scholarly journals LATERAL POSITION OF PLACENTA DETECTED ON ULTRA-SONOGRAM AT 18 TO 24 WEEKS OF PREGNANCY AS A PREDICTOR FOR DEVELOPMENT OF PREECLAMPSIA

2021 ◽  
Vol 10 (4) ◽  
pp. 3410-3413
Author(s):  
Minal Kalambe
Keyword(s):  
Critical Care ◽  
Observational Study ◽  
Pregnant Women ◽  
Screening Tool ◽  
Cost Effective ◽  
Lateral Position ◽  
Research Centre ◽  
Pregnancy Hypertension ◽  
Long Term Consequences

The placenta is an important organ that connects the mother to the fetus. It is a well-known cause of pregnancy hypertension. The position of the placenta and the development of preeclampsia are linked in several studies. The purpose of this study was to determine whether the percentage delay as determined by ultrasound could be used as a predictor of the development of preeclampsia. A retrospective and prospective, and observational study was done in Choithram Hospital & Research Centre, Indore. The study was done on 130 pregnant women, out of which 62 females had laterally located placenta and 68 had centrally located placenta selected randomly from November 2015 to November 2017. Preeclampsia developed in 68.09 percent of women in the lateral placenta group. Only 31.91 percent of women in the group with the central placenta developed preeclampsia. As a result, females with a laterally positioned placenta had a 3.7 times higher risk of having PIH than those with a centrally situated placenta. With a laterally placed placenta, the overall chance of having PIH was 3.769. This study, laterally located placenta increased association of development of preeclampsia in patients than centrally located placenta which reduces the hospital burden, and long term consequences of the disease thereby reducing the huge cost of critical care for mother and newborn. Thus, making ultrasonography a cost effective, practical, painless, beneficial and reliable screening tool.

scholarly journals NESTROFT—A Cost-Effective Mass Screening Tool for the Detection of β-Thalassemia Carrier Status in Anemic Pregnant Women: A Step Toward Reducing the National Disease Burden

2021 ◽  
Author(s):  
Manasi Gosavi ◽  
Ramesh Chavan ◽  
M. B. Bellad
Keyword(s):  
Pregnant Women ◽  
Effective Mass ◽  
Mass Screening ◽  
Predictive Value ◽  
Screening Tool ◽  
Hematological Parameters ◽  
False Negative ◽  
Cost Effective ◽  
Mean Corpuscular Hemoglobin ◽  
Carrier Status

Abstract Introduction β-Thalassemias are inherited hemoglobinopathies commonly encountered in practice. With chances of a promising cure being rare, the prevention of births with this disorder should assume priority, especially in low-resource countries. This can be achieved by the implementation of a mass screening program that is reliable and, at the same time, cost-effective. Objectives This study focuses on the utility of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) as a mass screening tool to detect thalassemia carriers. Hematological parameters that may predict carrier status were also evaluated. Materials and Methods Hemoglobin estimation was performed on all consented pregnant women. If the patient was found to have hemoglobin < 11 g/dL, the blood sample was subjected to other routine hematological tests along with peripheral smear examination. NESTROFT was performed using 0.36% saline solution. Confirmation was done using high-performance liquid chromatography (HPLC). Statistical Analysis Data obtained were tabulated using version 21 of the Statistical Package for Social Sciences. Means, standard deviations, and percentages were used to describe the sample. Chi-square test and Students’ “t” test were used to identify differences between the groups. Results Of 441 pregnant women enrolled, 206 were found to be anemic. Nineteen (9.2%) of the anemic pregnant women were detected to be carriers of hemoglobinopathies. Among the hematological parameters, mean red blood cell count and reticulocyte count were higher, while mean corpuscular hemoglobin concentration was lower in carriers. Also, carriers were more likely to present with microcytic hypochromic anemia. NESTROFT showed a sensitivity of 84.21%, specificity of 96.25%, a positive predictive value of 69.56%, and a negative predictive value of 98.36%. A false-positive result was seen in 3.74% of the tests, while a false negative result was seen in 15.78% of the tests. Conclusions NESTROFT (0.36%) can be used as a simple and cost-effective mass screening tool for the detection of carrier status. This should be followed by confirmation using HPLC or hemoglobin electrophoresis.

scholarly journals The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

2018 ◽  
Vol 8 (6) ◽  
pp. 93
Author(s):  
Ghada Shalaby Khalaf Mahran ◽  
Sayed K. Abd-Elshafy ◽  
Manal Mohammed Abd El Neem ◽  
Jehan A. Sayed
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Body Position ◽  
Critical Issue ◽  
Lateral Position ◽  
Abdominal Pressure ◽  
University Hospitals ◽  
Abdominal Hypertension

Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation.Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0º, 15º, and 30º). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0º, 15º, and 30º respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0º, 3.8 ± 1.00 mmHg at 15º, and 5.5 ± 1.01 mmHg at 30 º (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

scholarly journals Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed A. Adlan ◽  
Lakdasa D. Premawardhana
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Screening Tool ◽  
Cost Effective ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Screening Strategies ◽  
Considerable Morbidity ◽  
Postpartum Thyroid Dysfunction

Postpartum thyroid dysfunction (PPTD) is a common disorder which causes considerable morbidity in affected women. The availability of effective treatment for hypothyroid PPTD, the occurrence of the disease in subsequent pregnancies and the need to identify subjects who develop long term hypothyroidism, has prompted discussion about screening for this disorder. There is currently no consensus about screening as investigations hitherto have been variable in their design, definitions and assay frequency and methodology. There is also a lack of consensus about a suitable screening tool although thyroid peroxidase antibody (TPOAb) is a leading contender. We present data about the use of TPOAb in early pregnancy and its value as a screening tool. Although its positive predictive value is moderate, its sensitivity and specificity when used in early pregnancy are comparable or better compared to other times during pregnancy and the postpartum period. Recent studies have also confirmed this strategy to be cost effective and to compare favourably with other screening strategies. We also explore the advantages of universal screening.

Campylobacter jejuni Infection during Pregnancy: Long-Term Consequences of Associated Bacteremia, Guillain-Barré Syndrome, and Reactive Arthritis†

2002 ◽  
Vol 65 (4) ◽  
pp. 696-708 ◽  
Author(s):  
JAMES L. SMITH
Keyword(s):  
Pregnant Women ◽  
Campylobacter Jejuni ◽  
Reactive Arthritis ◽  
The United States ◽  
Guillain Barre Syndrome ◽  
Normal Infant ◽  
Guillain Barré Syndrome ◽  
Long Term Consequences ◽  
Guillain Barré

Campylobacter jejuni infections are the main cause of foodborne gastroenteritis in the United States and other developed countries. Generally, C. jejuni infections are self-limiting and treatment is not necessary; however, infections caused by this organism can lead to potentially dangerous long-term consequences for some individuals. Bacteremia, Guillain-Barré syndrome (GBS; an acute flaccid paralytic disease), and reactive arthritis (ReA) are the most serious of the long-term consequences of C. jejuni infections. During pregnancy, foodborne infections may be hazardous to both the woman and the fetus. C. jejuni–induced bacteremia during pregnancy may lead to intrauterine infection of the fetus, abortion, stillbirth, or early neonatal death. Infection of a newborn by the mother during the birth process or shortly after birth may lead to neonatal enteritis, bacteremia, and/or meningitis. C. jejuni enteritis is the inducing antecedent infection in approximately 30% of cases of GBS. Thus, pregnant women infected with C. jejuni may contract GBS. GBS during pregnancy does not affect fetal or infant development and does not increase spontaneous abortion or fetal death; however, it may induce spontaneous delivery during the third trimester in severe cases. Reactive arthritis occurs in approximately 2% of C. jejuni enteritis cases and leads to the impaired movement of various joints. Pregnant women with C. jejuni–induced reactive arthritis can be expected to deliver a normal infant. A pregnant patient with GBS or ReA may be unable to care for a newborn infant because of the physical impairment induced by these diseases. Since C. jejuni infections put both fetuses and pregnant women at risk, pregnant women must take special care in food handling and preparation to prevent such infections.

scholarly journals A protocol for the economic evaluation of the smoking Cessation in Pregnancy Incentives Trial III (CPIT III)

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038827
Author(s):  
Nicola McMeekin ◽  
Lesley Sinclair ◽  
Linda Bauld ◽  
David Michael Tappin ◽  
Alex Mitchell ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Usual Care ◽  
Pregnant Women ◽  
Financial Incentives ◽  
Cost Effective ◽  
Good Opportunity ◽  
Link Type ◽  
The Uk ◽  
In Pregnancy

IntroductionSmoking results in an average 10-year loss of life, but smokers who permanently quit before age 40 can expect a near normal lifespan. Pregnancy poses a good opportunity to help women to stop; around 80% of women in the UK have a baby, most of whom are less than 40 years of age. Smoking prevalence during pregnancy is high: 17%–23% in the UK. Smoking during pregnancy causes low birth weight and increases the risk of premature birth. After birth, passive smoking is linked to sudden infant death syndrome, respiratory diseases and increased likelihood of taking up smoking. These risks impact the long-term health of the child with associated increase in health costs. Emerging evidence suggests that offering financial incentives to pregnant women to quit is highly cost effective.This protocol describes the economic evaluation of a multi-centre randomised controlled trial (Cessation in Pregnancy Incentives Trial III, CPIT III) designed to establish whether offering financial incentives, in addition to usual care, is effective and cost effective in helping pregnant women to quit.Methods and analysisThe economic evaluation will identify, measure and value resource use and outcomes from CPIT III, comparing participants randomised to either usual care or usual care plus up to £400 financial incentives. Within-trial and long-term analyses will be conducted from a National Health Service and Personal Social Services perspective; the outcome for both analyses will be quality adjusted life-years measured using EQ-5D-5L. Patient level data collected during the trial will be used for the within-trial analysis, with an additional outcome of cotinine validated quit rates at 34–38 weeks gestation and 6 months postpartum. The long-term model will be informed by data from the trial and published literature.Ethics and disseminationTrial registration numberISRCTN15236311; Pre-results (https://doi.org/10.1186/ISRCTN15236311).

