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Emergency Open Cardiac Massage via Subxyphoid Approach in Ruptured Type A Aortic Dissection  [cached]
Hsing-Lin Lin,Wei-Che Lee,Shing-Ghi Lin,Liang-Chi Kuo
Signa Vitae , 2010,
Abstract: Patient sustained cardiac tamponade caused by rupture of type A aortic dissection may result in sudden death. Pericardiocentesis is a lifesaving procedure; nevertheless, blood may occlude the catheter and fail to relieve the pressure. However, open-chest cardiac massage in resuscitation has been studied in animal models by some medical centers and laboratories with inspiring results. We report a 58-year-old woman who was transferred from a local hospital with the diagnosis of cardiac tamponade caused by ruptured type A aortic dissection. Pulseless electrical activity followed by cardiac arrest occurred thereafter. Successful resuscitation in the emergency department was achieved using open cardiac massage through the sub-xyphoid region by opening a pericardial window. Therefore, in unstable patients with cardiac tamponade due to aortic dissection, this resuscitative procedure is feasible, safe and efficient.
Perineal massage
Laura Duarte González,Silvia García González,Ma Carmen Mejías Paneque
NURE Investigación , 2013,
Abstract: Most women want to give birth without perineal tears, cuts or sutures, because these often cause back pain and discomfort and may have a negative impact on sexual functioning. It is suggested that perineal massage during the last month of pregnancy as a possible way of allowing the perineal tissue to expand more easily during birth. Perineal massage, which makes the woman or her partner (for only one or two times a week from 35 weeks) reduces the likelihood of perineal trauma (mainly episiotomies) and perineal pain during and after birth.The FAME (Federation of Associations for Midwives in Spain) recognizes that perineal massage during pregnancy reduces perineal trauma (episiotomy and tears) during childbirth.
RUPTURED UTERUS
YASMEEN AKHTAR
The Professional Medical Journal , 2010,
Abstract: Objective: To analyze the risk factors for uterine rupture and to share the 5 years experience of ruptured uterus with othercolleagues of the specialty. Study design: Case series descriptive study. Settings: Gynae /Obstetrics Unit -I Lady Willingdon Hospital Lahore. Study Duration: Five years i.e Ist May 2004 to 30th April 2009. Material and Methods: Obstetric patients who presented with ruptured uteri. Results: Results showed that risk factor for ruptured uteri include cesarean sections (61.11%), grand multiparty (16.6%), Instrumental deliveries (4.44%) and undetected perforation (1.11%). Conclusion: Ruptured uterus is a high risk category of patients. The patients with previous scar, grand multiparas, obstructed prolonged labour must be managed by proper trained personnel and in tertiary care centers in order to avoid the morbidity or mortality due to ruptured uterus.
Management of foetal asphyxia by intrauterine foetal resuscitation
Velayudhareddy S,Kirankumar H
Indian Journal of Anaesthesia , 2010,
Abstract: Management of foetal distress is a subject of gynaecological interest, but an anaesthesiologist should know about resuscitation, because he should be able to treat the patient, whenever he is directly involved in managing the parturient patient during labour analgesia and before an emergency operative delivery. Progressive asphyxia is known as foetal distress; the foetus does not breathe directly from the atmosphere, but depends on maternal circulation for its oxygen requirement. The oxygen delivery to the foetus depends on the placental (maternal side), placental transfer and foetal circulation. Oxygen transport to the foetus is reduced physiologically during uterine contractions in labour. Significant impairment of oxygen transport to the foetus, either temporary or permanent may cause foetal distress, resulting in progressive hypoxia and acidosis. Intrauterine foetal resuscitation comprises of applying measures to a mother in active labour, with the intention of improving oxygen delivery to the distressed foetus to the base line, if the placenta is functioning normally. These measures include left lateral recumbent position, high flow oxygen administration, tocolysis to reduce uterine contractions, rapid intravenous fluid administration, vasopressors for correction of maternal hypotension and amnioinfusion for improving uterine blood flow. Intrauterine Foetal Resuscitation measures are easy to perform and do not require extensive resources, but the results are encouraging in improving the foetal well-being. The anaesthesiologist plays a major role in the application of intrauterine foetal resuscitation measures.
