​Diagnostic Indicators and Therapeutic Evaluation of Pregnancy Toxaemia in Goats

2021 ◽  
Author(s):  
V. Vijayanand ◽  
M. Balagangatharathilagar ◽  
P. Tensingh Gnanaraj ◽  
S. Vairamuthu
Keyword(s):  
Glucose Monitoring ◽  
Small Ruminants ◽  
Negative Energy ◽  
Clinical Pregnancy ◽  
Prognostic Indicators ◽  
Medical Conditions ◽  
Cure Rate ◽  
Peripheral Hospital ◽  
History Of ◽  
Pregnancy Toxaemia

Background: Periparturient mortality in goats have a great economic impact on the livelihood of marginal farmers. Pregnancy toxaemia, a metabolic disease in small ruminants occurs as a result of negative energy balance consequent to enhanced requirement for glucose by the developing fetuses in the last trimester (last 6 to 4 weeks) of gestation. The present study was aimed to identify diagnostic and prognostic indicators of pregnancy toxaemia. Methods: During the period October 2016 to September 2018, a total of 516 adult non descriptive does were brought to Veterinary University Peripheral Hospital, Madhavaram Milk Colony, Chennai - 51, of which 264 (51.16%) were treated for medical conditions. Among the does treated for various medical conditions, 72 does were in their last six weeks of gestation carrying twins/triplets and presented with the history of off feed. They were subjected to determination of blood β-hydroxybutyric acid (BHBA) level by means of a portable blood ketone and glucose monitoring system and qualitative urinalysis using urine dip stick. Does with BHBA level greater than 0.8 mmol/L and less than 1.6 mmol/L were classified as sub-clinical pregnancy toxaemic group (n=12) and BHBA level greater than 1.6 mmol/L were classified as clinical pregnancy toxaemic group (n=12) and subjected to therapy while the remaining 48 does had BHBA levels less than 0.8 mmol/L. The control animals were selected from adult Tellicherry does in the age group of 2 to 4 years maintained at Livestock Farm Complex (LFC), Madhavaram Milk Colony, Chennai - 600 051. Result: All the twelve does of sub-clinical pregnancy toxaemic group recovered completely with a cure rate of 100%, while in the clinical pregnancy toxaemic group the cure rate was only 33%. Reliable diagnostic indicators of pregnancy toxaemia include blood â-hyroxybutyric acid concentration (³ 0.8 mmol/L) and presence of ketone body, glucose and protein in urine, while hypergly­caemia in advanced pregnancy toxaemic does indicate fetal death.

scholarly journals An Investigation of the Glucose Monitoring Practices of Nurses in Stroke Care: A Descriptive Cohort Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Elizabeth Ann Laird ◽  
Vivien E. Coates ◽  
Assumpta A. Ryan ◽  
Mark O. McCarron ◽  
Diane Lyttle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Acute Stroke ◽  
Glucose Monitoring ◽  
Positive Association ◽  
Stroke Care ◽  
Routine Practice ◽  
Full Potential ◽  
Significant Positive Association ◽  
History Of

Glucose derangement is commonly observed among adults admitted to hospital with acute stroke. This paper presents the findings from a descriptive cohort study that investigated the glucose monitoring practices of nurses caring for adults admitted to hospital with stroke or transient ischaemic attack. We found that a history of diabetes mellitus was strongly associated with initiation of glucose monitoring and higher frequency of that monitoring. Glucose monitoring was continued for a significantly longer duration of days for adults with a history of diabetes mellitus, when compared to the remainder of the cohort. As glucose monitoring was not routine practice for adults with no history of diabetes mellitus, the detection and treatment of hyperglycaemia and hypoglycaemia events could be delayed. There was a significant positive association between the admission hospital that is most likely to offer stroke unit care and the opportunity for glucose monitoring. We concluded that adults with acute stroke, irrespective of their diabetes mellitus status prior to admission to hospital, are vulnerable to both hyperglycaemic and hypoglycaemic events. This study suggests that the full potential of nurses in the monitoring of glucose among hospitalised adults with stroke has yet to be realised.

