Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy. This prospective study was undertaken to validate the ...single-step non-fasting 75 gm Diabetes in Pregnancy Study Group of India (DIPSI) criteria of GDM in Indian patients in comparison with the two-step fasting 100 gm glucose challenge through the Carpenter Coustan criteria (CCC).
Two hundred patients underwent comparative testing using the DIPSI criteria and CCC. Plasma venous blood glucose levels were estimated using the hexokinase method; values ≥140 mg/dL at 2 hours were considered positive according to the DIPSI criteria. Any two values from ≥95 mg/dL for fasting, ≥180 mg/dL at 1 hour, ≥155 mg/dL at 2 hours, and ≥140 mg/dL at 3 hours were considered positive with the CCC.
The mean age and body mass index were 24.26±3.75 years and 20.7±3.07 kg/m2. The sensitivity, specificity, and positive and negative predictive values of the DIPSI guidelines were found as 100%, 97.14%, 83.87%, and 100%, respectively. The positive and negative likelihood ratios were 35.8 and zero. Diagnostic accuracy was found as 97.56%.
DIPSI having high sensitivity, specificity, negative predictive value and diagnostic accuracy. DIPSI offers simplicity, feasibility, convenience, and repeatability while economizing universal screening and diagnosis of GDM on a mass-scale. The DIPSI procedure has the potential to be applied to the entire obstetric population, in the implementation of public health programs to diagnose GDM in the community, thus reaching the needs of the developing world.
Distal arthrogryposis (DA) is a heterogeneous sub-group of arthrogryposis multiplex congenita (AMC), mostly characterized by having congenital contractures affecting hands, wrists, feet, and ankles. ...Distal arthrogryposis is mostly autosomal dominantly inherited, while only one sub-type DA type 5D is inherited in an autosomal recessive manner. Clinically, DA5D is described having knee extension contractures, micrognathia, distal joint contractures, clubfoot, ptosis, contractures (shoulders, elbows, and wrists), and scoliosis. Using whole exome sequencing (WES) followed by Sanger sequencing, we report on a first familial case of DA5D from Pakistani population having a novel biallelic missense mutation (c.158C>A, p.Pro53Leu) in the
ECEL1
gene. Our result support that homozygous mutations in
ECEL1
causes DA5D and expands the clinical and allelic spectrum of
ECEL1
related contracture syndromes.
EMERGENCY CONTRACEPTION: AN OVERVIEW AMONG USERS Khan, Shazia Amir; Hafeez, Humaira; Akbar, Rabiya
Journal of Ayub Medical College, Abbottabad,
2015 Jan-Mar, 20150101, Letnik:
27, Številka:
1
Journal Article
Emergency contraception Pills (ECP) provides a safe and effective means of post coital treatment and prevents at least 75% of expected pregnancies resulting from unprotected intercourse. The purpose ...of the study was to assess the awareness regarding emergency contraception and to see the knowledge attitude and preference about emergency contraception.
This was a descriptive cross sectional study carried out at Combined Military Hospital (CMH) Khuzdar. A total of 200 married women of reproductive age group who agreed to participate in the study were interviewed using a self-reported comprehensive, structured closed ended questionnaire.
77% of the women were practicing some contraceptive method at the time of study. Most were using condoms for contraception. 16% of all respondents have never used any contraceptive in their life. 70% believe that religion of Islam is not a barrier in family planning. Only 7.5% of the women were aware about ECP.
Knowledge about ECP is poor among the women of child bearing age. There is a room for improvement regarding the awareness and use of ECP which can contribute to prevention of unwanted pregnancies.
Performing an episiotomy is generally reserved for complicated childbirths, in cases of foetal distress, or when tearing of tissues with serious consequences are foreseen. In addition to the extent ...of the trauma, the surgical skill, repair after childbirth can have an important effect on the magnitude and degree of morbidity experienced by women after repair. The best technique for this repair would be that which produces less pain in the short and long term. The study was done with an objective to compare the frequency and severity of pain (slight/severe) by using interrupted and continuous methods for repair of episiotomy or second degree perineal tears.
It is a randomized control trial. This study was carried out in a Gynaecology and Obstetrics department of Benazir Bhutto Hospital Rawalpindi which is a tertiary care hospital. The duration of study was six months. One hundred & thirty-eight primigravidas (69 in each group) were included in the study.
