scholarly journals Prospective observational study to evaluate the efficacy of labetalol versus nifedipine in the management of preeclampsia

2020 ◽  
Vol 9 (4) ◽  
pp. 1448
Author(s):  
Sarulatha D. ◽  
Menaga M.
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Unknown Etiology ◽  
P Value ◽  
Maternal Risk ◽  
Medical Disorders ◽  
Number Of Patients

Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. It has effects both on expectant mother and fetus. Pre-eclampsia is a pregnancy specific multisystem disorder of unknown etiology, and accounts for 12-18% of maternal mortality. There is general consensus that maternal risk is decreased by antihypertensive treatment that lowers very high blood pressure. Objective of this study was to study the efficacy of oral labetalol versus oral Nifedipine in the management of preeclampsia in the antepartum and intrapartum period.Methods: The present study was conducted in a tertiary care centre, Chennai from October 2013 to September 2014. It was a prospective observational study done in antenatal ward and labor ward. All antenatal women diagnosed to have pre-eclampsia, irrespective of gestation are included in this study.Results: Age distribution of PIH patients and the maximum number of patients were 20-25 years of age. maximum patients of severe preeclampsia were primigravida. Both systolic and diastolic BP in the two groups (oral labetalol and oral Nifedipine groups) were not statistically significant as the p value is >0.005.Conclusions: From this study, authors found that both oral labetalol and oral nifedipine are effective and well tolerated when used for rapid control of blood pressure in severe hypertension of pregnancy.

scholarly journals Microbiological study of cervical flora in preterm labour

2020 ◽  
Vol 9 (3) ◽  
pp. 945
Author(s):  
Meenakshi Ruhil ◽  
Priti A. Hatkar
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Preterm Labour ◽  
Tertiary Care ◽  
P Value ◽  
Tertiary Care Centre ◽  
Microbiological Study ◽  
Spontaneous Preterm Delivery ◽  
Causative Factors ◽  
Secondary Objective

Background: Preterm labour occurs due to various causative factors. Genital infections contribute significantly to the preterm labour. Ours is a prospective, observational study looking at the cervical microbiota involved in the preterm labour. The cervical flora contributing to the occurrence of preterm labour was studied. The results were analyzed based on the microbiological study of cervical swabs. The primary objectives of this study were to determine the association of cervical microbiota of pregnant women with spontaneous preterm delivery. To characterize the effect of cervical microbiota on birth gestation. The secondary objective of this study was to analyse the role of cervical microbiota and its relationship between social and behavioural factors.Methods: It is a prospective, observational study, which includes 193 patients, studied over a period of one and a half year. It was conducted at our tertiary care centre after the approval by ethics committee, and the results were analysed. As this is a purely observational study, management decisions of treating obstetrician were not interfered with. No additional cost, intervention or injury was caused to the study subject.Results: In our study, cervical swab culture shows growth in 2.07% which is statistically insignificant. Though, it was found that preterm labour is more common with leucocytosis, i.e. WBC > 11000 cmm, which is found to be statistically significant (p value = 0.023).Conclusions: In our study, we found that there was no significant association of cervical flora with preterm labour, though we found an association with leucocytosis.

scholarly journals Role of Comorbidity Polypharmacy Score in Prediction of PostOperative Outcome in Geriatric Patients - A Prospective Observational Study in a Tertiary Care Hospital in Mysore

2021 ◽  
Vol 8 (20) ◽  
pp. 1549-1553
Author(s):  
Adarsh Hegde ◽  
Nalini Kotekar
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
Activities Of Daily Living ◽  
Correlation Coefficient ◽  
Barthel Index ◽  
Daily Living ◽  
Prospective Observational Study ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
P Value

