scholarly journals Alpha Feto Protein in vaginal fluid as a diagnostic marker of Premature rupture of membrane

2018 ◽  
Vol 10 (1) ◽  
pp. 335-338
Author(s):  
Nasreen Sultana ◽  
Shamima Rahman ◽  
Fakhruddin Ahmed ◽  
SK Ashraf Ullah
Keyword(s):  
Gold Standard ◽  
Normal Pregnancy ◽  
Vaginal Fluid ◽  
Sensitive Test ◽  
Premature Rupture ◽  
Paper Test ◽  
Cross Sectional ◽  
Group I ◽  
Alpha Feto Protein ◽  
Group Ii

Background : Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM. Objective : To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM. Method : It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test. Result : It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%. Conclusion : As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM. Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338

scholarly journals Raised Vaginal Fluid Fibronectin Level Indicates Premature Rupture of Membrane

2012 ◽  
Vol 2 (2) ◽  
pp. 74-79
Author(s):  
Shamima Rahman ◽  
Samsad Jahan ◽  
Samira Humaira Habib ◽  
Nasrin Sultana ◽  
Mst Nigar Sultana ◽  
...  
Keyword(s):  
Normal Pregnancy ◽  
Clinical Situation ◽  
Cross Sectional Study ◽  
Clinical Event ◽  
Vaginal Fluid ◽  
Premature Rupture ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
The Common

Background: Premature rupture of membrane (PROM) is one of the common complications  of pregnancy that has major impact on fetal and neonatal outcome. It is the commonest  clinical event where a normal pregnancy becomes suddenly a high-risk one for mother and  fetus or neonate. Objective: The study was undertaken to investigate whether raised  fibronectin level in vaginal fluid may indicate premature rupture of membrane. Materials and  Methods: This cross sectional study was conducted in the department of Obstetrics and  Gynecology in Sir Salimullah Medical College & Mitford Hospital, Dhaka during the period  of January 2006 to December 2007. A total of 114 pregnant women with gestational age 28th  week up to 40th week were included. Sixty were PROM (Group I) and 54 were non-PROM  (Group II) subjects. Fibronectin in vaginal fluid was measured by an immunochemical  reaction by nephelometer. Statistical analysis was done by SPSS version 10.0. Results: The  PROM patients had significantly higher concentration of fibronectin (225.77 ± 115.18 ng/mL)  compared to that in non-PROM subjects (8.04 ± 16.17 ng/mL) (p < 0.001). Conclusion: It  can be concluded that in cases of unequivocal rupture or intactness of the membranes, the  result of the fibronectin test corresponds well with the clinical situation. So fibronectin is a  sensitive test for detection of amniotic fluid in the vagina. DOI: http://dx.doi.org/10.3329/jemc.v2i2.12841 J Enam Med Col 2012; 2(2): 74-79

scholarly journals ALVARADO SCORE;

2012 ◽  
Vol 20 (01) ◽  
pp. 001-005
Author(s):  
SHAFAQAT ALI ◽  
ZAKA ULLAH MALIK ◽  
M. MUTTAHHAR ASIM NIAZ ◽  
Naveed Ahmed
Keyword(s):  
Acute Appendicitis ◽  
Gold Standard ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Negative Appendicectomy ◽  
Hospital Group

Objective: To determine the validity of Alvarado score in diagnosing acute appendicitis keeping histopathology of appendixas gold standard. Study Design: Cross sectional (Validation) study. Place and Duration of Study: Department of Surgery CombinedMilitary Hospital Rawalpindi from April 2009 to October 2009. Materials and Methods: 90 patients with clinical suspicion/diagnosis ofacute appendicitis were included in study. All were divided into two groups on the basis of Alvarado score. Group I with score 7-10, whounderwent open appendicectomy. Group II(a) with 5-6, who were observed in hospital. Group II(b) with< 4 were discharged. In alloperated cases appendix was sent for histopathology. Alvarado score was compared with histopathology (gold standard). Results: Maleto female ratio was 3.5 :1. Mean age was 25.34. Alvarado score had overall 88.13% sensitivity, 70.96% specificity, 85.24% PPV,75.86%NPV and 16.90% negative appendicectomy rate. Whereas in male patients it had 90.74% sensitivity, 75% specificity, 92.45%PPV,70.58%NPV and 6.89% negative appendicectomy rate. In female it had 60% sensitivity, 66.66% specificity, 37.5% PPV, 83.33%NPV and38.46% negative appendicectomy rate. Conclusion: Alvarado score is very accurate for acute appendicitis in male patients. Patients withscore 4 can safely be discharged home. USG should be performed routinely in female patients to improve the diagnostic accuracy ofAlvarado score.

