scholarly journals Role of lipid profile in early second trimester for prediction of pre-eclampsia

Author(s):  
Surbhi . ◽  
Bangali Majhi

Background: The aim of the study was to determine association of abnormal lipid profile in early second trimester (14 to 20 weeks) with development of pre-eclampsia.Methods: A prospective observational study included 260 women between 14-20 weeks of pregnancy attending a tertiary care Hospital in New Delhi. Serum lipid profile analysis was performed at the time of enrolment and cohort was followed up for occurrence of pre-eclampsia till 48 hours after delivery. Outcomes measured were difference in mean lipid levels in study (abnormal lipid profile) and control group (normal lipid profile) and accuracy of abnormal lipid profile to predict pre-eclampsia.Results: The incidence of pre-eclampsia in our study was 11.13%. The mean serum total cholesterol was significantly higher in pre-eclampsia group (199.74 mg/dl vs 171.7 mg/dl; p<0.05). The difference in mean triglyceride, HDL, VLDL and LDL levels between two groups was not significant. Total cholesterol has 44.83% sensitivity, 84.85% specificity, 27.08% PPV, 92.45% NPV with diagnostic accuracy of 80.38% in predicting pre-eclampsia (with 0.65% AUC with 95% confidence interval). While VLDL has maximum sensitivity of 68.97% while HDL has maximum specificity of 86.15% in predicting pre-eclampsia.Conclusions: Abnormal total cholesterol levels have diagnostic accuracy of 80.38% to predict pre-eclampsia and abnormal lipid profile in early second trimester is a simple, non-invasive and economical test for prediction of pre-eclampsia. 

2021 ◽  
Vol 8 (23) ◽  
pp. 1915-1921
Author(s):  
Supriya Sanke ◽  
Chitra Karuppiah ◽  
Hema Sundar Rao Dumpala ◽  
Sai Vishnu Vardhan Allu ◽  
Syamala Shanthi Kumari Bonela

BACKGROUND Hypertension is a silent killer, an asymptomatic chronic disorder if left untreated which results in major health problems. Goal of treatment is to decrease the morbidity and mortality associated with cardiovascular and cerebrovascular complications of hypertension when it is associated with dyslipidaemia. The renin angiotensin system plays an important role in the regulation of blood pressure and in the pathogenesis of hypertension. Telmisartan is an ARB (angiotensin receptor blocker) and Enalapril is an ACE inhibitor. The purpose of this study is to compare the efficacy of Telmisartan with Enalapril in patients of essential hypertension with dyslipidaemia, and to observe the effects of Telmisartan and Enalapril on blood lipid levels of these patients. METHODS This is a prospective, randomized, comparative and open label study conducted among 70 patients who were included in the study and were divided in to two groups. Group A - consisting of 35 patients receiving Telmisartan 40 mg, and Group B receiving Enalapril 5 mg orally once a day. Informed consent was obtained from all the patients. Follow up was done after 4, 8 and 12 weeks. Blood pressure was recorded at every visit and lipid profile was done at the time of enrolment and after 12 weeks of study period. RESULTS Baseline demographic attributes were comparable between both the groups including total cholesterol and low-density lipoprotein (LDL). The mean reduction in systolic and diastolic blood pressure (BP) after 12 weeks was highly significant (P value < 0.001) in both the groups but when mean reduction in SBP & DBP was compared, there was no significant difference (P > 0.05) between the drugs. Blood levels of total cholesterol, LDL, triglyceride had significantly reduced (P < 0.05) in Telmisartan group compared to Enalapril group after 12 weeks of follow up and mean high density lipoprotein (HDL) level significantly increased in Telmisartan group (P < 0.05) but no increment was seen in Enalapril group. CONCLUSIONS Telmisartan and Enalapril had comparable antihypertensive effect and significant reduction in blood pressure was seen after 12 weeks of therapy in both the groups. In addition, Telmisartan showed more beneficial effects on lipid profile when compared to Enalapril. KEYWORDS Hypertension, Dyslipidemia, Lipid Profile, Telmisartan, Enalapril


Author(s):  
Pundalik K. Sonawane ◽  
Deep M. Bhadra

Background: Umbilical cord around neck of the foetus is called the nuchal cord. The aims and objectives are to find out the incidence of nuchal cord around foetal neck at delivery, and to compare and evaluate intrapartum and postpartum maternal and foetal outcome in those with or without nuchal cord at delivery.Methods: It is a prospective cross-sectional study conducted at tertiary care hospital for period of 12 months. Of 1380 patients, 934 patients were enrolled in present study after meeting the inclusion and exclusion criteria of which 150 patients were included in study group who delivered with nuchal cord and 784 patients in control group who delivered without nuchal cord.Results: Present study showed 18.84% incidence of nuchal cord at delivery. Duration of labour was 6.51hrs in study group and 6.15hrs in control group and the difference was statistically significant. Rest of the intrapartum and postpartum events were statistically not significant. Mean length of cord was more in patients delivered with loop of cord around foetal neck as compared to another group and it is statistically significant.Conclusions: Nuchal cord is a common finding at the time of delivery. However, it is per-se not an indication of LSCS and it only increases the operative morbidity.


