Prophylactic Effect of Tranexamic Acid on Hemorrhage During and After the Cesarean Section

Objectives: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum hemorrhage (PPH). Therefore, finding low-cost and low-risk alternative methods to control obstetric hemorrhage is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on hemorrhage during and after the cesarean section (CS). In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Materials and Methods: This randomized double-blind control trial was performed on 60 women who underwent CS using spinal anesthesia. These women were randomly assigned to two groups. The experimental group received 1 g of TXA 15 minutes before the incision while the control group received dextrose 5% in water as a placebo. The amount of bleeding was measured during and after the surgery. Data were entered into SPSS software version 21 and reported by descriptive statistics and analyzed using chi-square, t test, Mann-Whitney U test, paired t test, and ANCOVA and Wilcoxon tests. Results: Based on the results, no significant difference was found between the groups regarding the mean age, mean gestational age, and the prothrombin time (PT) and partial thromboplastin time (PTT) (P > 0.05). The mean of the total bleeding volume was 551.8 and 713.1 mL for experimental and control groups, respectively which means that a significant difference was observed between both groups in this respect (P = 0.006). However, no significant difference was noted between the groups regarding changes in hemoglobin (Hb) concentration, systolic and diastolic blood pressure (BP), and heart rate. Conclusions: Generally, administering 1 mg of TXA in CS significantly reduced the volume of PPH. However, it did not cause significant changes in hemodynamic state or Hb level. Therefore, it can be recommended as an appropriate treatment for these patients.

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TO EVALUATE THE EFFECT OF PROPHYLACTIC USE OF TRENEXAMIC ACID ON BLEEDING DURING ELECTIVE LSCS. A STUDY CONDUCTED IN TERTIARY CARE HOSPITAL OF CENTRAL INDIA.

10.36106/gjra/4814441 ◽

2021 ◽

pp. 223-225

Author(s):

Dhara Singh ◽

Sujata bhargava

Keyword(s):

Blood Loss ◽

Tranexamic Acid ◽

Tertiary Care ◽

Alternative Methods ◽

World Health ◽

Study Cohort ◽

Care Hospital ◽

Total Blood ◽

And Control ◽

The Impact

Background: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum bleeding (PPH). Therefore, nding low-cost and lowrisk alternative methods to control obstetric bleeding is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on bleeding during and after the LSCS. In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Material and Methods: This prospective study conducted on 100 women in Department of Obstetrics &gynecolgy for one year period. They were divided in two groups: Cases: (n=50; women receiving prophylactic Tranexamic Acid) and Control: (n=50; women receiving saline). Estimated the amount of blood loss during surgery. The amount of blood loss during surgery were calculated Estimation of weight of dry towels and mops before autoclaving is noted. Results: Most common age group among Cases and Control was 26-30 years .%. Mean age among cases group (26.69±7.51 years) was signicantly lesser compared to control study cohort (29.75±7.72). Post operativehemoglobin level was signicantly higher among Case (11.26±12.03) as compared to Control (8.56±1.01). Comparing post operative complications revealedno signicant changes. Use of topical hemostatics was higher among the control (77%) as compared to Cases (57%). Conclusion: Prophylactic treatment with TXA in relation to elective LSCS reduces the overall total blood loss, and the risk of reoperations owing to postoperative hemorrhage as revealed by higher hemoglobin level among cases.

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The Impact of COVID-19 Infection on the Quality of Life of Health Care Workers

10.21203/rs.3.rs-1009194/v1 ◽

2021 ◽

Author(s):

Sadeel Shanshal ◽

Harith Kh. Al-Qazaz

Keyword(s):

