scholarly journals Lactate Level as a Prediction Factor of Reperforation after Repairing Gastric Perforation

2019 ◽  
Vol 55 (1) ◽  
pp. 43
Author(s):  
Vicky Sumarki Budipramana

Reperforation after gastric perforation repair is a complication which increases the rate of morbidity and mortality in gastric perforation. The lack of ability of the tissue to use oxygen in septic condition causes anaerobic cellular metabolism and furthermore it will cause failure in closing the perforation. The production of anaerobic metabolism is lactic acid which can be measured from the blood. The aim of this study is to determine the cut-off point of blood lactate level as a predictor of reperforation after repairing gastric perforation. Forty-six patients diagnosed as gastric perforation, who were repaired in Dr Soetomo Hospital from October 2014 to October 2015 were recruited as samples. Serum lactate was taken one hour before repairing the perforation. After being repaired, the patients were observed until the 14th day to evaluate whether any reperforation would occur or not . The design of this research was cross-sectional, analytic observational. The data was analyzed using independent t-test and ROC for obtaining the cut-off point as a predictor of the reperforation after the gastric perforation was repaired. There was a significant difference in the mean of lactate level in the group with reperforation compared with that of the non-reperforation group, that is as big as 3.74±0.59 mmol/L and 2.60±0.76 mmol/L. Using ROC curve analysis, there was the cut-off point of lactate level for reperforation 3.35 mmol/L, with sensitivity 92.9%, specificity 84.4%, positive predictive value 72% and negative predictive Value 96.4%, accuracy 87.0% and in the AUC value 0.902.

2021 ◽  
Vol 55 (1) ◽  
pp. 43
Author(s):  
Vicky Sumarki Budipramana

Reperforation after gastric perforation repair is a complication which increases the rate of morbidity and mortality in gastric perforation. The lack of ability of the tissue to use oxygen in septic condition causes anaerobic cellular metabolism and furthermore it will cause failure in closing the perforation. The production of anaerobic metabolism is lactic acid which can be measured from the blood. The aim of this study is to determine the cut-off point of blood lactate level as a predictor of reperforation after repairing gastric perforation. Forty-six patients diagnosed as gastric perforation, who were repaired in Dr Soetomo Hospital from October 2014 to October 2015 were recruited as samples. Serum lactate was taken one hour before repairing the perforation. After being repaired, the patients were observed until the 14th day to evaluate whether any reperforation would occur or not . The design of this research was cross-sectional, analytic observational. The data was analyzed using independent t-test and ROC for obtaining the cut-off point as a predictor of the reperforation after the gastric perforation was repaired. There was a significant difference in the mean of lactate level in the group with reperforation compared with that of the non-reperforation group, that is as big as 3.74±0.59 mmol/L and 2.60±0.76 mmol/L. Using ROC curve analysis, there was the cut-off point of lactate level for reperforation 3.35 mmol/L, with sensitivity 92.9%, specificity 84.4%, positive predictive value 72% and negative predictive Value 96.4%, accuracy 87.0% and in the AUC value 0.902.


2017 ◽  
Vol 57 (3) ◽  
pp. 124
Author(s):  
Zakaria Mukalla ◽  
Ria Nova ◽  
Legiran Legiran ◽  
Yangtjik Yangtjik

Background. Dyspnea could be caused by various reason, one of which is the presence of cardiac abnormality. Physical examination sometimes difficult to distinguish breath caused by heart abnormalities, especially small children, so we need another way to find out.Objective. To evaluate whether the examination of NT-proBNP levels can be used as a screening tool to diagnose cardiac abnormality in children presenting with dyspnea.Methods. A Cross sectional study was conducted from August to October 2015 on pediatric patients aged 1 month to 18 years presenting with dyspnea in pediatric ward Mohammad Hoesin Hospital Palembang. All subjects performed blood sampling for NT-proBNP examination and echocardiography to assess the presence of cardiac abnormalities. The diagnostic value analyzed by ROC curve, and determined the optimal cut-off point, sensitivity and specificity. Result. We obtained 58 subjects with median age 9.5 (1-180) months, consisted of 39 subjects with cardiac abnormalities and 19 subjects without cardiac abnormality. There is a significant difference (p = 0.002) of NT-proBNP levels in both groups with a median  1,775 (189-9,000) pg/ml vs 759 (245-9,000) pg/ml. In ROC curve analysis, AUC value was 0.75, and at the optimal cut-off point 1,235 pg/ml, sensitivity was 74.4% and specificity was 73.7%.Conclusion. The level of NT-proBNP can be used to diagnose cardiac abnormalities in children presenting with dyspnea.


Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.


2021 ◽  
pp. 263183182110274
Author(s):  
Deblina Roy ◽  
Sujita Kumar Kar ◽  
SM Yasir Arafat ◽  
Pawan Sharma ◽  
Russell Kabir

Background: The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world. Objectives: We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal). Methods: A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study. Results: A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified. Conclusion: There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.


2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.


