scholarly journals Study on Risk Factors, Clinical Presentation & Operative Management of Ectopic Pregnancy

2016 ◽  
Vol 28 (1) ◽  
pp. 9-14
Author(s):  
Kamrun Nahar ◽  
Turani Talukder ◽  
Sabiha Sultana ◽  
Md Anwar Hossain
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Operative Management ◽  
Age Group ◽  
Presenting Symptoms ◽  
Patient Profile ◽  
Short Period ◽  
History Of ◽  
Acute Condition

Introduction: Ectopic pregnancy is a major clinical problem in gynaecology because it is often difficult to diagnose as the patient present in different ways. An accurate history taking and physical examination is considered to be most important in the diagnosis of ectopic pregnancy. There are two treatment options, medical or surgical. Surgical treatment is the fastest treatment for ectopic pregnancy though surgical management decreased from approximately 90% to 65%1. Surgery may be the only treatment option if there is internal bleeding. In the medical treatment group, 15% of cases were categorized as failures and required surgery1.Objectives: This study was conducted in the department of obst and Gynae of Dhaka Medical College Hospital from January 2005 to June 2005 in an attempt to find out the risk factors of ectopic pregnancy, the way of presentation and to analyze the operative treatment of ectopic pregnancy.Materials and Methods: A total 50 consecutive patients who were clinically suspicious of ectopic pregnancy were included in this study between January 2005 to June 2005. Patients who were clinically suspicious of EP and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography were included in this study. Detailed discussion about the study was done with the patient and then informed verbal consent was taken from them. Detailed history about patient profile, presenting symptoms, any risk factors and clinical examination done and the findings were recorded in the predesigned data collection sheet. Data was expressed in terms of frequencies and percentagesResults: Most of the patients were in the age group of 20-30 years and 38% of low parity (para- 1).Previous miscarriage, infertility,IUCD users and PID identified as the risk factors of ectopic pregnancy— 42% patients had history of previous abortion or MR, period of infertility 22%, pelvic infection 12%, IUCD users 16%. In this study acute abdominal pain after a short period of amenorrhoea was found to be the main symptoms in ectopic pregnancy—100% patients were presented with lower abdominal pain, 70% with period of amenorrhea and 50% patients with per vaginal bleeding. All the patients were presented with acute condition and were surgically managed fastest treatment. At the time of operation 84% of ectopic tubal pregnancy were found ruptured, 10% were tubal abortion and 4% unruptured. Sites of ectopic pregnancy were ampullary 50%, isthmic 20%, fimbrial 10%.Conclusion: Most of the patient presented in acute condition with the classical features of ruptured ectopic pregnancy. Near half of the patient were in younger age group (26 – 30 years) having risk factors like history of previous abortion/MR 42%, infertility 22% use of IUCD 16%, PID 12%. More then three forth( 84%) of cases were diagnosed as ruptured ectopic during operation. Operative management was done on the basis of site of ectopic and parity of the womanBangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 9-14

scholarly journals ECTOPIC PREGNANCY : A MAJOR CAUSE OF MATERNAL MORTALITY?

2003 ◽  
Vol 42 (147) ◽  
pp. 151-155
Author(s):  
Rajshree Jha ◽  
M Singh ◽  
A Rana ◽  
A Singh ◽  
S Bastola
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Pelvic Surgery ◽  
Transvaginal Sonography ◽  
Pregnancy Risk ◽  
Abdominal Tenderness ◽  
Presenting Symptoms ◽  
History Of

ABSTRACTSeventyeight cases of ectopic pregnancy were studied retrospectively at Tribhuvan University TeachingHospital during April 1993 - December 1996. The overall incidence of etopic pregnancy was 0.86% livebirths. Grandmultipara were found to be at a low risk for ectopic pregnancy. A history of infertility andprevious pelvic surgery were positive risk factors. The most common presenting symptoms were abdominalpain (90%), history of amenorrhoea (46%), abnormal uterine bleeding (40%). On examination adenexaltenderness (72%), abdominal tenderness (68%), pallor (53%) and cervical excitation (33%) were the mostfrequent findings. Adenexal mass was noted in 22% cases and in 35 % cases the size of the uterus could notbe assessed. Ultrasonography and transvaginal sonography proved to be valuable diagnostic aids. Twomaternal deaths (2.6 %) due to ectopic pregnancy occurred in the hospital during this period.Key Words: Ectopic pregnancy, risk factors, sonography.

