scholarly journals Impact of Etiology on Efficacy of Oral Triclofos in Recording Pediatric Electroencephalography: A Tertiary Care Center Study

2019 ◽  
Vol 10 (02) ◽  
pp. 234-237
Author(s):  
Gopi Srikanth Matta ◽  
Ravi Prakash Peddisetty
Keyword(s):  
Sleep Duration ◽  
Behavioral Disorders ◽  
Care Center ◽  
Tertiary Care ◽  
Sleep Onset ◽  
Febrile Seizures ◽  
Sleep Onset Latency ◽  
Chi Square ◽  
Sleep Study ◽  
Chi Square Test

ABSTRACT Background and Objectives: Oral triclofos is a frequently used sedative in pediatric age to record sleep Electroencephalography (EEG). This study is aimed to assess efficacy, safety profile, need for second dose, and rescheduling of oral triclofos in relation to etiology. Materials and Methods: This is a retrospective study done enrolling all children aged 6 months to 5 years referred for EEG over 1 year. After a trial for natural sleep, the first dose of oral triclofos was given. If a child does not sleep after an hour, the second dose was given and rescheduled if does not sleep even with the second dose. Age, sex, diagnosis, sleep latency, sleep duration, adverse effects, EEG findings, patients needing second dose, and rescheduling were noted. Descriptive statistics and Chi-square test were used to analyze data. Results: A total of 384 children required oral triclofos. The common etiologies for sleep study were atypical febrile seizures, hypoxic-ischemic encephalopathy (HIE) sequelae, and behavioral disorders such as autism and attention-deficit hyperactive disorder (ADHD). Including the second dose, we were able to successfully record sleep EEG in 372 (96.8%) patients. Rescheduling was required in 3.2% of patients. Mean sleep-onset latency was 36 min and mean sleep duration was 84 min. Single dose was sufficient in 329 (85.6%) and the second dose in 55 (14.4%). Thirty (38.5%) children of HIE sequelae (P < 0.001) required the second dose followed by behavioral disorders (29.1%, P = 0.03). Irritability, vomiting, and dizziness were common side effects which resolved spontaneously. Conclusions: Oral triclofos was effective as sedative for recording EEG. Children with HIE sequelae and behavioral disorders such as autism/ADHD more commonly required second dosing and rescheduling.

scholarly journals Correlation of Hormonal Profile and Lipid Levels with Female Adult Acne in a Tertiary Care Center of Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Smriti Shrestha
Keyword(s):  
Lipid Profile ◽  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Bivariate Analysis ◽  
Female Adult ◽  
Chi Square ◽  
Chi Square Test ◽  
Relationship Of

 Background: Acne beyond 25 years of age is frequently associated with hormonal derangement in women. Hormonal association provides the impetus for hormonal therapy as well as underpins the need for blood investigations in this population. Hence, we aim to estimate the presence of hormonal derangement and lipid alteration in female adult acne.Methods: A prospective, observational study was conducted in Dhulikhel Hospital from July 2015 to February 2016. Females older than 25 years with acne were taken in the study after informed consent. Total 100 patients were enrolled aftersample sizeestimation. Hormonal paneland lipid profile were measured. Hormones tested were androgens, C-peptide and thyroid stimulating hormone. Data analysis was done with SPSS-23. Bivariate analysis was done by chi-square test for categorical data.Results: In this study, majority of patients were younger than 30 years (70.5%) and perioral area most commonly involved. Hormonal alteration was seen in 37.2% patients, among which 17.9% had hyperandrogenism, 15.4% had abnormal thyroid level and 10.3% had high C-peptides respectively. Lipid profile was altered in 15.4% patients. Hormonal alteration had significant association with irregular menstruation (P<0.05) but not acne severity.Conclusions: We observed hormonal alteration frequently in females with adult acne, which comprised of various hormonal parameters including hyperandrogenism. Hormonal alteration reflects deranged metabolic milieu and we suggestthat wide hormonal panel should be done in female adult acne. Relationship of hormones with menstrual irregularity but not with acne severity, suggest that clinical symptoms should lead hormonal investigations in all grades of acne.

Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women

2019 ◽  
Vol 35 (4) ◽  
pp. 665-671
Author(s):  
Whitney R. Bender ◽  
Nathanael C. Koelper ◽  
Mary D. Sammel ◽  
Celeste Durnwald
Keyword(s):  
Hospital Stay ◽  
Care Center ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Chi Square ◽  
Multiparous Women ◽  
Chi Square Test ◽  
Student’S T ◽  
Relationship Of ◽  
The Relationship

Background: A woman’s prior breastfeeding history may influence future decisions regarding infant feeding. Few quantitative tools utilizing this information have been demonstrated to predict breastfeeding success. Research aim: To evaluate the efficacy of a prenatal breastfeeding history (BAP) questionnaire administered in prenatal care to predict in-hospital formula supplementation among multiparous women. Methods: This is a prospective observational study of multiparous women with singleton pregnancies who presented to a Baby-Friendly urban tertiary care center for 1st prenatal visit at < 20 weeks’ gestation. The BAP tool generates a numerical score, with higher score (≥ 2) indicating prior successful breastfeeding experiences. The primary outcome was occurrence of non-medically indicated formula supplementation during the postpartum hospital stay. Student’s t test and Pearson’s chi-square test were used to compare continuous and categorical variables. A multivariable logistic regression was performed to assess the relationship of BAP score to formula supplementation. Of 587 women screened, 433 (73.8%) mother–infant dyads were analyzed. Results: Rates of formula supplementation in women with BAP scores ≤ 1 were 67% (156/234) compared with 37% (73/199) in women with higher scores ( p < 0.0001). After controlling for race/ethnicity, insurance, and obesity, women with BAP scores of ≤ 1 were 2.6 times more likely to supplement formula than women with higher scores (a OR 2.62, 95% CI [1.70, 4.04], p < .0001). Conclusion: In this prospective validation study, women with negative prior breastfeeding experiences, as evidenced by a lower BAP score, were more likely to supplement formula during the postpartum hospital stay.

scholarly journals Types and Patterns of Colonic Polyps Encountered at a Tertiary Care Center in a Developing Country in South Asia

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dakshitha Praneeth Wickramasinghe ◽  
Sanjeev F. Samaranayaka ◽  
Chamila Lakmal ◽  
Sashi Mathotaarachchi ◽  
Chula Kanishka Lal ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colonic Polyps ◽  
Colorectal Polyps ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Chi Square ◽  
Chi Square Test ◽  
Pathology Reports ◽  
Spearman’S Correlation

Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka.Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman’s correlation coefficient and chi-square test were used to identify correlations.Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n=1408) and flexible sigmoidoscopy (n=2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology.Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps.

scholarly journals Correlation of Hormonal Profile and Lipid Levels with Female Adult Acne in a Tertiary Care Center of Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 222-227
Author(s):  
Smriti Shrestha
Keyword(s):  
Lipid Profile ◽  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Bivariate Analysis ◽  
Size Estimation ◽  
Female Adult ◽  
Chi Square ◽  
Chi Square Test ◽  
Relationship Of

Background: Acne beyond 25 years of age is frequently associated with hormonal derangement in women. Hormonal association provides the impetus for hormonal therapy as well as underpins the need for blood investigations in this population. Hence, we aim to estimate the presence of hormonal derangement and lipid alteration in female adult acne.Methods: A prospective, observational study was conducted in Dhulikhel Hospital from July 2015 to February 2016. Females older than 25 years with acne were taken in the study after informed consent. Total 100 patients were enrolled after sample size estimation. Hormonal paneland lipid profile were measured. Hormones tested were androgens, C-peptide and thyroid stimulating hormone.Data analysis was done with SPSS-23. Bivariate analysis was done by chi-square test for categorical data.Results: In this study, majority of patients were younger than 30 years (70.5%) and perioral area most commonly involved. Hormonal alteration was seen in 37.2% patients, among which17.9% had hyperandrogenism, 15.4% had abnormal thyroid level and 10.3% had high C-peptides respectively. Lipid profile was altered in 15.4% patients. Hormonal alteration had significant association with irregular menstruation (P<0.05) but not acne severity. Conclusions: We observed hormonal alteration frequently in females with adult acne, which comprised of various hormonal parameters including hyperandrogenism.Hormonal alteration reflects deranged metabolic milieu and we suggest that wide hormonal panel should be done in female adult acne. Relationship of hormones with menstrual irregularity but not with acne severity, suggest that clinical symptoms should lead hormonal investigations in all grades of acne.Keywords: Acne; adult; hormones; lipid; thyroid.

scholarly journals Human Immunodeficiency Virus Infection Among Tuberculosis Patients in Mumbai

