Pub Date : 2024-05-12DOI: 10.23958/ijirms/vol09-i05/1878
Dr. Anvisha Upadhyaya, Deepak Shukla, Swati Patel
Introduction: The growing global incidence of diabetes, obesity and metabolic syndrome presents substantial public health challenges and is now recognized as a contributing factor to various systemic diseases. Also diabetic individuals, in particular, face a heightened risk, emphasizing the gravity of the underlying health issue. Failure to promptly recognize NAFLD can present a formidable healthcare obstacle. Anthropometric indicators are significant in understanding the intricate relationship between obesity, NAFLD, and diabetes in the Indian demography. Aim: Establishing connections between diverse anthropometric indices, such as BMI, WHR, WHtR and NAFLD, pinpointing which of the patients diagnosed with type 2 diabetes displayed the most significant predictive efficacy when considering these indicators. Material and Methods: Data from 132 diabetic patients was scrutinized, standard methodologies were employed for collecting anthropometric data, ultrasonography was utilized and routine pathological and biochemical investigations were conducted. Results: The study unveiled correlation between BMI, waist to hip ratio, waist to height ratio and NAFLD in individuals with type 2 diabetes diagnosis. Conclusion: Anthropometric indices such as BMI, waist to hip ratio and waist to height ratio can serve as efficient methods for identifying NAFLD, followed by an early intervention to tackle obesity, and help in reducing their negative effects on type 2 diabetes mellitus.
{"title":"Role of Anthropometric Indices in Prediction of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Patients","authors":"Dr. Anvisha Upadhyaya, Deepak Shukla, Swati Patel","doi":"10.23958/ijirms/vol09-i05/1878","DOIUrl":"https://doi.org/10.23958/ijirms/vol09-i05/1878","url":null,"abstract":"Introduction: The growing global incidence of diabetes, obesity and metabolic syndrome presents substantial public health challenges and is now recognized as a contributing factor to various systemic diseases. Also diabetic individuals, in particular, face a heightened risk, emphasizing the gravity of the underlying health issue. Failure to promptly recognize NAFLD can present a formidable healthcare obstacle. Anthropometric indicators are significant in understanding the intricate relationship between obesity, NAFLD, and diabetes in the Indian demography. Aim: Establishing connections between diverse anthropometric indices, such as BMI, WHR, WHtR and NAFLD, pinpointing which of the patients diagnosed with type 2 diabetes displayed the most significant predictive efficacy when considering these indicators. Material and Methods: Data from 132 diabetic patients was scrutinized, standard methodologies were employed for collecting anthropometric data, ultrasonography was utilized and routine pathological and biochemical investigations were conducted. Results: The study unveiled correlation between BMI, waist to hip ratio, waist to height ratio and NAFLD in individuals with type 2 diabetes diagnosis. Conclusion: Anthropometric indices such as BMI, waist to hip ratio and waist to height ratio can serve as efficient methods for identifying NAFLD, followed by an early intervention to tackle obesity, and help in reducing their negative effects on type 2 diabetes mellitus.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141128706","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 : 2024-05-08DOI: 10.23958/ijirms/vol09-i05/1873
Ahmed Anass Guerboub, Ali Halouache, Yassine Mouzaria, Jade Isouani, Yassine Er-Rahali
Objective: To evaluate the ophthalmic impact, compare characteristics, and identify risk factors related to diabetic retinopathy (DR) in patients seen for the first time in consultation. Patients and methods: This descriptive cross-sectional study was conducted during the period from June to December 2018, of a representative sample of 156 diabetics recruited in the department of endocrinology diabetology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat. Results: Among the 156 patients included in our study, 86 (55.1%) had a normal eye fundus, while 70 (44.8%) had DR. Glycemic control, age of diabetes, as well as diabetic nephropathy and abdominal obesity were risk factors (OR>1, p<0.05), while physical activity and development of lean body mass are protective factors (OR<1, p>0.05) of diabetic retinopathy. Conclusion: Our study reflects the epidemiological profile of the Moroccan population, where the prevalence of DR remains high, with poor control of risk factors.
