scholarly journals Characteristic of Referral Patients With Severe Preeclampsia In Surabaya

2018 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Myrna Evanda Adeline ◽  
Muhammad Ardian Cahya Laksana ◽  
S Atika
Keyword(s):  
Birth Weight ◽  
Apgar Score ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Hypertensive Disorder ◽  
Delivery Method ◽  
Common Cause ◽  
Number Of Patients ◽  
History Of ◽  
Almost All

Introductions: Pre-eclampsia is a hypertensive disorder of a pregnancy that remains major maternal mortality in developing country. Severe pre-eclampsia needed an advanced medical treatment since it could cause life treathening condition for both mother and fetus. The purpose of this research was to understand and got the  picture of the age, parity, complication, delivery method, referral pathway, age of pregnancy, birth weight, and Apgar score of baby from pre-eclamptic mother in dr. Soetomo General Hospital during 2011.Methods: This research is a retrospective-descriptive research which observed the age, parity, complication, delivery method, referral pathway, age of pregnancy, birth weight, and Apgar score of baby from pre-eclampsia mother This research used medical record then the data was recorded and analyzed  descriptively.Result: The number of patients who met the inclusion criteria were 239 patients. Patient’s age were distributed unimodally with a peak at productive age. Most of patients had previous history of pregnancy. Pulmonary edema was the most common cause of maternal complication and intra uterine fetal death was the most common cause of fetal complication. Most delivery were performed in Sectio Caesaria method. Almost all cases was direct refferal cases from other medical services. Then most of cases was reaching aterm periode. Most of babies were born with body weight ≥ 2500 gram. And based on Apgar score the babies were well adapted.Conclusions: Most of the patients with severe preeclampsia referrals were referred from a health care setting, only a small percentage of women were referred to relay. Most of severe preeclampsia occured in women with their gestational age has reached 37 weeks.

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

2021 ◽  
pp. 45-50
Author(s):  
Suher Dafaus ◽  
Amel Morgham ◽  
Nasreen Osman
Keyword(s):  
Caesarean Section ◽  
Positive Family History ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Adequate Treatment ◽  
History Of ◽  
The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

scholarly journals Obstetric Patients Characteristics Labor in Dr. M. Djamil General Hospital Padang December 2019-February 2020 Period

2021 ◽  
Vol 5 (2) ◽  
pp. 215-222
Author(s):  
Syntia Ambelina ◽  
Desmiwarti Desmiwarti
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Maternal Mortality ◽  
General Hospital ◽  
Apgar Score ◽  
Neonatal Death ◽  
Very Low Birth Weight ◽  
Severe Preeclampsia ◽  
Maternal Condition ◽  
History Of

Introduction : Maternal death in Indonesia was still high therefore efforts was needed to suppress this maternal mortality rate.Objective : To determine risk factors of maternal mortality and morbidity.Methods : This was a descriptive study using cross sectional design with study sample including all laboring mother in Obstetric Department of Dr. M. Djamil General Hospital Padang from December 2019 to February 2020 period. Sample were collected using total sampling technique with total of 119 samples included in this study. Data was collected from patients’ medical record, including age, gestational age, gravidity, history of labor, diagnosis, method of delivery, maternal condition, and neonates condition at birth.Results : Mean of age was 30.6 ± 5.4 years, mean of maternal age was 36.1 ± 3.8 weeks, about 77 patients (64.7%) were multipara, 49 patients (41.2%) had history of spontaneous labor, most frequent diagnosis were severe preeclampsia in 20 patients (16.8%), impending eclampsia in 9 patients (7.6%), history of cesarean section 8 patients (6.7%), twin pregnancy 7 patients (5.9%), and pregnancy with positive HBsAg in 7 patients (5,9%). Total 32 patients (26.9%) were referred patients from various general hospital in West Sumatra. A total of 105 patients (88.2%) had cesarean section. Mean birth weight of neonates was 2363.4 ± 964.7 gram, mean birth length was 44.1 ± 5.9 cm, mean apgar score in the first 1 minutes was 5,9 ± 2,2, and mean apgar score in the first 5 minutes 7.4 ± 2.3. During 3 months of study, total maternal deaths were found in 3 patients due to complicated eclampsia, severe preeclampsia, and maternal congenital heart disease, while neonatal death was found in 8 babies, where 6 (75%) had IUFD, and 2 (25%) had very low birth weight dying in the first 24 hours of life due to respiratory failure.Conclusion : Most of labored mother were multiparas with history of spontaneous birth, and mostly diagnosed as severe preeclampsia with method of delivery of cesarean section, and maternal and neonatal death were still occurred.Keywords: Death, Maternal, Neonatal