Quality Of Life ◽

Sleep Quality ◽

Psychological Health ◽

World Health ◽

World Health Organization Quality ◽

Significant Difference ◽

Males And Females ◽

The Mean ◽

The Impact

Abstract Background: COVID-19 pandemic has negatively affected the entire world and one of its impacts was the increased level of stress and anxiety, especially among healthcare workers. Therefore, this study aims at evaluating the quality of life (QoL) and sleep quality of healthcare professionals in Iraq.Methods: This study assessed the QoL and sleep quality by using World Health Organization Quality of Life Instruments (WHOQOL-BREF) and the Insomnia Severity Index (ISI) respectively. The questionnaires were administered through an online cross-sectional survey targeted at workers in medical fields in Iraq from 1st to 20th of August 2021. Results: Three hundred medical health workers participated, and females constituted 75.3%. The two questionnaires had very good internal consistency. The highest scoring domain was the social relationships, followed by physical health. Significant difference was found in the mean scores of psychological health domain between males and females, with higher scores observed in males. The mean of the total ISI score was 11.58 ± 6.88 with a range between 0 and 27. Severe insomnia was observed in only 9.7% of the participants. A significant negative correlation (r = -0.118) was found between age and ISI scores of the participants. Significant differences were found between males and females with higher ISI mean score observed among males. Conclusion: The quality of life and sleep pattern can be impacted by COVID-19 infection with the psychological aspect of QoL being the most affected and some degrees of insomnia being observed in many participants.

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The Impact of an Educational Program Based on the BASNEF Model on Knowledge and Self-Care Behaviors of Patients with Hypertension

Health Scope ◽

10.5812/jhealthscope.95588 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Sedigheh Abedini ◽

Farzaneh Pourjalil ◽

Shokrallah Mohseni

Keyword(s):

Educational Program ◽

Intervention Group ◽

Self Care ◽

Educational Interventions ◽

T Test ◽

Post Intervention ◽

Enabling Factors ◽

Significant Difference ◽

The Mean ◽

The Impact

Background: Hypertension is an important health problem that can be controlled by self-care. Objectives: The present study aimed to determine the impact of an educational program based (BASNEF) model on knowledge and self-care behaviors for hypertensive patients in Bastak, Iran. Methods: This quasi-experimental study was performed on 180 patients with hypertension who were admitted to health centers of the Bastak city. The participants were randomly assigned to intervention (n = 90) and control (n = 90) groups. Data were collected using a questionnaire that had three sections of demographic information, knowledge, and BASNEF constructs. The questionnaires were completed before the intervention and two months after providing the intervention. After the pre-test, an appropriate educational intervention was designed and implemented only among the intervention group. To analyze the data, paired t-test, independent t-test, and Chi-square tests were run by SPSS version 19. Results: The mean age of the participants was 50.62 ± 7.549 years. The results showed a statistically significant difference in the mean scores of attitudes, subjective norms, enabling factors, and self-care behaviors in the intervention group pre- and post-intervention (P = 0.001). Besides, it was found that enabling factors (0.311) play a significant role in predicting self-care behaviors. Conclusions: The results of this study support the effectiveness of educational interventions in raising awareness and improving self-care behaviors in patients with hypertension using the BASNEF model. Therefore, with an emphasis on enabling factors, the BASNEF model can be used as a framework to develop educational interventions for self-care.

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Analyzing the Impact of Large Dams on Seismicity Patterns around Their Locations

Archives of Hydro-Engineering and Environmental Mechanics ◽

10.1515/heem-2021-0001 ◽

2021 ◽

Vol 68 (1) ◽

pp. 3-17

Author(s):

Mina Parvizishad ◽

Simin Naseri ◽

Ramin Nabizadeh ◽

Abdollah Sohrabi Bidar ◽

Amir Hossein Mahvi ◽

...

Keyword(s):

Statistical Analysis ◽

T Test ◽

Dam Construction ◽

Seismicity Patterns ◽

Regional Seismicity ◽

Large Dams ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

The Impact

Abstract Dam construction is one of the most popular solutions for managing water resources. In recent years, changes in patterns of regional seismicity associated with large impoundment dams have raised concerns among environmentalists. In this study, five large dams located in Iran were studied from this perspective. The Gutenberg-Richter, linear regression and T-test were used to examine the seismic changes in the radius of 100 km of each of the dams during a twenty-five-year period before and after the construction of the dams. The results revealed that the seismicity level and relative density of large and small earthquakes in three of these dams have increased after dam construction. A significant difference between the magnitude of earthquakes, as well as the number of earthquakes before and after the construction of dams in the region, was recognized. However, the results of the T-test statistical analysis indicated that the mean depth of the earthquakes and their distance from the dams before and after construction have not changed significantly. Overall, these results indicated that the construction of large impoundment dams has been associated with some changes in patterns of regional seismicity. The findings would guide researchers to further investigate the type of impacts that dam construction may have on seismicity patterns.

