scholarly journals Effectiveness of Dexamethasone for Prevention of Intraoperative Shivering in Caesarean Delivery Under Subarachnoid Block

2020 ◽  
Vol 5 (1) ◽  
pp. 927-931
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Kanak Khanal
Keyword(s):  
Caesarean Delivery ◽  
Carbon Dioxide Production ◽  
Cross Sectional Study ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Subarachnoid Block ◽  
Increased Risk ◽  
Prophylactic Use ◽  
American Society

Introduction: Shivering is frequently seen after subarachnoid block. Subarachnoid block impairs the thermoregulation system by inhibiting tonic vasoconstriction with redistribution of blood flow and core heat from the trunk to the peripheral tissue. Intraoperative shivering leads to increase in oxygen consumption and carbon dioxide production. This causes an increase in heart rate, blood pressure resulting in exacerbation of ischemic heart disease, increased risk of hypoxemia, intraocular pressure, intracranial pressure, metabolic rate, lactic acidosis, pain at the surgical site and discomfort to the patient. Objective: To assess the effectiveness of Dexamethasone in preventing intraoperative shivering in patients of cesarean delivery under subarachnoid block. Methodology: This was a hospital based prospective, comparative, cross sectional study which was conducted from February 2019 to July 2019 among 88 pregnant patients of age group 18 to 35 years old, American Society of Anesthesiologists (ASA) physical status 1 and 2, posted for elective or emergency caesarean delivery at Birat Medical College and Teaching Hospital (BMCTH). Operation room temperature was recorded by a wall thermometer and maintained during surgery between 20 to 25 degree Celsius and intravenous fluids were kept at this temperature. Patients were divided into two equal groups. Group S (study group) patients received 2 ml or 8mg of dexamethasone IV (As a premedication before giving subarachnoid block) while group C (control group) patients received 2 ml of normal saline. If the patients shivered according to classification of shivering, the prophylaxis was regarded as ineffective. Results: Patients undergoing caesarean delivery under subarachnoid block had significantly reduced (p value = 0.002) intraopera tive shivering who received prophylactic dexamethasone (group S). Conclusion: The prophylactic use of 8mg i.v dexamethasone was significant in prevention of shivering in Nepalese population who underwent caesarean delivery under subarachnoid block.

scholarly journals Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

2019 ◽  
Vol 31 (3) ◽  
pp. 167
Author(s):  
Ankita Goyal ◽  
Vatchala Rani ◽  
Bhadravathi Cheluvaiah Manjunath ◽  
Kanupriya Rathore
Keyword(s):  
Dental Caries ◽  
Statistical Tests ◽  
Chronically Ill ◽  
Cross Sectional Study ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Chronically Ill Children

Introduction: Purpose of this research is to assess the relationship between long-term pediatric liquid medicines (PLMs) consumption and dental caries in 2–12-years-old chronically ill children. Methods: A cross-sectional study was performed in a public pediatric hospital in India for a period of 6 months. A total of 455 children aged 2–12 years old with various chronic diseases who were receiving PLMs for more than 6 months were selected as the subjects in this study and compared with 531 children of similar age group and diseases who received other forms of medication. Dental caries was measured by DMFT/dmft and data collected were analyzed with SPSS (17th version) using statistical tests such as t-test and one-way ANOVA. Univariable logistic regression was used where the significance was fixed at a a p value of less than 0.001. Results: Children on PLMs had an increased risk of dental caries than those on other forms of medications (OR: 3.142, 95% CI: 2.37–4.15, p < 0.001). The prevalence of dental caries was higher (77.8%) in children consuming PLMs when compared to other forms of medication (52.7%). The mean DMFT and dmft scores were significantly higher in the study group when compared to the control group (p = 0.001). Conclusion: Long-term consumption of pediatric liquid medicines containing sucrose as a risk factor for dental caries among chronically ill children. sugar free options has to be used during prescription to prevent medication-triggered caries.Keywords: Paediatric liquid medicine, medication-triggered caries, sugar-free medication

Increased circulating cell-derived microparticle levels in deep infiltrating endometriosis patients with larger implants

2019 ◽  
Vol 11 (3) ◽  
pp. 137-145
Author(s):  
Jordina Munrós ◽  
Dolors Tàssies ◽  
Joan Carles Reverter ◽  
Francisco Carmona ◽  
María Ángeles Martínez-Zamora
Keyword(s):  
Venous Blood ◽  
Cross Sectional Study ◽  
Positive Control ◽  
Severe Form ◽  
Control Group ◽  
P Value ◽  
Deep Infiltrating Endometriosis ◽  
Cross Sectional ◽  
American Society ◽  
Infiltrating Endometriosis

