Pub Date : 2020-01-01DOI: 10.35248/2161-10932.2020.10.527
Swati Jain
Background: Pregnancy is a dynamic physiological state evidenced by several transient changes which even affects the oral cavity. Present study was conducted with an aim to assess the changing patterns of gingivitis and periodontitis in different trimesters of pregnancy amongst pregnant and non pregnant women attending the outpatient Department of Government Hospitals in Delhi, India. Methodology: A total sample size of 800 pregnant and 800 non-pregnant women attending the O.P.D of 4 Government Hospitals of Delhi was obtained through Stratified Cluster Sampling Technique. A structured pretested assessment form was used to assess the gingival, periodontal and oral hygiene status using Gingival Index (GI), Community Periodontal Index (CPI) and Loss of Attachment (LOA) and Oral Hygiene Index-Simplified (OHI-S). Statistical analysis was done using SPSS v16.0 software package. Results: Mean GI scores was significantly high for pregnant women than non pregnant women (1.57 ± 0.51, 1.48 ± 0.35 respectively, p<0.001) and was more in 2nd trimester (1.73 ± 0.42) and 3rd trimester (1.75 ± 0.45) as compared to 1st trimester of pregnancy (1.25 ± 0.48) (p=0.001). Maximum CPI code 3 was seen in 14.6% of pregnant subjects and 8.1% of non pregnant subjects (p-0.001). Mean OHI-S score for pregnant and non-pregnant subjects was 2.89 ± 0 and 2.60 ± 1.07 respectively (p=0.002). Oral Hygiene status also worsened with increase in trimester of pregnancy, (p=0.001). Conclusion: Prevalence of the Gingival and Periodontal disease was significantly high among pregnant women and worsened with increasing gestation age Hence it is necessary to reinforce knowledge about significance of oral health in pregnant women by means of appropriate preventive and educational programs.
{"title":"Changing Pattern of Gingivitis and Periodontitis in Different Trimesters amongPregnant Women Comparing. The Same with Non Pregnant Women Attendingthe Government Hospitals in Delhi","authors":"Swati Jain","doi":"10.35248/2161-10932.2020.10.527","DOIUrl":"https://doi.org/10.35248/2161-10932.2020.10.527","url":null,"abstract":"Background: Pregnancy is a dynamic physiological state evidenced by several transient changes which even affects the oral cavity. Present study was conducted with an aim to assess the changing patterns of gingivitis and periodontitis in different trimesters of pregnancy amongst pregnant and non pregnant women attending the outpatient Department of Government Hospitals in Delhi, India. Methodology: A total sample size of 800 pregnant and 800 non-pregnant women attending the O.P.D of 4 Government Hospitals of Delhi was obtained through Stratified Cluster Sampling Technique. A structured pretested assessment form was used to assess the gingival, periodontal and oral hygiene status using Gingival Index (GI), Community Periodontal Index (CPI) and Loss of Attachment (LOA) and Oral Hygiene Index-Simplified (OHI-S). Statistical analysis was done using SPSS v16.0 software package. Results: Mean GI scores was significantly high for pregnant women than non pregnant women (1.57 ± 0.51, 1.48 ± 0.35 respectively, p<0.001) and was more in 2nd trimester (1.73 ± 0.42) and 3rd trimester (1.75 ± 0.45) as compared to 1st trimester of pregnancy (1.25 ± 0.48) (p=0.001). Maximum CPI code 3 was seen in 14.6% of pregnant subjects and 8.1% of non pregnant subjects (p-0.001). Mean OHI-S score for pregnant and non-pregnant subjects was 2.89 ± 0 and 2.60 ± 1.07 respectively (p=0.002). Oral Hygiene status also worsened with increase in trimester of pregnancy, (p=0.001). Conclusion: Prevalence of the Gingival and Periodontal disease was significantly high among pregnant women and worsened with increasing gestation age Hence it is necessary to reinforce knowledge about significance of oral health in pregnant women by means of appropriate preventive and educational programs.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"22 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85152640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-0932.2020.10.520
Adela Stoenescu, T. Friedl, N. Degregorio, F. Reister, A. Polasik, W. Janni, F. Ebner
