scholarly journals Comparison Among Fern, Amnisure, Creatinine and Urea Tests in Vaginal Wash for Detection of Rupture of Membrane in Iraqi Women

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Sarab Khalaf Hammood AlJuboory ◽  
Keyword(s):  
Detection Efficiency ◽  
Vaginal Fluid ◽  
Sample Collection ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity ◽  
Iraqi Women ◽  
Group 2 ◽  
Morbidity Risks ◽  
Vaginal Wash ◽  
Group 1

Prelabour rupture of membrane (PROM) is a cause for 85% of the neonatal period morbidities and fatalities. PROM is the main cause of preterm deliveries and accounts for 30-40% of these cases, indeed it complicates three percent of all pregnancies. The fetal and maternal mortality and morbidity risks of PROM, increases when the rupture occurs early in the course of pregnancy. In this study we sought to compare the detection efficiency of the standard diagnostic test of PROM with other new methods such as urea and Creatinine of vaginal fluid and Amnisure tests. The study sample is composed of 90 women divided into three groups; each woman had informed consent, questionnaire with full history, clinical examination (general and abdominal and sterile speculum examination to detect cervical dilatation, amniotic fluid leakage for sample collection to do Fern, Amnisure, Creatinine and urea tests. General investigations and ultrasound were done for each patient. Mean vaginal fluid Creatinine level among the group (1) were 0.44±0.14, versus 0.38±0.12, and 0.24±0.08 among group (2) and (3) respectively. When the results of the tests compared with the standard method of diagnosis, the specificity was 100% for Amnisure, vaginal fluid Creatinine and urea, while it was 80% for fern test. The sensitivity was 97% for Amnisure, 95% for vaginal fluid urea, 91% for vaginal fluid Creatinine and 60% for fern test. Amnisure is superior for other tests followed by vaginal fluid urea level, Creatinine and lastly Fern test.

scholarly journals The Feasibility of Blood Pressure Control with Autonomic-Assisted Hypertension Therapy Versus JNC 8 Therapy

2020 ◽  
pp. 1-5
Author(s):  
Gary L Murray ◽  
Joseph Colombo
Keyword(s):  
Blood Pressure ◽  
Pressure Control ◽  
Acid Group ◽  
Home Blood Pressure ◽  
Prescription Medications ◽  
Mortality And Morbidity ◽  
Hypertension Therapy ◽  
Group 2 ◽  
Assisted Management ◽  
Group 1

Background: Over one billion people have Hypertension (HTN); mortality and morbidity are increasing. The Parasympathetic and Sympathetic (P&S) nervous systems prominently affect the onset and progression of HTN, yet P&S measures are not used to assist in management. Our objective was to determine the feasibility of HTN control using P&S-guided to JNC 8 HTN therapy. Methods: 46 uncontrolled HTN patients were randomized prospectively to P&S-assisted management, adjusting JNC 8 therapy using the ANX 3.0 Autonomic Monitor and adding (r) Alpha Lipoic Acid (Group 1) vs. JNC 8 (Group 2). Results: The two Groups were similar in: 1) age (mean 66 vs. 70 y/o for Groups 1 and 2, respectively; 2) initial resting home Blood Pressure (BP, Group 1 mean=162/90 mmHg vs. Group 2 mean=166/87 mmHg, 3) initial resting office BP Group 1 mean=151/75 mmHg vs. Group 2 mean=155/73 mmHg, and 4) ethnicity. Upon follow-up (mean=8.35 mo.): 1) mean resting home BPs were 145/77 mmHg (Group 1, 74% of patients at JNC 8 goal) vs. 155/83.5 mmHg (Group 2, 30.4% at JNC 8 goal), and 2) mean resting office BPs were 138/71 mmHg (Group 1) vs. 146/65 mmHg (Group 2). At the studys conclusion, Group 1 Sympathetic tone was lower than that for Group 2 both at rest and upon standing, and Group 1 Parasympathetic tone was higher than that for Group 2 both at rest and upon standing. Conclusion: P&S-assisted HTN therapy is feasible, resulting in improved BP control, through healthier P&S tone on fewer prescription medications.

Primary or secondary Bentall-De Bono procedure: are the outcomes worse?