scholarly journals A STUDY ON MRI-FISTULOGRAM EVALUATION OF PERIANAL DISCHARGE IN AN INDIAN POPULATION

2018 ◽  
Vol 11 (5) ◽  
pp. 284
Author(s):  
Santosh Kumar Panda ◽  
Madhuri Panigrahi
Keyword(s):  
Previous History ◽  
University Hospital ◽  
Fistula Tract ◽  
Perianal Fistulas ◽  
Number Of Patients ◽  
Operative Evaluation ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Almost All ◽  
Operative Assessment

 Objective: Pre-operative assessment of perianal fistulas is very important for best planning of surgery and prevention of relapse. The goal of magnetic resonance imaging (MRI) of perianal discharge is to demonstrate accurately the anatomy of the perianal region. MRI can clearly show the relationship of fistulas to the anal sphincter complex, levator plate, and the ischiorectal/ischioanal fossa. The aim of the study was to find out the various types of fistula and compare MRI fistulogram with surgery findings.Methods: In the present study, 38 number of patients were included who were sent for pre-operative MRI evaluation of perianal discharge and their post-operative data were collected for analysis. Surgical grading was according to Park’s surgical classification. Fistulas were graded in MRI according to St James’s University Hospital MRI classification of perianal fistulas.Results: It was found from the study that most of the patients were adults (35/38), whereas one was a child and one was adolescent. Almost all were male (36/38) except two were female. Around 50% of patients had previous history of surgery and had come for persistent/recurrent lesion. According to MRI, all except one had true fistula, rest one had sinus, and one had ischioanal abscess. Percentage of Grade I, Grade II, Grade III, and Grade IV fistula were 31.58, 13.16, 15.79, and 34.21, respectively. Percentage of intersphincteric (I and II) type was 44.74 (17 in no) and transsphincteric (III and IV) was 55.26 (21 in no.), and supra- and extra-sphincteric type was 0 in number. Most had internal anal canal opening posterior to transverse anal line, out of which most were around 6 o’clock position. MRI successfully described fistula tract in all except for two cases (36/38).Conclusion: MRI is very accurate in pre-operative evaluation and planning for surgery of perianal fistulas.

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

scholarly journals Deliberate Self-Harm and the Elderly: A Volatile Combination—An Overview from the Plastic Surgery Perspective

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
J. Packer ◽  
M. A. Hussain ◽  
S. H. A. Shah ◽  
J. R. Srinivasan
Keyword(s):  
Plastic Surgery ◽  
Protective Factor ◽  
Previous History ◽  
Later Life ◽  
The Elderly ◽  
Elderly Group ◽  
History Of ◽  
Group A ◽  
Almost All ◽  
Surgery Department

Aims. To study the factors associated with the DSH in the elderly group of 60 years and above and to recommend changes to be implemented in order to improve the management in this specific group. Materials and Methods. Five-year retrospective study was undertaken from July 2005 to July 2010 in the Plastic Surgery Department of the Royal Preston Hospital, NHS Trust. A Performa was designed to collect data about the inpatient admission and included certain areas of key information. The case notes for all patients were extensively analysed in order to gather adequate information for the devised Performa. Results. DSH is getting more common in the elderly group, and males are more affected than females. 60% of the patients had a previous history of DSH. A large number (80%) of patients had a previous history of mental illness. 60% of those DSH patients were living with family. Almost all patients (90%) were reviewed by the Psychiatry Liaison Team. The timing of patients being assessed was highly variable. Conclusions. Marriage is not a protective factor in the prevention of the DSH in the elderly group. A mental health team referral in the early phases of the management would be of huge benefit and a likely step to prevent possible future admissions. The Department would benefit from the creation of a protocol for the management of these patients. There should be a joint effort of the professionals in the management of DSH in the elderly, and GPs play a very important role in the prevention of DSH in the later life.

