POSTPARTUM HAEMORRHAGE;

Objectives: To determine the frequency of postpartum haemorrhage in obeseprimigravid women. Study Design: Case series study. Period: Six months was conductedfrom 1st October 2014 to 30 March 2015. Setting: Department of gynecology and obstetricsat Liaquat University Hospital Jamshoro. Patients and Methods: All the primigravid obese(≥30kg/m2) ladies 18 to 35 years of age with 37-42 weeks of gestational age were evaluate forthe occurrence of PPH by estimating blood loss of greater than 500 ml of blood following vaginaldelivery or 1000 ml of blood loss following caesarean section. All data was entered and analyzedthrough statistical package SPSS version 17, the chi-square statistical test was applied and thep-value ≤0.05 was considered as statistical significant. Results: Total 203 primigravid obeseladies were studies, the age group was analyzed which shows that in age group between 18-25years were 105(52.00%) women, in age group of 26-30 years were 62(30.69%) women and agegroup of 30 years and above were 35 (17.31%) women. The modes of delivery were evaluatedwhich shows that 66.5% women underwent C-section and 33.4% women had normal vaginaldelivery. The PPH was observed in 34.97% patients (70.4% with C-Section and 29.6 with NVD).Conclusion: Obesity carries a significant increased risk of complications during pregnancyand maternal risks during labour are PPH and more frequent C-section and nulliparous obesewomen have twofold high risk for PPH

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Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study

Journal of Clinical Medicine ◽

10.3390/jcm10040880 ◽

2021 ◽

Vol 10 (4) ◽

pp. 880

Author(s):

Caterina Caminiti ◽

Giuseppe Maglietta ◽

Tiziana Meschi ◽

Andrea Ticinesi ◽

Mario Silva ◽

...

Keyword(s):

Hospital Admissions ◽

Case Series ◽

Communicable Diseases ◽

University Hospital ◽

Negative Consequences ◽

Non Communicable Diseases ◽

Case Series Study ◽

And Gender ◽

Long Term Impact ◽

Series Study

Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.

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Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03875-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Koech Irene ◽

Poli Philippe Amubuomombe ◽

Richard Mogeni ◽

Cheruiyot Andrew ◽

Ann Mwangi ◽

...

Keyword(s):

Pregnant Women ◽

Perinatal Mortality ◽

Mode Of Delivery ◽

Case Series ◽

Perinatal Outcomes ◽

Induction Of Labour ◽

Chi Square ◽

Case Series Study ◽

Chi Square Test ◽

Series Study

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.

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Maternal and Perinatal Outcomes in Women with Eclampsia by Mode of delivery at Riley Mother Baby Hospital: A longitudinal case-series study

10.21203/rs.3.rs-61697/v1 ◽

2020 ◽

Author(s):

Philippe Amubuomombe Poli ◽

Koech MMED Irene ◽

Richard Mogeni ◽

Ann Mwangi ◽

Andrew Cheruiyot ◽

...

Keyword(s):

Mode Of Delivery ◽

Case Series ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Sub Saharan Africa ◽

Categorical Variables ◽

Chi Square ◽

Case Series Study ◽

Chi Square Test ◽

Series Study

Abstract Background Eclampsia, considered a serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0-40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1-2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. Instead, it increases the risk of perinatal adverse outcomes, including the risk of admission to the newborn unit and perinatal death.

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Endoscopic Harmonic Midline Partial Glossectomy in Obstructive Sleep Apnea

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i130800 ◽

2021 ◽

pp. 98-104

Author(s):

A. I. Elkawa ◽

Y. I. Aglan ◽

M. A. Hagras

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Case Series ◽

University Hospital ◽

Obstructive Sleep ◽

Case Series Study ◽

Prospective Case Series ◽

Series Study ◽

Partial Glossectomy ◽

Posterior Midline

Aim: Our study was done to evaluate the role of Endoscopic posterior midline partial glossectomy as a surgical modality for the hypopharyngeal collapse in obstructive sleep apnea patients. Study design: Prospective case series study. Place and Duration of Study: Tanta university hospital, otolaryngology department, from October 2017 till March 2019. Methodology: This was a prospective case series study, conducted on 10 patients from 2017 -2019 with tongue base collapse and normal craniofacial angles, the patients were evaluated preoperative and 6 months postoperative subjectively by Epworth sleepiness scale (ESS) and objectively by polysomnography and lateral cephalometry. Results: Our study included 10 patients with age (mean ± SD48.70±4.08), BMI( mean ±SD24.45±1.56), 5 patients showed a significant reduction in AHI with a success rate of 50% with a significant change in ESS and the non-significant changes in cephalometric parameters. Conclusion: Transoral endoscopic posterior midline partial glossectomy can improve the surgical outcomes of obstructive sleep apnea patients.