ABSTRACT Background: Twin pregnancies continue to be associated with increased perinatal morbidity and mortality. The aim of this study is to describe our experience with twin deliveries and provide this data as reference. Methods: In this retrospective study, twin deliveries occurring after 22+0 weeks of gestational age in the Department of Obstetrics and Gynecology, University Hospital Ulm were analyzed. 1663 datasets (including 3326 children) were available for analysis. Results: Over time there was an average of 83 twin births per year (median 80, range 56 - 104) in our department, with a significant increase in the number of twin births per year over time (n = 20, rs = 0.821, p < 0.001). The average maternal age was 31 years (range 17 - 47), and in the time frame maternal age significantly increased (rs = 0.167, p < 0.001). The median gestational age at delivery was 35 weeks (range 22+0 - 42+0 weeks). Overall, 400 (20.1%) twin births had a planned/elective cesarean section (C/S). In 575 (34.6%) cases both twins were delivered vaginally and in 641 (38.5%) cases both twins were delivered by secondary (unplanned / emergency) C/S. In 47 (2.8%) cases, the first twin was born vaginally, and the second twin by secondary C/S. Of the 575 vaginal twin births, both twins were born spontaneously in 471 (81.9%) and by assisted vaginal delivery in 24 (4.2%) cases. In 53 (9.2%) cases the first twin was born by assisted vaginal delivery while the second twin was born spontaneously, and for 27 (4.7%) twin births this pattern was reversed. Conclusions: The optimal mode of delivery of twins is still a subject of continuing debate. Though the database provides very detailed information on the delivery it is not possible to draw clinical conclusions from our results as these need to be evaluated in prospective randomized trials. Keywords: Gemini, Twin, Delivery, Outcome, Retrospective, Pregnancies
背景:双胎妊娠继续与围产期发病率和死亡率增加相关。本研究的目的是描述我们对双胞胎分娩的经验，并提供这些数据作为参考。方法:回顾性分析乌尔姆大学医院妇产科22+0周后分娩的双胞胎。1663个数据集(包括3326名儿童)可用于分析。结果:随着时间的推移，我科每年平均有83例双胞胎出生(中位数80例，范围56 ~ 104例)，随着时间的推移，每年双胞胎出生的数量显著增加(n = 20, rs = 0.821, p < 0.001)。产妇平均年龄为31岁(17 ~ 47岁)，在时间范围内产妇年龄显著增加(rs = 0.167, p < 0.001)。分娩时中位胎龄为35周(22+0 - 42+0周)。总体而言，400例(20.1%)双胞胎采用了计划/选择性剖宫产术(C/S)。575例(34.6%)双胎均为顺产，641例(38.5%)双胎均为二次(计划外/紧急)剖腹产。47例(2.8%)中，第一个双胞胎是顺产的，第二个双胞胎是继发性C/S。在575例阴道分娩的双胞胎中，471例(81.9%)为自然分娩，24例(4.2%)为辅助阴道分娩。在53例(9.2%)病例中，第一个双胞胎是通过辅助阴道分娩出生的，而第二个双胞胎是自然出生的，在27例(4.7%)双胞胎中，这种模式是相反的。结论:双胞胎的最佳分娩方式仍然是一个持续争论的主题。虽然数据库提供了非常详细的分娩信息，但由于需要在前瞻性随机试验中进行评估，因此不可能从我们的结果中得出临床结论。关键词:双子座，双胞胎，分娩，结局，回顾性，妊娠
{"title":"A Single-Center Cohort Study on 1663 Twin Births from Two Decades: Descriptive Statistics and General Trends","authors":"Adela Stoenescu, T. Friedl, N. Degregorio, F. Reister, A. Polasik, W. Janni, F. Ebner","doi":"10.35248/2161-0932.2020.10.520","DOIUrl":"https://doi.org/10.35248/2161-0932.2020.10.520","url":null,"abstract":"ABSTRACT Background: Twin pregnancies continue to be associated with increased perinatal morbidity and mortality. The aim of this study is to describe our experience with twin deliveries and provide this data as reference. Methods: In this retrospective study, twin deliveries occurring after 22+0 weeks of gestational age in the Department of Obstetrics and Gynecology, University Hospital Ulm were analyzed. 1663 datasets (including 3326 children) were available for analysis. Results: Over time there was an average of 83 twin births per year (median 80, range 56 - 104) in our department, with a significant increase in the number of twin births per year over time (n = 20, rs = 0.821, p < 0.001). The average maternal age was 31 years (range 17 - 47), and in the time frame maternal age significantly increased (rs = 0.167, p < 0.001). The median gestational age at delivery was 35 weeks (range 22+0 - 42+0 weeks). Overall, 400 (20.1%) twin births had a planned/elective cesarean section (C/S). In 575 (34.6%) cases both twins were delivered vaginally and in 641 (38.5%) cases both twins were delivered by secondary (unplanned / emergency) C/S. In 47 (2.8%) cases, the first twin was born vaginally, and the second twin by secondary C/S. Of the 575 vaginal twin births, both twins were born spontaneously in 471 (81.9%) and by assisted vaginal delivery in 24 (4.2%) cases. In 53 (9.2%) cases the first twin was born by assisted vaginal delivery while the second twin was born spontaneously, and for 27 (4.7%) twin births this pattern was reversed. Conclusions: The optimal mode of delivery of twins is still a subject of continuing debate. Though the database provides very detailed information on the delivery it is not possible to draw clinical conclusions from our results as these need to be evaluated in prospective randomized trials. Keywords: Gemini, Twin, Delivery, Outcome, Retrospective, Pregnancies","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82507564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.2020.10.526
F. Ebner, M. Tzschaschel, N. Gregorio, A. D. Gregorio, J. Schütze, Miriam Deniz
