scholarly journals Pregnancies past the estimated date of confinement: labour and delivery outcome

2003 ◽  
Vol 9 (5-6) ◽  
pp. 955-960
Author(s):  
M. Al Taani
Keyword(s):  
Caesarean Section Rate ◽  
Adverse Outcomes ◽  
Mortality And Morbidity ◽  
Delivery Outcome ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
The Difference ◽  
A Prospective Study ◽  
Onset Group ◽  
Spontaneous Onset

To compare labour and delivery outcomes in women undergoing induction and those having spontaneous onset for pregnancies past the estimated date of delivery, a prospective study of 395 singleton, uncomplicated pregnancies was performed. Labour was induced in 175 women. Overall caesarean section rate was 9.4%, with no significant difference between the 2 groups. Overall rate of assisted vaginal deliveries was 7%, higher in the induction group than the spontaneous onset group but the difference was not significant. There was no significant difference in occurrence of intrapartum meconium, nor for maternal morbidity. No neonate needed intubation. No perinatal deaths occurred. Perinatal mortality and morbidity are preventable, and induction of labour before 42 weeks is justifiable to prevent adverse outcomes

A prospective study to determine the clinical utility of pharmacogenetic testing of veterans with treatment-resistant depression

2021 ◽  
pp. 026988112110152
Author(s):  
Michael J McCarthy ◽  
Yucui Chen ◽  
Anna Demodena ◽  
Susan G Leckband ◽  
Eileen Fischer ◽  
...  
Keyword(s):  
Social Stress ◽  
Risk Groups ◽  
Adverse Outcomes ◽  
Treatment Resistant Depression ◽  
Post Traumatic Stress ◽  
Treatment Resistant ◽  
Treatment As Usual ◽  
Resistant Depression ◽  
The Difference ◽  
A Prospective Study

Background: Pharmacotherapies for depression are often ineffective and treatment-resistant depression (TRD) is common across bipolar disorder (BD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Patient genetic information can be used to predict treatment outcomes. Prospective studies indicate that pharmacogenetic (PGX) tests have utility in the treatment of depression. However, few studies have examined the utility of PGX in other diagnoses typified by depression, or in veterans, a cohort with high rates of medical comorbidity, social stress, and suicide. Aim: To determine the efficacy of genetically guided pharmacological treatment of TRD. Methods: We conducted an 8-week, prospective, multisite, single-blind study in 182 veterans with TRD including patients with BD, MDD, and PTSD. Subjects were randomly assigned to PGX-guided treatment in which the clinician incorporated PGX information into decision-making, or treatment as usual (TAU). Results: Overall, the PGX group improved marginally faster compared to TAU, but the difference was not statistically significant. Secondary analyses revealed that only PTSD patients showed a potential benefit from PGX testing. Patients predicted by PGX testing to have moderate levels of genetic risk showed a significant benefit from the PGX-guided treatment, whereas other risk groups demonstrated no benefit. Clinicians generally found the PGX test was useful, particularly in more depressed patients and/or those with more warnings for significant or serious adverse outcomes. Clinicians more often used the results to select a drug, but only rarely to adjust dosing. Conclusions: The data reveal possible group differences in the utility of PGX testing in veterans with TRD. ClinicalTrials.gov Identifier: NCT04469322.

scholarly journals Impact of Fluoroquinolone Exposure Prior to Tuberculosis Diagnosis on Clinical Outcomes in Immunocompromised Patients

2016 ◽  
Vol 60 (7) ◽  
pp. 4005-4012 ◽  
Author(s):  
Ju Young Lee ◽  
Hyun Jung Lee ◽  
Yong Kyun Kim ◽  
Shinae Yu ◽  
Jiwon Jung ◽  
...  
Keyword(s):  
Median Time ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Care Hospital ◽  
Immunocompromised Patients ◽  
Tb Treatment ◽  
Significant Difference ◽  
Tuberculosis Diagnosis ◽  
The Difference

