scholarly journals Reinvestigation on Newer Facts to Anticipate, Avoid And Mitigate The Development of Post-Dural Puncture Headache-A Prospective Cohort Study

2021 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Causative Factor ◽  
Spinal Needle ◽  
Related Factors ◽  
Needle Size ◽  
Neuraxial Blockade ◽  
Investigation Methods

Purpose: Various researchers have described the size and the type of spinal needle used for neuraxial anesthesia as the most common risk factor for developing postdural puncture headache (PDPH). Even though the occurrence of the PDPH is rare in modern anesthesia practice, we come across many such patients despite following all guidelines or precautions. Patient-related factors for developing PDPH are relatively understudied. For that, clinical features commonly present in such patients may require a thorough investigation. Methods: This prospective cohort study included fifty patients admitted for lower extremities orthopedic surgeries and developed PDPH following the neuraxial blockade. We screened all patients in this study for the presence or absence of common manifestations suggestive of connective tissue disorders (CTD). The other outcomes, like the effect of spinal needle size/type to develop PDPH and time to develop PDPH, were also measured. Results: Almost all PDPH patients included in this study had common features suggestive of CTD: the ligamentous laxity (96%), high-arched palate (96%), the blue sclera (45%), joint hyperextensibility (82%), and ejection clicks (64%). PDPH occurred more frequently with the 25G spinal needle of Quincke type than 27G of Whitacre type (82% vs. 18%). The mean (SD) headache freedom time was 73.14 (24.74) hours. Conclusions: The CTD might also be a causative factor responsible for the development of PDPH in some individuals. It can be considered a risk factor to anticipate, avoid, and mitigate the development of PDPH.

scholarly journals Incidence and risk factors of Postdural Puncture Headache: Prospective cohort study design

2020 ◽  
Author(s):  
Bedilu Girma Weji ◽  
Mohammed Suleiman Obsa ◽  
Kidest Getu Melese ◽  
Gedion Asnake Azeze
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Lumbar Puncture ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Spinal Needle ◽  
Postdural Puncture Headache ◽  
Needle Size ◽  
Cohort Study Design

Abstract Background:Postdural puncture headache is one of the complications following spinal anaesthesia and accidental dural puncture. Several modifiable risk factors contribute to the development of headache after lumbar puncture, which includes needle size, needle design, direction of the bevel and number of lumbar puncture attempts. This study aimed to assess the incidence and risk of postdural puncture headache.Methods:This prospective cohort study design was conducted using a consecutive sampling method. Regular supervision and follow-up were performed. Data were entered into Epi info version 7 software and transported to SPSS version 20 for analysis. The odds ratio and 95% confidence interval were computed. The findings of the study were reported using tables, figures and narrations. Variables that were found to be candidates (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of postdural puncture headache.Results:One hundred fifty eligible study participants were included in our study, of which 28.7% had developed postdural puncture headache. This study found that needle size, number of cerebro spinal fluid drops and multiple attempts were significant independent predictors of postdural puncture headache (p < 0.05). In addition, twenty-five needles were identified as the strongest preoperative independent predictor of postdural puncture headache (AOR = 4.150, CI = 1.433- 12.021)Conclusions:A recent study revealed that a small spinal needle was much better than a large cutting spinal needle regarding the frequency of postdural puncture headache. In addition, frequent attempts during lumbar puncture and increased cerebro spinal fluid leakage were associated with the events. In view of this, we recommend the use of a small spinal needle to avoid more leakage of cerebrospinal fluid and multiple attempts at spinal anesthesia and lumbar puncture.

scholarly journals Travel style is a major risk factor for diarrhoea in India: a prospective cohort study

2015 ◽  
Vol 21 (7) ◽  
pp. 676.e1-676.e4 ◽  
Author(s):  
V.M. Schindler ◽  
V.K. Jaeger ◽  
L. Held ◽  
C. Hatz ◽  
S. Bühler
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Major Risk Factor

scholarly journals Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

2021 ◽  
Author(s):  
Prajwal Paudel ◽  
Avinash K Sunny ◽  
Rejina Gurung ◽  
Abhishek Gurung ◽  
Honey Malla ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Birth Defects ◽  
Prospective Cohort ◽  
Birth Defect ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Birth Asphyxia ◽  
Neonatal Infection

Abstract Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.

scholarly journals Risk Factors for the Occurrence and Protraction of Anterior Knee Pain in Children and Adolescents: a Prospective Cohort Study of 3 Years

2021 ◽  
Author(s):  
Manato Horii ◽  
Ryuichiro Akagi ◽  
Sho Takahashi ◽  
Shotaro Watanabe ◽  
Yuya Ogawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Children And Adolescents ◽  
Knee Pain ◽  
Prospective Cohort Study ◽  
Anterior Knee Pain ◽  
Prospective Cohort ◽  
Activity Level ◽  
Anterior Knee

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

scholarly journals Hyperthyroidism is not a risk factor for subclinical bacteriuria in cats: A prospective cohort study

2020 ◽  
Vol 34 (3) ◽  
pp. 1157-1165
Author(s):  
Mark E. Peterson ◽  
Alice Li ◽  
Peter Soboroff ◽  
Graham E. Bilbrough ◽  
Mark Rishniw
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort
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