Background: Birth can be a high-risk situation requiring identification of potential complications and decisive action. Identifying times of increased risk with respect to working patterns is important to optimise quality and safety. The umbilical cord pH and the 1-minute APGAR score are evaluated predictive parameters for the neonatal outcome. Aberrant values may be related to many factors, including special circumstances during birth. Objectives: In this study, we checked the data of our hospital to find out, whether the day, the time of birth, as well as the Hand Over Times (HOT), may be correlated to conspicuous findings. Methods: This retrospective cohort study included deliveries of 20 years. The impaired fetal outcome was defined as pH values 6. Conclusion: These results demonstrate a high standard of care during the different days, times, and HOT over the last decades despite an increased workload. As the neonatal outcome depends on various factors, further studies are necessary to improve the working environment
{"title":"Do Organisational Circumstances In the Birth Ward Influence Perinatal Outcome? A Retrospective Analysis of Over 43.000 Deliveries","authors":"F. Ebner, M. Tzschaschel, N. Gregorio, A. D. Gregorio, J. Schütze, Miriam Deniz","doi":"10.35248/2161-10932.2020.10.526","DOIUrl":"https://doi.org/10.35248/2161-10932.2020.10.526","url":null,"abstract":"Background: Birth can be a high-risk situation requiring identification of potential complications and decisive action. Identifying times of increased risk with respect to working patterns is important to optimise quality and safety. The umbilical cord pH and the 1-minute APGAR score are evaluated predictive parameters for the neonatal outcome. Aberrant values may be related to many factors, including special circumstances during birth. Objectives: In this study, we checked the data of our hospital to find out, whether the day, the time of birth, as well as the Hand Over Times (HOT), may be correlated to conspicuous findings. Methods: This retrospective cohort study included deliveries of 20 years. The impaired fetal outcome was defined as pH values 6. Conclusion: These results demonstrate a high standard of care during the different days, times, and HOT over the last decades despite an increased workload. As the neonatal outcome depends on various factors, further studies are necessary to improve the working environment","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"16 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78907263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-0932.2020.10.521
B. Marta, J. Winiecki, T. Nowikiewicz, A. Makarewicz
Purpose: Patients with advanced cervical cancer require interdisciplinary therapeutic treatment, after detailed diagnostics (CT, MR and also PET/CT), due to the high risk of metastases to the pelvic lymph nodes and/or paraaortic lymph nodes as well as supraclavicular region. Aim: The aim of this retrospective study was to assess the response to treatment in women with cervical cancer with metastases to the para-aortic lymph nodes given radiotherapy or radiochemotherapy Material and Methods: The study was conducted in 40 cervical cancer patients with para-aortic lymph node metastases undergoing radiation therapy with/whitout concomitantly a cisplatin-based chemotherapy. Subsequently, total doses were set for pelvic lymph nodes and para-aortic lymph nodes, and were between 45 and 50.4Gy with dose increase to the tumor and metastatic lymph nodes for a total dose of 48.6-60Gy in 1.8 to 2.0Gy fractionation. Results: The analysis of overall survival demonstrates that OS was significantly longer in patients with local reccurence (p=0.0165) or distant metastases (p=0.0266) as compared to patients without reccurence or dissemination. An effect on overall survival (OS) was observed of emergency radiation therapy (p=0.026) but we did not observe anything particular for emergency chemotherapy. The analysis of disease-free survival time included the assessment of various parameters using the log-rank test to demonstrate that DFS was significantly longer in patients without local recurrence (p=0.0452) and distant metastases (p<0.0001) as compared to patients with dissemination. It was demonstrated that the presence of metastases caused a significantly higher risk of non-remission (OR = 42.5; +/- 95% CI: 4.58-394.45; p = 0.001), and the recurrence of the disease reduced the chance of remission (OR = 0.35; +/- 95% CI: 0.15-0.83; p = 0.016). Conclusion: It is well-known that our study has several limitations which could have influenced the results we obtained, including the small number of patients and a non-homogeneous group: some patients were operated on prior to radiotherapy +/- chemotherapy, therefore it is advisable to continue testing on larger groups of patients.
