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To study the correlation between severe oligohydramnios with perinatal outcome along with histopathology of placenta
Get PDFThe aim: To study the correlation between severe oligohydramnios with perinatal outcome and the placenta's histopathology.
Materials and methods: comprised of 100 patients with oligohydramnios diagnosed after 28 weeks of gestation, admitted on an emergency basis, both booked / unbooked, who were willing to cooperate, were chosen. All patients with oligohydramnios (AFI<5 %) were included in the study.
Results: 3 cases came with intra-uterine death. All three were totally unbooked cases. 2 preterm babies died neonatal intensive care unit after 4 days due to meconium aspiration syndrome. Thus the perinatal mortality was 5 %. 44 % of neonates required admission into the neonatal intensive care unit. In our study, it was found that neonatal mortality and morbidity increased significantly when oligohydramnios was associated with complications like IUGR and pregnancy-induced hypertension in mothers. All the cases associated with these histopathological changes had adverse perinatal outcomes. Hence estimation of the amount of liquor is important in the antenatal period because oligohydramnios gives insight into the associated maternal complications or fetal anomalies and has a significant bearing on the perinatal outcome. The placental examination will illuminate all the conditions affecting the perinatal outcome. Without associated complications, oligohydramnios does not have adverse perinatal outcomes.
Conclusions: Thus, in cases of oligohydramnios with no associated complications, expectant management can be tried for a better fetal outcome. Only oligohydramnios may be the first sign of placental insufficiency and an independent manifestation of the placental-related complications spectrum
A study of clinico etiological profile of children with cerebral palsy in a tertiary care centre
Get PDFThe clinical spectrum of Cerebral palsy (CP) can differ in various places depending upon the knowledge of the people and resources for prevention, diagnosis and management. Although studied extensively in high-resource countries, adequate data related to CP from resource-constraint settings are lacking.
The aim: The present study is a descriptive study done on clinical profiles, aetiology, and comorbidities.
Materials and methods: Present study is a hospital-based descriptive study of 80 children with Cerebral Palsy from January 2020 to June 2021 (18 months) admitted to Niloufer Hospital for Child Health, cases chosen as per inclusion criteria guided by "The Definition and classification of cerebral palsy, April 2006 International consensus". Clinical history and clinical examination and necessary investigations using a systematically designed proforma
Results: The most common types were spastic type (78.9 %) and hypotonic type (12.5 %). Spastic quadriparesis (55 %) was the most common among subtypes. Males were more affected than females, with more rural than urban distribution. 48.8 % belonged to the lower middle and 37.5 % to the upper lower class of socio-economic status. Consanguinity was observed in 33 %, and 3 % had a similar family history. A high incidence (65 %) was seen in firstborn children. Term gestation was commonest at 87 % and prematurity at 13 %. 91.3 % of the cases were institutional deliveries. For causes of cerebral palsy, 45 % required resuscitation at birth, 2.5 % had neonatal sepsis, 1.25 % had a cerebral malformation, 7.5 % had an intracranial bleed, 7.5 % had post-meaning encephalitic sequelae, 1.3 % had TORCH infection. Comorbidities Like mental retardation were seen in 90 %, seizure disorder in 87.5 %, visual problems in 24.8 %, hearing problems in 13.75 %, 56.25 % of cases were malnourished.
Conclusions: Comorbidities are significantly observed in cases of cerebral palsy. Appropriate screening and management of comorbidities, especially vision, hearing, speech, seizures, and nutrition, improve the overall prognosis in cases of Cerebral palsy
Spindle cell carcinoma of the breast: a case study report from Mankweng hospital & literature review
Get PDFSpindle cell carcinoma of the breast is a rare breast malignancy, and it accounts for <1 % of breast neoplasms. Tumours are usually large, well-circumscribed, and cystic-containing lesions in the upper outer quadrant of the breast.
The aim: The main objective of the case report is to highlight our experience with Spindle cell carcinoma of the breast.
Result: A case presentation of a 58-year-old female who was referred from the peripheral hospital to our breast oncology clinic with a left breast mass rapidly growing for the past five months. The mass measured 23cm x 20 cm, palpable in all quadrants of the breast but more in the upper outer quadrant of the breast. Mammography and ultrasound showed a massive heterogeneous left breast solid mass involving the entire breast and all quadrants, with areas of cystic components and increased flow. There were no calcifications noted. She was assessed as BI-RAD 5. A core needle biopsy showed spindle cell carcinoma of the left breast. The patient was offered a modified radical mastectomy.
