scholarly journals Unusual Neurological Manifestation of Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in a Postpartum Woman: A Case Report

2021 ◽  
Vol 08 (01) ◽  
pp. 19-21
Author(s):  
Shalini Shakarwal ◽  
Keyword(s):  
Neurological Manifestation ◽  
Postpartum Woman ◽  
Prior History ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Global Spread ◽  
History Of ◽  
The Impact ◽  
Multiple Episodes ◽  
In Pregnancy

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of the disease (COVID-19) at present. Our understanding of the impact of the virus on the nervous system is limited. The involvement of CNS and neurological manifestations reports are further limited in obstetrical cases. We are reporting a case of an unusual presentation of COVID-19 infection in an admitted P2L2 postpartum woman who developed multiple episodes of seizures on postpartum day 8 of lower segment caesarean section, with no prior history of seizures or hypertension. This report will add to a rare neurological manifestation of COVID-19 in pregnancy.

Catastrophic complications of urolithiasis in pregnancy

2021 ◽  
Vol 14 (5) ◽  
pp. e241597
Author(s):  
Harkirat Singh Talwar ◽  
Vikas Kumar Panwar ◽  
Rudra Prasad Ghorai ◽  
Ankur Mittal
Keyword(s):  
Pregnancy Loss ◽  
Stone Disease ◽  
Intrauterine Death ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Definitive Management ◽  
In Pregnancy

Urolithiasis is the most common non-obstetric complication in pregnancy and has the potential to cause grave consequences resulting in pregnancy loss. We present two such cases. First, a 24-year-old woman, 5 weeks pregnant with a history of urolithiasis presented with right flank pain and fever. She was found to have a right perinephric collection and during the course of her treatment suffered an abortion. The second case was a 25-year-old woman who presented in septic shock. She underwent emergency lower segment caesarean section elsewhere 10 days ago for intrauterine death at 38 weeks of gestation. On evaluation, she was found to have bilateral stone disease with a left subcapsular haematoma. Both the cases were managed conservatively and are planned for definitive management. Thus, women of childbearing age with diagnosed urolithiasis should get themselves evaluated and be free of stone disease before planning a family to prevent increased obstetric complications during pregnancy.

SPINAL ANAESTHESIA USING TAYLOR’S APPROACH SAVES THE DAY IN OBESE PARTURIENT.

2021 ◽  
pp. 228-228
Author(s):  
Vishal Vashist ◽  
Roohani Mahajan ◽  
Bhanu Gupta
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Case History ◽  
Breech Presentation ◽  
Lower Segment ◽  
Subarachnoid Block ◽  
Lower Segment Caesarean Section ◽  
History Of

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .

scholarly journals Impact of the M184V/I Mutation on the Efficacy of Abacavir/Lamivudine/Dolutegravir Therapy in HIV Treatment-Experienced Patients

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Flaminia Olearo ◽  
Huyen Nguyen ◽  
Fabrice Bonnet ◽  
Sabine Yerly ◽  
Gilles Wandeler ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Antiviral Treatment ◽  
Composite Endpoint ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
Prior History ◽  
History Of ◽  
The Impact ◽  
Hiv 1

Abstract Objective The impact of the M184V/I mutation on the virological failure (VF) rate in HIV-positive patients with suppressed viremia switching to an abacavir/lamivudine/dolutegravir regimen has been poorly evaluated. Method This is an observational study from 5 European HIV cohorts among treatment-experienced adults with ≤50 copies/mL of HIV-1 RNA who switched to abacavir/lamivudine/dolutegravir. Primary outcome was the time to first VF (2 consecutive HIV-1 RNA >50 copies/mL or single HIV-1 RNA >50 copies/mL accompanied by change in antiretroviral therapy [ART]). We also analyzed a composite outcome considering the presence of VF and/or virological blips. We report also the results of an inverse probability weighting analysis on a restricted population with a prior history of VF on any ART regimen to calculate statistics standardized to the disparate sampling population. Results We included 1626 patients (median follow-up, 288.5 days; interquartile range, 154–441). Patients with a genotypically documented M184V/I mutation (n = 137) had a lower CD4 nadir and a longer history of antiviral treatment. The incidence of VF was 29.8 cases (11.2–79.4) per 1000 person-years in those with a previously documented M184V/I, and 13.6 cases (8.4–21.8) in patients without documented M184V/I. Propensity score weighting in a restricted population (n = 580) showed that M184V/I was not associated with VF or the composite endpoint (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.35–4.59 and HR 1.66; 95% CI, 0.81–3.43, respectively). Conclusions In ART-experienced patients switching to an abacavir/lamivudine/dolutegravir treatment, we observed few VFs and found no evidence for an impact of previously-acquired M184V/I mutation on this outcome. Additional analyses are required to demonstrate whether these findings will remain robust during a longer follow-up.