{"title":"The Outcomes of Extended Field Radiotherapy in Patients with Para-aorticLymph Node Metastases of Cervical Cancer","authors":"B. Marta, J. Winiecki, T. Nowikiewicz, A. Makarewicz","doi":"10.35248/2161-0932.2020.10.521","DOIUrl":"https://doi.org/10.35248/2161-0932.2020.10.521","url":null,"abstract":"Purpose: Patients with advanced cervical cancer require interdisciplinary therapeutic treatment, after detailed diagnostics (CT, MR and also PET/CT), due to the high risk of metastases to the pelvic lymph nodes and/or paraaortic lymph nodes as well as supraclavicular region. Aim: The aim of this retrospective study was to assess the response to treatment in women with cervical cancer with metastases to the para-aortic lymph nodes given radiotherapy or radiochemotherapy Material and Methods: The study was conducted in 40 cervical cancer patients with para-aortic lymph node metastases undergoing radiation therapy with/whitout concomitantly a cisplatin-based chemotherapy. Subsequently, total doses were set for pelvic lymph nodes and para-aortic lymph nodes, and were between 45 and 50.4Gy with dose increase to the tumor and metastatic lymph nodes for a total dose of 48.6-60Gy in 1.8 to 2.0Gy fractionation. Results: The analysis of overall survival demonstrates that OS was significantly longer in patients with local reccurence (p=0.0165) or distant metastases (p=0.0266) as compared to patients without reccurence or dissemination. An effect on overall survival (OS) was observed of emergency radiation therapy (p=0.026) but we did not observe anything particular for emergency chemotherapy. The analysis of disease-free survival time included the assessment of various parameters using the log-rank test to demonstrate that DFS was significantly longer in patients without local recurrence (p=0.0452) and distant metastases (p<0.0001) as compared to patients with dissemination. It was demonstrated that the presence of metastases caused a significantly higher risk of non-remission (OR = 42.5; +/- 95% CI: 4.58-394.45; p = 0.001), and the recurrence of the disease reduced the chance of remission (OR = 0.35; +/- 95% CI: 0.15-0.83; p = 0.016). Conclusion: It is well-known that our study has several limitations which could have influenced the results we obtained, including the small number of patients and a non-homogeneous group: some patients were operated on prior to radiotherapy +/- chemotherapy, therefore it is advisable to continue testing on larger groups of patients.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"64 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90628326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.2020.10.522
E. Henri, Gregory Hk, Thomas Eo, Theophile Nn, R. Em, Colette Nm
Introduction: Maternal mortality is the death of a woman occurring during pregnancy or within 42 days after its termination, whatever its duration and location for any cause determined or aggravated by pregnancy or the care it motivated. All countries of the world are affected by maternal mortality. Objective: The objective of this study was to study the epidemiology of maternal mortality at the Laquintinie hospital in Douala. Methodology: This was a cross-sectional study with retrospective collection of data on maternal deaths at the Laquintinie Hospital in Douala from January 1, 2011 to December 31, 2016. All cases of maternal death conform to the WHO definition were included. The data collected was entered and analyzed respectively by Cspro 6.3 and IBM SPSS 23 software according to age, marital status, type of occupation, parity, quality of prenatal consultation, level of education, patient's place of origin, time of arrival at the hospital and causes of death. Results: Two hundred and fifty-four (254) maternal deaths were identified during the study period for fifteen thousand four hundred and ninety-eight (15,498) live births, representing a maternal mortality rate of one thousand six hundred and thirty-eight per one hundred thousand live births (1638/100000 NV). The 25-30 age group was the most affected (33.1%) by death, with an average age of 29.26 ± 6.1 years. Housewives (51.6%), Singles (73.6%) women with primary education 54.3% were mostly affected. Hemorrhage was the leading direct cause of death (67%) followed by complications from hypertensive disease (14.1). Malaria and HIV infection were the main indirect causes. The majority (53.93%) of the women in our series died within an hour of admission. Conclusion: The maternal mortality rate at Laquintinie Hospital in Douala is 1,638 /100,000 Live Births. The 25-30 age group was the most affected. Singles, housewives, women referred from health centers, women with a primary education level constituted the mask and the majority of women died less than an hour after admission