scholarly journals Impact Of Maternal Factors on Birth weight In Salah- Aldeen general Hospital/Tikrit City

2021 ◽  
Vol 05 (1) ◽  
pp. 1-13
Author(s):  
Sahar Talab ◽  
Sarab Jasim
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Iron Deficiency ◽  
Low Birth Weight ◽  
General Hospital ◽  
Iron Deficiency Anemia ◽  
Previous History ◽  
Deficiency Anemia ◽  
Normal Birth ◽  
History Of

Birth weight is a crucial determinant of the developmental potential of the newborn. Birth weight is the body weight of a baby at its birth. The range of normal is between 2.5 and 4.5 kilograms (5.5 and 9.9 lb). On average, babies of south Asian and Chinese heritage weigh about 3.26 kilograms (7.2 lb). Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. World Health Organization has defined low birth weight as birth weight less than 2,500 grams. Giving birth to a low-birth-weight infant is influenced by several factors. This study aimed to identify key determinants that influence the frequency of normal and low birth weight in Salah Al-Deen general Hospital in Tikrit city-Iraq. This study is a Cross- sectional study, was conducted in obstetric department in Salah Al-Deen general hospital during the period from 1st Feb to the 31st of August 2020. The study sample included full term babies (gestational age 37-42 week) chosen by using a convenient sampling method selecting 197 delivered babies with their mothers. Data collection done by face-to-face interview, using the structured questionnaire developed by the researcher include the following information: Information regarding the mother included demographic variables, reproductive health, medical and obstetrical history and antenatal care visits, use of ferrous sulfate and other supplements during pregnancy. Birth weight was measured at birth, to the nearest 50 g, with the nude infant lying on the available scale. Zero adjustment of the scale was frequently done to ensure accuracy of the readings. Birth weight was categorized into two as low birth weight (birth weight < 2500 grams), and normal birth weight (birth weight ≥ 2500 grams). The current study showed that prevalence of low birth weight was (2.4%), macrosomia (15.6%) and normal birth weight was (82%). The study showed that the low birth weight was higher among primigravida (3.4%), than multigravida women (1.7%) and that the low birth weight was higher among 1st and 2nd birth order (3.4%), (6.7%) respectively while it was (0%) among the 3rd baby order. Previous history of Diabetes Mellitus was associated with 0(0%) low birth weight babies and (2.6%) of those women without Diabetes Mellitus had low birth weight babies. Those with history of iron deficiency anemia was more prone to had babies with low birth weight (3.1%), versus those without history of iron deficiency anemia (1.3%). Those with history of hypertension more prone to had babies with low birth weight (4%), versus those without history of iron deficiency anemia (2.2%). The current study showed that those with ferrous sulfate supplements had lower proportion of babies with low birth weight (1.2%), versus those without supplements (7.7%), this relation statistically significant. This study has demonstrated that the younger maternal age, mother with diabetes mellitus, hypertension and irregular antenatal care had babies with lower birth weight. Previous history of low birth weight also is a predisposing factor for low birth weight.

scholarly journals Predictive factors for developing acute cholangitis and cholecystitis in patients undergoing delayed cholecystectomy: a retrospective study

