OBJECTIVES: Suppressed immune system and physiological changes in pregnancy put pregnant women vulnerable to various viral diseases. Various studies have reported adverse pregnancy outcomes in SARS-CoV-2 infection. This study aimed to evaluate the maternal and fetal outcomes in SARS-CoV-2 affected pregnancies at our set up. STUDY DESIGN: It was a prospective cohort study conducted at a tertiary care Army Hospital, India. The first 50 cases of SARS CoV-2 positive pregnant women and 144 suspected cases that were found SARS-CoV-2 negative, received and managed at separate set up, during a period extending from 01 April 2020 to 15 Sep 2020 were included in our study. Their obstetric and neonatal outcomes along with the demographic and other clinical data were compared. RESULTS: Total RT-PCR positivity rate of SARS-CoV-2 infection in pregnant women was 2.7%. 96% of our patients were asymptomatic for SARS-CoV-2 infection. Premature rupture of membrane, preterm delivery, and NICU admission was similar in both groups. There were increased incidences (70%) of cesarean section in SARS-CoV-2 positive pregnant women. CONCLUSION: The study reported comparable maternal and fetal outcomes in SARS-CoV 2 positive pregnant women when compared with SARS-CoV-2 negative pregnant women.
OBJECTIVE: The ongoing COVID-19 pandemic is causing widespread concern, fear, stress, anxiety, and depression throughout the population worldwide. Pregnant women, being a vulnerable group, are grossly affected by these changing environmental scenarios. The spread of Corona Virus infection itself and the subsequent nation-wide lockdown in India, just like many other countries, has caused a serious impact on antenatal patients. The objective of this study was to bring out the specific concerns of pregnant women during the ongoing COVID-19 pandemic and also to assess the prevalence of Depression and Anxiety Disorder owing to the pandemic. STUDY DESIGN: This cross-sectional survey among antenatal patients was conducted in the outpatient department of a tertiary care obstetric center which is also a designated COVID hospital. Prevalidated questionnaires, Personal Health Questionnaire-9 & Generalized Anxiety Disorder questionnaire-7 were used for data collection. A semi-structured questionnaire was used to evaluate pregnancy-specific concerns of the patients with respect to the COVID-19 pandemic. RESULTS: The overall prevalence of moderate to severe depression in the survey was found to be 13.2% (n=66). The prevalence of moderate to severe anxiety disorder was found to be 9.8% (n=49). CONCLUSION: This study has brought out the need for urgent attention to the psychological impact of COVID-19 on pregnant women. Pregnant women being a vulnerable group, especially during this pandemic, need special attention to their psychological wellbeing as well.
Purpose: Susac syndrome (SS) is a rare autoimmune disorder that affects the brain and the retina and causes unilateral or bilateral sensorineural hearing loss. Although vestibular dysfunction is reported in SS, limited information is available underlying the vestibular pathophysiology. Method: The diagnosis of SS was established based on symptoms and diagnostic tools such as magnetic resonance imaging and fundus fluorescein angiography. The audiovestibular evaluation was done on the seventh day of admission (Session 1) into the emergency unit, whereas the second and third evaluations were done at 3-month (Session 2) and 8-month (Session 3) follow-ups after discharge, respectively. The audiovestibular test battery consisted of routine audiological tests, auditory brainstem response, and vestibular evoked myogenic potentials (VEMPs; both cervical and ocular). Results: We found unilateral sensorineural hearing loss and absent cervical VEMPs(cVEMPs) when testing the left ear during Session 1. In the following sessions, the unilateral hearing loss did not recover; however, cVEMPs were present bilaterally. The ocular VEMPs showed an increase in amplitude during Sessions 2 and 3. Conclusions: SS can selectively disrupt auditory and vestibular structures. It may present with unique findings of audiovestibular tests. A detailed audiovestibular evaluation may be essential in patients with SS. Supplemental Material: https://doi.org/10.23641/asha.21513843