{"title":"Maternal Mortality in Cameroon: Prevalence survey and Epidemiological Aspects at the Laquintinie Hospital in Douala From 2011 to 2016","authors":"E. Henri, Gregory Hk, Thomas Eo, Theophile Nn, R. Em, Colette Nm","doi":"10.35248/2161-10932.2020.10.522","DOIUrl":"https://doi.org/10.35248/2161-10932.2020.10.522","url":null,"abstract":"Introduction: Maternal mortality is the death of a woman occurring during pregnancy or within 42 days after its termination, whatever its duration and location for any cause determined or aggravated by pregnancy or the care it motivated. All countries of the world are affected by maternal mortality. Objective: The objective of this study was to study the epidemiology of maternal mortality at the Laquintinie hospital in Douala. Methodology: This was a cross-sectional study with retrospective collection of data on maternal deaths at the Laquintinie Hospital in Douala from January 1, 2011 to December 31, 2016. All cases of maternal death conform to the WHO definition were included. The data collected was entered and analyzed respectively by Cspro 6.3 and IBM SPSS 23 software according to age, marital status, type of occupation, parity, quality of prenatal consultation, level of education, patient's place of origin, time of arrival at the hospital and causes of death. Results: Two hundred and fifty-four (254) maternal deaths were identified during the study period for fifteen thousand four hundred and ninety-eight (15,498) live births, representing a maternal mortality rate of one thousand six hundred and thirty-eight per one hundred thousand live births (1638/100000 NV). The 25-30 age group was the most affected (33.1%) by death, with an average age of 29.26 ± 6.1 years. Housewives (51.6%), Singles (73.6%) women with primary education 54.3% were mostly affected. Hemorrhage was the leading direct cause of death (67%) followed by complications from hypertensive disease (14.1). Malaria and HIV infection were the main indirect causes. The majority (53.93%) of the women in our series died within an hour of admission. Conclusion: The maternal mortality rate at Laquintinie Hospital in Douala is 1,638 /100,000 Live Births. The 25-30 age group was the most affected. Singles, housewives, women referred from health centers, women with a primary education level constituted the mask and the majority of women died less than an hour after admission","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"3 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79281666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.2020.10.524
N. Garg, S. Dhananjaya
Background: Preterm labour is defined as the onset of labour before 37 weeks of gestation, in pregnancy beyond 20 weeks of gestation, and is responsible for nearly 75% of all neonatal mortality and neurological morbidity. Cervical length (CL) is one of the major determinants of preterm delivery. Several studies have been able to conclude that transvaginal CL assessment may be a useful tool for the prediction of preterm delivery. The risk of preterm birth varies inversely with CL measured by ultrasound in low-risk women. Objective: To evaluate and compare the predictive value of transvaginal cervical length between 11-14 weeks and 20-22 weeks of gestation in preterm labour. Material and Methods: A total of 264 pregnant women who were primigravida, singleton pregnancy, and women at gestational age 11-14 weeks and 20-22 weeks were included in the study. They were subjected for CL measurement at 11-14 and 20-22 weeks of gestation using transvaginal ultrasonography with the standard longitudinal view of the cervix while the patient’s bladder was empty. GEL VOLUSON 730 PRO Trans Vaginal Ultrasound (TVS) probe IC 5-9 H instrument with 5-9 MHz was used to measure CL. Results: The variables analyzed were the mean cervical length at 11-14 weeks and 20-22 weeks, the rate of shortening of cervical length in those who deliver at term and preterm and the cervical length at 11-14 weeks 20-22 weeks was correlated with gestational age at delivery and the predictive value of the same was determined. Cut-off of cervical length at 11-14 and 20-22 weeks of gestation was 3.73 cm and 2.89 and was statistically significant for the prediction of pre-term labour. Reduction in cervical length from 11-14 weeks to 20-22 weeks of gestation of more than 0.7 cm is predictive of preterm labour with statistical significance (p<0.001). Conclusion: Routine mid-pregnancy cervical length assessment in low-risk women can be a cost-effective method of preterm birth reduction but the implementation of such a policy is highly dependent upon local factors. If it is to be undertaken, cervical length assessment should be performed according to a standardized technique.
