The quality of intrapartum cardiotocography in preterm labour

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zohal Faiz ◽  
Eline M. Van ’t Hof ◽  
Gerard J. Colenbrander ◽  
Ralf Lippes ◽  
Petra C.A.M. Bakker

Abstract Objectives The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus. Methods From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24–26 weeks and 26–28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated. Results One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01). Conclusions The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution.

2020 ◽  
Vol 103 (6) ◽  
pp. 548-552

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR


Author(s):  
Abinaya Raja ◽  
Pallavee P. ◽  
Rupal Samal

Background: This study aimed to investigate whether perineal massage during second stage of labour could decrease perineal trauma in the form of episiotomy and perineal tears.Methods: One hundred and fifty term antenatal women in labour were randomly assigned to two groups, one of which received perineal massage and the other received routine care during the second stage. Frequency of episiotomies, perineal tears, intact perineums, degrees of perineal tears, duration of second stage of labour and perineal pain after 24 hours was compared.Results: Perineal massage was efficient in reducing incidence of episiotomy, duration of second stage of labour and perineal pain assessed 24 hours after delivery. The frequency of perineal tears and intact perineums did not differ significantly. Perineal massage was protective against severe form of third degree perineal tears.Conclusions: Authors suggest that perineal massage can be routinely practiced by health professionals to improve quality of life in women post vaginal delivery.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Tatjana Vukadinov ◽  
Larisa Blažić ◽  
Ivana Kantardžić ◽  
Tijana Lainović

Aim. The aim of this study was to evaluate the radiographic technical quality of endodontic treatment performed by undergraduate students at the School of Dentistry, Faculty of Medicine, University of Novi Sad, Serbia.Materials and Methods. Electronic records of 220 patients treated by final-year undergraduate students during the school year 2011/2012 were examined, and the final sample consisted of 212 patients, 322 teeth, and 565 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length and density and absence of iatrogenic errors (ledge, fractured instrument, untreated canal, and apical transportation). Chi-square test was used to determine statistical significance between different parameters.Results. Adequate root canal fillings were found in 74.22% of the teeth. The percentage of root fillings with adequate length and density was 89.73% and 92.6%, respectively. Fractured instruments and ledges were present in 16 root canals (2.8%), while the presence of missed canal and apical transportation was observed in 2 cases, each (0.3%).Conclusions. Overall, the technical quality of root canal fillings performed by undergraduate students was satisfactory.


2000 ◽  
Vol 55 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Marco Aurélio Monteiro Peluso ◽  
Hermano Tavares ◽  
Gilberto D'Elia

INTRODUCTION: Debates about the quality of medical education have become more evident in the recent past, and as a result several different assessment methods have been refined for that purpose. The use of questionnaires filled out by medical students to assess the quality of lectures is one of the most common methods employed in our milieu. However, the reliability of this investigation method has not yet been systematically tested. The authors present the reliability of a specific form applied to the fourth grade medical students during the clinical psychiatry course. METHOD: Eighty-one fourth grade medical students were instructed to complete a form immediately after each clinical psychiatry lecture. Thirty-four students (42%) failed to turn in the forms after the final lecture. These students were given an identical form to assess the lectures in a retrospective fashion. The grades given by both groups of students for each performed lecture and the number of students who have graded an unperformed lecture were compared. Statistical significance for both groups was determined by means of the chi-square test (p< 0.05). RESULTS: Eighteen out of the 34 students who filled out the forms retrospectively (53%) rated the unperformed lecture, whereas only 5 out of the 47 students who filled out the forms during the course (11%) did so. This is statistically significant (p< 0.05). There was no statistical difference for the grades given to the lectures that were actually performed. DISCUSSION: The authors concluded the low reliability rate of the retrospective evaluation warrant a continuous assessment method during the course.


2020 ◽  
pp. 158-167
Author(s):  
Roland Okoro ◽  
Aminu Biamb

Context: Pharmacists providing pharmaceutical care are often confronted with a variety of professional issues, ethical dilemmas and moral problems that require professionalism to appropriately address. Aims: To investigate undergraduate fifth- year (final-year) Bachelor of Pharmacy (B. Pharm.) students’ views on professionalism, ethical dilemmas, and their application of bioethical principles, and to compare responses of various groups (pharmacy schools, age, gender, and religion). Methods: This was a cross-sectional survey of the final-year B.Pharm. students in two pharmacy schools in northern Nigeria. The descriptive and inferential statistics (Chi-square or Fisher’s exact tests and Independent-sample t-test) were utilised to analyse the study data. Statistical significance was considered at p<0.05. Results: Ninety-five students, corresponding to 49.5% response rate, participated in the study. More than 79% of the students strongly agreed that their actions as future pharmacists could affect how the profession is viewed by patients and other healthcare providers. Patients’ right to autonomy and non-maleficence were the most utilised bioethical principles by the participants. Conclusions: The study shows that the participants had good overall perceived professionalism and fair bioethical reasoning. Different bioethical principles were used by various groups considered to support how they would deal with each ethical dilemma. New strategies in teaching pharmacy practice courses by pharmacy educators in these schools are necessary to improve students’ bioethical reasoning which will maximise the quality of their future practice.


