Association of Teenage Pregnancy with Increased Risk of Maternal and Neonatal Complications: An Overview | Chapter 9 | Medicine and Medical Research: New Perspectives Vol. 7

The present study examines whether teenage pregnancy is associated with an increased risk of maternal and neonatal complications compared to adults through a systematic literature review to help clinicians in their actions before and during pregnancy in adolescents. Adolescent pregnancy is still a common occurrence, mostly in developing nations. Because it is associated with both obstetric and perinatal outcomes, maternal age is an important factor to consider while managing obstetric patients. A literature review to address the obstetric results of pregnancy in teenage mothers was conducted. Articles for the last 5 years in different databases including ‘Pregnancy’, ‘Teenager’, ‘Adolescent’, ‘Complications’, and ‘Outcomes’ as keywords were reviewed. A total of 2260 articles were obtained after the initial search, but only 28 met the inclusion criteria and were therefore reviewed. The outcomes were divided into complications of pregnancy, childbirth, puerperium, and neonatal complications. It was found that there is an association between young maternal age and preterm birth, pre-eclampsia/eclampsia, fetal growth restriction, and stillbirth, among others. The results of this review indicate that there is an association between young maternal age and low birth weight, preterm birth, pre-eclampsia/eclampsia, anaemia, fetal growth restriction, stillbirth, and premature rupture of membranes. For the newborn, it was found that outcomes such as low APGAR scores and admission to intensive care were more frequent in teenage mothers. It is assumed that the risk is greater when taking into account other aspects such as the socio-economic and cultural impact on adolescents or the weight of parenting, data that do not arise from our research but should be the object of further studies. Finally, it is recommended that future research addressing adolescent pregnancy could help better understand this phenomenon and its implications.

 

Author (s) Details

Paller L
Clinica Ginecotocologica B, Uruguay.

 

Feldman F
Clinica Ginecotocologica B, Uruguay.

 

Lauria W
Clinica Ginecotocologica B, Uruguay.

 

Rey G
Clinica Ginecotocologica B, Universidad de la Republica, Uruguay.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v7/11725F

 

Organ Preservation Treatment for Clinical T1bN0M0 Thoracic Esophageal Squamous Cell Carcinoma: A Long-Term Outcome Analysis of Radical Esophagectomy vs. Definitive Chemoradiotherapy | Chapter 7 | Medicine and Medical Research: New Perspectives Vol. 10

 

Background: For patients with clinical T1aN0M0 thoracic esophageal squamous cell carcinoma (ESCC), endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) are the standard treatment modalities. For patients with clinical staging higher than clinical T1aN0M0 thoracic ESCC, surgery alone, chemotherapy, radiotherapy, or concurrent chemoradiotherapy are the standard treatment options. For patients with clinical T1aN0M0 thoracic ESCC, surgery is currently the recommended clinical treatment, but surgery may entail potential risks and loss of organ function. Therefore, the study conducted a retrospective analysis comparing the long-term outcomes of patients with clinical T1bN0M0 thoracic ESCC treated with radical esophagectomy to those treated with definitive chemoradiotherapy (dCRT).

Methods: A total of 320 consecutive patients with clinical T1bN0M0 thoracic ESCC who initially underwent radical esophagectomy or chemoradiotherapy during 2001–2011 were deemed eligible. Of these patients, 102 and 218 underwent radical esophagectomy and dCRT, respectively. Overall survival (OS) and causes of death were compared between the esophagectomy group and the chemoradiotherapy group.

Results: Five-year OS in the esophagectomy group was significantly better than that of the chemoradiotherapy group in both the overall sample and a subset of patients aged 70 years (P=0.004 and P=0.040). Male patients appeared to benefit more from radical esophagectomy (P=0.005). Until 2006, radical esophagectomy yielded superior results relative to dCRT (P=0.009). However, the survival outcomes after chemoradiotherapy were non-inferior to those after esophagectomy since 2007 (P=0.255). Up to 2006, esophagectomy and chemoradiotherapy groups exhibited significant differences in the causes of death (P=0.024), such that the latter group had a significantly higher rate of deaths due to respiratory complications (P=0.025). However, the introduction of 3-dimensional radiation with CT-guided planning in 2007 resolved this inter-group difference (P=0.460). The SANO study's findings in organ preservation in esophageal cancer have spurred further research into more organ-sparing treatment strategies for esophageal cancer and have provided patients with a new therapeutic option.

