scholarly journals MATERNAL OBESITY AND OBSTETRIC OUTCOMES IN A TERTIARY CARE CENTER

2021 ◽  
pp. 1-3
Author(s):  
H. Anitha Virgin Kumari ◽  
S. Nivedita
Keyword(s):  
Body Mass ◽  
Maternal Obesity ◽  
Care Center ◽  
Strong Association ◽  
Tertiary Care ◽  
Obese Group ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Childbearing Age ◽  
Risk Pregnancy

BACKGROUND: Pregnancy is unique, yet normal physiological chapter in women’s life. Pre-existing morbidity can complicate pregnancy affecting mother and fetus resulting in high risk pregnancy .One of which is obesity causing antepartum, intrapartum and postpartum complications both in mother and child. AIM OF THE STUDY: The aim of this study is to evaluate the effect of obesity on the maternal and perinatal outcome in pregnancies complicated by obesity. MATERIALS: A prospective study is done in Govt. RSRM lying in hospital during June 2019-june 2020 .Among antenatal mothers attending antenatal outpatient department, mothers were chosen in their first trimester who had Body Mass Index>30kg/m2 as study group and mothers with a Body Mass Indexbetween18.5kg/m2and25kg/m2 as control group. Detailed history taking and investigations done and they were followed up to delivery and postpartum until discharge and outcome studied. RESULTS: In the present study, increasing age, sedentary lifestyle and low socio economic status show a positive relation to obesity. The proportion of primiparous Women was more in obese group(51.9%)when compared to control group(48.1%). Higher incidence of gestational diabetes and pre eclampsia are seen in obese group. Higher rates of cesarean deliveries among this group. Preterm delivery in obese women 10.4% compared to control group. CONCLUSION: Maternal BMI has a strong association with pregnancy complications and outcome. The best time of intervention may be before a woman considers a pregnancy and attempts are to be made to maintain a normal BMI in women of childbearing age.

scholarly journals Enhancing Patient Experience in Office-Based Laryngology Procedures With Passive Virtual Reality

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2097502
Author(s):  
Joseph Chang ◽  
Sen Ninan ◽  
Katherine Liu ◽  
Alfred Marc Iloreta ◽  
Diana Kirke ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Local Anesthesia ◽  
Controlled Trial ◽  
Care Center ◽  
Tertiary Care ◽  
Depression Scale ◽  
Control Group ◽  
Procedure Time ◽  
Pain Scores ◽  
Distress Scale

Objectives Virtual reality (VR) has been used as nonpharmacologic anxiolysis benefiting patients undergoing office-based procedures. There is little research on VR use in laryngology. This study aims to determine the efficacy of VR as anxiolysis for patients undergoing in-office laryngotracheal procedures. Study Design Randomized controlled trial. Setting Tertiary care center. Methods Adult patients undergoing office-based larynx and trachea injections, biopsy, or laser ablation were recruited and randomized to receive standard care with local anesthesia only or local anesthesia with adjunctive VR. Primary end point was procedural anxiety measured by the Subjective Units of Distress Scale (SUDS). Subjective pain, measured using a visual analog scale, satisfaction scores, and procedure time, and baseline anxiety, measured using the Hospital Anxiety and Depression Scale (HADS), were also collected. Results Eight patients were randomized to the control group and 8 to the VR group. SUDS scores were lower in the VR group than in the control group with mean values of 26.25 and 53.13, respectively ( P = .037). Baseline HADS scores did not differ between groups. There were no statistically significant differences in pain, satisfaction, or procedure time. Average satisfaction scores in VR and control groups were 6.44 and 6.25, respectively ( P = .770). Average pain scores were 3.53 and 2.64, respectively ( P = .434). Conclusion This pilot study suggests that VR distraction may be used as an adjunctive measure to decrease patient anxiety during office-based laryngology procedures. Procedures performed using standard local anesthesia resulted in low pain scores and high satisfaction scores even without adjunctive VR analgesia. Level of Evidence 1

Association of Body Mass Index and Waist to Hip Ratio With Gallstone Disease in Patients Visiting Rural Tertiary Care Center in North India

2020 ◽  
pp. 155335062095058
Author(s):  
Pushpendra Malik ◽  
Deepak Singla ◽  
Mahinder K Garg ◽  
Mukesh Sangwan
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Care Center ◽  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Daily Routine ◽  
Waist To Hip Ratio ◽  
South Indian