2016 ◽  
Vol 15 ◽  
pp. 487
Author(s):  
Aline Aparecida Oliveira ◽  
Júlia Trevisan Martins

Aim:  to  analyze  the  quality  of  life  and  factors  associated  with  it among  disabled  retired  public  workers  of  a  public  university.  Method:  this  is  an epidemiological study, featuring an observation-analysis, and a transversal, quantitative approach. The sample is composed of 59 disabled public employees who retired between 2000  and  2014.  The  data  was  collected  through  a  questionnaire  of  socio-demographic characteristics and the SF-36v2 form in order to evaluate the retirees’ quality of life. F or the   quantitative   variables,   the   evaluations   of   absolute   and   relative   frequencies, measurements of central trends, and variability were observed. The Mann-Whitney test, Chi-square test, and Wilcoxon W test were used due to the asymmetrical distribution of the  variables  found.  The  level  of  statistical  significance  was determined  to  be  p<0.05.  Expected Results: this study will provide support to personnel management in order to implement policies for the promotion of health, illnesses prevention, and the reduction of injuries; as a result, a decrease in the rate of early retirement, higher productivity in the labor  market,  an  improvement  in  self-esteem,  and  the  decline  in  retirement  fund expenses are expected.


2021 ◽  
Vol 14 (4) ◽  
pp. 578-586
Author(s):  
Mirela Morcov ◽  
◽  
◽  
Iuliana-Raluca Gheorghe ◽  
Maria Veronica Morcov ◽  
...  

The quality of working relationships among medical team members is influenced by communication, which has a significant impact on patient safety. Our study took place at the Dr. Nicolae Robanescu National Neurorehabilitation Center for Children, Bucharest, between October and December 2019 and included 44 participants that were grouped into three categories: physicians, physical therapists, and nurses (32 women and 12 men), aged between 23 and 53, all of whom were employed in the same unit. A total of 5 questions were used to select data on communication difficulties. The chi-square test used for statistical analysis revealed no significant differences between the professional categories participating in the research (p>0.05). We suggest increasing the group size in a future study to increase the statistical significance.


2011 ◽  
Vol 02 (01) ◽  
pp. 033-038 ◽  
Author(s):  
Pushparaja H Shetty ◽  
K Punith ◽  
Ravishankar K Naik ◽  
AO Saroja

ABSTRACT Background: People with epilepsy have impairment in their quality of life (QOL) due to effect of epilepsy on various aspects of their life and the medication effects. Systematic studies on QOL in epilepsy from developing countries are sparse. Objectives: To assess the QOL in people with epilepsy and to evaluate various factors affecting the QOL in them. Materials and Methods: People with generalized and partial epilepsy on medication aged more than 18 years were included in the study. The QOL was assessed with QOLIE-89 instrument. Statistical significance was evaluated by the use of Chi-square test and one-way analysis of variance (ANOVA). Results: Sixty people with epilepsy were studied among whom the older patients had lower overall QOL scores compared to younger patients. Female patients had lower scores compared to males. Married people had lower quality of health score. Patients with simple partial seizures had lowest overall QOL mean score. There was reduction in the overall QOLIE scores with increasing duration of the epilepsy. Patients who had their last seizure within 10 months prior to evaluation had lower mean overall scores. Conclusion: QOL was impaired in people with epilepsy with increased impairment in women, older patients, simple partial seizures, and those with recent seizure.


