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2022 ◽  
Vol 19 (1) ◽  
pp. 89-91
Author(s):  
Kamar Jahan ◽  
Binod Kumar Mahaseth

Introduction: Foetal death at any stage of pregnancy is not just a tragic event but also a more traumatic for the mental well-being of a mother. It is one of the most wrenching events in the field of obstetrics. Aims: The study was done to determine the probable risk factors of intrauterine foetal death and role of antenatal care in its prevention. Methods: The study was conducted  in Obstetrics and Gynecology department at Nepalgunj Medical college from July 2018 to July 2020 .Inclusion criteria were  intrauterine fetal death  of >28 weeks of gestation and baby weighing  1000 grams or more . An exclusion criterion was molar pregnancy. Results: There were 115(3.52%) intrauterine fetal death during the study period, making it 35 per 1000 cases. In 17(14.78%) the cause of intrauterine fetal death was not known. The other common associated risk factors were prematurity in 14(12.17%) and hypertension in 13(11.30%). Similarly anemia and antepartum hemorrhage were seen in 13(11.30%) each. 11(9.56%) patients had oligohydramnios. Mal presentation was found in 8(6.95%) patients while polyhydromnios in 6(5.21%).The commonest age range in whom intrauterine fetal death was seen was 20-30 (73.90%). 28 (24.34%) patients were at preterm pregnancy ranging between 28-30 weeks whereas 17(14.78) intrauterine fetal death occured at  32-34 weeks. 77 foetuses were preterm and their birth weight was between 1 - 1.5 kg  with the mean wt of  1175.73 gms. Conclusion: Intrauterine fetal death is still common inspite of the improving awareness in importance of regular antenatal care. In majority, the cause of intrauterine fetal death is still unknown. However, where the cause was known prematurity was the commonest.


Liver Cancer ◽  
2022 ◽  
Author(s):  
Sabrina Welland ◽  
Catherine Leyh ◽  
Fabian Finkelmeier ◽  
André Jefremow ◽  
Kateryna Shmanko ◽  
...  

Background Lenvatinib is approved as first-line treatment for patients with advanced hepatocellular carcinoma (HCC). The efficacy of lenvatinib in Caucasian real-world patients is insufficiently defined. The purpose of this study was to evaluate the efficacy of lenvatinib in a multi-center cohort (ELEVATOR) from Germany and Austria. Methods A retrospective data analysis of 205 patients treated with first-line systemic lenvatinib at 14 different sites was conducted. Overall survival, progression free survival, overall response rate and adverse event rates were assessed and analyzed. Results Patients receiving lenvatinib in the real-world setting reached a median overall survival of 12.8 months, which was comparable to the results reported from the REFLECT study. Median overall survival (mOS) and progression free survival (mPFS) was superior in those patients who met the inclusion criteria of the REFLECT study compared to patients who failed to meet the inclusion criteria (mOS 15.6 vs 10.2 months, HR 0.55, 95% CI 0.38-0.81, p=0.002; mPFS 8.1 vs 4.8 months HR 0.65, 95% CI 0.46-0.91, p=0.0015). For patients with an impaired liver function according to the Albumin-Bilirubin (ALBI) grade, or reduced ECOG performance status ≥2, survival was significantly shorter compared to patients with sustained liver function (ALBI grade 1) and good performance status (ECOG performance status 0), respectively (HR 1.69, 95% CI 1.07-2.66, p=0.023; HR 2.25, 95% CI 1.19-4.23, p=0.012). Additionally, macrovascular invasion (HR 1.55, 95% CI 1.02-2.37, p=0.041) and an AFP ≥200 ng/mL (HR 1.56, 95% CI 1.03-2.34, p=0.034) were confirmed as independent negative prognostic factors in our cohort of patients with advanced HCC. Conclusion Overall, our data confirm the efficacy of lenvatinib as first-line treatment and did not reveal new or unexpected side effects in a large retrospective Caucasian real-world cohort, supporting the use of lenvatinib as meaningful alternative for patients that cannot be treated with IO-based combinations in first-line HCC.


