Findings In Female Patients Research Articles

Comparison of Angiographic Findings in Diabetic and Non-Diabetic Female patients presenting with Acute Coronary Syndrome at a Tertiary Cardiac Care Center in Karachi, Pakistan

Objective: -To evaluate the angiographic differences in female patients and to compare the frequency of different angiographic findings in diabetic and non-diabetic female cases with acute coronary syndrome. Place and Duration of Study: Department of Adult Cardiology, Tabba Heart Institute Karachi, Pakistan from 1st February 2018 to 31st August 2018 Study design: Cross-sectional study Methodology: Two hundred patients presenting with acute coronary syndrome undergoing angiography with diabetes mellitus and non-diabetes mellitus were enrolled. Demographic profile of the cases was recorded Angiography was performed by experienced cardiologist for all patients. Study outcome, number of vessels involved, type of vessels, was recorded for all patients. All the collected information was recorded using pre-designed structural questionnaire. Results: 67% were diabetic and 23% were non-diabetic. In diabetic group single vessel disease was observed in 29 (23%), 2 vessel disease in 37 (29.4%) and 3 vessel disease in 49 (38.9%) while in non-diabetic group single vessel disease, 2 vessel disease and 3 vessel disease was observed in 24 (32.4%), 19 (25.37%) and 19 (25.7%) respectively (P=0.092). Three vessel disease involving LAD+ Circumflex+ RCA is 49 [38.88%] and 19 [25.67%] in diabetic and non-diabetic group respectively. Three-vessel disease was more prevalent in diabetics but it was not statistically significant (p=0.092). Conclusion: Three vessel diseases is most frequently present as angiographic finding in female patients presenting with acute coronary syndrome. Keywords: Acute coronary syndrome (ACS), Diabetes mellitus (DM), Unstable angina, ST-elevated myocardial infarction

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience.

To evaluate the efficacy of Trans-perineal ultrasonography (TPUS) in assessment of stress urinary incontinence (SUI) and its correlation with urodynamic study (UDS) and physical examination in women with SUI. The study enrolled a total of 91 females including 66 women with SUI and 25 women with no history of urinary incontinence as control group. The α and β angles (anterior urethral and posterior urethro-vesical angle respectively) were recorded both at rest and at straining, using TPUS. The differences between these angles at rest and during the straining were considered as the rotational angles (Rα and Rβ). Urethral length and caliber, bladder neck funneling, and pubo-urethral distance were measured as well. The mean (SD) α angle at rest of the SUI group was 49.0 (±14.3)°, which was higher than the same parameter in the control group: 47.6 (±9.7)°. Similarly, the α angle at straining was significantly higher in the SUI group versus the control group, 61.0 (±15.4)° versus 55.8 (±15.8)°. The mean (SD) β angle in the SUI group at rest was 124.6 (±28.5)°, which was significantly higher than that of the control group at 114.0 (±22.5)°. The mean (SD) β angle at straining was also higher in the SUI group versus the control group: 151.8 (±90.6) versus 136.0 (±27)°. Moreover, higher Rα and Rβ angels were documented in the SUI group. Our data suggest that TPUS can be considered as a non-invasive, easily conducted, and accurate modality in early diagnosis of female SUI. It may reduce the need for performing relatively invasive UDS. However, the role of TPUS in assessment of SUI severity remains to be studied probably with a larger sample size.

The effect of a sexual abuse history on symptoms and anorectal physiology findings in patients presenting to a colorectal pelvic floor service.

Studies report that 12%-23% of patients with functional anorectal disorders have a history of sexual abuse (SA). This article aims to assess whether there is a difference in symptom severity, quality of life or anorectal physiology findings in female patients presenting to a colorectal pelvic floor service with and without a history of sexual abuse. A retrospective analysis of all female patients attending a single tertiary pelvic floor unit for faecal incontinence or constipation between 2017 and 2019 was performed. Patients were divided into two groups depending on the presence or absence of a volunteered history of sexual abuse. Validated quality of life and symptom severity scores, along with anorectal physiology studies were analysed and compared between the two groups. There were 148 patients included in the study period and 17% reported a history of SA. There was no statistically significant difference in symptom severity, quality of life scores or anorectal physiology studies between those with and without a history of SA. In female patients seeking management for defaecatory symptoms, those who have reported a history of SA did not demonstrate any significant difference in symptom severity, quality of life or physiological measures when compared to those without a history of SA.

