scholarly journals Prenatal Attachment pada Kehamilan Remaja dengan Gangguan Penyesuaian dan Retardasi Mental Berat

2021 ◽  
Vol 5 (2) ◽  
pp. 50-57
Author(s):  
Frilya Rachma Putri ◽  
◽  
Mayniar Ayu Rahmadianti ◽  
Keyword(s):  
Emergency Room ◽  
Gestational Age ◽  
Condyloma Acuminata ◽  
Prenatal Attachment ◽  
Initial Screening ◽  
Bonding Quality ◽  
Iq Test ◽  
History Of ◽  
Maternal Role Attainment ◽  
Negative Feelings

Prenatal attachment is an abstract and unidirectional bond between parents and the fetus that develops during pregnancy. It is closely associated with how the mother utilizes her abilities and knowledge to organize and perform the duties related to her maternal role attainment. We report a case of 15 years old girl admitted to the emergency room with an official request of visum et repertum in January 2018 due to becoming suspected sexual violence victim. The history of present illness revealed a 15 y.o. girl G1P0A0, singleton, at 34-36W Estimated Gestational Age with condyloma acuminata. During her pregnancy, she described relatively negative feelings about her pregnancy including shame, anxiety, and anger. She felt lack of energy and motivation since she became aware of her pregnancy, therefore spent her most of her time on the bed. Her IQ-test showed a profound intelligence rate followed by a total score of Strength and Difficulty Questionnaire (SDQ) 16, and scored low in Prenatal Attachment Inventory (PAI) at 31. We concluded that PA scoring can be utilized as a predictor of mother-infant bonding quality after birth, thus the instrument will be beneficial as initial screening before choosing appropriate management for vulnerable population mother.

scholarly journals Locked twins—remote from term: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abraham Fessehaye ◽  
Ferid A. Abubeker ◽  
Mekdes Daba
Keyword(s):  
Gestational Age ◽  
Twin Pregnancy ◽  
Caesarian Section ◽  
Obstetric Complication ◽  
Second Stage ◽  
Case Summary ◽  
History Of ◽  
Twin Pregnancies ◽  
Abdominal Delivery ◽  
First Stage Of Labor

Abstract Background Locked twins is a rare and hazardous obstetric complication, which occurs in approximately 1:100 twin pregnancies. One of the known etiologic factors for locked twins is size of the twins. We report a case of chin-to-chin locked twins that occurred at gestational age of 30 weeks pus 6 days. Case summary A 27 years-old primigravida Oromo mother presented with a history of pushing down pain and passage of liquor of 6 hours duration at gestational age of 30 weeks plus 6 days. With a diagnosis of twin pregnancy (first twin non-vertex), abdominal delivery was decided in latent first stage of labor but mother refused caesarian delivery and she was allowed to labor with the hope of achieving a vaginal delivery. In second stage, interlocking twin was encountered and a low vertical cesarean section was done to effect delivery of twins without the need to decapitate the first twin. Conclusion Locked twin is a rare obstetric complication. Whenever it is encountered, successful delivery can be achieved without the need to have decapitation of the first twin during caesarian section.

Attempted suicide attention at an emergency room: A hospital-based descriptive approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S603-S603
Author(s):  
D. Torres ◽  
G. Martinez-Ales ◽  
M. Quintana ◽  
V. Pastor ◽  
M.F. Bravo
Keyword(s):  
Emergency Room ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Study Results ◽  
History Of ◽  
Competing Interest ◽  
Reported Data ◽  
Medium Cost ◽  
Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comorbid Depressive Disorders in Epilepsy

CNS Spectrums ◽  
2010 ◽  
Vol 15 (S4) ◽  
pp. 3-6 ◽  
Author(s):  
Andres M. Kanner ◽  
Andrew J. Cole
Keyword(s):  
Emergency Room ◽  
Depressive Disorders ◽  
Clonic Seizure ◽  
Resonance Imaging ◽  
Abnormal Signal ◽  
The Past ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
History Of Depression