Hormone Replacement Therapy With GnRH Agonist Pretreatment Improves Pregnancy Outcomes in Patients With Previous Intrauterine Adhesions: a Retrospective Study

2021 ◽  
Author(s):  
Meilan Mo ◽  
Qizhen Zheng ◽  
Hongzhan Zhang ◽  
Shiru Xu ◽  
Fen Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Pregnancy Outcomes ◽  
Preparation Method ◽  
Clinical Pregnancy ◽  
Ongoing Pregnancy ◽  
Intrauterine Adhesions ◽  
Endometrial Preparation ◽  
History Of ◽  
Early Miscarriage

Abstract Objective: This retrospective study aimed to explore the optimal endometrial preparation method in women with intrauterine adhesions (IUAs).Method: A total of 882 frozen-thawed embryo transfer (FET) cycles from patients with history of IUAs were categorized into three groups based on endometrial preparation methods: hormone replacing therapy cycle (HRT, n=636), natural cycle (NC n=174), and HRT with GnRH-a pretreatment (HRT+GnRH-a, n=72. Logistic regression was performed to investigate the association between cycle regimens and pregnancy outcomes. Subgroup analysis of IUAs combined with thin endometrium (≤7mm) was also performed.Results: HRT with GnRH-a pretreatment was associated with higher incidences of clinical pregnancy, ongoing pregnancy, and live birth, but lower early miscarriage compared with either HRT or NC. Logistic regression indicated that after controlling for potential confounders, the incidences of live birth (HRT+GnRH-a as reference; NC: aOR=0.577, 95%CI 0.304-1.093; HRT: aOR=0.434, 95%CI 0.247-0.765) and ongoing pregnancy (NC: aOR=0.614, 95%CI 0.324-1.165; HRT: aOR=0.470, 95%CI 0.267-0.829) remained significantly higher in HRT+GnRH-a compared to those in HRT, but comparable to those in NC. While there was no significant difference with respect to the clinical pregnancy rate (NC: aOR=0.695, 95%CI 0.374-1.291; HRT: aOR=0.650, 95%CI 0.374-1.127) and early miscarriage rate (NC: aOR=1.734, 95%CI 0.417-7.175; HRT: aOR=2.594, 95%CI 0.718-9.378) between groups. Subgroup analysis suggested there was no superiority of endometrial preparation method in IUAs combined with thin endometrium.Conclusion: HRT with GnRH-a pretreatment improves pregnancy outcomes in women with history of IUAs. GnRH-a may restore the endometrial receptivity in the FET cycles in IUAs.

Pregnancy Toxaemia in Small Ruminants

2020 ◽  
pp. 541-556
Author(s):  
P. B. A. Simões ◽  
R. Bexiga ◽  
L. P. Lamas ◽  
M. S. Lima
Keyword(s):  
Small Ruminants ◽  
Pregnancy Toxaemia

scholarly journals Porcine Babesiosis Caused by Babesia sp. Suis in a Pot-Bellied Pig in South Africa

2021 ◽  
Vol 7 ◽  
Author(s):  
Alida Avenant ◽  
Janice Y. Park ◽  
Ilse Vorster ◽  
Emily P. Mitchell ◽  
Angela M. Arenas-Gamboa
Keyword(s):  
South Africa ◽  
Blood Smear ◽  
Clinical Manifestations ◽  
Small Ruminants ◽  
Renal Tubules ◽  
Dipstick Test ◽  
Uncommon Disease ◽  
Urine Dipstick Test ◽  
History Of ◽  
Tick Borne Disease

