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

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.

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How Did Prenatal Education Impact Women’s Perception of Pregnancy and Postnatal Life in a Romanian Population

Medicina ◽

10.3390/medicina57060581 ◽

2021 ◽

Vol 57 (6) ◽

pp. 581

Author(s):

Anca Maria Balasoiu ◽

Octavian Gabriel Olaru ◽

Romina Marina Sima ◽

Liana Ples

Keyword(s):

Prenatal Care ◽

Newborn Care ◽

Control Group ◽

Postnatal Life ◽

Study Group ◽

Prenatal Education ◽

Questionnaire Online ◽

A Prospective Study ◽

The Impact ◽

Official Information

Background and Objectives: Prenatal education represents an important part of maternal prenatal care in Western countries. In Romania, prenatal education is of recent interest but there is no official information about prenatal courses and their impact on prenatal care and patients in Romania. Material and methods: A prospective study based on the STROBE statement was designed in order to assess the prenatal education delivered in our unit. The study group included women who gave birth at Bucur Maternity, “Saint. John” Hospital, Bucharest, Romania and attended the prenatal courses, compared with a control group (women who gave birth in our unit but did not attend the prenatal lecture). Patients’ perception about the impact of prenatal education was collected by applying a questionnaire. Results: The analysis included 89 women who fulfilled the questionnaire online. In our study, 62 women (69.7%) attended the prenatal education classes and represented the study group while 27 women (30.3%) constituted the control group. Women who attended the prenatal lecture recognized the utility of the topic regarding newborn care (90.3%), while women from the control group did not consider it useful (n = 55.6%), χ2 = 18.412, p < 0.001. Patients from the study group admitted the importance of the topics (93.5%) from the lectures about breast feeding, while the percentage of these women from the control group is significantly lower (55.6%) χ2 = 27.867, p < 0.001. Conclusions: The benefits of prenatal education were recognized by women who attended the prenatal lecture, while women who did not participate underestimated the utility of the topics. Further actions are required to inform mothers about the necessity of antenatal education.

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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

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Intriguing New Faces Of Covid-19: Persisting Clinical Symptoms And Cardiac Effects in Children

Cardiology in the Young ◽

10.1017/s1047951121003693 ◽

2021 ◽

pp. 1-27

Author(s):

Nurdan Erol ◽

Abdullah Alpinar ◽

Cigdem Erol ◽

Erdal Sari ◽

Kubra Alkan

Keyword(s):

Blood Pressure ◽

Cardiovascular Health ◽

Clinical Symptoms ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Control Group ◽

Study Group ◽

Ventricular Ejection Fraction ◽

Significant Difference ◽

The Impact

Abstract Objective: This study was conducted to evaluate the persisting Covid-19-related symptoms of the cases included in our study and to assess their cardiac findings in order to determine the impact of Covid-19 on children’s cardiovascular health. Methods: In this study, 121 children between the ages of 0-18 with Covid-19 were evaluated based on their history, blood pressure values, and electrocardiography and echocardiography results. These findings were compared with the findings of the control group which consisted of 95 healthy cases who were in the same age range as the study group and did not have Covid-19. The results were evaluated using the statistics program, SPSS 21. Results: There was no significant difference between the study group and the control group in terms of age, weight, and body mass index. The clinical symptoms (chest and back pain, dizziness, headache, palpitation, fatigue, shortness of breath, loss of balance, coughing) of 37.2% of the cases persisted at least 1 month after Covid-19 recovery. Statistically significant differences were found in systolic blood pressure, left ventricular ejection fraction, relative wall thickness, and tricuspid annular plane systolic excursion. Conclusion: The continuation of some cases’ clinical symptoms post-recovery indicates that long Covid infection can be observed in children. The fact that statistically significant differences were observed between the echocardiographic parameters of the study and control groups suggests that Covid-19 may have effects on the cardiovascular system. To shed light on the long Covid cases among children and the infection’s cardiac impacts, it would be beneficial to conduct more comprehensive studies on this matter.

