scholarly journals Analysis of placental pathology and fetal outcome

Author(s):  
Amrutha Ramachandran

Background: A careful examination of placenta along with microscopic study may frequently point to the cause of perinatal death. The American College of Pathologists has provided guidelines for the examination of placenta. Aim of this study was to illustrate the gross and histopathological changes in placenta in certain normal and abnormal pregnancies and to analyse the relationship of placental pathology with fetal outcome.Methods: A prospective study of 120 deliveries at a tertiary teaching centre in India. Each placenta was studied macroscopically and sent to the pathology department for histological examination.  The study included placentas of normal pregnancies and those with maternal high-risk features. The placenta was fixed in formalin and 6 sections were taken. The paraffin sections were studied for vessel wall thickening, infarction, villitis, chorioangiosis, calcification and intervillous hemorrhage. The primary outcome variables were fetal and neonatal morbidity. Abnormal fetal /neonatal events in each histological group were compared with the normal group using Ψ2 test for homogeneity. For cell frequencies less than 5, Fischer exact test was used.Results: Vessel wall thickening was demonstrated in 54/120 patients (45%). 7 out of 54 (12.96%) fetuses were still born in this group compared to 2/30 (6.67%) with normal histology (p value <0.05). Infarcts were demonstrated in 15/120 (12.5%). The occurrence of abnormal neonatal events in this group was significant p <0.01.Conclusions: Placental histological features of vessel wall thickening, and infarction is associated with abnormal fetal and neonatal outcome. Larger studies are required to establish the inference.

2008 ◽  
Vol 15 (03) ◽  
pp. 317-322
Author(s):  
NAZIA AMJAD ◽  
TAYYBA IMRAN ◽  
AHSEN NAZIR AHMED

.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profileand non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were dividedinto two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweeklyantenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode ofdelivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety sixpercent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group comparedto 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rateof instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery wasfound to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas foundin 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery instudy group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while therewas no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to bestatistically insignificant which concluded the validity of either mode of management.


Author(s):  
Jason D. Tegethoff ◽  
Rafael Walker-Santiago ◽  
William M. Ralston ◽  
James A. Keeney

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.


2021 ◽  
pp. 175342592110299
Author(s):  
Alexander Varzari ◽  
Igor V. Deyneko ◽  
Elena Tudor ◽  
Harald Grallert ◽  
Thomas Illig

Polymorphisms in genes that control immune function and regulation may influence susceptibility to pulmonary tuberculosis (TB). In this study, 14 polymorphisms in 12 key genes involved in the immune response ( VDR, MR1, TLR1, TLR2, TLR10, SLC11A1, IL1B, IL10, IFNG, TNF, IRAK1, and FOXP3) were tested for their association with pulmonary TB in 271 patients with TB and 251 community-matched controls from the Republic of Moldova. In addition, gene–gene interactions involved in TB susceptibility were analyzed for a total of 43 genetic loci. Single nucleotide polymorphism (SNP) analysis revealed a nominal association between TNF rs1800629 and pulmonary TB (Fisher exact test P = 0.01843). In the pairwise interaction analysis, the combination of the genotypes TLR6 rs5743810 GA and TLR10 rs11096957 GT was significantly associated with an increased genetic risk of pulmonary TB (OR = 2.48, 95% CI = 1.62–3.85; Fisher exact test P value = 1.5 × 10−5, significant after Bonferroni correction). In conclusion, the TLR6 rs5743810 and TLR10 rs11096957 two-locus interaction confers a significantly higher risk for pulmonary TB; due to its high frequency in the population, this SNP combination may serve as a novel biomarker for predicting TB susceptibility.


2019 ◽  
Vol 28 ◽  
Author(s):  
Jéssica Naylla de Melo Bezerra ◽  
Sara Rebeca de Oliveira Lessa ◽  
Marcelo Francisco do Ó ◽  
Givaneide Oliveira de Andrade Luz ◽  
Anna Karla de Oliveira Tito Borba