scholarly journals Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year Retrospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 6-11
Author(s):  
Sonam Gyamtsho ◽  
Karma Tenzin ◽  
Tshering Choeda ◽  
Karma Lhaden ◽  
Tandin Om
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Inflammatory Disease ◽  
Vaginal Bleeding ◽  
Morbidity And Mortality ◽  
Clinical Presentations ◽  
History Of ◽  
Ectopic Pregnancies

Introduction: Ectopic pregnancy is an emergency and a life-threatening condition which is an important cause of major maternal morbidity and mortality. This study was designed to determine incidence, common identified risk factors, clinical presentations, management, morbidity and mortality due to ectopic pregnancy at the national referral hospital in Thimphu, Bhutan. Methods: This was a retrospective study of all cases of ectopic pregnancies for a period of two years from 1st January 2018 to 31st December 2019. Socio-demographic characteristics, risk factors, clinical presentations, investigations and mode of treatments were extracted. Simple descriptive statistics such as frequencies, percentages, mean and range were utilised. Results: There were 9603 pregnant women admitted for delivery, out of which 122 were ectopic pregnancies. The incidence of ectopic pregnancy was 12.7/1000 pregnancies. Majority of them were in the age group of 21-30 years and 32.69% of the affected were nulliparous. While Pelvic inflammatory disease was seen in 41.35%, 20.19% were unmarried. Abdominal pain, amenorrhea, and vaginal bleeding were the most common symptoms. Among the ectopic pregnancies, 99.5% were diagnosed with ultrasound. A total of 94.23% had undergone surgical intervention, of which only 1% had laparoscopic surgery. No maternal mortality had occurred. Conclusions: Women with past history of pelvic inflammatory disease, previous miscarriage, unmarried, and nulliparous presenting with history of amenorrhea, abdominal pain, vaginal bleeding should be a high index of suspicion for ectopic pregnancy. Timely diagnosis and intervention in the form of surgical or medical management will reduced the morbidity and mortality due to ectopic pregnancy.

scholarly journals A clinical study on ectopic pregnancy in tertiary care hospital Imphal

2021 ◽  
Vol 10 (2) ◽  
pp. 562
Author(s):  
Naorem Sunanda Chanu ◽  
Vinodkumar Suresh Basavaradder ◽  
Cibi Darsani ◽  
Ahanthembi Sanaton
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Grey Zone ◽  
Age Group ◽  
History Of

Background: Ectopic pregnancy is one of the most common life-threatening emergencies in early trimester of pregnancy. The aim of this study was to determine the incidence, age group, gravidity, parity, risk factors, clinical presentation, treatment modalities associated with ectopic pregnancy in the current scenario.Methods: We conducted a prospective study for the period of two years starting from Aug 2017 to Aug 2019 at JNIMS OBG Department.Results: A total of 94 patients who were diagnosed as ectopic pregnancy and they were analysed for clinical presentation, risk factors, operative findings and treatment modality. Majority of patients were in the age group of 25 to 30 years. Ectopic pregnancy was more commonly associated with history of prior abortions, prior LSCS and PID. Commonly presented with amenorrhea of 6-8 weeks with abdominal pain and bleeding PV, most common site being ampulla followed by isthmus. Most of the patients had ruptured pregnancy at presentation. Majority of the patients underwent salpingectomy and salpingectomy with contralateral tubectomy.Conclusions: Ectopic pregnancy diagnosis is a grey zone and challenging. Early diagnosis by keeping suspicion in first trimester with PV bleeding and pain abdomen with history of amenorrhea about ectopic pregnancy, which helps in management to reduce maternal morbidity and even mortality.

scholarly journals Risk factors, clinical presentation and management of ectopic pregnancy in a rural tertiary care centre- An observational study

2021 ◽  
Vol 8 (3) ◽  
pp. 296-300
Author(s):  
Lopamudra B John ◽  
Lingampalli Naga Saketha ◽  
Setu Rathod
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Ectopic Pregnancy ◽  
Teaching Hospital ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Teaching Hospital ◽  
History Of ◽  
Ectopic Pregnancies

: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the risk factors, clinical features at presentation, diagnostic tools, management modalities and outcome of ectopic pregnancies in a tertiary care teaching hospital.: This was an observational study of 90 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from February 2019 to August 2020. Relevant data of the 90 patients was tabulated and descriptive analysis was done. : Chi square and Fischer exact test: Majority of the patients belonged to 21-30 yrs age group. Maximum number of cases (57%) had a history of previous abdomino pelvic surgery. The predominant symptom was amenorrhea (96.6%) and classical triad of amenorrhea, bleeding per vagina and abdominal pain was seen in 30% of the study population. Majority of the patients i.e 76.7% underwent surgical intervention.: Most common age group at presentation is 21-30years. History of previous abdominal surgery being the most important risk factor whereas amenorrhea was the most common symptom. Surgical intervention was the main mode of management in ruptured ectopic pregnancy.

