scholarly journals Relationship between Time Interval from Admission to Delivery and Obstetrics Outcomes in Eclampsia/Severe Preeclampsia

2016 ◽  
Vol 11 (1) ◽  
pp. 30-36
Author(s):  
Upendra Pandit
Keyword(s):  
Descriptive Analysis ◽  
College Teaching ◽  
Severe Preeclampsia ◽  
P Value ◽  
Time Interval ◽  
Case Review ◽  
Retrospective Case ◽  
Still Births ◽  
Vaginal Deliveries ◽  
Significant Difference

Aims: The purpose of this study was to find out the time interval from admission to delivery in eclamptic/ severe preeclamptic mothers and see the relationship to their obstetrics (maternal and fetal) outcomes.Methods: A retrospective case review was conducted at Nepalgunj Medical College, Teaching hospital, Nepalgunj. About 152 mothers with eclampsia/severe preeclampsia and postpartum eclampsia whom received either loading or both loading and maintenance doses of Magnesium Sulfate, while they were admitted to the hospital from 1stJanuary 2011 to 31st December 2015. Out of them, 132 were eclampsia/severe preeclampsia (antepartum / intrapartum) and 20 mothers were postpartum eclampsia were enrolled in the study. Descriptive analysis was used by reviewing medical records and Maternity registers. A 95% CI and P-value of <0.05 were considered as statistically significant.Results: Among 132 mothers, 53 (40.1%), 35 (26.5%) and 44 (33.3%) mothers delivered within 2 hours, 6 hours and ≥12 hours respectively. Ninety seven (73.4%) mothers underwent caesarean section, 27 (20.4%) had spontaneous vertex delivery 8(6%) underwent assisted vaginal deliveries. Out of 139 births there were 118 (84.8%) live births; 21 (15.1%) still births. The apgar score ≥7 at 5 minutes was seen in 81(58.2%) babies and low apgar <7 was seen in 37(26.6%) babies. and no evidence of live apgar "0" was seen in 23(16.5%).There were 2 neonatal deaths. Eleven still births in 2 hours, 4 in 6 hours and 6 in≥12 hours of admission were noted .Among 152 mothers including postpartum 20(13.1%) eclampsia, complications developed in 51 (33.5%) mothers. Maternal deaths were 2(1.3%).Conclusions: There is no significant difference in obstetrics outcomes in early (2 hour), later (6 hours) and late (≥12 hours) delivery of eclamptic/severe preeclamptic mothers. 

Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor

2019 ◽  
Vol 47 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Katharina Redling ◽  
Sabine Schaedelin ◽  
Evelyn Annegret Huhn ◽  
Irene Hoesli
Keyword(s):  
Mode Of Delivery ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Efficacy And Safety ◽  
Retrospective Case ◽  
Application Form ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Time To Delivery

Abstract Objectives To compare the oral application form of misoprostol with the misoprostol vaginal insert (MVI) in a Swiss cohort with special regards to the efficacy and safety. Methods We performed a retrospective case series including a historical group induced with oral misoprostol (MO, n=101) and an MVI group (n=101). The primary outcome was time to delivery. Secondary outcomes were mode of delivery, occurrence of tachysystole, use of analgesia and neonatal adverse outcome. Results A total of 202 women were included in the analysis (101 in the MVI as well as in the MO group). Time from start of induction to delivery was significantly shorter in the MVI group compared to the MO group (15.91 h vs. 37.68 h, P<0.001). Within the first 24 h, 78.2% of the women in the MVI group had given birth compared to 28.7% in the MO group (P<0.001). Tachysystole occurred more often in the MVI group (22.8% vs. 5.0%, P<0.001). Women in the MVI group more often needed opioid analgesia during the induction before onset of active labor (31.7% vs. 2.0%, P<0.001). There was no significant difference between neonatal outcomes in the two groups. Conclusion Time to delivery was significantly shorter in the MVI group with a higher rate of vaginal deliveries within the first 24 h. However, patients needed more opioids for pain relief during induction with MVI. There was no difference in neonatal outcomes.

