Prospective Cross-sectional Analytical Study Research Articles

Evaluation of the criteria for the interpretation of the oral glucose tolerance test in the National Mother-Child Teaching Hospital “San Bartolome”

Abstract Diabetes mellitus (DM) is a metabolic disorder that causes chronic hyperglycemia with disturbances in the metabolism of carbohydrates, fats and proteins, and alterations in microcirculation. We evaluate the criteria for the interpretation of the oral glucose tolerance test (OGTT) in the Hospital Nacional Docente Madre-Nino “San Bartolome” in Lima, Peru, and determine the percentages of pre-diabetic patients, diabetics that should not be included in the test, and those with alterations in their glucose curve during the biochemical determinations. To this purpose, a non-experimental, prospective cross-sectional analytic study was performed in 1271 patients, included in the study to comply with the guidelines and recommendations of the ADA and the CLSI POCT12-A3 guide, which were processed in the Biochemical Autoanalyzer Biosystems A25. Data analysis was performed using SPSS version 20.0 statistical analyzer, and respecting ethical diabetics. The main results are 1.97% diabetic and 13.85% pre-diabetic. The LJ phenomenon occurred with 6.45% (alteration in glucose curve after oral load decreases plasma glucose concentration determination after 60 min and returns at relatively higher than the basal concentration levels at 180 min) and 5.19% were poorly studied, including a >110 mg/dl baseline ( p =

The Role of Musculoskeletal USG as Diagonostic Tool of CTS

Abstract Introduction Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS. Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study. Methodology After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG). Results At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG. Conclusion USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.

Clinical characteristics and treatment outcomes in patients with Helicobacter pylori-positive chronic immune thrombocytopenic purpura

Immune thrombocytopenic purpura (ITP) is the condition caused by increased platelet destruction and or decreased platelet production. Previous studies have demonstrated the association and efficacy of Helicobacter pylori (H. pylori) eradication therapy in patients with chronic ITP. Data in Thai patients, however, are limited. A prospective cross-sectional analytic study was conducted in adult patients with chronic ITP to determine the prevalence and clinical predictive factors of H. pylori infection and evaluate the efficacy of H. pylori eradication therapy. H. pylori-infected patients received eradication therapy (omeprazole 40 mg/day, clarithromycin 1000 mg/day, amoxicillin 2000 mg/day) for 2 weeks. The platelet counts at baseline and monthly for 6 months after the end of treatment were evaluated. Of the 25 patients, 9 patients (36%) had H.pylori infection. H. pylori infection is higher among women than men. There were two clinical factors included 1) relapsed ITP 2) response after the first-line treatment statistically proven to be associated with H. pylori infection with an odds ratio and p value of 7.7, p = 0.035 and ND (not determined due to small sample size), p < 0.001. Nearly 80% of infected patients had the platelet count response after eradication therapy with the median time to response of 4 months. The prevalence of H. pylori infection is modest in Thai adult patients with chronic ITP. A history of relapsed ITP and high quality of response after first-line treatment indicated H. pylori infection. Therefore, the urea breath test should be recommended in patients who have a relapsed ITP condition with a history of good response after first-line therapy.

Tabagisme féminin en milieu africain

BackgroundIn Africa, female smoking is frowned upon; a woman who smokes is considered to have a bad character. Nevertheless, the image of the liberated self-confident women the tobacco industry have conveyed for decades seems to have taken effect. The objective of this study was to determine the characteristics of smoking among women in Abidjan and their knowledge about tobacco. MethodologyThis was a prospective cross-sectional descriptive and analytical study on the smoking female population over the age of 15 years residing in Abidjan for at least one year. We established a representative sample of the female population of Abidjan by town, neighborhood and socio-occupational level. ResultsIn all, we enrolled 1479 women. The prevalence of smoking among women was 13.6%. These women began smoking at the age of 16–20 years. In general, they had an unfavorable socio-economic background; most had received an education and were not married (80%). The majority of the smokers (90%) consumed 1 to 10 cigarettes per day. Smoking was prevalent in nightclubs and snack bars (64.7%) and in the company of friends (52.2%). The factors most favoring smoking were imitation, curiosity and a smoking environment. Knowledge about tobacco and its consequences was deficient. Nicotine was the best known substance in cigarettes. The most often cited smoking-related conditions were cardiovascular and lung diseases. Basically, these women were unaware of the dangers of female smoking. ConclusionFemale smoking is increasing in Abidjan. It mainly affects young educated (high school or university) individuals with a disadvantaged socio-occupational background.