{"title":"Epidemiological Profile and Risk Factors for Retinopathy in Moroccan Type 2 Diabetics","authors":"Ahmed Anass Guerboub, Ali Halouache, Yassine Mouzaria, Jade Isouani, Yassine Er-Rahali","doi":"10.23958/ijirms/vol09-i05/1873","DOIUrl":"https://doi.org/10.23958/ijirms/vol09-i05/1873","url":null,"abstract":"Objective: To evaluate the ophthalmic impact, compare characteristics, and identify risk factors related to diabetic retinopathy (DR) in patients seen for the first time in consultation. Patients and methods: This descriptive cross-sectional study was conducted during the period from June to December 2018, of a representative sample of 156 diabetics recruited in the department of endocrinology diabetology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat. Results: Among the 156 patients included in our study, 86 (55.1%) had a normal eye fundus, while 70 (44.8%) had DR. Glycemic control, age of diabetes, as well as diabetic nephropathy and abdominal obesity were risk factors (OR>1, p<0.05), while physical activity and development of lean body mass are protective factors (OR<1, p>0.05) of diabetic retinopathy. Conclusion: Our study reflects the epidemiological profile of the Moroccan population, where the prevalence of DR remains high, with poor control of risk factors.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141129261","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 : 2024-02-19DOI: 10.23958/ijirms/vol09-i02/1832
Sultan Al-Nozha, Khalid AlShehri, Manal AlJabri, Hani Abozaid, Ayman Atalla
Background: Patients with diabetes were shown to report poor quality of life and significant depressive symptoms. Only a dearth of surveys was conducted to evaluate the extent of depression among Saudi patients with diabetes and how depression mediate the effect of diabetes on perceived quality of life. Method: The study is a cross sectional questionnaire-based observational investigation using a simple random sampling scheme. We utilized World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and Primary Health Questionnaire PHQ-9 to evaluate depressive symptoms and quality of life. We used generalized linear regression and mediation analysis to estimate the effect of clinical and demographic variables on quality of life and the mediating effect for depressive symptoms. Results: (n = 203) agreed to be included in the study. The prevalence for severe depression was (11.3%), and for moderate depression was (18.7%) among the participating patients. Poor QoL was found in retired patients, prolonged duration of diabetes, depressive score, and experiencing DKA. Notably, we found significant interaction between duration of DM and HbA1c level in terms of their combined effect on quality of life. Among patients with prolonged diabetes duration HbA1c level was associated with poorer quality of life. However, paradoxically, among newly diagnosed diabetes patients the higher the HbA1c the better was the quality of life. Age effect was negative on the QoL, after adjusting for the HbA1c*DM duration interaction. We found that depression score significantly mediated the negative effect of age on quality of life among patients living with diabetes (Sobel test t = -2.851, p = 0.004); however, the depression-mediated effect on the path from duration of diabetes to quality-of-life score was statistically not significant (Sobel test t = -0.021, p = 0.984). Recommendations: Patients with diabetes should be screened and treated for symptoms of depression throughout the course of their illness, given their detrimental effect on their life quality. Older patients with diabetes require amelioration of depressive symptoms given their effect on life quality regardless of duration of diabetes or presence of complications.
