scholarly journals Clinical Outcomes of Trans-caesarean and Vaginal Post-placental CuT380A IUCD Insertions: A Comparative Study

2021 ◽  
pp. 46-57
Author(s):  
C. P. Okoye ◽  
D. N. Onwusulu ◽  
C. P. Nnamani
Keyword(s):  
Clinical Outcomes ◽  
Post Partum ◽  
Sampling Technique ◽  
Categorical Variables ◽  
P Value ◽  
Contraceptive Device ◽  
Continuous Variables ◽  
Expulsion Rate ◽  
Post Placental ◽  
Pregnant Mothers

Background: Immediate postpartum CuT380A intrauterine contraceptive device (PPIUCD) insertion provides a novel approach in reducing the unmet contraceptive needs of family planning. The insertion can be trans-caesarean or vaginal following delivery of the placenta. The clinical outcomes of the different routes of insertion have not been adequately studied. Aim: The study aimed at comparing the clinical outcomes following trans-caesarean and vaginal post-placental insertions of CuT380A IUCD. Methodology: The study was a prospective cohort study of 81 pregnant mothers managed at a tertiary health institution in southern Nigeria. They were recruited into two groups using a convenient sampling technique; 27 and 54 mothers in the caesarean and vaginal delivery groups respectively. The pregnant mothers were followed up till delivery and at the six weeks postnatal visit. Information on their socio-demographic characteristics, Obstetrics and Gynecology history were obtained with the aid of a proforma. The proforma was updated with the clinical outcomes of immediate PPIUCD insertions in the two groups, at the six weeks visit. Data obtained were analyzed using statistical package of social sciences version 21. Continuous variables were expressed as means and standard deviations. The Chi square test was used for dichotomous or categorical variables. A p-value of less than 0.05 was considered statistically significant. Results: The study showed that PPIUCD is a safe practice in both vaginal and caesarean deliveries with no significant differences in clinical outcomes. However, incidence of missing string was higher in the caesarean group compared to vaginal group (81.5% vs 51.9%; p value-0.01); and expulsion rate was also high in the vaginal group but not significant. (13.0% vs 7.4%; p value 0.45). Conclusion: Immediate postpartum CuT380A contraception, irrespective of route of insertion, is convenient, effective, and safe. Although there is a relatively higher incidence of missing strings, including expulsions after vaginal PPIUCD insertions, immediate post-partum contraception should be encouraged. This will help to reduce high unmet contraceptive needs in our environment and loss to follow up irrespective of route of delivery. Recommendation: Immediate PPIUCD, irrespective of the route, should be encouraged and integrated into the existing Maternal and Child Health Programme. Awareness should be created to promote acceptance in our environment.

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 Pengaruh intra uterine device (IUD) post plasenta terhadap involusi uterus

2020 ◽  
Vol 12 (2) ◽  
pp. 129-134
Author(s):  
Istri Utami ◽  
Mochammad Anwar ◽  
Herlin Fitriana Kurniawati
Keyword(s):  
Post Partum ◽  
Health Centre ◽  
Sampling Technique ◽  
Primary Health Centre ◽  
P Value ◽  
Multiple Logistic Regression ◽  
Control Groups ◽  
Chi Square ◽  
Primary Health ◽  
Post Placental

Abstract: The study is a quantitative in nature with cohort prospectiveapproach. The population of the study was all post-partum mothers atMlati II Primary Health Centre of Sleman. The samples were takenusing accidental sampling technique with 25 respondents in each caseand control groups. The data were analyzed using Chi Square (X2)while the multivariate analysis used multiple logistic regression of riskfactors model. According to the result, p-value is 0,04 in which there isdifference between post-partum period length on post-partum motherswho use Post placental IUD and post-partum mothers who do notuses Post placental IUD.

617 Who Benefits the Most from Burn Camps?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Jennifer B Radics-Johnson ◽  
Daniel W Chacon ◽  
Li Zhang
Keyword(s):  
Retrospective Review ◽  
Burn Injury ◽  
Statistical Significance ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Self Evaluation ◽  
Significant Difference ◽  
Return Home ◽  
The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

scholarly journals POS0942 THE NEGATIVE IMPACT OF UNDIAGNOSED DEPRESSION IN AXIAL SPONDYLOARTHROPARTHY: RESULTS OF A SCREENING STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 734.1-734
Author(s):  
S. Maguire ◽  
F. B. O’shea
Keyword(s):  
Disease Activity ◽  
Negative Impact ◽  
Depression Scale ◽  
Clinic Visit ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Numerical Result ◽  
Co Morbidity ◽  
Patient Reported