Majority of the patients in both groups belonged to 20-25 years age group, i.e., 48.53% (n=33) in group-A and 50% (n=34) in group-B, mean and SD, was 27.69±3.21 in group-A and 28.16±3.89 in group-B, gestation age of the patients in group-A 77.94% (n=53) and 83.82% (n=57) in group-B between 37-40 weeks of gestation. Complication of pain and its severity in both groups at 24 hours and 10th day were compared which showed no significant difference at any severity (i.e., no pain, mild moderate/severe).
There is no significant difference in frequency and severity of pain (slight/severe) in using interrupted and continuous methods for repair of second degree perineal tears or episiotomy
Background: The duration of analgesia in the brachial plexus block (BPB) with local anesthetics (LAs) only is not sufficient to avoid the requirement of analgesia for breakthrough pain. ...Dexmedetomidine (DEX) is an upcoming adjuvant with long-acting LA to reduce the requirement of analgesics in the postoperative period. However, there is no documented consensus about the dose of DEX in this regard. Aim: We compared two doses of DEX with LA in the BPB to find out the effectiveness of analgesia and other effects. Materials and Methods: All patients were separated into two groups, namely Group A (0.5 μg/kg DEX added to 20 mL of 0.25% bupivacaine) and Group B (1.0 μg/kg DEX added to 20 mL of 0.25% bupivacaine). Thirty patients in each group were analyzed. The sample size was estimated with a type I error of 0.05 and a power of the study as 80%. Statistical analysis was performed using SPSS (version 13.0) software. Rescue analgesia was decided as injection morphine (0.05–0.15 mg/kg) intramuscularly as indicated. Results: The mean time of onset of sensory analgesia (18.04 ± 3.195 vs. 12.20 ± 1.848 min) and motor blockade (23.7 ± 2.8 vs. 17.3 ± 1.7 min) were comparable (P < 0.05); however, the duration for the motor (668.0 ± 22.7 vs. 702.0 ± 111.6 min) and sensory blockade (734.8 ± 47.9 vs. 755.6 ± 126.8 min) and time to first demand of analgesics were insignificant. Conclusion: A dose of 1.0 μg/kg DEX has no added benefit when compared with a lower dose of 0.5 μg/kg DEX as an adjuvant to LA.
The current study aims to gauge the EFL learners' ability to incorporate multiword expressions from an input text into their subsequent writing without direct instruction of the target expressions. ...To this end, 113 female EFL learners read and/or listened to a story twice while target multiword expressions were (not) underlined. Then, the learners re-told the story in writing individually. Examining the written narrative of the learners revealed that the learners incorporated multiword expressions from the original text in their writing only marginally in all the experimental conditions without any significant differences across the groups. This came in stark contrast with the strong influence the input text had on the learners' choice of single words in their writing. The results also failed to show any relation between the participants' language proficiency and the number of mined single words or expressions. The results are discussed and interpreted in light of the existing literature and Schmidt’s (1990, 2011) Noticing Hypothesis.
•This study aims to gauge the EFL learners' ability to mine texts for multiword expressions.•The learners incorporated a large number of single words from the original story in their re-told story.•The learners' mining of the target multi-word expressions from the original text was marginal.•The study failed to show any relation between the language proficiency and text mining.
Introduction: Evaluating Otoacoustic Emissions (OAEs) is one of the audiological methods for ototoxicity monitoring. The absence of OAEs indicates cochlear damage. The aim of this study was to study ...the usefulness of OAEs in early detection and prevention of ototoxicity. Materials and Methods: A prospective, comparative study was conducted to evaluate Transient-Evoked OAEs (TEOAEs) and Distortion-Product OAEs (DPOAEs) as they relate to Pure Tone Audiometry (PTA) in cases of ototoxicity. Hearing assessments of study group of 55 individuals exposed to ototoxic drugs were evaluated and compared at regular intervals, within the group and with control group of 25 individuals using PTA, TEOAEs, and DPOAEs. The abnormal OAE responses were calculated as predictive of significant changes in PTA thresholds. Student's t-test (independent samples, two-tailed) and ANOVA used for analysis. Results: PTA thresholds in the study group remained unaffected in the first three follow-ups whereas TPOAEs and DPOAEs were both found affected at the third follow-up, in significant number of ears in the study group. Significantly lower PTA thresholds were found in study group only at the fourth follow-up. Conclusions: Changes in TEOAEs and DPOAEs precede changes in PTA thresholds in ototoxicity and have high sensitivity and specificity in predicting hearing loss in such cases.
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