scholarly journals The Impact of COVID-19 on Epilepsy Care: A Survey of the American Epilepsy Society Membership

2020 ◽  
Vol 20 (5) ◽  
pp. 316-324
Author(s):  
Dara V. F. Albert ◽  
Rohit R. Das ◽  
Jayant N. Acharya ◽  
Jong Woo Lee ◽  
John R. Pollard ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Clinical Care ◽  
Single Point ◽  
The United States ◽  
Prior History ◽  
Delivery Of Care ◽  
History Of ◽  
Almost All ◽  
The Impact ◽  
New Onset

The COVID-19 pandemic has impacted the delivery of care to people with epilepsy (PWE) in multiple ways including limitations on in-person contact and restrictions on neurophysiological procedures. To better study the effect of the pandemic on PWE, members of the American Epilepsy Society were surveyed between April 30 and June 14, 2020. There were 366 initial responses (9% response rate) and 337 respondents remained for analysis after screening out noncompleters and those not directly involved with clinical care; the majority were physicians from the United States. About a third (30%) of respondents stated that they had patients with COVID-19 and reported no significant change in seizure frequency. Conversely, one-third of respondents reported new onset seizures in patients with COVID-19 who had no prior history of seizures. The majority of respondents felt that there were at least some barriers for PWE in receiving appropriate clinical care, neurophysiologic procedures, and elective surgery. Medication shortages were noted by approximately 30% of respondents, with no clear pattern in types of medication involved. Telehealth was overwhelmingly found to have value. Among the limitation of the survey was that it was administered at a single point in time in a rapidly changing pandemic. The survey showed that almost all respondents were affected by the pandemic in a variety of ways.

scholarly journals A Correlation between Complication in Pregnancy and Postpartum Depression: Literature Review

2021 ◽  
Vol 3 (1) ◽  
pp. 31-39
Author(s):  
Desy Meldawati
Keyword(s):  
Literature Review ◽  
Postpartum Depression ◽  
Pregnant Women ◽  
General Hospital ◽  
Maternal Anemia ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
The Impact ◽  
History Of Depression ◽  
In Pregnancy

Postpartum depression is a depression syndrome that occurs in mothers after childbirth and can be prevented and cured. According to Fazraningtyas, in South Kalimantan, to be precise in the city of Banjarmasin, namely Ulin General Hospital of Banjarmasin and Dr. H.M. Ansari Saleh General Hospital of Banjarmasin showed 56.8% mild postpartum depression, 26.1% moderate postpartum depression, 17.0% severe postpartum depression. The impact of mothers experiencing postpartum depression is that mothers have difficulty interacting and can endanger their children. Postpartum depression is caused by several factors, the factors that contributed are complications in pregnancy. This study used a literature review approach. The articles obtained from Google Scholar, Biomed Central, and Pubmed. The criterias applied be restricted. As many as 10 journals are found. Based on the previous study, complications in pregnancy are the cause of postpartum depression. Complications that are often experienced by pregnant women are maternal anemia that can appear during the pregnancy process until the birth process occurs and 30-70% of pregnant women with maternal anemia have a risk of postpartum depression. Second, gestational diabetes is one of the complications of pregnancy that occurs in women who are pregnant. Pregnant women can increase hormones including the progesterone hormone, human placental lactogen estrogen, and cortisol. The last, a history of depression is a cause of postpartum depression because if pregnant women have a history of depression before pregnancy, they will have a higher risk of experiencing postpartum depression.

scholarly journals Uterine Perforation - A Spontaneous Recurrence

2021 ◽  
Vol 10 (13) ◽  
pp. 988-990
Author(s):  
Tanvi Desai ◽  
Muthulakshmi D ◽  
Vasanthalakshmi G.N. ◽  
Jaya Vijayaraghavan
Keyword(s):  
Caesarean Section ◽  
Lower Abdominal Pain ◽  
Posterior Wall ◽  
Pelvic Abscess ◽  
Uterine Perforation ◽  
Lower Segment ◽  
High Grade Fever ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Air Pockets