Ruptured uterus in Azare, north eastern Nigeria
LM Dattijo, NI Umar, BM Yusuf
Jos Journal of Medicine , 2011,
Abstract: Background:-Ruptured uterus is an obstetric emergency and results in significant maternal and perinatal morbidity and mortality in Nigeria. The objective of the review is to determine the incidence, predisposing factors, maternal and foetal outcome in cases of ruptured uterus. Methods:- A 4-year retrospective review of patients that had uterine rupture between July 2003 and June 2007 in Federal Medical Centre, Azare was carried out. Analysis of available records of the cases of ruptured uterus from the labour room, and theatre during the period under review was done. Results:-A total of 75 cases of ruptured uterus and 9015 deliveries were recorded in the period under review. The incidence of uterine rupture is 1 in 120 deliveries. The highest incidence of ruptured uterus was found in the grand multiparous women, 46 (63%). Injudicious use of oxytocin was found in more than half of the cases 41(56.2%). Majority of the rupture (56.3%) occurred in the lower segment. Thirty-two (45.1%) had repair and tubal ligation done. Maternal case fatality was 10.7% while foetal wastage was 86.3%.The commonest complication was anaemia, which occurred in 44% of the patients. Conclusion:-The incidence of uterine rupture is very high in Azare. There should be a multi-sectoral collaboration aimed at improving the utilization of medical services by the populace and the organization of health institutions offering obstetric emergency care. Key Words:-Uterine rupture, Predisposing factors, Management, Outcome, Azare
Touch and Massage for Medically Fragile Infants  [PDF]
Karen Livingston,Shay Beider,Alexis J. Kant,Constance C. Gallardo,Michael H. Joseph,Jeffrey I. Gold
Evidence-Based Complementary and Alternative Medicine , 2009, DOI: 10.1093/ecam/nem076
Abstract: Research investigating the efficacy of infant massage has largely focused on premature and low birth weight infants. The majority of investigations have neglected highly acute patients in academic neonatal intensive care units (NICUs). The current study was developed with two aims: (Phase 1) to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and (Phase 2) to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care in a level III academic Center for Newborn and Infant Critical Care (CNICC). Certified infant massage instructors (CIMIs) taught parents to massage their hospitalized infants. Massage therapy and instruction were performed for seven consecutive days and health outcomes were collected for up to 1 month following treatment. Caregivers, nurses and certified infant massage therapists indicated moderate to high levels of satisfaction and feasibility with the implementation of hand containment/massage in a level III academic center CNICC. In addition, infant behavioral and physiological measures were within safe limits during the massage sessions. All caregivers participating in the massage group reported high levels of satisfaction 7 days into the intervention and at the 1-month follow-up with regards to their relationship with their infant, the massage program's impact on that relationship and the massage program. Due to unequal and small sample sizes, between group analyses (control versus massage) were not conducted. Descriptive infant characteristics of health outcomes are described. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants' safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage. Massage in a tertiary urban academic NICU continues to be an area of needed study. Future studies examining infant health outcomes, such as weight gain, decreased length of hospitalization and caregiver–infant bonding, would provide greater insight into the impact of massage for medically fragile infants.
ANTENATAL FOETAL MONITORING
SHAHID IRSHAD
The Professional Medical Journal , 2003,
Abstract: This is one year study in which we selected 290 high risk pregnancies from antenatal clinic, which comprises19.8% of total patients who came to our clinic. Amongst these commonest age group was 21 -30 yearscomprising of 255 (77.5%) patients. Most of these patients were between 33-36 weeks of gestation i.e. 210(72.4%). Commonly presented patients had bad obstetrical history 110 (37.9%), reduced foetal movements80 (27.5%) anaemia 60(20.8%) and previous caesarean section 60 (20.8%). Diabetes mellitus 45 (15.5%)and pregnancy induced hypertension 40 (13.8%). Methods used for foetal monitoring were symphysis fundalheight chart, kick count chart, ultrasonography, cardiotocography and biophysical profile and Doppler bloodflow studies. The foetal loss in this group of 290 was only 3 (1.04%).