Background:The frequent headache syndrome is among the most challenging disorder that conforms clinician on a routine basis. A major problem with the relatively new form chronic daily headache (CDH) has been its confusion with chronic tension type headache (CTTH) and other community used term for which there have never been operational diagnosable criteria or even informal clinical criteria. The medical literature is replete with example over the past three decades in which the terms mixed headache combined headache tension headache; vascular headache and rebound headache are used interchangeably by interference. CDH became synonymous in many clinical setting with CTTH or inconvenient vascular or migrainous features or medication overuse. Now CDH is well described in literature with defined classification. Hence, the researcher is used to interested what is the burden and proportion of the various type of CDH. Aims and Objectives: Primary aim of this exploratory prospective study was to study the incidence of primary headache and secondary headache which were CDH in patient attending neurology outpatient department, to study the incidence of type of primary headache, the cause of secondary headache, the age wise distribution and sex wise attribution of CDH and to study the impact of family history, occupation and precipitating factor on CDH. Materials and Methods: In our study, a total of 626 cases fulfilling the International Headache Society-4 th revised criteria comprising inclusion and exclusion criteria were included after informed consent, meticulous history taking pertaining to headache, in particular, thorough examinations and relevant laboratory investigations, and were certified by one neurologist. Results: Primary headache including migraine, tension-type headache, Short-lasting unilateral neuralgiform headache with conjunctival injection, new daily persistent headache, and medication overuse headache was the most common headache that caused CDH. Neurocysticercosis was leading cause of a secondary headache that leads to CDH. Light, fast, and stress were leading precipitants associated with CDH. Conclusion: CDH was mostly associated with primary headache over the secondary headache. Chronic migraine was leading cause of CDH in comparison to CTTH. Females were more affected both in chronic migraine and CTTH. Family history was more positive in case of chronic migraine. Vomiting nausea, photophobia, and phonophobia vertigo were leading symptoms associated with CDH whereas light, fast, and stress were leading precipitants associated with CDH.
Background We sought to determine the utility of PET-MRI in diagnosing Idiopathic Inflammatory Myositis (IIM), and look for association between FDG uptake and clinical, pathological and laboratory parameters. Methods A retrospective, observational study was conducted on IIM patients having positive serum autoantibodies and who underwent PET-MRI (3-Tesla SIEMENS Biograph MR scanner) between 2017 and 2021. Thirty patients who underwent PET-MRI to detect systemic metastasis without muscle involvement formed the control group. Results In the IIM cohort, female: male sex ratio was 1.73, mean age at diagnosis was 40.33 years, and the mean duration of illness was 7 months. 33.33% of patients had severe limb weakness. Mi2B (43.33%), Mi2A (43.33%), PL-7(10%), PL-12(6.67%), SRP (16.67%), Tif1gamma (3.33%), NxP2 (3.33%), Ro-52(40%), PM-Scl, U1-RNP, ANA (26.67%) were the serum autoantibodies identified. Using SUV max Ratio to quantify FDG uptake, PET-MRI showed a sensitivity of 100% with 93.3% specificity in diagnosing IIM.FDG uptake was maximum in proximal lower limb region followed by proximal upper limb. Multivariate regression analysis showed that the severity of muscle weakness, serum Mi2B antibody positivity and serum creatinine kinase levels had a significant positive correlation with FDG uptake (value of 0.005, 0.043, 0.042, respectively for whole-body FDG uptake). FDG uptake also showed good correlation with histopathological features and muscle MRI, but there was no significant association with treatment response. Three female patients in our cohort had primary malignancy involving the breast, uterus, and cervix. Conclusions PET-MRI is a promising diagnostic modality for IIM. PET-MRI reflects the severity of muscle inflammation, showing good association with various clinical/laboratory parameters, histopathology, and muscle MRI. Parameters associated with severe muscle inflammation in PET-MRI—clinical severity of muscle weakness, Mi2B positivity, and serum creatine kinase levels—may be used as clinical/laboratory markers of disease severity in IIM. PET-MRI has the added advantage of detection of systemic malignancy.
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