Background:Previous research in axial spondyloarthropathy(axSpA) has shown this population to have a high prevalence of depression. This co-morbidity has been previously shown to impact disease activity in patients with rheumatic disease.Objectives:The purpose of this study was to screen for early signs of depression using two validated tools, the Patient Health Questionaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale for depression (HADs-D) in patients with known axSpA.Methods:AxSpA patients attending the Rheumatology department in St James’ Hospital between February and October 2020 were invited to take a self-administered survey which included the PHQ-9 and the HADs-D. Scores from the HADs-D yielded a numerical result which was then categorised as normal, borderline or abnormal. PHQ-9 numerical results were categorised as normal, mild, moderate, moderate/severe or severe. Patients with a known diagnosis of depression were excluded. In addition to baseline demographics, patient reported outcomes from the clinic visit were also recorded.Data analysis was performed using IBM SPSS version 26. Continuous variables were recorded as means, categorical variables as frequencies with percentages. A one-way analysis of variance analysis (ANOVA) was used to determine significance of variation in outcomes between patient outcomes as determined by the HADs-D and PHQ-9. A p-value of <0.05 was deemed significant. Consent was obtained prior to participation. Approval was received from the St James’/Tallaght Hospital Joint Ethics Committee.Results:In total 71 axSpA patients took part in the survey. The population was 70.4%(50) males and 29.5%(21) female, with an average age 47.9 years and mean disease duration 19.7 years (mean outcomes: BASDAI 4.08, BASFI 3.62, BASMI 3.54, ASQoL 6.79). Overall, 7 (9.9%) participants recorded abnormal HADs-D scores, while 17 (23.9%) recorded moderate to severe PHQ-9 scores indicative of underlying depression. AxSpA females had higher mean HADs-D scores (7.5 vs 4.8, p=0.01) than males, with abnormal scores in 19%(4) of females and 6% (3) of males. No significant differences were found in PHQ-9 scores between genders.Analysis revealed significantly worse BASDAI (6.27 vs 3.42, p<0.01) and AQoL scores (12.57 vs 5.26, p<0.01) in axSpA patients with abnormal compared to normal HADs-D scores. No significant differences were noted in BASFI, BASMI or baseline demographics. A similar pattern was noted on analysis of PHQ-9 scores, with significantly worse BASDAI (7.9 vs 2.55, p<0.01), BASFI (8.05 vs 2.33, p<0.01) and ASQoL (19.5 vs 2.62, p<0.01) noted in those scoring as severe compared to normal. No significant differences were detected in BASMI scores or baseline demographics.Conclusion:A high percentage of axSpA patients recorded high HADs-D and PHQ-9 scores concerning for undiagnosed depression. These patients were noted to have significantly worse disease activity and quality of life as compared to patients with normal scores. Clinicians treating axSpA should consider screening for depression in this population.Disclosure of Interests:Sinead Maguire Speakers bureau: Speaker fee from Jassen, Grant/research support from: Recipient of the Gilead Inflammation Fellowship Grant, Finbar Barry O’Shea: None declared

scholarly journals Hubungan Pemberian Anestesi Regional Dengan Kelancaran ASI Pada Ibu Post Partum Sectio Caesarea Di Rumah Sakit Muhammadiyah Gresik

2020 ◽  
Vol 7 (2) ◽  
pp. 42
Author(s):  
Vina Rahmatika ◽  
Musa Ghufron ◽  
Nenny Triastuti ◽  
Syaiful Rochman
Keyword(s):  
Breast Milk ◽  
Caesarean Section ◽  
Post Partum ◽  
Secondary Data ◽  
Sampling Technique ◽  
Primary Data ◽  
Sectio Caesarea ◽  
P Value ◽  
Cross Sectional ◽  
Anesthetic Drugs