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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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Impact of Education on the Perception of Muslim People about Instant Triple Talaq Law

Shanlax International Journal of Arts, Science and Humanities ◽

10.34293/sijash.v9i1.3857 ◽

2021 ◽

Vol 9 (1) ◽

pp. 68-74

Author(s):

Raja Rajhans ◽

Sanjaya Sahu ◽

Mahendra Prasad Behera

Keyword(s):

Random Sampling ◽

Comparative Method ◽

T Test ◽

Mean Difference ◽

Stratified Random Sampling ◽

Significant Difference ◽

Muslim People ◽

The Mean ◽

Causal Comparative ◽

The Impact

The present study designed to investigate the Impact of Education in the Perception of Muslim People about Instant Triple Talaq Law. The main objectives of the study were to compare mean scores of perceptions of educated and uneducated Muslim people about Instant Triple Talaq Law, to compare mean scores of perceptions of educated male and educated female Muslim people about Instant Triple Talaq Law, and to compare mean scores of perceptions of uneducated male and uneducated female Muslim people about Instant Triples Talaq Law. For this study, 100 Muslim people were selected from Bargarh district, Odisha through stratified random sampling. A Causal comparative method was employed by the researcher. The investigator prepared a Perception Scale for collecting data. The ‘t’ test revealed that a significant difference was found in the mean scores of perceptions between educated and uneducated Muslim people towards instant triple talaq law. The findings also reveal that no significant mean difference was found between educated male and educated female and uneducated male and uneducated female Muslim people in perceiving the impact of education about Instant Triple Talaq Law.

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The Impact of Gender on Adjustment Level of Dire Dawa University Lecturers

10.14293/s2199-1006.1.sor-.ppkrxdr.v1 ◽

2021 ◽

Author(s):

Mustefa Jibril

Keyword(s):

T Test ◽

University Teaching ◽

Male And Female ◽

Significant Difference ◽

Dire Dawa ◽

The Mean ◽

Conducting Research ◽

University Lecturers ◽

The Impact ◽

Better Than

The present investigation is to find out the Adjustment of Dire Dawa University Lecturers concerning their gender. The sample consisted of 120 lecturers out of which 60 were male and 60 were female. For this purpose of investigation, the Teachers Adjustment Inventory was used. The obtained data were analyzed through the "t" test to know the mean difference between the lecturers concerning their gender. The result shows that there is no significant difference in University, Teaching, and Overload course adjustment of male and female Dire Dawa university Lecturers. But there is a significant difference in conducting research adjustment of male & female Lecturers at 0.05 levels. It means males Conducting research adjustment are better than female Lecturers.

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Are Saudi adults supportive of Saudi Food & Drug Authority’s food policies? Assessment of public support & awareness for Saudi Food & Drug Authority’s food policies

10.21203/rs.3.rs-34372/v1 ◽

2020 ◽

Author(s):

Suzan Tami ◽

Mohammed Al-Mahish

Keyword(s):

Public Perception ◽

Public Support ◽

Food Products ◽

T Test ◽

Cross Sectional ◽

The Public ◽

Significant Difference ◽

The Mean ◽

Food Policies ◽

The Impact

Abstract Background Numerous countries, including Saudi Arabia, are considering nutrition and food policies to help control the obesity epidemic and other non-communicable diseases. The present study examined public support and awareness, among Saudi adults, for the Saudi Food and Drugs Authority’s (SFDA) food policies, specifically whether public support and awareness for SFDA policies and regulations have a significant impact on their average Body Mass Index (BMI), and how socio-economic variables impact the public support and awareness for SFDA policies and regulations. Methods In this cross-sectional study, 584 Saudi adults completed an electronic questionnaire, collected data on whether the public were aware and supportive of SFDA’s different food polices and regulations. To examine whether participants’ awareness and support of SFDA’s food policies had a significant impact on their average BMI, two sample t-test was used, and a logistic regression model was used to examine the impact of demographics variables on participants’ support and awareness for SFDA policies and regulations. Results Saudi adults followed SFDA’s latest news and regulations and were supportive of SFDA’s food policies. Particularly, high support was for food policies of requiring restaurants and coffee shops to report calorie amounts in foods and beverages, reducing the salt amount in bread, eliminate hydrogenated oil from food products, and preventing misleading written nutrition information on food products, and preventing food advertisements without permission. The results of the two-sample t-test showed that there was a significant difference in the mean BMI between the participants who followed and those who did not follow SFDA news and regulations. The mean BMI between the participants who cooperated and those who did not cooperate with SFDA by reporting food safety violations was significantly different. The results of the binary logit model indicated that several socio-demographic characteristics were significantly associated with food policy awareness and support. Conclusion The findings of this study may assist nutrition educators to plan programs to improve health-related behaviors, and may allow stakeholders and policy makers to consider public perception and social desirability in the policy-making and implementation process.