2018 ◽  
Vol 5 (4) ◽  
pp. 978
Author(s):  
Tumbanatham A. ◽  
Jayasingh K. ◽  
Varun Vijayan Vijayan

Background: Subclinical hypothyroidism (SH) is characterized by elevated levels of serum thyroid stimulating hormone in the presence of normal thyroxin levels. Subclinical hypothyroidism is often associated with elevated total cholesterol and other lipid profile parameters. This study was done to evaluate the lipid metabolism in subclinical hypothyroidism.Methods: This case control study was done to compare the lipid profile parameters between subclinical and overt hypothyroidism cases attending the outpatient facility of our tertiary care hospital of our medical college in Puducherry. Newly diagnosed cases of hypothyroidism were selected by convenient sampling. A total of 37 SH cases and 31 overt hypothyroidism cases were included. Blood samples were drawn to measure lipid profile. A 2D echocardiogram was done to evaluate cardiac function. Ultrasonogram was done to evaluate fatty liver.Results: The mean age of the participants in the subclinical hypothyroidism group was 34.2±12.2 years while in the clinical hypothyroidism group was 35.7±9.8 years. About 13.5% of the participants in subclinical hypothyroidism group and 12.9% of the participants in clinical hypothyroidism had fatty liver in ultrasound. A significant difference was observed in the mean values of total cholesterol, triglycerides and LDL levels between clinical and subclinical hypothyroidism.Conclusions: This study highlights the need for screening of subclinical hypothyroidism in order to prevent the incidences of cardiovascular complications and other diseases like metabolic syndrome.


2020 ◽  
Vol 11 (SPL2) ◽  
pp. 302-307
Author(s):  
Janani K ◽  
Muthuvel E ◽  
Sudha Vasudevan

Hypercholesterolemia is defined as high levels of cholesterol in the blood. Platelet indices include: Plateletcrit (PCT), Platelet Distribution Width (PDW) and Mean platelet volume (MPV). Hypercholesterolemia is associated with the increased risk of developing cardiovascular diseases like atherosclerosis which in turn results in platelet activation and thrombotic events. This study is aimed to evaluate the variations in platelet indices in adults with hypercholesterolemia which may be significant in indicating cardiovascular diseases. It is a retrospective case-control study which includes 50 patients with a total cholesterol level of more than 170mg/dl as the study group and 50 healthy controls with normal lipid profile parameters. Data were collected from the lipid profile register in the Biochemistry department of Saveetha Medical College for 3 months duration. The fasting blood samples were run in the machine ‘vitros 5600 dry chemistry’. The lipid profile values included in this study were Total cholesterol, HDL and TGL. The platelet indices were collected from the automated haematology analyzer 'Sysmex XN 1000' from the Pathology Department, Saveetha Medical College. The data collected were tabulated and analysed using SPSS software. Statistical tool used is the independent T-test. The mean value of the platelet parameters such as MPV, PCT and PDW in the study group was 10.397061, .3000, and 12.452 respectively and that of the control group was 9.907480, .2882, 11.174 respectively. On comparing the platelet parameters such as MPV, PCT and PDW between the study and the control group it was observed that there was a significant variation in MPV and PDW. In the independent sample test, the p-value of MPV, PCT and PDW were 0.21, 0.481 and 0.008, respectively. Thus MPV and PDW shows a significant variation between the study and the control group as it is higher in hypercholesterolemia patients (p-value is <0.05).


Author(s):  
Urmila Sunda ◽  
Priyanka Bhadana

Background: Postpartum haemorrhage (PPH) is most dreaded complication which occurs worldwide, more prevalent in developing countries after both vaginal and caesarean delivery. Prophylactic administration of a uterotonics immediately after delivery is the only procedure that has been proved to reduce rates of postpartum haemorrhage. Tranexamic acid, an antifibrinolytic is recommended by WHO for management of PPH, its role to reduce blood loss in caesarean section as a prophylactic agent is not well studied.Methods: This study was conducted in a tertiary care hospital at New Delhi total 100 pregnant women with age ≥18 and <35 years and singleton alive fetus who underwent caesarean section were included for this study.  Study population was divided in two group. Women assigned to the study group received 1 gm tranexamic acid slowly intravenously over 10 minutes after delivery of the baby as per existing unit protocol. Those women who received tranexamic acid was compared with other group who did not received tranexamic acid. The primary outcomes were mean blood loss (ml) and mean fall in hemoglobin level within 48 hours after surgery.Results: Amount of blood loss was significantly low (mean 369 ml) in tranexamic acid group as compared to control group (488 ml), the difference was statistically significant (p value 0.001).  Mean fall in haemoglobin level was also low (1.17 mg/dl) in group who received tranexamic acid as compared to control group (1.87 mg/dl), the difference was statistically significant (p value 0.001). Postpartum hemorrhage (blood loss more than 1000 ml) was observed in 1 patient in control group and no case of PPH was observed in study group.Conclusions: Tranexamic acid administration prior to caesarean section was effective in reducing the blood loss intra and postoperative period, without any immediate maternal and neonatal adverse events as well as reduces the need of blood transfusion.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ya-ping Xu ◽  
Pei-yu Zhao ◽  
Yi-tong Bai ◽  
Shuang Li

Abstract Background The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.


2014 ◽  
Vol 35 (4) ◽  
pp. 434-436 ◽  
Author(s):  
Larissa M. Pisney ◽  
M. A. Barron ◽  
E. Kassner ◽  
D. Havens ◽  
N. E. Madinger

We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-β-lactamase–producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.


2021 ◽  
pp. 14-16
Author(s):  
Asha Premlata Omega Oraon ◽  
Bela Rose Ekka

OBJECTIVE: To estimate the value of Alkaline Phosphatase in cancer breast patients in a tertiary care hospital. MATERIAL AND METHODS: The study was conducted to estimate the value of Serum Alkaline Phosphatase in 50 cancer breast patients and 50 normal patients of same age as a control group. RESULTS: The level of serum Alkaline Phosphatase was signicantly increased (p<0.05)in cancer patients compared to the control group. CONCLUSION: There is an increase in serum Alkaline Phosphatase in cancer patients compared to the control group and can be a prognostic markers for the progress of the disease.


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