Best Guess method: A further external validation study and comparison with other methods

Validation of the 'Best Guess' weight estimation method on a geographically divergent external sample of children, plus comparison with APLS and Broselow weight estimation methods. Prospective cross-sectional analytical study at Princess Margaret Hospital Emergency Department. A convenience sample of children aged 0-14 years recruited from May to June 2008. Age, sex, ethnicity, height and actual weight obtained. Agreement between the methods is reported as a comparative mean and distribution of the percentage error, plus the proportion of instances where the error exceeded 20% of the measured weight. A total of 1235 children were included. The 'Best Guess' method was the most accurate, particularly in children aged 1-4 years (mean percentage error +1.69%). In other age groups it overestimated weight, with mean percentage errors ranging from 3.41% to 6.25%. Across all age groups the Broselow method was most precise, with tendency to underestimate weight across age groups with mean percentage errors ranging from -5.28% to -7.24%. The APLS method was least accurate and precise, with mean percentage errors ranging from -12.61% to -17.36%. Net weight underestimation errors exceeding 20% were associated with increased mean body mass index. The Best Guess weight estimation method is accurate, especially in children aged 1-4 years. It moderately overestimates weight in other ages. The Broselow method was more precise, whereas the APLS method was the least accurate and precise of all. The ease of use of the Broselow method argues for greater use in the ED and prehospital setting.

Role of a second stage partogram in predicting the outcome of normal labour

Management of the second stage of labour is dictated by arbitrary time limits rather than true measures of progress. No partogram is available for second stage of labour. To evaluate a partogram designed for use for the second stage of labour. This prospective cross-sectional analytical study included low-risk pregnant women with singleton fetuses with vertex presentations at term. From onset of the second stage, vaginal examinations were performed every 30 min until delivery. A scoring system developed by Sizer et al. was used based on station and position of fetal head. Scores were plotted on a second stage partogram and used to predict labour outcomes, such as duration of second stage and mode of delivery. Of 79 women examined, 73 had spontaneous vaginal delivery. Of the remaining six, four required oxytocin infusion and other two required vacuum extraction. The median durations of the second stage of labour for primigravidas (n = 34) and multigravidas (n = 45) were 35 and 25 min, respectively. The median Sizer's partogram score at the onset of second stage was 4. Multiple regression analysis showed that the partogram score (r2 = 0.27) and gravidity (r2 = 0.10) were independent predictors of duration of the second stage. There was a significant association between second stage progress plotted to the right of the partogram line and non-spontaneous delivery (P = 0.01). The second stage partogram score at onset can predict the duration of second stage. Poor progress plotted on the partogram is associated with non-spontaneous delivery.

The ability of computed tomography to identify a painful zygapophysial joint in patients with chronic low back pain.

A prospective cross-sectional analytic study. To assess in patients with chronic low back pain whether the presence or absence of pain originating from the lumbar zygapophysial joints correlates with changes seen on computed tomography. Results of studies have been divided as to whether or not radiologic imaging is able to predict those patients with pain originating from the zygapophysial joints. Sixty-three patients with low back pain lasting for longer than 3 months underwent computed tomography and blocks of the zygapophysial joints at L5-S1, L4-L5, and L3-L4. The zygapophysial joints of all images were scored by three independent, masked radiologists. Interobserver agreement was poor with intraclass correlation coefficients of 0.34-0.66 using total joint scores for all three assessors. Using the results of a repeat assessment with two radiologists there was no statistically significant difference in joint scores between those with and those without pain originating from the zygapophysial joint. Computed tomography has no place in the diagnosis of lumbar zygapophysial joint pain.