Conclusions: Significant advancements in radiation technology have facilitated comparable long-term outcomes for patients with clinical T1bN0M0 thoracic esophageal squamous cell carcinoma (ESCC) in the chemoradiotherapy group, rivaling those of the esophagectomy group.

In recent years, the increasingly prominent role of immunotherapeutic drugs in the treatment of esophageal squamous cell carcinoma has made organ preservation an increasingly viable option for early-stage esophageal cancer. The SANO clinical study from the Netherlands, which has achieved notable results in organ-sparing strategies for esophageal cancer, has propelled further research into esophageal organ preservation treatment approaches. This progress also offers patients a novel therapeutic alternative.

 

Author (s) Details

Hongbo Zhao
Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan and Department of Thoracic Surgery, National Cancer Center / National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shenzhen 518116, China.

 

Kazuo Koyanagi
Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan and Department of Gastroenterological Surgery, Tokai University School of Medicine, Tokyo, Japan.

 

Ken Kato
Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

 

Yoshinori Ito
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.

 

Jun Itami
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.

 

Hiroyasu Igaki
Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan.

 

Yuji Tachimori
Cancer Care Center, Kawasaki Saiwai Hospital, Kawasaki, Japan.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v10/2584

Unraveling the Weighty Enigma: Exploring the Intricate Relationship between Obesity and Intracerebral Hemorrhage | Chapter 4 | Achievements and Challenges of Medicine and Medical Science Vol. 2

Introduction: Obesity is a global health concern with significant implications for various medical conditions, including cerebrovascular diseases. Intracerebral hemorrhage (ICH), characterized by bleeding within the brain parenchyma, is a severe form of stroke. While obesity is linked to an increased risk of cardiovascular diseases, its specific relationship with ICH is not well understood. This study aims to explore how obesity influences the incidence, severity, and outcomes of ICH.

Methodology: A retrospective cohort study was conducted at D.Y. Patil Medical College, and Hospital Kolhapur, from 2019-2023. The cohort included 500 ICH patients, with detailed clinical and demographic data collected. Statistical analyses, including logistic regression and survival analysis, assessed the relationship between obesity and ICH incidence, severity, short-term survival, and long-term outcomes.

Results: Obesity was significantly associated with an increased incidence of ICH. Interestingly, obese patients showed a short-term survival advantage, with lower mortality rates in the weeks following ICH. However, this benefit diminished over time, with no significant differences in long-term outcomes across BMI categories. Obese patients did not exhibit greater ICH severity or complications compared to non-obese patients.

Conclusion: Obesity is associated with an increased risk of ICH and a paradoxical short-term survival advantage. However, this benefit fades over time, emphasizing the need for continued monitoring and tailored interventions in obese ICH patients.

 

Author (s) Details

Sagar Goya
D. Y. Patil Medical College, Kolhapur, Maharashtra, India.

 

Gayatri G. Dhavalshankh
Department of Pharmacology, D. Y. Patil Medical College, Kolhapur, Maharashtra, India.

 

Sheetal
Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India.

 

Ganesh P. Dhavalshank
Department of Dermatology, D. Y. Patil Medical College, Kolhapur, Maharashtra, India.

 

Archana G. Dhavalshankh
Department of Pharmacology, D. Y. Patil Medical College, Kolhapur, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v2/2938

Bilateral Paediatric Cataract Surgery: An Observational Cohort Study at Kinshasa, Democratic Republic of the Congo | Chapter 8 | Advancement and New Understanding in Medical Science Vol. 5

 Introduction: Cataract is the main cause of blindness among children in Africa, replacing vitamin A deficiency and measles thanks to successful immunization programs. The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and diminish the burden of childhood blindness.

Objective: This retrospective observational cohort study reports the long-term outcomes of 298 children who had bilateral cataract surgery with IOL implantation from 2001-2016 in Kinshasa, Democratic Republic of the Congo.

Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient’s follow-up, complications, and visual outcomes were recorded and analysed.

Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%). Most of the children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%). Complications that also negatively influence outcomes can be divided into short-term and long-term. Short-term complications (2.3%) include retinal detachment and IOL decentration. Long-term complications (7.3%) are composed of the groups of secondary glaucoma and secondary cataracts.

Conclusion: In spite of the post-conflict challenges, the elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long-term follow-up is poor. There is a need for program strengthening in these areas.  It is recommended that the incorporation of routine cataract surgical outcome auditing should be performed regularly to monitor outcomes by surgeon. This has been seen to facilitate consist improvement in surgeons and centre surgical outcomes and enhances a reduction in surgical complication over time.

Author(s) Details:

Janvier Kilangalanga Ngoy,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.