A 30-year-old female, gravida-3, para–1, live–1, abortion–1, admitted in Sri Ramachandra Institute of Higher Education and Research (SRIHER) at 37 weeks and 6 days of gestation–planned for elective lower segment Caesarean section. Growth scan done at 37 weeks showed fetal growth restriction (estimated fetal weight-EFW at 3rd centile) with uterine artery Doppler showing high resistance flow. She had mild anaemia (haemoglobin 9g / dl), B negative blood group, indirect Coomb’s test was negative, and injection anti D was not given antenatally. She had an uneventful antenatal period. In 2013, at 23-years of age, she was referred to SRIHER with high grade fever and lower abdominal pain for one-week duration. She had history of dilatation and curettage done one week back for missed abortion. Pelvic ultrasound and computed tomography showed an adnexal mass with air pockets suggestive of a pelvic abscess. She was taken up for emergency laparoscopy which revealed a pelvic abscess walled off by omental and bowel adhesions along with perforation on the upper part of the posterior surface of uterus with extensive sloughing. In view of the nulliparous status of the patient conservative management was opted for and decision was taken to preserve the uterus under stepped up antibiotic cover. Thorough peritoneal wash was given, and intraperitoneal drain was kept. Patient was intensively monitored. Though she developed features of evolving sepsis prompt critical care management resulted in her steady recovery without undergoing hysterectomy.1 In 2018, (G2A1) patient was planned for elective lower segment Caesarean section (LSCS) at 37 weeks. However, she came to our institute at 33 weeks and 4 days of gestation in early labour. In view of history of previous septic abortion with uterine perforation, she delivered by emergency lower segment Caesarean section. Baby was a late preterm girl, weighing 1.9 Kg, cried immediately at birth. Placenta and membranes were delivered in toto. Intraoperative period was uneventful. Posterior wall of uterus did not show any signs of the previous perforation. Postoperative period was uneventful.

scholarly journals Spontaneous Haemoperitoneum in Pregnancy (SHiP) with Placenta Percreta in Bicornuate Uterus with Successful Pregnancy Outcome

2021 ◽  
Author(s):  
Jayasree Santhosh ◽  
Latha V. Kharka ◽  
Atheel Kamona ◽  
Sumaiya S. Al Amri
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Placenta Percreta ◽  
Bicornuate Uterus ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Intraperitoneal Bleeding ◽  
In Pregnancy

Intraperitoneal haemorrhage during pregnancy or postpartum without any history of trauma is termed Spontaneous Haemoperitoneum in Pregnancy (SHiP). This is a rare condition, causing significant morbidity and mortality for the mother and the neonate. We report a case of SHiP in a patient who presented to us at 31 weeks of gestation with right iliac fossa pain, pallor and tachycardia. Radiological investigations revealed intraperitoneal bleeding and a right adnexal haematoma. She was managed conservatively with blood transfusion and supportive care. At 36 weeks of gestation, lower segment caesarean section (LSCS) was done and a live baby with good Apgar score was delivered. Per-operatively, she was found to have a bicornuate uterus, placenta percreta at the junction of the horns and a right adnexal haematoma. This case highlights the significance of thorough evaluation of acute abdominal pain in pregnancy in avoiding unnecessary surgical intervention and iatrogenic prematurity. Keywords: Abdominal pain; Caesarean Section; Hemoperitoneum; Placenta accreta; Pregnancy.

scholarly journals The impact of information about different absolute benefits and harms on intention to participate in colorectal cancer screening: A think-aloud study and online randomised experiment

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246991
Author(s):  
Juliet A. Usher-Smith ◽  
Katie M. Mills ◽  
Christiane Riedinger ◽  
Catherine L. Saunders ◽  
Lise M. Helsingen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Tests ◽  
Baseline Risk ◽  
Prior History ◽  
Think Aloud ◽  
Individual Level ◽  
Risk Levels ◽  
Crc Screening ◽  
History Of ◽  
The Impact

Background There is considerable heterogeneity in individuals’ risk of disease and thus the absolute benefits and harms of population-wide screening programmes. Using colorectal cancer (CRC) screening as an exemplar, we explored how people make decisions about screening when presented with information about absolute benefits and harms, and how those preferences vary with baseline risk, between screening tests and between individuals. Method We conducted two linked studies with members of the public: a think-aloud study exploring decision making in-depth and an online randomised experiment quantifying preferences. In both, participants completed a web-based survey including information about three screening tests (colonoscopy, sigmoidoscopy, and faecal immunochemical testing) and then up to nine scenarios comparing screening to no screening for three levels of baseline risk (1%, 3% and 5% over 15 years) and the three screening tests. Participants reported, after each scenario, whether they would opt for screening (yes/no). Results Of the 20 participants in the think-aloud study 13 did not consider absolute benefits or harms when making decisions concerning CRC screening. In the online experiment (n = 978), 60% expressed intention to attend at 1% risk of CRC, 70% at 3% and 77% at 5%, with no differences between screening tests. At an individual level, 535 (54.7%) would attend at all three risk levels and 178 (18.2%) at none. The 27% whose intention varied by baseline risk were more likely to be younger, without a family history of CRC, and without a prior history of screening. Conclusions Most people in our population were not influenced by the range of absolute benefits and harms associated with CRC screening presented. For an appreciable minority, however, magnitude of benefit was important.