ABSTRACT Objective: to assess the functional levels of health literacy in individuals undergoing dialysis. Method: a cross-sectional study with 42 patients of the Nephrology Unit of a public hospital in Recife, Brazil, from May to August 2016. Data were collected through scripted interviews and chart analysis. Functional health literacy was measured using the Brazilian version of the Short-Test of Functional Health Literacy in Adults questionnaire. Data analysis was performed using the Statistical Package for Social Sciences (SPSS®) software, version 18.0, with a univariate analysis to verify the association between independent variables and functional health literacy levels using Fisher's exact test. Results: 80.9% of the patients presented inadequate health literacy and 19.1% presented adequate health literacy. The number of correct answers remained between 0-18 in the reading comprehension and in the scheduling appointment card. Among the independent variables, only marital status (p-value=0.018) and personal income (p-value=0.009) were factors associated with the worst scores in the test, indicating that these variables influence the increase in inadequate literacy. Conclusion: the prevalence of inadequate functional literacy was high, reflecting difficulties in understanding and processing health information, which may interfere with therapeutic management and self-care.


2011 ◽  
Vol 77 (3) ◽  
pp. 351-354 ◽  
Author(s):  
Neeraj Singh ◽  
Monica Kohli ◽  
Harjeet Kohli

Frey's syndrome was first described by Lucia Frey, a Polish neurologist in 1923. It is well accepted that it involves injury to the branches of the auriculotemporal nerve with subsequent aberrant regeneration. Due to this abnormal communication, the skin glands and vessels are always stimulated at the same time as eating and mastication, which results in symptoms such as flushing and sweating. The incidence of Frey's syndrome in the literature has been variously described from 6 to 96 per cent. We analyzed the chart of 18 patients who had parotidectomy from March 2002 to December 2009. All procedures were performed by a single surgeon at the same facility. A total of 16 superficial and three total parotidectomies were done; one patient had bilateral parotidectomy. Oxidized regenerated cellulose (Interceed) was used after 10 surgeries (study group) and no adjuvant was used after nine surgeries (control group). All of the surgeries were done using similar technique. All the patients were followed-up with for a period of about 6 months postoperatively. The absolute risk reduction associated with the placement of an Interceed was 11 per cent. The small number of cases (n = 19) and an empty cell limits statistical analysis (a Fisher's exact test revealed a P value of 0.44). Clearly the low number of procedures restricted the power to test these differences. The development of Frey's syndrome is a very disabling but under-reported complication. The placement of a temporary barrier like Interceed may help in the prevention of Frey's syndrome without increasing any complications.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Tariq Hammad ◽  
Emmanuel C. Obusez ◽  
Rula Hajj-ali ◽  
...  

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) and central nervous system (CNS) vasculitis often have similar initial clinical presentation, laboratory findings and imaging features creating a diagnostic dilemma. High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Methods: A retrospective analysis of all patients with a diagnosis of RCVS or CNS vasculitis that underwent HR-MRI at our institution was performed. Inclusion criteria for RCVS were clinical presentation, no aneurysmal subarachnoid hemorrhage, normal cerebrospinal fluid and reversible multifocal intracranial vessel stenosis whereas criteria for CNS vasculitis were cases with positive brain biopsy or typical clinical presentation, course and laboratory markers with rheumatology and stroke neurology agreement in diagnosis. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected. Results: Eleven patients with RCVS [10 (90.9%) females, mean age 45.2] and 8 with CNS vasculitis [6 primary CNS vasculitis, 6 (75%) males, mean age 43.5] were included in the study. No abnormal vessel wall enhancement or thickening was seen in any of the RCVS patients in areas of vessel stenosis. Six (75%) of CNS vasculitis patients had vessel wall thickening or enhancement (p=0.001 for comparison to RCVS) and the remaining 2 patients had HR-MRI performed 6 and 10 years after diagnosis and chronic treatment. All RCVS patients who had follow up HR-MRI demonstrated resolution of the multifocal stenosis. Two out of 4 CNS vasculitis patients with subsequent HR-MRI imaging had decrease in vessel wall thickening and enhancement after immunosuppressive therapy. Conclusion: In acute stages of presentation, HR-MRI may be useful in differentiating RCVS from CNS vasculitis. It may also be useful in following the disease course to look for resolution of intracranial vessel stenosis in RCVS or treatment response in vasculitis. Further studies are needed to confirm the utility of HR-MRI in diagnosis and disease progression in RCVS and vasculitis.


