scholarly journals A case series of uterine rupture: a continuing cause of maternal and fetal morbidity!

2017 ◽  
Vol 4 (7) ◽  
pp. 2247
Author(s):  
Vinu Choudhary ◽  
Surendra Bisu

Background: Uterine rupture is defined as a full-thickness separation of the uterine wall and the overlying serosa. It is a rare peripartum complication associated with severe maternal and neonatal morbidity and mortality. The objective of this study was to review the incidence of ruptured uterus and evaluate associated risk factors, maternal and fetal complications.Methods: 14 case notes were reviewed for every patient with a ruptured uterus for a period of 4 years, from January 2012 to December 2015.Results: 79% patients had uterine rupture while in labour. Three patients were not in labour (two had a spontaneous rupture at 28/40 and 33/40 weeks respectively and for one patient it was found during an elective C/S). Two out of five patients with 2 previous C/S ruptured at 28 and 33 weeks respectively. Two or more C/S were associated with increased risk of pre- labour rupture uterus as highlighted by the three cases.Conclusions: Challenging diagnosis and cases of pre- labour rupture may necessitate pre- pregnancy counselling and antenatal LUS thickness USS in certain cases.

2021 ◽  
Vol 14 (12) ◽  
pp. e244801
Author(s):  
Isabela dos Anjos Siqueira ◽  
Sita Murugappan ◽  
Paul Howat ◽  
Arzoo Khalid

Uterine rupture can be associated with severe maternal and neonatal morbidity and mortality. It should be considered as a differential diagnosis in all pregnant women who present with acute abdomen, haemoperitoneum and have specific risk factors, even during the first trimester. This is a case report of a 25-year-old woman who presented to emergency department with abdominal pain and vaginal bleeding at approximately 6–8 weeks gestation. She developed an acute surgical abdomen and required urgent surgical management. Despite intervention, she had massive haemorrhage, disseminate intravascular coagulation, admission to intensive care unit and prolonged hospital stay as complications. Posterior uterine wall rupture while rare, must be considered as a differential diagnosis as early intervention is crucial to prevent bad outcomes.


Author(s):  
Ramin Sami ◽  
Nafiseh Sereshti

Severe acute respiratory syndrome coronavirus 2 can cause pulmonary complications, such as increased risk of barotrauma (BT), but its prevalence and risk factors are not known. In this case series, the course of BT and its related risk factors were discussed in patients with COVID-19 who were admitted to the intensive care unit. Medical records of the patients with COVID-19 and BT and hospitalized in the intensive care unit for 5 months were extracted. The course of BT and its possible associated risk factors are descriptively presented. Among 103 patients with COVID-19 who were intubated, 13 patients (12.6%) had BT. One patient developed BT before intubation. All patients with BT were male. Half of them developed BT in the first 5 days of intubation. Eight patients (61.53%) had a positive culture for Klebsiella pneumoniae. Nine patients (69.9%) died. High positive end-expiratory pressure, coinfection with bacterial pneumonia, and history of lung disease may affect BT incidence. The treatment team should increase their upervision on the ventilator setting, especially in the first week of intubation.


2021 ◽  
Vol 15 (1) ◽  
pp. 1-8
Author(s):  
Nwankwo B ◽  
◽  
Mumueh KP ◽  
Olorukooba AA ◽  
Usman NO

Background: Computers and other visual display devices have become essential in the present era and have led to a rise in computer-related health problems. Using computers in homes, universities and other institutions has increased output greatly but has also led to an increased risk of developing Computer vision syndrome (CVS). Objectives: To determine the prevalence and risk factors associated with computer vision syndrome among undergraduates. Methodology: A cross-sectional study was conducted among153 respondents who were selected using a multi-stage sampling technique. A pretested, structured, interviewer-administered questionnaire was used to collect data. SPSS version 23 was used to analyze the data. A Chi-square test was used to determine the relationship between CVS and associated risk factors at a P-value of <0.05. Results: The mean age of respondents was 22.4 ± 3.4 years. The prevalence of CVS in this study was 83 (54.3%). The common symptoms experienced among the respondents were headache (51, 61.4%), eye strain (48, 57.8%) and blurred vision (42, 50.6%). The risk factors significantly associated with CVS in this study were duration of computer use, hours of computer use per day, level of a computer screen and taking breaks during computer use. Conclusion: About half of the students in this study had at least one symptom of CVS. Therefore, awareness of CVS should be created by the institution during which students would be educated on CVS and its prevention.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Marina Njelekela ◽  
Alfa Muhihi ◽  
Akum Aveika ◽  
Donna Spiegelman ◽  
Claudia Hawkins ◽  
...  