scholarly journals Impact of prior cancer history on the survival of patients with larynx cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kaiquan Zhu ◽  
Renyu Lin ◽  
Ziheng Zhang ◽  
Huanqi Chen ◽  
Xingwang Rao
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Protective Factor ◽  
Larynx Cancer ◽  
Prior History ◽  
Second Primary ◽  
Cancer History ◽  
History Of ◽  
The Impact ◽  
History Of Cancer

Abstract Background Patients with a prior history of cancer are commonly excluded from clinical trial. Increasing number of studies implied that a prior cancer did not adversely affect the clinical outcome among various types of cancer patients. However, the impact of prior cancer on survival of larynx cancer patients remains largely unknown. The aim of this study was to evaluate the prevalence of prior cancer and assess its impact on survival of patients diagnosed with larynx cancer. Methods Patients with larynx cancer as the first or second primary malignancy diagnosed from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier method, multivariate Cox proportional hazard model, and multivariate competing risk model were performed for survival analysis. Results A total of 24,812 eligible patients with larynx cancer were included in the study, wherein a total of 2436 patients (9.8%) had a prior history of cancer. Prostate (36%), lung and bronchus (10%), urinary bladder (7%), and breast (6%) were the most common types of prior cancer. A prior cancer history served as a risk factor for overall survival (AHR =1.30; 95% CI [1.21–1.41]; P < 0.001) but a protective factor for cancer-specific mortality (AHR = 0.83; 95% CI [0.72–0.94]; P = 0.004) in comparison with those without prior cancer. The subgroup analysis showed that a prior history of cancer adversely affected overall survival of patients with larynx cancer in most subgroups stratified by timing and types of prior cancer, as well as by different clinicopathologic features. Conclusion Our study indicated an adverse survival impact of a prior history of cancer on patients with larynx cancer. Except for a few particular prior cancer, clinical trials should be considered prudently for laryngeal cancer patients with prior cancers.

scholarly journals Outcome Following Concussion: Prospective Investigation into the Cumulative Effects of a Prior History of Brain Injury and a History of Repeated Sub-Concussive Injuries on Recovery

2019 ◽  
Vol 34 (6) ◽  
pp. 852-852
Author(s):  
J Bailie ◽  
R Remigio-Baker ◽  
W Cole ◽  
K Stuessi ◽  
M Ettenhofer ◽  
...  
Keyword(s):  
Brain Injury ◽  
Negative Impact ◽  
Prior History ◽  
State University ◽  
Symptom Scores ◽  
Two Factors ◽  
History Of ◽  
Severe Tbi ◽  
The Ohio State University ◽  
The Impact

Abstract Objective To investigate the impact of patient history of repeated head injury (RHI) and mild traumatic brain injury (mTBI) on recovery from an acute concussion. Methods There were 64 participants from 3 military installations treated for an acute concussion ( < 72 hours) and monitored at < 72 hours, 1 week, 1 month, 3 months, and 6 months. Participants had no concussion in the last year and no history of moderate/severe TBI. TBI history was based on the Ohio State University TBI Identification Method and limited to mTBI with loss of consciousness. Primary outcome was symptoms evaluated using the Neurobehavioral Symptom Inventory. A total of 33 participants completed the study. Results Participants were as follows: n = 12 TBI(-)/RHI(-); n = 6 TBI(+)/RHI(-); n = 9 TBI(-)/RHI(+); n = 6 TBI(+)/RHI(+). A multivariate ANOVA examining TBI/RHI group effect on symptoms was significant (F = 2.31, p = 0.010), whereby the TBI(+)/RHI(+) had higher symptom scores than other groups at < 72 hours, 1 week, and 6 months. At 1 month, TBI(+)/RHI(+) had more symptoms than the TBI(-)/RHI(+). At 3 months, the TBI(+)/RHI(+) had higher symptom scores than the TBI(-)/RHI(-) and the TBI(-)/RHI(+). The TBI(-)/RHI(+) did not differ from TBI(-)/RHI(-) except at 1 week where they had lower overall symptoms. Conclusions Participants with an acute mTBI had more severe symptoms if they had RHI and a prior remote mTBI. The combination of these two factors had a negative impact on recovery for up to 6 months. RHI in the absence of TBI did not impact recovery.

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