Facial Nerve Outcomes in Middle Cranial Fossa vs Translabyrinthine Approaches

2005 ◽  
Vol 133 (6) ◽  
pp. 906-910 ◽  
Author(s):  
Brandon Isaacson ◽  
Steven A. Telian ◽  
Hussam K. El-Kashlan
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Middle Cranial Fossa ◽  
Vestibular Schwannomas ◽  
Care Hospital ◽  
Case Review ◽  
Retrospective Case ◽  
Increased Risk ◽  
Significant Difference ◽  
Cranial Fossa

OBJECTIVE: To compare the final facial nerve outcomes between middle cranial fossa (MCF) vs translabyrinthine (TL) resection of size-matched vestibular schwannomas. STUDY DESIGN AND SETTING: Retrospective case review at a tertiary care hospital. All patients who underwent resection utilizing either MCF or TL approaches with tumors 18 mm or smaller and complete data were included in the analysis. One hundred twenty-four patients were identified meeting the above criteria, with sixty-three in the translabyrinthine group and sixty-one in the middle fossa group. One-week-postoperative and final facial nerve examinations were compared in the two surgical groups. Patients were separately analyzed in subgroups: tumors smaller than 10 mm and those that were between 10 and 18 mm. RESULTS: The tumor size range for the MCF group was 3-18 mm while it was 4-18 mm for the TL group. No statistically significant difference was found in facial nerve outcomes between the two surgical groups, at the first postoperative visit week and at last follow-up. CONCLUSION: Facial nerve outcomes are similar using TL and MCF approaches for resection of vestibular schwannomas up to 18 mm in size. SIGNIFICANCE: Patients undergoing the MCF approach for hearing preservation can be counseled that there is no increased risk of permanent facial nerve weakness, compared to the TL approach. EBM RATING: B-3

scholarly journals Astigmatic change after pterygium excision with autologous limbal conjunctival graft

2020 ◽  
Vol 9 (1) ◽  
pp. 25-30
Author(s):  
Dikchhya Sharma ◽  
Gunjan Prasai ◽  
Om Krishna Malla
Keyword(s):  
Age Groups ◽  
College Teaching ◽  
Corneal Astigmatism ◽  
P Value ◽  
Ocular Surgery ◽  
Medical College ◽  
Corneal Scarring ◽  
Significant Difference ◽  
History Of ◽  
Pterygium Excision

Background: Pterygium induces a significant amount of astigmatism. Pterygium excision with conjunctival limbal autograft results in significant reduction in astigmatism by inducing a reversal of pterygium induced corneal flattening thereby improving the vision. Objectives: The aim of this study was to investigate the amount of corneal astigmatism in patients with pterygium before and one month (4 weeks) after surgery.  Methodology: The prospective observational study was conducted in 31 patients who underwent pterygium excision with limbal autograft in Kathmandu Medical College Teaching Hospital during the study period of 12 months duration. Patients with recurrent pterygium, pseudopterygium, history of ocular trauma, history of ocular surgery, corneal scarring were excluded from the study. After surgery, patients were followed for four weeks. Findings were recorded in the proforma and statistical analysis was done in SPSS version 19.   Results: Pterygium was seen in all age groups with majority being in the active age range of 41-50 yrs. Females were most commonly affected. Significant difference in corneal astigmatism was noted postoperatively with a p value being 0.01. Conclusion: The technique of pterygium excision with limbal conjunctival autograft not only reduces the chances of recurrence but also helps in reducing the induced corneal astigmatism which is responsible for decreased vision in patients with pterygium.

scholarly journals Perbedaan Fungsi Kognitif Mahasiswa Fakultas Kedokteran Unissula dengan IPK Kurang dari 3 dan IPK Lebih sama dengan 3 Yudisium Tahun 2018

2019 ◽  
Vol 2 (1) ◽  
pp. 293
Author(s):  
Ahmadi NH ◽  
Elly Noerhidajati ◽  
Siti Maesaroh
Keyword(s):  
Mini Mental State Examination ◽  
Descriptive Analysis ◽  
P Value ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Chi Square Test ◽  
The One ◽  
State Examination

Cognitive function varies in each human being, from simple to complex, requiring attention, concentration, and coordination. Cognitive is related to a person's ability to think, solve problems, organize and also to communicate and interact with others and the environment. Methods: cross-sectional research, samples involve the students of medical faculty of Unissula-Semarang with GPA less than 3 and more than 3 graduated in 2018, instrument Mini-Mental State Examination (MMSE). Descriptive analysis and Chi-square test. Results and Discussion: samples are 56 students, the highest gender is men (51%), the range of age 18-21 years old (53.6%), the number of GPA is the same as the one below and above 3 there are 28 (50%). Test Chi Square gender difference with P value of 0.422 GPA gender does not have significant difference to the GPA, based on the age of the results of T-test p-value 0.000, showed age had significant difference to the GPA, where the age is getting younger GPA is getting better, based on the scores of MMSE test, it was obtained p 1.000, MMSE score has no significant difference with the GPA. Conclusion: Gender and MMSE value have no difference with GPA, there is difference between age and GPA, the younger the students the better GPA the students achieve.

