scholarly journals Optimal Time Intervals for Vaginal Breech Births: A Case-Control Study

2021 ◽  
Author(s):  
Emma Spillane ◽  
Shawn Walker ◽  
Christine McCourt
Keyword(s):  
Predictive Value ◽  
Case Control Study ◽  
Algorithm Design ◽  
Population Sample ◽  
Case Control ◽  
Optimal Time ◽  
Retrospective Case ◽  
Second Stage Of Labour ◽  
Breech Birth ◽  
Control Study

Objective: To test the predictive value of the Physiological Breech Birth Algorithm. Design: Retrospective case-control study Setting: Teaching Hospital, United Kingdom Population/sample: Cases were all vaginal breech births >37 weeks’ gestation where neonatal admission or death occurred between April 2012 and April 2020. Controls were the two term breech births without admission immediately prior to the cases. Methods: Data was collected from intrapartum care records and analysed using SPSS v26 statistical software. The chi-square test was used to determine association between exposure to the variables of interest and admission to the neonatal unit. Multiple logistic regression was used to test the predictive value of delays defined as non-adherence to the Algorithm. Main outcome measures: Intervals between the start of labour, the start of second stage of labour and various stages of emergence (presenting part, buttocks, pelvis, arms, head). Results: Logistic regressing modelling using the Algorithm time frames had an 84.2% accuracy, a sensitivity of 66.7% and a specificity of 92.3%. Delays between umbilicus and head >3 minutes (OR: 9.508 [95% CI: 1.390-65.046] p=0.022) and from buttocks on the perineum to head >7 minutes (OR: 6.682 [95% CI: 0.940-41.990] p=0.058) showed the most effect. Lengths of time until the first intervention were also longer among the cases, suggesting that at least some of this delay is modifiable. Conclusions: Improved recognition of delay and efficient assistance may help improve vaginal breech birth outcomes. Further research should determine whether training based on the Physiological Breech Birth Algorithm can reduce neonatal admissions.

scholarly journals Clinical and Laboratory Markers of Brain Abscess in Tetralogy of Fallot (‘BA-TOF’ Score): Results of a Case–Control Study and Implications for Community Surveillance

2021 ◽  
Author(s):  
Vidyasagar Kanneganti ◽  
Sumit Thakar ◽  
Saritha Aryan ◽  
Prayaag Kini ◽  
Dilip Mohan ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Brain Abscess ◽  
Predictive Value ◽  
Case Control Study ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Case Control ◽  
Retrospective Case ◽  
Neutrophil Lymphocyte Ratio ◽  
Control Study

Abstract Background Cardiogenic brain abscess (CBA) is the commonest noncardiac cause of morbidity and mortality in cyanotic heart disease (CHD). The clinical diagnosis of a CBA is often delayed due to its nonspecific presentations and the scarce availability of computed tomography (CT) imaging in resource-restricted settings. We attempted to identify parameters that reliably point to the diagnosis of a CBA in patients with Tetralogy of Fallot (TOF). Methods From among 150 children with TOF treated at a tertiary care institute over a 15-year period from 2001 to 2016, 30 consecutive patients with CBAs and 85 age- and sex-matched controls without CBAs were included in this retrospective case–control study. Demographic and clinical features, laboratory investigations, and baseline echocardiographic findings were analyzed for possible correlations with the presence of a CBA. Statistical Analysis Variables demonstrating significant bivariate correlations with the presence of a CBA were further analyzed using multivariate logistic regression (LR) analysis. Various LR models were tested for their predictive value, and the best model was then validated on a hold-out dataset of 25 patients. Results Among the 26 variables tested for bivariate associations with the presence of a CBA, some of the clinical, echocardiographic, and laboratory variables demonstrated significant correlations (p < 0.05). LR analysis revealed elevated neutrophil–lymphocyte ratio and erythrocyte sedimentation rate values and a lower age-adjusted resting heart rate percentile to be the strongest independent biomarkers of a CBA. The LR model was statistically significant, (χ2 = 23.72, p = <0.001), and it fitted the data well. It explained 53% (Nagelkerke R 2) of the variance in occurrence of a CBA, and correctly classified 83.93% of cases. The model demonstrated a good predictive value (area under the curve: 0.80) on validation analysis. Conclusions This study has identified simple clinical and laboratory parameters that can serve as reliable pointers of a CBA in patients with TOF. A scoring model—the ‘BA-TOF’ score—that predicts the occurrence of a CBA has been proposed. Patients with higher scores on the proposed model should be referred urgently for a CT confirmation of the diagnosis. Usage of such a diagnostic aid in resource-limited settings can optimize the pickup rates of a CBA and potentially improve outcomes.

scholarly journals Decreased SFRP5 Correlated With Excessive Metabolic Inflammation in Polycystic Ovary Syndrome Can Be Reversed by Metformin: A Retrospective Case-Control Study

2021 ◽  
Author(s):  
Yi Zhang ◽  
Yuxin Ran ◽  
Lingna Kong ◽  
Lihong Geng ◽  
Hua Huang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Predictive Value ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Case Control ◽  
Metabolic Abnormality ◽  
Retrospective Case ◽  
Ovary Syndrome ◽  
Metabolic Inflammation ◽  
Control Study