Conclusion: Spindle cell carcinoma of the breast poses a diagnostic challenge due to the rarity of the disease; overlapping morphological features on histology and biomarkers specific to spindle cells have not been extensively studie
Prevalence and major risk factors of non-communicable diseases: a machine learning based cross-sectional study
Get PDFThe aim: The study aimed to determine the prevalence of several non-communicable diseases (NCD) and analyze risk factors among adult patients seeking nutritional guidance in Dhaka, Bangladesh.
Participants: 146 hospitalized adults of both genders aged 18-93 participated in this cross-sectional research.
Methods: We collected the demographic and vital information from 146 hospitalized patients in Dhaka, Bangladesh. We checked the physical and vital parameters, including blood sugar, serum creatinine, blood pressure, and the presence or absence of major non-communicable diseases. Then we used descriptive statistical approaches to explore the NCDs prevalence based on gender and age group. Afterwards, the relationship between different NCD pairs with their combined effects was analyzed using different hypothesis testing at a 95 % confidence level. Finally, the random forest and XGBoost machine learning algorithms are used to predict the comorbidity among the patients with the underlying responsible factors.
Result: Our study observed the relationships between gender, age groups, obesity, and NCDs (DM, CKD, IBS, CVD, CRD, thyroid). The most frequently reported NCD was cardiovascular issues (CVD), which was present in 83.56 % of all participants. CVD was more common in male participants. Consequently, male participants had a higher blood pressure distribution than females. Diabetes mellitus (DM), on the other hand, did not have a gender-based inclination. Both CVD and DM had an age-based progression. Our study showed that chronic respiratory illness was more frequent in middle-aged participants than in younger or elderly individuals. Based on the data, every one in five hospitalized patients was obese. We analyzed the comorbidities and found that 31.5 % of the population has only one NCD, 30.1 % has two NCDs, and 38.3 % has more than two NCDs. Besides, 86.25 % of all diabetic patients had cardiovascular issues. All thyroid patients in our study had CVD. Using a t-test, we found a relationship between CKD and thyroid (p-value 0.061). Males under 35 years have a statistically significant relationship between thyroid and chronic respiratory diseases (p-value 0.018). We also found an association between DM and CKD among patients over 65 (p-value 0.038). Moreover, there has been a statistically significant relationship between CKD and Thyroid (P<0.05) for those below 35 and 35-65. We used a two-way ANOVA test to find the statistically significant interaction of heart issues and chronic respiratory illness in combination with diabetes. The combination of DM and RTI also affected CKD in male patients over 65 years old. Among machine learning algorithms, XGBoost produced the highest accuracy, 69.7 %, in comorbidity detection. Random forest feature importance detected age, weight and waist-hip ratio as the major risk factors behind the comorbidity.
Conclusion: The prevalence study helps to identify the future risks and most vulnerable groups. By initiating and implementing control plans based on the prevalence study, it is possible to reduce the burden of NCDs on the elderly and middle-aged population of Bangladesh
Impact of low birth weight and breastfeeding practices on the nutritional status of children aged 2 to 5 years in the slums
Get PDFMalnutrition among children in developing countries is a major public health problem, especially in India. Inappropriate feeding practices, in combination with other causes such as infection and food shortage, may be responsible for 1/3rd of malnutrition. Moreover, the risk of mortality is inversely related to children's height-for-age and weight-for-height.
The aim: To assess the nutritional status of children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati and to determine the impact of low birth weight, breastfeeding practices and other related factors on the nutritional status of the above study population.
Materials and methods: This is a community-based observational cross-sectional study conducted among 282 children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati. Socio-demographic data, Birth history, breastfeeding practices and anthropometric measurements were noted in the study questionnaire. Nutritional status was determined using HAZ, WHZ and WAZ scores of WHO child growth standards. Data was entered and analyzed using IBM SPSS Statistics 26 version to test for association between categorical variables, and a p-value < 0.05 was considered statistically significant.
Results: A total of 282 school children with mean age of 39.9 (+10.4) months participated in the study, of which 132 (46.8 %) were boys and 150 (53.2 %) were girls. This study observed exclusive breastfeeding in 193 (68.4 %) children. Prevalence of stunting, wasting and being underweight were 22 %, 12.4 % and 23.8 %, respectively. A statistically significant association was found between stunting (p=0.006) and underweight (p=0.001) with low birth weight children.
