scholarly journals Maternal and neonatal outcome in pregnancy at 40 years and beyond in a tertiary care center: a retrospective case control study

Author(s):  
Vrunda Appannagiri ◽  
Divya K. ◽  
Beena Kingsbury ◽  
Swati Rathore ◽  
Jiji E. Mathews ◽  
...  

Background: Obstetric outcome in women with advanced maternal age (AMA) is not usually studied especially in India.Methods: This study was a case control study. The cases were pregnancy in 100 women at 40 years of age and beyond and there were two control arms of 100 each of ages 20-29 years and 30-39 years. The demography, maternal complications, delivery outcomes and neonatal outcomes were compared.Results: Women with AMA were mostly multipavrous and had higher Body Mass Index (BMI). Hypertensive disease in pregnancy was more common in AMA but the difference was statistically significant. Women with AMA were more likely to have gestational diabetes (p ≤ 0.011), more likely to have anemia (p = 0.038), more likely to have preterm birth (p = 0.001), other medical complications compare to the control group (p = 0.005). They were also more likely to have Lower Segment Caesarean Section (LSCS) (p ≤ 0.001) and have postpartum complications. The birth weight of the neonate was significantly decreased in the AMA group (p < 0.001). The neonates were also more likely to be admitted to Neonatal Intensive Care Unit (NICU) (p ≤ 0.006).Conclusions: Adverse maternal and neonatal outcomes were seen despite individualized and optimal obstetric care. Thus, these women need preconceptional counselling.

2020 ◽  
Vol 9 (9) ◽  
pp. 2703
Author(s):  
Christina Kwon ◽  
Nishadh Sutaria ◽  
Raveena Khanna ◽  
Erik Almazan ◽  
Kyle Williams ◽  
...  

Excoriation disorder is a psychocutaneous disorder characterized by repetitive skin-picking and associated with significant morbidity. Currently, epidemiological data in patients with excoriation disorder are lacking so we sought to characterize common patient demographics and comorbidities. We conducted a retrospective case-control study comparing 250 patients with excoriation disorder with 250 age-, race- and sex-matched controls identified between 2007 and 2019 at a single tertiary care center. We found that the majority of excoriation disorder patients were female (76%), Caucasian (82%) and unmarried (62%), with a mean age of 49 years. Compared to the matched controls, patients with excoriation disorder had increased odds of several psychiatric illnesses, including obsessive compulsive disorder (odds ratio (OR) 28.48, 95% confidence interval (CI): 1.68, 481.75), substance use disorder (OR 24.33, 95% CI: 5.81, 101.77), post-traumatic stress disorder (OR 8.23, 95% CI: 2.24, 129.40), depression (OR 8.19, 95% CI: 4.86, 13.80), bipolar disorder (OR 7.55, 95% CI: 2.22, 25.65), attention-deficit/hyperactivity disorder (OR 5.63, 95% CI: 1.62, 19.57), and anxiety (OR 5.01, 95% CI: 2.92, 8.62). Only a minority (42%) of patients were given psychiatry referrals and of those referred, a majority (64%) did not follow-up with psychiatry. The outcomes were also generally unfavorable as only 21% of patients experienced a resolution or improvement in their symptoms. This highlights the need for a multidisciplinary approach to manage patients with excoriation disorder, involving both dermatologists and psychiatrists.


2018 ◽  
Vol 79 (1) ◽  
pp. 152-155 ◽  
Author(s):  
Laura Kooistra ◽  
Claudia Ricotti ◽  
Fabrizio Galimberti ◽  
Carmen Gota ◽  
Anthony P. Fernandez

2019 ◽  
Vol 70 (10) ◽  
pp. 3649-3653
Author(s):  
David Angelescu ◽  
Teodora Angelescu ◽  
Meda Romana Simu ◽  
Alexandrina Muntean ◽  
Anca Stefania Mesaros ◽  
...  