2021 ◽  
Vol 5 (2) ◽  
pp. 139
Author(s):  
Widya Retno ◽  
Ivon Diah Wittiarika ◽  
Muhammad Aldika Akbar

 Abstract Background: Preeclampsia is one of the biggest causes of maternal-fetal morbidity and mortality. Based on the prognosis, the classification of Preeclampsia is early onset (<34 weeks) and late onset (> 34 weeks). Purpose: to investigate the relationship between the onset of severe Preeclampsia and perinatal complications. Method: This research is a quantitative study with a retrospective observational analytic study type and collected medical record data. The study population was severe Preeclampsia  patients who gave birth at RUMKITAL Dr. Ramelan Surabaya for the period January 2018 - June 2020 and has no previous history of chronic hypertension. The research sample was 79 subjects with 44 subjects early onset, and 35 subjects late onset. Perinatal complications  examined are preterm delivery, asphyxia, LBW, IUGR, stillbirth. The chi-square test or Fisher’s Exact Test was used to analyze relationships. Result: From the results of the study, the comparison of the percentage from early onset and late onset that experienced complications was 93.2% vs 48.6%, p-value = 0.000, OR = 14.5, CI = 3,764–55,635.  At preterm delivery, it was found that 75% vs 28.6%, p-value = 0.000,  OR = 7.5, CI = 2,754-20,422. . In asphyxia, it was found 41.7% vs 31.4%, p-value = 0.46. At LBW, it was found 72.7% vs 17.1%, p-value = 0,000, OR = 12.9, CI = 4,285-38,771. In IUGR, it was found that 15.9% vs 2.9%, p-value = 0.000. In stillbirth, it was found 18.2% vs 0% and p-value = 0.008. Conclusion: the onset of severe Preeclampsia is related with perinatal complications. Complications associated with the onset severe Preeclampsia are preterm, LBW, stillbirth. Meanwhile, complications that are not related with the onset severe Preeclampsia are asphyxia and IUGR  


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
L Girardi ◽  
M Serdaroğulları ◽  
C Patassini ◽  
S Caroselli ◽  
M Costa ◽  
...  

Abstract Study question What is the effect of varying diagnostic thresholds on the accuracy of Next Generation Sequencing (NGS)-based preimplantation genetic testing for aneuploidies (PGT-A)? Summary answer When single trophectoderm biopsies are tested, the employment of 80% upper threshold increases mosaic calls and false negative aneuploidy results compared to more stringent thresholds. What is known already Trophectoderm (TE) biopsy coupled with NGS-based PGT-A technologies are able to accurately predict Inner Cell Mass’ (ICM) constitution when uniform whole chromosome aneuploidies are considered. However, minor technical and biological inconsistencies in NGS procedures and biopsy specimens can result in subtle variability in analytical results. In this context, the stringency of thresholds employed for diagnostic calls can lead to incorrect classification of uniformly aneuploid embryos into the mosaic category, ultimately affecting PGT-A accuracy. In this study, we evaluated the diagnostic predictivity of different aneuploidy classification criteria by employing blinded analysis of chromosome copy number values (CNV) in multifocal blastocyst biopsies. Study design, size, duration The accuracy of different aneuploidy diagnostic cut-offs was assessed comparing chromosomal CNV in intra-blastocysts multifocal biopsies. Enrolled embryos were donated for research between June and September 2020. The Institutional Review Board at the Near East University approved the study (project: YDU/20l9/70–849). Embryos diagnosed with uniform chromosomal alterations (single or multiple) in their clinical TE biopsy (n = 27) were disaggregated into 5 portions: the ICM and 4 TE biopsies. Overall, 135 specimens were collected and analysed. Participants/materials, setting, methods Twenty-seven donated blastocysts were warmed and disaggregated in TE biopsies and ICM (n = 135 biopsies). PGT-A analysis was performed using Ion ReproSeq PGS kit and Ion S5 sequencer (ThermoFisher). Sequencing data were blindly analysed with Ion-Reporter software. Intra-blastocyst comparison of raw NGS data was performed employing different thresholds commonly used for aneuploidy classification. CNV for each chromosome were reported as aneuploid according to 70% or 80% thresholds. Categorical variables were compared using Fisher’s exact test. Main results and the role of chance In this study, a total of 50 aneuploid patterns in 27 disaggregated embryos were explored. Single TE biopsy results were considered as true positive when they displayed the same alteration detected in the ICM at levels above the 70% or 80% thresholds. Alternatively, alterations detected in the euploid or mosaic range were considered as false negative aneuploidy results. When the 70% threshold was applied, aneuploidy findings were confirmed in 94.5% of TE biopsies analyzed (n = 189/200; 95%CI=90.37–37.22), while 5.5% showed a mosaic profile (50–70%) but uniformly abnormal ICM. Positive (PPV) and negative predictive value (NPV) per chromosome were 100.0% (n = 189/189; 95%CI=98.07–100.00) and 99.5% (n = 2192/2203; 95%CI=99.11–99.75) respectively. When the upper cut-off was experimentally placed at 80% of abnormal cells, a significant decrease (p-value=0.0097) in the percentage of confirmed aneuploid calls was observed (86.5%; n = 173/200; 95%CI=80.97–90.91), resulting in mosaicism overcalling, especially in the high range (50–80%). Less stringent thresholds led to extremely high PPV (100.0%; n = 173/173; 95%CI=97.89–100.00), while NPV decreased to 98.8% (n = 2192/2219; 95%CI=98.30–99.23). Furthermore, no additional true mosaic patterns were identified with the use of wide range thresholds for aneuploidy classification. Limitations, reasons for caution This approach involved the analysis of aneuploidy CNV thresholds at the embryo level and lacked from genotyping-based confirmation analysis. Moreover, aneuploid embryos with known meiotic partial deletion/duplication were not included. Wider implications of the findings: The use of wide thresholds for detecting intermediate chromosomal CNV up to 80% doesn’t improve PGT-A ability to discriminate true mosaic from uniformly aneuploid embryos, lowering overall diagnostic accuracy. Hence, a proportion of the embryos diagnosed as mosaic using wide calling thresholds may actually be uniformly aneuploid and inadvertently transferred. Trial registration number N/A


