scholarly journals The diagnostic accuracy of mean arterial pressure in second trimester for prediction of preeclampsia in females.

2021 ◽  
Vol 28 (12) ◽  
Author(s):  
Sidra Mushtaq ◽  
Naeem Hameed ◽  
Rabika Bint Khamis Butt ◽  
Shahid Abbas ◽  
Ali Sajjad

Objective: To assess the diagnostic accuracy of mean arterial pressure in second trimester for prediction of pre-eclampsia in females. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynecology Unit III, Allied hospital, Faisalabad. Period: October 2016 to September 2017. Material & Methods: Total 386 patients were enrolled after obtaining informed consent. Booked females of age 18-40 years, parity<5 presenting at gestational age >16 weeks (on LMP) for antenatal checkup were included in study. Patients with multiple gestation (on medical record and USG), Females with chronic hypertension (BP≥140/90mmHg), chronic or gestational diabetes (BSR>186mg/dl), Females having oligohydramnios (AFI<5cm) or polyhydramnios (AFI>21cm) on USG, females having abnormal placental implantation or placental abruption (on USG) were excluded. The mean age of the patients was 28.59±6.93 years. The MAP of the patients was 94.88±14.68 mmHg. Results: The sensitivity, specificity and diagnostic accuracy of MAP was 92.89%, 89.12% and 91.45% respectively taking preeclampsia as gold standard. Conclusion: The mean arterial pressure in second trimester is very effective and useful screening method for prediction of preeclampsia with high values of sensitivity, specificity and diagnostic accuracy. 

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie-Hélène Masse ◽  
Neill K. J. Adhikari ◽  
Xavier Théroux ◽  
Marie-Claude Battista ◽  
Frédérick D’Aragon ◽  
...  

Abstract Background In randomized clinical controlled trials, the choice of usual care as the comparator may be associated with better clinician uptake of the study protocol and lead to more generalizable results. However, if care processes evolve to resemble the intervention during the course of a trial, differences between the intervention group and usual care control group may narrow. We evaluated the effect on mean arterial pressure of an unblinded trial comparing a lower mean arterial pressure target to reduce vasopressor exposure, vs. a clinician-selected mean arterial pressure target, in critically ill patients at least 65 years old. Methods For this multicenter observational study using data collected both prospectively and retrospectively, patients were recruited from five of the seven trial sites. We compared the mean arterial pressure of patients receiving vasopressors, who met or would have met trial eligibility criteria, from two periods: [1] at least 1 month before the trial started, and [2] during the trial period and randomized to usual care, or not enrolled in the trial. Results We included 200 patients treated before and 229 after trial initiation. There were no differences in age (mean 74.5 vs. 75.2 years; p = 0.28), baseline Acute Physiology and Chronic Health Evaluation II score (median 26 vs. 26; p = 0.47) or history of chronic hypertension (n = 126 [63.0%] vs. n = 153 [66.8%]; p = 0.41). Mean of the mean arterial pressure was similar between the two periods (72.5 vs. 72.4 mmHg; p = 0.76). Conclusions The initiation of a trial of a prescribed lower mean arterial pressure target, compared to a usual clinician-selected target, was not associated with a change in mean arterial pressure, reflecting stability in the net effect of usual clinician practices over time. Comparing prior and concurrent control groups may alleviate concerns regarding drift in usual practices over the course of a trial or permit quantification of any change.


2021 ◽  
Vol 15 (7) ◽  
pp. 1646-1649
Author(s):  
Anum Awais ◽  
Saulat Sarfraz ◽  
Fatima Saleem ◽  
Sidra Sajjad ◽  
Tuba Tariq ◽  
...  

Background: When ultrasonographic data are restricted, magnetic resonance imaging (MRI) scans can assist identify adnexal mass features. Two European centers have done pioneering work on Dynamic MRI with varied accuracy in diagnosis of complex adnexal lesions. Aim: To evaluate diagnostic accuracy of Dynamic MRI in diagnosing complex adnexal masses, Methods: The Department of Radiology conducted a cross-sectional study. Sheikh Zayed hospital, Lahore for 6 months (September 2017-March 2018). Procedure was done for MRI and histopathology for detecting the adnexal masses. Results of MRI were compared with histopathology results, which are taken as gold standard. Reporting was done by researcher herself under supervision of consultant radiologist. SPSS version 20 was used to enter and evaluate the data. Results: The mean age of patients was 41.57±11.69 years. Dynamic MRI has a 95% sensitivity, specificity, and diagnostic accuracy. 94.37% and 94.7% respectively. Conclusion: Dynamic MRI is reliable and useful tool with high values of responsiveness, for detecting complicated indeterminate adnexal masseson Doppler considering histopathology as gold standard.Specificity and diagnostic accuracy are important. Keywords: Dynamic MRI, Histopathology, Complex Adnexal Mass


2004 ◽  
Vol 96 (2) ◽  
pp. 463-468 ◽  
Author(s):  
Eric Laffon ◽  
Christophe Vallet ◽  
Virginie Bernard ◽  
Michel Montaudon ◽  
Dominique Ducassou ◽  
...  