Urodynamic findings in female patients with nocturia: An age-matched case-control study.

Nocturia negatively impacts the quality of life and is associated with poor general health, but our understanding of its etiologies is incomplete. Urodynamic studies (UDS) findings in patients with nocturia are not well described and may help guide management. Our objective was to compare UDS findings with age-matched patients with and without nocturia. We retrospectively reviewed UDS findings of 1124 patients (2010-2017). A total of 484 (43%) presented with nocturia and 821 (73%) were female. Female patients were separated into age-matched groups with and without nocturia. Urinary symptoms, past medical diagnoses, demographic information, and UDS findings were compared. A total of 596 female patients were included, 298 (50%) with nocturia and 298 without. Past medical history, including diabetes mellitus and cardiovascular disease, did not differ between groups. Patients with nocturia were more likely to have pelvic pain (p = 0.0014) and other daytime symptoms (frequency, urgency, and urgency incontinence). On UDS, patients with nocturia were more likely to have bladder outlet obstruction(BOO) (p = 0.025) and dysfunctional voiding(DV) (p < 0.0001). There was no difference in the frequency of detrusor overactivity (DO). Bladder capacity and postvoid residual volumes were lower, though not significantly, in the nocturia group. When comparing UDS findings in contemporary, age-matched groups of female patients with and without nocturia, we found only BOO and DV to be associated with nocturia. While the treatment of nocturia is often aimed at managing DO, our data suggest that this may not be the primary urodynamic correlation with nocturia. Further studies are needed to assess whether successful treatment of BOO and DV can improve nocturia.

Is there a relationship between hand grip strength and knee osteoarthritis in terms of radiological and functional findings in female patients?

Objectives The aim of this study was to assess the presence of the relationship between hand grip strength (HGS) and radiological and functional signs of knee osteoarthritis (KOA).Patients and methods Between March 2019 and January 2020, a total of 64 female patients (mean age: 63.4±8.8 years; range, 50 to 80 years) with bilateral chronic knee pain who were diagnosed with KOA using radiological and clinical findings according to the 2019 American College of Rheumatology guidelines were included in the study. Patient demographics, body mass index (BMI) values, and hand dominance were recorded. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Lower Extremity Functional Scale (LEFS) were used for the assessment of KOA functionality. The Kellgren-Lawrence (KL) grading system was used for the radiological assessment of KOA. Electronic dynamometer was used for HGS measurement and values were normalized according to BMI results.Results In the assessment of relationship between HGS and functionality of KOA, a negative, moderate correlation was found between the WOMAC and HGS-Dominant (D) (r=0.312, p<0.05) and HGS-Non-Dominant (ND) (r=0.391, p<0.01). In addition, a positive, moderate correlation was found between the LEFS and HGS-D (r=0.344, p<0.01) and HGS-ND (r=0.371, p<0.01). There was a weak, negative correlation between the HGS-ND, KL-D (r=0.256, p<0.05) and KL-ND (r=0.283, p<0.05), while no significant correlation was found between the HGS-D and KL.Conclusion Our study results show that HGS-ND is associated with KOA radiologically and functionally. The HGS should be added in the WOMAC and LEFS scales in the functional assessment of KOA and new scales including HGS assessment should be developed.

Evaluation of female pelvic mass - correlation of clinical and histopathological findings in female patients attending at Birat Medical College and Teaching Hospital, Morang, Nepal

Introduction: The female pelvis is a quite complex anatomical region consisting of uro-genital system as its main part and other structures like blood vessels, gastrointestinal tracts, lymphatics, nerves and a part of musculoskeletal system. Thus, the differential diagnosis of pelvic masses may be of gynecological or non gynecological origin. Gynecological pelvic masses are uterine, ovarian or adnexal masses which may be benign or malignant.&#x0D; Objective: The objective of this study was to evaluate the type of various gynecological pelvic masses and to correlate the preoperative diagnosis with histopathological diagnosis.&#x0D; Methodology: This was a hospital based cross sectional study conducted on 107 patients from September 2018 to September 2019 at Birat Medical College and Teaching Hospital (BMCTH) with presenting complian of lump in the abdomen. These patients underwent clinical examination, routine and specific investigations along with ultrasonographic evaluation and tumour markers to reach a preoperative clinical diagnosis. Patients were admitted and preanesthetic consultation was done. Patients were taken for therapeutic or diagnostic laparoscopy or exploratory laparotomy and diagnosis were confirmed with histopathological diagnosis.&#x0D; Results: Total 107 patients were enrolled in the study with age ranging from 21 to ≥70 years and among them majority (42.1%) were in the age group of 41-50 years. The most common presenting complain of patients were lower abdominopelvic pain (58.87%). The most common clinical diagnosis was leiomyoma in 39.25% patients followed by adenomyosis in 24.29% patients. The most common histopathological diagnosis was fibroid uterus seen in 42.05% patients. There were 2 (1.86%) patients of ovarian malignancies and 1 (0.93%) patient of uterine malignancy.

