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Background: The purpose of this study was to evaluate the contribution of Amnioreduction to the management of pregnancies that are complicated by symptomatic polyhydramnios. Study Design: Retrospective review of all s pregnancies that received at least one. Methods: Amnioreduction for polyhydramnios from 2017-2018 at a Lala Ded hospital that provides a statewide service. The indications, procedural techniques, and pregnancy outcomes were evaluated. Results: Twenty-eight women with polyhydramnios (maximal vertical pocket [MVP], >8 cm) had 61 Amnioreduction procedures during the study period. The median gestation at the first drain was 31.4 weeks (interquartile range, 28.4-34 weeks) and a median of 1 procedure (interquartile range, 1-2 procedures) was performed per pregnancy. Sixteen women (57.1%) required >1 Amnioreduction. The median volume removed per pregnancy was 1200 mL (interquartile range, 650-1860 mL). The median duration from the first Amnioreduction until delivery was 26 days (interquartile range, 15-52.5 days). There was no significant association between gestation at delivery and the volume per procedure or total volume that was removed. Earlier gestation at first drain was associated positively with earlier gestations at delivery. In 10.5% of Amnioreduction procedures (3/28 procedures), there was an unplanned preterm birth within 48 hours. The median gestation at delivery was 36.4 weeks (interquartile range, 34-38 weeks). The final diagnoses were gastrointestinal malformations (17.9%), idiopathic polyhydramnios (50%), chromosomal anomaly (10.7%), syndromic condition (14.3%), and neurologic condition (7.1%). Conclusion: Amnioreduction has a useful role in the management of polyhydramnios in pregnancies. Complications are uncommon, and delivery typically occurs near term.
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Introduction: Seizures have been classified in several ways, according to their etiology, ie, idiopathic (primary) or symptomatic (secondary); their site of origin; their clinical form (generalized or focal); their frequency (isolated, cyclic, or repetitive, or the closely spaced sequence of status epilepticus); or their electrophysiologic correlates Epileptic seizures are brief episodes of abnormal excessive or synchronous neuronal brain activity, characterized by typical ictal neurophysiological patterns and postictal and/or interictal abnormalities Computed tomography introduced in 1973, with its widespread availability at emergent care facilities, rapid scan time, high sensitivity in detecting major abnormalities is widely used for screening patients with newonset seizures The present study is to evaluate the magnetic resonance imaging characteristics of epileptogenic substrates to identify the epileptogenic substrates based on imaging features, to assess the distribution of epileptogenic substrates, the diagnostic yield of magnetic resonance imaging and evaluate the role of magnetic resonance imaging in the pre-operative evaluation of patients with intractable epilepsy Material and methods: The present study was a prospective observational study, conducted in the Department of Radiodiagnosis and Imaging, GMC Srinagar J&K, MRI centre, Sheerin Bagh Imaging was done with Magnetom Skyra, 3 Tesla Magnetic Resonance Imaging equipment from Siemens All patients with magnetic resonance imaging reference for seizures at SMHS and Associated Hospitals between April 2017 to April 2018, irrespective of age and sex were included in the study This was a type of purposive sampling Results: Majority of the patients were in the first two decades, the percentage of patients in the first decade being 29% and those in the second decade being 27% Mesial temporal sclerosis was the most Shadab Maqsood, Peerzada Ziaulhaq, Iqubal Hussain Dar, Shaafiya Ashraf Role of Magnetic Resonance Imaging in Evaluation of Epilepsy IAIM, 2018; 5(12): 102-110 Page 103 common abnormality identified in 29% of the study group MRI was normal in 60 patients while abnormalities were identified in 90 patients of the study group Among patients with partial seizures, 68 patients had lesions detected in magnetic resonance imaging The diagnostic yield in the partial seizure group was 68% Conclusion: Magnetic resonance imaging should be considered in the initial evaluation of patients presenting with seizures, particularly with intractable partial seizures because of its high sensitivity for epileptogenic substrates, superior soft tissue contrast, multiplanar capability, lack of beam hardening artifact and lack of ionizing radiation
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There are several situations that complicate the diagnosis of abdominal injuries. Physical examination may be unreliable due to the presence of multiple trauma or changes in the levels of consciousness. This prospective observational study was done consecutive adult blunt abdominal trauma patients. Parameters from pre hospital information, physical examination, laboratory investigations, FAST, and CR were recorded for all patients. Predictors for the presence of ≥1 injuries on abdominal CT were determined. 175 patients were included, with mean ages of 32.94± 14.21 years. 145 had injuries on abdominal CT. Patients with abdominal injuries had significantly lower mean systolic BP on admission (98.79±12.8 v/s 114±7.38), lower mean GCS (11.70±2.02 vs 13.10±1.74), significantly lower levels of hematocrit (29.18±8.31 v/s 34.33±6.46 %); significant difference in presence of abdominal bruises [pvalue ≤ 0.0001,or 6.669 CI (2.42-18.47)]; abdominal tenderness [p value ≤ 0.0001, or 63.708 CI (20.171-201.218)] and guarding /rigidity[ p value ≤ 0.0001, or 5.662 CI (2.054- 15.608) ], significantly higher frequency of abnormal chest CR [p value 0.019, or: 7.886 CI (1.033- 60.202)] ; significantly higher frequency of abnormal pelvic CR [p value : 0.011; or : 8.545 ( CI: Peerzada Ziaulhaq, Mohammad Imran Wagay, Sheikh Riaz Rasool, Rouf A Wani, Naseer A Choh, Saba Banday. Clinical, sonological and radiographic predictors of abdominal injuries after blunt abdominal trauma. IAIM, 2018; 5(4): 144-152. Page 145 1.121-65.115)]; significantly higher frequency of FAST score of > 3 [ p value : ≤ 0.0001 , or 0.034 (0.005-0.256)] as compared to the group of patients with no organ injuries on CT. we observed that the predictors for injuries on CT are: Hemodynamic instability, Altered level of consciousness (GCS≤13), Decreased haematocrit levels, Abnormal physical examination of the abdomen (particularly abdominal tenderness), Fracture of the ribs ,Fracture of the pelvis and FAST score of >3.