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.


2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Abaid ur Rehman ◽  
Muhammad Imran Khan ◽  
Omer Sabir ◽  
Muhammad Mohsin Riaz ◽  
Mubashar Dilawar ◽  
...  

The initiation of hemodialysis in patients with chronic kidney disease (CKD) requires vascular access formation. The choice of vascular access for individual patient depends on various factors however arteriovenous fistula (AVF) is conventionally considered to be the vascular access of choice. Once hemodialysis is initiated through a mature AVF, there is an ongoing need for surveillance of the AVF to ensure adequate function and prevent vascular access issues among which flow obstruction (both inflow and outflow) remains the most important. AVF stenosis can potentially lead to inadequate dialysis delivery and thrombosis thus leading to access loss. Physical examination and AVF Doppler ultrasonography (DUS) are useful for evaluation of stenosis in the  arteriovenous connection and the outflow tract. Periodic assessment of the AVF with Static Intra access Pressure (SIAPR) determination may be a reliable means of predicting vascular access stenosis. Material & Methods  A cross sectional study carried out at Department of Nephrology, Fatima Memorial Hospital, Lahore from July 2018 to December 2018. In total 113 patients were included, and all patients underwent SIAPR assessment and Doppler Ultrasound of AVF. Results Mean age of the patients was 56.81±9.38 years, male to female ratio of the patients was 1.8:1. In this study the SIAPR was suggestive of  stenosis in 87(76.99%) patients. The sensitivity, specificity and diagnostic accuracy of SIAPR against Doppler US of the AVF for detection of stenosis was 75.86%, 22.62% & 36.28% respectively Conclusion SIAPR has low specificity and diagnostic accuracy compared to Doppler US for detection of AVF stenosis.


2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.


2019 ◽  
Vol 3 (2) ◽  
pp. 100-111
Author(s):  
Nurlinawati Nurlinawati ◽  
Dini Rudini ◽  
Yuliana Yuliana

Latar Belakang : Pasien hemodialisis seringkali mengalami kecemasan. Kecemasan ini apabila tidak diatasi akan mempengaruhi aspek fisiologis dan hemodinamik yang dikhawatirkan akan menimbulkan komplikasi yaitu dialysis disequilibrium syndrome. Penelitian ini bertujuan untuk mengetahui  hubungan  tingkat  kecemasan  dengan  kondisi  hemodinamik  pasien  gagal  ginjal kronik yang sedang menjalani hemodialisa. Metode : Jenis penelitian kuantitatif dengan menggunakan cross sectional. Sampel dalam penelitian ini berjumlah 57 responden. Analisis univariat menggunakan distribusi frekuensi dan analisis bivariat menggunakan regresi linier sederhana. Hasil : Hasil penelitian didapat tingkat kecemasan hanya berhubungan dengan Mean Arterial Pressure (MAP) sebelum hemodialisis dengan nilai signifikan 0.023 dan sesudah hemodialisis didapatkan nilai signifikan 0.026. Sedangkan nadi dan respirasi rate tidak terdapat hubungan dengan nilai signifikan >0.05. Kesimpulan : Ada hubungan antara tingkat kecemasan dengan Mean Arterial Pressure (MAP) pasien gagal ginjal kronik yang sedang menjalani hemodialisa di ruang Hemodialisa RSUD Raden Mattaher Jambi Tahun 2018.


2020 ◽  
Vol 5 (2) ◽  
pp. 138-145
Author(s):  
Ely Kurniati ◽  
Rusnawati

Preeclampsia complicates 4-7% of pregnancies and remains the leading cause of maternal and fetal morbidity and mortality worldwide. Despite improvements in health care over the last decade, preeclampsia remains the second most common cause of maternal mortality in Indonesia. This study aims to determine whether the mean arterial pressure (MAP) is related to the incidence of preeclampsia in pregnant women at the Bontobangun Puskesmas, Bulukumba district for the period 2018 to 2019. This research uses a descriptive-analytic approach with Historical Cohort Studies, namely by looking at the cohort book of the history of blood pressure measurement results for pregnant women at the Bontobangun Public Health Center, Bulukumba Regency for the period 2018 to 2019. Determining the sample using the sampling method taken by purposive sampling. 31 samples of pregnant women who experienced preeclampsia and 31 controls were pregnant women with normal conditions who had certain criteria (matching) with the sample. The results explained that from the paired T-test results, the value of α> 0.037 so that it is said that there is a relationship between mean artery pressure (MAP) and the incidence of preeclampsia in pregnant women at Bontobangun puskesmas for the period 2018-2019.


2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.


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