2022 ◽  
Author(s):  
Natalie Clinkscales ◽  
Katherine Berlouis ◽  
Lisa Golds ◽  
Angus MacBeth

Background: Anxiety disorders are a relatively common occurring mental health issue during pregnancy and the perinatal period. There is evidence that untreated perinatal anxiety is a risk factor for adverse outcomes for mother and infant. Despite their potential acceptability to users, psychological interventions research for this population is still in its infancy. This systematic review and meta-analysis aimed to comprehensively evaluate the evidence of the effectiveness of psychological interventions for reducing perinatal anxiety. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included EMBASE, MEDLINE, PsychINFO, MIDIRS, CINAHL and the Cochrane Library. Search terms included: Psychological Therapy, Perinatal Period, Antenatal, Postnatal, Anxiety, Obsessive Compulsive Disorder and Phobia. Results: The search strategy identified 2025 studies. A total of 21 studies published between 2004 and 2021 fulfilled inclusion criteria. Of those, 17 were included in the meta-analysis. Overall results indicated that psychological interventions were more effective than control conditions in reducing symptoms of perinatal anxiety with a medium post treatment effect size. Significant effect sizes were also identified for online, face-to-face, group and guided self-help treatment modalities. Limitations: A small sample of studies are represented and limited to articles published in English. The review was unable to draw specific conclusions about what works (i.e. therapeutic modality/delivery) for whom (i.e. specific diagnoses) due to purposefully broad inclusion criteria. The longer-term effects of psychological interventions for perinatal anxiety and infant outcomes could not be established. Conclusions: This review demonstrates that psychological interventions are effective in reducing symptoms of both anxiety and comorbid anxiety and depression in the antenatal and postnatal periods. The results also demonstrate the efficacy of delivering such interventions in multiple settings, including online, and in group format. Further research is required to optimise treatment delivery to individual needs.


2022 ◽  
Vol 8 (12) ◽  
pp. 408-411
Author(s):  
Tripti Sharma ◽  
Mohit Ajmera ◽  
Gopikishan Sharma ◽  
Amrita Mayenger

Objectives: The objectives of the study were to study the effect of different stages of lumber puncture (LP) procedure on oxygen saturation (SpO2) in newborn baby. Materials and Methods: It was a 1-year, prospective observational study conducted in a tertiary care hospital. Forty neonates were included who fulfilled the inclusion criteria. SpO2 was measured during the different stages of LP in the recruited newborns and comparison was done between SpO2 changes in LP duration of <5 min and more than 5 min groups and the effect on SpO2 in preterm and term babies during LP. Results: Mean SpO2 during baseline, flexion, needle insertion, immediate repositioning, and 5 min after procedure were 94.5, 91.82, 88.92, 94.7, and 95.38, respectively. When compare to baseline, drop in SpO2 was found during flexion and needle insertion with p = 0.0025 and <0.0001, respectively. While comparing Mean SpO2 during different phases between duration of LP >5 min versus <5 min group, the saturation was less during flexion positioning with maximum fall at the time of needle insertion in LP duration >5 min. The regain of saturation during repositioning was more in LP <5 min versus duration >5 min group. Comparing between LP duration >5 min versus <5 min group, fall in SpO2 from baseline (5 min before LP procedure) was more in LP duration >5 min group during flexion and needle insertion phase. Hypoxemia is more in preterm than term neonates during flexion and during needle insertion, supine repositioning. Furthermore, hypoxia recovered after 5 min of supine repositioning more in term infants. Conclusions: Significant hypoxia was associated in newborn in flexion and needle insertion phase of lumbar puncture, especially in preterm newborns and those with prolonged duration of procedure.