2019 ◽  
Vol 27 (4) ◽  
pp. 271-277
Author(s):  
Ameya Kaskar ◽  
Deepak V Bohra ◽  
Rahul Rao K ◽  
Varun Shetty ◽  
Devi Shetty
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Median Sternotomy ◽  
Postoperative Mortality ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background The aim of this study was to compare the outcomes of a primary and secondary Bentall-De Bono procedure. Methods From 2008 to 2015 (8-year period), 308 patients underwent a Bentall-De Bono procedure in our institute. The mean age was 43 ± 13 years and 80% were men. Twenty-eight patients had prior cardiac surgery through a median sternotomy (group 1) and 280 underwent a primary Bentall-De Bono procedure (group 2). Various preoperative and perioperative parameters were analyzed before and after propensity-score matching. Results Before propensity-score matching, patients undergoing a secondary Bentall-De Bono procedure had a worse preoperative profile, as indicated by a higher EuroSCORE II ( p < 0.0001), with hospital mortality in group 1 of 14% (4/28) and 5% (14/280) in group 2 ( p = 0.069). After propensity-score matching, there was no significant difference in EuroSCORE II ( p = 0.922) or hospital mortality ( p = 0.729). After adjusting for the different variables, repeat sternotomy could not be identified as an independent predictor of postoperative mortality or morbidity. Survival at the end of 1 and 5 years in both groups showed no significant differences before or after propensity-score matching ( p = 0.328 and p = 0.356, respectively). In Cox multivariable regression analysis, reoperation was not identified as an independent factor for survival before ( p = 0.559) or after propensity-score matching ( p = 0.365). Conclusion A secondary Bentall-De Bono procedure can be performed with acceptable mortality and morbidity, and with midterm survival rates comparable to those of a primary Bentall-De Bono procedure.

Single Center Outcome of Multiple Births in the Premature and Very Low Birth Weight Cohort in Singapore

2020 ◽  
Author(s):  
Amudha Jayanthi Anand ◽  
Karthik Sabapathy ◽  
Bhavani Sriram ◽  
Victor Samuel Rajadurai ◽  
Pratibha Keshav Agarwal
Keyword(s):  
Neonatal Mortality ◽  
Low Birthweight ◽  
Ductus Arteriosus ◽  
Multiple Pregnancy ◽  
Neonatal Morbidity ◽  
Reproductive Technologies ◽  
Multiple Births ◽  
Mortality And Morbidity ◽  
Group 2 ◽  
Group 1

Objective The aim of this study is to compare neonatal mortality and morbidity in multiple and singleton preterm/very low birthweight (PT/VLBW) multiethnic Asian infants. Study Design Cohort study of 676 singleton and 299 multiple PT/VLBW infants born between 2008 and 2012 at KK Women's and Children's Hospital, the largest tertiary perinatal center in Singapore with further stratification by gestational ages 23 to 25 (Group 1), 26 to 28 (Group 2), and ≥29 (Group 3) weeks. Outcome measures included predischarge mortality and major neonatal morbidity. Results Overall survival to discharge was comparable for singletons 611/676 (90%) and multiples 273/299 (91%). Use of assisted reproductive technologies (47 vs. 4%), antenatal steroids (80 vs. 68%), and delivery by cesarean section (84 vs. 62%) were significantly higher (p < 0.001) in multiples while pregnancy induced hypertension (8.7 vs. 31.6%, p < 0.001) and maternal chorioamnionitis (31 vs. 41%, p < 0.01) were seen less commonly compared with singleton pregnancies. Survival was comparable between singletons and multiples except for a lower survival in multiples in Group 2 (81.7 vs. 92.4%, p = 0.007). Major neonatal morbidities were comparable for multiples and singletons in the overall cohort. Presence of hemodynamically significant patent ductus arteriosus (HsPDA) requiring treatment (88.9 vs. 72.5%), air leaks (33 vs. 14.6%, p = 0.02), NEC (30 vs. 14.6%, p = 0.04), and composite morbidity (86 vs. 66%, p = 0.031) were significantly higher in multiples in Group 1. A significantly higher incidence of HsPDA (68.1 vs. 52.4%, p = 0.008) was also observed in multiples in Group 2. Multiple pregnancy was not an independent predictor of an adverse outcome on regression analysis (OR: 0.685, 95% confidence interval: 0.629–2.02) even in GA ≤25 weeks. Conclusion Neonatal mortality and morbidity were comparable in our cohort of PT/VLBW singletons and multiple births, but preterm multiple births ≤25 weeks had a higher incidence of neonatal morbidity. Key Points

Contribution of Xpert MTB/RIF to clinical diagnosis in adolescents with tuberculosis in Rio de Janeiro, Brazil

