3 research outputs found
Antenatal screening for chromosomal and genetic abnormalities:Cost effectiveness and outcome
Introduction: As an
essential part of antenatal care, pregnant women of all ages should be offered
screening for chromosomal abnormalities before 20 weeks of gestation. This
study was aimed to evaluate the type and frequency of chromosomal abnormalities
following pregnancy screening tests, so that we can compare the actual
pregnancy outcomes with test results, helping us in practical decision making.
Methods: A cross-sectional study was conducted on 557
pregnant patients, presenting for prenatal diagnostic amniocentesis for
chromosomal abnormalities, to Al-Zahra hospital, Tabriz, Iran, since 2012 to
2015. Amniocentesis was conducted by an expert obstetrician at second trimester
between 16 and 22 weeks of gestation. An interview was set for pregnancy
outcomes to assess the test results.
Results: Of
557 cases, the mean maternal age in amniocentesis was 31.84 ± 6.92 years
(range:
15-47 years). Amniocentesis revealed the presence of chromosomal abnormalities
in 32 cases (5.7%). The most common diagnosed chromosomal abnormality was Down
syndrome (50.0%) followed by other chromosomal abnormalities. Following up the
patients, 92.4% of newborns did not have any congenital abnormality, but the
remaining (7.6%) had both chromosomal and non-chromosomal abnormalities. No
fetal loss was reported in this study. Assessment of
total costs revealed that US500 for genetic tests.
Conclusion:
There is still no consensus on the most
cost-effective strategy that should be implemented to diagnose chromosomal anomalies.
Therefore, we did not have an actual gold standard to compare with
amniocentesis. More studies analyzing natural outcome after prenatal diagnosis
of these chromosomal abnormalities are neede
Long-term results of open gastric bypass with Roux-en-Y method for morbid obesity: brief report
Background: This study aims to evaluate the outcomes and late complications of open Roux-en-Y gastric bypass surgery in the treatment of morbid obesity.
Methods: Over a 15 year-period between May 1997 and May 2012, we reviewed our experiments with 39 patients who underwent open gastric bypass for morbid obesity. The weight of the patient and surgical complications were recorded. Ideal weight, body mass index, weight loss and excess weight loss were calculated.
Results: The follow up period ranged from 6 to 180 months with a mean of 100 months after operation. Average weight loss was 3.9 and 0.28 kg per month during the first and second years after operation weight loss was slower from the third year on-wards. Weight loss generally was stabilized between 12 and 18 months after operation. Only one patient (2.6%) had a weight loss failure criterion. Concomitant condition ex-isted in 14 patients (48.2%) of our series. These included hypertension in 3 cases (10.3%) that was resolved in 100%, diabetes mellitus in 4 (13.7%) that was resolved in 75%, cholelithiasis in 7 cases (24.1%) that was resolved by cholecystectomy during the operation. There was no early postoperative death. Early complications occurred in 2 patients (5.1%), including pulmonary embolism (2.6%) and gastrointestinal bleeding (2.6%). The late complications occurred in 7 patients (17.9%) involved 2 patients with anastomotic stricture at the gastrojejunostomy (5.1%), One patient with symptomatic cholelithiasis (2.6%), three patient with anemia (7.7%), and one patient had Wernicke ’s disease who died of this complication (2.6%).
Conclusion: The results of the study showed that the open Roux-en-Y gastric bypass surgery is an effective procedure in the treatment of morbid obesity with minimal late complications
Staphylococcus aureus: resistance pattern and risk factors
Introduction: Methicillin resistant Staphylococcus aureus (MRSA) has emerged as a nosocomial pathogen of major worldwide importance and is an increasingly frequent cause of community-acquired infections. In this study, different risk factors and MRSA resistance pattern were investigated. Methods: In a 24 months period, all of the patients who were confined to bed in the surgery ward were included in the study. Then they were assessed to find out as if they had MRSA infection when hospitalized and once when they were discharged. Almost 48 h after admission, when patients were discharged, social and medical histories were acquired. Acquired samples were examined. Results: During the present study of 475 patients, 108 patients (22.8%) had S. aureus. About frequency of antibiotic resistance among collected S. aureus colonies, erythromycin resistance, was the most frequent antibiotic resistance, also resistance to vancomycin was 0.4% that was the least. Only hospitalization duration had statistically significant correlation with antibiotic resistance, also resistance to erythromycin had statistically significant relation with history of surgery and alcohol consumption. Of all 34 MRSA species, 22 (64.7%) samples were resistant to erythromycin, 17 (50.0%) resistant to cefoxitin, 5 (14.7%) resistant to mupirocin, 1 (2.9%) resistant to vancomycin and 1 (2.9%) resistant to linezolid. Conclusion: The results of the current study show that among hospitalized patients, there is resistance against methicillin. Since based on results of the study there is resistance against oxacillin and erythromycin in most cases, administering appropriate antibiotics have an important role in minimizing the resistance burden among bacterial species