Introduction. In India the prevalence of gall stone disease varies in different parts of India. Malhotra in 1996 conducted an epidemiological study in Indian Railway employees and showed that North Indians has 7 times higher prevalence of gall stones compared to South Indian employees. It is said that Gall bladder is a disease of “Fatty, Fertile, Females in their Forties”. In our daily routine we observe that it is found not only in fatty females but common in average built patients also. Material and Methods. Study includes patients visiting to BPS GMC Khanpur Kalan with diagnosis of gall stone diseases and operated at our center with sample size of 135. Body mass index (BMI) and Waist to Hip ratio are calculated using their standard formulas. All data was compiled in IBM SPSS statistics (20.0). Result. Normal BMI is considered up to 25 and more than 50% patients lie in normal BMI range. Only 13% of cases lie in obese group that is BMI greater than 30. Waist to hip ratio, maximum patients that is BMI greater than 30. Waist to hip ratio, maximum patients that is (83%) lie in group more than 0.85. Minimum Waist to Hip ratio is .77 and maximum Waist to Hip ratio is 1.45. Out of 135 patients 90 patients are having high Waist to Hip ratio. Conclusion. Waist to Hip Ratio (abdominal adiposity) is better indicator of Gall stone diseases than BMI.

scholarly journals 573. Enterococcal Bacteremia in a Tertiary Care Center in Mexico: A Retrospective Analysis Focus on Vancomycin-Resistant E. faecium and Ampicillin-Resistant E. faecalis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S270-S271
Author(s):  
Bruno A Lopez Luis ◽  
Darwin Lambraño-Castillo ◽  
Edgar Ortiz-Brizuela ◽  
Andrea Ramirez-Fontes ◽  
Yanet Estrella Tovar-Calderon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Care Center ◽  
Strong Association ◽  
Tertiary Care ◽  
Acquired Resistance ◽  
Venous Catheter ◽  
Vana Gene ◽  
Vancomycin Resistant ◽  
History Of Use

Abstract Background The primary pathogens in genera enterococcus are E. faecalis and E. faecium, increasing acquired resistance to glycopeptides and β lactamic has done the management more challenging. We aimed to describe the risk factors for acquisition of bacteremia for vancomycin-resistant E. faecium (VRE) and ampicillin-resistant E. faecalis (ARE) and the 30-day mortality in comparison to susceptible enterococcal bloodstream infection (BSI) Methods From 2007- 2017 medical records of all BSI for E. faecalis and E. faecium were evaluated. Risk factor for acquisition of VRE and ARE as well as the significant variables associated with 30-day mortality for enterococcal BSI were determined by univariate and multivariate analysis. The molecular mechanism of VRE was performed by PCR Results There were 192 patients with E. faecium BSI of which 107(56%) patients had VRE BSI with 94% VRE strains expressing vanA gene. The index bacteremic episodes were classified as nosocomial o healthcare associated in 99%, 102(95%) had hospitalization 1 year before and 101(94%) history of use of antibiotics 3 months earlier, the multivariate analysis showed duration of the previous hospitalization >10 days (OR, 80.18; 95% CI, 1.81–634), use of central venous catheter [OR, 11.15; 95% CI, 2.48–50.2), and endotracheal cannula [OR, 17.91; 95% CI, 1.22–262) as significant associated variables. The mortality for VRE was greater than susceptible E. faecium (60% vs. 24%, P < 0.001). The only factors for 30-day mortality for E. faecium BSI in the multivariate analysis was APACHE ll score [OR,1.45; 95% CI, 1.26–1.66) and patients with chemotherapy of cancer. (OR, 3.52; 95% CI, 1.09–11.39). 147 patients had E. faecalis BSI of which 18 (11%) patients had ARE, we did not find relevant clinical differences of ARE in comparison with ampicillin-susceptible E. faecalis, neither in risk factors for acquisition of ARE nor 30-day mortality [7(39%) vs. 38(29%), P = 0.58] in uni and multivariate analysis Conclusion Our evaluation showed in a period of 10 years that VRE expressing vanA gene had a strong association with patients with previous nosocomial exposure. Severely ill patients and cancer patients on chemotherapy during the bacteremic episode were the variables more associated with 30-day mortality. ARE is yet of low prevalence and less known, constant surveillance about it is warranted Disclosures All authors: No reported disclosures.

