Notes

[Professor ZHENG Liang's experience as well as understanding of postoperative cosmetic paralysis treated with acupotomy].
Excess serum growth hormone (GH) induces insulin resistance leading to reduced uptake of glucose in peripheral tissues, gluconeogenesis in the liver and lipolysis and finally an increase in the blood glucose levels. We report a case where a 54-year-old woman presented with uncontrolled blood glucose levels since 5 years. On examination, she had signs and symptoms consistent with acromegaly including recurrent headaches, sleep apnea, soft tissue swelling, enlargements of the feet, hands, ears and lips, mandibular overgrowth, forehead protrusio and teeth spacing. She was on oral hypoglycemic agents (OHAs) for 12 years before she visited our hospital, but the blood glucose levels have been uncontrolled for the past 5 years with recurrent hyperglycaemic and occasional hypoglycaemic events. She underwent pituitary surgery for GH producing tumor and 2 years post surgery, we had to stop all the medications for the diabetes mellitus. This indicates that even long-standing diabetes mellitus can resolve in some patients with acromegaly. © 2020 Sreeramaneni and Ghanta.Background Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case-control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE. Methods We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P less then 0.01). Conclusion Our results suggest that previous UAE is a significant risk factor for PAS. © 2020 Jitsumori et al.Background Maternal health delays like delay in deciding to seek care, reaching a health facility, and receiving appropriate care were identified as the main contributing factors for maternal mortality and morbidity in many developing countries including Ethiopia. However, little is known about the magnitude and factors predisposing for maternal health delays in Ethiopia especially in a rural part of the country. Therefore, the aim of this study is to assess the magnitude of maternal delays for institutional delivery and associated factors among mothers attending post-natal service at public health facilities of the Gamo zone, Southern Ethiopia. Methods A cross-sectional study was conducted in rural districts of Gamo zone. Eleven public health centers in the two districts were selected randomly. The Systematic random sampling method was used to select study participants from each public health centers. A total of 394 postnatal mothers were selected every secondly and interviewed in a separate room. Face to fates that most mothers were not receiving institutional delivery services at the recommended time. Maternal socio-economic, obstetric factors and health-care system factors affected the three delays in this study. Therefore, improving women empowerment and resource availability at health facilities is vital. © 2020 Wanaka et al.Purpose There is a growing evidence suggesting that hypertensive disorders of pregnancy (HDP), especially preeclampsia, are associated with an increased risk of cardiometabolic disease for both mother and child later in life. The objective of this study was to determine the association of maternal and umbilical cord blood (UCB) lipid profiles with uterine and fetal-placental blood flow at the third trimester of pregnancy. Patients and Methods A total of 1,135 women were prospectively followed through pregnancy and data for 812 mother-newborn pairs, including 170 HDP ‎developed subjects and ‎642 ‎normotensive subjects were analyzed at the end of the study. Maternal serum and UCB triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and non-HDL-C levels were compared between HDP and normotensive groups; moreover, the association between lipid parameters and abnormal pulsatility indices (PIs) of uterine (UtA), umbilical (UA), and middle cerebral (MCA) arteries was evaluated with multivariate regression analysis models. The same analyses were carried out on subgroups of HDP (preeclampsia vs gestational hypertension). Results The mean TG, TC, LDL-C, and non-HDL-C levels were significantly higher in mother-newborn pairs of the HDP group compared to the normotensive group. In the HDP group, maternal TG and non-HDL-C levels were shown to have a significant association with abnormal UtA-PI (p less then 0.001 and p=0.039, respectively). We also found a positive significant association of fetal hypertriglyceridemia with abnormal UA-PI and MCA-PI in the HDP group (p=0.042 and p=0.021, respectively). However, no such associations were observed in normotensive mother-newborn pairs. Similar trends were observed in preeclamptic subjects after subgroup analysis. Conclusion Maternal TG and non-HDL-C levels as well as fetal TG level are significantly associated with disturbed uterine and fetal-placental blood flow in HDP. © 2020 Hessami et al.Purpose For thousands of years, fertility control has been used in different forms. This study was carried out to evaluate the knowledge and practice of participants regarding birth control methods with the prevalence of each method. Patients and Methods A cross-sectional study design was employed to evaluate knowledge and practice among females. Three family-planning