ABSTRACTThere have been concerns about an association of fluoroquinolone (FQ) use prior to tuberculosis (TB) diagnosis with adverse outcomes. However, FQ use might prevent clinical deterioration in missed TB patients, especially in those who are immunocompromised, until they receive definitive anti-TB treatment. All adult immunocompromised patients with smear-negative and culture-positive TB at a tertiary care hospital in Korea over a 2-year period were included in this study. Long-term FQ (≥7 days) use was defined as exposure to FQ for at least 7 days prior to TB diagnosis. A total of 194 patients were identified: 33 (17%) in the long-term FQ group and 161 (83%) in the comparator, including a short-term FQ group (n= 23), non-FQ group (n= 78), and a group receiving no antibiotics (n= 60). Patients in the long-term FQ group presented with atypical chest radiologic pattern more frequently than those in the comparator (77% [24/31] versus 46% [63/138];P= 0.001). The median time from mycobacterial test to positive mycobacterial culture appeared to be longer in the long-term FQ group (8.1 weeks versus 7.7 weeks;P= 0.09), although the difference was not statistically significant. Patients in the long-term FQ group were less likely to receive empirical anti-TB treatment (55% versus 74%;P= 0.03). The median time from mycobacterial test to anti-TB therapy was longer in the long-term FQ group (4.6 weeks versus 2.2 weeks;P< 0.001), but there was no significant difference in FQ resistance (0% versus 3%;P> 0.99) or in the 30-day (6% versus 6%;P> 0.99) or 90-day (12% versus 12%;P> 0.99) mortality rate between the two groups. FQ exposure (≥7 days) prior to TB diagnosis in immunocompromised patients appears not to be associated with adverse outcomes.

scholarly journals The Difference of Lymphocyte, hs-CRP, and Electroencephalogram with and without Simvastatin in Acute Ischemic Stroke

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Chairil Amin Batubara ◽  
Aldy Safruddin Rambe ◽  
Nindia Sugih Arto
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Epileptic Seizures ◽  
Chi Square ◽  
Double Blind ◽  
Mortality And Morbidity ◽  
Randomized Control Trial Design ◽  
Significant Difference ◽  
The Difference ◽  
Hs Crp

Mortality and morbidity due to stroke rank the highest in Indonesia (15.4%), and most types of stroke are ischemic (87%). Inflammation has a role in the pathophysiology of both ischemic stroke and also inhibits acute symptomatic epileptic seizures (3-6%) in the first 7 days after stroke. Statins have been used for the treatment of dyslipidemia in stroke patients. Some studies showed that statins reduced the inflammatory response after a stroke and prevented the recovery of epileptic seizures. This study aimed to determine the differences in lymphocytes, hs-CRP, Electroencephalogram (EEG) with and without Simvastatin in acute ischemic stroke. This research was an experimental study with a double-blind, randomized control trial design consisting of two groups, a group given Simvastatin 20 mg/day, and a group given a placebo for seven days. The difference in lymphocytes, hs-CRP, EEG, and epileptic seizures between the two groups were then analyzed. The sample was 26 people, consisting of 17 (65.4%) males and 9 (34.6%) females with an average age of 59±5.8 years. Chi-Square and Fisher's test showed a significant difference in hs-CRP (p=0.005) and epileptic seizures (p=0.015), but no significant difference in lymphocytes (p=0.336) and EEG (p=0.42) between groups given Simvastatin 20 mg/day and those given placebo. There was a significant difference in hs-CRP and epileptic seizures, but no significant difference in lymphocyte count and EEG between the two groups with and without Simvastatin administration.

scholarly journals Preventing cesareans with peanut ball use

2019 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Lauren Outland ◽  
Yolanda Alvarado
Keyword(s):  
Retrospective Study ◽  
Epidural Anesthesia ◽  
The United States ◽  
High Rate ◽  
Post Intervention ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Cesarean Births ◽  
Retrospective Study Design ◽  
The Difference