A 27-year-old woman presented to the emergency room after having witnessed generalized tonic clonic seizure while asleep. Birth and development were normal. She had suffered a single febrile seizure at 13 months of age, but had no other seizure risk factors. She was otherwise well except for a history of depression for which she was taking sertraline. Depressive symptoms had been well controlled over the past 3 months, but she had been under increased stress working to finish a doctoral thesis. Neurological examination was normal. Magnetic resonance imaging (MRI) showed modest asymmetry of the hippocampi, slightly smaller on the right, but no abnormal signal and well-preserved laminar anatomy. An electroencephalogram was negative. She was discharged from the emergency room with no treatment. Three weeks later, the patient's boyfriend witnessed an episode of behavioral arrest with lip smacking and swallowing automatisms lasting 45 seconds, after which the patient was confused for 20–30 minutes. The next morning she and her boyfriend kept a previously scheduled appointment with a neurologist.

scholarly journals Altered Mental Status and a Retro-auricular Mass

2006 ◽  
Vol 33 (3) ◽  
pp. 317-319
Author(s):  
Lauren M. Segal ◽  
Angela Walker ◽  
Eric Marmor ◽  
Errol Stern ◽  
Mark Levental ◽  
...  
Keyword(s):  
Eye Movements ◽  
Glasgow Coma Scale ◽  
Emergency Room ◽  
Mental Status ◽  
External Auditory Canal ◽  
Posterior Wall ◽  
Altered Mental Status ◽  
Facial Paresis ◽  
Coma Scale ◽  
History Of

A 29-year-old woman was found lying unconscious in the shower. There was a two-day history of headache and dizziness. In the emergency room, she was initially stuporous (Glasgow Coma Scale 10/15), afebrile, bradycardic and hypertensive. She exhibited roving, conjugate eye movements, left facial paresis (including frontalis), left ptosis, diffuse hypotonia, extensor plantar responses bilaterally and a 1.5 cm warm, fluctuant mass with surrounding erythema behind the left ear (Figure 1). Otoscopy revealed a bulge in the posterior wall of the left external auditory canal.

Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room

1987 ◽  
Vol 60 (4) ◽  
pp. 219-224 ◽  
Author(s):  
Thomas H. Lee ◽  
Gregory W. Rouan ◽  
Monica C. Weisberg ◽  
Donald A. Brand ◽  
Denise Acampora ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Natural History ◽  
Emergency Room ◽  
Clinical Characteristics ◽  
History Of

scholarly journals Cardiometabolic and mental health in women with early gestational diabetes mellitus: A prospective cohort study

2021 ◽  
Author(s):  
Dan Yedu Quansah ◽  
Justine Gross ◽  
Leah Gilbert ◽  
Amelie Pauchet ◽  
Antje Horsch ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Gestational Weight ◽  
Pregnancy And Postpartum ◽  
History Of

Abstract Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 women with cGDM and 76 women with eGDM. eGDM had GDM-risk factors (BMI >30kg/m 2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age and diagnosed using ADA prediabetes criteria. Women underwent lifestyle adaptations. Obstetric, neonatal, mental, cardiometabolic outcomes were assessed during pregnancy and postpartum. Results eGDM had lower gestational weight gain than cGDM (10.7±6.2 vs 12.6±6.4, p=0.03), but needed more medical treatment (66% vs 42%, p<0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%, p=0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (p≤0.001). In eGDM, the postpartum prevalence of metabolic syndrome (MetS) was 1.8-times, prediabetes was 3.1-times and diabetes was 7.4-times higher than cGDM (MetS-waist circumference-based: 62% vs 34%/MetS-BMI-based: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all p<0.001). These differences remained unchanged after adjusting for GDM-risk factors. Conclusion Compared to cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM-risk factors and gestational weight gain. This hints to a pre-existing risk-profile in eGDM.

scholarly journals Accelerated Bilateral Cataract Formation as a First Manifestation of Diabetes Mellitus

