RESUMO
BACKGROUND: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries. AIMS: The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome. STUDY DESIGN: A prospective cross-sectional study. METHODS: This prospective study was conducted between January 2013 and May 2014. In total 570 women with AKI were referred to the Kidney Institute during this period, out of which 52 patients with obstetrics AKI were included in this study. RESULTS: Incidence of obstetric AKI was 9.12 %. Their age varied from 19 to 34 years, with an average of 26.2 years. About 42(80.8 %) patients had not received antenatal care. The main causes of AKI were obstetric hemorrhage (38.46 %) and puerperal sepsis (15.38 %). The outcome was favorable with complete renal function recovery in 55.76 % patients. Four (7.69 %) patients became dialysis dependent. Maternal mortality was 32.69 %. CONCLUSION: Obstetric AKI is a critical situation in developing countries. Lack of antenatal care (80.8 %) is a major contributing factor for obstetric-related complications leading to renal failure. Obstetric hemorrhage (38.46 %) is the most common cause of obstetric AKI. Late referral in 18 (34.61 %), puerperal sepsis in six (33.33 %), obstetric hemorrhage in five (27.77 %) and combined sepsis and hemorrhage in five (27.77 %) are the common contributing factors leading to its unfavorable outcomes as maternal morbidity and mortality. Hence, a multidisciplinary approach is warranted to prevent such an avoidable complication.
RESUMO
BACKGROUND: Endometriosis appears to affect every aspect of a women's reproductive system resulting in infertility and spontaneous pregnancy loss. This study aims to find out the prevalence & clinical characteristics of endometriosis amongst infertile women. SETTINGS AND DESIGN: A Hospital based retrospective study over a period of one year. MATERIALS AND METHODS: It is a retrospective study conducted in the gynaecology department in Institute of Kidney Diseases & Research Centre; Ahmedabad from April 2012 to March 2013 amongst women with a primary complaint of infertility (Primary/Secondary).A total of 372 patients underwent diagnostic hysterolaparoscopy and of these 180 patients who had laparoscopic evidence of endometriosis was included in the study. All of these patients and their findings were analysed with respect to the clinical signs and symptoms. The outcome after appropriate management was analysed in subsequent follow up. STATISTICAL ANALYSIS: All collected data was entered into the SPSS version 20. Categorical data are expressed in frequency or percentage. Chi-Square test and Fisher-Exact test has been performed to carry out p-value for categorical data. P-value <0.05 shows statistically significant difference. RESULTS: The frequency of endometriosis among women with infertility subjected to diagnostic hysterolaparoscopy was found to be 48.38%. Statistical significant association with severity of disease was associated with symptoms like dysmenorrhea, chronic pelvic pain, restricted uterine mobility and adnexal tenderness. (p <0.01) Ultrasound finding of endometrioma with ground glas appearance also had statistical significant association with staging of disease (p <0.01). CONCLUSION: Endometriosis amongst infertile women is increasingly being detected due to greater use of laparoscopy in evaluation of infertility.Though most signs do not correlate with severity of disease however the presence of restricted uterine mobility, adnexal tenderness & chronic pelvic pain should always raise the suspicion of endometriosis. Laparoscopy remains the gold standard for diagnosing and staging endometriosis.
RESUMO
BACKGROUND: Olecranon fractures are one of the most commonly seen orthopaedic injuries in the emergency room. The K-wire which is used in the AO Tension Band Wiring (TBW) technique resists the shear better than the figure of eight wire alone, but, it does not add compression to the fixation strength. But, the cancellous screw plus the tension band wire, in combination, provides the strength of fixation i.e., by converting the tensile force to a compressive force at the fracture site, with additional resistance to the displacement due to the lag screw compression. OBJECTIVE: To clinically evaluate the result of the cancellous screw with tension band wiring for fractures of the olecranon.To assess the elbow joint motion and stability after the procedure. MATERIAL AND METHODS: Tweenty five cases of fractures of the olecranon which were treated by using 6.5mm AO cancellous screws with a screw length of 80-105mm with a 16 gauge TBW, were evaluated . All the cases were followed up and the results were analyzed by using a 19 point scale. RESULTS: The results which were obtained in our series were excellent in 15(60%) patients, good in 3(12%) patients and fair in 7(28%) patients and there were no poor results. CONCLUSION: The technique of open reduction and internal fixation with a 6.5mm AO cancellous screw and TBW, is a simple and effective means of treating fractures of the olecranon and it is based on the biomechanical principle of sound.