scholarly journals Clozapine-induced stercoral colitis: a surgical perspective

2019 ◽  
Vol 12 (8) ◽  
pp. e227718 ◽  
Author(s):  
Jayan George ◽  
Richard Hotham ◽  
William Melton ◽  
Keith Chapple
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Total Colectomy ◽  
Postoperative Recovery ◽  
Presenting Symptoms ◽  
History Of

We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.

scholarly journals Risk Factors of Stroke in Young and Old Age Group Admitted in a Tertiary Level Hospital, Dhaka - A Comparative Study

2014 ◽  
Vol 27 (2) ◽  
pp. 94-100
Author(s):  
Md. Nurul Amin Miah ◽  
MA Azhar ◽  
Aminur Rahman ◽  
Durba Halder ◽  
Md. Akteruzzaman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Old Age ◽  
Transient Ischemic Attack ◽  
Oral Contraceptive Pill ◽  
Age Group ◽  
Old Patients ◽  
History Of ◽  
Ischemic Attack ◽  
Stroke In Young

Background: Stroke is an important cause of death and disability. Prevalence of stroke in Bangladesh differs with age. The risk factors in young differ in comparison to old age group. In this study risk factors of stroke in young in comparison to old age group were evaluated. Objectives: To compare the risk factors associated with stroke in young adult and to those of old age group. Methodology: This comparative study conducted in the department of Medicine and Neurology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from January 2008 to June 2009. One hundred two stroke patient of above 15 years of age were confirmed by CT scan or MRI of brain those were included in young and old age groups. The risk factors of stroke were defined in terms of hypertension, diabetes mellitus, dyslipidaemia, ischemic heart diseases, valvular heart disease, history of transient ischemic attack or stroke, smoking and oral contraceptive pill. Results: Of total 102 cases 17 were young adults and 85 old patients between 19 to 100 years. Mean age young adult was 39.76 (± 6.379) and old age was 65.06 (± 11.238). 61.7% were male & 38.2% were female and the ratio was 1.6:1. Amongst male 58.8% patients were smoker in each age group and only 2.9% old patients were alcoholic. Only 17.6% had previous history of transient ischemic attack or stroke in each age group. 58.8% of young and 48.2% of old were hypertensive. 7% old patients had history of ischemic heart disease. 5.9% of young and 2.4% of old patients had valvular heart disease but no patient had vasculitis. 16.7% old patients had diabetes mellitus. 4.9% of total patients (young 11.8% and 3.5% old) were oral contraceptive pill user. Out of all patients 24.7% old patients and 5.9% young adult was dyslipidaemic. Among all patients 66.7% patients had the Ischemic stroke and 33.3% patients had the hemorrhagic stroke. 68.2% old patients and 58.8% young patients had Ischemic stroke; 31.8% old patients and 41.2% young patients had hemorrhagic stroke. Conclusion: In young age group smoking, transient ischemic attack or stroke, hypertension, valvular heart disease, oral contraceptive pill and in old age group smoking, transient ischemic attack or stroke, hypertension, Ischemic heart disease, diabetes mellitus and dyslipidaemia were found significant risk factors for development of stroke. So modification of risk factors may reduce the incidence of stroke. Bangladesh Journal of Neuroscience 2011; Vol. 27 (2) : 94-100 DOI: http://dx.doi.org/10.3329/bjn.v27i2.17576

scholarly journals Prevalence and risk factors of pulmonary nontuberculous mycobacterial infections in the Zhejiang Province of China

2019 ◽  
Vol 147 ◽  
Author(s):  
Jintian Xu ◽  
Ping Li ◽  
Shengchao Zheng ◽  
Wei Shu ◽  
Yu Pang
Keyword(s):  
Risk Factors ◽  
Reference Group ◽  
The Elderly ◽  
Zhejiang Province ◽  
Age Group ◽  
Pulmonary Tb ◽  
History Of ◽  
Normal University ◽  
The Difference ◽  
Culture Positive