The aim of this retrospective case-control study is to determine a possible correlation between breathing mode and craniofacial morphology. The study was carried out in the Department of Pedodontics,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. The sample comprised 80 patients, age between 6 and 13 years, which were divided in two groups based on respiratory pattern: control group composed of 38 nasal breathing children and case group composed of 42 oral breathing children. Three quantitative craniofacial parameters were measured from the frontal and lateral photos: facial index, lower facial height ratio and upper lip ratio. The statistical analysis showed a significant higher facial index (p=0.006*) and an increase lower facial height (p=0.033*) for the oral breathers group. No differences in facial morphology were found between genders and age groups, when comparing the data between the same type of respiratory pattern children. Spearman�s rho Correlation show a significant positive correlation (p=0.002*) between facial index and lower facial height and a significant negative correlation between facial index and upper lip (p=0,005*). Long faces children are more likely to develop oral breathing in certain conditions, which subsequently have a negative effect on increasing the lower facial height by altering the postural behavior of mandible and tongue.


Author(s):  
Yosuke Sato ◽  
Tatsuya Sugiyama ◽  
Tohru Mizutani

Abstract BACKGROUND Intraoperative prediction of postoperative cerebral hyperperfusion syndrome (CHS) after cerebrovascular bypass surgery is challenging. OBJECTIVE To conduct a retrospective case-control study with indocyanine green (ICG) intensity analysis of the superficial temporal artery-middle cerebral artery (STA-MCA) bypass and investigate whether its washout pattern might be a marker for intraoperative prediction of CHS. METHODS Between 2012 and 2018, 6 of 112 patients (5.4%) that underwent STA-MCA bypass exhibited CHS. We selected 5 patients with CHS (3 with atherosclerotic cerebrovascular disease [ASCVD] and 2 with moyamoya) and 15 patients without CHS (60% ASCVD and 40% moyamoya) as a matched control group. During prebypass and postbypass, washout times (WTs) for the first 10%, 25%, 50%, and 75% of maximum ICG intensity measured in the whole-camera field were compared between groups. The changes in WT (ΔWT) from prebypass to postbypass for each ICG intensity level were compared between groups. The cutoff ΔWTs, sensitivities, and specificities were also calculated. RESULTS Postbypass WTs were significantly longer in the CHS group than the control group at all ICG intensities (P < .05). ΔWT was significantly greater in the CHS group than the control group for the first 10%, 25%, and 50% ICG intensities (P < .001). A cutoff ΔWT of ≥2.66 s for the first 50% ICG intensity showed a sensitivity of 100% and specificity of 100%. CONCLUSION We found that a ΔWT ≥2.66 s for the first 50% ICG intensity could be an intraoperative predictive factor for CHS.


Author(s):  
Pedro Hidalgo-Lopezosa ◽  
Ana María Cubero-Luna ◽  
Andrea Jiménez-Ruz ◽  
María Hidalgo-Maestre ◽  
María Aurora Rodríguez-Borrego ◽  
...  

Background: Birth plans are used for pregnant women to express their wishes and expectations about childbirth. The aim of this study was to compare obstetric and neonatal outcomes between women with and without birth plans. Methods: A multicentre, retrospective case–control study at tertiary hospitals in southern Spain between 2009 and 2013 was conducted. A total of 457 pregnant women were included, 178 with and 279 without birth plans. Women with low-risk gestation, at full-term and having been in labour were included. Sociodemographic, obstetric and neonatal variables were analysed and comparisons were established. Results: Women with birth plans were older, more educated and more commonly primiparous. Caesarean sections were less common in primiparous women with birth plans (18% vs. 29%, p = 0.027); however, no significant differences were found in instrumented births, 3rd–4th-degree tears or episiotomy rates. Newborns of primiparous women with birth plans obtained better results on 1 min Apgar scores, umbilical cord pH and advanced neonatal resuscitation. No significant differences were found on 5 min Apgar scores or other variables for multiparous women. Conclusions: Birth plans were related to less intervention, a more natural process of birth and better outcomes for mothers and newborns. Birth plans can improve the welfare of the mother and newborn, leading to birth in a more natural way.