背景：研究表明，糖尿病患者的生活质量较差，并伴有严重的抑郁症状。目前只有少数调查对沙特籍糖尿病患者的抑郁程度以及抑郁如何调节糖尿病对生活质量的影响进行了评估。研究方法本研究是一项基于问卷的横断面观察性调查，采用简单随机抽样方案。我们采用世界卫生组织生活质量简明版（WHOQOL-BREF）和初级健康问卷 PHQ-9 评估抑郁症状和生活质量。我们使用广义线性回归和中介分析来估计临床和人口统计学变量对生活质量的影响以及抑郁症状的中介效应。结果：（n = 203）同意被纳入研究。在参与研究的患者中，重度抑郁症的发病率为 11.3%，中度抑郁症的发病率为 18.7%。研究发现，退休患者、糖尿病病程较长、抑郁评分和经历过 DKA 的患者的 QoL 较差。值得注意的是，我们发现糖尿病病程与 HbA1c 水平对生活质量的综合影响之间存在明显的交互作用。在糖尿病病程较长的患者中，HbA1c 水平与较差的生活质量相关。然而，矛盾的是，在新诊断的糖尿病患者中，HbA1c 越高，生活质量越好。在调整 HbA1c*DM 持续时间的交互作用后，年龄对生活质量的影响为负。我们发现，在糖尿病患者中，抑郁评分明显介导了年龄对生活质量的负面影响（Sobel 检验 t = -2.851，p = 0.004）；然而，抑郁介导的糖尿病病程对生活质量评分的影响在统计学上并不明显（Sobel 检验 t = -0.021，p = 0.984）。建议：鉴于抑郁症状对生活质量的不利影响，糖尿病患者在整个病程中都应接受抑郁症状的筛查和治疗。鉴于抑郁症状对生活质量的影响，无论糖尿病病程长短或有无并发症，老年糖尿病患者都需要改善抑郁症状。
{"title":"Assessment of Quality of Life and Prevalence of Depression Among Type 1 Diabetic Patients at Prince Mansour Military Hospital, Taif, KSA","authors":"Sultan Al-Nozha, Khalid AlShehri, Manal AlJabri, Hani Abozaid, Ayman Atalla","doi":"10.23958/ijirms/vol09-i02/1832","DOIUrl":"https://doi.org/10.23958/ijirms/vol09-i02/1832","url":null,"abstract":"Background: Patients with diabetes were shown to report poor quality of life and significant depressive symptoms. Only a dearth of surveys was conducted to evaluate the extent of depression among Saudi patients with diabetes and how depression mediate the effect of diabetes on perceived quality of life. Method: The study is a cross sectional questionnaire-based observational investigation using a simple random sampling scheme. We utilized World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and Primary Health Questionnaire PHQ-9 to evaluate depressive symptoms and quality of life. We used generalized linear regression and mediation analysis to estimate the effect of clinical and demographic variables on quality of life and the mediating effect for depressive symptoms. Results: (n = 203) agreed to be included in the study. The prevalence for severe depression was (11.3%), and for moderate depression was (18.7%) among the participating patients. Poor QoL was found in retired patients, prolonged duration of diabetes, depressive score, and experiencing DKA. Notably, we found significant interaction between duration of DM and HbA1c level in terms of their combined effect on quality of life. Among patients with prolonged diabetes duration HbA1c level was associated with poorer quality of life. However, paradoxically, among newly diagnosed diabetes patients the higher the HbA1c the better was the quality of life. Age effect was negative on the QoL, after adjusting for the HbA1c*DM duration interaction. We found that depression score significantly mediated the negative effect of age on quality of life among patients living with diabetes (Sobel test t = -2.851, p = 0.004); however, the depression-mediated effect on the path from duration of diabetes to quality-of-life score was statistically not significant (Sobel test t = -0.021, p = 0.984). Recommendations: Patients with diabetes should be screened and treated for symptoms of depression throughout the course of their illness, given their detrimental effect on their life quality. Older patients with diabetes require amelioration of depressive symptoms given their effect on life quality regardless of duration of diabetes or presence of complications.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"228 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140449609","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}
This study aims to investigate the inter-observer consistency among two qualified neuro-radiologists and a neurosurgeon in the assessment of nerve root compression on MRI. The primary objective is to explore the consistency and discordance in their interpretations, shedding light on the reliability of radiological evaluations in identifying nerve root compression. This correlation analysis has direct implications for clinical decision-making, potentially altering the management algorithm by influencing the decision to pursue surgery or opt for a non-surgical approach. Notably, this study represents the largest series reporting such analyses from a third-world country, contributing valuable insights into the context-specific challenges and nuances associated with neuroimaging assessments in resource-constrained settings.