Background. Elevated blood pressure has been reported among treatment naïve HIV-infected patients. We investigated prevalence of hypertension and its associated risk factors in a HAART naïve HIV-infected population in Dar es Salaam, Tanzania.Methods. A cross-sectional analysis was conducted among HAART naïve HIV-infected patients. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Overweight and obesity were defined as body mass index (BMI) between 25.0–29.9 kg/m2and ≥30 kg/m2, respectively. We used relative risks to examine factors associated with hypertension.Results. Prevalence of hypertension was found to be 12.5%. After adjusting for possible confounders, risk of hypertension was 10% more in male than female patients. Patients aged ≥50 years had more than 2-fold increased risk for hypertension compared to 30–39-years-old patients. Overweight and obesity were associated with 51% and 94% increased risk for hypertension compared to normal weight patients. Low CD4+ T-cell count, advanced WHO clinical disease stage, and history of TB were associated with 10%, 42%, and 14% decreased risk for hypertension.Conclusions. Older age, male gender, and overweight/obesity were associated with hypertension. Immune suppression and history of TB were associated with lower risk for hypertension. HIV treatment programs should screen and manage hypertension even in HAART naïve individuals.


Author(s):  
Kelly Hsieh ◽  
Haleigh M. Scott ◽  
Sumithra Murthy

Abstract A better understanding of the factors associated with depression and anxiety in people with intellectual and developmental disabilities (IDD) is needed to provide guidelines for service providers, clinicians, and researchers as well as to improve the diagnostic process. The current study used a longitudinal dataset to explore demographic, health, and psychosocial risk factors of anxiety and depression in adults with IDD. Women were more likely to have depression while older adults, people with autism, and people with hearing impairments, were more likely to have anxiety. Chronic health conditions were associated with both anxiety and depression, while changes in stressful life events were associated with an increased risk of anxiety. Clinical and research contributions are discussed.


2012 ◽  
Vol 146 (6) ◽  
pp. 1012-1016 ◽  
Author(s):  
Alla Solyar ◽  
Annie S. Lee ◽  
Barbara Przybyszewski ◽  
Donald C. Lanza

Objectives. Atypical mycobacterium (AM) involvement in refractory chronic rhinosinusitis (CRS) is sought by some surgeons with customary acid-fast bacilli cultures (AFBC) in the operating room (OR). We evaluate our experience with AM in CRS by describing (1) associated risk factors, (2) species identified, and (3) frequency of positive cultures in clinic versus OR. Study Design. Case series with chart review. Setting. Tertiary rhinology practice. Subjects and Methods. AFBC taken between 2005 and 2011 were identified from a microbiology laboratory database. Charts were reviewed for gender, age, medical history, risk factors for AM, pathogen types, and treatments, with statistical comparison using Pearson χ2. The benefit of “targeted AFBC” for cases with high clinical suspicion was compared with “customary AFBC” in the OR. Results. Thirty-seven patients were identified with AM, of which 10 had one or more risk factors for AM including foreign body (n = 4), non-HIV immune dysfunction (n = 4), and previous chemoradiation (n = 4). Six different AM species were identified: most frequently Mycobacterium abscessus (57.1%), followed by Mycobacterium avium-intracellulare complex (14.3%) and Mycobacterium chelonae (14.3%). “Targeted AFBC” from the outpatient setting were positive in 10 of 190 (5.3%) patients, whereas 10 of 373 (2.6%) patients of “customary AFBC” in the OR were positive ( P = .12). Macrolide therapy was employed in 23 of 37 (62%) patients with AM-associated CRS but was not prescribed in patients with positive “customary AFBC” alone. Conclusion. AM-associated CRS is an uncommon condition that can occur in the absence of foreign body or overtly altered innate/adaptive immunity. Indications and efficacy of macrolide therapy, as well as the potential relationships between existence of AM in tap water, AM biofilms, and frequent use of nasal irrigations warrant further investigation in refractory CRS.


