scholarly journals Co-Relation of Ocular Fundus Changes and Pregnancy Induced Hypertension and Its Foetal Outcomes

2021 ◽  
pp. 219-228
Author(s):  
Mohmed Kandeel ◽  
Hoda El-Sobky ◽  
Ahmed Shalah ◽  
Essam A. Amin
Keyword(s):  
Blood Pressure ◽  
Neonatal Death ◽  
Pregnancy Induced Hypertension ◽  
Slit Lamp ◽  
Ocular Fundus ◽  
Follow Up Study ◽  
Significant Difference ◽  
Induced Hypertension ◽  
Grade Ii

Background: Pregnancy-Induced Hypertension (PIH) is a stigmatizing condition in obstetrics and a significant cause of maternal and neonatal death. It is a kind of pregnancy-related hypertension that develops after 20th week of pregnancy with no presence of other reasons of high blood pressure. Objectives: To study the relation between grades of ocular fundus changes& degree of features severity of pregnancy induced hypertension and its maternal and foetal outcomes. Subjects and Methods: This is a prospective observational follow up study, the research lasted about 16 months and included 121 pregnant women diagnosed with PIH. Ocular examinations were performed using a direct ophthalmoscope, a slit lamp and grades of retinopathy were recorded and linked to the severity of PIH and its consequences. The data were analyzed statistically. Results: Results of the study revealed that most of the patients 62% had no abnormal fundus changes while 29.8% of the patients were grade I retinopathy and 7.4% of the patients were grade II retinopathy & There was significant difference between grades of retinopathy and degree of features of severity of PIH & some of its important maternal & foetal outcomes. Conclusion: Grades of ocular fundus alterations are associated with the severity of PIH's characteristics and are predictive of maternal and fetal comorbidity.

scholarly journals COMPARISON OF TREATMENT OUTCOME OF ANTIHYPERTENSIVE DRUGS IN THE MANAGEMENT OF PREGNANCY INDUCED HYPERTENSION

2017 ◽  
Vol 9 (3) ◽  
pp. 287
Author(s):  
Sivakumar Velusamy
Keyword(s):  
Blood Pressure ◽  
Treatment Outcome ◽  
Pregnancy Outcome ◽  
Prospective Observational Study ◽  
Antihypertensive Drugs ◽  
Drug Group ◽  
Pregnancy Induced Hypertension ◽  
Significant Difference ◽  
Specialty Hospital ◽  
Induced Hypertension

This study was aimed to find out the differences in the pregnancy outcome of PIH women treated with the antihypertensive drugs methyldopa and nifedipine. The prospective observational study was conducted in a multi specialty hospital at Coimbatore with 161 PIH diagnosed women. Women were categorised into the no-drug group, methyldopa group, nifedipine group and methyldopa with nifedipine group. All the women were monitored from diagnosis to delivery. The maternal and neonatal data were collected and analysed. The drugs were significantly controlled the blood pressure (BP) from base to end (P<0.001). There was no significant difference in the reduction of BP between the drugs. Cesarean delivery (>90%) and preterm delivery were high across all the groups. No significant difference was seen between these groups. The AGA (Average for gestational age) babies were significantly higher with a no-drug group (83%) and lower with nifedipine group (40%). Two women were reported with HELLP syndrome in methyldopa with nifedipine group. No significant difference was found in terms of pregnancy outcome between these groups except for eclampsia and AGA. Eclampsia was affected more with 14% in methyldopa with nifedipine group. We found similar outcomes; there were no significant changes between methyldopa, nifedipine, and the no-drug treatment. The antihypertensive drugs nifedipine and methyldopa both were significantly reduced the BP. The maternal and neonatal complications were similar between these two drugs. No beneficial effect can be identified one over another.

scholarly journals Perinatal Survival and Predictors of Mortality among Mothers with Hypertensive Disorders of Pregnancy at Antenatal care Clinics in Gamo Zone Public Hospitals

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Samuel Dessu Sifer ◽  
Fikre Bojola ◽  
Zinabu Dawit ◽  
Habtamu Samuel ◽  
Mulugeta Dalbo
Keyword(s):  
Blood Pressure ◽  
Antenatal Care ◽  
Perinatal Mortality ◽  
Blood Pressure Level ◽  
Pressure Level ◽  
Public Hospitals ◽  
Pregnancy Induced Hypertension ◽  
Systolic Blood Pressure Level ◽  
Induced Hypertension