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Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.6.1982 ◽

2020 ◽

Vol 36 (6) ◽

Author(s):

Xue Zhou ◽

Ben Li ◽

Chao Wang ◽

Zhihong Li

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Subclinical Hypothyroidism ◽

First Trimester ◽

Control Group ◽

Study Group ◽

Significant Difference ◽

Hs Crp ◽

The Impact

Objective: To investigate the effect of vitamin D deficiency on the levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), interleukin-1 (IL-1) and high-sensitivity C-reactive protein (hs-CRP) in pregnant women with early pregnancy complicated by subclinical hypothyroidism. Methods: A total of 172 pregnant women with subclinical hypothyroidism in the first trimester diagnosed and treated in a given hospital from August 2014 to May 2018 were selected, and their levels of vitamin D were determined. Depending on the abnormality of their vitamin D levels, the study participants were divided into two groups: the study group (vitamin D≤20 ng/L) and the control group (vitamin D>20 ng/L). The levels of TSH, TPO-Ab, IL-1 and hsCRP in the two groups were measured. Results: The levels of TSH, hsCRP and TPO-Ab in the study group were significantly higher than those in the control group (P < 0.05). The comparison between the two groups in terms of IL-1 showed no statistically significant difference. Conclusion: Vitamin D deficiency in the first trimester is associated with in an increased level of TSH in the first trimester, thereby aggravating subclinical hypothyroidism. The mechanism may be associated with the impact of vitamin D deficiency on hs-CRP and other body inflammation indicators, as well as on thyroid autoantibodies and other immune indicators, but has no effect on IL-1 levels. doi: https://doi.org/10.12669/pjms.36.6.1982 How to cite this:Zhou X, Li B, Wang C, Li Z. Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.1982 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Evaluation of Periodontal Status in Alcoholic Liver Cirrhosis Patients: A Comparative Study

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1296 ◽

2013 ◽

Vol 14 (2) ◽

pp. 179-182 ◽

Cited By ~ 13

Author(s):

K Vijay Raghava ◽

H Shivananda ◽

Darshan Mundinamane ◽

Vinita Boloor ◽

Biju Thomas

Keyword(s):

Liver Cirrhosis ◽

Comparative Study ◽

Bacterial Infections ◽

Control Group ◽

Alcoholic Liver Cirrhosis ◽

Gram Negative ◽

Periodontal Status ◽

Periodontal Index ◽

Significant Difference ◽

Periodontal Destruction

ABSTRACT Aim Bacterial infections are common complicating findings in course of liver cirrhosis, most of them being Gram-negative. Similarly periodontal pathogens are also mostly Gram-negative bacteria hence the objective was to evaluate the periodontal status in alcoholic liver cirrhosis patients and to compare the periodontal status of alcoholic liver cirrhosis patients in: a. Smokers with periodontitis and b. Nonsmokers with periodontitis. Materials and methods A total of 150 patients made up the sample of this study. The sample size was divided into four groups. The first two groups comprised of 50 patients each comprising of patients with periodontitis who were nonsmokers and patients with periodontitis who were smokers respectively and the next two groups comprised of 25 patients each, which included patients diagnosed as suffering from alcoholic liver cirrhosis who are nonsmokers and patients diagnosed as suffering from alcoholic liver cirrhosis who are smokers. Screening examination included a proper medical history, dental history and Russell's periodontal index was done to evaluate and compare the periodontal status among the selected groups. Results The data obtained was subjected to statistical analysis using the ANOVA Fisher's F-test. Multiple group comparisons were made using the Tukey's HSD test. Conclusion Conclusions that can be drawn from this study are: 1. Alcoholic liver cirrhosis patients demonstrated greater alveolar bone loss and increased periodontal destruction. 2. There is very high statistically significant difference on periodontal destruction in alcoholic liver cirrhosis patients (with or without smokers) when compared to the control group. Clinical significance Periodontal diseases are bacterial infections associated with a bacterial load or insult to the host that elicits a strong inflammatory response cumulating to produce significant pathologic alterations in the systemic status of the host. Alcoholic liver cirrhosis patients as a consequence of liver dysfunction have elevated levels of serum cytokines. These are involved in the destructive process of periodontal disease probably through enhancement of collagenase and metalloproteinase activity. Hence, a study has been planned to evaluate periodontal status in patients with alcoholic liver cirrhosis. How to cite this article Raghava KV, Shivananda H, Mundinamane D, Boloor V, Thomas B. Evaluation of Periodontal Status in Alcoholic Liver Cirrhosis Patients: A Comparative Study. J Contemp Dent Pract 2013;14(2):179-182.

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Insulin Resistance, Glycemia and Cortisol Levels in Surgical Patients who Had Preoperative Caloric Load with Amino Acids

PRILOZI ◽

10.1515/prilozi-2015-0079 ◽

2015 ◽

Vol 36 (3) ◽

pp. 61-70 ◽

Cited By ~ 2

Author(s):

Marija Jovanovski-Srceva ◽

Biljana Kuzmanovska ◽

Maja Mojsova ◽

Andrijan Kartalov ◽

Mirjana Shosholcheva ◽

...