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Frequency of Mortality in Patients with Post-Partum Eclampsia-A Study at Liaquat University Hospital, Hyderabad, Sindh, India

International Journal of Multidisciplinary and Current Research ◽

10.14741/ijmcr/v.7.3.16 ◽

2019 ◽

Vol 7 (03) ◽

Author(s):

Almas Almas ◽

Naushaba Rizwan ◽

Syed Farhan Uddin

Keyword(s):

Post Partum ◽

Case Series ◽

University Hospital ◽

Study Patient ◽

Inclusion Criteria ◽

Risks And Benefits ◽

Number Of Patients ◽

Case Series Study ◽

Patient Will ◽

Series Study

Postpartum preeclampsia is the occurrence of hypertension and proteinuria after delivery. Preeclampsia plus seizures after delivery is defined as postpartum eclampsia. Objective: To determine the frequency of mortality in patients with post-partum eclampsia; To determine the obstetrical factors leading to maternal mortality in patient with postpartum eclampsia. Methodology: The descriptive case series study was carried out in the department of Department of obstetrics and gynecology LUMHS Hospital Hyderabad from 1st January 2018 to 30 June 2018. All patients who fulfilled the inclusion criteria were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. All patients of postpartum eclampsia with increase blood pressure and proteinuria admitted through out-patient department or emergency within 48 hours of delivery will be included in the study. Patient will be followed for 10 days. All the collected data were entered into the proforma attached at the end. Results: Mean ± SD of age was 27.88±7.77 with C.I (27.02…….28.74) years. Mean ± SD of systolic B.P and urine protein was 161.46±22.09 mmhg and 1432.59±967.33 mg respectively. Out of 369 was occurred mortality in 190 (60%) women. Conclusion: It is to be concluded that mortality is most in eclampctic women followed by patients with Pre-eclampsia. However a study design comprising multiple centers, and a higher number of patients over a longer period of time will be more representative.

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HEMORRHAGIC STROKE;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2626 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1204-1208

Author(s):

Faisal Shahab ◽

Irfan Murtaza Shahwani ◽

Shuaib Ansari ◽

Syed Zulfiquar Ali Shah

Keyword(s):

Blood Pressure ◽

Hemorrhagic Stroke ◽

Case Series ◽

Health Sciences ◽

Hypertensive Retinopathy ◽

Age Group ◽

Female Ratio ◽

Case Series Study ◽

Male To Female ◽

Series Study

Objectives: To identify the frequency of risk factors in hemorrhagic stroke at Liaquat university of medical and health sciences. Patient and methods: This Descriptive case series study of six months was carried out in the department of medicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of age with hemorrhagic stroke on CT were enrolled in the study after taking consent from caretaker of patients. Detailed history focusing on hypertension, diabetes and smoking and their duration was taken. Blood pressure was recorded and fundoscopy was done to find out diabetic or hypertensive retinopathy. Thorough neurological examination and fasting / random blood glucose level was evaluated while the data was done was analyzed using SPSS version 16. Results: A total of 100 patients were included in the study during study period. 61% of patients were in > 50 years of age group with mean age of 53.4±11 years. A total of 66 (66%) were male; with male to female ratio was 2:1. Hypertension was present in 63% of cases, Diabetes was found in 24% cases and 44 patients were cigarette smokers. Conclusions: It was concluded that high blood pressure, diabetes mellitus and smoking are associated with hemorrhagic stroke.

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Risk of Immune Thrombocytopenia Induced By Influenza Vaccine. a Nationwide Population-Based Study in France

Blood ◽

10.1182/blood-2019-124720 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 1086-1086

Author(s):

Margaux Lafaurie ◽

Bérangère Baricault ◽

Maryse Lapeyre-Mestre ◽

Laurent Sailler ◽

Agnès Sommet ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Research Funding ◽