2011 ◽  
Vol 3 (01) ◽  
pp. 012-014 ◽  
Author(s):  
Sandhya S Sawant ◽  
Sachee R Agrawal ◽  
Jayanthi S Shastri ◽  
Medha Pawaskar ◽  
Pradeep Kadam
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Antibody Detection ◽  
Mycobacterium Tuberculosis Infection ◽  
Chi Square ◽  
Immunodeficiency Virus ◽  
High Prevalence ◽  
Chi Square Test

ABSTRACT Background: Human Immunodeficiency Virus (HIV) is the most powerful risk factor for the progression of Mycobacterium tuberculosis infection to Tuberculosis (TB) disease. TB accelerates the progression of HIV infection to AIDS and shortens the survival of such patients. Aim: To determine the seroprevalence of HIV infection among TB confirmed patients in a tertiary care center in Mumbai in view of the significance of HIV in TB. Its association with gender and age was also determined. Materials and Methods: Blood samples were collected by venipuncture from 432 TB patients and their HIV status was determined. HIV antibody detection was carried out as per Strategy III, National AIDS Control Organisation (NACO) guidelines. Statistical analysis was carried out by applying the Chi-square test. Results and Conclusion: Of the 432 patients screened, 9% (39) were HIV positive. The prevalence of co-infection was higher among females (9.4%) than the male (8.7%) patients and highest amongst those aged 21to40 years (13.7%). Co-infection was found to be statistically highly associated with age (p < 0.05). This high prevalence calls for routine screening of TB patients for HIV infection.

scholarly journals Histopathological Findings of Cystic Endometrial Morphology Based on Ultrasonographic Imaging in Premenopausal Women

2018 ◽  
pp. 1
Author(s):  
Tugba Kinay ◽  
Metin Kaplan ◽  
Fulya Kayikcioglu ◽  
Jale Karakaya
Keyword(s):  
Endometrial Hyperplasia ◽  
Care Center ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Binary Logistic Regression ◽  
Endometrial Biopsy ◽  
Binary Logistic Regression Analysis ◽  
Chi Square ◽  
Histopathological Findings ◽  
Chi Square Test

<p><strong>Objective:</strong> To evaluate the histopathological findings of cystic endometrial morphology based on ultrasonographic imaging in premenopausal women.</p><p><strong>Study Design:</strong> The medical records of 3607 premenopausal women that underwent ultrasonographic examination at a tertiary care center were reviewed, as were endometrial biopsy findings in 816 of the women. These 816 women were divided in 2 groups according to ultrasonographic endometrial findings: the cystic group and the non-cystic group. Clinical and histopathological findings in the 2 groups were compared. Statistical analysis was performed using independent samples t test, chi-square test, and binary logistic regression analysis.</p><p><strong>Results:</strong> Three hundred and eighty one (46.7%) of the women that underwent endometrial biopsy had cystic endometrium, whereas 435 (53.3%) had non-cystic endometrium. The most common histopathological finding in the cystic group was endometrial hyperplasia without atypia (44.6%). Cystic morphology was nearly 8-fold more common in the women with endometrial hyperplasia without atypia (95% CI: 5.43-11.67). The premalignant and malignant pathology rates in the cystic group and non-cystic group were similar (1.1% vs. 0.5% [p=0.426] and 0.8% vs. 0.5% [p=0.669], respectively). Secretory endometrium was less common in the cystic group than in the non-cystic group (5.0% vs. 37.9% [p&lt; 0.001])</p><p><strong>Conclusion:</strong> Cystic endometrial morphology based on ultrasonographic imaging was more common in women with endometrial hyperplasia without atypia. There wasn’t an association between cystic endometrium and other endometrial pathologies or functional endometrium. <br />Keywords: Cystic endometrium, Endometrium, Endometrial hyperplasia, Premenopausal, Ultrasonography</p>

scholarly journals Feto-maternal outcomes following labor induction at a tertiary care center

2020 ◽  
Vol 10 (2) ◽  
pp. 29-32
Author(s):  
Upendra Pandit ◽  
Basant Sharma ◽  
Rakshya Joshi ◽  
Julli Chaudhari ◽  
Prekshya Singh ◽  
...  
Keyword(s):  
Apgar Score ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Labor Induction ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test

