scholarly journals Caesarean Section in Eclampsia and its Outcome in Bangladesh

KYAMC Journal ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 583-586
Author(s):  
MA Mazid ◽  
Shahida Akter
Keyword(s):  
Heart Failure ◽  
Pulmonary Embolism ◽  
Caesarean Section ◽  
Conservative Management ◽  
Causes Of Death ◽  
Post Partum ◽  
Economic Status ◽  
Treatment Options ◽  
Age Difference ◽  
Significant Difference

This prospective study was carried out on a total number of 58 eclamptic subjects during the period of July 2010 to June 2012 where 38 were undergone caesarean section (LUCS - Lower Uterine Caesarean Section) and 20 received conservative management. Mean (±SD) Age of the subjects who undergone Caesarean Section and conservative management (NVD) were 23.67±8.63 and 23.45±9.31 years respectively. Significant mean age difference was also present between these two groups. In 38 subjects of LUCS 34 subjects were recovered and rest 4 cases were died. Possible causes of death were due to heart failure and post partum pulmonary embolism. Among these 20 subjects who were treated conservatively 14 were recovered and 6 subjects were died. Causes of death in these groups were pulmonary embolism, Septic pneumonia, and HELLP syndrome. Significant difference was found between these two treatment options. It was observed that socio-demographic, economic status and BMI had significant effects on management outcome.KYAMC Journal Vol. 6, No.-1, Jul 2015, Page 583-586

Massive Pulmonary Embolism In A Postpartum Case of Caesarean Section A Case Report

JMS SKIMS ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 90-94
Author(s):  
Javid Ahmad Wani ◽  
Irfan Ahmed ◽  
Showkat Ali Mufti
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Caesarean Section ◽  
Supportive Care ◽  
Pulmonary Thromboembolism ◽  
Post Partum ◽  
Standard Of Care ◽  
Massive Pulmonary Embolism ◽  
Sudden Onset ◽  
Postoperative State

Introduction : The overall incidence of acute pulmonary embolism is 0.004% per year1; among post-partum women, the incidence of venous thromboembolism is approximately 3 to 7 every 10,000 deliveries, which is 15 to 35 times that of females of the same age who are not pregnant2. Venous thromboembolism contributes to 20% of pregnancy-related mortalities. The highest risk is in the puerperium3. Thrombolysis is standard of care in pulmonary thromboembolism with shock and right ventricular hypokinesia4-7, however, immediate postoperative state compels conventional treatment. Patients do well with anticoagulation and proper supportive treatment as illustrated in this case.Case report : We report a case of a 34-year old female who developed sudden onset breathlessness while walking on the 2nd post-operative day of an uneventful caesarean section. She was dyspneic, cyanosed and in hypotension. CXR was normal, ECG showed S1Q3T3 pattern, and d-dimer was raised. CTPArevealed features of pulmonary embolism. Thrombolysis was contemplated but was abandoned in view of recent surgery. She received anticoagulation with Heparin (and later warfarin) and supportive care including intravenous fluids, oxygen and Dopamine and Doubutamine. She improved and was discharged after 10 days on warfarin anticoagulation.Conclusion: Breathlessness in a patient in the post-operative period or pregnancy should lead to the possibility of pulmonary thromboembolism. PTE with hypotension or RV hypokinesia has a high mortality, merits thrombolysis plus anticoagulation. But patients with contraindication to thrombolysis should receive anticoagulation and standard supportive care. JMS 2016; 19(2):90-94.

How safe is surgery in obese lung cancer patients?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17555-e17555
Author(s):  
Binod Dhakal ◽  
Sunitha Sukumaran ◽  
Rafael Santana-Davila ◽  
George Haasler ◽  
Daniel Eastwood ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lung Cancer ◽  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Respiratory Failure ◽  
Surgical Procedures ◽  
Wedge Resection ◽  
The Body ◽  
Operative Morbidity ◽  
Significant Difference