Conclusions: The present study revealed a high prevalence of malnutrition, especially stunting, a common outcome of long-term malnutrition among young children. Low birth weight and inappropriate breastfeeding practices result in long-term adverse consequences on the nutrition of preschool children, which should be prevented through appropriate strategies
Comparison of serum copper levels between coronary artery disease patients and normal individuals: a case-control study
Get PDFCardiovascular diseases (CVD) are the leading causes of death in technologically developed and developing countries. Copper, an active redox element, is involved in energy production through various mechanisms. Copper and coronary artery disease can be associated directly, through its direct effect on the vascular endothelium, or indirectly through lipoprotein metabolism. Hence an evaluation of copper in the coronary artery disease individual is important.
The aim is to compare the relationship of serum copper levels between coronary artery disease patients and control individuals based on age, sex, hypertension and diabetes mellitus.
Materials and methods: The study design was a case-control study in which proven coronary artery disease patients attending cardiology OPD were selected as cases. Control individuals were mainly selected from the master health check-up. Serum copper levels, plasma glucose, cholesterol, serum triglycerides, and serum HDL & LDL cholesterol were done. Glycated haemoglobin (HbA1C) was also measured. The data were analyzed using IBM SPSS software version 24.
Result: The correlation of serum copper level with other quantitative parameters is determined by calculating Pearson’s correlation coefficient among cases and controls.
Conclusion: The serum copper level is significantly (p=0.001) higher in CAD patients than in age, sex, DM, and HT-matched controls. The serum copper level has a significant (p=0.001) effect on disease, and the adjusted odds ratio is 1.032 (CI 1.011–1.054). In addition, the serum copper level has a significant (0.01) negative correlation with LDL cholesterol and total cholesterol
Determination of the relationship of visphatin and homocysteine levels with indicators of glucose metabolism and lipid metabolism in peri- and postmenopause women with type 2 diabetes mellitus and osteoarthritis
Get PDFType 2 diabetes mellitus (T2DM), among other modern diseases, certainly occupies a leading position today. Moreover, the comorbid combination of T2DM and osteoarthritis (OA) is a common example of the development of complications, disability and mortality these days. As you know, T2DM develops against the background of obesity and overweight. A significant group of patients prone to these pathologies are peri- and postmenopausal women. Estrogen deficiency during this period worsens the course of these interdependent conditions. Therefore, searching for ways of early diagnosis of OA in women with T2DM is an urgent task of internal medicine.
Purpose. To determine the interdependencies of indicators of glucose metabolism and lipid metabolism with levels of visfatin (VF) and homocysteine (HC) in women with T2DM and OA in peri- and postmenopause.
Methods. For the study, 120 thematic women in peri- and postmenopause were selected and were divided into three groups: 1st (n=20) - women with a mono-course of T2DM; 2nd (n=20) – with a mono-course of OA; 3rd (n=64) – with the comorbid course of T2DM and OA. The control group (CG) consisted of 16 relatively healthy women of the appropriate age. Diagnoses of T2DM and OA were established in accordance with the current Orders of the Ministry of Health of Ukraine. Laboratory diagnostic methods were performed according to standard methods.
The results. According to the obtained results, the presence of interdependencies of all indicators of lipid metabolism and glucose-insulin metabolism was reliably determined, which indicated direct correlations (mostly of moderate strength) with the levels of HC and VF in the blood of the examinees, most pronounced in the comorbid combination of T2DM and OA in peri- and postmenopause.
Conclusions. In work, an analysis of the correlations of indicators of glucose metabolism and lipid metabolism with disturbances in the metabolism of VF and HC in women with T2DM and OA in pre- and postmenopause was carried out, and their interdependent relationships were determined. The highest levels of VF and HC were recorded in the group of women with comorbid pathology of T2DM and OA
COVID-19 transmission in dental practice: risks and prevention – narrative review
Get PDFDentists are on the frontline of infection, especially regarding respiratory viruses like the new coronavirus. The production of aerosols and droplets accompanies many dental procedures. The emergence of severe acute air-droplet disease, respiratory syndrome, or SARS, warrants a revision of the infection control procedures for aerosols.
The aim. In this article, we aim to raise awareness of the potential risks of COVID-19 transmission in dental practice and discuss and suggest some preventive measures.
Methods. This study reviewed the published research articles and the guidelines of international healthcare institutions on dentistry and COVID-19. We searched Pubmed, Web of Science, and SCOPUS electronic databases using MESH terms.