{"title":"Comparison of the Predictive Value of Transvaginal Cervical Length at 11-14 Weeks and at 20-22 Weeks of Gestation in Preterm Labour","authors":"N. Garg, S. Dhananjaya","doi":"10.35248/2161-10932.2020.10.524","DOIUrl":"https://doi.org/10.35248/2161-10932.2020.10.524","url":null,"abstract":"Background: Preterm labour is defined as the onset of labour before 37 weeks of gestation, in pregnancy beyond 20 weeks of gestation, and is responsible for nearly 75% of all neonatal mortality and neurological morbidity. Cervical length (CL) is one of the major determinants of preterm delivery. Several studies have been able to conclude that transvaginal CL assessment may be a useful tool for the prediction of preterm delivery. The risk of preterm birth varies inversely with CL measured by ultrasound in low-risk women. Objective: To evaluate and compare the predictive value of transvaginal cervical length between 11-14 weeks and 20-22 weeks of gestation in preterm labour. Material and Methods: A total of 264 pregnant women who were primigravida, singleton pregnancy, and women at gestational age 11-14 weeks and 20-22 weeks were included in the study. They were subjected for CL measurement at 11-14 and 20-22 weeks of gestation using transvaginal ultrasonography with the standard longitudinal view of the cervix while the patient’s bladder was empty. GEL VOLUSON 730 PRO Trans Vaginal Ultrasound (TVS) probe IC 5-9 H instrument with 5-9 MHz was used to measure CL. Results: The variables analyzed were the mean cervical length at 11-14 weeks and 20-22 weeks, the rate of shortening of cervical length in those who deliver at term and preterm and the cervical length at 11-14 weeks 20-22 weeks was correlated with gestational age at delivery and the predictive value of the same was determined. Cut-off of cervical length at 11-14 and 20-22 weeks of gestation was 3.73 cm and 2.89 and was statistically significant for the prediction of pre-term labour. Reduction in cervical length from 11-14 weeks to 20-22 weeks of gestation of more than 0.7 cm is predictive of preterm labour with statistical significance (p<0.001). Conclusion: Routine mid-pregnancy cervical length assessment in low-risk women can be a cost-effective method of preterm birth reduction but the implementation of such a policy is highly dependent upon local factors. If it is to be undertaken, cervical length assessment should be performed according to a standardized technique.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"59 5","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72423346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.20.10.523
U. Cornelli, Hern, E. Santos, G. Belcaro
Background: Premenstrual Syndrome (PMS) is a very common disease in females, and safe treatments are stillneeded. Objective: To treat symptoms of PMS using a combination of natural products at low dosages following the conceptsof Physiological Modulation. Methods: Twenty two female affect by PMS were admitted and treated with a combination consisting of calcium,Vitamin D, lycopene, astaxanthin, and citrus bioflavonoids (Formula A28) in comparing with placebo. Twotablets/day were given at the moment of symptoms appearance and for the following three days.The scoring of somatic and behavioral symptoms (in total 32) was applied using a scale between 0 (no symptom) to 4(maximum expression of the symptom). The main variable to be measured was the sum of the scores (total score). Results: Formula A28 was effective in reducing by 75% the total score (t-test p<0.05) and each of the symptoms(somatic and behavioral) was significantly reduced (p<0.05 U Mann Whitney test) from the 63% (anxiety) up to 96%(indecision). Colic pain was also consistently reduced (83%). Conclusion: The approach to reduce symptoms of PM Susing Physiological Modulators was found to be effective.