Thomas Stahnke,
Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.

Serge Dinkulu,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.

Emile Makwanga,
Programme National de Sante Oculaire et Vision (PNSOV), Kinshasa, DRC.

Astrid Moanda,
Réhabilitation à Assise Communautaire (RAC/CBR), Kinshasa, DRC.

Georgette Ngweme,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.

Edith Mukwanseke,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.

Günther Kundt,
Rostock University Medical Center, Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock, Germany.

Frank Thiesen,
Rostock University Medical Center, Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock, Germany.

Adrian Hopkins,
Programme National de Sante Oculaire et Vision (PNSOV), Kinshasa, DRC.

Rudolf F. Guthoff,
Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.

Please see the link here: https://stm.bookpi.org/ANUMS-V5/article/view/13308

Qualitative Analysis of Free Reproductive and Maternal Health Care and Its Implications for Universal Health Coverage in Kenya | Chapter 09 | Emerging Trends in Disease and Health Research Vol. 6

 Universal health coverage and equity are the primary goals of any health-care system in the world. As a result, Kenya's government has made improving reproductive, maternal, child, and adolescent health (RMCAH) outcomes a top priority. The government of Kenya's 'Linda Mama' project intends to increase access, equity, and coverage of RMCAH services utilising tax revenues that go directly from the NHIF to the bank accounts of individual healthcare facilities. Antenatal care, delivery services, postnatal care, emergency referrals, conditions and difficulties throughout pregnancy, and infant care are all included in the initiative's benefit packages, which follow national norms. In actuality, several of these services are not provided by health care facilities. Furthermore, the implementation has encountered a number of difficulties that have harmed the country's capacity to achieve the planned goals. High catastrophic health expenses, limited geographic access, bureaucracy in getting money by public facilities, unpredictability, and delays in disbursement of funds are only a few examples. Other issues include low payment rates, a complex claim process caused by a lack of training, and poorly developed hardware for filing claims in the public sector. In order to adequately address important social determinants of RMCAH such as education, sociocultural factors, nutrition and food security, housing, communication, transportation, access to safe water, sanitation, and hygiene, achieving UHC in this area requires a multi-sectoral strategy.

Author(S) Details

C. T. Okech
Chandaria School of Business, United States International University (USIU), Kenya.

B. O. Awuonda
Department of Paediatrics & Child Health, School of Medicine, Maseno University, Kenya.

View Book:- https://stm.bookpi.org/ETDHR-V6/article/view/6421

A Systemic Review on Robotic Versus Laparoscopic Adrenalectomy | New Visions in Science and Technology Vol. 5

 Background: For most surgical procedures, minimally invasive surgery has become the norm. Many research have been conducted to compare robotic and laparoscopic adrenalectomy.   The goal of this study is to look at the majority of the papers that compare robotic and laparoscopic adrenalectomy to see whether treatment has better clinical outcomes. Methods: A comprehensive search of the ScienceDirect and PubMed databases. Two independent reviewers gathered the perioperative clinical results. The pooled effect estimates were calculated using random-effects (DerSimonian-Laird) models.   In our investigation, 18 studies were found to be eligible. Ten of them were prospective, while the other eight were retrospective. A total of 1376 patients underwent adrenalectomy, with 592 (43.02%) receiving RA treatment and 784 (56.9%) receiving LA treatment. The conversion rate (OR: 0.70, 95 percent CI 0.31-1.57, P= 0.65), intraoperative complications (OR: 2.18, 95 percent CI 0.49- 9.71, P= 0.28), post-operative complications (OR: 0.83, 95 percent CI 0.55-1.24, P= 0.49), and mortality (OR: 0.42, 95 percent CI 0.07-2.72, P= 0.98) were all similar in both groups. Robotic adrenalectomy, on the other hand, was related with longer operational times (MD: 9.89 min, 95 percent CI: -2.79 to 22.58), a shorter hospital stay (MD: -0.33, 95 percent CI: -0.46 to -0.21), and less blood loss (MD: -0.33, 95 percent CI: -0.46 to -0.21). (MD: -25.34, 95 percent CI: -36.77 to -13.91). Conclusions: When compared to laparoscopic adrenalectomy, we found that robotic adrenalectomy is equally safe and feasible, with similar clinical outcomes. To assess the role and cost-effectiveness of robotic adrenal surgery, however, further well-designed research are needed.

Author (S) Details

Emad Rezkallah

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

Andrew Elsaify

Medical School, Misr University for Science and Technology, Egypt.

