includes 50 patients who fulfill the inclusion criteria of age 40-80 years of either sex. After the approval of Hospital Ethical Committee, informed consent taken from every patient. Results: The average age was 63.70±11.64 years. Seventeen (34%) patients were male and 33 (66%) patients were female. On visual analogue scale of pain, 23 (46%) patients had no pain and 27 (54%) patients had mild pain. Forty six percent patients shows excellent results and 54% patient shows good results. Conclusion: Closed reduction and plaster splintage was used to assess the functional outcome in distal radius extraarticular fractures. Overall results were excellent in 64% cases and good in 54% cases in the distal radial extraarticular fractures treated with plaster splintage. Keywords: Distal radius extraarticular fractures, Plaster splintage, Visual deformity, Pain and grip strength.

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Four petal evisceration versus standard technique: A retrospective study

European Journal of Ophthalmology ◽

10.1177/1120672120950160 ◽

2020 ◽

pp. 112067212095016

Author(s):

Stefano Ranno ◽

Massimiliano Serafino ◽

Paolo Nucci

Keyword(s):

Surgical Techniques ◽

Case Series ◽

Standard Technique ◽

Complication Rates ◽

Inclusion Criteria ◽

Implant Exposure ◽

Case Series Study ◽

Series Study ◽

Low Rate

Purpose: To compare the four-petal evisceration technique and the standard evisceration technique. Methods: In this retrospective, comparative case series study, sixteen charts of patients fulfilled the inclusion criteria and were were reviewed. Orbital implant exposition and complication rates between the two surgical techniques were evaluated. Results: A total of 16 eye of 16 patients fulfilled the inclusion criteria and were included in the analysis (eight in the four petal group and eight in the standard evisceration group). During postoperative follow-up there were no cases of implant exposure or migration in the four-petal group and two cases (25%) of implant exposure in the standard evisceration group. Exposed orbital implants dimension were both 16 mm and patients eviscerated for phtisis bulbi All surgeries were uneventful, and there were no serious complications during the study. Conclusion: Four petal evisceration technique seems particularly useful in patients with phtisis bulbi because it allowed the placement of an implant significantly larger than the standard technique with low rate of esposition.

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How to determine the amount of levator resection in congenital ptosis repair

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2021.002 ◽

2021 ◽

Vol 25 (1) ◽

pp. 415-422

Author(s):

Muhamed Hamadamin ◽

Jalal Fattah

Keyword(s):

Case Series ◽

Private Hospitals ◽

Congenital Ptosis ◽

Fascial Sling ◽

Number Of Patients ◽

Case Series Study ◽

Levator Resection ◽

Prospective Case Series ◽

Series Study ◽

Levator Aponeurosis

Background and objective: Levator aponeurosis resection is an effective technique to correct blepharoptosis when the levator function is fair to good. This study aimed to determine the amount of levator resection in congenital blepharoptosis repair. Methods: This is a prospective case series study conducted in Rizgary teaching hospital and private hospitals in Erbil city, Kurdistan Region, Iraq, from June 2011 to August 2019. The data of 53 patients (64 eyelids) affected by congenital blepharoptosis with poor to good levator function that underwent unilateral orbilateral levator resection blepharoptosis repair through the standard approach were included. The final outcome measures included postoperative eyelid height, contour, and symmetry. Results: This study includes a total of 53 patients with congenital blepharoptosis (64 eyelids); 20 males and 33 females. The age of the patients ranged from 3 years to 54 years, with a mean age ± SD of 14.11 ± 10.66 years. The ptosis was right sided in 22 patients (41.5%), left sided in 20 patients (37.7%), and bilateral in 11 patients (20.8%). The study showed good patient satisfaction in 66.03% of the cases, suboptimal satisfaction in 22.64% of the cases, and poor satisfaction in 11.32% of the cases. Conclusion: The levator resection for congenital ptosis is effective even with poor levator function and replaced in our practice the traditional fascial sling. We recommend that further studies be done on a larger number of patients to investigate the effectiveness of levator resection in patients with severe ptosis and very poor levator function. Keywords: Congenital blepharoptosis; Levator aponeurosis; Levator resection; Levator resection.

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Combined endophthalmitis and orbital cellulitis in patients with corona virus disease (COVID-19)

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00258-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mohamed Farouk Sayed Othman Abdelkader ◽

Ahmed Mohamed Kamal Elshafei ◽

Mahmoud Mamdouh Nassar ◽

Mostafa A. Abu Elela ◽

Raafat Mohyeldeen Abdelrahman Abdallah

Keyword(s):

Visual Loss ◽

Clinical Laboratory ◽

Virus Disease ◽

Systemic Disease ◽

Case Series ◽

Orbital Cellulitis ◽

University Hospital ◽

Case Series Study ◽

Work Up ◽

Series Study

Abstract Purpose To document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis. Patients and methods This interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease. Results The patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss. Conclusion Combined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis. Trial registration Clinical registration: clinicaltrials.gov identifier: NCT04456556.