Case Series ◽

Population Based ◽

Case Control ◽

Population Based Study ◽

Case Series Study ◽

Increased Risk ◽

Series Study

Introduction: Epidemiological studies suggest a risk of immune thrombocytopenia (ITP) following viral infections, particularly influenza. Conversely, an increased risk of ITP following vaccination has been proven for some vaccines like Measles-Mumps-Rubella vaccine. However, the risk of ITP induced by influenza vaccine is debated. Two case-controls studies has been conducted, with contradictory results: in the Berlin Case-Control Surveillance Study, an increased risk has been found (odds ratio - OR: 3.8 [95% confidence interval - CI: 1.5- 9.1]. Conversely, the French PGRx study suggested the absence of risk of ITP after influenza vaccination [OR: 0.9; 95% CI: 0.4-2.1]. These studies were limited by the number of ITP patients included (169 and 198, respectively) and other limitations. Therefore, we aimed to assess the risk of ITP induced by influenza vaccine in a nationwide cohort in France. Methods: We conducted a population-based study in France within the FAITH cohort (NCT03429660). This cohort is built within the National Health Database that links sociodemographic, hospital and out-hospital data. The FAITH cohort includes all adult patients with incident ITP in France since 2009. Patients are identified using a validated algorithm combining diagnosis codes and drug exposures (with very high positive predictive values). We included in the present study all patients with incident primary ITP aged ≥65 years at ITP diagnosis (indication of influenza vaccination in the general population in France) between July 2009 and June 2015. We assessed the link between influenza vaccine and ITP onset using two designs: a case-control and a self-controlled case series designs. In the case-control design, ITP cases were matched with four controls from the general population for age, sex and place of residency. Index dates for controls were similar to index dates of their matched cases. Cases and controls were compared for exposure to influenza vaccine in the 6 weeks before the index date using conditional logistic regression models adjusted for exposure to other drugs known as inducers of ITP. In the self-controlled case series study, only vaccinated ITP cases were included. The analysis compared the incidence of ITP within periods of risk (6 weeks following vaccination) to the incidence of ITP within other periods of time. We further excluded the 2 weeks prior to vaccine dispensing from the analysis to address selective survival bias (healthy vaccinee effect). Incidence rate ratios (IRRs) adjusted for seasonality were calculated. Results: We included 3,142 incident primary ITP patients aged ≥65 years matched with 12,528 controls in the case-control study. Overall, 147 cases (4.7%) and 579 controls (4.6%) were vaccinated with influenza vaccine during the 6 weeks prior to the index date (adjusted OR: 0.99; 95% CI: 0.80-1.23]). In the self-controlled case series study, 1,875 vaccinated ITP cases were included. Among them, 146 (7.8%) patients were diagnosed for ITP during one of the risk periods following vaccination. The adjusted IRR was 0.96 [95 CI%: 0.80-1.17]. Conclusion: This nationwide population-based study using two different designs showed no increased risk of ITP after influenza vaccination. Disclosures Moulis: Novartis pharma: Research Funding, Speakers Bureau; Amgen pharma: Research Funding, Speakers Bureau; CSL Behring: Research Funding.

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Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions

Internal and Emergency Medicine ◽

10.1007/s11739-020-02586-8 ◽

2020 ◽

Author(s):

Giada Crescioli ◽

Valentina Brilli ◽

Cecilia Lanzi ◽

Andrea Burgalassi ◽

Alessandra Ieri ◽

...

Keyword(s):

Adverse Drug Reactions ◽

Case Series ◽

University Hospital ◽

Drug Reactions ◽

Case Evaluation ◽

Hospitalised Patients ◽

Number Of Patients ◽

Case Series Study ◽

Caucasian Patients ◽

Series Study

AbstractDue to the need of early and emergency effective treatments for COVID-19, less attention may have been paid to their safety during the global emergency. In addition, characteristics of drug–drug interaction (DDI)-related adverse drug reactions (ADRs) in COVID-19 patients have not yet been studied in depth. The aim of the present case-series study is to describe clinical and pharmacological characteristics of SARS-CoV-2 hospitalised patients, focusing on ADRs, particularly those related to DDIs. We evaluated all reports of COVID-19 medication-related ADRs collected within the COVID-19 Units of Careggi University Hospital, Florence (Italy), between January 1st and 31st May 2020. Information regarding COVID-19 medications, patients’ demographic and clinical characteristics, concomitant drugs, ADRs description and outcome, were collected. Each case was evaluated for the causality assessment and to identify the presence of DDIs. During the study period, 23 Caucasian patients (56.5% males, mean age 76.1 years) experienced one or more ADRs. The majority of them were exposed to polypharmacy and 17.4% presented comorbidities. ADRs were referred to cardiovascular, psychiatric and gastrointestinal disorders. The most frequently reported preferred term was QT prolongation (mean QT interval 496.1 ms). ADRs improved or resolved completely in 60.8% of cases. For all patients, a case-by-case evaluation revealed the presence of one or more DDIs, especially those related to pharmacokinetic interactions. Despite the small number of patients, our evidence underline the clinical burden of DDIs in SARS-CoV-2 hospitalised patients and the risk of unexpected and uncommon psychiatric ADRs.

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Association between Ophthalmic Timolol and Hospitalisation for Bradycardia

Journal of Ophthalmology ◽

10.1155/2015/567387 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Nicole L. Pratt ◽

Emmae N. Ramsay ◽

Lisa M. Kalisch Ellett ◽

Tuan A. Nguyen ◽

Elizabeth E. Roughead

Keyword(s):

Beta Blocker ◽

Case Series ◽

Cardiovascular Effects ◽

Eye Drops ◽

Continuous Exposure ◽

Case Series Study ◽

Increased Risk ◽

Risk Period ◽

Series Study ◽

Remaining Time

Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia.Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol initiation was partitioned into risk periods: 1–30 days, 31–180 days, and >180 days. A 30-day risk period prior to initiating timolol was also included. All remaining time was considered unexposed.Results. There were 6,373 patients with at least one hospitalisation for bradycardia during the study period; 267 were exposed to timolol. Risk of bradycardia was significantly increased in the 31–180 days after timolol initiation (incidence rate ratio (IRR) = 1.93; 95% confidence interval (CI) 1.00–1.87). No increased risk was observed in the first 30 days or beyond 180 days of continuous exposure (IRR = 1.40; 95% CI 0.87–2.26 and IRR = 1.21; 95% CI 0.64–2.31, resp.).Conclusion. Bradycardia is a potential adverse event following timolol initiation. Practitioners should consider patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical nonselective beta-blocker eye drops.

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