2018 ◽  
Vol 52 (6) ◽  
pp. 571-579 ◽  
Author(s):  
Sean M. McConachie ◽  
Sheila M. Wilhelm ◽  
Ashish Bhargava ◽  
Pramodini B. Kale-Pradhan

Objective: To review the mechanism and association of infectious risk among the tumor-necrosis factor α (TNF-α) antagonists used in inflammatory bowel disease. Data Sources: A PubMed literature search was performed using the following search terms: infliximab, adalimumab, certolizumab, golimumab, inflammatory bowel disease, crohn’s, ulcerative colitis, adverse effects, adverse events, safety, and infection. Study Selection and Data Extraction: Meta-analyses and cohort studies with outcomes pertaining to quantitative infectious risk were reviewed. Case reports and case series describing association between TNF-α inhibitors and infection were also reviewed. Data Synthesis: A total of 7 recent meta-analyses of randomized trials demonstrate inconclusive association of infection with TNF-α antagonists. Registry data suggest that medications carry an independent risk of opportunistic infections. Risk factors for infection include older age, malnutrition, diabetes, and possibly combination therapy. Reported infections vary widely but include intracellular and granulomatous bacteria, viruses, and fungi. Conclusion: TNF-α antagonists are associated with an increased risk of opportunistic infection, although this risk has not been demonstrated conclusively in randomized controlled trials. Knowledge of concomitant risk factors, mechanism of infectious risk, and available treatment options can improve patient care in the clinical setting.


Animals ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 1053
Author(s):  
Julia Nitz ◽  
Volker Krömker ◽  
Doris Klocke ◽  
Nicole Wente ◽  
Yanchao Zhang ◽  
...  

To reduce the negative effects of mastitis in dairy heifers in early lactation on the future milking performance, the aim of this study was to define the time-related period of intramammary infections and to relate this to risk factors at heifer and quarter level for intramammary infections and subclinical mastitis. In total, 279 German Holstein Frisian heifers in three farms in Northern and Eastern Germany were included in this study. Quarter milk samples for cytomicrobiological examination were collected 3 ± 1 days after calving and 17 ± 3 days after calving, and risk factors at heifer and quarter level associated with intramammary infections and clinical mastitis were recorded during the trial period. Data were analyzed using logistic regression procedures and odds ratios were calculated. Calving at older ages increased the odds of intramammary infections with non-aureus staphylococci (NAS) and coryneforms 17 ± 3 days after calving compared to heifers calving at a younger age. Detaching of milking cups during milking is a risk factor for new infections between day 3 ± 1 and 17 ± 3 postpartum. The milk yield after calving is associated with a decrease in intramammary infections with environmental pathogens and clinical mastitis. A high milk yield assists the development of udder edema with an increased risk of intramammary infections with NAS and coryneforms. An increased somatic cell count (SCC) after calving increased the odds of intramammary infections with contagious pathogens 17 ± 3 days postpartum. The early lactation has an important influence on udder health and intramammary infections postpartum in dairy heifers. Udder quarters eliminated pathogens during early lactation by 6.9% for cases in this study. New infections manifest themselves up until 17 ± 3 days postpartum, especially with Corynebacterium spp. and NAS. In total, 82.9% of the infected quarters showed new infections with another pathogen species 17 ± 3 days postpartum than 3 ± 1 days postpartum. In conclusion, the early lactation has an important influence on udder health and intramammary infections postpartum in heifers with the possibility that udder quarters eliminate pathogens, but also the danger that new infections manifest themselves. Thus, the prevention of new infections by minimizing the associated risk factors is of great importance.


Author(s):  
Mehdi Noroozi ◽  
Peter Higgs ◽  
Azadeh Bayani ◽  
Bahram Armoon ◽  
Ali Nazeri Astaneh ◽  
...  

