Utility of transport risk index of physiological stability score for predicting likely outcome of extramural neonates transferred to NICU

2020 ◽  
Vol 7 (5) ◽  
pp. 1081
Author(s):  
Deepali M. Shah ◽  
Bhuvaneswari M. ◽  
Ramaprasad G. S.
Keyword(s):  
Neonatal Mortality ◽  
Risk Index ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Early Neonatal Mortality ◽  
Significant Difference

Background: To accomplish ‘Mission Twenty - Twenty’ and to achieve ‘Sustainable Development Goal 3’, now we need to focus our attention more towards neonates being transported to higher centre in this very fragile period. We planned this study to assess demographic, transport and clinical characteristics of referred neonates and to determine whether TRIPS score serves as predictor of early neonatal mortality i.e. mortality within the first seven days after admission in these babies.Methods: This cross sectional descriptive study with analytic components was carried out in a tertiary care teaching hospital. All neonates ≥1 kg, born outside of this hospital, and referred here during study period for further management were included. All the data pertaining to clinical, demographic and transport characteristics were recorded. TRIPS score was applied at admission and was related with the final outcome within first seven days of admission; expired or survived. The association between the outcome and TRIPS score was tested using chi square test or fisher’s exact test. ROC curve analysis was done to find out optimum TRIPS score to predict mortality.Results: Neonatal mortality within first 7 days after admission is related to the TRIPS rating. The score of the survivors and neonatal deaths show a significant difference which is also even reflected by its individual components (p< 0.001). For a score of >18.5, a sensitivity of 89.47% and a specificity of 91.47%; area under the curve of 0.954 was determined.Conclusions: TRIPS score is a valid predictor of early neonatal mortality. The components of TRIPS score also correlate with early neonatal death. It is important to establish measures to improve physiological stability of the newborn before, during and after the transfer in order to reduce neonatal mortality.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

The influence of varying maxillary central incisor vertical dimension on perceived smile aesthetics

2019 ◽  
Vol 46 (2) ◽  
pp. 137-142
Author(s):  
Elis Janaina Lira dos Santos ◽  
Alana Moura Xavier Dantas ◽  
Raíssa Marçal Vilela ◽  
Karina Jerônimo Rodrigues Santiago de Lima ◽  
Rejane Targino Soares Beltrão
Keyword(s):  
Age Groups ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Central Incisor ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Maxillary Central Incisor ◽  
Significant Difference ◽  
Chi Square Test

Objective: To evaluate patient perception of the smile focused on analysis of the upper incisors. Design: Cross-sectional study. Setting: Department of Clinical and Social Dentistry at Federal University of Paraíba, João Pessoa, Brazil. Participants: The sample consisted of 135 individuals (73 women and 62 men). Methods: Images with different characteristics associated with the incisal edges were shown at random and analysed using a Likert scale. Data were analysed using the Chi-square test or Fisher’s exact test with a statistically significant difference ( P < 0.05). Results: Smile I (difference of 1.5 mm in relation to the central incisor and lateral) was considered the most aesthetic, while Smile III (no difference in height between the central and lateral incisors) was the least aesthetic. A significant difference was found between perception of smile II (difference of 1 mm in relation to the central incisor and lateral) and age groups ( P < 0.005), with 31% (n = 13) of individuals aged 45–64 years considering smile II as not pleasant, 4.4% (n = 2) aged 15–24 years and 8.3% (n=4) aged 25–44 years and 4.4% (n = 2) aged 15–24 years considering the same. A significant difference was also found in relation to educational background of the assessor and smile perception, with smile III ( P = 0.0441) and smile IV ( P = 0.0053) considered the most aesthetic ( P = 0.0116). Conclusion: The smile considered most attractive among the sample was that with 1.5 mm steepness between the central and lateral incisors, while a flat smile arc was considered least attractive.

scholarly journals Oral-dental hygiene and oral microorganisms in children with and without congenital heart disease

2016 ◽  
Vol 45 (3) ◽  
pp. 127
Author(s):  
Erniwaty P Panggabean ◽  
Lily Irsa ◽  
Rosihan Anwar ◽  
Munar Lubis ◽  
Rusdidjas Rusdidjas ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Congenital Heart ◽  
Dental Hygiene ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Decayed Tooth ◽  
Significant Difference ◽  
Oral Microorganisms