2019 ◽  
Vol 23 (10) ◽  
pp. 1115-1121 ◽  
Author(s):  
M. C. B. Oliveira ◽  
C. C. Sant'Anna ◽  
R. R. Luiz ◽  
E. C. C. Soares ◽  
A. L. Kritski
Keyword(s):  
Treatment Outcomes ◽  
Clinical Diagnosis ◽  
Rio De Janeiro ◽  
Care Process ◽  
Sample Collection ◽  
Negative Results ◽  
Group 3 ◽  
Group 2 ◽  
Culture Negative ◽  
Group 1

SETTING: Rio de Janeiro, RJ, Brazil, a high tuberculosis (TB) burden city.OBJECTIVE: To compare the sociodemographics, clinical characteristics, care process indicators (CPIs) and treatment outcomes among adolescents with pulmonary TB (PTB) and those with PTB + extrapulmonary TB (EPTB), who underwent testing with Xpert® and sputum culture.DESIGN: This was a retrospective study of data from three national databases from 2014 to 2016 of adolescents (aged 10–18 years) residing and notified in Rio de Janeiro City. Three groups were identified according to their Xpert and culture results: Group 1, Xpert- and culture-positive; Group 2, Xpert-positive and culture-negative; and Group 3, Xpert- and culture-negative. Study CPIs were as follows: the time between ‘sample collection and Xpert result release', ‘sample collection and treatment initiation' and ‘notification and treatment outcome'.RESULTS: Of 258 adolescents included in the study, 223 (86.4%) were in Group 1, 20 (7.8%) in Group 2 and 15 (5.8%) in Group 3. Groups 1 and 2 had a similar profile. Compared to Group 1, Group 3 had a higher proportion of HIV-positive cases (21.4% vs. 3.0%, P = 0.016), adolescents with a hospital diagnosis (53.3% vs. 7.6%, P < 0.001), and PTB + EPTB cases (20% vs. 0.4%; P < 0.001). There were no statistically significant differences in CPIs or treatment outcomes.CONCLUSION: The clinical diagnosis was decisive in more critical or complex patients, despite Xpert-negative results.

scholarly journals Carbetocin and Oxytocin in the Active Management of third Stage of Labor after Vaginal Birth of Baby

2017 ◽  
Vol 46 (1) ◽  
pp. 7-10
Author(s):  
Hena Rani Barua ◽  
Rita Rani Barua ◽  
Sushanta Barua ◽  
Ajoy Kishore Barua ◽  
Kohinoor Begum
Keyword(s):  
Post Partum ◽  
Active Management ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
The Third ◽  
Third Stage Of Labor ◽  
Significant Difference ◽  
Third Stage ◽  
Group 2 ◽  
Group 1

Postpartum hemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labor has been proven to be effective in the prevention of PPH. Carbetocin; a long-acting Oxytocin agonist appears to be a promising agent for the prevention of PPH. In this study Carbetocin is used for the active management of third stage of labor to prevent PPH. Two hundred pregnant women from July 2015 to December 2015 at Rangamati Medical College Hospital, Rangamati, Bangladesh were included in this study. The patients were divided into two groups: Group- 1 (100 women) were received 100μg Carbetocin intravenously and group- 2 (100 women) received 10 IU Oxytocin intramuscularly and both doses were single. These uterotonics were injected at anterior shoulder after the delivery of the baby. Significant difference was observed between the Carbetocin and Oxytocin receiving groups regarding amount of blood loss (335.70 ± 117.71 versus 375.12 ± 145.30), PPH (3 % versus 12%), need of use of other uterotonics (18% versus 30%) and the difference in hemoglobin percent before and after delivery (0.58 ± 0.34 versus 0.97± 0.52). All these parameters were lower in Carbetocin group except hemoglobin level which is higher in group- 2 during 24 hours after delivery. Moreover, blood transfusion was not indicated in group- 1. In conclusion, Carbetocin is superior to Oxytocin in prevention of post partum hemorrhage at the third stage of vaginal delivery with minimal homodynamic changes and side effects.Bangladesh Med J. 2017 Jan; 46 (1): 7-10

scholarly journals The effects of low levels of dietary trace minerals on the plasma levels, faecal excretion health and performance of pigs in a hot African climate

2009 ◽  
Vol 76 (3) ◽  
Author(s):  
M.H. Boma ◽  
G. Bilkei
Keyword(s):  
Plasma Levels ◽  
Dietary Treatment ◽  
Trace Minerals ◽  
Trace Mineral ◽  
Faecal Excretion ◽  
Mortality And Morbidity ◽  
African Climate ◽  
Pig Performance ◽  
Group 2 ◽  
Group 1