Babesiosis is a worldwide, tick-borne disease of economic importance in livestock caused by Babesia spp., which are hemoparasitic piroplasms that target the host erythrocytes. Cattle, dogs, small ruminants, and wild ruminants are the species most commonly affected, while in cats, horses, and pigs, it is less frequently reported. Although babesiosis has been observed worldwide, porcine babesiosis remains an uncommon disease with a very limited number of cases reported. Here, we describe a case in a 12-year old pot-bellied pig from South Africa that died after a history of anorexia and reluctance to rise for 2 days. A complete necropsy, blood smear cytology, reverse line blot (RLB) hybridization and 18S rRNA sequencing were performed. Numerous Babesia spp. hemoparasites and a moderate regenerative anemia were identified on blood smear, and a urine dipstick test yielded 4+ heme. Diffuse icterus and splenomegaly were observed upon gross examination. Histopathology revealed hemoglobin casts within renal tubules and collecting ducts, pulmonary edema, splenic congestion, and intrahepatic cholestasis. BLASTN homology of the 18SrRNA sequence revealed a 100% identity to the published sequence of Babesia sp. Suis isolated from pigs in Italy. This case of babesiosis in a pig highlights the clinical manifestations and gross and pathological findings of porcine babesiosis.

scholarly journals Evaluation of efficacy and safety of cryotherapy in benign and premalignant cervical lesion

2021 ◽  
Vol 10 (8) ◽  
pp. 3066
Author(s):  
Krishankumar D. Patel ◽  
Ronak D. Karnavat ◽  
Dimple G. Viramgama ◽  
Roma K. Dalal
Keyword(s):  
Pap Smear ◽  
Benign Lesion ◽  
Precancerous Lesion ◽  
Low Grade ◽  
Cure Rate ◽  
High Satisfaction ◽  
High Satisfaction Rate ◽  
History Of ◽  
Intraepithelial Lesion ◽  
Postcoital Bleeding

 Background: Cervical cancer ranks 3rd leading cause of cancer in the world. Cervical erosion is mostly asymptomatic in women but when symptoms like postcoital bleeding and vaginal discharge occur in the presence of cervical erosion, it becomes important to identify whether the erosion is a benign lesion or CIN or cancer by means of PAP smear and Biopsy. Treatment for benign and precancerous lesion can be provided by ablative or excisional methods. Cryotherapy was reliably used to treat cervical lesions.Methods: Women among 18 to 60 years of age attending outpatient department who had history of chronic discharge per vaginum, postcoital bleeding, dyspareunia, chronic pelvic pain. Patients were divided in two by PAP smear in erosion with inflammatory changes and presence of low grade squamous intraepithelial lesion. Cryotherapy was performed using double-freeze single session procedure. Each patient was followed up at 2, 6 and at 12 weeks. Complications and patients’ satisfaction were recorded and compared to calculate cure rate of symptoms, healing of lesion.Results: The healing efficacy of cryotherapy at 6th and 12th week was 87.8% and 91.1% respectively. Cryotherapy had high satisfaction rate. The cure rate was not affected by location of lesion and size of lesion in both inflammation and LSIL.Conclusions: Cryotherapy is an effective method for treatment of cervical erosion and effectively eliminates symptoms. Patients were highly satisfied. Cryotherapy is cheap, easy, and safe treatment. It is suitable for both hospital and office-based practice.

P–747 Implementation of the ESHRE Congenital uterine anomaly classification into practice and clinical pregnancy outcomes at a Tertiary University Teaching Hospital Fertility department

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Samanta ◽  
L Lacey ◽  
M Isdale ◽  
M Akhtar
Keyword(s):  
Conservative Management ◽  
Surgical Intervention ◽  
Recurrent Miscarriage ◽  
Clinical Pregnancy ◽  
University Teaching ◽  
Ultrasound Scan ◽  
Septate Uterus ◽  
Patient Counselling ◽  
Uterine Anomalies ◽  
History Of