{"title":"Examining Consistency Among Observers in MRI Assessment of Lumbar Disc Disease and its Clinical Consequences: An In-Depth Investigation in a Developing Nation","authors":"Uzair Siddiqui, Manzar Hussain, Sadaf Nasir, Bushra Shamim","doi":"10.23958/ijirms/vol09-i02/1831","DOIUrl":"https://doi.org/10.23958/ijirms/vol09-i02/1831","url":null,"abstract":"This study aims to investigate the inter-observer consistency among two qualified neuro-radiologists and a neurosurgeon in the assessment of nerve root compression on MRI. The primary objective is to explore the consistency and discordance in their interpretations, shedding light on the reliability of radiological evaluations in identifying nerve root compression. This correlation analysis has direct implications for clinical decision-making, potentially altering the management algorithm by influencing the decision to pursue surgery or opt for a non-surgical approach. Notably, this study represents the largest series reporting such analyses from a third-world country, contributing valuable insights into the context-specific challenges and nuances associated with neuroimaging assessments in resource-constrained settings.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"125 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452599","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 : 2024-01-20DOI: 10.23958/ijirms/vol09-i01/1806
Mourad Abdelbaki, N. Khellafi, D. Benmessaoud
Behçet syndrome is a systemic vasculitis of unknown etiology, frequently characterized by recurrent oral and genital ulcerations and uveitis. Patients with Behçet syndrome can have both arterial and venous involvement. We report the observation of a case of a 29-year-old man who was admitted with clinical presentation of pulmonary embolism, for whom investigations for the etiology concluded in the diagnosis of Behçet's disease.
{"title":"Pulmonary Embolism in a Patient with Behçet's Disease: A Case Report","authors":"Mourad Abdelbaki, N. Khellafi, D. Benmessaoud","doi":"10.23958/ijirms/vol09-i01/1806","DOIUrl":"https://doi.org/10.23958/ijirms/vol09-i01/1806","url":null,"abstract":"Behçet syndrome is a systemic vasculitis of unknown etiology, frequently characterized by recurrent oral and genital ulcerations and uveitis. Patients with Behçet syndrome can have both arterial and venous involvement.\u0000We report the observation of a case of a 29-year-old man who was admitted with clinical presentation of pulmonary embolism, for whom investigations for the etiology concluded in the diagnosis of Behçet's disease.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"167 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140501555","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}
Introduction and importance: Subhepatic appendicitis, a rare variant of acute appendicitis, presents unique challenges in diagnosis and management. This discussion will delve into its incidence, diagnostic approach, and prognosis. Case presentation: A 58-year-old female patient with multiple co-morbidities presented with 2 days of right-sided abdominal pain fever and vomiting. CT scan was done showing features of sub-hepatic appendicitis. A Laparoscopic appendectomy was done. Clinical discussion: Subhepatic appendicitis is considered an uncommon manifestation of acute appendicitis. Due to its unusual anatomical location, it can pose difficulties in recognizing and diagnosing, mimicking other conditions. The prognosis of subhepatic appendicitis depends on early detection and intervention. Delayed diagnosis could lead to complications. Conclusion: Subhepatic appendicitis, a rare condition, poses distinct clinical challenges. The report analyzes its prevalence, symptoms, diagnosis, and treatment, aiming to enhance comprehension of its impact on medical and surgical approaches.