e17555 Background: Obesity is a risk factor for increased peri-operative morbidity and mortality in surgery. There have been limited studies to correlate morbidity of lung cancer resection with obesity. Methods: We performed a retrospective study of patients who underwent surgical resection for lung cancer at the Medical College of Wisconsin from 2006 to 2010. Data on patient demographics, weight, pathology findings and hospital course were abstracted after appropriate IRB approval. Peri-operative morbidity was defined as atrial fibrillation, heart failure, respiratory failure, pulmonary embolism or any medical complications arising within 30 days after surgery. Fisher’s exact test was used to test the association between BMI and perioperative morbidities. Results: Between 2006 and 2010, 320 lung resections were performed for lung cancer. Median age was 67 (25-88) years and 185 (57.8%) were females. The body mass index (BMI) distribution was 121 (37.8%) in BMI<25 and 199(62.18%) in BMI≥25. In patients with BMI < 25, surgical procedures consisted 76 (23.75%) lobectomy, 38 (11.8%) wedge resection and 7 (2.18%) pneumonectomy. In patients with BMI ≥ 25, surgical procedures consisted: 131 (40.93%) lobectomy, 61 (19.06%) wedge resection and 7 (2.18%) pneumonectomy. Tumor histology was: adenocarcinoma 138 (42.9%), squamous cell cancer 107 (33.3%), bronchoalveolar 25 (7.7%), large cell 19 (5.9%) and mixed 31 (9.68%). The 30-day mortality rate was 1.8 % (6 patients), out of which only 2 had BMI ≥ 25. Peri-operative morbidity occurred in 28 (23.14%) of normal BMI patients and 47 (23.6%) of BMI ≥ 25 patients (p=0.54). Specific morbidities encountered by patients with normal vs. BMI ≥ 25 were: atrial fibrillation 11(9.09%) vs. 24(12.06%) (p=0.46), pulmonary embolism 1(0.83%) vs. 3(1.51%) (p=1.0), congestive heart failure 2(1.65%) vs. 2(1.01%) (p=0.63), respiratory failure 12(9.92%) vs. 17(8.54%) (p=0.69) and ARDS 2(1.65%) vs. 1(0.50%) (p=0.55).Median hospital stay was 5 days in lower BMI group and 4 days in BMI ≥25 groups (p=0.52). Conclusions: Potential curative surgical resections can be offered to even significantly overweight patients as there is no significant difference in the peri-operative morbidities and length of stay as compared to normal BMI patients.

scholarly journals Factors Related to Patient Expectation and Satisfaction among New and Existing Denture wearers with Complete Denture therapy

2020 ◽  
Vol 3 (2) ◽  
pp. 86-91
Author(s):  
A Pandey
Keyword(s):  
Patient Satisfaction ◽  
Social Life ◽  
Economic Status ◽  
Treatment Options ◽  
Complete Denture ◽  
P Value ◽  
Functional Rehabilitation ◽  
Patient’S Satisfaction ◽  
Significant Difference ◽  
Denture Status

Introduction: Edentulism is considered a debilitating condition with aging in which several dental and non-dental factors play a vital role in the success of prosthodontic treatment. Patient satisfaction is an important non-dental component. The dentist should aim for functional rehabilitation by satisfying the patient medically, functionally, and psychologically. Patient satisfaction depends on two factors: patient factor and dentist factor. From the patient’s view, satisfaction is guided by improved quality with factors like eating, easy communication, comfort, social life, economic status, and vocational opportunities. From dentist’s view, treatment options, treatment cost etc. affects the patient’s satisfaction. Materials and Methods: Experimental study conducted in Department of Prosthodontics, College of Medical Sciences, Bharatpur in patients receiving complete denture by convenience sampling in six months duration in sixty-five samples. Questionnaires regarding patient’s expectations and satisfaction in terms of retention, mastication, phonetics, esthetics, and comfort were used in both 1st-time denture wearer and existing denture wearer was recorded. Grading was rated with Visual Analog Scale (VAS) from 0 to 10 using the optimum cutoff values. Data were recorded in SPSS 21 and analyzed. Results: Independent t-test was carried out for expectation showing a statistically significant difference between retention, mastication, aesthetics, phonetics, comfort, and denture status with p value 0.036, 0.00, 0.001, 0.003, and 0.013 respectively. Statistically, a significant difference was found for satisfaction between aesthetics and denture status with a p-value of 0.01. Conclusions: Expectation and satisfaction were found to be more in first-time denture wearers than existing denture wearers. Experiences obtained beforehand with complete dentures could influence patient expectations and satisfaction.