BACKGROUND Comorbidity in elderly has negative impact on physiological and cognitive functions, the prevalence of which is increasing. Management of multiple comorbidities has resulted in polypharmacy in elderly. Comorbidity Polypharmacy Score (CPS) is a clinical tool to quantify severity of comorbidities using polypharmacy as surrogate for intensity of treatment required to adequately manage comorbidities. We wanted to evaluate CPS as predictor of post-operative outcomes in geriatric patients undergoing elective surgeries. METHODS A prospective observational study was conducted in a tertiary care centre among elderly patients (more than 65 years) undergoing elective surgeries satisfying inclusion criteria. Calculated sample size was 250. CPS was calculated by assigning one point to each comorbidity and medication taken and sum calculated was categorised. Primary outcomes were defined by hospital length of stay and Barthel index at day 3 and day 5. RESULTS We found moderate positive correlation using Pearson Correlation with CPS and Barthel index at day 3 (p - value = 0.0024, correlation coefficient = - 0.191) and day 5 (p - value = 0.0013, correlation coefficient= -0.202). ANOVA test was applied to compare age with Barthel index at day 3 (p - value = 0.0005) and day 5 (p - value < 0.0001) which was statistically significant. Advanced age was not associated with longer Length of Stay (LOS) (p - value = 0.32). CPS was also not associated with longer LOS (p - value = 0.821). CONCLUSIONS CPS is an easy to measure tool for the evaluation of elderly surgical patients. CPS can be used to predict recovery in terms of activities of daily living (ADL) after surgery thereby preparing patient and family to cope up with stress of surgery and its financial and psychological outcomes. KEYWORDS Geriatric Anaesthesia, Comorbidity-Polypharmacy Score, Activities of Daily Living, Length of Stay, Barthel Index

scholarly journals A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia

2017 ◽  
Vol 5 (5) ◽  
pp. 1785 ◽  
Author(s):  
Santosh Kumar Dora ◽  
Lalmohan Nayak ◽  
Benudhar Pande ◽  
Atal Bihari Dandapat
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Medical College ◽  
Labour Room

Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication. 

scholarly journals A prospective observational study for the safety of Nd-YAG Laster posterior capsulotomy procedure in patients of Posterior Capsular Opacification (PCO) at the ophthalmology outpatient department of a tertiary care teaching hospital in western India

2021 ◽  
Vol 7 (3) ◽  
pp. 574-578
Author(s):  
Rajendra Choudhary ◽  
Nishant V Shah ◽  
Meet Mashru
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Posterior Capsular Opacification ◽  
P Value ◽  
Western India ◽  
Yag Laser ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

: Nd YAG laser is preferred method to manage thickened posterior capsule because it is an easy, non-invasive and an OPD basis procedure considering the comfort of the patients.: The present study was carried out with objectives to evaluate the safety profile of Nd-YAG Laser Capsulotomy mainly in terms of rise in intraocular pressure (IOP) and other intra as well as post-operative complications.This prospective observational study was carried out with prior Institutional Ethics Committee (IEC) approval and written informed consent from the participants at Ophthalmology Outpatients Department (OPD) of a tertiary care teaching hospital of western India, for the duration of two years from Oct’2015 to Sept’2017. A detailed ocular, systemic, family history was taken of all the enrolled patients with pre- and post-procedure evaluation of IOP by Goldman’s Applanation Tonometry, Slit lamp examination and Fundus examination by direct and indirect ophthalmoscopy. Capsulotomy was done using VISULAS YAG III laser of Zeiss company.The data was entered and tabulated in Microsoft Excel 2007 and analyzed. Data was analyzed by frequency distribution. The ‘p’ value was determined to finally evaluate and P &#60;0.05 was considered as statistically significant.Acute transient rise of IOP up to 5mmHg or more (P value &#60;0.001) was found in Nine cases which is highly significant compared with pre-procedural stage. Intraocular lens pitting was observed in Four cases. Cystoid macular edema was found in one case. Two patients developed mild iritis. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Due precautions should be taken in pre- and post-procedural stages including medications, thorough counselling, proper focusing and steady fixation of the patients to minimise the complication.

scholarly journals Is the age of diagnosis of esophageal adenocarcinoma getting younger? Analysis at a tertiary care center

2020 ◽  
Vol 33 (9) ◽  
Author(s):  
Alexandra Strauss ◽  
Eun Jeong Min ◽  
Qi Long ◽  
Peter Gabriel ◽  
Yu-Xiao Yang ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Care Center ◽  
Tertiary Care ◽  
Age Distribution ◽  
Cancer Center ◽  
P Value ◽  
Number Of Patients ◽  
Significant Difference ◽  
Age Of Diagnosis ◽  
Diagnosis Age