Results. The main way of transmission of the SARS CoV is air-droplet. Thus, healthcare professionals that perform aerosol-generating procedures, i.e. dentists, need to be updated about the origin of the disease. The patient and the dentist often share close contact while ongoing dental treatment; thus, knowledge about the disease and necessary preventive measures is required. In addition to the standard precautions, some special preventive measures that should be implemented during an outbreak of disease have been raised in this review.
Conclusions. Following the protective protocols in the COVID-19 crisis is of utmost importance in a dental settin
Changing trends in the clinical profile of childhood in tuberculosis patients -at a tertiary centre
Get PDFThe aim: To study the clinical profile of childhood tuberculosis in the age group of 6 months to 12 years.
Materials and methods: This сross-sectional study was conducted on patients of tuberculosis who were admitted for treatment. A total of 75 patients were enrolled in the study who are of age group: 6 months to 12 years and Stengen score>3.
Results: Approximately 50 % of the study population was under 5 years. 39 % belonged to the age group of 8–12 years. The male-to-female ratio was 1:1.02. 36 % of the study population belonged to the lower class. 33.33 % of the study population belonged to the middle class. One-quarter of the patients were not malnourished. Among the ones who were malnourished, 36 % belonged to Grade I, and 53.33 % had a Stengen score of 5–6. 46.66 % had a Stengen score of 46.66 %. Acid Fast Bacilli in 1.33 %, 18.66 % had tubercle present, 82.66 % had Mantoux positive, which was >10mm, and 62.66 % of them had suggestive radiology of tuberculosis, where the fever was present in 90 % of the study population. Fever with <2 weeks duration was present in 52 %, and the rest had a fever for more than two weeks. Cough was present in 77 % of the study population. Weight loss was present in 37.33 %. 22.66 % had pulmonary tuberculosis, and 77.33 % had extrapulmonary tuberculosis. Among extrapulmonary tuberculosis, lymphadenopathy was the common manifestation. It was present among 40 % of the study population. It includes cervical lymphadenopathy among 24 %, axillary lymph node involvement among 12 %, Sub mandibular lymph node among 2.66 % and supra clavicular in 1.33 %. The other manifestations of extrapulmonary tuberculosis include pleural effusion, the second most common one present among 29.33 % of the study population.
Conclusion: There is an urgent need for a systematic approach to determining the prevalence and incidence of M. tuberculosis infection among children. This has to become the cornerstone of TB control and of assessing the change in the trend of infection over time in the community until it reaches the required goa
Improvement of the scheme of preventive and treatment measures for associated respiratory infections in cats
Get PDFThe aim of the research was to study the etiological structure of associated infectious rhinotracheitis in cats. It has been established that infectious rhinotracheitis is registered among cats in association with infectious diseases of bacterial aetiology.
Materials and methods. The research was conducted based on a private veterinary clinic in the city of Kharkiv in 2021–2023. A total of 48 cats with signs of respiratory tract damage were examined in the clinic. Samples for laboratory diagnosis were obtained by oropharyngeal swab and transnasal lavage. To confirm the laboratory diagnosis of infectious rhinotracheitis in cats, we used the PCR method (using the Rynovir test system), as well as rapid IXA tests (FHV Ag) manufactured by ASAN PHARM (China) or ZRbio (China). To detect specific antibodies, the method of serological (retrospective) ELISA diagnostics was used using the immunoComb Feline VacciCheck device-free ELISA test system manufactured by Biogal, Israel. Bacteriological studies were carried out according to well-known methods using special nutrient media for the selection and identification of associated bacterial microflora. The sensitivity of selected dominant cultures of bacteria to antibiotics was determined by diffusion in agar using discs containing antibiotics.
Results. It was investigated that Bordetella bronchiseptica was determined as the dominant pathogen in the bacterial association – 52.0 %. Isolated cultures of Bordetella bronchiseptica were sensitive to cefamycin. The proposed science-based scheme for the treatment of infectious rhinotracheitis in association with feline bordetelliosis ensures high therapeutic efficiency.
Conclusions. For the treatment of infectious respiratory diseases in cats, it is necessary to carry out individual complex etiotropic, pathogenetic and symptomatic therapy. Homoeopathic therapy relieves the symptoms of the disease, promotes faster recovery, and is an addition to the main methods of treatment. The main specific measure of disease prevention is timely vaccination (inoculation), the effectiveness of which, according to our research, ranges from 71 % to 100 %