2020 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Siti Lestari ◽  
Dyah Dwi Astuti ◽  
Fachriza Malika Ramadhani

Asfiksia perinatal merujuk pada kekurangan oksigen selama persalinan, sehingga berpotensi menyebabkan kematian dan kecacatan. WHO memperkirakan  4 juta anak terlahir dengan asfiksia setiap tahun, dimana 1 juta di antaranya meninggal dan 1 juta anak bertahan hidup dengan gejala sisa neurologis yang parah. Penelitian ini bertujuan untuk menganalisis faktor risiko fetal dan tali pusat pada asfiksia neonatal.Penelitian dilakukan di lakukan di RS Dr Moewardi Surakarta dengan pendekatan  quantitative retrospective case control study. Data diambil dari rekam medis antara  tahun 2013-2018. Penelitan ini melibatkan  264 neonatal yang terdiri dari 88 kelompok kasus dan 176  kelompok control. Kelompok kasus adalah bayi dengan diagnosa  asfiksia yang  dilakukan analisis terhadap faktor risiko fetal, sedangkan bayi yang tidak mengalami asfiksia dijadikan  kelompok kontrol. Hasil analisis statistik uji Chi-Square dan Fisher Exact ditemukan bahwa  kelahiran prematur (OR 2,07 CI 95% P 0,02), persalinan dengan tindakan (OR 3,61 CI 95% P 0,00), berat bayi (OR 2,85 CI 95% P 0,00), posisi janin (OR 2,37 CI 95% P 0,05), tali pusat ( QR 3,071 CI 95%  P 0,01)  berisiko terhadap insiden asfiksia perinatal. Air ketuban yang bercampur meconium (OR 1,51 CI 95% P 0,16) tidak memiliki risiko  dengan Asfiksia perinatal. Kesimpulan: Risiko terhadap insiden asfiksia perinatal  meliputi kelahiran prematur, persalinan dengan tindakan, berat bayi, posisi janin,  dan tali pusat.Perinatal asphyxia refers to a lack of oxygen during labor, which has the potential to cause death and disability. WHO estimates  4 million children born with asphyxia each year, in  which 1 million dies and 1 million survive with severe neurological sequelae. This study aims to analyze fetal and umbilical risk factors in neonatal asphyxia.This research is a quantitative retrospective case-control study, which was conducted at The Dr. Moewardi  hospital,  Surakarta. Data was taken from  medical records from 2013-2018. The case group was patients diagnosed  asphyxia, while those who did not experience asphyxia were treated as a control group.  A total of 264  samples, consisting of 88 case group respondents and 176 control group respondents. Statistical analysis Chi- Square and Fisher Exact found that preterm birth (OR 2.07 CI 95% P 0.02), labor with instrument or complication (OR 3.61 CI 95% P 0.00), infant weight (OR 2.85 CI 95% P 0, 00), fetal position (OR 2.37 CI 95% P 0.05), umbilical cord (QR 3.071 CI 95% P 0.01) are at risk for the incidence of perinatal Asphyxia. The amniotic fluid mixed with meconium (OR 1.51 CI 95% P 0.16) has no risk with perinatal asphyxia.The risk factors of incidences of perinatal asphyxia were  preterm birth, labor with instrument or complication, baby weight, fetal position and umbilical cord. 


Author(s):  
Surender Kumar ◽  
Neha Salaria ◽  
Deepak Verma ◽  
Uma Garg ◽  
Monika Verma

Background- Head and neck squamous cell carcinomas(HNSCC) are one of the most widespread malignancies worldwide. Trace elements such as magnesium are essential at cellular level, and it has been suggested that magnesium plays a role in carcinogenesis. Methods- A hospital based case control study was conducted in a tertiary care medical college with an aim to determine the levels of serum magnesium in patients with head and neck cancer and to  compare  the  levels  of  serum  magnesium  of head and neck cancer patients   with healthy matched control  group  and  derive significance if any. Results- HNSCC was mainly found in males of age group 46 to 55 years. The mean serum Mg value of head and neck cancer patients was 0.71± 0.18 mmol/l while that seen in controls was 0.85± 0.09 mmol/l which was significantly lower(p<0.001). Average serum magnesium levels in stages I, II, III and IV were 0.85, 0.849, 0.682 and 0.554 mmol/l respectively, and a statistically significant association was determined between the two. Conclusion- As the stage of cancer progressed, average magnesium levels decreased congruently, hence establishing that magnesium levels were undeniably correlated to onset as well as progression of HNC. These evidences could be utilized to identify role of magnesium asa potential prognostic biomarker to assess progression of disease or clinical response to various modes of therapy in head and neck cancer patients.


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