Abstract Background With increasing frequencies of non-fatal overdose in people who inject drugs (PWID), it is essential to improve our knowledge about associated risk factors for overdose to inform overdose prevention and assistance programs. The aim of present study was to determine the prevalence of non-fatal overdose and the associated risk factors among PWID in Tehran, Iran. Methods Snowball sampling was used to collect data from 465 participants in Tehran using a cross-sectional survey. Consenting participants who reported drug injecting in the past month and were able to speak and comprehend Farsi enough to respond to survey questions were interviewed. The endpoint of interest was non-fatal overdose in the previous 6 months, or answering “Yes” to the question: “In the last six months, have you ever overdosed by accident? (at least once)”. We used STATA v. 14 for this analysis. Statistical significance was defined as p < 0.05 for all analyses. Results Of 465 PWIDs who participated in this study, all were male, and about half had less than a high school education. The prevalence of self-reported non-fatal overdose in the past 6 months was 38% (CI95%: 34, 43%). Our findings indicate that characteristics and behaviors that were associated with an increased risk of experiencing an overdose in the past 6 months were drug use initiation under 22 years (AOR =2.2, P < 0.05), using methamphetamine (AOR =2.8, P < 0.05), and using multiple drugs at the same time (AOR =2.1, P < 0.05). Also, more recent initiates to injecting (< 2 years) had an increased risk of experiencing an overdose in the past 6 months. The odds of experiencing a non-fatal overdose among PWIDs who regularly attended NSP were 0.6 times less than for those who did not attend regularly (OR = 0.6,95% CI: 0.2–0.9). Conclusion Methamphetamine and alcohol use were the most significant association for non-fatal overdose among PWIDs. Our results indicate that intervention and prevention initiatives seeking to reduce overdoses among PWIDs should not only be focused on the primary drug used but also the use of alcohol and poly-drug use.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sigrun Henjum ◽  
Victoria Telle Hjellset ◽  
Marte Karoline Raberg Kjollesdal ◽  
Merethe Flaaten ◽  
Eivind Andersen ◽  
...  

Abstract Objectives Economic development, globalization and urbanization has resulted in a shift in dietary consumption and energy expenditure in low- and middle-income countries, called the Nutrition Transition. At the same time, the prevalence of type 2 diabetes (T2D) and associated co-morbidities are rising worldwide. The Saharawi refugees have been living in refugee camps in the Algerian desert since 1975 and are totally dependent on food aid. High prevalence of overweight and obesity has been reported among Saharawi women. Limited knowledge about the prevalence of T2D and associated risk factors exists in this population; therefore, the aim with this study was to address this gap in the literature. Methods A cross-sectional survey was carried out in five Saharawi refugee camps, in Algeria and 180 women and 175 men were randomly selected. Participants’ blood glucose levels was assessed by HbA1c measurements and diagnosed with diabetes if HbA1c ≥48 mmol/mol and prediabetes if HbA1c was between 42–47 mmol/mol. The Finnish Diabetes Risk Score (FINDRISK) was used to assess various risk factors for T2D. Results Mean HbA1c among the Saharawi refugees was 38 mmol/mol. Seven and 15% were diagnosed with T2D and prediabetes, respectively, and 26% and 19% were overweight and obese, respectively. According to FINDRISK, 9% of the participants had high risk of developing diabetes, 10% had moderate risk, 37% had some risk and 44% had low risk. In multiple logistic regression models, after controlling for age, gender, number of children, BMI and education, the strongest predictor for diabetes was waist circumference, OR (95% CI): 1.1 (1.0, 1.1). The strongest predictor for prediabetes was age and waist circumference OR (95% CI): 1.0 (1.0, 1.1) and OR (95% CI): 1.1 (1.0, 1.1), respectively. Conclusions We found moderate prevalence of diabetes among the Saharawi refugees; however a high proportion had prediabetes and were suffering from overweight and obesity. In light of this, the rates of T2D are likely to increase dramatically in the near future. The Saharawi health authorities should pay attention to the increased risk of diabetes in this in this vulnerable population. Funding Sources Oslo Metropolitan University.


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