The Association of Women's Health Obstetrical and Neonatal Nurses (AWHONN) has launched a Peanut Ball campaign to help curb the high rate of cesarean births in the United States. Cesarean births are especially likely in women who receive epidural anesthesia due to immobility and pelvic laxity. The peanut ball (PB) is a birthing ball that when placed between the mother's legs can increase pelvic dimensions and facilitate fetal descent and birth. For PB to increase vaginal deliveries (VDs), nurses on obstetrical wards need to “buy in” to using this innovation. Having “innovator” nurses on the shift helped disseminate the PB intervention and increased the rate of VDs. Using a retrospective study design that uses data collected for non-research purposes saves time and cost. Our retrospective study examined the difference in VDs with patient controlled epidural anesthesia (PCEA) in the first five months of 2016 prior to PB use compared with the same months in 2017 post intervention. Using a paired t-test we found a significant difference of successful PCEA vaginal births in 2016 compared to 2017 (p = .008). This relatively inexpensive and easy survey can be done by most obstetrical services and help AWHONN in their campaign to decrease the rate of cesarean sections.

Partograph versus no partograph: effect on labour progress and delivery outcome: a comparative study

2017 ◽  
Vol 6 (11) ◽  
pp. 4928 ◽  
Author(s):  
Benazir Ahmed ◽  
Meena Jain ◽  
Hema Bharwani
Keyword(s):  
Comparative Study ◽  
Total Duration ◽  
Birth Asphyxia ◽  
Active Phase ◽  
Delivery Outcome ◽  
Second Stage ◽  
Active Labour ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Group 1

Background: Abnormal labour which includes prolonged labour and obstructed labour remain major causes of maternal morbidity. The major reason for neonatal mortality, birth asphyxia and subsequent morbidity is essentially the repercussion which occurs when a complicated labour is not intervened at the right time. A Partograph provides a graphic overview of the progress of labour and records information about maternal and fetal condition during labour. It is considered to be a very effective tool to monitor labour progress and prevent prolonged and obstructed labour.Methods: This prospective randomised comparative study was conducted in the Department of Obstetrics and Gynaecology, JLN Hospital and RC, Bhilai, Chattisgarh, from January 2015 to June 2016. Pregnant women were randomly assigned to two groups, of 200 each, after satisfying the inclusion and exclusion criteria. Women assigned to Group 1 had their active labour modified using modified WHO partograph whereas those assigned to Group 2 were not monitored using the partograph.Results: Use of Partograph (group 1) significantly reduced the duration of active phase of labour (p <0.0001), duration of second stage (p <0.0001) and thus the total duration of labour (active phase plus second stage) (p <0.0001). Requirement of augmentation was also significantly reduced (p <0.05). Group 1 also had significantly more spontaneous vaginal deliveries (p <0.01) with lesser requirement of operative interventions like LSCS or instrumental deliveries like forceps. Use of partograph also significantly improved neonatal outcome with significantly lesser newborns with Apgar <7 (p <0.05). However, there was no significant difference between the two groups with regard to NICU admissions (p>0.05).Conclusions: The use of Partograph, when compared to no Partograph plotting in active labour, is associated with better monitoring of labour progress as well as delivery outcome in the form of a healthy mother and a healthy child.

The Differences of Myelosuppression before and after Doxorubicin Chemotherapy in Breast Cancer Patients in Rsup. H. Adam Malik Medan

2021 ◽  
Vol 8 (7) ◽  
pp. 18-24
Author(s):  
Arnaldi Fernando ◽  
Dairion Gatot ◽  
Yan Indra Fajar Sitepu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Therapeutic Option ◽  
P Value ◽  
Breast Cancer Patients ◽  
Research Subjects ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Before And After ◽  
The Difference

Introduction: Breast cancer is formed from breast cells, either lobule or duct epithelium, which undergoes uncontrolled growth and development. The therapy of breast cancer to reduce mortality and morbidity can be done by way of surgery, chemotherapy, and radiotherapy. Doxorubicin chemotherapy is a therapeutic option to kill cells directly or by stopping the cell division based on the tumor pathogenesis. Method: This research is a paired numerical comparative analytical study using a retrospective cohort approach. This study was conducted on 56 breast cancer patients to see the differences in myelosuppression before and after doxorubicin chemotherapy at H. Adam Malik General Hospital Medan from January-December 2019. The data were obtained through recording the routine blood laboratory results listed in the patient's medical record and were analyzed with dependent t-test by using SPSS. The difference is significant if p <0.05. Result: The results showed that the average age of the research subjects was 40.79 years, 28 patients (50%) graduated from high school, 38 patients (67.9%) did not work and 53 patients (94.6%) had marital status. In a significant myelosuppression difference, anemia occured with chemotherapy Hb levels of 8.48 ± 1.09, the Hb difference in Hb prior to and after doxorubicin chemotherapy obtained a mean of 1.28 with p value <0.001. Conclusion: Based on the demographic characteristics of patients with breast cancer, it was found that the mean age of patients with breast cancer in women was 46.79 years; most of the subject’s education level was highschool, unemployed and married status. There was a very significant difference between the subject's Hb level and breast cancer before and after doxorubicin chemotherapy. Keywords: myelosuppression, doxorubicin, breast cancer.