Objective This study was done to compare the dental and oralhygiene status of children with and without congenital heart dis-ease (CHD) by investigating oral microorganisms and dental andoral hygiene indices.Methods A cross-sectional study was done on children aged 2 to15 years from April 2002 to December 2003 at the Department ofChild Health, Haji Adam Malik Hospital, Medan. There were twosubject groups, the first consisting of children with CHD and thesecond of those without. The dental and oral hygiene status wasdetermined by determining caries index and oral hygiene index.Swabs from the subjects’ upper first molars were taken and cul-tured to determine the types of microorganisms present. Data wereanalyzed using the chi-square test, Fisher’s exact test, and t-test.Results There was a significant difference in mean oral hygieneindex between children with (mean 2.75; SD 1.85) and without(mean 1.45; SD 0.78) CHD (P<0.001). Positive bacterial cultureswere more frequent in children with CHD than in those without.The proportion of normal anaerobes was significantly higher in chil-dren with CHD (P=0.038). Such a significant difference was notfound for normal aerobes, pathogenic aerobes, and pathogenicanaerobes. In children with CHD, there was no significant asso-ciation between mean caries index and oral hygiene index withculture results. In those without CHD, a significant association wasfound between the caries index components of decayed tooth in-dex (P=0.003) and DMF-T (P=0.022) with culture results.Conclusions Oral-dental hygiene in children with CHD is poorrelative to that in children without CHD. Microorganism growth ap-pears more likely in children with CHD than in those without

scholarly journals Adherence to antiretrovirals in people coinfected with the human immunodeficiency virus and tuberculosis

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Larissa de Araújo Lemos ◽  
Maria Luciana Teles Fiuza ◽  
Renata Karina Reis ◽  
André Carvalho Ferrer ◽  
Elucir Gir ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Low Income ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Number Of Children ◽  
Significant Difference ◽  
Adherence Assessment

Objective: assess the adherence levels to antiretroviral therapy in people coinfected with HIV/tuberculosis and correlate these levels with the sociodemographic and clinical variables of the study population. Method: cross-sectional study involving 74 male and female adults coinfected with HIV/tuberculosis. For the data collection, a sociodemographic and clinical assessment form and the Antiretroviral Treatment Adherence Assessment Questionnaire were used. For the data analysis, the software STATA version 11 was used, through descriptive statistics, Fisher's chi-square exact test and the probability test. Results: men were predominant (79.7%), between 30 and 39 years of age (35.1%), low income (75.7%) and pulmonary tuberculosis (71.6%). Adherence to antiretroviral therapy was inappropriate in 78.1% of the men; 61.0% of single people; 47.0% unemployed and 76.5% among people gaining less than one minimum wage. A significant difference was observed between compliance and length of use of antiretrovirals (p=0.018), sexual orientation (p=0.024) and number of children (p=0.029). Conclusion: the coinfected patients presented inappropriate adherence to the antiretrovirals, a fact that negatively affects the health conditions of the people living with HIV/tuberculosis coinfection. A statistically significant correlation was found between the levels of adherence and some sociodemographic and clinical characteristics.

scholarly journals Study of Delirium on Psychiatric Referrals at Helping Hands Community Hospital, Kathmandu, Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 19-26
Author(s):  
Praveen Bhattarai ◽  
Devavrat Joshi
Keyword(s):  
Risk Factors ◽  
Alcohol Intoxication ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Liaison Psychiatry ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Associated Risk Factors

Background and Objectives: Delirium is one of the most important neuro-psychiatric disorders in Consultation liaison psychiatry. There is a dearth of studies in this subject in Nepalese context. The objective of this study was to find out the demographic profile, source of referral, reason for referral and possible risk factors for delirium and association between risk factors and subtypes of delirium.Material and Methods: This is a descriptive cross-sectional study carried out in a tertiary care center over a period of six months. Delirium was diagnosed by psychiatrist based on International Classification of Disease, 10th revision, Diagnostic Criteria for Research (ICD-10 DCR) and was classified into subtypes using the Liptzin and Levkoff criteria. Data analysis was done using SPSS version 16 and chi- square test was applied to find the association between risk factors and subtypes of delirium.Results: A total of 52 cases of delirium were included in the study. Majority of cases were aged 65 years and above with male preponderance. The most common cause for referral was disturbed behavior and disorientation. Hyperactive delirium was the most common subtype of delirium. Most of the referred cases of delirium were from Medical ward and Intensive Care Unit/Critical Care Unit (ICU/CCU). Infection / Inflammation, Drug/alcohol intoxication or withdrawal and those with multiple etiologies were the most common possible causes of delirium. There was no significant difference in terms of associated risk factors between the clinical subtype (p = 0.8023).Conclusion: The presence of delirium warrants prompt intervention to identify and treat the underlying causes and consultation liaison psychiatric services should be enhanced to achieve this goal.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 19-26

scholarly journals Study of perinatal outcome of labour complicated with meconium stained liquor