scholarly journals Conhecimento dos acadêmicos de odontologia sobre traumatismos em dentes decíduos

2019 ◽  
Vol 10 (2) ◽  
pp. 89
Author(s):  
Joana Vitória Melo ◽  
Gustavo Peres ◽  
Éllen Andrade ◽  
Daniela Nogueira ◽  
Márcia Cruz ◽  
...  
Keyword(s):  
Linear Trend ◽  
Descriptive Analysis ◽  
Dental Trauma ◽  
Education Institution ◽  
Trend Test ◽  
P Value ◽  
Time Interval ◽  
Academic Knowledge ◽  
Car Accidents ◽  
Treatment Objective

INTRODUCTION: Dental trauma is the set of impacts that affect the teeth and their supporting structures from enamel fracture to the definitive loss of the dental element. Among the main etiological factors of childhood dental trauma are sports practices, car accidents, child-related activities, aggressions and individual predisposing factors. The prognosis of traumatic lesions is influenced by the type and severity of the injury, the time interval between the trauma episode and the initial treatment. OBJECTIVE: To analyze the knowledge of dentistry academics of a higher education institution on dental trauma in primary teeth. MATERIAL AND METHODS: This is a transversal research. The data were collected through the application of a questionnaire, with questions about knowledge in dental trauma and the conduct of dental trauma, carried out with students who attended the discipline of Integrated Children's Clinic I, II and III. A descriptive analysis of the data was performed and the Linear Trend Test was applied, considering p value <0.05. RESULTS: A low level of academic knowledge about the subject was observed, only 8% answered all questions, with the least amount of correct answers in cases of subluxation (37.3% of correct answers) and avulsion (41.2% of correct answers). There was no association of the period with level of knowledge (p value> 0.05). CONCLUSION: The students' knowledge about dental trauma is low, mainly in the treatment of cases of trauma, such as subluxation and avulsion.

scholarly journals Neurotologic Complications Following Microvascular Decompression: A Retrospective Study

2019 ◽  
Vol 81 (01) ◽  
pp. 037-042
Author(s):  
Matthew Bartindale ◽  
Ayah Mohamed ◽  
Jason Bell ◽  
Matthew Kircher ◽  
Jacqueline Hill ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Retrospective Study ◽  
Microvascular Decompression ◽  
Tertiary Care ◽  
Significant Risk ◽  
Complication Rates ◽  
Case Review ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Significant Difference

Objective The main purpose of this article is to determine the frequency of neurotologic complications after posterior fossa microvascular decompression (MVD) surgery. Design Retrospective case review. Setting Tertiary care referral center. Participants A total of 215 consecutive MVD operations by a single surgeon between March 1996 and May 2016 were reviewed with 192 surgeries on 183 patients meeting inclusion criteria. Main Outcome Measures Neurotologic complications secondary to MVD. Results The 52 males and 131 females had a mean age of 58.52 years (range, 28–92 years). Indications for MVD were trigeminal neuralgia (n = 162), hemifacial spasm (n = 23), glossopharyngeal neuralgia (n = 13), vagal palsy (n = 1), and tinnitus (n = 1). The outcomes examined were postoperative hearing loss, tinnitus, vertigo, and hemifacial paresis. At least one of these complications was present in 17.7% of patients. There were 4.17% with permanent hearing loss, 6.77% with transient hearing loss, 5.21% with tinnitus, 5.73% with vertigo, and 0.52% with hemifacial paresis. There was no significant difference in complication rates based on surgical indication. Conclusions Neurotologic complications are a significant risk when performing MVD. It is important for otolaryngologists as well as neurosurgeons to be aware of such complications. We recommend perioperative audiometry in all patients undergoing MVD and believe there is utility in routine otolaryngologist involvement.

Clinical Experience of Switching Anti-VEGF Therapy from Ranibizumab to Aflibercept in Age-Related Choroidal Neovascularization

2016 ◽  
Vol 27 (3) ◽  
pp. 342-345 ◽  
Author(s):  
Lauren Van Lancker ◽  
Robert Petrarca ◽  
Kyros Moutsouris ◽  
Panos Masaoutis ◽  
George Kampougeris
Keyword(s):  
Visual Acuity ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Case Review ◽  
Intravitreal Ranibizumab ◽  
Retrospective Case ◽  
Age Related ◽  
Significant Difference ◽  
Intravitreal Aflibercept ◽  
Endothelial Growth Factor