Abstract Risk factors and prevalence of pulmonary nontuberculous mycobacterial (NTM) diseases were retrospectively evaluated in 1208 suspected pulmonary TB patients seeking care at the Affiliated Hospital of Hangzhou Normal University between July 2018 and December 2018. Further analysis of 390 culture-positive cases demonstrated that 358 (358/390, 91.8%) were infected with Mycobacterium tuberculosis (MTB), 24 (24/390, 6.2%) with NTM and eight (8/390, 2.0%) with both MTB and NTM. M. intracellulare was the most prevalent NTM isolated (16/24, 66.7%), followed by M. abscessus (3/24), M. kansasii (2/24), M. avium (1/24), M. szulgai (1/24) and M. fortuitum (1/24). The difference between NTM and TB case rates for the ⩾65-year-old age group significantly exceeded the difference for the reference group (patients aged 25–44 years) (OR (95% CI): 4.63 (1.03–20.90)). Pulmonary NTM diseases incidence positively correlated with prior TB history (OR (95% CI): 12.92 (3.24–31.82)). Moreover, pulmonary NTM patients were significantly more likely to exhibit underlying bronchiectasis than pulmonary TB patients (OR (95% CI): 18.89 (7.54–47.88)). In conclusion, approximately one-tenth of culture-positive suspected pulmonary TB patients are infected with NTM (most frequently M. intracellulare) in Zhejiang Province, China. The elderly and those with bronchiectasis or a history of TB are at the greatest risk of contracting pulmonary NTM disease.

scholarly journals Risk Factors of Stroke in Young and Old age Group - A Comparative Study

2012 ◽  
Vol 13 (2) ◽  
pp. 138-142 ◽  
Author(s):  
MNA Miah ◽  
MA Azhar ◽  
A Rahman ◽  
D Halder ◽  
M Akteruzzaman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Old Age ◽  
Transient Ischemic Attack ◽  
Oral Contraceptive Pill ◽  
Age Group ◽  
Old Patients ◽  
History Of ◽  
Ischemic Attack ◽  
Stroke In Young

Background: Stroke is an important cause of death and disability. Prevalence of stroke in Bangladesh differs with age. The risk factors in young differ in comparison to old age group. In this study risk factors of stroke in young in comparison to old age group were evaluated. Objectives: To compare the risk factors associated with stroke in young adult and to those of old age group. Methodology: This comparative study conducted in the department of Medicine and Neurology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from January 2008 to June 2009. One hundred two stroke patient of above 15 years of age were confirmed by CT scan or MRI of brain those were included in young and old age groups. The risk factors of stroke were defined in terms of hypertension, diabetes mellitus, dyslipidaemia, ischemic heart diseases, valvular heart disease, history of transient ischemic attack or stroke, smoking and oral contraceptive pill. Results: Of total 102 cases 17 were young adults and 85 old patients between 19 to 100 years. Mean age young adult was 39.76 (± 6.379) and old age was 65.06 (± 11.238). 61.7% were male & 38.2% were female and the ratio was 1.6:1. Amongst male 58.8% patients were smoker in each age group and only 2.9% old patients were alcoholic. Only 17.6% had previous history of transient ischemic attack or stroke in each age group. 58.8% of young and 48.2% of old were hypertensive. 7% old patients had history of ischemic heart disease. 5.9% of young and 2.4% of old patients had valvular heart disease but no patient had vasculitis. 16.7% old patients had diabetes mellitus. 4.9% of total patients (young 11.8% and 3.5% old) were oral contraceptive pill user. Out of all patients 24.7% old patients and 5.9% young adult was dyslipidaemic. Among all patients 66.7% patients had the Ischemic stroke and 33.3% patients had the hemorrhagic stroke. 68.2% old patients and 58.8% young patients had Ischemic stroke; 31.8% old patients and 41.2% young patients had hemorrhagic stroke. Conclusion: In young age group smoking, transient ischemic attack or stroke, hypertension, valvular heart disease, oral contraceptive pill and in old age group smoking, transient ischemic attack or stroke, hypertension, Ischemic heart disease, diabetes mellitus and dyslipidaemia were found significant risk factors for development of stroke. So modification of risk factors may reduce the incidence of stroke. DOI: http://dx.doi.org/10.3329/jom.v13i2.12741 J Medicine 2012; 13 : 138-142

Risk factors of colorectal adenoma recurrence among individuals under 50 years of age compared to those 50 years of age or older.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1554-1554
Author(s):  
Christine Louise Sardo Molmenti ◽  
Jingyan Yang ◽  
Cynthia A Thomson ◽  
Elizabeth A Hibler ◽  
Gloria Ho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Adenoma ◽  
Colorectal Adenomas ◽  
Age Group ◽  
Current Smoking ◽  
Adenoma Recurrence ◽  
Younger Age ◽  
History Of ◽  
Colorectal Adenoma Recurrence