2018 ◽  
Vol 7 (9) ◽  
pp. 3582
Author(s):  
Asmita N. Patil ◽  
Misbah M. Inamdar ◽  
Jaynarayan B. Senapati
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Demographic Data ◽  
Tertiary Care ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference

Background: Meconium stained amniotic fluid occurs in 9 to 20% of deliveries. It has long been implicated as a factor influencing foetal wellbeing during the intrapartum and postpartum period. Many authors have suggested that the type and the time of passage of meconium are most significant factors affecting foetal outcome. This study was carried out to find out the effect of meconium stained liquor during labour and its perinatal outcome.Methods: This prospective cross sectional and comparative study was carried out in a tertiary care hospital over a period of 1 year. The study group comprised of 118 women having MSAF during labour and the comparative group of 118 women with clear amniotic fluid which were randomly selected. The demographic data, obstetrical history, intrapartum findings and Apgar score were documented on predesigned proforma. Data collected was analysed using student t-test, chi square test, Z test for comparison of proportions and coefficient of variation for comparison of consistency of distributions.Results: Out of 1192 cases studied 118 cases showed presence of meconium stained liquor (9.89%). Caesarean section was performed in 41.52% cases with meconium stained liquor versus 31.35% in clear liquor group. Apgar score at 1 minute was significantly lower in meconium stained liquor (p<0.01). In meconium stained liquor group 42.37% foetuses had normal, 36.44% had suspicious and 21.18% had abnormal heart rate patterns respectively. There was no significant difference in the number of cases requiring NICU admission in meconium stained liquor (14.4%) and clear liquor groups (9.3%) (Z=1.214, P>0.05).Conclusions: Meconium staining is a commonly observed phenomenon. labour complicated with thick meconium stained liquor should ideally be categorised in to high risk obstetrics and managed in tertiary care with consultant obstetrician, consultant neonatologist and NICU in order to improve the perinatal outcome.

scholarly journals Correlation of Cord Lactate with Cord pH as a Morbidity Predictor in Term Neonates Delivered with Non-Reassuring Fetal Heart Status

2020 ◽  
Vol 8 (3) ◽  
pp. 17-22
Author(s):  
Aluru Ananya ◽  
Kanta Kumari PML ◽  
B Vijayalakshmi ◽  
R Chandrasekhar ◽  
Naga Saritha Kolli
Keyword(s):  
Fetal Heart ◽  
Perinatal Asphyxia ◽  
Multiple Logistic Regression Analysis ◽  
Colorimetric Method ◽  
Area Under The Curve ◽  
Birth Asphyxia ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Term Neonates ◽  
Significant Difference

Background: Perinatal asphyxia is accounting to 20% of neonatal mortalityin India. Cord lactate can be an alternative that is more readily available than cord pH and may help in early identification of birth asphyxia in resource limited settings. The aim of the current study is to correlate cord lactate levels with cord pH in term neonates with non-reassuring fetal heart status and thereby its use as a surrogate for cord    pH. Subjects & Methods: Study design: Cross-sectional study. Setting: Neonatology unit at NRI general hospital, Chinakakani from August 2018 to July 2019. Study participants: All singleton term neonates delivered by assisted vaginal delivery or emergency caesarean section due to non-reassuring fetal heart status. Umbilical cord blood gas and lactate was obtained. Lactate was analysed by colorimetric method. Results: A total of 74 neonates were included. An analysis of cord pH & lactate, using correlation coefficient showed statistically significant p-values. Cord lactate was found to be statistically significant predictor for admission to NICU, post resuscitation care, invasive/noninvasive ventilation, and therapeutic hypothermia on multiple logistic regression analysis. Cord Lactate was found to have an Area under the curve (AUC) of 0.88 with no significant difference to cord pH on ROC curve analysis. Conclusion: Cord Lactate can be used as an objective test in predicting the neonates requiring NICU admission for morbidities related to fetal hypoxia similar to that of cord pH in term neonates.

scholarly journals BREASTFEEDING TEMPORAL DISTRIBUTION TRENDS AMONG NEONATES IN TERTIARY CARE HOSPITAL IN LAHORE

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Hamid Mehmood ◽  
Zarmast Khan ◽  
Abdul Rauf ◽  
Ammara Waqar
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Temporal Distribution ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference ◽  
Initiation Of Breastfeeding