scholarly journals Laparoscopic Management of Adhesions Developed after Peritoneal Nonclosure in Primary Cesarean Section Delivery

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Emaduldin Seyam ◽  
Emad Moussa Ibrahim ◽  
Ayman Moheb Youseff ◽  
Eissa M. Khalifa ◽  
Enas Hefzy
Keyword(s):  
Adhesion Formation ◽  
Cross Sectional Study ◽  
Parietal Peritoneum ◽  
Reproductive Capacity ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Cesarean Section Delivery ◽  
Visceral Peritoneum ◽  
Group I ◽  
Group Ii

Objective. The aim of the current study was to laparoscopically investigate the effects of peritoneal nonclosure on the sites, types, and degrees of adhesions developed after primary caesarean section (CS) in women complaining of secondary infertility after first CS delivery. Study Design. This was a cross-sectional study, where 250 women suffering from secondary infertility after their first CS had been recruited. They had been classified into group I (n = 89), where both the visceral and parietal peritoneum had been left opened; group II (n = 75), where only the parietal peritoneum had been closed; and group III (n = 86), where both peritoneal layers had been closed. Laparoscopy had been used to classify those adhesions according to the location, severity, and their adverse impact on the reproductive capacity. Results. Both adnexal and nonadnexal adhesions had been found significantly higher in group I, while adnexal types of adhesions were significantly higher after nonclosure of the visceral peritoneum in group II. Laparoscopic tubal surgery performed included tubo-ovariolysis, fimbrioplasty, and neosalpingostomy. Pregnancy rate was found correlating with the adnexal adhesion location and score. Conclusion. Nonclosure of the peritoneum in CS is associated with more adhesion formation, which might adversely affect the future women reproduction.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

scholarly journals TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya
Keyword(s):  
Lung Function ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Young Smokers ◽  
The Mean ◽  
Group Ii

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers

Echocardiographic assessment of LV mass in rabbits: models of pressure and volume overload hypertrophy

1993 ◽  
Vol 265 (6) ◽  
pp. H2066-H2072 ◽  
Author(s):  
J. F. Plehn ◽  
E. Foster ◽  
W. N. Grice ◽  
M. Huntington-Coats ◽  
C. S. Apstein
Keyword(s):  
Pressure Overload ◽  
Volume Overload ◽  
Accurate Method ◽  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Group I ◽  
Lv Mass ◽  
Wet Weight ◽  
Group Ii

We describe a method for the noninvasive measurement of left ventricular mass in small animals using two-dimensionally guided M-mode echocardiography. We compared echocardiographic cross-sectional area (CSA) and cubed-based volumetric indexes of left ventricular (LV) mass with postmortem wet weight in renovascular hypertension-induced pressure overload (group I) and acute aortic insufficiency-induced volume overload (group II) models of ventricular hypertrophy. CSA and cubed echocardiographic indexes correlated well with wet weight from a combination of group I and II animals and their controls (r = 0.89, P < 0.001 for both groups). Separate analyses of groups I and II also demonstrated significant relationships between mass indexes and wet weight using CSA and cubed formulas, respectively, in both pressure (r = 0.57, P = 0.01 and r = 0.71, P < 0.001) and volume (r = 0.90 and r = 0.89, P < 0.001) overload models. Echocardiographically predicted LV mass derived from cubed and CSA regression formulas was 89 and 56% sensitive for pressure overload hypertrophy in group I and 100% sensitive (both cubed and CSA methods) for volume overload hypertrophy in group II. Cubed and CSA mass regression formulas were 60 and 80% specific for hypertrophy in group I and 100 and 90% specific in group II. Normalization of predicted LV mass for body weight added little to the overall technique accuracy with measured sensitivities of 83 and 75% and specificities of 92 and 77%, respectively, for cubed and CSA methods. Two-dimensionally guided M-mode echocardiography provides a reasonably accurate method of LV mass determination in rabbits with pressure- or volume-overloaded ventricles.

scholarly journals Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34–36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

2020 ◽  
Vol 42 (11) ◽  
pp. 717-725
Author(s):  
Malú Flôres Ferraz ◽  
Thaísa De Souza Lima ◽  
Sarah Moura Cintra ◽  
Edward Araujo Júnior ◽  
Caetano Galvão Petrini ◽  
...  
Keyword(s):  
Gestational Age ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Management Group ◽  
Group I ◽  
Adverse Perinatal Outcomes ◽  
Group Ii

Abstract Objective To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p < 0.001), latency time (20.9 versus 33.6 hours, p = 0.001), and gestational age at delivery (36.5 versus 37.2 weeks, p = 0.025). There were no significant associations between the groups and the presence of adverse perinatal outcomes. Gestational age at diagnosis was the only significant predictor of adverse composite outcome (x2 [1] = 3.1, p = 0.0001, R2 Nagelkerke = 0.138). Conclusion There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes.