Maternal obesity influences the endocrine cord blood profile of their offspring

2020 ◽  
Vol 48 (3) ◽  
pp. 242-248 ◽  
Author(s):  
Carolina Carvalho Mocarzel ◽  
Guillermo Coca Velarde ◽  
Roberto de Azevedo Antunes ◽  
Renato Augusto Moreira de Sá ◽  
Asim Kurjak
Keyword(s):  
Cord Blood ◽  
Maternal Obesity ◽  
Density Lipoprotein ◽  
Obese Group ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
Healthy Controls ◽  
Obese Women ◽  
Blood Profile ◽  
The Mean

AbstractObjectiveTo compare the endocrine cord blood characteristics of offspring from obese mothers with those of offspring from healthy controls.MethodsCross-sectional case control study. Setting: University medical centers. Patient(s): Offspring from obese mothers (n = 41) and healthy controls (n = 31). Intervention(s): Cord blood withdrawal from neonates. Main outcome measure(s): Cord blood total cholesterol (TC), triglycerides (TGs), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), blood glucose (GL) and insulin (Ins).Result(s)Fetal GL and TGs were reduced in the offspring of obese women when compared to those in the offspring of the controls. The mean cord blood GL level was 47.8 mg/dL standard deviation (SD 33.1) in the offspring of the obese group vs. 57.9 mg/dL (SD 12.5) in the offspring of the control group, and the mean cord blood TG level was 26.5 (SD 33.6) in the offspring of the obese group vs. 34.6 (SD 12.3) in the offspring of the control group. Maternal obesity was also associated with reduced levels of TC and HDL-C in the pregnant women.ConclusionThe observed results suggest that GL and TGs in the cord blood of the offspring of obese mothers were significantly lower than those in the offspring of the control group.

scholarly journals Does Intra-Wound Vancomycin Powder Affect the Action of Intra-Articular Tranexamic Acid in Total Joint Replacement?

2020 ◽  
Vol 8 (5) ◽  
pp. 671
Author(s):  
Antonios A. Koutalos ◽  
Athanasios Drakos ◽  
Apostolos Fyllos ◽  
Nikos Doxariotis ◽  
Sokratis Varitimidis ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Total Joint Replacement ◽  
Care Center ◽  
Tertiary Care ◽  
Joint Space ◽  
Control Group ◽  
Treatment Groups ◽  
Vancomycin Powder ◽  
Total Knee ◽  
Hip Arthroplasties

The intra-articular use of tranexamic acid (TXA) has contributed to reduced blood loss in total joint arthroplasty (TJA). The purpose of this study is to assess the efficacy of simultaneously topical use of tranexamic acid and vancomycin powder within the TJA space. From 2016 to 2017, 219 consecutive total hip arthroplasties (THAs) and 272 total knee arthroplasties (TKAs) were performed in a tertiary care center, with a group of patients receiving intra-articular TXA and vancomycin, compared to patients receiving only TXA and to a control group that did not receive anything. Haemoglobin and hematocrit were measured preoperatively, on the first and third days. Transfusions and adverse events were recorded. Haemoglobin and hematocrit dropped significantly in all THA and TKA groups till the third day postoperatively, with a major reduction in the control group, compared to the other two treatment groups. Infections and thromboembolic events were similar in either group of the TJAs. In conclusion, the topical use of tranexamic acid mixed with the vancomycin powder within the joint space after the TJAs of the hip and knee did not alter the anti-fibrinolytic effect of TXA.

Demonstration of an expedited breast care (EBC) clinic

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16023-16023 ◽  
Author(s):  
A. Lopez ◽  
C. C. Venker ◽  
A. Howerter ◽  
G. P. Barker ◽  
A. Bhattacharyya ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Breast Biopsy ◽  
Digital Images ◽  
Care Center ◽  
Tertiary Care ◽  
Control Group ◽  
Tertiary Care Center ◽  
Oncology Care ◽  
Breast Care ◽  
To Receive