Grace Lim

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

Wael Elsaify

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

View Book :- https://stm.bookpi.org/NVST-V5/article/view/4101

An Experience in a Single Hospital in the City of São Paulo, Brazil: Epidemiology of Metastatic Lesions and Aggressive Benign Lesions Affecting the Spine | Chapter 10 | Highlights on Medicine and Medical Science Vol. 12

 The goal of this study is to determine the occurrence of metastatic lesions in the spine, as well as to diagnose and stage them.

Materials and Procedures: This study covered patients with metastatic lesions in the spine, either single or double locations, that could be treated surgically. Between July 2014 and July 2016, 67 cases were reviewed at the Hospital Santa Marcelina – Itaquera's orthopaedics outpatient clinic. Sex, age, tumour site, number of lesions, neurological condition, tumour type, and the occurrence of fractures were the variables studied.

The study enlisted the participation of 34 males and 33 women. The lumbar spine was the most severely affected, with L2 being the most severely affected, followed by L1 and L3. The primary tumour that revealed secondary implants in the column was breast cancer, followed by prostate cancer. The average age of the participants was 53 years old. The vertebral bodies of 45 individuals were fractured. We discovered abnormalities in 18 individuals and just 01 A Frankel while examining neurological changes.

Conclusion: All patients treated for primary tumours who have axial pain or have cracked vertebrae should be thoroughly examined, including imaging of the entire spine, because the spine is affected by 40-50 percent of metastatic distant lesions.

Author (S) Details

Luiz Cláudio Lacerda Rodrigues
Santa Marcelina School of Medicine, Brazil.

Fernanda Andrea Minutti Navaro
Department of Orthopedics and Traumatology, Hospital Santa Marcelina, Brazil.

Rodrigo Yuiti Nakao
Department of Orthopedics and Traumatology, Hospital Santa Marcelina, Brazil.

Nathalia Adelina Neves Justino Pereira
Santa Marcelina School of Medicine, Brazil.

View Book :- https://stm.bookpi.org/HMMS-V12/article/view/2701

A Review of Surgical Management Options of Megameatus Intact Prepuce | Chapter 14 | Highlights on Medicine and Medical Science Vol. 2

 First and foremost, Megameatus intact prepuce (MIP) is a rare form of glandular hypospadias that affects about 3-6 percent of hypospadias patients. Surgical options in the management of megameatus intact prepuce depend on multiple scenarios and are multifactorial, resulting in a variety of surgical options with varying outcomes. The purpose of this article is to go over the surgical options for this rare type of hypospadias known as megameatus intact prepuce.

Materials and Methods: We look for information on the platforms listed below. Google Scholar, PubMed Central (PMC), PubMed, AJOL, and EMBASE for articles on Megameatus intact prepuce, and the last search was on 14th May, 2021, using the keywords surgical management options of megameatus intact prepuce, and the relevant articles were reviewed to extract surgical management options of megameatus intact prepuce variant of hypospadias from experts.

Results: Several surgical techniques, including the glanular approximation procedure (GAP), the pyramid procedure, the cutaneous advancement procedure, the tubularised incised plate (TIP), the tubularised Urethral Plate Urethroplasty (TUPU), the Mathieu technique, and the subcutaneous frenulum flap with many modifications, are used to restore function and cosmesis in MIP.

Discussion: MIP is a rare condition that was first described by Juskiewenski and colleagues in 1983. Several researchers have reported on various surgical treatment options with varying results. In 2011, Elbatarny et al observed GAP in seventeen patients with MIP over a five-year period, with an excellent outcome in 14 patients and a subjective score of 1 in two patients, with one patient expressing disappointment with the outcome. M. Sanal et al. discovered an excellent outcome in seven GAP cases.

Conclusion: The surgical management options for megameatus intact prepuce are numerous, with varying modifications and outcomes, necessitating a urologist's knowledge of as many procedures as possible to achieve a desired goal in treating this group of patients with an unusual anomaly.

Author (s) Details

Dr. Muhammad Ujudud Musa
Department of Surgery, Federal Medical Center Katsina, Katsina State, Nigeria.

Abdulkadir Abubakar
Department of Surgery, Aminu Kano Teaching Hospital Kano, Kano State, Nigeria.

Dr. Bashir Yunusa
Department of Surgery, Aminu Kano Teaching Hospital Kano, Kano State, Nigeria.

Sadiq Abubakar
Department of Surgery, Usman Danfodio University Teaching Hospital Sokoto, Sokoto State, Nigeria

View Book :- https://stm.bookpi.org/HMMS-V2/article/view/1360