{"title":"Sub-Hepatic Appendicitis: Case Report","authors":"MASHAL ALHOSENI, Yousef Alhusaini, Jarah Alenezi, Nora Almutairi","doi":"10.23958/ijirms/vol08-i11/1770","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i11/1770","url":null,"abstract":"Introduction and importance: Subhepatic appendicitis, a rare variant of acute appendicitis, presents unique challenges in diagnosis and management. This discussion will delve into its incidence, diagnostic approach, and prognosis. Case presentation: A 58-year-old female patient with multiple co-morbidities presented with 2 days of right-sided abdominal pain fever and vomiting. CT scan was done showing features of sub-hepatic appendicitis. A Laparoscopic appendectomy was done. Clinical discussion: Subhepatic appendicitis is considered an uncommon manifestation of acute appendicitis. Due to its unusual anatomical location, it can pose difficulties in recognizing and diagnosing, mimicking other conditions. The prognosis of subhepatic appendicitis depends on early detection and intervention. Delayed diagnosis could lead to complications. Conclusion: Subhepatic appendicitis, a rare condition, poses distinct clinical challenges. The report analyzes its prevalence, symptoms, diagnosis, and treatment, aiming to enhance comprehension of its impact on medical and surgical approaches.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"207 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135875996","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 : 2023-11-01DOI: 10.23958/ijirms/vol08-i11/1767
Rose-Danielle Ngoumou, Louis Marie Gael Bidzogo Ekobono, Titus Yannick Ngoumou
Rare diseases (RD) are complex medical incidents that constitute a burden for health systems globally. In Cameroon, the absence of a national framework for RDs means that very little is known about these diseases. Many health professionals due to the rarity of cases and complexity of symptoms, face challenges in detecting and treating them. The aim of this paper is to examine the knowledge of Cameroonian physicians on RDs in order to highlight the medical constructions of RDs in Cameroon. The study is cross-sectional and associates quantitative and qualitative research approaches with 23 health practitioners who responded to an open-ended questionnaire to (1) evaluate their knowledge of RDs, (2) describe the medical discourse on RDs in Cameroon and (3) identify prevailing RDs in Cameroon. The study showed on the one hand that, health professionals have strong theoretical knowledge of RDs. About 40.9% know that an RD is one that has a very low prevalence. 73.1% have come across a case of RD in their practice. RDs practitioners indicated they have encountered in their practice were mainly Down syndrome, hemophilia, and G6PD. 81% say they have difficulties detecting an RD. On the other hand, there are certain health practitioners who view that RDs are not (yet) a public health concern in Cameroon when there is a rise of non-communicable diseases like high blood pressure, diabetes, etc. Treatment strategies highlighted were mainly multidisciplinary consults, surgery, and specialized care. The study suggests that decision makers and practitioners should design strategies to strengthen expertise for the diagnostic and management of RDs in Cameroon. Also, health practitioners should be trained regularly on how to manage RDs.
{"title":"Exploring Healthcare Practitioners’ Knowledge of Rare Diseases in Cameroon","authors":"Rose-Danielle Ngoumou, Louis Marie Gael Bidzogo Ekobono, Titus Yannick Ngoumou","doi":"10.23958/ijirms/vol08-i11/1767","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i11/1767","url":null,"abstract":"Rare diseases (RD) are complex medical incidents that constitute a burden for health systems globally. In Cameroon, the absence of a national framework for RDs means that very little is known about these diseases. Many health professionals due to the rarity of cases and complexity of symptoms, face challenges in detecting and treating them. The aim of this paper is to examine the knowledge of Cameroonian physicians on RDs in order to highlight the medical constructions of RDs in Cameroon. The study is cross-sectional and associates quantitative and qualitative research approaches with 23 health practitioners who responded to an open-ended questionnaire to (1) evaluate their knowledge of RDs, (2) describe the medical discourse on RDs in Cameroon and (3) identify prevailing RDs in Cameroon. The study showed on the one hand that, health professionals have strong theoretical knowledge of RDs. About 40.9% know that an RD is one that has a very low prevalence. 73.1% have come across a case of RD in their practice. RDs practitioners indicated they have encountered in their practice were mainly Down syndrome, hemophilia, and G6PD. 81% say they have difficulties detecting an RD. On the other hand, there are certain health practitioners who view that RDs are not (yet) a public health concern in Cameroon when there is a rise of non-communicable diseases like high blood pressure, diabetes, etc. Treatment strategies highlighted were mainly multidisciplinary consults, surgery, and specialized care. The study suggests that decision makers and practitioners should design strategies to strengthen expertise for the diagnostic and management of RDs in Cameroon. Also, health practitioners should be trained regularly on how to manage RDs.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"26 25","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371856","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}
Background: Disseminated intravascular coagulation (DIC) can present postpartumly in women with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. This report highlights the importance of drain insertion following emergency cesarean section in anticipation of DIC. This would avoid the need of an open exploratory laparotomy procedure. Case: At 34 weeks of gestation, a P1G4 woman was diagnosed with severe pre-eclampsia and HELLP syndrome and her baby with intrauterine growth restriction (IUGR) and fetal distress. The woman received hydralazine, labetalol, methyl-dopa, magnesium sulphate and an emergency cesarean section was performed. A few hours later, the woman developed DIC. Red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLTs) were administered and an abdominal CT was performed, revealing intra-abdominal and anterior rectus sheath haematomas. An open exploratory laparotomy was performed to identify areas of bleeding and a drain was inserted to monitor the bleeding. The woman was closely monitored and regained haemodynamic stability. Conclusion: DIC is a common postpartum complication in women diagnosed with HELLP syndrome. Preemptive drain insertion following cesarean section in these women could avoid the need for additional revision surgery should DIC occur. Clear guidelines on the topic are lacking. Teaching Points: Postpartum surgical drain placement in women diagnosed with HELLP syndrome who later develop DIC could avoid the need of additional surgery. Precis Preemptively placing a surgical drain following cesarean section in patients with HELLP syndrome may avoid additional surgery in patients that go on to develop DIC.