Objective: Circulating cell-derived microparticles have been reported to be elevated in inflammatory and procoagulant conditions including deep infiltrating endometriosis. The objective of this pilot study was to investigate whether higher circulating cell-derived microparticle levels may be associated with specific clinical features and the extension or severity of deep infiltrating endometriosis. Methods: This is an observational analytical cross-sectional study, including three groups of patients undergoing gynecological surgery. The DIE group included 75 patients with deep infiltrating endometriosis, the control group (C group) consisted of 39 patients without endometriosis, and a positive control group was composed of 31 patients with ovarian endometriomas but not deep infiltrating endometriosis (OE group). Venous blood samples for circulating cell-derived microparticle determinations in plasma were obtained before surgery. The following variables were assessed: severe dysmenorrhea, dyspareunia, non-cyclic chronic pelvic pain, dyschezia, dysuria, hematuria, rectal bleeding, sterility, presence of ovarian endometrioma, adenomyosis, and adhesions, rASRM (revised American Society for Reproductive Medicine) stage, Enzian classification, number of sites affected, and the cumulative size of deep infiltrating endometrial implants. Results: Circulating cell-derived microparticle levels were statistically higher in the DIE group compared with the C group ( p-value = 0.001). None of the variables analyzed showed higher levels of circulating cell-derived microparticles in the DIE group, except for a significant positive correlation between the cumulative size of deep infiltrating endometrial lesions and circulating cell-derived microparticle levels ( r = 0.264, p = 0.022). Conclusion: Patients having deep infiltrating endometriosis with a larger cumulative size of endometriotic implants showed higher circulating cell-derived microparticle levels suggesting an increased inflammatory and/or hypercoagulable systemic status in this more severe form of the disease. Further research is needed to assess our findings and to explore the role of circulating cell-derived microparticles in the pathophysiology of deep infiltrating endometriosis.

scholarly journals Validation of the SavvyCheckTM Vaginal Yeast Test for Screening Pregnant Women for Vulvovaginal Candidosis: A Prospective, Cross-Sectional Study

2021 ◽  
Vol 7 (3) ◽  
pp. 233
Author(s):  
Philipp Foessleitner ◽  
Herbert Kiss ◽  
Julia Deinsberger ◽  
Julia Ott ◽  
Lorenz Zierhut ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Control Group ◽  
Gram Stain ◽  
Cross Sectional ◽  
Point Of Care Test ◽  
Increased Risk ◽  
Vulvovaginal Candidosis

Pregnant women have an increased risk of vulvovaginal candidosis. Recurrent candidosis is under debate as a contributor to preterm birth, and vertical transmission may cause diaper dermatitis and oral thrush in the newborn. Apart from cultural methods, the gold standard for diagnosing candidosis is Gram staining, which is time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care vaginal yeast detection assay (SavvyCheckÔ Vaginal Yeast Test) and to evaluate it in asymptomatic pregnant women. We enrolled 200 participants, 100 of whom had vulvovaginal candidosis according to Gram stain (study group) and 100 were healthy pregnant controls (control group). Of these, 22 participants (11%) had invalid test results. The point-of-care test of the remaining 85 and 93 study participants in the study and control groups, respectively, showed a sensitivity of 94.1%, specificity of 98.9%, positive predictive value of 90.3%, and negative predictive value of 99.4% when compared with Gram stain. In conclusion, we found a high correlation between the SavvyCheckÔ Vaginal Yeast Test and Gram-stained smears during pregnancy. This suggests a potential role of this point-of-care test as a screening tool for asymptomatic pregnant women in early gestation.

scholarly journals Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Fatma Al Hoqani ◽  
Wadha Al Ghafri ◽  
Saneya El tayeb ◽  
Yahya Al Farsi ◽  
Vaidyanathan Gowri
Keyword(s):  
Recurrent Miscarriage ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Recurrent Miscarriages ◽  
Sultan Qaboos University ◽  
Chi Squared ◽  
History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

scholarly journals Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

Thorax ◽  
2020 ◽  
Vol 75 (8) ◽  
pp. 632-639 ◽  
Author(s):  
Anitha Vijayasingam ◽  
Emily Frost ◽  
Julie Wilkins ◽  
Lise Gillen ◽  
Presanna Premachandra ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Hearing Loss ◽  
Intraclass Correlation ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
P Value ◽  
Cross Sectional ◽  
Web Based ◽  
High Frequency Audiometry ◽  
Increased Risk

IntroductionIndividuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.MethodsHearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.ResultsPrevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.ConclusionsAdults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.