Association of Risk Factors with Coronary Angiographic Findings of Female Patients with Acute Myocardial Infarction at a Tertiary Hospital of Bangladesh

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity of women in developed and developing country. Although women in low and middle income countries have worse situation they are least studied. Cardiovascular risk factors assessment and their correlation with angiographic severity in female patients is essential to take preventive strategy and timely intervention.&#x0D; Aim: The aim of this study was to evaluate the major risk factors of coronary artery disease and to study the relation of those cardiovascular risk factors with coronary angiographic findings in female patients with AMI .&#x0D; Methods: This was a cross-sectional observational study carried out in the department of Cardiology, Chittagong Medical College Hospital (CMCH) from January 2017 to December 2017. One hundred and fifty consecutive female patients diagnosed as acute myocardial infarction (AMI) who subsequently underwent coronary angiography (CAG) during the study period were included in the study. Data regarding demographic, clinical &amp; laboratory features were recorded. Severity of CAG findings was assessed by Gensini score.&#x0D; Results: The mean age of the study population was 53.19(±10.71) years. Hypertension was the commonest cardiovascular risk factor (78%) in this study followed by obesity (68%), dyslipidaemia (62%) and diabetes mellitus (57.3%). About 80% patients had clustering of ≥3 risk factors. Proportion of patients having STsegment elevation myocardial infarction (STEMI) and non ST-segment elevation myocardial infarction (NSTEMI) were 47% and 53% respectively. Thrombolytic was the most frequently used treatment modality for the management of STEMI patients. Double Vessel Disease, type B lesion with Gensini score ≥20 were the most common CAG findings. Triple vessel disease and severe CAD (Gensini score ≥20) were more in women with three or more risk factors. A significant (p&lt;0.05) linear correlation was found between Gensini score and age, triglyceride level and total cholesterol level. Other factors, including, obesity, family history, hypertension, diabetes mellitus, menopausal status were found to be more prevalent among severe coronary artery disease on CAG but the differences were not statistically significant (p&gt;0.05).&#x0D; Conclusion: The present study showed a significant relation of having multiple cardiovascular risk factors with developing more aggressive angiographic findings. It also revealed that Bangladeshi female patients of AMI had clusters of cardiovascular risk factors and presence of multiple risk factors is a predictor of severe coronary artery disease.&#x0D; Bangladesh Heart Journal 2019; 34(2) : 100-110

Urodynamic findings in women with refractory overactive bladder symptoms.

To assess: (i) the correlation between overactive bladder symptoms and urodynamic findings in female patients; and (ii) the association of urinary symptoms with the presence of detrusor overactivity and/or bladder outlet obstruction. The present retrospective study included female patients with overactive bladder symptoms who underwent urodynamic evaluation by a single physician. Patients with previous anti-incontinence surgery or neurogenic bladder were excluded. Spearman's correlation coefficients were calculated to correlate overactive bladder symptoms with the urodynamic findings. Univariate and multivariate logistic regression analyses were used to determine the independent factors for detrusor overactivity and bladder outlet obstruction. Overall, 1737 reports were analyzed. All patients had urgency with or without urgency urinary incontinence. Urgency, urgency urinary incontinence and nocturia correlated with detrusor overactivity. The severity of frequency, nocturia and slow stream correlated with bladder outlet obstruction. In contrast, stress urinary incontinence showed an inverse, but weak, correlation with bladder outlet obstruction. Stress urinary incontinence correlated moderately with urine leak. Storage symptoms showed an inverse, but weak, correlation with maximum cystometric capacity. Multivariate analysis data showed that age, urgency, urgency urinary incontinence and nocturia were independent predictors of detrusor overactivity, whereas the severity of frequency was a predictor of bladder outlet obstruction. As overactive bladder symptoms increase in severity, female patients tend to have a smaller bladder capacity and a higher incidence of detrusor overactivity. A significant number of these patients have bladder outlet obstruction.