Purpose To report the response of participants switching from ranibizumab to aflibercept treatment for neovascular age-related macular degeneration (nAMD) requiring further anti-vascular endothelial growth factor treatment. Methods In this retrospective case review of 68 participants treated in a single hospital, all participants, prior to switching, received ranibizumab injections only. Best-corrected visual acuity (BCVA), clinical examination, and optical coherence tomography (OCT) were performed at each visit. Active nAMD was defined as persistent intraretinal or subretinal fluid on OCT. Participants had their first aflibercept injection at baseline and 2 more injections at 2 monthly intervals. Afterwards, they were followed up every 6-8 weeks and given injections as needed. The main outcome measures were visual acuity and the OCT central retinal thickness (CRT), average thickness (AT), and total macular volume (TMV). Results The BCVA at baseline visit was 0.57 ± 0.33 log MAR and the final BCVA was 0.54 ± 0.37 log MAR (p = 0.215). The CRT mean change was -75.6 ± 85.6 (p = 0.001), the AT mean change was -24.2 ± 27.2 (p = 0.001), and TMV mean change was -0.69 ± 0.78 (p = 0.001). There were no significant ophthalmic complications related to treatments. Conclusions Intravitreal aflibercept improved anatomic outcomes (as measured by OCT) in eyes with nAMD that were previously treated with intravitreal ranibizumab and were still active. There was no statistically significant difference in logMAR visual acuity in participants who switched to aflibercept with a follow-up of at least 6 months.

scholarly journals STUDY ON STILL BIRTH: A CATASTROPH FOR PATIENT AND NIGHTMARE FOR THE OBSTETRICIAN

2020 ◽  
Vol 8 (10) ◽  
pp. 249-253
Author(s):  
Somya Saxena ◽  
◽  
Veena Gupta ◽  
Nidhi Sachan ◽  
◽  
...  
Keyword(s):  
Antenatal Care ◽  
Low Socioeconomic Status ◽  
Birth Rate ◽  
Early Recognition ◽  
P Value ◽  
Vaginal Route ◽  
Skilled Attendant ◽  
Still Birth ◽  
Still Births ◽  
Significant Difference

Introduction: Still Birth is a catastrophic event for both treating doctor and the patient.World wide in 2015, for every 1000 total births, 18.4 babies were stillborn, mostly in low and middle income countries. India has the highest number of stillbirths, with an estimated 592 100 deaths per year Aim : To evaluate the still birth rate of our institution and to assess the sociodemographic factors contributing to it, and to predict the maximum risk period for still birth. Material and Methods: All patients who gave consent and delivered a baby either vaginally or by caeserian section after 28 weeks of gestation during the study period(july 2019-June 2020) were included in the study.Still Birth was defined as a baby born after 28 completed weeks of gestation or weighing more than 1 kg,with no signs of life .Total no of patients during the study period were 2629, with 5 sets of twins. So total no of birth during the study period was 2634. Epidemiological data were compared between still birth and total births.Causes of still births were analysed and period of maximum risk for still birth was predicted. Statistical Analysis :Descriptiveanalytes were expressed in proportion. Chi square test was used to assess the significance level and p value of <.05 was taken as significant. Result: Total no. of births by either vaginal route or caesarean section during june 2019 to july 2020 were 2634 foetuses. among which,137 fetus were still born. So still birth rate was 52/1000 live births.Maximum no of still births were in the age group of 20-25 years 69(50.3%), were primigravida 46(33.5%), belonged to low socioeconomic status 95(69.3%), came from rural areas79(57.6%) and were unbooked 94(68.6%).There was statistically significant difference(p=.0012) in unbooked cases when still births and total births were compared. No cause could be attributable to still birth in 15(10.9%) of cases, whereas 81(59.1%) had maternal causes,17(12.4%) had fetal causes, 19(13.8%) had placental causes while 5(3.6%) had other reasons like acute infections or thermal burns. Major reason of StillBirth amongst the maternal causes, was labour complications 38(37.7%), whereas intra uterine growth restriction was the leading cause 8(5.8%) amongst the fetal factors.36-40 week was the gestational age during which maximum still births occured.95(69.31%) of still birth cases were delivered by vaginal route Conclusion:Majority of still births were in unbooked cases and labourcomplications were the leading cause of still births overall. Hence antenatal care and delivery by skilled attendant is of paramount importance. Routine antenatal care would also lead to early recognition of maternal and fetal high risk factors and their management.