Cortisol secretion pattern in overweight/obese and normal-weight infants: a cross-sectional study

2020 ◽  
Vol 33 (2) ◽  
pp. 241-246
Author(s):  
Ana Cristina Resende Camargos ◽  
Pedro Henrique Scheidt Figueiredo ◽  
Sueli Ferreira da Fonseca ◽  
Mariana Aguiar de Matos ◽  
Katherine Simone Caires Oliveira ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Area Under The Curve ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Control Group ◽  
Cortisol Secretion ◽  
Cross Sectional ◽  
Increased Risk ◽  
Highly Sensitive ◽  
Cortisol Levels

AbstractBackgroundThe salivary circadian diurnal cortisol plays an important role in growth and development. Inappropriate levels may induce changes associated with an increased risk of obesity later in life. It is unknown if there are differences in cortisol secretion pattern between overweight/obese infants when compared with theirs peers in infancy. Thus, this study aimed to compare the salivary cortisol secretion pattern in overweight/obese and normal-weight infants.MethodsThirty-three (overweight/obese = 17 and normal weight = 16) infants between 6 and 24 months of age had saliva samples collected upon awakening (T1), 30 min after waking (T2), at 12:00 am or before the baby’s meal (T3), and prior to bedtime (T4). Highly sensitive enzyme immunoassays were used for cortisol analyses.ResultsSalivary cortisol levels were similar between the groups: T1 (p = 0.22; 95% confidence interval [CI]: −5.65, 1.37), T2 (p = 0.24; 95% CI: −8.23, 2.17), T3 (p = 0.95; 95% CI: −3.16, 2.96), and T4 (p = 0.81; 95% CI: −1.39, 1.08); and no differences were observed between area under the curve (AUC) (p = 0.80; 95% CI: −4.58–13.66). The cortisol level reduced in T4 (95% CI: 1.35–2.96) compared to T1 (95% CI: 5.15–8.49) and T2 in the overweight/obese group (p < 0.001; 95% CI: 6.02–11.04). In the normal-weight group, the cortisol reduced in T3 (95% CI: 2.86–8.18) compared to T1 (95% CI: 5.64–12.28) and decreased until T4 (p = 0.001; 95% CI: 1.25–3.37).ConclusionsThe overweight/obese infant group presented a different pattern of cortisol secretion, although cortisol levels did not differ between the control group.

scholarly journals Study of Patients with First unprovoked Seizure in the Eastern Part of Nepal

2019 ◽  
Vol 8 (1) ◽  
pp. 22-26
Author(s):  
Dilli Ram Kafle ◽  
Surendra Sah ◽  
Miluna Bhusal
Keyword(s):  
Recurrence Risk ◽  
Cross Sectional Study ◽  
P Value ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Neuro Imaging

Background: About 5-10% of the population get at least one seizure in their lifetime. Treatment is started in patients with first unprovoked seizure if the risk of seizure recurrence is predicted to be high. If patients with first seizure are not treated 40-50% of patients develop recurrence within 2 years of the initial seizure. Starting treatment may cause reduction in the risk of recurrence by almost one half. The aim of the study was to identify the factors causing recurrence in patients with first unprovoked seizure. Materials and Methods: It is a prospective cross-sectional study conducted at Nobel Medical College from March 2015 to March 2019. Patients who presented to Nobel Medical College with first unprovoked seizure were enrolled in the study with follow up during the hospital visit. Results: Eighty six patients participated in our study. Recurrence of seizure occurred in 21(24.4%) patients within the study period of 4 years. Abnormal Electroencephalography was significantly associated with recurrence of seizure in patients with first seizure. (P value<0.001) Neuro imaging abnormality was also associated with increased risk of seizure recurrence (Pvalue<0.001) .Starting an antiepileptic after first seizure reduced the risk of further seizure. Conclusion: Recurrence of seizure was observed in almost a quarter of patients within the study period of four years. Recurrence risk was higher in those patients with abnormal Electro encephalography and in those patients with identified cause than those patients whose seizure was assumed to be idiopathic.

scholarly journals Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Kiggundu ◽  
Robert Kalyesubula ◽  
Irene Andia-Biraro ◽  
Gyaviira Makanga ◽  
Pauline Byakika-Kibwika
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
P Value ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Increased Risk