Background: The birth rate by caesarean section method is getting higher. Risk data for 2013 shows the method of birth with the operation method of 9.8 percent of the total 49,603 births during 2010 to 2013. Being in practice the mother must be given anesthetic before the surgery begins. This anesthesia will later affect the pain that will occur after SC. Purpose: The purpose of this study was to determine the correlation between regional anesthetic drugs and the smoothness of breast milk in women born in sectio caesarea at Muhammadiyah Gresik Hospital. Method: Method with Cross Sectional approach. The population in this study mothers who gave birth in a caesarean section at Muhammadiyah Hospital Gresik in December 2019 to January 2020. The sampling technique in this study is probability / random simple sampling. The sample in this study was a portion of mothers who gave birth in a caesarean section at Muhammadiyah Gresik Hospital. The instrument used was primary data collection in the form of questionnaires and secondary data in the form of patient medical records. Result: The data obtained in this study were processed using spearman correlation statistics. From the statistical test the Correlation coefficient value was 0.807, and obtained P-Value equal to 0,000 this value is less than 0.05. Conclusion: The conclusion of this study is that there is a correlation between the administration of a regional anesthetics and the smoothness of breast milk in mothers of post partum caesarea at Muhammadiyah Gresik Hospital.

scholarly journals Leptospira spp. seroprevalence in humans involved in a cross-sectional study in Garissa and Tana River Counties, Kenya

2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  
Keyword(s):  
Case Fatality ◽  
Cross Sectional Study ◽  
Wilcoxon Test ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Sectional Study ◽  
Test Statistic ◽  
Cross Sectional ◽  
Tana River

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.

Abstract P165: Comparing Grip Strength, Weakness, And Frailty Based On Comorbidity And Laboratory Data Among Patients With Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Gloria Kim ◽  
Arati A Gangadharan ◽  
Matthew A Corriere
Keyword(s):  
Grip Strength ◽  
Frailty Index ◽  
Laboratory Data ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Chi Square ◽  
Mean Values ◽  
Multivariable Models ◽  
And Gender

Introduction: Some approaches to frailty screening use diagnostic or laboratory data that may be incomplete. Grip strength can identify weakness, a component of phenotype-based frailty assessment. We compared grip strength as a reductionist, phenotype-based approach to frailty screening with comorbidity and laboratory-based alternatives. Hypothesis: Grip strength and categorical weakness are correlated with the modified frailty index-5 (mFI-5) and lab values associated with frailty. Methods: Weakness based on grip, BMI, and gender was compared with mFI-5 comorbidities and lab values. Patients with at least 3/5 mFI-5 comorbidities were considered frail. Lab data collected within 6 months of grip measurement was assessed. Associations were evaluated using multivariable models and kappa. Methods: 2,597 patients had grip strength measured over 5 months. Mean age was 64.4±14.6, mean BMI was 29.5±6.9;46% were women, and 87% white. Prevalent comorbidities included hypertension (28%), CHF (22%), diabetes (29%), and COPD (26%); 9% were functionally dependent. 34% were weak, but only 13% were frail based on mFI-5. Hemoglobin, creatinine, and CRP differed significantly based on weakness ( Table ). Laboratory data were missing for 36%- 95% of patients. Multivariable models identified significant associations between weakness, hemoglobin, and all MFI-5 comorbidities. Categorical agreement between weakness and frailty was limited (kappa =0.09; 95% CL 0.0641-0.1232). Conclusion: Weakness based on grip strength provides a practical, inexpensive approach to risk assessment, especially when incomplete data excludes other approaches. Comorbidity-based assessment categorizes many weak patients as non-frail. Table. Demographic, laboratory values, and comorbidities by categorical weakness based on grip 20 th percentile. Mean values for continuous variables by weakness adjusted for gender and BMI, p-value for T-test; frequency and total percent for categorical variables, p-value represents chi-square test.

VOMITING

2018 ◽  
Vol 25 (12) ◽  
pp. 1887-1891
Author(s):  
Malik Jamil Ahmed ◽  
Muhammad Nasir ◽  
Aamir Furqan
Keyword(s):  
Computer Software ◽  
Outcome Variable ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Postoperative Vomiting ◽  
Hospital Data ◽  
Chi Square ◽  
Oral Ketamine ◽  
The Difference

Objectives: To investigate whether the addition of dexamethasone and chloropheniramine to oral ketamine premedication affects the incidence of postoperative vomiting. Study Design: Randomized control trail. Setting: Department of Anesthesia and Intensive Care Nishtar Hospital, Multan. Period: March 2016 to March 2017. Methodology: After obtaining ethical approval ethical and review board of hospital. Data was entered in a computer software SPSS version 23.1 and analyzed for possible variables. Continuous variables were presented as mean and standard deviation like age, weight, sedation time, anesthesia time, admission time and PACU time. Categorical variables were presented as gender, ASA statusand postoperative vomiting. Student test and chi square test was applied to see association of outcome variable. P value of 0.05 was taken as significant. Results: Overall, 100% (n=80) patients were included in this study, both genders. The study group was further divided into twoequal groups, 50% (n=40) in each, i.e. Group K (Ketamine) group and group KD (Ketamine-Dexamethasone). The main outcome variable of this study was postoperative vomiting. In this study, Postoperative vomiting observed in 35% (n=10) and 10% (n=4) patients, for group K and group KD respectively. The difference was statistically significant (p=0.007). Conclusion: Addition of dexamethasone and chloropheniramine with ketamine as premedication reduce the incidence of postoperative vomiting.