{"title":"Premenstrual Syndrome (PMS) Treatment with Physiological Modulators","authors":"U. Cornelli, Hern, E. Santos, G. Belcaro","doi":"10.35248/2161-10932.20.10.523","DOIUrl":"https://doi.org/10.35248/2161-10932.20.10.523","url":null,"abstract":"Background: Premenstrual Syndrome (PMS) is a very common disease in females, and safe treatments are stillneeded. Objective: To treat symptoms of PMS using a combination of natural products at low dosages following the conceptsof Physiological Modulation. Methods: Twenty two female affect by PMS were admitted and treated with a combination consisting of calcium,Vitamin D, lycopene, astaxanthin, and citrus bioflavonoids (Formula A28) in comparing with placebo. Twotablets/day were given at the moment of symptoms appearance and for the following three days.The scoring of somatic and behavioral symptoms (in total 32) was applied using a scale between 0 (no symptom) to 4(maximum expression of the symptom). The main variable to be measured was the sum of the scores (total score). Results: Formula A28 was effective in reducing by 75% the total score (t-test p<0.05) and each of the symptoms(somatic and behavioral) was significantly reduced (p<0.05 U Mann Whitney test) from the 63% (anxiety) up to 96%(indecision). Colic pain was also consistently reduced (83%). Conclusion: The approach to reduce symptoms of PM Susing Physiological Modulators was found to be effective.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"57 1","pages":"7-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78692521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.20.10.518
L. Pillarisetty, S. Nagalla, M. Buschardt, B. SumanthKumar, aru
Introduction: Metastasis of breast carcinomas to the GI tract is uncommon, and when present is usually of the invasive lobular carcinoma subtype. This case report presents an even more unusual example of invasive ductal carcinoma metastasizing to the GI tract, and with the unusual presentation of a ruptured appendix and Small bowel obstruction. Case presentation: This case report describes a 52-year-old female patient who was diagnosed with metastatic invasive ductal breast carcinoma, which had an extremely unusual presentation of severe abdominal pain, nausea, and vomiting and perforation of the appendix and small bowel obstruction. Although tumors themselves are not an uncommon cause of SBO, metastatic breast cancer is extremely uncommon. Suspicion of breast carcinoma was initially considered after CT scan performed for abdominal pain revealed a previously unknown breast nodule. Subsequent worsening of symptoms, caused by rupture of an appendiceal metastasis, required laparotomy revealed mass of the appendix. Conclusion: This case report and review highlights that it is essential to keep an open mind regarding nonspecific symptoms, and always consider unusual presentations. Early diagnosis from appropriate and timely workup results in better patient outcomes and reduces morbidity and mortality. Invasive Ductal carcinomas of the breast very rarely metastasize to the GI tract, Invasive lobular carcinomas more commonly metastasize to the GI tract whereas invasive Ductal carcinoma metastasizes to lungs and liver. Throughout 23 years reviewing about 8699 appendectomy specimens only about 15 cases of secondary appendiceal tumors were identified.
{"title":"Invasive Ductal Carcinoma of the Breast Presenting as Small Bowel Obstruction and Ruptured Appendix: A Rare Case Report and Review","authors":"L. Pillarisetty, S. Nagalla, M. Buschardt, B. SumanthKumar, aru","doi":"10.35248/2161-10932.20.10.518","DOIUrl":"https://doi.org/10.35248/2161-10932.20.10.518","url":null,"abstract":"Introduction: Metastasis of breast carcinomas to the GI tract is uncommon, and when present is usually of the invasive lobular carcinoma subtype. This case report presents an even more unusual example of invasive ductal carcinoma metastasizing to the GI tract, and with the unusual presentation of a ruptured appendix and Small bowel obstruction. Case presentation: This case report describes a 52-year-old female patient who was diagnosed with metastatic invasive ductal breast carcinoma, which had an extremely unusual presentation of severe abdominal pain, nausea, and vomiting and perforation of the appendix and small bowel obstruction. Although tumors themselves are not an uncommon cause of SBO, metastatic breast cancer is extremely uncommon. Suspicion of breast carcinoma was initially considered after CT scan performed for abdominal pain revealed a previously unknown breast nodule. Subsequent worsening of symptoms, caused by rupture of an appendiceal metastasis, required laparotomy revealed mass of the appendix. Conclusion: This case report and review highlights that it is essential to keep an open mind regarding nonspecific symptoms, and always consider unusual presentations. Early diagnosis from appropriate and timely workup results in better patient outcomes and reduces morbidity and mortality. Invasive Ductal carcinomas of the breast very rarely metastasize to the GI tract, Invasive lobular carcinomas more commonly metastasize to the GI tract whereas invasive Ductal carcinoma metastasizes to lungs and liver. Throughout 23 years reviewing about 8699 appendectomy specimens only about 15 cases of secondary appendiceal tumors were identified.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"19 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85278124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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