BACKGROUND፡ Pregnancy induced hypertension represents a significant public health problem throughout the world, which may complicate 0.5%–10% of all pregnancies. It is the leading cause of maternal as well perinatal mortality and morbidity worldwide. Pregnancy induced hypertension is a multisystem disorder unique to pregnancy and results in high perinatal mortality. The objective of this study was to determine the survival status, incidence and predictors of perinatal mortality among mothers with pregnancy induced hypertension at antenatal clinics of Gamo Zone public hospitals.METHODS: Facility-based retrospective cohort study was conducted among selected 576(192 exposed and 384 unexposed) antenatal care attendants' record at Gamo Zone public hospitals from 1st January 2018 to 31st December 2018. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. Kaplan Meier survival curve together with log rank test was fitted to test the survival time. Statistical significance was declared at Pvalue <0.05 using cox proportional hazard model.RESULT: The incidence of perinatal mortality was 124/1000 births. The cumulative proportion of surviving at the end of 4th , 8th, 12th and 16th weeks of follow-up among the exposed groups was 96.9%, 93.5%, 82.1% and 61.6% respectively whereas it was 99.5%, 98.9% and 98.5% at the end of 4th, 8th and 12th weeks of follow-up for the non-exposed groups respectively. Parity of >5(AHR: 6.3; 95%CI: 1.36,10.55), mothers who delivered at<34 weeks of gestation(AHR:7.8; 95%CI: 2.6,23.1), being preterm(AHR:6; 95%CI: 5.3,19.2), perinatal birth weight<2500gm(AHR:6.1; 95&CI: 1.01,37.9), vaginal deliveryn(AHR:2.7; 95%CI:1.13,6.84), maternal highest systolic blood pressure level >160mmHg (AHR: 2.3; 95%CI: 1.02,5.55) and prepartum onset of pregnancy induced hypertension (AHR:6; 95%CI: 5.3,19.2) were statistically significant in multivariable analysis.CONCLUSION: The risk of perinatal mortality was high among the mothers with pregnancy induced hypertension compared to those of pregnancy induced hypertension free mother,s and the perinatal mortality rate was high. High parity, low gestational age, low number of antenatal care visits, low birth weight, vaginal delivery, antepartum onset of pregnancy induced hypertension and highest maternal systolic blood pressure level were the independent predictors of perinatal mortality.

Relation of ocular fundus changes with blood pressure and proteinuria in pregnancy induced hypertension

2014 ◽  
Vol 2 (3) ◽  
pp. 97
Author(s):  
AkshayJ Bhandari ◽  
SurekhaV Bangal ◽  
DiptiD Padghan ◽  
PratikY Gogri
Keyword(s):  
Blood Pressure ◽  
Pregnancy Induced Hypertension ◽  
Ocular Fundus ◽  
Induced Hypertension ◽  
In Pregnancy

Serum Uric Acid Level as a Predictive Biomarker of Gestational Hypertension Severity; A Prospective Observational Case-Control Study

2020 ◽  
Vol 15 (3) ◽  
pp. 227-239 ◽  
Author(s):  
Hader I. Sakr ◽  
Akef A. Khowailed ◽  
Reham S. Al-Fakharany ◽  
Dina S. Abdel-Fattah ◽  
Ahmed A. Taha
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Case Control Study ◽  
Serum Urate ◽  
Interleukin 1Β ◽  
Pregnancy Induced Hypertension ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Induced Hypertension ◽  
Control Study

Background: Pre-eclampsia poses a significant potential risk of hypertensive disorders during pregnancy, a leading cause of maternal deaths. Hyperuricemia is associated with adverse effects on endothelial function, normal cellular metabolism, and platelet aggregation and adhesion. This study was designed to compare serum urate levels in normotensive pregnant women to those with pregnancy-induced hypertension, and to evaluate its value as a potential predictive marker of hypertension severity during pregnancy. Methods: A prospective, observational, case-control study conducted on 100 pregnant women in their third trimester. Pregnant women were classified into two groups (n=50) according to arterial blood pressure measurements: group I had normal blood pressure, and group II had a blood pressure of ≥ 140/90, which was further subdivided according to hypertension severity into IIa (pregnancy- induced hypertension, IIb (mild pre-eclampsia), and IIc (severe pre-eclampsia). Blood samples were obtained on admission. Serum urate, high sensitive C-reactive protein, and interleukin-1β levels, and lipid profile were compared among the groups. Results: A significant increase in the mean values of serum urate, C-reactive protein, and interleukin- 1β levels was detected in gestational hypertensives. In addition, there was a positive correlation between serum urate levels and C-reactive protein and interleukin-1β, as well as between serum urate levels and hypertension severity. Conclusion: Hyperuricemia and increased C-reactive protein and interleukin-1β serum levels correlate with the severity of pregnancy-induced hypertension, and these biomarkers may play a role in the pathogenesis of pre-eclampsia. Serum urate measurement is sensitive, reliable markers that correlate well with the severity of hypertension in pregnant females with pre-eclampsia.