2019 ◽  
Vol 4 (2) ◽  
pp. 89-101
Author(s):  
Samfriati S ◽  
Lilis N ◽  
Mercy N G

Academic procrastination is one of the postponement behaviors in lecture activities that are often found in students, in this study respondents experiencees a high level of procrastination that could hamper academic activities. One of the causes of procrastination is the use of gadgets that are too long to play games, music, entertainment and so on. Goals : The purpose of this study is to find out the relationship between the use of gadgets and academic procrastination onNursing Students level II Saint Elisabeth Medan 2019. Method : The study design is Cross Sectional. Total sampling technique sample are112 students. The measuring instrument used is a questionnaire. Result : The results shows that the majority of use of positive gadgets (92.9%) and moderate academic procrastination (63.4%). Based on the Fisher's Exact Test, it obtained p-value 0.026 (p <0.05), thus indicating a relationship between the use of gadgets and academic procrastination on nursing students level II STIKes Saint Elisabeth Medan. Conculsion: It is expected that respondents will be able to manage time well and not use gadgets for a long time for things that are not useful. Respondent s are expected to use gadgets for things that can support learning activities.


2020 ◽  
Vol 10 (3) ◽  
pp. 200-204
Author(s):  
Sana Akbar ◽  
Misbah Riaz ◽  
Lalarukh Munawar ◽  
Shazia Shakoor

Objective: The purpose of this study was to correlate the hypochondriacal concerns related to diseases with level of anxiety and depression symptoms among medical and engineering undergraduates. Study design and Setting: Cross sectional study was conducted among undergraduates of final year students of BUMDC (Bahria University Medical & Dental College) and engineering students from NUST- PNEC (NUST – Pakistan Navy Engineering College). Methodology: In this study; (99) final year medical students and (92) engineering students were recruited. In order to maintain consistency of age, students aging between 21–26 years were selected. Selected students were handed to fill the required ‘Self-administered Questionnaire’ comprising of demographic details, short health anxiety inventory, medical history and DASS (depression, anxiety and stress scale) which were completed on-site. Data was entered in SPSS version 21 and analyzed using Fisher’s exact test. P value < 0.05 was considered as statistically significant. Result: Out of 191 students in total from both the groups n=86 (45%) were females and n=105(55%) were males. There were 99 participants from MBBS and 92 from engineering. The participants’ ages ranged from 21-26 years with a mean= 23.95 (SD±2.29), both the cohorts belonged to approximately same age group. While assessing depression the responses were not very different for both the groups. When responses of depression scale were related to visits to psychiatrists or psychologist or psychotherapist a strong relationship was observed (p=0.012) in medical students cohort. Conclusion: The results of the study reflected comparable psychosocial strain at an elevated level among both student groups


Sign in / Sign up

Export Citation Format

Share Document