2021 ◽  
pp. 147775092110401
Author(s):  
Mahsa Dadkhah-Tehrani ◽  
Mohsen Adib-Hajbaghery

Background Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses. Objective This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Materials and Methods A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital of Kashan, Iran. Data collection instruments included a personal characteristics questionnaire, the Nursing Ethics Questionnaire, and the National Aeronautics and Space Administration Task Load Index. The Chi-square, the Spearman correlation coefficient, the Kruskal–Wallis, and Mann–Whitney U tests were used to analyze the data. Results A majority of nurses were females (77.5%), married (79.3%), and permanently employed (55.4%). The mean of the overall perceived workload and adherence to professional codes of ethics were 76.36 ± 13.64 and 13.98 ± 2.58, that were at high and moderated level, respectively. Spearman correlation test showed no significant correlation between perceived workload and adherence to professional codes of ethics ( r = 0.03, P = 0.6). A significant difference was found between the mean scores of adherence to professional codes of ethics in nurses working in different departments ( P < 0.001). Conclusion Participating nurses perceived high levels of workload but their mean adherence to professional codes of ethics was at a moderate level. The perceived workload was indirectly correlated with adherence to professional codes of ethics.


2019 ◽  
Vol 41 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Fabiana Baggio Nerbass ◽  
Edcléia Regina Canzi ◽  
Renata dos Anjos Araujo ◽  
Dyane Corrêa ◽  
Rafaela Gonzaga dos Santos ◽  
...  

Abstract Introduction: Hyperphosphatemia is associated with unfavorable outcomes, and the percentage of patients presenting with this condition in hemodialysis (HD) in kidney foundation units in the state of Santa Catarina (SC) is historically higher than that of patients in the state of Tocantins (TO). Objective: To assess the frequency of consumption of the main dietary sources of phosphorus and to compare them between the two states. Methodology: A cross-sectional study was carried out involving 123 patients, 66 of SC and 57 of TO: 52% were men, average age was 46.9 ± 15.7 years, and mean HD time 48 (57-71) months. A food frequency questionnaire (FFQ) with 33 items that are dietary sources of phosphorus was applied. A consumption score was calculated for sources of organic, inorganic, and total phosphorus, and the six-month average of phosphatemia was obtained. Results: The mean phosphatemia of SC patients was higher (6.2 ± 1.5 vs 4.7 ± 1.3 mg/dL, p <0001) than TO patients, as well as the prevalence of hyperphosphatemia (62% vs 28%; p <10001). In the total sample, the foods most frequently consumed were milk and beans. Comparing the frequency of consumption between the two states, a significant difference was found in 17 items. In TO, beef and beans were the foods most frequently consumed, and in SC, fourteen other items of the FFQ (pork, sausages, dairy products, etc.) were the most frequently consumed. Phosphatemia correlated with the frequency of consumption of inorganic phosphorus sources. Conclusion: the frequency of consumption of several items was different between the states, and this explains the differences in phosphatemia between the two regions.


Author(s):  
AW Ali ◽  
MZ Hossain

Aim: To investigate the correlation between anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion, as well as their prevalence in Bangladeshi population. This study would act as a reference for diagnosis, treatment planning and assessment of prognosis in some orthodontic cases. Methods: This cross sectional study was conducted in the Department of Orthodontics & Dentofacial Orthopedics, Dhaka Dental College & Hospital. A total number of 200 subjects were selected in Angle's Class l, ll, lll and corresponding normal group. Each group had 50 subjects with males and females. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among Angle's Class l, ll, lll malocclusions and corresponding normal occlusion and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of angle classification and gender. Statistical differences were determined at the 95% confidence level (p< 0.05). Results: No significant difference was observed in the mean Bolton anterior ratio between normal group and class-I malocclusion group (p = 0.343). Significant differences were observed between Class-II malocclusion and normal group (p=0.001), and also between Class-III malocclusion and normal group (p = 0.001). Individuals with Angle Class lll and Class ll malocclusions showed significantly greater prevalence of tooth size discrepancy than Class l malocclusion and corresponding normal group. Conclusion: The great diversity and ethnic mix of Bangladeshi population should alert our orthodontist to use Bolton analysis as an important diagnostic tool and become aware of the moderate variations that may be present and treated. It may somehow guide planning of this type of study in future. DOI: http://dx.doi.org/10.3329/bjodfo.v1i2.15982 Ban J Orthod & Dentofac Orthop, April 2011; Vol-1, No.2, 1-4


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mahnaz Zarshenas ◽  
Mozhgan Sorkhenezhad ◽  
Marzieh Akbarzadeh

Background: Uterine leiomyomas are considered as a major source of complications and the most common cause of hysterectomy. Objectives: The aim of this study was to compare the quality of life in women with and without uterine leiomyoma referred to gynecology clinics of Shiraz University of Medical Sciences in 2018. Methods: In this cross-sectional study, a total of 126 patients who referred to the clinics of Shiraz University of Medical Sciences were selected and divided into equal groups according to uterine leiomyoma, 1 - 7 cm uterine leiomyoma group and non-uterine leiomyoma group by convenience sampling. The World Health Organization Quality of Life and Healthy Lifestyle questionnaires were used for data collection. Independent t-test was used to analyze the data. Results: The mean quality of life of women with uterine leiomyoma was 47.20 ± 12.41 and women without uterine leiomyoma had a significant difference (51.11 ± 11.23, t = 3.93, P = 0.041). The mean lifestyle of women with uterine leiomyoma was 114.18 ± 25.48 and women without uterine leiomyoma had 149.11 ± 23.81 (t = 4.01, P = 0.029). Conclusions: The mean score of quality of life and lifestyle were significantly different in women with and without uterine leiomyoma. Therefore, it is necessary to improve the quality of life of women by improving their lifestyle and providing psychological counseling.


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