{"title":"Severe HELLP Syndrome Complicated by Multiorgan Impairment and DIC: The Role of Drain Placement: A Case Report","authors":"Xenofontas Bazoukis, Alkistis Victoros Khristianov, Giannis Pavlides, Athanasios Chasiotis, Ioannis Kazakos","doi":"10.23958/ijirms/vol08-i11/1774","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i11/1774","url":null,"abstract":"Background: Disseminated intravascular coagulation (DIC) can present postpartumly in women with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. This report highlights the importance of drain insertion following emergency cesarean section in anticipation of DIC. This would avoid the need of an open exploratory laparotomy procedure. Case: At 34 weeks of gestation, a P1G4 woman was diagnosed with severe pre-eclampsia and HELLP syndrome and her baby with intrauterine growth restriction (IUGR) and fetal distress. The woman received hydralazine, labetalol, methyl-dopa, magnesium sulphate and an emergency cesarean section was performed. A few hours later, the woman developed DIC. Red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PLTs) were administered and an abdominal CT was performed, revealing intra-abdominal and anterior rectus sheath haematomas. An open exploratory laparotomy was performed to identify areas of bleeding and a drain was inserted to monitor the bleeding. The woman was closely monitored and regained haemodynamic stability. Conclusion: DIC is a common postpartum complication in women diagnosed with HELLP syndrome. Preemptive drain insertion following cesarean section in these women could avoid the need for additional revision surgery should DIC occur. Clear guidelines on the topic are lacking. Teaching Points: Postpartum surgical drain placement in women diagnosed with HELLP syndrome who later develop DIC could avoid the need of additional surgery. Precis Preemptively placing a surgical drain following cesarean section in patients with HELLP syndrome may avoid additional surgery in patients that go on to develop DIC.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"26 32","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371992","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}
This study was conducted to determine the contraception utilization pattern and to assess the factors influencing contraceptive utilization among women in the reproductive age group in Ajman, UAE. This cross-sectional study was conducted in April 2022. A total of 209 participants were recruited from University Hospital, shopping malls, and residential areas in Ajman. An interviewer-administered validated questionnaire was used for data collection. The domains covered include Socio-demographic profile, Reproductive history, Utilization pattern, and Factors influencing the choice and discontinuation of contraception. Participants were women in the reproductive age group (18-44 years), of any nationality and those who consented to participate in the research. Collected data was entered into an Excel spreadsheet and transferred to SPSS version 28 for analysis. Descriptive statistics was used to describe the study population. The chi-square test was used to test the association between independent variables and dependent variables (choice, use, and discontinuation). The p-value was set at ≤ 0.05 which is considered statistically significant. Out of 209 women interviewed, only 53.1% utilized contraception to limit family size. Participants who considered their partner’s wishes as very important refrained from using contraceptives (42, 80.8%). Cultural background had a major negative influence which led participants to avoid contraceptive use (37, 72.5%). with regard to participant’s education, there is a contrast between the usage of contraception among individuals with an education above the undergraduate level (53;31.3%) and below (11;27.5%). Participants with husbands who received an education above undergraduate level (36;26.3%) showed limited usage of contraception as compared to those less than undergraduate (13;39.4%). To conclude the prevalence of utilization of contraception was 53.1%. The nationality of the participants and husband's education was highly associated with contraceptive use. The number of previous live births also determined the use of contraceptives. Healthcare professionals especially doctors played a pivotal role in spreading awareness about contraception and newer forms of contraceptives. Along with complications in the previous pregnancy, Influence from both partner and family leading to discontinuation of contraceptives also had a major impact. The belief among participants that contraception influences hormones was a factor that impacted the usage of contraception.