Student nurses’ unethical behavior, social media, and year of birth

2016 ◽  
Vol 23 (8) ◽  
pp. 910-918 ◽  
Author(s):  
Gloria Copeland Smith ◽  
Troy Keith Knudson
Keyword(s):  
Social Media ◽  
Nursing Students ◽  
Unethical Behavior ◽  
Ethics Education ◽  
Student Nurses ◽  
Clinical Cohort ◽  
Follow Up Study ◽  
Significant Difference ◽  
Use Of Social Media

Background: This study is the result of findings from a previous dissertation conducted by this author on Student Nurses’ Unethical Behavior, Boundaries, and Social Media. The use of social media can be detrimental to the nurse–patient relationship if used in an unethical manner. Method: A mixed method, using a quantitative approach based on research questions that explored differences in student nurses’ unethical behavior by age (millennial vs nonmillennial) and clinical cohort, the relationship of unethical behavior to the utilization of social media, and analysis on year of birth and unethical behavior. A qualitative approach was used based on a guided faculty interview and common themes of student nurses’ unethical behavior. Participants and Research Context: In total, 55 Associate Degree nursing students participated in the study; the research was conducted at Central Texas College. There were eight faculty-guided interviews. Ethical considerations: The main research instrument was an anonymous survey. All participants were assured of their right to an informed consent. All participants were informed of the right to withdraw from the study at any time. Findings: Findings indicate a significant correlation between student nurses’ unethical behavior and use of social media (p = 0.036) and a significant difference between student unethical conduct by generation (millennials vs nonmillennials (p = 0.033)) and by clinical cohort (p = 0.045). Further findings from the follow-up study on year of birth and student unethical behavior reveal a correlation coefficient of 0.384 with a significance level of 0.003. Discussion: Surprisingly, the study found that second-semester students had less unethical behavior than first-, third-, and fourth-semester students. The follow-up study found that this is because second-semester students were the oldest cohort. Conclusion: Implications for positive social change for nursing students include improved ethics education that may motivate ethical conduct throughout students’ careers nationally and globally for better understanding and promotion of ethics and behavior.

Myocardial work analysis in screening of familial dilated cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Triantafyllou ◽  
R Monteiro ◽  
A Protonotarios ◽  
T Gossios ◽  
P Elliott ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Dilated Cardiomyopathy ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Systemic Hypertension ◽  
Work Efficiency ◽  
Work Analysis ◽  
Significant Difference ◽  
Global Work