Keyword(s):

Insulin Resistance ◽

Amino Acids ◽

Amino Acid ◽

Surgical Patients ◽

Control Group ◽

Study Group ◽

C Peptide ◽

Significant Difference ◽

Cortisol Levels ◽

The Impact

Abstract Introduction: Surgical stress response, results in elevated levels of anti-insulin hormones and reduced insulin secretion. This hormonal state may be detrimental for surgical patients due to the presence of insulin resistance and hyperglycemia. Additionally, pre-operative fasting favors this conditions. The aim of this study is to analyze the impact of pre-operative caloric load, with 440kJ from amino acid infusions on the levels of glucose, cortisol and insulin resistance in surgical patients.Material and Methods: The study included 20 female patients scheduled for mastectomy, aged 30-60 years without diabetes and BMI < 30 m2, divided into two groups. The study group A, the evening before the surgery, received 1000 ml amino acid infusions, while the control group B didn′t receive any infusion. In both groups glucose, C-peptide and cortisol levels were determinate preoperatively and postoperatively. From the obtained C-peptide and glucose values, with the help of computer model (HOMA2*), the insulin resistance (IR), functionality of beta cells (BETA) and insulin sensitivity (IS) were calculated. Results: Postoperative values of insulin resistance (0.94 ± 0.12 vs 1.13 ± 0.2; p = 0.02) and glucose (4.79 ± 0.5 vs 5.77 ± 0.6; p = 0.002) were lower in the study group compared to control group. Postoperative cortisol levels in both groups were higher than the preoperative, but no significant difference was found. The study group showed higher values for BETA and IS. Percentage changes between the groups were significant for all parameters. Conclusion: Pre-operative caloric load (amino acids) reduces the level of insulin resistance and glucose in the presence of elevated cortisol levels.

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

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.413 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1431.2-1432

Author(s):

O. Hamdi ◽

M. Sellami ◽

M. Yasmine ◽

A. Fazaa ◽

S. Miladi ◽

...

Keyword(s):

Cesarean Section ◽

Rheumatic Diseases ◽

Premature Delivery ◽

Control Group ◽

Study Group ◽

Childbearing Age ◽

Significant Difference ◽

History Of ◽

The Mean ◽

The Impact

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

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Congestive Heart Failure and Upper Digestive Endoscopic Lesions

Acta Medica Marisiensis ◽

10.2478/amma-2019-0001 ◽

2019 ◽

Vol 65 (1) ◽

pp. 19-24

Author(s):

Adriana-Stela Cosma ◽

Claudia Bănescu ◽

Simona Mocan ◽

Beáta Balla ◽

Anca Negovan

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Alcohol Consumption ◽

Anticoagulant Therapy ◽

Cardiac Insufficiency ◽

Control Group ◽

Study Group ◽

Modifiable Factors ◽

Mucosal Lesions ◽

The Impact

AbstractObjective: To evaluate the impact of congestive heart failure and the most important clinical and pathological factors on severe upper digestive mucosal lesions.Methods: The study included 749 patients referred for upper digestive endoscopy, divided into two groups: 140 subjects with congestive heart failure (study group) and 609 subjects without heart failure (control group).Results: Severe endoscopic lesions quantified according to Lanza score (OR = 3.84, 95% IC: 2.62-5.62), active/inactive gastritis (OR = 2.07, 95% CI: 1.36-3.14), intestinal metaplasia and/or gastric atrophy (OR = 2.42, 95% CI: 1.67-3.52) were significant more frequent among patients with heart failure. Anemia (OR = 3.65, 95% IC: 2.48-5.37) and all investigated comorbidities, as well as alcohol consumption (OR = 1.60, 95% IC: 1.10-2.34) and smoking (OR = 1.76, 95% IC: 1.17-2.64) were more frequent in the study-group. Dividing the patients with cardiac insufficiency according to the severity of their endoscopic lesions, the male gender (OR = 2.76, 95% IC: 1.35–5.61) and daily low-dose aspirin consumption were found to be more frequent among patients with severe endoscopic lesions (OR = 7.71, 95% IC: 3.62–16.40), while anticoagulant therapy and alcohol consumption were borderline associated with mucosal lesions (p=0.08).Conclusions: Male patients and aspirin consumers with heart failure, but not those with H. pylori infection seem to be more prone to develop upper digestive endoscopic lesions, while alcohol consumption or anticoagulant therapy could be other modifiable factors associated with severe endoscopic lesions in a congestive gastro-duodenal mucosa.