Author(s):  
Biya Tang ◽  
Kirsten Barnes ◽  
Andrew Geers ◽  
Evan Livesey ◽  
Ben Colagiuri

Abstract Background Choice has been proposed as a method of enhancing placebo effects. However, there have been no attempts to systematically evaluate the magnitude, reliability, and moderators of the influence of choice on the placebo effect. Purpose To estimate the effect size of choice on the placebo effect and identify any moderators of this effect. Methods Web of Science, PsycINFO, EMBASE, and PubMed were systematically searched from inception to May 2021 for studies comparing placebo treatment with any form of choice over its administration (e.g., type, timing) to placebo treatment without choice, on any health-related outcome. Random-effects meta-analysis was then used to estimate the effect size associated with the influence of choice on the placebo effect. Meta-regression was subsequently employed to determine the moderating effect of factors such as type of choice, frequency of choice, and size of the placebo effect without choice. Results Fifteen independent studies (N = 1,506) assessing a range of conditions, including pain, discomfort, sleep difficulty, and anxiety, met inclusion criteria. Meta-analysis revealed that choice did significantly enhance the placebo effect (Hedges’ g = 0.298). Size of the placebo effect without choice was the only reliable moderator of this effect, whereby a greater effect of choice was associated with smaller placebo effects without choice. Conclusions Treatment choice can effectively facilitate the placebo effect, but this effect appears more pronounced in contexts where the placebo effect without choice is weaker. Because most evidence to date is experimental, translational studies are needed to test whether providing choice in clinical scenarios where placebo effects are weaker may help boost the placebo effect and thereby improve patient outcomes.


Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 294
Author(s):  
Adyya Gupta ◽  
Laura Alston ◽  
Cindy Needham ◽  
Ella Robinson ◽  
Josephine Marshall ◽  
...  

The aim of this systematic review of reviews was to synthesise the evidence on factors influencing the implementation, sustainability and scalability of food retail interventions to improve the healthiness of food purchased by consumers. A search strategy to identify reviews published up until June 2020 was applied to four databases. The Risk of Bias in Systematic Review tool was used. Review findings were synthesised narratively using the socio-ecological model. A total of 25 reviews met the inclusion criteria. A number of factors influenced implementation; these included retailers’ and consumers’ knowledge and preferences regarding healthy food; establishing trust and relationships; perceived consumer demand for healthy food; profitability; store infrastructure; organizational support, including resources; and enabling policies that promote health. Few reviews reported on factors influencing sustainability or scalability of the interventions. While there is a large and rapidly growing body of evidence on factors influencing implementation of interventions, more work is needed to identify factors associated with their sustainability and scalability. These findings can be used to develop implementation strategies that consider the multiple levels of influence (individual, intrapersonal and environmental) to better support implementation of healthy food retail interventions.


2022 ◽  
Vol 15 ◽  
Author(s):  
Valeriy Shafiro ◽  
Nathan Luzum ◽  
Aaron C. Moberly ◽  
Michael S. Harris

Objectives: Improved perception of environmental sounds (PES) is one of the primary benefits of cochlear implantation (CI). However, past research contains mixed findings on PES ability in contemporary CI users, which at times contrast with anecdotal clinical reports. The present review examined extant PES research to provide an evidence basis for clinical counseling, identify knowledge gaps, and suggest directions for future work in this area of CI outcome assessment.Methods: Six electronic databases were searched using medical subject headings (MeSH) and keywords broadly identified to reference CI and environmental sounds. Records published between 2000 and 2021 were screened by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to identify studies that met the inclusion criteria. Data were subsequently extracted and evaluated according to synthesis without-meta-analysis (SWiM) guidelines.Results: Nineteen studies met the inclusion criteria. Most examined PES in post-lingually implanted adults, with one study focused on pre/perilingual adults. Environmental sound identification (ESI) in quiet using open- or closed-set response format was most commonly used in PES assessment, included in all selected studies. ESI accuracy in CI children (3 studies) and adults (16 studies), was highly variable but generally mediocre (means range: 31–87%). Only two studies evaluated ESI performance prospectively before and after CI, while most studies were cross-sectional. Overall, CI performance was consistently lower than that of normal-hearing peers. No significant differences in identification accuracy were reported between CI candidates and CI users. Environmental sound identification correlated in CI users with measures of speech perception, music and spectro-temporal processing.Conclusion: The findings of this systematic review indicate considerable limitations in the current knowledge of PES in contemporary CI users, especially in pre/perilingual late-implanted adults and children. Although no overall improvement in PES following implantation was found, large individual variability and existing methodological limitations in PES assessment may potentially obscure potential CI benefits for PES. Further research in this ecologically relevant area of assessment is needed to establish a stronger evidence basis, identify CI users with significant deficits, and improve CI users' safety and satisfaction through targeted PES rehabilitation.