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Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia

European Journal of Medical Research ◽

10.1186/s40001-021-00618-3 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Saad Alhumaid ◽

Abbas Al Mutair ◽

Header A. Alghazal ◽

Ali J. Alhaddad ◽

Hassan Al-Helal ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Medical Records ◽

Prospective Observational Study ◽

Rescue Therapy ◽

Case Series ◽

Multiple Organ ◽

Membrane Oxygenation ◽

Number Of Patients ◽

Case Series Study ◽

Series Study

Abstract Background Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient’s medical records prospectively. Results ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations.

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Volar Scaphoid Plating for Nonunion: A Multicenter Case Series Study

Journal of Wrist Surgery ◽

10.1055/s-0040-1702199 ◽

2020 ◽

Vol 09 (03) ◽

pp. 225-229

Author(s):

Kevin Eng ◽

Stephen Gill ◽

Simon Hoy ◽

Vivek Shridar ◽

Natasha Van Zyl ◽

...

Keyword(s):

Case Series ◽

Visual Analogue Score ◽

Rotational Stability ◽

Volar Aspect ◽

Number Of Patients ◽

Case Series Study ◽

Structural Graft ◽

The Mean ◽

Series Study

Abstract Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favorable to such a device with increased rotational stability. It may act as a buttress plate for correction of humpback deformity for example. It has been used in nonunions and with vascularized grafts. Questions Our study aims to assess the results of our patients with scaphoid nonunion treated with scaphoid volar plating over a larger number of patients. We aim to identify techniques to increase the success of plating. Methods Patients from our cohort were retrospectively reviewed. Operations were performed by three hand fellowship trained surgeons and in two centers. Inclusion involved a scaphoid plate procedure for a nonunion of the scaphoid with a minimum of 6 months of follow-up. Exclusions were those who had less than 6 months of follow-up. Data included demographics, patient-rated wrist evaluation (PRWE), a quick disabilities of the arm, shoulder, and hand (qDASH), visual analogue score, and range and grip. Radiology was reviewed. Results Thirty-two eligible patients were assessed. The mean age was 25 years (range 13–46), 2 were female and 15 were smokers. Mean follow-up postsurgery was 18 months. Twenty-nine of 32 patients united (90.6%) on computed tomography scan. Clinical assessment was performed in the 25 patients. The mean qDASH score was 12.5 (range 0–42) and mean PRWE was 11 (range 0–54). The mean arc of motion was 115 degrees. The mean grip strength was 39 kg compared with 41 kg on the nonoperated side. Conclusion We postulate that the plate acts like an internal bridging device, acting over a small distance, and inherent stability of the construct with structural graft and accurate reduction prior to plating is advantageous. Potential problems include plate impingement on the volar lip of the radius, particularly when trying to plate more proximal fractures. Ideally, it is utilized for mid to distal waist fractures.

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POSTPARTUM HAEMORRHAGE;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.07.1031 ◽

2017 ◽

Vol 24 (07) ◽

pp. 1016-1019

Author(s):

Raheela Rani Junejo ◽

Rabail Rani Junejo ◽

Shahla Baloch ◽

Raheel Sikandar ◽

Mehrunnisa Khaskheli

Keyword(s):

Blood Loss ◽

Postpartum Haemorrhage ◽

Case Series ◽

University Hospital ◽

Age Group ◽

Chi Square ◽

Case Series Study ◽

Increased Risk ◽

Maternal Risks ◽

Series Study

Objectives: To determine the frequency of postpartum haemorrhage in obeseprimigravid women. Study Design: Case series study. Period: Six months was conductedfrom 1st October 2014 to 30 March 2015. Setting: Department of gynecology and obstetricsat Liaquat University Hospital Jamshoro. Patients and Methods: All the primigravid obese(≥30kg/m2) ladies 18 to 35 years of age with 37-42 weeks of gestational age were evaluate forthe occurrence of PPH by estimating blood loss of greater than 500 ml of blood following vaginaldelivery or 1000 ml of blood loss following caesarean section. All data was entered and analyzedthrough statistical package SPSS version 17, the chi-square statistical test was applied and thep-value ≤0.05 was considered as statistical significant. Results: Total 203 primigravid obeseladies were studies, the age group was analyzed which shows that in age group between 18-25years were 105(52.00%) women, in age group of 26-30 years were 62(30.69%) women and agegroup of 30 years and above were 35 (17.31%) women. The modes of delivery were evaluatedwhich shows that 66.5% women underwent C-section and 33.4% women had normal vaginaldelivery. The PPH was observed in 34.97% patients (70.4% with C-Section and 29.6 with NVD).Conclusion: Obesity carries a significant increased risk of complications during pregnancyand maternal risks during labour are PPH and more frequent C-section and nulliparous obesewomen have twofold high risk for PPH

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