scholarly journals Neonatal Late Onset Infection with Severe Acute Respiratory Syndrome Coronavirus 2

2020 ◽  
Vol 37 (08) ◽  
pp. 869-872 ◽  
Author(s):  
Simonetta Costa ◽  
Danilo Buonsenso ◽  
Maurizio Sanguinetti ◽  
Paola Cattani ◽  
Brunella Posteraro ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Observational Study ◽  
Late Onset ◽  
Early Period ◽  
Key Points ◽  
Long Term Consequences ◽  
Late Onset Infection ◽  
In Pregnancy

Objective To date, no information on late-onset infection in newborns to mother with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contracted in pregnancy are available. This study aimed to evaluate postdischarge SARS-CoV-2 status of newborns to mothers with COVID-19 in pregnancy that, at birth, were negative to SARS-CoV-2. Study Design This is an observational study of neonates born to mothers with coronavirus disease 2019 (COVID-19). Results Seven pregnant women with documented SARS-CoV-2 infection have been evaluated in our institution. One woman had a spontaneous abortion at 8 weeks of gestational age, four women recovered and are still in follow-up, and two women delivered. Two newborns were enrolled in the study. At birth and 3 days of life, newborns were negative to SARS-CoV-2. At 2-week follow-up, one newborn tested positive although asymptomatic. Conclusion Our findings highlight the importance of follow-up of newborns to mothers with COVID-19 in pregnancy, since they remain at risk of contracting the infection in the early period of life and long-term consequences are still unknown. Key Points

scholarly journals Long Term Cost-Effectiveness of Resilient Foods for Global Catastrophes Compared to Artificial General Intelligence Safety

2021 ◽  
Author(s):  
David Denkenberger ◽  
Anders Sandberg ◽  
Ross Tieman ◽  
Joshua M. Pearce
Keyword(s):  
Cost Effectiveness ◽  
Charitable Giving ◽  
Probabilistic Models ◽  
Cost Effective ◽  
General Intelligence ◽  
Artificial General Intelligence ◽  
Long Run ◽  
Long Term Consequences ◽  
Nuclear Winter

Global agricultural catastrophes, which include nuclear winter and abrupt climate change, could have long-term consequences on humanity such as the collapse and nonrecovery of civilization. Using Monte Carlo (probabilistic) models, we analyze the long-term cost-effectiveness of resilient foods (alternative foods) - roughly those independent of sunlight such as mushrooms. One version of the model populated partly by a survey of global catastrophic risk researchers finds the confidence that resilient foods is more cost effective than artificial general intelligence safety is ~86% and ~99% for the 100 millionth dollar spent on resilient foods at the margin now, respectively. Another version of the model based on one of the authors produced ~95% and ~99% confidence, respectively. Considering uncertainty represented within our models, our result is robust: reverting the conclusion required simultaneously changing the 3-5 most important parameters to the pessimistic ends. However, as predicting the long-run trajectory of human civilization is extremely difficult, and model and theory uncertainties are very large, this significantly reduces our overall confidence. Because the agricultural catastrophes could happen immediately and because existing expertise relevant to resilient foods could be co-opted by charitable giving, it is likely optimal to spend most of the money for resilient foods in the next few years. Both cause areas generally save expected current lives inexpensively and should attract greater investment.

scholarly journals Exploration of introducing a chlamydia screening programme to the Democratic People's Republic of Korea

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Gareth Mark Jones ◽  
Ye Jin Kang
Keyword(s):  
Screening Programme ◽  
Acute Infection ◽  
Cost Effective ◽  
Chlamydia Screening ◽  
Men And Women ◽  
Ct Screening ◽  
Increased Risk ◽  
Long Term Consequences ◽  
The Cost

Chlamydia trachomatis is a common STI that is often asymptomatic, and can only be diagnosed through a screening test. Despite acute infection being asymtpoamtic, long term consequences of untreated CT infection can lead to infertility in men and women, increased risk of ectopic preganancy, and the economic burden of the long-term impacts far outweigh the cost of testing and treatment. Despite this, there is currently no concentrated CT screening programme in the DPRK, a region that is indicated to have high STI rates, including CT. Taking into account prevalency, the geopolitical situation of the DPRK, and the cost per positive test, this paper explores whether or not a CT screening programme would be cost-effective in the DPRK.

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