Background: Labor induction is one of the most common Obstetrics interventions worldwide. It has got significant risks and benefits. Careful selection of cases for induction improves the feto­maternal outcomes. So, the study was designed to assess the fetomaternal outcome and factors associated with mode of delivery following the induction of labor. Methods: It was a descriptive observational study conducted in the department of Obstetrics and Gynecology from July 17, 2018, to July 16, 2019. The study comprised of 264 mothers admitted in the labor ward subjected to labor induction as clinical management of labor and delivery. Data analyzed with chi-square test and one-way analysis of variance (ANOVA) wherever appropriate. Results: Of 2950 deliveries, the induction rate was 8.94%. Out of them, 264 mothers undergone labor induction. A caesarean was the highly associated mode of deliveries 168(63.63%) due to in­duction failure 94(55.97%) followed by fetal distress 37(22%). The mean birth weight of neonates was 3.09±0.41 kg. Apgar score in one minute and hospital stay showed a significant difference (p-value .002), in modes of deliveries. No significant association was observed in maternal and fetal complications like PPH, endometritis, and low Apgar score <7 in five minutes. The majority of neonates admitted for observation at the care unit. The neonatal mortality was two. Conclusions: Caesarean mode of delivery highly was associated with labor induction due to in­duction failure and fetal distress. Carefully selected cases improve morbidity and fetomaternal outcomes following labor induction.

scholarly journals The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

2020 ◽  
Vol 4 (2) ◽  
pp. 167-176
Author(s):  
Achim Elfering ◽  
Christin Gerhardt ◽  
Diana Pereira ◽  
Anna Schenker ◽  
Maria U. Kottwitz
Keyword(s):  
Sleep Duration ◽  
Sleep Onset ◽  
Monday Morning ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Social Stressors ◽  
Monday Effect ◽  
Work Related ◽  
Cognitive Failure ◽  
Delayed Sleep

Abstract Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.

scholarly journals 193 Sleep Variability and Affect Dynamics Among College Students during COVID-19 Pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A78-A78
Author(s):  
Zahra Mousavi ◽  
Jocelyn Lai ◽  
Asal Yunusova ◽  
Alexander Rivera ◽  
Sirui Hu ◽  
...  
Keyword(s):  
Emerging Adults ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Positive And Negative Affect ◽  
Sleep Onset Latency ◽  
Deep Sleep ◽  
Onset Latency ◽  
Sleep Patterns ◽  
Light Sleep ◽  
Affect Dynamics

Abstract Introduction Sleep disturbance is a transdiagnostic risk factor that is so prevalent among emerging adults it is considered to be a public health epidemic. For emerging adults, who are already at greater risk for psychopathology, the COVID-19 pandemic has disrupted daily routines, potentially changing sleep patterns and heightening risk factors for the emergence of affective dysregulation, and consequently mood-related disturbances. This study aimed to determine whether variability in sleep patterns across a 3-month period was associated with next-day positive and negative affect, and affective dynamics, proximal affective predictors of depressive symptoms among young adults during the pandemic. Methods College student participants (N=20, 65% female, Mage=19.80, SDage=1.0) wore non-invasive wearable devices (the Oura ring https://ouraring.com/) continuously for a period of 3-months, measuring sleep onset latency, sleep efficiency, total sleep, and time spent in different stages of sleep (light, deep and rapid eye movement). Participants reported daily PA and NA using the Positive and Negative Affect Schedule on a 0-100 scale to report on their affective state. Results Multilevel models specifying a within-subject process of the relation between sleep and affect revealed that participants with higher sleep onset latency (b= -2.98, p&lt;.01) and sleep duration on the prior day (b= -.35, p=.01) had lower PA the next day. Participants with longer light sleep duration had lower PA (b= -.28, p=.02), whereas participants with longer deep sleep duration had higher PA (b= .36, p=.02) the next day. On days with higher total sleep, participants experienced lower NA compared to their own average (b= -.01, p=.04). Follow-up exploratory bivariate correlations revealed significant associations between light sleep duration instability and higher instability in both PA and NA, whereas higher deep sleep duration was linked with lower instability in both PA and NA (all ps&lt; .05). In the full-length paper these analyses will be probed using linear regressions controlling for relevant covariates (main effects of sleep, sex/age/ethnicity). Conclusion Sleep, an important transdiagnostic health outcome, may contribute to next-day PA and NA. Sleep patterns predict affect dynamics, which may be proximal predictors of mood disturbances. Affect dynamics may be one potential pathway through which sleep has implications for health disparities. Support (if any):

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