2022 ◽  
Vol 12 ◽  
Author(s):  
Shudian Cao ◽  
Soh Kim Geok ◽  
Samsilah Roslan ◽  
He Sun ◽  
Soh Kim Lam ◽  
...  

Mental fatigue (MF) is a psycho-biological state that impairs sports-related performances. Recently, it has been proved that MF can affect basketball performance. However, a systematic overview detailing the influences of MF on basketball performance is still lacking. This study aims to investigate the effects of MF on the physical, technical, tactical, and cognitive performance of basketball. We used the databases of PubMed, Web of Science, SPORTDiscus, Scopes, and CKNI for articles published up to 31 May 2021. The articles included in this study were projected to test whether MF influences basketball athlete performance. Only experimental design studies were selected, and the control condition was without MF. Finally, seven articles fit the inclusion criteria. The results imply that MF impairs the technical aspects of basketball (free throws, three-point shots, and total turnover) and the players' cognitive [take-the-first (TTF) heuristics and decision-making] performance, which results in athletes not using their techniques skillfully and being unable to make practical decisions during critical points in the game. In addition to that, the influences of MF on physical and tactical performance have not been studied. Further studies should look into comprehensive research on the influences of MF on basketball performance, especially on a player's physical and tactical performance.Systematic Review Registration: [https://inplasy.com/] [INPLASY2021100017].


F1000Research ◽  
2022 ◽  
Vol 10 ◽  
pp. 1262
Author(s):  
Jean Noronha ◽  
Stephen Samuel ◽  
Vijay Pratap Singh ◽  
H Shivananda Prabhu

Background: Prehabilitation is a therapeutic strategy involving preoperative physical exercises, nutritional support, and stress and anxiety reduction. This approach has been gaining popularity and has been seeing effective results in adults in terms of improving pre and postoperative outcomes. The purpose of this review was to summarise the evidence about the effects of exercise-based prehabilitation programs on various outcome measures in children post elective surgeries.­­ Methods: PubMed, Scopus, Web of Science, PEDro, CINAHL/EBSCO and EMBASE electronic databases were searched from inception to June 2021. Based on the inclusion criteria, titles and abstracts were independently screened by the authors. After that, a data extraction table of the selected studies which included the participants, type, and details of exercise intervention, outcome measures and results were analysed after which the quality assessment of the studies was done. Results: The search yielded 2219 articles of which three articles fulfilled the inclusion criteria with two studies being randomized controlled trials and one being a quasi-experimental pre-post type of study. One randomized controlled trial was on the effects of exercise-based prehabilitation in reducing pulmonary complications post cardiac surgeries in children and the other two studies were on the effects of prehabilitation on functional capacity & pulmonary function. All the three articles found that exercise-based prehabilitation had a positive effect on children’s post-surgery. Conclusion: Although there is a paucity of evidence-based literature, we conclude based on the existing literature retrieved by our review that exercise-based prehabilitation improves postoperative outcomes and helps in reducing postoperative complications in children undergoing various surgeries.


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