Prevalence of Impaired Orthostasis after Concussion Injury

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S1.3-S2
Author(s):  
Michael F. La Fountaine ◽  
Asante Hohn ◽  
Caroline Leahy ◽  
Anthony Testa
Keyword(s):  
Collegiate Athletes ◽  
Transient State ◽  
Incidence Rates ◽  
Control Group ◽  
Clinical Approach ◽  
Male Age ◽  
Significant Difference ◽  
The Difference ◽  
Clinically Significant ◽  
A Prospective Study

ObjectiveTo determine the prevalence of orthostatic hypotension (OHypo) and hypertension (OHTN), respectively after a concussion in collegiate athletes.BackgroundOrthostasis causes a gravity-dependent redistribution of blood volume to the lower extremities. The baroreflex coordinates the cardiovascular autonomic nervous system to mitigate aberrant changes in systolic blood pressure (SBP). In autonomic dysfunction (AD), impaired accommodation may lead to a clinically significant? SBP decreases (OHypo: SBP fall = 20 mm Hg) or paradoxical increases (OHTN: SBP rise = 20 mm Hg) within 3 minutes of assuming the standing (STND) posture. Concussion injuries may induce a transient state of AD. A clinical approach to surveil this state has yet to be defined.Design/MethodsA prospective study was performed in 36 concussed (gender: 23 female, 13 male; age: 20 ± 1 years; height: 1.75 ± 0.12 meters; weight: 73 ± 14 kilograms) and 20 non-concussed athletes (gender: 12 female, 8 male; age: 21 ± 2 years; height: 1.74 ± 0.15 meters; weight: 72 ± 18 kilograms). Continuous beat-to-beat SBP was collected for 10-minutes in a resting supine position (SUP) and then for 3-minutes in the STND position within 48 hours (48H) of concussion. The average SBP was computed from the difference between SUP and the final 15 seconds of STND. SBP were then categorized: Normal (NR: SBP -15 to +15 mm Hg); Borderline OHypo (BordOHypo: SBP −16 to −19 mm Hg) and OHTN (BordOHTN: SBP +16 to +19 mm Hg); OHypo; and, OHTN.ResultsIn concussed athletes, the SBP prevalence rates were 42% NR, 31% OHypo, 11% OHTN, 11% BordOHTN, and 6% BordOHypo compared to 90% NR, 5% OHypo and 5% OHTN in the non-concussed athletes. ?2 test revealed a significant difference in this distribution (p = 0.012).ConclusionsWithin 48H of concussion injury, a combined 42% of injured athletes had an abnormal SBP response to orthostasis and a further 6% had borderline responses that warrant re-evaluation. The incidence rates for each circumstance exceeded the control group.

scholarly journals Induction of labour in prolonged pregnancy and its outcome

2015 ◽  
Vol 26 (2) ◽  
pp. 100-103
Author(s):  
Rabeya Sultana ◽  
Kohinoor Begum ◽  
Nahid Sultana ◽  
Naireen Sultana ◽  
Salma Akter Munmun ◽  
...  
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Uterine Action ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Delivery Outcome ◽  
Cause Of Failure ◽  
Prolonged Pregnancy ◽  
A Prospective Study