ABSTRACT  BACKGROUND & OBJECTIVE: Breastfeeding provides immunity against bacterial, viral, and other infectious diseases. More than four million new neonates die due to vaccine-related diseases in the first 28 days of their lives. It is therefore emphasized that breastfeeding in the first hours after delivery may save the neonate. The objective of this study was to determine the factors affecting the pattern of breastfeeding among the neonates and assess the frequency of early breastfeeding among neonates at Gulab Devi Hospital, Lahore. METHODOLOGY: It was a cross-sectional descriptive study. One hundred mothers were selected through convenient purposes sampling. Chi-square test applied for an association between mode of delivery and initiation of breastfeeding. RESULTS: The result of the study showed variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery. Pre-lacteal was given to 59 mothers, while 41 were not given with any pre-lacteal. A significant association was found between mode of delivery and initiation of breastfeeding with a p-value less than 0.001 CONCLUSION: The result of the study showed that variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery provided a significant difference in the production of the neonate in the first 28 days.

scholarly journals THE ASSOCIATION BETWEEN THE USE OF ALCOHOL, MARIJUANA AND COCAINE AND THE SOCIODEMOGRAPHIC CHARACTERISTICS OF UNIVERSITY STUDENTS OF RIBEIRÃO PRETO, BRAZIL

2019 ◽  
Vol 28 (spe) ◽  
Author(s):  
Ana Carolina Guidorizzi Zanetti ◽  
Francisco Cumsille ◽  
Robert Mann
Keyword(s):  
University Students ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Psychoactive Substances ◽  
Chi Square ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Exact Test ◽  
Significant Difference ◽  
Chi Square Test

ABSTRACT Objective: to determine the prevalence of use in life and in the last three months of alcohol, marijuana and cocaine among university students from the social and health Sciences areas of Ribeirão Preto, Brazil and to evaluate the association between use in life and in the last three months of alcohol, marijuana and cocaine and the variables gender, area of the course, with whom the student lives, importance of religion, age and year of study. Method: a cross-sectional study, carried out with a convenience sample of 275 students from a public university in Ribeirão Preto-SP. For data collection, two instruments were used, containing sociodemographic, training and psychoactive substances. For the analysis, the following tests were used: Fisher's exact test, Chi-square test of Person and Mann-Whitney test. Results: As for sociodemographic factors, there was a significant association between the gender of the participants among the use of marijuana and cocaine in life (p=0.024 and p=0.005, respectively) and the last three months (p=0.013 and p=0.009, respectively), among the importance of religion and the lifetime use of alcohol, marijuana and cocaine (p <0.001, p <0.001 and p = 0.024, respectively) and the use of only marijuana in the last three months (p <0.001) and among the use of marijuana in the last three months and the year of graduation (p=0.003). Regarding age, the results showed a significant difference only between the groups that reported not to use alcohol in life (p=0.037). Conclusion: the investigated university students presented a prevalence of use in their lifetime and in the last three months of marijuana and cocaine greater among men, but not for alcohol. The importance of religion was negatively associated with the use of investigated drugs. The results can provide important subsidies for the structuring of preventive measures for abuse of psychoactive substances between university students and the need for new investigations that cover the subject.

scholarly journals The Method and Results of a Treatment Targeting SARS-CoV-2-Activated Inflammasomes

2021 ◽  
Author(s):  
Badar Kanwar ◽  
Asif Khattak ◽  
Chul Joong Lee ◽  
Jenny Balentine ◽  
R. E. Kast ◽  
...  
Keyword(s):  
Case Series ◽  
Cross Sectional Study ◽  
Control Group ◽  
P Value ◽  
Test Statistic ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Pyrin Domain ◽  
Significant Difference

Abstract Background Clinicians in critical care medicine considered dapsone administration to treat SARS-CoV-2 inflammasome. Dapsone is useful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3). Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by dapsone must be responsible for its observed preventive effects, functioning as a competitor. Methods This is case series with or without intervention; a cross-sectional study. We set out to use objective criteria of improvement, such as A. a reduction in the FIO2 requirement and B. a decrease in the progression of hypoxia. We treated the patients with standard COVID-19 ARDS treatment with dapsone 100 mg to target NLRP3 inflammasomes. Results The 22 cases were treated with standard COVID-19 therapy with dapsone (trial group), and the 22 cases were the control group. The comparison was made assuming that only decreased FIO2 was influential in the trial and control groups, which applied to only the ARDS onset stage. The chi-square statistic is 5.1836. The p-value is .02280. Fisher’s exact test statistic value is 0.0433. (The result is significant at p < .05) Furthermore, the ARDS-onset mortality rates were 0% (with dapsone) and 40% (without dapsone). Conclusion There was a significant difference in dapsone treatment results in the ARDS-onset group. We confirmed that dapsone clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and dapsone are competing, proving that it is only effective in treating early ARDS.

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