2013 ◽  
Vol 114 (4) ◽  
pp. 258-262 ◽  
Author(s):  
M. R. Manaviat ◽  
Nasim Oveisi ◽  
A. Zare-Bidoki
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Emergency Room ◽  
Type 1 Diabetes Mellitus ◽  
Cataract Formation ◽  
Bilateral Cataract ◽  
Duration Of Diabetes ◽  
History Of ◽  
New Onset

There is a proved relationship between diabetes mellitus and the cataract formation. The incidence of this is usually related to the duration of diabetes. In this manuscript we report a 15 years old female presented to the emergency room with a 4 hour history of rapid bilateral diminished vision, initially diagnosed with idiopathic cataracts, but after more laboratory evaluations revealed new-onset type 1 diabetes mellitus without ketosis.

scholarly journals Call for Emergency Room Guidelines to Identify Hyperthyroid Patients Prior to Contrast Imaging

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A922-A923
Author(s):  
Sandhya Bassin ◽  
Louis F Amorosa
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Room ◽  
Definitive Treatment ◽  
Graves Disease ◽  
Contrast Imaging ◽  
Iodinated Contrast ◽  
Increased Risk ◽  
History Of ◽  
The Impact ◽  
Hyperthyroid Patients

Abstract Background: Thyrotoxicosis can be mistaken for conditions such as atrial fibrillation and pulmonary embolism (PE) given the nonspecific symptoms of fatigue, palpitations, and dyspnea. Patients often undergo further imaging on presentation to the emergency room (ER), many of which use iodine for contrast. This can put patients at increased risk for iodine induced hyperthyroidism and delay definitive treatment in patients with Graves’ disease, the most common cause of hyperthyroidism. Clinical Case: A 53-year-old male with history of hyperthyroidism, atrial fibrillation, and prior PE presented with palpitations to the ER. He developed worsening dyspnea on exertion and palpitations over the last three days. He was unable to afford his medications, including methimazole, for the last nine months. In the ER he was in atrial fibrillation with rapid ventricular response. Due to concern for PE, he underwent a CTA with contrast, which was negative. His physical exam was notable for a diffusely enlarged goiter. His labs showed low TSH <0.01 (norm 0.35-5.50mIU/L) and high free T4 >7.77 (norm 0.9-1.8ng/dL). TSH stimulating antibodies were elevated at 1.9 (norm <1.3 TSI index), consistent with Graves’ hyperthyroidism. Endocrinology was then consulted for severe thyrotoxicosis, initially treating the patient with PTU and propranolol. The patient was transitioned to methimazole and continued propranolol on discharge. Since he was given contrast, plan was for repeat thyroid uptake scan and iodine ablation in 3 months. However, patient was not compliant with medications, resulting in readmission for thyrotoxicosis 3 months later. Conclusion: This case highlights the impact of increased use of contrast in imaging in hyperthyroid patients. Hyperthyroid patients are at an increased risk for emboli. However, iodine can cause contrast-induced hyperthyroidism and delay definitive treatment of Graves’ disease. As almost half of thyrotoxic patients receive iodinated contrast prior to an endocrine consultation, endocrinologists should work with emergency physicians to develop a set of guidelines to identify at risk populations for hyperthyroidism (1). We advocate for urgent thyroid testing in patients with new onset atrial fibrillation, a history of Graves’ disease, specific symptoms of Graves’, or those taking thyrotoxic-inducing medications. This will assist in determining if patients should receive a prophylactic dose of anti-thyroid medication prior to iodinated contrast imaging. These guidelines can help prevent contrast induced hyperthyroidism and disruptions in treatment of Graves’ while still imaging patients for other diagnoses on the differential. Reference: (1) Giacomini A, et al. Urgent thyroid-stimulating hormone testing in emergency medicine: A useful tool? J Emerg Med. 2015;49(4):481-487.

scholarly journals Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

2016 ◽  
Author(s):  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Gestational Age ◽  
Post Partum ◽  
Severe Preeclampsia ◽  
Maternal Complications ◽  
History Of ◽  
Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/μl, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

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