16023 Background: Women report waiting for a breast biopsy result as a time of psychological distress. Waiting also delays entry into definitive oncology care, and patients in underserved communities may be lost to follow up. In this proof-of-concept demonstration, an Expedited Breast Care (EBC) clinic was developed to give patients the opportunity to receive same-day biopsy results. Methods: Patients requiring core breast biopsy at a community hospital were approached sequentially to participate. Following surgical biopsy, tissue underwent ultra-rapid fixation and processing. After paraffin sections were prepared and stained, the glass histopathology slides were imaged with a virtual slide scanner. Digital images were stored on a server and viewed on the Internet by a telepathologist at a tertiary care center. Light microscopy review was concurrently performed as the gold standard. After telepathology review and light microscopy confirmation, patients presented to the telemedicine suite to receive biopsy results. A teleoncologist at the tertiary care center presented all pathology results to the patient, whether benign or malignant. Time and patient satisfaction data were collected. Results: Nine patients have participated. Within 2 hours from the time the tissue arrived at the laboratory, digital images were available to the telepathologist. The teleoncologist presented results to patients within 3–5 hours after the biopsy procedure. Patients reported satisfaction with the same-day service, and stated they would seek EBC again in the event of a future breast biopsy. Many patients expressed relief at receiving results so promptly and felt they had avoided the stress of waiting longer for results. The elapsed time from mammogram to definitive oncology care was shorter for EBC patients compared to a control group of patients at a clinic not offering EBC, although the results did not reach statistical significance (Mann-Whitney U: Z = −1.804, p = 0.0713). Conclusions: These data indicate EBC can be successfully accomplished. Current studies to assess EBC’s role in facilitating prompt entry into definitive oncology care are underway. By incorporating rapid tissue processing with telepathology and teleoncology, EBC can improve access to breast care in underserved areas. [Table: see text]

scholarly journals Acute Respiratory Distress and Its Risk Factors among Neonates Admitted in a Tertiary Care Center of Western Nepal

2017 ◽  
Vol 15 (1) ◽  
pp. 5-8
Author(s):  
Jyoti Adhikari ◽  
Sajju Aryal ◽  
Veena Gupta
Keyword(s):  
Respiratory Distress ◽  
Rural Areas ◽  
Teenage Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Early Marriage ◽  
Respiratory Pattern ◽  
Control Group ◽  
Female Ratio

Background: Neonatal period is defined as a period from birth to under 4 weeks (<28 days) of age. It is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra uterine existence. The term Respiratory distress (RD) is used to indicate signs & symptoms of abnormal respiratory pattern. Methods: All neonates admitted in neonatal intensive care unit of Nepalgunj Medical College, Kohalpur with respiratory distress were included. Same number of age and sex matched controls without RD were selected. Results: The NICU based hospital incidence of RD was 9.1% with  male: female ratio 1.4:1 The Most Common etiology was neonatal sepsis (51.6%), followed by hyaline membrane disease (17.8%), TTN (12.7%), meconium aspiration syndrome (6%), birth asphyxia (5.08%), tracheoesophageal fistula (2%) and pneumothorax (2%). Newborns with poor APGAR score requiring resuscitation were more likely to develop RD (p=0.025). Newborns with birth weight <2.5 kg and >4 kg were 2 times likely to develop RD as compared to control group (p<0.012). There was 7 times higher risk of developing MAS when a baby was born through thick MSL as compared to control group (P<0.022). Inadequate ANC visit significantly increased RD in newborns (p<0.001). Babies born to mother with PROM for more than 18 hours were 5.5 times likely to develop RD (p<0.001) whereas those born to mother who had any source of infection were about 6 times at risk of developing respiratory distress than control group (p=0.007). Conclusion: Certain measures that could be taken to reduce the number of RD are: 1. discouraging early marriage and teenage pregnancy. 2. Increasing awareness regarding temporary and permanent contraceptive measures. 3. Promoting education of girls. 4. Increasing coverage of ANC visit in rural areas and 5. formulating integrated plan and policies from the Government level.

scholarly journals Impact of Maternal Obesity and Mobile Phone Use on Fetal Cardiotocography Pattern

2018 ◽  
Vol 6 (10) ◽  
pp. 1813-1817 ◽  
Author(s):  
Zaheera Saadia
Keyword(s):  
Clinical Trial ◽  
Mobile Phone ◽  
Maternal Obesity ◽  
Well Being ◽  
Obese Group ◽  
Control Group ◽  
Cardiovascular Development ◽  
Obese Women ◽  
Mobile Phone Use ◽  
The Impact

BACKGROUND: The fetal heart rate (FHR) is a good marker of fetal well-being during labour. Cardiotocography is used to record the FHR and uterine contractions and can detect possible fetal hypoxia. Mobile phones use, and obesity is suggested to influence the FHR and cardiovascular development. AIM: The present study aimed to study the differences in FHR pattern between fetuses of obese vs non-obese groups when using a mobile phone. METHODS: We conducted a clinical trial to test the impact of mobile phone use on FHR using a single mobile phone with Specific Absorption Rate rating of 0.99 W/kg for 10 minutes. Data from this clinical trial were analysed to compare the FHR pattern between fetuses of obese women (exposed group) vs those of non-obese women (control group). The two study groups (obese vs non-obese) were compared regarding four FHR patterns: baseline FHR, variability, acceleration and deceleration scores. Data were analysed by SPSS software version 23.0 using the independent-samples t-tests. RESULTS: Sixty-nine women were included in the final analysis (obese group: n = 22 and non-obese group: n = 47). Fetuses of the obese women had significantly higher baseline FHR and less FHR variability scores when compared with fetuses of the non-obese women (mean difference 2.9 and 3.18, respectively). CONCLUSION: Fetuses of obese women had abnormal FHR pattern compared with fetuses of non-obese women. The use of mobile phone slightly influenced the FHR variability score. These results highlight the importance of proper management of obesity in women within the childbearing period.