Abstract Study question What’s the incidence of class U1-U6 CUAs in subfertile women? What’s the clinical pregnancy rate in women with the most common anomaly, a septate uterus? Summary answer The incidence of CUAs is 5.9% in our subfertile population, with a septate uterus (U2) being the most common abnormality in 4.2% of the population What is known already Congenital uterine anomalies (CUAs) are common. A systematic review suggested an estimated overall prevalence of 5.5% in an unselected population, 8.8% in the subfertile population, 13.3% in those with a history of recurrent miscarriage and 24.5% in those with a history of subfertility and recurrent miscarriage. A septate uterus (U2) is the most common CUA and is amenable to surgical intervention although at present there is a lack of evidence suggesting benefit in subfertile patients. Women with a septate uterus are known to have poorer reproductive outcomes, including reduced conception rate and increased first trimester loss. Study design, size, duration All patients referred to our department for subfertility had a 2D pelvic ultrasound scan as part of their baseline investigations. Since it was established in 2016, all patients with a suspected CUA based on clinical history and investigations, were referred to the clinic and data collected prospectively. Prior to this, women with suspected CUAs required a hysteroscopy or MRI scan for confirmation of diagnosis, often leading to long waiting lists and treatment delays. Participants/materials, setting, methods Out of the 4716 patients referred to the department for subfertility from 2016–2018, 302 women were referred to the 3D clinic due to suspicion of a CUA. Transvaginal 3D-ultrasound scan was performed and CUAs classified according to the ESHRE/ESGE working groups. Patients diagnosed with a septate uterus were given options of conservative versus surgical treatment, in the light of unclear benefits of hysteroscopic septum resection. Clinical pregnancy data were collected about this cohort. Main results and the role of chance Of the 302 women referred to the service, the uteri of 25 patients were unable to be assessed accurately, most commonly as the cavity was unclear due to a thin endometrium. The remaining 277 patients were classified as having the following CUAs; Normal (U0) 63 patients, Dysmorphic (U1) 5 patients, Septate (U2) 199 patients, Bicorporeal (U3) 6 patients and Hemi uterus (U4) 4 patients. No women were classified as having an aplastic uterus (U5) or unclassified (U6). Of the 199 women with a septate uterus, 15 women opted for surgical intervention, 143 women decided to have conservative management and 41 women were lost to follow up. The women who had hysteroscopic resection of the septum had a mean age of 35 years, 6/15 had primary subfertility and 6/15 had a history of recurrent miscarriage. The women who had conservative management had a mean age of 32.5 years, 100/143 had primary subfertility and 20/143 had a history of recurrent miscarriage. At present, 89/143 women who have had conservative management and 12/15 women who had surgical interventions have had a clinical pregnancy, 72/89 and 6/12 of these pregnancies were IVF/ICSI pregnancies respectively. Limitations, reasons for caution This is an observational study, these findings can be useful for patient counselling. However, ideally randomised controlled trials are needed as evidence for the different treatment options for the cohort of patients with septate uterus, which are largely lacking in the current literature, as their feasibility remains a challenge. Wider implications of the findings: Three-dimensional transvaginal ultrasonography clinics are cost-effective one-stop services, successfully providing a diagnosis and management plan in 92% of patients referred with a suspected CUA. They increase patient satisfaction by providing an opportunity to discuss risks in future pregnancies and reducing reliance on hysteroscopy and MRI scans. Trial registration number Not applicable

An Epidemiological Assessment of Endometrial Carcinoma Including Demographics and Histopathological Correlation, from a Tertiary Care Teaching Hospital in South India

2021 ◽  
Vol 8 (30) ◽  
pp. 2751-2756
Author(s):  
Jeenu Babu ◽  
Reeba George Pulinilkunnathil ◽  
Bindu R. Kumar
Keyword(s):  
Risk Factors ◽  
Endometrial Carcinoma ◽  
Teaching Hospital ◽  
South India ◽  
Tertiary Care ◽  
Endometrial Biopsy ◽  
Prognostic Indicators ◽  
Histopathological Correlation ◽  
History Of ◽  
The Mean