centers were included in addition to 2 general hospitals. A total of 440 married women between the ages of 18 and 40 years were interviewed by the first author. Self-administered version of a previously translated questionnaire was used to evaluate practice and knowledge concerning contraception use. Results A total sample of 388 women of child-bearing age was interviewed. The mean age ± SD was 29.76 ± 6.67, while the mean number of their offspring was 4.06 ± 2.08. The intrauterine contraceptive device was the most frequently used method followed by oral contraceptive pills, while the safe-period method was the least frequently used. More than 5m contraception and the incidence of unplanned pregnancies. © 2020 Aldabbagh and Al-Qazaz.Background Poisoning causes significant patient morbidity and mortality worldwide. It is a common reason for emergency department visits and hospitalizations. Acute poisoning needs immediate effective management to prevent patient mortality or sequela. This study was carried out to determine the pattern of acute poisoning cases and their management at the emergency department of Dessie referral hospital, northeast Ethiopia. Methods A retrospective cross-sectional study of all registered poisoning cases managed at the emergency department of Dessie referral hospital was conducted from March 10 to May 2, 2018. Results There were a total of 147 registered poisoning cases listed in the registry during the study period, of which 120 cases (81.6%) had complete data and were included in the study. Among the total of 120 studied poisoning cases, 66 (55%) were females, and 53 (44.2%) were in the age group of 21-30 years. The causative poison was documented for 118 cases. Organophosphates were the most common poisoninhe three major reasons for intentional poisoning were mental disorders (20.8%), family disharmony (19.2%) and marital disharmony (15.8%). Cimetidine (98.3%) was the most commonly used pharmacologic treatment of the poisoning cases. © 2020 Getie and Belayneh.Purpose To investigate whether progestin-primed ovarian stimulation (PPOS) can be an alternative as gonadotrophin-releasing hormone agonist (GnRHa) long protocol for infertile women with normal ovarian reserve during IVF/ICSI. Methods A prospective randomized controlled trial (RCT) including 257 patients was conducted between 1 August 2017 to 1 January 2018. Computerized randomization was performed to assign participants into two treatment groups at a 11 ratio PPOS (130 patients) or GnRHa long protocol (127 patients) followed by their first IVF/ICSI with fresh/frozen embryo transfer. The primary outcome was the number of oocytes retrieved. Patients with normal ovarian reserve undergoing their first IVF/ICSI procedure were included. The embryological and clinical outcomes were measured. Only the first embryo transfer cycle was followed-up. Results Basic characteristics such as infertility duration, age, and body mass index (BMI) were comparable in both groups. Midostaurin price No significant difference was found in the number tive of the treatments for infertile patients with normal ovarian reserve undergoing IVF as well as traditional protocols. Trial Registration Number ChiCTR-INR-17012089. Trial Registration Date Chictr.org.cn 23 July 2017. Date of First Patient’s Enrollment 1 August 2017. © 2020 Xi et al.Purpose The majority of acutely admitted older medical patients are multimorbid, receive multiple drugs, and experience a complex treatment regime. To be able to optimize treatment and care, we need more knowledge of the association between different patterns of multimorbidity and healthcare utilization and the complexity thereof. The purpose was therefore to investigate patterns of multimorbidity in a Danish national cohort of acutely hospitalized medical patients aged 65 and older and to determine the association between these multimorbid patterns with the healthcare utilization and complexity. Patients and Methods Longitudinal cohort study of 129,900 (53% women) patients. Latent class analysis (LCA) was used to develop patterns of multimorbidity based on 22 chronic conditions ascertained from Danish national registers. A latent class regression was used to test for differences in healthcare utilization and healthcare complexity among the patterns measured in the year leading up to the index admission. Results LCA identified eight distinct multimorbid patterns. Patients belonging to multimorbid patterns including the major chronic conditions; diabetes and chronic obstructive pulmonary disease was associated with higher odds of healthcare utilization and complexity than the reference pattern ("Minimal chronic conditions"). The pattern with the highest number of chronic conditions did not show the highest healthcare utilization nor complexity. Conclusion Our study showed that chronic conditions cluster together and that these patterns differ in healthcare utilization and complexity. Patterns of multimorbidity have the potential to be used in epidemiological studies of healthcare planning but should be confirmed in other population-based studies. © 2020 Juul-Larsen et al.
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