2019 ◽  
Author(s):  
Takashi Miyata ◽  
Daisuke Matsui ◽  
Yuta Fujiwara ◽  
Hiroto Saito ◽  
Yoshinao Ohbatake ◽  
...  
Keyword(s):  
Risk Factor ◽  
Surgical Outcomes ◽  
Intraoperative Complications ◽  
Acute Cholangitis ◽  
Previous History ◽  
Cell Counts ◽  
Number Of Patients ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Background We evaluated the risk of acute cholangitis and cholecystitis while waiting for cholecystectomy for gallstones. Methods We retrospectively enrolled 168 patients who underwent cholecystectomy for gallstones after a waiting period and conservative therapy between April 2014 and March 2018 at our hospital. We compared the clinical data from 20 patients who developed acute cholangitis and cholecystitis while waiting for cholecystectomy (group A) with data from 148 patients who did not develop cholangitis and cholecystitis (group B). The risk factors for developing acute cholangitis and cholecystitis and all patients' surgical outcomes were investigated. Results Preoperatively, significant differences in age (68.6 years vs 60.7 years; p= 0.004) and the number of patients with a previous history of acute grade II or III cholecystitis (55.0% vs 10.8%; p< 0.001) and biliary drainage (20.0% vs 2.0%; p= 0.004) were observed between group A and group B, respectively. Preoperative white blood cell counts (13500/µL vs 8155/µL; p< 0.001) and serum C-reactive protein levels (12.6 mg/dL vs 5.1 mg/dL; p< 0.001) were significantly increased, and serum albumin levels (3.2 g/dL vs 4.0 g/dL; p< 0.001) were significantly decreased in group A vs group B, respectively. Gallbladder wall thickening (≥ 5 mm) (45.0% vs 18.9%; p= 0.018), incarcerated gallbladder neck stones (55.0% vs 22.3%; p= 0.005), and abscess around the gallbladder (20.0% vs 1.4%; p= 0.002) were seen significantly more frequently during imaging in group A vs group B, respectively. Furthermore, investigating patients' surgical outcomes revealed a higher conversion rate to open surgery (20.0% vs 2.0%; p= 0.004), longer operation time (137 min vs 102 min; p< 0.001), and a higher incidence of intraoperative complications (10.0% vs 0%; p= 0.014) in group A vs group B, respectively. Conclusions Our results suggest that a history of severe cholecystitis is a risk factor for developing acute cholangitis and cholecystitis in patients waiting for surgery, and a risk factor for increased surgical difficulty.

scholarly journals Impact of COVID-19 on Neurological Manifestations: An Overview of Stroke Presentation in Pandemic.

2020 ◽  
Author(s):  
Nida Fatima ◽  
Maher Saqqur ◽  
Ashfaq Shauib
Keyword(s):  
Risk Factors ◽  
Virus Disease ◽  
Previous History ◽  
Neurological Manifestation ◽  
Cochrane Library ◽  
Mesh Terms ◽  
History Of ◽  
The Mean ◽  
Almost All ◽  
Underlying Risk

Abstract Introduction: Corona virus disease 2019 (COVID-19) pandemic has become a globally challenging issue after its emergence in December 2019 from Wuhan, China. Despite its common presentation as respiratory distress, patients with COVID-19 have also shown neurological manifestation especially stroke. Therefore, the authors sought to determine the etiology, underlying risk factors, and outcomes among patients with COVID-19 presenting with stroke. Methods: We conducted a systematic review of the electronic database (PubMed, Google Scholar, Scopus, Medline, EMBASE, and Cochrane library) using different MeSH terms from January 2000 to June 2020. Results: A total of 39 patients with stroke from 6 studies were included. The mean age of our included patients was 61.4±14.2 years. Majority of the patients (92.3%) with COVID-19 had ischemic stroke, 5.1% had hemorrhagic stroke, and 2.6% had cerebral venous thrombosis at the time of initial clinical presentation. Almost all of the patients presented had underlying risk factors predisposing to stroke which included, diabetes mellitus, hyperlipidemia, hypertension, and previous history of cerebrovascular disease. 51.2% of the included patients infected with COVID-19 with stroke died, while remaining patients were either discharged home or transferred to a rehabilitation unit. Conclusion: Exploring the neurological manifestation in terms of stroke among patients with COVID-19 is a step towards better understanding of the virus, preventing further spread, and treating the patients affected by this pandemic.

scholarly journals The subsequent newborn effects of stillbirth and abortion, a longitudinal study.

