ABSTRACT
Background: Ultrasound is being used in obstetrics for assessment of fetal well-being and for accurate assessment of gestational age. The various parameters used in ultrasonography are biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), crown-rump length (CRL) etc. The present study is conducted to assess the relationship of placental thickness with gestational age.Methods: A total of 100 normal pregnant cases were subjected to ultrasonographic examination and gestational age was calculated by measuring biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) by ultrasonography. Placental thickness was measured at the level of cord insertion with 3 Mhz sector probe. Symphysio-fundal height was also measured and gestational age was calculated by comparing with the standard chart. Results: A high degree of correlation is found between the gestational age and the fundal height (r=0.991, p< 0.001), bi-parietal diameter(r=0.964, p< 0.001), head circumference (r=0.979, p<0.001), femur length (r=0.99, p< 0.001), abdominal circumference (r=0.975, p<0.001). Conclusion: In this work placental thickness was taken as a new parameter for predicting gestational age and a good correlation between them was marked (r=0.993, p<0.001).
ABSTRACT
ABSTRACT OBJECTIVE: Prospectively analyze the effect of preoperative walking status and the patient's surgical education on functional outcomes and the three dimensions of quality of life (QoL) (pain, physical function, and mental health) after elective total knee arthroplasty (TKA). METHODS: A comparative analysis on the QoL and functional outcomes in patients who underwent total knee arthroplasty between January 2014 and June 2015. To compare effects of the patient's walking status and knowledge of the surgical procedure on QoL and functional outcomes following TKA by means of SF-36 questionnaire, CES D10, VAS, KSS, KSFS, WOMAC, as well as Friedmann and Wyman scores, 10MWT, and 30-second timed chair test, assessed before the operation and one, three, and six months after the operation. RESULTS: There were 168 knees in 154 patients: 46.75% men and 53.24% women. 52.38% of knees had grade-III OA and 40.47% of knees had grade-IV OA. Preoperatively, SF-36 PCS was 33.2 and MCS was 35.4. Mean KSS and KSFS in females was 37.3 (16.2) and 31.5 (13.8); in males it was 49.2 (18.4) and 42.5 (15.7), respectively. Mean WOMAC scores were 64.2 in females and 56.5 in males. Mean VAS and CES D10 scores were 8.8 and 8.2 in females, and 6.9 and 6.4 in males, respectively. Post operatively at the first, third, and sixth month, significant improvements in QoL and mean SF-36, CES D10, VAS, KSS, KSFS, WOMAC, and Friedmann and Wyman scores were observed, as well as in the 10MWT and 30 s timed chair test scores. Patients with better preoperative functional activity and satisfactory understanding of TKA presented a better functional performance and achieved a good quality life (p< 0.01). DISCUSSION: Surgeons educate TKA candidates regarding the surgical procedure, the nature of implants, and how the procedure would affect their lifestyle and what their expectations from TKA should be. These crucial considerations should boost their confidence, enhancing their involvement and cooperation in post-surgical rehabilitation, thereby improving their QoL, functional results, and post TKA experience. CONCLUSION: TKA candidates with good preoperative walking ability and understanding of knee arthroplasty have better QoL in early and late post-surgery periods. Patient's lifestyle and understanding significantly enhances the postoperative functional ability.
RESUMO OBJETIVO: Analisar prospectivamente o efeito do estado ambulatório pré-operatório e da educação cirúrgica do paciente sobre os resultados funcionais e das três dimensões da qualidade de vida (QV; dor, função física e saúde mental) após a artroplastia total do joelho (ATJ). MÉTODOS: Análise comparativa da QV e dos resultados funcionais em pacientes submetidos a artroplastia total de joelho entre janeiro de 2014 e junho de 2015. Para comparar os efeitos do estado ambulatório do paciente e o conhecimento sobre o procedimento cirúrgico na qualidade de vida e nos resultados funcionais após ATJ, os questionários SF-36, CES D10, EVA, KSS, KSFS e Womac foram usados, bem como os escores de Friedman e Wyman, 10MWT e o teste de cadeira de 30 segundos, no pré-operatório e um, três e seis meses após a cirurgia. RESULTADOS: O estudo incluiu 168 joelhos de 154 pacientes: 46,75% homens e 53,24% mulheres. 52,38% dos joelhos apresentaram OA de grau III e 40,47% dos joelhos, OA de grau IV. No período pré-operatório, o SF-36 PCS foi 33,2 e o MCS foi 35,4. A média do KSS e do KSFS em mulheres foi de 37,3 (16,2) e 31,5 (13,8), respectivamente; nos homens, foi de 49,2 (18,4) e 42,5 (15,7), respectivamente. Os escores médios do Womac foram 64,2 para as mulheres e 56,5 para os homens. Os escores médios da EVA e CES D10 foram 8,8 e 8,2 nas mulheres e 6,9 e 6,4 nos homens, respectivamente. No primeiro, terceiro e sexto meses pós-operatórios, foram observadas melhorias significativas na QV e na média dos escores SF-36, CES D10, EVA, KSS, KSFS, Womac e Friedmann e Wyman, bem como no 10MWT e no teste de cadeira de 30 segundos. Pacientes com melhor atividade funcional pré-operatória e com compreensão satisfatória sobre a ATJ obtiveram resultados funcionais melhores e alcançaram uma boa qualidade de vida (p < 0,01). DISCUSSÃO: Cirurgiões explicam aos pacientes candidatos a ATJ o procedimento cirúrgico, a natureza dos implantes, como o procedimento afetaria o estilo de vida e quais devem ser as expectativas em relação ao resultado da ATJ. Essas considerações cruciais devem aumentar a confiança do paciente, aumentar o seu envolvimento e a sua cooperação no processo de reabilitação pós-cirúrgica, melhorar assim sua qualidade de vida, seus resultados funcionais e sua experiência após a ATJ. CONCLUSÃO: Candidatos à ATJ com boa capacidade ambulatória pré-operatória e compreensão da cirurgia apresentam melhor qualidade de vida no período pós-operatório inicial e de longo prazo. O estilo de vida e o grau de compreensão do paciente em relação à cirurgia aumentam significativamente a capacidade funcional pós-operatória.