Evaluation of Urodynamic Findings Before and After Mid-Urethral Tape Sling Operation for Female Stress Urinary Incontinence

Study ObjectiveTo compare the urodynamic findings in female patients with stress urinary incontinence (SUI) before and after a mid-urethral tape sling operation. DesignMulti-channel urodynamic study (Canadian Task Force classification II-3). SettingDepartment of Urology, Huashan Hospital, Shanghai, China. PatientsWomen with SUI. InterventionsOne hundred ten patients underwent tension-free vaginal tape (TVT) surgery from September 2002 to December 2004 and 312 patients underwent tension-free vaginal tape–obturator (TVT-O) surgery from January 2005 to December 2011. The study was performed in all patients before surgery and at 3 and 6 months after surgery. Urine flow rate and residual urine volume were measured before and at 1, 3, and 6 month after surgery. Preoperative and postoperative data were compared to determine the urodynamic changes. Measurements and Main ResultsOf 422 patients, only 34 were lost to follow-up. The mean (SD) age of the remaining 388 patients was 57.6 (10.8) years, and parity was 1.87 (1.00). Compared with preoperative evaluation, there were significant changes in abdominal leak-point pressure and the urethral pressure profile including the maximal urethral pressure and the maximal urethral closure pressure at both 3 and 6 months postoperatively (p < .001). Insofar as urine flow rate and residual urine volume, statistical differences were observed at 1 month postoperatively but not at 3 and 6 months. ConclusionThese urodynamic findings suggest that patient storage and voiding functions are not substantially affected by the mid-urethral tape sling operation.

Determinants of Lower Extremity Amputation or Revascularization Procedure in Patients With Peripheral Artery Diseases: A Population-Based Investigation

We used the National Health Insurance Claim data in Taiwan to evaluate determinants for nontraumatic lower extremity amputation (LEA) or peripheral revascularization procedures (PRP) in patients with peripheral artery diseases (PAD). We identified 14 241 patients. Sex-specific odds ratios of age, diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), cerebral vascular accident (CVA), or using cilostazol for LEA or PRP were explored. In patients with PAD, 14.3% of male and 7.4% of female had LEA; whereas 7.1% of male and 4.6% of female had PRP. Among male patients, HTN and CAD were significant risk factors for LEA, whereas DM and using cilostazol had protective roles. Findings in female patients were similar. For PRP, elderly patients had less such procedures. The risk/protective factors were similar. In conclusion, PAD patients having DM and using cilostazol had less LEA or PRP, whereas those having HTN and CAD had more LEA or PRP.

Clinical Features and Angiographic Findings in Premature Coronary Artery Disease; Comparison Between Males and Females

Introduction : Coronary artery disease has emerged as one of the leading causes of premature mortality and morbidity in South Asians. In contrast to males, younger women are ignored due to prevailed social trends. Better characterization of disease presentation in this group will help us in formulating adequate management policies. Objectives: To study clinical features, risk factors and angiographic findings in female patients with premature Ischemic heart disease comparing with men of similar age. Study design : It was Interventional:Quasi experimental study. Setting : Punjab Institute of Cardiology Lahore. Duration : From 19 th of January 2002 till 27 th of September 2003. Subjects and methods: 100 female patients and 100 male patients age 50 or below were studied, who were referred for coronary angiography. Patients with previous coronary angiogram or revascularization were excluded. Data was collected over prescribed proforma and results analyzed. Results : Prevalence of significant risk factors in women compared with men were hypertension, (50% vs 28%; P<0.01), hyperlipidemia (62% vs 26%; P<0.01) diabetes mellitus (46% vs 8%; P<0.01), sedentary life style (44% vs 24%; P<0.01) and obesity (58% vs 22%; P<0.01). Majority of women (84% vs 54%; P<0.01) presented with angina compared with men. No significant difference was noted in distribution of coronary artery disease between two sexes. Conclusion : Women who developed premature coronary artery disease had significant prevalence of majority of conventional risk factors than their male counterparts and more likely to present with angina than myocardial infarction. However distribution and severity of coronary artery disease was similar between the two sexes. Key words : Females coronary disease chest pain risk factors coronary angiography

Colposcopical, cytological and histological findings in female patients with STD

Colposcopical, cytological and histological findings in female patients with STD