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Utilization of the Feto-Maternal triage Program in Maternity Hospitals Of Baghdad City

Iraq Medical Journal ◽

10.22317/imj.v4i4.967 ◽

2020 ◽

Vol 4 (4) ◽

Author(s):

Wisam M. Muttaleb ◽

Ezedeen F. Baha’aldeen

Keyword(s):

Waiting Time ◽

Positive Influence ◽

Control Group ◽

Study Group ◽

Flow Sheet ◽

Age Group ◽

Mean Waiting Time ◽

Maternity Hospitals ◽

Significant Difference ◽

The Impact

Objectives: To evaluate the impact of fate-maternal triage program upon laboring women's outcomes. Methods: Quazi- experimental design was conducted upon laboring women seeking for care in Baghdad hospitals The study was conducted At Baghdad hospitals, which in both sides Al-Kargh (13 hospital) and Al-Resafa(23 hospital). The sample of the study consist of 280 laboring women, 140 women for each control and study group who are attending to the labor room in selected hospitals. Questionnaire format conducted as a flow sheet. It is designed and developed by the researcher depending on the feto-maternal triage index of AWHONN'S and Manchester triage system with some modification done by a researcher. Results:the mean age for both groups is 29.85 ± 8.64. More than a quarter of participants in the study group are within the age group of (21-25) years-old (n = 40; 28.6%), followed by those who are in the age group of (31-35) years-old (n = 36; 25.7%). For the control group, more than a third are in the age group of (21-25) years-old (n = 47; 33.6%), followed by those who are in the (31-35) years-old (n = 33; 23.6%).Concerning participants’ BMI, more than two-fifths in the study group are overweight (n = 61; 43.6%),for the control group, more than two-fifths in the study group are overweight (n = 61; 43.6%).More than a third of participants in the study group reported that the waiting time is (10-20) minutes and (21-30) minutes (n = 53; 37.9%) for each of them,For the control group, more than two-fifths reported that the waiting time is (31-60) minutes (n = 58; 41.4%).The mean waiting time for the control group is greater than that of the study group (1.68, 1.32) respectively. also more than a third of participants in the study group reported that the severity of cases are very urgent and emergency cases (n = 44; 31.4%), (n=23; 16.4%) respectively for each of them. For the control group, more than half of participants reported that the severity of case is very urgent and emergency cases (n = 44; 33.6 %),(n=20;14.3) respectively.There is a statistically significant difference in the mothers’ complications between the study and the control groups (χ2 = 13.755, df = 1, p-value = .000). This indicates a positive influence of the program in reducing the mother's complications. Conclusion: The study shows that the positive influence of the program in triage the cases according to its severity and according to the levels used in the triage.

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Impact of educational nursing program on reducing the level of anxiety and complications among patients undergoing cardiac catheterization

International Journal of Advanced Nursing Studies ◽

10.14419/ijans.v7i2.15445 ◽

2018 ◽

Vol 7 (2) ◽

pp. 109

Author(s):

Mohamed Aboel-Kassem F. Abdelmegid ◽

Sahra Zaki Azer ◽

Samia Youssef Sayed ◽

Hanan Mohamed Youness ◽

Reda Abd Elal thabet

Keyword(s):

Cardiac Catheterization ◽

Rating Scale ◽

Routine Care ◽

Structure Interview ◽

Nursing Program ◽

Control Group ◽

Study Group ◽

Significant Difference ◽

Quasi Experimental ◽

The Impact

The current studyAimed: to identify the impact of implementing an educational nursing program on reducing the level of anxiety and complications among patients undergoing cardiac catheterization.Design: quasi-experimental design was used in this study. Setting: the Current study was conducted atAssiutUniversityHospital in the cardiac catheterization unit.Subjects: 60 adult patients, age between 20 – 65 years, male and female, thirty for each group (study and control). The group of patients who received educational nursing program was considered a study group, while who received a routine care was the control group. Tools: four.Tools: Structure Interview Questionnaire sheet, Hamilton Anxiety Rating Scale, Assessment of complications, & educational nursing program.Results: there was the statistically significant difference between both groups regarding the level of anxiety and incidence of local complications.Conclusion: giving written nursing program for patients more effective in decreasing level of anxiety for patients in the study group than the control group patients.Recommendations: Permanent attendance of a specialized nurse in the cardiac catheterization unit is of great importance to instruct and apply the guidelines of the patients. Simple illustration booklet and pamphlets must be adequate and available for patients with Arabic explanation that helps the patient how to live safely.

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