BACKGROUND Endometrial cancer (EC) is also the second most common gynaecologic malignancy in developing countries, with an incidence of 5.9 per 100,000 women. Due to the multiple modifiable factors, a better understanding of the prognostic indicators can lead to early detection and treatment. The purpose of this study was to evaluate the frequency and the distribution of various risk factors, epidemiological factors, and histological patterns of patients diagnosed with endometrial carcinoma in a tertiary teaching hospital in south India and compare them with similar studies. The compiled findings of 60 consecutive cases that presented to our tertiary care teaching hospital in Kerala, south India, over oneand-a-half-year period were studied. METHODS This study was essentially an ex post facto retrospective study done on 60 patients for one and half years. Retrospective data collection and compilation were done with previously prepared structured questionnaires in patients with histologically proven endometrial carcinoma. All cases were subjected to hysterectomy with post-surgical histopathology correlation. A study of the risk factors, general epidemiological characteristics, endometrial biopsy findings, and post-surgical histopathology was done. RESULTS The mean age at presentation was 59.83 years. The mean age of menarche was 13.72 years, and menopause was 49.42 years. The majority of patients were married, multiparous, and presented with bleeding per vaginum (77 %). 61.7 % of the patients had a history of hypertension, 31.7 % had a history of hypothyroidism, and 43.3 % had a history of diabetes mellitus in the study population. The most common histopathological type by endometrial biopsy and histopathological correlation was endometrioid adenocarcinoma (88.3 %). CONCLUSIONS Postmenopausal age group, with early menarche and late menopause, high body mass index (BMI), thickened endometrium on ultrasound, and atrophic uterus were some of the features associated with endometrial carcinoma. The most common histological subtype was found to be endometrioid carcinoma KEYWORDS Endometrial Carcinoma, Risk Factors, Prognostic Indicators

scholarly journals Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Matthew T. Carr ◽  
Camille J. Hochheimer ◽  
Andrew K. Rock ◽  
Alper Dincer ◽  
Lakshmi Ravindra ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Medical Center ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Individual Characteristic ◽  
Prior History ◽  
Central Nervous System Tumor ◽  
Medical Conditions ◽  
Characteristic Analysis ◽  
History Of

AbstractGlioblastoma (GBM) is an aggressive central nervous system tumor with a poor prognosis. This study was conducted to determine any comorbid medical conditions that are associated with survival in GBM. Data were collected from medical records of all patients who presented to VCU Medical Center with GBM between January 2005 and February 2015. Patients who underwent surgery/biopsy were considered for inclusion. Cox proportional hazards regression modeling was performed to assess the relationship between survival and sex, race, and comorbid medical conditions. 163 patients met inclusion criteria. Comorbidities associated with survival on individual-characteristic analysis included: history of asthma (Hazard Ratio [HR]: 2.63; 95% Confidence Interval [CI]: 1.24–5.58; p = 0.01), hypercholesterolemia (HR: 1.95; 95% CI: 1.09–3.50; p = 0.02), and incontinence (HR: 2.29; 95% CI: 0.95–5.57; p = 0.07). History of asthma (HR: 2.22; 95% CI: 1.02–4.83; p = 0.04) and hypercholesterolemia (HR: 1.99; 95% CI: 1.11–3.56; p = 0.02) were associated with shorter survival on multivariable analysis. Surgical patients with GBM who had a prior history of asthma or hypercholesterolemia had significantly higher relative risk for mortality on individual-characteristic and multivariable analyses.

Pretreatment Predictors of Outcome in Anorexia Nervosa

1979 ◽  
Vol 134 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Katherine A. Halmi ◽  
Solomon C. Goldberg ◽  
Regina C. Casper ◽  
Elke D. Eckert ◽  
John M. Davis
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Prognostic Indicators ◽  
Predictors Of Outcome ◽  
Outcome Predictor ◽  
Delivery Complications ◽  
The Poor ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

SummaryThe relationship of selected pretreatment characteristics to weight gain during treatment was examined in 81 anorexia nervosa patients. Good prognostic indicators correlating positively with weight gain were: no previous hospitalizations for anorexia nervosa, a great amount of overactivity before treatment, less denial of illness, less psychosexual immaturity and the admission to feeling hunger. A perinatal history of delivery complications was associated with the poor outcome predictor of prior hospitalizations.

General medical disorders with psychiatric implications

2015 ◽  
Author(s):  
Erik J. Garcia ◽  
Warren J. Ferguson
Keyword(s):  
Mental Illness ◽  
Psychiatric Symptoms ◽  
The United States ◽  
Prior History ◽  
Medical Illness ◽  
Medical Conditions ◽  
Presenting Symptoms ◽  
Medical Disorders ◽  
Increased Risk ◽  
History Of

Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.

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