2021 ◽  
Vol 162 (47) ◽  
pp. 1891-1896

Összefoglaló. Bevezetés: A szédülés időskorban gyakori panasz, amely jelentősen befolyásolja az életminőséget. Háttere sok esetben multifaktoriális, egyes esetekben azonban jól meghatározott ok kimutatható. Célkitűzés: Kutatásunk célja az időskori szédülő populáció panaszainak, valamint életminőségének felmérése volt. Anyag és módszer: Kutatásunkba 36 (13 férfi, 23 nőbeteg, átlagéletkor ± SD, 72,78 év ± 4,6), Otoneurológiai Ambulanciánkon szédülés miatt vizsgált, 65 év feletti beteget vontunk be. Ők az általunk összeállított, panaszokkal és rizikófaktorokkal kapcsolatos kérdőív mellett a Dizziness Handicap Inventory-t is kitöltötték. Az utóbbi alapján meghatározható volt az életminőség-romlás, illetve annak mértéke. A statisztikai elemzést az IBM SPSS V24 szoftver segítségével végeztük, Mann–Whitney U-teszt és khi-négyzet-próba alapján. Minden esetben p<0,05 értéket tekintettünk szignifikáns különbségnek. Eredmények: A leggyakoribb diagnózisként a Ménière-betegséget, valamint a centrális vestibularis eltéréseket detektáltuk. A betegek visszajelzése alapján a szédülés volt a legdominánsabb tünet, amely a leggyakrabban órákig, illetve napokig tartott, és fele arányban volt forgó jellegű. Emellett a fülzúgás, a halláscsökkenés, valamint a vegetatív tünetek is dominánsak voltak. A leggyakoribb társbetegségek közül gyakoriságuk miatt kiemelendők a mozgásszervi, illetve szemészeti eltérések, a hypertonia, valamint a pszichiátriai betegségek. A betegek 77,8%-a jelzett valamilyen mértékű életminőség-romlást, és kiemelendő, hogy 30%-uk a súlyos kategóriába esett. A Dizziness Handicap Inventory kérdőívek alapján a fizikális, funkcionális, valamint emocionális részpontszámok hasonló értéket mutattak. Következtetés: Az időskori szédülés lényeges a beteg romló életminősége szempontjából. A társuló komorbiditások mellett a háttérben álló vestibularis eltérések kizárása, illetve diagnosztizálása fontos feladat. Ennek függvényében tervezhető a terápia, amely kapcsán a kísérő tünetekre is fontos hangsúlyt fektetni. Így az érintett betegek életminősége javítható. Orv Hetil. 2021; 162(47): 1891–1896. Summary. Introduction: Vertigo is a common complaint in elderly, which has significant influence on the patients’ quality of life. In many cases its background is complex, although, in some cases specific diagnosis can be made. Objective: Our study aimed to analyze the symptoms and quality of life of old-age vertiginous population. Material and method: 36 patients (13 males, 23 females, mean age ± SD, 72.78 years ± 4.6) over 65 years, examined due to vertigo at our Neurotologic Department, were enrolled. A questionnaire including questions regarding the symptoms, risk factors, along with the Dizziness Handicap Inventory was used. Statistical analysis was carried out using IBM SPSS V24 software. Mann–Whitney U and chi square tests were used. Statistical significance was defined as p<0.05. Results: Ménière’s disease and central vestibular disorders were found as the most frequent diagnoses. Vertigo was the most tormenting symptom, which usually lasted for hours or days, and was defined as rotatory in 50%. Tinnitus, hearing loss and vegetative symptoms were also dominant. The most frequent comorbidities were musculoskeletal disorders, hypertension, ophthalmological diseases and psychiatric disorders. 77.8% of the patients have reported worsened quality of life, of which 30% was detected as severe. Based on the Dizziness Handicap Inventory, physical, functional and emotional scores showed similar results. Conclusion: Vertigo in elderly is important due to its influence on patients’ quality of life. Besides comorbidities, the diagnosis of vestibular pathologies is of great importance. Therefore, therapy planning is possible, and patients’ quality of life can be improved. Orv Hetil. 2021; 162(47): 1891–1896.


2021 ◽  
Author(s):  
Elkhalloufi Fahd ◽  
Saber boutayeb ◽  
Youssef Lamrani Alaoui ◽  
Mounia Eljaouhari ◽  
Hassan Errihani ◽  
...  

Abstract Background: Many researchers have associated between religiosity with a lower level in depression and anxiety among patients with chronic diseases and especially in cancer patients.The aim of this study is to examine the association between spirituality and depression among Moroccan cancer patients. Another aim resides in to examining the association between spirituality and anxiety among Moroccan cancer patients.Methods: 1054 cases were included. Cancer profile, socio demographic and spiritual characteristics were considered. The data were firstly analyzed using the validated HADS scale arabic version. The statistical significance was tested using Chi-square test. The Odds ratios were also computed for the likelihood of being in depression and/or anxiety.Results: The results obtained revealed that the performance of religious practices such as reading Quran, doing Roquia , and the consideration of cancer as a divine test are factors that significantly decrease the risk of having depression and/or anxiety. However women wearing the “hijab” have three times higher chances of having anxiety compared to other women that do not wear the “hijab”. Patients considering cancer as a divine punishment have significantly higher odds of having anxiety and/or depression. Regarding charity, pilgrimage, visit of “marabouts”, use of medicinal plants and fasting are found to be insignificant predictors of depression and anxiety.Conclusions: The current evidence indicates that religiosity is important to patients facing cancer. Religiosity is not just protective in nature, but it can also be therapeutic. Praying, reading or listening to the Quran, as well as considering cancer as a divine test have been shown to reduce the level of depression and anxiety . In conclusion, the spiritual aspect plays an important role in the quality of life of cancer patients.


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