Summary There are emerging data that patients &lt;50 years are diagnosed with esophageal adenocarcinoma (EAC) more frequently, suggesting that the age threshold for screening should be revisited. This study aimed to determine the age distribution, outcomes, and clinical features of EAC over time. The pathology database at the Hospital of the University of Pennsylvania was reviewed from 1991 to 2018. The electronic health records and pathology were reviewed for age of diagnosis, pathology grade, race, and gender for a cohort of 630 patients with biopsy proven EAC. For the patients diagnosed from 2009 to 2018, the Penn Abramson Cancer Center Registry was reviewed for survival and TNM stage. Of the 630 patients, 10.3% (65 patients) were &lt;50 years old [median 43 years, range 16–49]. There was no increase in the number of patients &lt;50 years diagnosed with EAC (R = 0.133, P = 0.05). Characteristics of those &lt;50 years versus &gt;50 years showed no difference in tumor grade. Among the 179 eligible patients in the cancer registry, there was no significant difference in clinical or pathological stage for patients &lt;50 years (P value = 0.18). There was no association between diagnosis age and survival (P = 0.24). A substantial subset of patients with EAC is diagnosed at &lt;50 years. There was no increasing trend of EAC in younger cohorts from 1991 to 2018. We could not identify more advanced stage tumors in the younger cohort. There was no significant association between diagnosis age and survival.

scholarly journals Analysis of Scoring System to Identify High Risk Patients and their Outcome in Isolated Blunt Chest Trauma- A Prospective Observational Study

2021 ◽  
Author(s):  
Annrish Tan Baby ◽  
Anuraj Appukuttan ◽  
Harihara Jothi ◽  
Reema Sajan
Keyword(s):  
Observational Study ◽  
Scoring System ◽  
Blunt Chest Trauma ◽  
Prospective Observational Study ◽  
Chest Trauma ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Rib Fractures ◽  
Morbidity And Mortality ◽  
P Value

Introduction: Chest trauma is a major cause of mortality accounting for a substantial proportion of all trauma admissions and death. In India, the reported mortality range is between 4-60% and no current national guidelines exist to assist the management of this patient group unless patient has severe immediate life threatening injuries. A scoring system for identification of patients at higher risk for development of morbidity and mortality will allow early selection of vulnerable patients, choice of an appropriate treatment protocol and therapeutic interventions. Aim: This present study aims for the analysis of a scoring system to identify patients with isolated blunt chest trauma at higher risk for morbidity and mortality, in order to prioritise intervention and improve the outcome. Materials and Methods: This was a prospective observational study conducted at the departments of emergency medicine and general surgery of a tertiary care teaching hospital in South India over a period of 18 months. The study included 85 isolated blunt chest trauma patients. We utilised a Chest Trauma Score (CTS) composed of patient factors like age, smoking, lung disease and severity factors like rib fractures, parenchymal and pleural involvement, partial pressure of oxygen/ fraction of inspired oxygen (PaO2/FiO2) ratio. CTS were applied at the time of admission after detailed assessment of all injuries. Patient was followed-up at regular intervals upto 30 days. The CTS and outcome measurements were analysed using logistic regression analysis. Results: The area under Receiver Operating Characteristic curve (ROC) was found to be 0.979 (p-value <0.001). The CTS cut-off value was ≥11.5 with 89% sensitivity and 95% specificity. In patients with CTS ≥11.5, 98.3% had associated morbidity and complications whereas only 25.9% with CTS <11.5 had associated morbidity (p-value<0.001). Number of rib fractures, pulmonary contusion and PaO2/FiO2 ratio (odds ratio 10.632, 6.007, 12.859, respectively) were found to be significant independent predictors of morbidity and complications. Conclusion: In summary, CTS ≥11.5 has shown a significant association with poor outcome. Patients who sustained isolated blunt chest trauma and together with increasing scores, had increasing incidence of morbidity and complications. The scoring system used in this study proved that it makes a useful tool to predict the outcome in thoracic trauma.

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

scholarly journals Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Functional Health ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Post Stroke ◽  
Self Rated Health ◽  
Modifying Factors ◽  
Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

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