The present study was performed in order to evaluate the effects of lower than usual industry levels of dietary trace minerals on plasma levels, faecal excretion, performance, mortality and morbidity in growing-finishing pigs in a hot African climate. Group 1 (n =100 pigs) received a diet with common industry levels of trace minerals. Group 2 (n =100 pigs) received reduced dietary trace mineral levels but were fed the same basic diet as Group 1. Mortality, morbidity, pig performance and carcass measurements were evaluated. Two pigs in Group 1 and three pigs in Group 2 died. Thirteen pigs in Group 1 and 27 pigs in Group 2 were medically treated (P < 0.05). Carcass masses, back fat depth, loin depth, and lean percent were not significantly different between the groups. However, the carcasses when evaluated revealed a non-significant higher back fat thickness, lower loin eye area and percentage of fat free lean in barrows compared to gilts within each group. Despite lower initial masses, pigs fed diets containing industry levels of trace minerals were heavier (P < 0.05) and had a higher (P < 0.05) than average daily gains compared to those that received a diet containing lower levels of trace minerals. Faecal zinc excretion was significantly lower (P < 0.05) in pigs fed with lower dietary zinc levels. Copper, manganese and iron excretion were not affected (P > 0.05) by the dietary levels of these trace minerals. Plasma trace mineral concentrations were not affected by the dietary treatment.

scholarly journals Modern cemented Furlong hemiarthroplasty: Are dislocations rates better?

2021 ◽  
pp. 175045892110206
Author(s):  
CU Menakaya ◽  
M Shah ◽  
H Ingoe ◽  
R Malhotra ◽  
A Mannan ◽  
...  
Keyword(s):  
Major Complication ◽  
Historical Cohort ◽  
Death Rates ◽  
Mortality And Morbidity ◽  
Hip Hemiarthroplasty ◽  
Uncemented Prosthesis ◽  
Significant Difference ◽  
Morbidity Data ◽  
Group 2 ◽  
Group 1

Background Dislocation following hip hemiarthroplasty is a major complication with increased mortality and morbidity. Data looking at dislocation following contemporary bipolar stems are lacking in literature. Methods Retrospective review of our prospective national hip fracture database over a two-year period. Group 1 comprised of consecutive patients receiving bipolar Furlong prosthesis (N222) while Group 2 was made up of a historical cohort (uncemented; N254). Clinical and radiological records were reviewed to determine dislocation rates, causes and associative factors of dislocations. Data were analysed using SPSS. Results Following 476 hemiarthroplasties performed during the study period, 12 (2.5%) dislocations were reported (eight in Group 1; four in Group 2). There was no significant difference in dislocation rates (3.6% vs 1.6%) between groups ( p = 0.159). Subgroup analysis of Group 1 demonstrated a significant difference in dislocations with Furlong cemented (6%) as compared with Furlong uncemented (0%) hemiarthroplasties ( p = 0.024). Following dislocation, death rates increased to 8.3% from 1.7% in both groups. Conclusion There is a statistically significant increase in dislocation rate following use of cemented Furlong prosthesis when compared to similar uncemented prosthesis at the same treatment period. However, when compared to traditional uncemented prosthesis, there is no difference in dislocation rates.

scholarly journals Early Results of Combined and Staged Coronary Bypass and Carotid Endarterectomy in Advanced Age Patients in Single Centre

2009 ◽  
Vol 3 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Hikmet Iyem ◽  
Suat Buket
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Endarterectomy ◽  
Combined Surgery ◽  
Carotid Disease ◽  
Mortality And Morbidity ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim:In present study, we aimed to compare the staged and combined surgery in patients with severe carotid stenosis and coronary atherosclerosis and detect the factors affecting mortality and morbidity.Material and method:Between 2004 and 2008, 120 patients with predominant ischemic heart disease were enrolled to study. Patients were divided into three groups on basis surgery procedure. Group 1 (n=40) includeed patients had coronary artery disease without carotid disease underwent coronary artery by-pass graft (CABG) operation. Group 2 (n=40): included patients underwent combined surgery procedure including CABG and carotid endarterectomy (CEA). Patients underwent staged CABG and CEA were enrolled to Group 3 (n=40). All patients were in advanced aged and were had the same risk factors atributable atherosclerosisResults:Mean age of the patients in all groups were 68±6, 69±3, 71±2 respectively, and 83% were male. Eight patients died in all groups at follow-up(seven in group 2 and 3, and one in group 1) and the difference between both groups was statistically significant (p<0.001). The follow-up period in the intensive care unit, and hospitalization period were not statistically different between CABG group and combined CEA plus CABG group.Conclusion:We think that the results of staged or combined CABG plus CEA surgery are satisfactory in patients with severe carotid disease and advanced coronary artery disease. However, the mortality and morbidity in both procedures are higher than those of alone.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

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