A prospective study was done in the Department of Obstetric and Gynecology, Dhaka Medical College Hospital, Dhaka from the January 2007 to June 2007. For the study 50 patients with uncomplicated prolonged pregnancy admitted during the study period were selected fulfilling the inclusion and the exclusion criteria. The study was conducted to evaluate the outcome of induction in prolonged pregnancy. From this study it was found that routine induction of labour at 41 to 42 weeks may be beneficial rather than continuing the pregnancy to have spontaneous labour which may increase the per perinatal mortality and morbidity. It was also found that due to routine induction of labour in prolonged pregnancy, vaginal delivery rate is more than caesarean section in multigravida than primigravida. Regarding the cause of failure of induction of labour it was found that the main causes are foetal distress and abnormal uterine action. The present study has proved that the use of Prostaglandin for cervical ripening, the delivery outcome can be improved. The study also showed that indiction of labour is not associated with any major intraprtum and postpartum foetal and maternal complication.Medicine Today 2014 Vol.26(2): 100-103

scholarly journals Comparison of the Effects of Maternal Supportive Care and Acupressure (BL32 Acupoint) on Pregnant Women’s Pain Intensity and Delivery Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Marzieh Akbarzadeh ◽  
Zahra Masoudi ◽  
Mohammad Javad Hadianfard ◽  
Maryam Kasraeian ◽  
Najaf Zare
Keyword(s):  
Supportive Care ◽  
Pain Intensity ◽  
Care Group ◽  
Control Group ◽  
Control Groups ◽  
Delivery Outcome ◽  
Effective Strategies ◽  
Significant Difference ◽  
The Difference ◽  
And Control

Delivery is considered as one of the most painful experiences of women’s life. The present study aimed to compare the effects of supportive care and acupressure on the pregnant women’s pain intensity and delivery outcome. In this experimental study, 150 pregnant women were randomly divided into supportive care, acupressure, and control groups. The intensity of pain was measured using Visual Analogue Scale (VAS). The supportive care group received both physical and emotional cares. In the acupressure group, on the other hand, BL32 acupoint was pressed during the contractions. Then, the data were analyzed using descriptive and inferential statistics. The results revealed significant difference among the three groups regarding the intensity of pain after the intervention (P<0.001). Besides, the highest rate of natural vaginal delivery was observed in the supportive care group (94%) and the acupressure group (92%), while the highest rate of cesarean delivery was related to the control group (40%) and the difference was statistically significant (P<0.001). The results showed that maternal supportive care and acupressure during labor reduced the intensity of pain and improved the delivery outcomes. Therefore, these methods can be introduced to the medical team as effective strategies for decreasing delivery pain. This trial is registered with the Iranian Registry of Clinical Trial CodeIRCT2014011011706N5.

Primary pterygium is not associated with corneal endothelial cell decrease in a rural Chinese population

2019 ◽  
Author(s):  
Yijun Hu ◽  
Alp Atik ◽  
Li Li ◽  
Wei Qi ◽  
Zhenhao Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Endothelial Cell ◽  
Prospective Study ◽  
Corneal Endothelial Cell ◽  
Chinese Patients ◽  
Significant Difference ◽  
Corneal Endothelial Cell Density ◽  
The Difference ◽  
A Prospective Study ◽  
Primary Pterygium

Abstract Purpose: To investigate corneal endothelial cell density (ECD) in eyes with primary pterygium. Methods: We first conducted a retrospective study to compare the ECD between 1670 eyes with primary pterygium and 4060 eyes without pterygium. Then we designed a prospective study to confirm the findings of our retrospective study in 95 patients with unilateral primary pterygium. Results: In the retrospective study, the mean ECD in eyes with primary pterygium (2453±306 cells/mm2) was significantly lower than those in eyes without pterygium (2529±313 cells/mm2, P<0.0001). However, the difference was not as high as previously reported (76 cells/mm2, 3.1%). In the prospective study, there was no significant difference in mean ECD in eyes with unilateral primary pterygium (2480±263 cells/mm2) and the contralateral eyes with no pterygium (2527±277 cells/mm2, P=0.20). There was also no significant difference in hexagonality (P=0.10) or coefficient of variation of size (P=0.15) of corneal endothelial cells between eyes with pterygium and the contralateral eyes with no pterygium. Conclusion: Primary pterygium may not be associated with a decrease in ECD in our study population of rural Chinese patients.

Sign in / Sign up

Export Citation Format

Share Document