Mechanism of reduced maximum expiratory flow in methacholine-induced bronchoconstriction in dogs

1983 ◽  
Vol 55 (3) ◽  
pp. 897-912 ◽  
Author(s):  
S. N. Mink
Keyword(s):  
Wave Speed ◽  
Cross Sectional ◽  
Pressure Losses ◽  
Lung Capacity ◽  
Group I ◽  
Maximum Expiratory Flow ◽  
Pressure Area ◽  
Expiratory Flow ◽  
Group Ii ◽  
Viscous Pressure

Airway sites of flow limitation [“choke points” (CP)] were identified during forced deflation in open-chest dogs before (C) and after (B) bronchoconstriction was produced by nebulizing a solution of methacholine chloride into their airways. CP were identified in two respective groups. In group I (n = 8) a retrograde catheter was used to locate CP and in the other a Pitot static tube (group II, n = 5), CP were identified at multiple lung volumes (VL) over the lower one-half of total lung capacity. Both groups showed similar findings at each condition. At B, corresponding values of maximum expiratory flow (Vmax) at each VL decreased to about 10% of those at C. Movement of CP relative to their original location varied at each VL and, especially at the lower VL, showed little peripheral movement. In group I, equal pressure points were also measured and were found to move peripherally at all the measured VL. In group II, cross-sectional area (A*) and airway compliance (K) at CP were estimated. During bronchoconstriction, A* decreased at the respective VL, and airways became less compliant. The reduction in Vmax could be explained in terms of changes in A* and K as described by wave-speed theory, and Vmax decreased because A* decreased. The decrease in A* was related in part to an increase in viscous pressure losses that reduced total pressure at CP and also in part to a change in the pressure-area behavior of bronchi at CP. Their relative effects on reducing A* and Vmax were examined.

Acoustic Rhinometry of Asian Noses

2008 ◽  
Vol 22 (6) ◽  
pp. 617-620 ◽  
Author(s):  
Pongsakorn Tantilipikorn ◽  
Perapun Jareoncharsri ◽  
Siriporn Voraprayoon ◽  
Chaweewan Bunnag ◽  
Peter A. Clement
Keyword(s):  
Reference Value ◽  
Acoustic Rhinometry ◽  
Cross Sectional ◽  
Mean Values ◽  
Thai Subjects ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Black Populations ◽  
Female Subjects

Background Each ethnic group has different nasal cavity geometries. The reference value of the minimal cross-sectional area (MCA) and the nasal volume (NV) is mandatory for rhinologic evaluation in regular practice and for research. This study was designed to study the normal value of acoustic rhinometry (AR) in Asian subjects in comparison with other ethnic groups. Methods AR was performed in 135 healthy Thai subjects. Subjects were divided into two groups: group I, with normal anterior rhinoscopic appearance; group II included subjects with asymptomatic, slightly deviated nasal septa. Results The mean of the MCA was 0.61 ± 0.60 cm2 before decongestion and 0.64 ± 0.14 cm2 after decongestion. The mean distance from the nostril to the point of MCA (D) was 1.66 ± 0.59 cm before decongestion and 1.41 ± 0.74 cm after decongestion. The mean of the NV measured between 0 and 4 cm was 3.66 ± 0.67 cm3 before decongestion and 4.18 ± 0.75 cm3 after decongestion. Before decongestion, there were no significant differences in the mean of the MCA, D, and NV between group I and group II subjects; however, there were significant differences in mean MCA and NV after decongestion. There were no differences in the parameters between male and female subjects before decongestion, except for the D, but after decongestion the mean values of the MCA, D, and NV were significantly higher in male subjects compared with female subjects. Conclusion The results of this study can be used as a reference value for Asian ethnicities. Thai subjects had measurements comparable with those of the European study and somewhat different from the study in black populations.

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