785 Causes of death on heart failure

2006 ◽  
Vol 5 (1) ◽  
pp. 188-189
Author(s):  
M ANASTASIU ◽  
C MIHAI ◽  
C CALTEA ◽  
C SINESCU
Keyword(s):  
Heart Failure ◽  
Causes Of Death

AWARENESS ABOUT INDOOR AIR POLLUTION IN GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD

2018 ◽  
Vol 8 (2) ◽  
pp. 80-83
Author(s):  
Nadia Tariq ◽  
Tamkeen Jaffry ◽  
Rahma Fiaz ◽  
Abdul Majid Rajput ◽  
Sadaf Khalid
Keyword(s):  
Air Pollution ◽  
General Population ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Economic Status ◽  
Educational Status ◽  
Epidemiological Studies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference

Background: Indoor air pollutants are increasingly being associated with respiratory illnesses leading to high degree of morbidity and mortality. There are not sufficient epidemiological studies from Pakistan which assess level of awareness of indoor air pollution resulting in respiratory diseases in population. Methods: This cross sectional survey was carried out on general population of Rawalpindi/Islamabad. Sample size was 223 study subjects selected by non-probability convenient sampling. Knowledge of the study subjects was determined with regard to indoor air pollution, its effects on health and different sources of indoor air pollution with the help of a questionnaire. The influence of age, gender, educational status and socio economic status on the level of awareness was also analyzed. Results: Out of total 223 participants, 115 were males and108 females. Participants aware of indoor air pollution were 91.5% and adequate awareness about its sources was 80.7%. Those who knew indoor air pollution is detrimental to health were 95.1%. Awareness about building construction dust as source of indoor air pollution was maximum (84.8%). There was significant difference in awareness among participants with different monthly incomes and educational status and also between males and females. Conclusion: This study concludes that general population of Rawalpindi/Islamabad has fairly good awareness about sources of indoor air pollution. Use of harmful material causing indoor air pollution should be limited or substituted with better ones where possible.

Long-term survival of the nasal NK/T cell lymphoma

2008 ◽  
Vol 149 (17) ◽  
pp. 801-805
Author(s):  
Péter Rajnics ◽  
László Krenács ◽  
András Kenéz ◽  
Zoltán Járay ◽  
Enikő Bagdi ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Guidelines ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
T Cell Lymphoma ◽  
Term Survival ◽  
Barr Virus ◽  
Significant Difference ◽  
Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

INFLUENCE OF RIGHT VENTRICULAR LEAD IMPLANTATION SITE CHOICE ON PACING EFFICIENCY

2020 ◽  
pp. 13-17
Author(s):  
Dmitrii Aleksandrovich Lopyn ◽  
Stanislav Valerevich Rybchynskyi ◽  
Dmitrii Evgenevich Volkov
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Treatment Options ◽  
Global Longitudinal Strain ◽  
Optimal Method ◽  
Cardiac Stimulation ◽  
Ventricular Lead ◽  
The Right ◽  
Stimulation Of

Currently the electrophysiological treatment options have been considered to be the most effective for many patients with arrhythmogenic cardiomyopathies, as well as in those with arrhythmias on the background of heart failure. Currently, the dependence of efficiency of the pacemakers on the location of the electrodes has been proven. In order to study the effect of a myocardial dysynchrony on the effectiveness of pacing depending on the location of the right ventricular electrode, an investigation has been performed. This study comprised the patients with a complete atrioventricular block, preserved ejection fraction of the left ventricle (more than 50 %), with no history of myocardial infarction, who were implanted with the two−chamber pacemaker. It has been established that the best results were achieved with a stimulation of the middle and lower septal zone of the right ventricle, the worst ones were obtained with a stimulation of its apex. It has been found that the dynamics of the magnitude of segmental strains and a global longitudinal strain coincided with the dynamics of other parameters of the pacemaker effectiveness, which indicated the pathogenetic value of myocardial dysynchrony in the progression of heart failure after implantation of the pacemaker. Therefore it could be concluded that the studying of myocardial mobility by determining a longitudinal strain for assessing the functional state of the myocardium and the effectiveness of pacing is highly advisable. It is emphasized that the use of the latest strains−dependent techniques for cardiac performance evaluation in the patients with bradyarrhythmia have a great potential to predict the development of chronic heart failure and to choose the optimal method of physiological stimulation of the heart. Key words: right ventricular lead, cardiac stimulation, myocardial dyssynchrony.

scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

scholarly journals Is computed tomographic pulmonary angiography justified in all patients with suspected pulmonary embolism – tertiary multidisciplinary hospital perspective