1554 Background: Colorectal cancer incidence and mortality are increasing among individuals < 50 years of age. Data are limited regarding the epidemiology of colorectal adenomas in this younger age group. This study investigated and compared risk factors associated with recurrence of adenomas in individuals under and over 50 years of age. Methods: Pooled analyses from the Wheat Bran Fiber and Ursodeoxycholic Acid phase III, randomized, controlled clinical trials included 1,623 participants, aged 40-80 years. Each completed baseline questionnaires related to family history and lifestyle habits, had one or more colorectal adenomas removed at baseline, and had a follow-up colonoscopy during the trial (mean follow up 36 months). Univariate and multivariate logistic regression modeling estimated the association between age and colorectal adenoma recurrence, and evaluate multiple risk factors, while controlling for confounding factors. Results: A statistically significant increased trend was found for colorectal adenoma recurrence with increasing age ( Ptrend= < 0.001). Multivariate logistic regression revealed that risk factors significantly associated with adenoma recurrence in the ≥50 age group (n = 1,523) included history of previous polyps, characteristics of adenomas removed at baseline (multiple adenomas and villous feature), current smoking, and an increased waist circumference. Although risk profile in the < 50 age group (n = 95) shared similarities with that in the ≥50 age group (e.g., current smoking), there were a few notable differences: history of previous polyps was a more prominent predictor for recurrence for the < 50 (OR< 50 = 4.76 and OR≥50 = 1.33, Pinteraction = 0.042), whereas baseline characteristics of adenomas were more important for the ≥50 (multiple adenomas: OR< 50 = 0.40 and OR≥50 = 2.28, Pinteraction = 0.043). Conclusions: Predisposition to colorectal adenoma is a more important risk factor for recurrence in the < 50 as compared to the ≥50. Future studies need to identify susceptibility factors contributing to the increasing incidence of colorectal cancer in this younger age group.

scholarly journals Seroprevalence and Associated Risk Factors of Hepatitis B Virus Infection Among Children in Enugu Metropolis

2018 ◽  
Vol 9 ◽  
pp. 1178122X1879285 ◽  
Author(s):  
Maryann Chinenye Ezeilo ◽  
Godwill Azeh Engwa ◽  
Romanus Ifeanyi Iroha ◽  
Damian Chukwu Odimegwu
Keyword(s):  
Risk Factors ◽  
Hepatitis B Virus ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Clinical Manifestations ◽  
Hbv Infection ◽  
Age Group ◽  
History Of Surgery ◽  
B Virus ◽  
History Of

Background: Though measures are being put in place for the management of Hepatitis B virus (HBV) infection in Nigeria, children remain the most vulnerable to develop chronic hepatitis. Routine screening in children is therefore necessary for effective control. However, the performance of the commonly used immunochromatographic test (ICT) strips has been challenging. Also, identifying the risk factors of transmission in this age group is of importance for the implementation of preventive measures. Hence, the goal of this study was to assess the test performance of the routinely used ICT strip and identify the associated clinical manifestations and risk factors of HBV. Methods: A cross sectional study involving 270 children below six years of age was conducted at ESUTH and Favor Child Pediatrics Hospital in Enugu, Nigeria. The subjects were screened for HBV by ICT and ELISA assays and a structured questionnaire was used to obtain participants data including demographic, socioeconomic, signs and symptoms, risk factors and vaccination. Results: BBased on ELISA, 31 out of 270 children were positive for HBV with an infection rate of 11.5%. ICT kit showed a low sensitivity of 51.6% in diagnosing HBV but was highly specific (100%) and accurate (94.4%). HBV infection was not associated with sex (χ2: 0.209; p = 0.401). The prevalence of HBV infection was similar in all the age group and HBV infection was not associated (χ2: 2.099; p = 0.914) with age group. All the clinical manifestations were not associated ( p > 0.05) with HBV infection. Blood transfusion, shared items, tattoo marks and history of surgery associated significantly ( p < 0.05) with HBV infections having odd ratios of 4.247, 4.224, 3.134 and 3.195 respectively. The vaccination rate was 55.2% (159/270) and only 3 (1.1%) out of 159 vaccinated subjected contracted the infection (OR: 0.068, p < 0.0001). Conclusions: HBV was prevalent (11.5%) in children below six years old in Enugu metropolis. Moreover, the routinely used ICT test was less reliable than ELISA in diagnosis HBV infection. More so, shared items, blood transfusion, tattooing and history of surgery were potential risk factors while vaccination served as a protective factor against the infection.

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