{"title":"Utilization of Contraception Among Women of Reproductive Age in Ajman, UAE","authors":"Navana Hemanth, Musamat U Saifa, Ashiba Ashik, Mehrin Sherif, Jayakumary Muttappallymyalil","doi":"10.23958/ijirms/vol08-i11/1771","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i11/1771","url":null,"abstract":"This study was conducted to determine the contraception utilization pattern and to assess the factors influencing contraceptive utilization among women in the reproductive age group in Ajman, UAE. This cross-sectional study was conducted in April 2022. A total of 209 participants were recruited from University Hospital, shopping malls, and residential areas in Ajman. An interviewer-administered validated questionnaire was used for data collection. The domains covered include Socio-demographic profile, Reproductive history, Utilization pattern, and Factors influencing the choice and discontinuation of contraception. Participants were women in the reproductive age group (18-44 years), of any nationality and those who consented to participate in the research. Collected data was entered into an Excel spreadsheet and transferred to SPSS version 28 for analysis. Descriptive statistics was used to describe the study population. The chi-square test was used to test the association between independent variables and dependent variables (choice, use, and discontinuation). The p-value was set at ≤ 0.05 which is considered statistically significant. Out of 209 women interviewed, only 53.1% utilized contraception to limit family size. Participants who considered their partner’s wishes as very important refrained from using contraceptives (42, 80.8%). Cultural background had a major negative influence which led participants to avoid contraceptive use (37, 72.5%). with regard to participant’s education, there is a contrast between the usage of contraception among individuals with an education above the undergraduate level (53;31.3%) and below (11;27.5%). Participants with husbands who received an education above undergraduate level (36;26.3%) showed limited usage of contraception as compared to those less than undergraduate (13;39.4%). To conclude the prevalence of utilization of contraception was 53.1%. The nationality of the participants and husband's education was highly associated with contraceptive use. The number of previous live births also determined the use of contraceptives. Healthcare professionals especially doctors played a pivotal role in spreading awareness about contraception and newer forms of contraceptives. Along with complications in the previous pregnancy, Influence from both partner and family leading to discontinuation of contraceptives also had a major impact. The belief among participants that contraception influences hormones was a factor that impacted the usage of contraception.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"32 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371603","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}
Background: The emerging role of technology in health settings is paving the pathway for novel ways to manage chronic diseases. In recent times, continuous remote monitoring of vital signs using wearable devices has gained immense interest because it enables real-time access to patient data from anywhere. Aim: The objective of this study was to correlate the vital parameters; including ECG, pulse rate, respiratory rate, temperature, heart rate, oxygen saturation, and blood pressure; derived from Real Time Multi vital remote monitoring (RTMVRM) solution and standard vital monitoring methods in chronic ischemic heart disease patients, stable on medication. Methods: A total of 199 patients with confirmed diagnosis of chronic ischemic heart disease, stable on medication, presenting to the Department of General Medicine in ESIC Medical College and Hospital, Hyderabad, were enrolled into the study. The data for Vital parameters was obtained from the subjects at prespecified time points for a 24 hr duration using both RTMVRM and standard methods under direct and continued supervision of the physician. The Spearman's rank coefficient of correlation was used to evaluate the correlation between the data obtained from RTMVRM solution and standard measurements. The study also examined the safety and efficacy of the RTMVRM using the Vigo Vitals solution. Results: The vital parameters showed statistically significant (p<.0001) positive