scholarly journals Knowledge and practices among parents of asthmatic children: a quasi-experimental study conducted at tertiary care center of Western India

2021 ◽  
Vol 8 (7) ◽  
pp. 3430
Author(s):  
Dhirja . ◽  
Mukesh C. Sharma ◽  
Jagdish P. Goyal ◽  
Remiya M.
Keyword(s):  
Positive Impact ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Respiratory Disease ◽  
Primary Caregiver ◽  
Control Group ◽  
Western India ◽  
Control Group Design ◽  
Asthmatic Children ◽  
Quasi Experimental

Background: Asthma is one of the most common chronic respiratory disease of childhood and emerging as a global health issue. It is primary cause of school absences and the third leading cause of hospitalization in children younger than the age of 15 years. Parents as the primary caregiver plays an important in management of the disease. The main objective of this study was to assess the knowledge and practices of parents of asthmatic children and improve it with the help of an informational booklet at AIIMS, Jodhpur.Methods: It was a quasi-experimental, pre-test post-test control group design on 60 parents of children suffering from asthma (30 in control group and 30 in experimental group) coming to paediatric OPD. Non probability purposive sampling was used to select the subjects. Self-structured tools like socio-demographic information, knowledge questionnaire and practices extended questionnaire were used to collect the required data. Reliability and validity of tools were analysed. Data analysis was performed in SPSS version 16.Results: The study findings reveal that most of the subjects had unsatisfactory level of knowledge and practices regarding asthma which significantly improvement in knowledge (t=11.449, p<0.05) and practices (t=-8.079, p<0.05) after application of informational booklet. Knowledge level of subjects were found to have significant association with education, occupation and monthly income of family.Conclusions: Prevention is better than cure. Parents are primary caregiver of children and spend most of the time with them. Their sufficient knowledge regarding asthma and right practices can help in reducing sudden asthma attacks and hospital visit in these children. Informational booklet have a positive impact on improving the knowledge and practices among parents.

scholarly journals Prevalence of Obesity in Inguinal Hernia Repair Patients in a Tertiary Care Center

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Sundar Shrestha ◽  
Pramod Kumar Upadhyay
Keyword(s):  
Body Mass Index ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Body Mass ◽  
Care Center ◽  
Tertiary Care ◽  
Body Mass Index Category ◽  
Tertiary Care Center ◽  
Prevalence Of Obesity

Introduction: Inguinal hernia is a common surgical problem, with a lifetime risk of 27% in men and 3% in women. Its cumulative incidence is 17.2% and 12.3% in body mass index of <25 kg/m2 and 25–30 kg/m2 respectively. Obesity had been regarded as the risk factor for the development of an inguinal hernia. However, recent epidemiologic studies have suggested the decreased prevalence of inguinal hernia in increased weight and body mass index individuals. The aim of this study is to find out the prevalence of obesity in inguinal hernia repair patients in a tertiary care center. Methods: A descriptive cross-sectional observational study was performed in Bir Hospital from May 2018 to December 2019 after taking ethical approval from the institutional review board of NAMS. Convenient sampling was done with a sample size of 219. Statistical analysis was done using SPSS ver. 23 and Microsoft Excel software by descriptive statistics. Results: The mean body mass index was 22.10 ±3.07 kg/m2. Body mass index Category 18.5 – 22.9 kg/m2 had 133 (61%) male and seven (3.2%) female patients, category ≥30 kg/m2 had four (1.8%) male. Most of inguinal hernia repair patients were farmers 158 (72.5%). Common risk factors noted were smoking 142 (65.1%), heavy work 112 (51.4%), chronic cough 65 (29.8%). Most of the complications occurred in the normal body mass index category and the prevalence of complications decreased as the body mass index increased. The recurrence was found in 3 (1.4%) inguinal hernia repairs. Conclusions: The majority of inguinal hernia repair patients were non-obese, and complications were less in obese patients.

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