ABSTRACT
Objectives: Pulmonary embolism [PE] is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules [CPRs] were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas [ABG] analysis and D-dimer in predicting PE in cancer patients
Methods: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms [CTPAs] were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive [patients with PE] and CTPA negative [PE excluded]. Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs
Results: Of the total of 104 individuals who had CTPAs, 33 [31.7%] were positive for PE and 71 [68.3%] were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE [68.1 mmHg vs. 71 mmHg, p = 0.030]. Clinical prediction rules showed good sensitivities [88?100%] and negative predictive values [93?100%]. An alveolar-arterial [A-a] gradient > 20 had 100% sensitivity and negative predictive values
Conclusions: CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results
ABSTRACT
To compare the adverse fetometernal out come in overweight and normal weight pregnant women. This comparative cohort study was conducted from 1[st] October 2010 to 30 September 2012. Total 200 gravid women 100 were overweight and 100 normal weight pregnant women with gestational age for 08-40 weeks were included. Women having BMI [25 - 29.9 Kg/m[2]] were measured overweight and included in group A and 100 women having normal BMI of 18.5 to 24.9 as controls were in-group B. Chi-square test was applied to compare the proportion of maternal and fetal outcomes. Significant P - value of < 0.05 was considered. The age range was between 30 to 45 years with mean age of 30 +/- 4.1 years in both groups. Overweight pregnant women had significantly high frequency of pre-eclampsia [27% versus 9% in controls], PIH [24% versus 8% in controls], gestational diabetes mellitus [22% versus 5% in controls], prolonged labour [4% versus 6% in controls], Caesarean section [44% versus 16% in controls], Wound infection [3% versus 2% in controls] and Postpartum Hemorrhage [5% versus 2% in controls]. P-value < 0.001 was considered significance. Fetal complications in overweight pregnant women compared to controls i.e. Still birth [13% versus 2%], Early neonatal death [11% versus 1%], shoulder dystocia [5% versus 1%] and NICU admission [47% versus 10%]. Results were statistically significant except shoulder dystocia. We conclude that the result of present study indicates obesity exerts deleterious effect, both on fetal and maternal outcome
Subject(s)
Humans , Female , Pregnant Women , Pregnancy , Pregnancy OutcomeABSTRACT
Objectives: To elaborate the impact of family planning training on general practitioners' knowledge, attitude and practices regarding emergency contraception
Methods: A cross sectional survey involving 270 general practitioners was conducted in Hyderabad from 1[st] Oct to 31[st] Dec 2010. Participants were divided into two groups on the basis of attending family planning training course after graduation and were interviewed face to face. Data was noted on questionnaire asking their knowledge, attitude and practices regarding emergency contraception. Data was analyzed on SPSS version 11. Student t-test was applied to compare the proportions among two groups
Results: Out of 270 general practitioners, male and female participants were 132 [48.9%] and 138 [51.1%] respectively. Mean experience as private general practitioner was 7.48 +/- 7.6 years. One third of the participants 84 [31.1%] have attended five days training course on family planning in the past, while 186 [69.9%] did not have any training. Source of training was government institutes 46[17%] and non government organization in 38 [14.1%] cases. Significant positive difference was noted on emergency contraception knowledge, attitude and use in group who attended family planning training
Conclusion: Educational intervention has a positive impact on health care provider's knowledge, attitude and practices of emergency contraception