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Morawiec ◽  
O Brycht ◽  
M Nadel ◽  
J Drozdz
Keyword(s):  
Heart Failure ◽  
Pulmonary Embolism ◽  
Creatinine Level ◽  
Pulmonary Angiography ◽  
Hospital Death ◽  
Contrast Induced Nephropathy ◽  
Computed Tomographic ◽  
Level Increase ◽  
Computed Tomographic Pulmonary Angiography ◽  
Egfr Decline

Abstract Background According to 2019 ESC guidelines for management in patients with the pulmonary embolism (PE), the computed tomographic pulmonary angiography (CTPA) is the diagnostic method of choice in suspected high-risk PE defined as patients with hemodynamic instability. In stable cases, it is recommended to assess the pre-test probability of the PE. However, CTPA with its great accuracy and wide availability in most medical centers is used as often to confirm as to exclude the diagnosis in PE suspected patients, despite the fact that it is linked with the risk of radiation and iodine-containing contrast exposure. Purpose The aim of the study was to assess the validity of CTPA use in patients with suspected PE form the perspective of multidisciplinary clinical center. Methods We retrospectively analyzed the data of from 52,474 hospitalized patients between 01.2018 and 12.2019. A total of 261 (0.5%) consecutive patients with suspected PE (in the emergency department or during hospitalization) were included into the study. Due to suspicion of PE all patients underwent the CTPA. In this group, we analyzed all available clinical data, results of laboratory and diagnostic tests (before and after CTPA) including estimated glomerular filtration rate (eGFR), creatinine level, transthoracic echocardiography (TTE) and planar ventilation/perfusion (lung scintigraphy) scan (V/Q SPECT) if performed. Results The CTPA confirmed PE in 28.9% of patients. The most common final diagnoses, established in the group with negative CTPA result, include heart failure (33.9%), pneumonia (14.4%) exacerbation of chronic obstructive pulmonary disease or asthma (9.3%) and acute coronary syndrome (5.9%). Acute PE was the cause of in-hospital death in 2.4% of patients and the rate of all cause in-hospital death was 11.4%. In 54.2% of patients we observed the eGFR decline and creatinine level increase, meeting the criteria of the acute contrast-induced nephropathy in 33 of them of them (19.8%). In the group with excluded PE, mean eGFR before CTPA was 70.9ml/min/1.73m2 with the decline to mean 60.4ml/min/1.73m2 during the hospitalization (p&lt;0.01). In patients with negative CTPA result and the worsening of the renal function mean eGFR decline was 17.8ml/min/1.73m2 (p&lt;0.01) and mean creatinine level increase was 38.6μmol/l (p&lt;0.01). CONSLUSIONS The initial data collected show the overuse of CTPA in suspected PE, as the diagnosis was confirmed in less than one-third of them. Although CTPA allows to exclude or confirm PE unambiguously, its use is associated with risk of acute contrast-induced nephropathy. Additionally, in patients with exacerbation of heart failure established as final diagnosis after excluding PE, intensive diuretic treatment is crucial and may cause further accompanying renal function worsening. Therefore, optimizing the diagnostic pathway in patients with suspected PE into less aggravating procedures such as TTE or V/Q SPECT is justifiable. Funding Acknowledgement Type of funding source: None

scholarly journals Pulmonary Hypertension Complicating Pregnancy

2021 ◽  
Author(s):  
Sheila Krishnan ◽  
Erin M. Fricke ◽  
Marcos Cordoba ◽  
Laurie A. Chalifoux ◽  
Reda E. Girgis
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Post Partum ◽  
Severe Heart Failure ◽  
Neonatal Morbidity ◽  
Risk Of Death ◽  
Risk Condition ◽  
Pulmonary Arterial ◽  
Phosphodiesterase Type ◽  
Type V

Abstract Purpose of review This study aims to describe the pathophysiology of pregnancy in pulmonary hypertension (PH) and review recent literature on maternal and fetal outcomes. Recent findings There is an increasing number of pregnant women with PH. Maternal mortality in pulmonary arterial hypertension (PAH) ranges from 9 to 25%, most commonly from heart failure and arrythmias. The highest risk of death is peri-partum and post-partum. Fetal/neonatal morbidity and mortality are also substantial. There are high rates of prematurity, intrauterine growth retardation, and preeclampsia. Women should be referred to expert centers for management. Combination PAH therapy with parenteral prostacyclin and a phosphodiesterase type V inhibitor is recommended. Induced vaginal delivery is preferred, except in cases of severe heart failure or obstetric indications for cesarean section. Summary Despite advances in management, pregnancy in PAH remains a high-risk condition and should be prevented.

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