ABSTRACT
@#Introduction: Secure attachment to parents prevents adolescents from externalizingbehaviours especially in developing countries. The aim of this study was to identify thecontributors to parental attachment in a developing society. Methodology: This crosssectional study was performed on urban secondary students (aged between 13 and 17 years)based on multistage sampling in Pasir Gudang District, Johor, Malaysia. The depression,anxiety and stress (DASS-21) and Inventory of parent and peer attachment (IPPA)questionnaires were used along with a questionnaire for demographic information. Analysisof covariance (ANCOVA) was used to identify the main effect of study parameters on IPPAscores for father and mother. Results: A total of 2980 students (46.9% male and 53.1%female) participated in this study. Mean and SD for age was 14.39±1.28. Depression scoreand school form had a significant main effect on both paternal and maternal attachment(p<0.05). Age (p=0.003), ethnicity (p=0.01), history of intimate relationship (p=0.03),paternal education level (p=0.006) and maternal education level (p=0.04) had a main effecton paternal attachment, while gender (p=0.02) and stress (p=0.001) were shown to havesignificant main effect on maternal attachment. Discussion: The findings of this studyrevealed different contributors for adolescent attachment with father and mother. Local,cultural and economic structure of the community should be taken into account in order toplan for an intervention strategy to secure adolescent’s relationship with parents.
ABSTRACT
Early pregnancy losses occur in 10-20% of all pregnancies. Surgical evacuation has always been the mainstay of management of miscarriages. The main aim of this study was to understand the success rate of expectant management of miscarriage with regards to gestational sac size and period of gestation. The secondary outcome was to measure the satisfaction level and the rate of pregnancy after 6 month of expectant management. Patients diagnosed with missed miscarriages were requested to choose between expectant or surgical management. Those decided for expectant management on “wait and watch” approach were assessed weekly up to 5 completed weeks until complete miscarriage was achieved spontaneously. Surgical evacuation was performed if medically indicated or requested by the patients at any time or at the end of fifth week if complete miscarriage was not achieved. Out of 212 cases, 75 (35.4%) opted for expectant management. Complete miscarriage was achieved in 85.3% of subjects by the end of fifth weeks respectively. Mean of Gestational sac size and period of gestation was not found to influence the success rate of complete spontaneous miscarriage in the expectant management. No morbidity was recorded during the five weeks of the study period. Mean satisfaction score was 9.7±8.3. Pregnancy occurred in 47% of patients within 6 months follow up. The Receiver operation characteristic (ROC) curve analysis suggested the end of second week as the cut off for surgical intervention. This study revealed that expectant management of missed miscarriage is a reliable management of missed miscarriage within the first two weeks.
Subject(s)
Pregnancy Complications , Abortion, SpontaneousABSTRACT
The most effective and accurate treatment of hypertensive patients reduces cardiovascular events and improves the quality of life. This study compared the efficacy and safety of combined [combination therapy] with an angiotensin-receptor blocker [ARB] a calcium-channel blocker [CCB] [Losartan / Amloidipine 50/10mg] vs maximal combination doses of ARB with hydrochlorothiazide [Losartan /HCTZ 100/25 mg] and maximal combination doses of CCB with HCTZ [Amlodipine /HCTZ 10/25 mg] in the management of stage 2 hypertension. This randomized clinical trial [RTC] comprised 478 hypertensive patients with mean age 50.5 +/- 5.21 years, and took place between January 2010 and December 2011 in Vasei Hospital clinic in Sabzevar. Antihypertensive drugs were washed out after 5 days of discontinuation of drugs and the patients with mean blood pressure in sitting position >/= 160 and <200 mmHg in systole and >/= 100 and <110 mmHg in diastole were randomized into three groups: Losartan / Amlodipine 50/10 mg [n =164], Losartan / HCTZ 100/25 mg [n =155] and Amlodipine / HCTZ 10/25 mg [n =159]. The end point was reaching the blood pressure below 140/90 within 56 days of treatment in each group. There was a significant difference in systolic blood pressure reductions between treatment groups [P<0.001] and also there was a significant difference between groups in reducing diastolic blood pressure [P<0.01]. The highest systolic and diastolic blood pressure reduction respectively was found in Amlodipine/losartane and losartane/HTCZ group. The ANCOVA analysis revealed that only treatment regimen had a significant effect [P=0.01] and other factor including Age, Gender, Diabetes Mellitus, Smoking and High serum cholesterol didn't have significant effect on blood pressure reduction. ARB/CCB combination therapy reduced blood pressure more effectively than the maximal doses of ARB or CCB with HCTZ in stage 2 hypertensive patients within this period of study