Abstract Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder of heterogeneous nature. Secreted frizzled-related protein (SFRP) 5 is an anti-inflammatory adipokine implicated in metabolic homeostasis. We aimed to confirm the correlation between SFRP5, metabolic inflammation and PCOS, investigate the predictive value of SFRP5 for PCOS and the involvement of SFRP5 in metformin treated PCOS.Methods: This retrospective case-control study included PCOS and control women (67 vs. 33) for detecting serum SFRP5 and its correlation with metabolic inflammation. Predictive value of SFRP5 for PCOS was evaluated by logistic regression and receiver operating characteristic (ROC) analyses. The effects of metformin on SFRP5 and pro-inflammatory cytokines and ovulation of PCOS with metabolic abnormality (37 vs. 36) were analysed.Results: Plasma SFRP5 levels were decreased in PCOS (odds ratio: 0.78, 95% confidence interval (CI):0.703–0.866, P<0.001) independent of obesity. SFRP5 was negatively associated with IL-6, TNFα, FAI and HOMA-IR. The cut-off point of SFRP5 < 46.13 ng/ml was optimal to identify PCOS with a higher specificity of 96.87% and a relatively lower sensitivity compared to AMH. SFRP5 increased specificity of AMH for predicting PCOS, especially which with relatively decreased AMH (< 4.7 ng/ml). Metformin promoted SFRP5 and decreased leptin, IL-6 and TNFα secretion in PCOS women with metabolic abnormality in a time dependent manner and with improved ovulation rate and pregnancy outcomes.Conclusion: Decreased SFRP5 was associated with metabolic inflammation in PCOS and has a potential role for the supplement of AMH in predicting PCOS. The reverse of serum SFRP5 by metformin indicated that SFRP5 participated in the improvment of follicular development by metformin. Further prospective investigations are needed to confirm these preliminary data.

Assessment of Craniofacial Morphology in Mouth Breathing Children. A retrospective case-control study

2019 ◽  
Vol 70 (10) ◽  
pp. 3649-3653
Author(s):  
David Angelescu ◽  
Teodora Angelescu ◽  
Meda Romana Simu ◽  
Alexandrina Muntean ◽  
Anca Stefania Mesaros ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Craniofacial Morphology ◽  
Respiratory Pattern ◽  
Control Group ◽  
Upper Lip ◽  
Retrospective Case ◽  
Oral Breathing ◽  
Facial Height ◽  
Control Study

The aim of this retrospective case-control study is to determine a possible correlation between breathing mode and craniofacial morphology. The study was carried out in the Department of Pedodontics,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. The sample comprised 80 patients, age between 6 and 13 years, which were divided in two groups based on respiratory pattern: control group composed of 38 nasal breathing children and case group composed of 42 oral breathing children. Three quantitative craniofacial parameters were measured from the frontal and lateral photos: facial index, lower facial height ratio and upper lip ratio. The statistical analysis showed a significant higher facial index (p=0.006*) and an increase lower facial height (p=0.033*) for the oral breathers group. No differences in facial morphology were found between genders and age groups, when comparing the data between the same type of respiratory pattern children. Spearman�s rho Correlation show a significant positive correlation (p=0.002*) between facial index and lower facial height and a significant negative correlation between facial index and upper lip (p=0,005*). Long faces children are more likely to develop oral breathing in certain conditions, which subsequently have a negative effect on increasing the lower facial height by altering the postural behavior of mandible and tongue.

scholarly journals Prevalence of Balance Impairment and Factors Associated with Balance among Patients with Stroke. A Cross Sectional Retrospective Case Control Study

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 320
Author(s):  
Fayaz Khan ◽  
Mohamed Faisal Chevidikunnan
Keyword(s):  
Case Control Study ◽  
Binary Logistic Regression ◽  
Berg Balance Scale ◽  
Case Control ◽  
Knee Extensors ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Balance Impairment ◽  
Factors Associated ◽  
Control Study

Stroke is a major cause of disability worldwide, and balance impairments are common disabling factors in patients with stroke, leading to falls. Thus, the study objectives were as follows: (i) To find the prevalence of balance impairment among patients with stroke. (ii) To find out the factors associated with balance impairment in patients with stroke. This cross-sectional retrospective case control study involved eighty-one post stroke patients with a mean age of 58.36 ± 14.06, recruited from six hospitals, who underwent an assessment of balance, walking speed, depression and isometric strength of the ankle and knee. These patients were later categorized into subjects with good balance (<45) in the Berg balance scale (BBS) and those with poor balance (≥45), as cases and controls, to assess the factors associated with balance impairment using binary logistic regression. The prevalence of balance impairment among patients with stroke was 48.1%. The reduction in power of knee flexors (OR = 0.858), knee extensors (OR = 0.880) and ankle dorsiflexors (OR = 0.820) was found to be significantly associated with balance impairment, along with speed (OR = 1.187 (95% CI = 1.100, 1.280)), depression (OR = 1.331 (95% CI = 1.055–1.679)) and activities of daily living (OR = 0.313 (95% CI = 0.150–0.650)). In summary, around half of the patients with stroke exhibited balance impairments, with females being more prone.

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