ID: 101: ROTHIA MUCILAGINOSA BACTEREMIA: 8 YEAR REVIEW OF A SINGLE INSTITUTION EXPERIENCE

2016 ◽  
Vol 64 (4) ◽  
pp. 953.1-953
Author(s):  
M Abidi ◽  
P Hari ◽  
A Banerjee ◽  
N Ledeboer
Keyword(s):  
Hematologic Malignancy ◽  
Descriptive Analysis ◽  
Marrow Transplant ◽  
Blood Cultures ◽  
Attributable Mortality ◽  
P Value ◽  
Morbidity Score ◽  
Co Morbidity ◽  
Significant Difference ◽  
Neutropenic Patients

BackgroundRothia spp. are gram positive bacteria which are known to cause infections in the immune compromised host. Literature is limited on the epidemiology and clinical significance of Rothia bacteremia.MethodsWe reviewed medical records of all patients with blood cultures positive from 2006–2014. Descriptive analysis was performed as well as comparative analysis of neutropenic patients (absolute neutrophil count ≤1000 /μL) at the time of bacteremia with non-neutropenic patients at the time of bacteremia. Fische's exact tests were used for comparisons of proportions and medians, respectively, with p-values <0.05 considered statistically significant.Results29 patients with Rothia bacteremia were identified. Median age was 58 years (range 27–73), with no significant gender difference (p=0.94). Charlson co-morbidity score of 4 or greater was found in 20 (69%) of patients; 20 (69%) patients had a hematologic malignancy or bone marrow transplant. While there were 14 deaths, only 1 was possibly attributed to Rothia infection. Neutropenia was observed in 21(72%) patients at the time of bacteremia. Neutropenic patients were less likely than non-neutropenic patients to have polymicrobial infection (24% vs. 63%, p=0.083); and were also more likely to have multiple positive blood cultures (76% vs. 0%; p value=0.0003). There was no difference between the two groups in need for ICU care, mortality or attributable mortality. Statistically significant difference was seen for steroid use (81% vs. 13%, p=0.0014), and fluroquinolone use (86% vs.13% p=<0.0001) preceding bacteremia in neutropenic patients. Presence of intra-vascular catheter was also more pre-dominant in the neutropenic group (86% vs. 50%, p=0.068) at the time of bacteremia.ConclusionsRothia bacteremia is seen in patients with medical co-morbidities, predominantly in patients with leukemia.A significant association was seen with prior use of steroid and fluroquinolone prophylaxis in neutropenic patients who developed Rothia bacteremia.Rothia bacteremia in neutropenic hosts was mostly monomicrobial and less likely thought to be a contaminant.

scholarly journals The Association Between Anemia of Chronic Inflammation and Alzheimer’s Disease and Related Dementias

2020 ◽  
Vol 4 (1) ◽  
pp. 379-391
Author(s):  
Alexander Andreev ◽  
Burak Erdinc ◽  
Kiran Shivaraj ◽  
Julia Schmutz ◽  
Olga Levochkina ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Chronic Inflammation ◽  
Binding Capacity ◽  
Control Group ◽  
P Value ◽  
Iron Level ◽  
Retrospective Case ◽  
Significant Difference ◽  
Anemia Of Chronic Inflammation

Background: Dementia is a spectrum of neurological diseases characterized by memory impairment and cognitive decline with the pathogenesis and effective management remaining elusive. Several studies have identified a correlation between anemia and Alzheimer’s disease and related dementias (ADRD); however, anemia subtypes and association with ADRD have yet to be studied conclusively. Objective: To study an association between ADRD and anemia of chronic inflammation. Methods: We conducted a retrospective case-control study of the patients, diagnosed with ADRD at Brookdale Hospital. Pair-wise comparisons between means of controls and cases in terms of iron studies and laboratory results were performed using a Mann–Whitney U test. Pair-wise comparisons between anemia subgroups (moderate and severe) were performed using a Two Sample proportion Z-Test, where for each couple of normally distributed population. Results: There was a total of 4,517 (1,274 ADRD group; 3,243 Control group) patients. There was significant difference in hemoglobin 10.15 versus 11.04 [p-value <0.001]. Iron studies showed a significant difference in ferritin 395±488.18 versus 263±1023.4 [p < 0.001], total iron binding capacity 225±84.08 versus 266±82.30 [p < 0.001] and serum iron level 64±39.34 versus 53±41.83 [p < 0.001]. Folic acid and vitamin B12 levels were normal in both groups. Severe and moderate anemia in the ADRD group were respectively 6.2% [95% CI: 4.2–8.4] and 13% [95% CI: 9.8–16.2] higher. Overall, incidence of moderate-to-severe anemia was found to be 19% higher in ADRD group [95% CI: 15.8–22.1]. Conclusion: We demonstrated an association between ADRD and anemia of chronic inflammation independent of age, renal function, and HgbA1C levels.

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