Abstract Introduction Early detection of affected family relatives of patients with dilated cardiomyopathy (DCM) is essential in order to guide follow up, outcomes and initiate early treatment. Myocardial work analysis is a novel method which integrated strain imaging and blood pressure and has the potential to identify patients with subclinical disease. Purpose We analysed myocardial work in family relatives of DCM patients with positive genotype but negative phenotype in order to identify whether myocardial work can identify early changes. Methods Seventy-four family relatives of DCM patients attending for screening were examined. All individuals were asymptomatic with either positive (45/74, G+) or negative (29/74, G-) genotype and no echocardiographic evidence of left ventricular dilatation or systolic impairment. Non-invasive myocardial work analysis using two-dimensional (2D) speckle tracking echocardiography was analysed. Global longitudinal strain (GLS) was measured by the same vendor specific software used for myocardial work analysis. Left ventricular (LV) ejection fraction (EF) was measured with the Simpson's biplane method. The peak systolic arm cuff blood pressure (BP) measurement at the time of echocardiography was used for the myocardial work study. Results In total we included 74 individuals (37±15 years old, 50.7% women) with mean systolic and diastolic BP of 121.3±14 and 73.2±10 mmHg respectively, mean EF was 58±5% and mean GLS at 18.4±2.5%. G+ individuals had pathogenic and very likely pathogenic mutations in 8 different genes (TTN, BAG3, DSP, FLNC, LMNA, DMD, RBM20, TPM1). There was no difference in age, systemic hypertension, diabetes or medical treatment between the 2 groups. No significant difference was found among G+ and G- individuals in mean systolic and diastolic BP (121.2±14.7 vs 121.2±15.2 mmHg), mean EF (57.3±5 vs 59.1±4%), GLS (−18.2±1.5 vs −18.6±2.9%), mean global work index (1818±403 vs 1928±295 mmHg%) and global constructive work (2192±464 vs 2260±318 mmHg%). However, we found significant reduction of the global work efficiency (GWE) with a GWE of 94.4±2.7% in the G+ versus 95.9±1.6% in the G- individuals (p 0.02). Moreover, the global wasted work (GWW) was increased in the G+ with a GWW of 111±58 mmHg% versus 82±41 mmHg% in the G- individuals (p 0.03). Conclusion DCM gene carriers show, early on, decreased myocardial work efficiency and increased wasted work compared to unaffected family members, which appears to be earlier than other parameters such as EF and GLS. Myocardial work analysis could potentially recognize individuals showing early cardiac involvement and guide closer follow up and early initiation of treatment. Funding Acknowledgement Type of funding source: None

scholarly journals Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 734
Author(s):  
Ivona Djordjevic ◽  
Dragoljub Zivanovic ◽  
Ivana Budic ◽  
Ana Kostic ◽  
Danijela Djeric
Keyword(s):  
Splenic Abscess ◽  
Operative Management ◽  
High Energy ◽  
Significant Difference ◽  
Injury Grade ◽  
Grade Ii ◽  
The Mean ◽  
Non Operative Management ◽  
Grade Iii

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

Impact of cardiac rehabilitation on 3 year outcomes amongst patients after acute coronary syndrome: (ACS) SNAPSHOT ACS follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Redfern ◽  
K Hyun ◽  
D Brieger ◽  
D Chew ◽  
J French ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Data Linkage ◽  
Research Network ◽  
Funding Source ◽  
Cardiovascular Research ◽  
Coronary Syndrome ◽  
Follow Up Study ◽  
Significant Difference

Abstract Background Cardiovascular disease is the leading cause of disease burden globally. With advancements in medical and surgical care more people are surviving initial acute coronary syndrome (ACS) and are in need of secondary prevention and cardiac rehabilitation (CR). Increasing availability of high quality individual-level data linkage provides robust estimates of outcomes long-term. Purpose To compare 3 year outcomes amongst ACS survivors who did and did not participate in Australian CR programs. Methods SNAPSHOT ACS follow-up study included 1806 patients admitted to 232 hospitals who were followed-up by data linkage (cross-jurisdictional morbidity, national death index, Pharmaceutical Benefit Schedule) at 6 and 36 months to compare those who did/not attend CR. Results In total, the cohort had a mean age of 65.8 (13.4) years, 60% were male, only 25% (461/1806) attended CR. During index admission, attendees were more likely to have had PCI (39% v 14%, p&lt;0.001), CABG (11% v 2%, p&lt;0.001) and a diagnosis of STEMI (21% v 5%, p&lt;0.001) than those who did not attend. However, there was no significant difference between CR attendees/non-attendees for risk factors (LDL-cholesterol, smoking, obesity). Only 19% of eligible women attended CR compared to 30% of men (p&lt;0.001). At 36 months, there were fewer deaths amongst CR attendees (19/461, 4.1%) than non-attendees (116/1345, 8.6%) (p=0.001). CR attendees were more likely to have repeat ACS, PCI, CABG at both 6 and 36 months (Table). At 36 months, CR attendees were more likely to have been prescribed antiplatelets (78% v 53%, p&lt;0.001), statins (91% 73%, p&lt;0.001), beta-blockers (11% v 13%, p=0.002) and ACEI/ARBs (72% v 61%, p&lt;0.001) than non-attendees. Conclusions Amongst Australian ACS survivors, participation in CR was associated with less likelihood of death and increased prescription of pharmacotherapy. However, attendance at CR was associated with higher rates of repeat ACS and revascularisation. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): New South Wales Cardiovascular Research Network, National Heart Foundation

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