Abstract Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

scholarly journals The Association Between Time in Range %, and Physical & Functional Indices Amongst Older People With Type 2 Diabetes: A Cross Sectional Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A477-A478
Author(s):  
Yamit Basson-Shleymovich ◽  
Tali Cukierman-Yaffe ◽  
Tal Yahalom-Peri ◽  
Michal Azmon
Keyword(s):  
Lower Extremity ◽  
Older People ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lower Extremity Strength ◽  
Increased Risk ◽  
Time In Range

Abstract Diabetes is a major public health burden associated with high mortality, morbidity, hospitalization and health care services utilization rates. People with diabetes have an increased risk for mobility disability compared to those without diabetes, after controlling for age. People with diabetes also have a higher risk for falls and fractures. Data from the last several years suggests that this increased risk is not only due to diabetes co-morbidities but also due to an accelerated decline in physical capacity due to lower muscle quality and a more rapid decline in muscle mass (sarcopenia) and lower extremity strength over time. HBA1C is a measure of average glucose levels; however, it does not provide information about glycemic variability, or daily patterns of glycemia. In the last several years, several organizations have published consensus statements on the role of continuous glucose monitoring (CGM) in glucose control. The use of CGM has brought about the development of many glucose indices, amongst them is: Time In Range% (TIR) of 70–180 mg/dL (3.9–10 mmol/L). Less is known regarding the association between TIR and sarcopenia, muscle mass loss that leads to deterioration in mobility, disabilities and decline in physical indices in older people with diabetes. Aims: To assess among older people with diabetes type 2, the cross sectional association between: TIR and aerobic capacity, gait speed, strength, balance and frailty indices. Methods: A cross sectional study, conducted amongst people with diabetes over the age of 60. Participants were provided with a blinded CGM system- (I Pro2 carelink, Medtronic) for 1 week and underwent elaborate physical-functional assessment in the beginning and at the end of that week. The association between the % of time in range (Time in Range-TIR) and several physical indices was determined using linear regression. Results: This analysis pertains to 55 men and women who completed the evaluation. After adjustment for age and gender, we found that 1% increase in TIR was associated with a 0.341 higher score on the 30 second Sit to Stand score (a measure of lower extremity strength) (P-value=0.02), a 0.351 higher score on the BERG scale (a measure of balance) (P-value=0.01), a 0.271 lower score on the timed up and go score (a measure of fall risk and balance) (P-value=0.008), a 0.289 higher score on the 6-minute walk score (a measure of aerobic capacity and endurance) (P-value=0.02) and a 0.261 lower score on the 360 turn test (a measure of dynamic balance) (P-value=0.0004). The same was not observed for the relationship between HGA1C & physical indices.

scholarly journals Frequency of Stress, Anxiety and Depression in Patients with Alopecia Areata and Control Group Referring to Skin Clinics of Yazd City in 2017

2020 ◽  
Author(s):  
Mohammad Ebrahimzadeh Ardakani ◽  
Ghasem Dastjerdi ◽  
Sepideh Hasani
Keyword(s):  
Alopecia Areata ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Control Group ◽  
P Value ◽  
Common Disease ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
The Mean ◽  
Yazd City

Introduction: Alopecia areata is a fairly common disease characterized by patchy aria of hair loss. The role of psychological factors in the occurrence of alopecia areata has long been discussed. The present study was conducted to determine the frequency of stress and anxiety and depression in the patients with alopecia areata in Yazd City in 2017. Methods: This study was a cross-sectional study and 50 patients with alopecia areata in Yazd were compared with 50 in the control group in the year 2016. Sampling method was a census and variables, including sex, age, education level, duration of lesion, frequency of relapse, and location of the disease were collected and recorded using a questionnaire. The depression anxiety stress-scale (DASS) (Dass11) questionnaire was used for scoring anxiety, stress and depression. For analyzing the collected data were entered into SPSS version 13. Results: The results of the study showed that the mean age of the participants in the study was 30.27 ± 8.7, the mean duration of lesion was 23.5±53.52 months and the mean recurrence rate was 1.4±2.2. From 100 participants in the study, 36 (36%) were women and 64 (64%) were men. The mean score of depression (6.8 vs 4.6), anxiety score (6.08 vs 3.5) and stress score (10.06 vs 8.06) were found to be significantly different between the two groups. Also, in women and in the age range of 17-29 years, the mean of depression and anxiety scores was significantly different in the two groups (P-value <0.05). Conclusion: According to results, it can be concluded that the frequency of depression, anxiety and stress in the patients with alopecia areata is significantly more than the control group.  

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