correlations (spearman) between the RTMVRM solution and standard measurements for pulse rate (0.9418), respiratory rate (0.96766), temperature (0.82103), heart rate (0.98522), systolic BP (0.97468), diastolic BP (0.90832) and SpO2 (0.99620) at 24th hour. The ECG data showed statistically significant (p<.0001) positive correlations (spearman) between the RTMVRM solution and standard measurements for P-wave 0.94749, PR-interval 0.93432, QRS-complex 0.95305, RR-interval 0.66011, QT-interval 0.77310, ST-segment 0.97749 and T-wave 0.95881 at 24th hour. Vigo vitals solutions reported 99% accuracy with 99% sensitivity and 100% capture rate. No device related serious adverse events were reported during the study. Conclusion: The results of this study validated the remote monitoring technology of RTMVRM, a cloud technology based vital monitoring solution. With its ability to offer access to continuous vitals in real time, RTMVRM may enable quick clinical decisions, prevent complications, and enable care providers to stay ahead of the disease. Both the clinician and the patient’s satisfaction were guaranteed by the solution, with accuracy and precision in vital monitoring and a decluttered monitoring experience.
{"title":"Validation of Safety and Efficacy of Real Time Multi Vital Remote Monitoring in Patients with Chronic Ischemic Heart Disease","authors":"Sowjanya Patibandla, Rajani Adepu, Appireddy Thamma, Madhuri Bheemanapally","doi":"10.23958/ijirms/vol08-i10/1753","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1753","url":null,"abstract":"Background: The emerging role of technology in health settings is paving the pathway for novel ways to manage chronic diseases. In recent times, continuous remote monitoring of vital signs using wearable devices has gained immense interest because it enables real-time access to patient data from anywhere. Aim: The objective of this study was to correlate the vital parameters; including ECG, pulse rate, respiratory rate, temperature, heart rate, oxygen saturation, and blood pressure; derived from Real Time Multi vital remote monitoring (RTMVRM) solution and standard vital monitoring methods in chronic ischemic heart disease patients, stable on medication. Methods: A total of 199 patients with confirmed diagnosis of chronic ischemic heart disease, stable on medication, presenting to the Department of General Medicine in ESIC Medical College and Hospital, Hyderabad, were enrolled into the study. The data for Vital parameters was obtained from the subjects at prespecified time points for a 24 hr duration using both RTMVRM and standard methods under direct and continued supervision of the physician. The Spearman's rank coefficient of correlation was used to evaluate the correlation between the data obtained from RTMVRM solution and standard measurements. The study also examined the safety and efficacy of the RTMVRM using the Vigo Vitals solution. Results: The vital parameters showed statistically significant (p<.0001) positive correlations (spearman) between the RTMVRM solution and standard measurements for pulse rate (0.9418), respiratory rate (0.96766), temperature (0.82103), heart rate (0.98522), systolic BP (0.97468), diastolic BP (0.90832) and SpO2 (0.99620) at 24th hour. The ECG data showed statistically significant (p<.0001) positive correlations (spearman) between the RTMVRM solution and standard measurements for P-wave 0.94749, PR-interval 0.93432, QRS-complex 0.95305, RR-interval 0.66011, QT-interval 0.77310, ST-segment 0.97749 and T-wave 0.95881 at 24th hour. Vigo vitals solutions reported 99% accuracy with 99% sensitivity and 100% capture rate. No device related serious adverse events were reported during the study. Conclusion: The results of this study validated the remote monitoring technology of RTMVRM, a cloud technology based vital monitoring solution. With its ability to offer access to continuous vitals in real time, RTMVRM may enable quick clinical decisions, prevent complications, and enable care providers to stay ahead of the disease. Both the clinician and the patient’s satisfaction were guaranteed by the solution, with accuracy and precision in vital monitoring and a decluttered monitoring experience.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"39 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136376960","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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