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Multi-Center Study of Thromboplastin Calibration Precision – Influence of Reagent Species, Composition, and International Sensitivity Index (ISI)

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651544 ◽

1993 ◽

Vol 69 (01) ◽

pp. 035-040 ◽

Cited By ~ 12

Author(s):

A M H P van den Besselaar ◽

R M Bertina

Keyword(s):

Oral Anticoagulants ◽

International Normalized Ratio ◽

The Other ◽

World Health ◽

Rabbit Brain ◽

Sensitivity Index ◽

Bovine Plasma ◽

Significant Difference ◽

The Mean ◽

International Sensitivity Index

SummaryFour thromboplastin reagents were tested by 18 laboratories in Europe, North-America, and Australasia, according to a detailed protocol. One thromboplastin was the International Reference Preparation for ox brain thromboplastin combined with adsorbed bovine plasma (coded OBT/79), and the second was a certified reference material for rabbit brain thromboplastin, plain (coded CRM 149R). The other two thromboplastin reagents were another rabbit plain brain thromboplastin (RP) with a lower ISI than CRM 149R and a rabbit brain thromboplastin combined with adsorbed bovine plasma (RC). Calibration of the latter two reagents was performed according to methods recommended by the World Health Organization (W. H. O.).The purpose of this study was to answer the following questions: 1) Is the calibration of the RC reagent more precise against the bovine/combined (OBT/79) than against the rabbit/plain reagent (CRM 149R)? 2) Is the precision of calibration influenced by the magnitude of the International Sensitivity Index (ISI)?The lowest inter-laboratory variation of ISI was observed in the calibration of the rabbit/plain reagent (RP) against the other rabbit/plain reagent (CRM 149R) (CV 1.6%). The highest interlaboratory variation was obtained in the calibration of rabbit/plain (RP) against bovine/combined (OBT/79) (CV 5.1%). In the calibration of the rabbit/combined (RC) reagent, there was no difference in precision between OBT/79 (CV 4.3%) and CRM 149R (CV 4.2%). Furthermore, there was no significant difference in the precision of the ISI of RC obtained with CRM 149R (ISI = 1.343) and the rabbit/plain (RP) reagent with ISI = 1.14. In conclusion, the calibration of RC could be performed with similar precision with either OBT/79 or CRM 149R, or RP.The mean ISI values calculated with OBT/79 and CRM 149R were practically identical, indicating that there is no bias in the ISI of these reference preparations and that these reference preparations have been stable since their original calibration studies in 1979 and 1987, respectively.International Normalized Ratio (INR) equivalents were calculated for a lyophilized control plasma derived from patients treated with oral anticoagulants. There were small but significant differences in the mean INR equivalents between the bovine and rabbit thromboplastins. There were no differences in the interlaboratory variation of the INR equivalents, when the four thromboplastins were compared.

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Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system

Journal of Neurosurgery ◽

10.3171/2019.5.jns19780 ◽

2020 ◽

Vol 133 (4) ◽

pp. 1010-1019 ◽

Cited By ~ 4

Author(s):

Hiroaki Takei ◽

Jun Shinoda ◽

Soko Ikuta ◽

Takashi Maruyama ◽

Yoshihiro Muragaki ◽

...

Keyword(s):

Positron Emission Tomography ◽

Pet Imaging ◽

Who Classification ◽

Standardized Uptake Value ◽

Emission Tomography ◽

World Health ◽

Pet Tracers ◽

Positron Emission ◽

Significant Difference ◽

The Mean

OBJECTIVEPositron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification.METHODSIn total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers.RESULTSThere were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG.CONCLUSIONSPET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

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