scholarly journals Under-five malnutrition in a South-Eastern Nigeria metropolitan city

1970 ◽  
Vol 19 (4) ◽  
pp. 3078-3084
Author(s):  
Chukwuemeka Kenechukwu Jude ◽  
Agozie Ubesie Chukwunedum ◽  
Kunle Obidike Egbuna
Keyword(s):  
Maternal Education ◽  
Sampling Technique ◽  
Relevant Information ◽  
Overweight And Obesity ◽  
Primary School Children ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Socioeconomic Class ◽  
Under Five

Background: Malnutrition (under and overnutrition) presents significant threats to child health. The co-existence of under and overnutrition in a population is increasingly being described in the literature .Objective: To identify the prevalence of malnutrition among under-five children in Enugu metropolis.Methods: A cross-sectional study of pre-primary school children conducted from January to May 2016. using stratified sampling technique. Caregiver-administered questionnaire was used to obtain relevant information. Weights and heights were measured using a standard weight scale and stadiometer/ length mat respectively. Wasting, stunting, overweight and obesity were determined based on the recommended WHO Growth Standard. Data analysis was done with SPSS version 20.0. The associations between nutritional status on one hand, and categorical variables such as age grouping, sex, socio-economic status, and maternal educationwere determined using chi square. . P-value < 0.05 were reported as statistically significant.Results: Eighteen (2.4%) and 26 (3.5%) subjects were wasted and stunted respectively. Eleven (1.5%) subjects were overweight while another 11(1.5%) subjects were obese. Risk factors for undernutrition were maternal education and low socioeconomic class while risk factor for overnutrition was upper socioeconomic class..Conclusion: There is a low rate of malnutrition in the area of study. However, sustained efforts must continue to prevent further rise and possibly eliminate the scourge of malnutrition.Keywords: Malnutrition, Nigeria.

scholarly journals A multidisciplinary pulmonary embolism response team (PERT)—experience from a national multicenter consortium

2019 ◽  
Vol 9 (3) ◽  
pp. 204589401882456 ◽  
Author(s):  
Jacob Schultz ◽  
Nicholas Giordano ◽  
Hui Zheng ◽  
Blair A. Parry ◽  
Geoffrey D. Barnes ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Patient Characteristics ◽  
Risk Groups ◽  
The United States ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Exact Test ◽  
Advanced Therapy ◽  
Chi Squared

Background We provide the first multicenter analysis of patients cared for by eight Pulmonary Embolism Response Teams (PERTs) in the United States (US); describing the frequency of team activation, patient characteristics, pulmonary embolism (PE) severity, treatments delivered, and outcomes. Methods We enrolled patients from the National PERT Consortium™ multicenter registry with a PERT activation between 18 October 2016 and 17 October 2017. Data are presented combined and by PERT institution. Differences between institutions were analyzed using chi-squared test or Fisher's exact test for categorical variables, and ANOVA or Kruskal-Wallis test for continuous variables, with a two-sided P value < 0.05 considered statistically significant. Results There were 475 unique PERT activations across the Consortium, with acute PE confirmed in 416 (88%). The number of activations at each institution ranged from 3 to 13 activations/month/1000 beds with the majority originating from the emergency department (281/475; 59.3%). The largest percentage of patients were at intermediate–low (141/416, 34%) and intermediate–high (146/416, 35%) risk of early mortality, while fewer were at high-risk (51/416, 12%) and low-risk (78/416, 19%). The distribution of risk groups varied significantly between institutions ( P = 0.002). Anticoagulation alone was the most common therapy, delivered to 289/416 (70%) patients with confirmed PE. The proportion of patients receiving any advanced therapy varied between institutions ( P = 0.0003), ranging from 16% to 46%. The 30-day mortality was 16% (53/338), ranging from 9% to 44%. Conclusions The frequency of team activation, PE severity, treatments delivered, and 30-day mortality varies between US PERTs. Further research should investigate the sources of this variability.

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