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1.
Article | IMSEAR | ID: sea-207364

ABSTRACT

Background: Posterior reversible encephalopathy is a clinico-radiological syndrome marked by headache, altered mental status, seizures, visual disturbances, and extensive white-matter changes, also known as hyper perfusion encephalopathy, brain capillary leak syndrome, and hypertensive encephalopathy. This syndrome was a possible consequence of several medical conditions but especially in pregnancy it is associated with pre-eclampsia and eclampsia. Objective of this study was to know the incidence and analyze the clinical features, biochemical, and radiological abnormalities in posterior reversible encephalopathy syndrome (PRES) as a complication of preeclampsia.Methods: This was a one-year cross-sectional analytical study conducted at NRI general hospital, Chinakakani, Guntur of patients with the diagnosis of PRES. Data was obtained from medical records and analyzed them in terms of mean for continuous variables and percentages for categorical data.Results: Total no of patients diagnosed as PRES were 16 out of 127 patients of preeclampsia. Among them, 14 presented with eclampsia, and two presented with severe preeclampsia and imminent symptoms of eclampsia. Headache was the most common symptom (100%). PRES occurred at a peak SBP of ≥160 mmHg in 75% cases and peak DBP of ≥110 mmHg in 50% cases. Serum lactate dehydrogenase (LDH) level was ≥600 in 56.25% and serum uric acid level ≥6 in 50% of patients of PRES. The drug of choice was magnesium sulfate.Conclusions: Neuroimaging abnormality is a definitive component in the diagnosis of PRES. These cerebral abnormalities are vital components in the pathogenesis of eclampsia. Considerable number of patients of preeclampsia might develop PRES even without eclampsia, with mild elevation in BP, serum LDH, and serum uric acid levels.

2.
Article | IMSEAR | ID: sea-207015

ABSTRACT

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3.

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