2020 ◽  
Author(s):  
Berhanu Elfu Feleke ◽  
Teferi Elfu Feleke
Keyword(s):  
Birth Weight ◽  
Serum Iron ◽  
Survival Curve ◽  
Previous History ◽  
Serum Zinc ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Iron And Zinc ◽  
History Of ◽  
Zinc Levels

Abstract Introduction This study was conducted to assess the effects of stillbirth and abortion on the health of the subsequent newborn. Methods A prospective cohort study was implemented. The data were collected from January 2015 to August 2019. The study participants were selected using the simple random sampling technique. The data were collected using interviewing the pregnant mothers, reviewing medical charts, analyzing the blood samples from the newborn, and scheduled medical checkups. General linear model was used to assess the effects of stillbirth and abortion on the health of the newborn, Poisson regression was used to identify predictors of childhood infectious diseases episodes and Kaplan Meier survival curve were used to estimate time to childhood pneumonia and diarrhea. Results 2872 infants were included giving for the response rate of 88.97%. Neonate born from mothers with a previous history of stillbirth or abortion had low birth weight, low serum iron, and zinc levels. High infection episodes of diarrhea and pneumonia were observed among infants born from a previous history of stillbirth and abortion mothers. The infection episodes during the childhood period were determined by serum zinc level [IRR 0.71; 95% CI: 0.61- 0.83], birth weight [IRR 0.86; 95% CI: 0.81 – 0.91], breastfeeding frequency [IRR 0.9; 95% CI: 0.87-0.93]. Conclusion The birth weight, serum iron and zinc levels of neonates born from the previous history of stillbirth and abortion were lower. The infection episodes of newborns born from mothers with previous history stillbirth or abortion were higher.

FIBRINOLYTIC ALTERATIONS AS RISK FACTOR IN PATIENTS WITH CORONARY HEART DISEASE

1987 ◽  
Author(s):  
J Aznar ◽  
A Estelles ◽  
G Tormo ◽  
F Espafia ◽  
V Torino
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Plasminogen Activator ◽  
Exercise Test ◽  
Stable Angina ◽  
Previous History ◽  
Control Group ◽  
Number Of Patients ◽  
History Of ◽  
Patient Groups

It has been reported that young survivors of myocardial infarction (MI) have elevated plasminogen activator inhibitor (PAI) levels. We have studied several fibrinolytic parameters (euglobulin lysis time, fibrin-plate lysis, tissue plasminogen activator (t-PA) antigen, t-PA activity, PAI activity, plasminogen, az antiplasmin and FDP/fdp in 55 patients with coronary heart disease (CHD), before and after an exercise test. The patients were classified in 4 groups:A) Patients with unstable angina (n=5); B) Patients with stable angina and previous history of MI (n=13); C) Patients with stable angina without previous history of MI (n=ll) and D) Patients with MI about 3 weeks before this study (n=26). All the groups were similars in age and life habits. Patients suffering from dislipemia and diabetes were excluded from the study. In basal conditions, PAI activity (U/ml) was high in the 4 patient groups (A:2.5±2.8; B:5.2 ± 4.9; C:2.8 ± 2.6; D: 4.6 ± 4.6) ascompared to a group of 10 healthy volunteers (0.46±0.5). In all the clinical groups there were a large number of patients (about 60%) whose PA inhibitor level was > 2 U/ml. t-PA antigen (ng/ml) was slightly elevated in all patient groups (A: 12.4+±4.6; B:12.4±5.6; C:12.5+4.0; D: 13.3+4.3) in comparison with control group (10.1+2.9). The release of t-PA antigen after the exercise test did not differ significantly from one group to another. However, this release was < 3 ng/ml in about 50% of patients in all clinical groups, as compared to the control group, in which the release of t-PA antigen was higher than 3 ng/ml in all the subjects. After the exercise PAI activity remained high in the patient groups. The increased level of t-PA inhibitor activity founded in the patients was partially inhibited by antiserum against PA inhibitor-1 but not by antiserum against PA inhibitor-2. The formation of a complex of about 115,000 daltons between the increased plasma PA-Inhibitor and purified single t-PA was observed by a zymographic fibrin technique. These findings demonstrate that CHD patients have a fibrinolytic hypofunction caused basically by an increase in t-PA inhibitor. This increase in PAI activity is more evident in patient with a previous history of MI.

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