Ruptured tubal hydatidiform mole  [cached]
Modupeola Omotara Samaila,Adebiyi Gbadebo Adesiyun,Calvin Bifam
Journal of the Turkish-German Gynecological Association , 2009,
Abstract: Objective: Ruptured ectopic gestation is a life threatening medical emergency especially in developing countries. However, the occurrence of hydatidiform mole in ruptured tubal pregnancy is uncommon. Material and Methods: A consecutive analysis of patients with hydatidiform mole in ruptured tubal gestation over a 9-year period in a tertiary hospital. Results: Of a total of 101 females with ectopic gestations, only five had ruptured tubal hydatidiform mole. The ages ranged from 20-37years and they all presented with acute abdominal symptoms which necessitated emergency surgical intervention. Intra-operative findings revealed ruptured/ leaking tubal gestation. The excised tissue specimens showed hydatidiform mole characterized by circumferential trophoblastic proliferation, hydropic degeneration and stromal karyorrhexis. Patients’ serial HCG levels were monitored before discharge. Conclusion: Ruptured tubal hydatidiform mole is uncommon and strict histologic criteria are important in diagnosis. Serial HCG levels must be monitored in individual patients to forestall development of malignant trophoblastic disease.
Anxiolytic Effect of Aromatherapy Massage in Patients with Breast Cancer  [PDF]
Jiro Imanishi,Hiroko Kuriyama,Ichiro Shigemori,Satoko Watanabe,Yuka Aihara,Masakazu Kita,Kiyoshi Sawai,Hiroo Nakajima,Noriko Yoshida,Masahiro Kunisawa,Masanori Kawase,Kenji Fukui
Evidence-Based Complementary and Alternative Medicine , 2009, DOI: 10.1093/ecam/nem073
Abstract: We examined how aromatherapy massage influenced psychologic and immunologic parameters in 12 breast cancer patients in an open semi-comparative trial. We compared the results 1 month before aromatherapy massage as a waiting control period with those during aromatherapy massage treatment and 1 month after the completion of aromatherapy sessions. The patients received a 30 min aromatherapy massage twice a week for 4 weeks (eight times in total). The results showed that anxiety was reduced in one 30 min aromatherapy massage in State-Trait Anxiety Inventory (STAI) test and also reduced in eight sequential aromatherapy massage sessions in the Hospital Anxiety and Depression Scale (HADS) test. Our results further suggested that aromatherapy massage ameliorated the immunologic state. Further investigations are required to confirm the anxiolytic effect of aromatherapy in breast cancer patients.
Effect of Massage Therapy on Children with Asthma
Afsaneh Nekooee,Jamal Faghihinia,Ramin Ghasemy,Mahin Ghaibizadeh
Iranian Journal of Pediatrics , 2008,
Abstract: Objective: Asthma is the most common chronic illness in childhood and despite significant improvements for disease control and development of many different drugs, its prevalence is increasing worldwide. Recently, the use of complementary and alternative medicine (CAM) in treatment of many diseases is increasing. The aim of this study was to investigate the effect of massage therapy on children with asthma. Material & Methods: In this work, 44 asthmatic children aged 5 to 14 years were studied in the allergy and asthma clinic. The samples were chosen randomly divided into two groups. The first group received massage therapy the second group received routine therapy and care (control group). Parents in the massage group were instructed and asked to conduct a 20 minutes child massage every night at bedtime for one month. The massage involved stroking and kneading motions in face, head, neck, shoulders, arms, hands, legs, feet and back. Data was collected through interview and spirometry measurements. The control group received only standard asthma therapy for one month. A spirometry along with exercise was done in both groups at baseline. A one month ambulatory observation followed. Descriptive and inferential statistics were used to analyze the findings. Findings: There was a statistically significant difference in mean spirometric indexes in massage group at baseline and after one month follow up [forced vital capacity (FVC) with (P=0.05) Forced expiratory volume in 1 second (FEV1) with (P=0.02) and FEV1 after exercise with (P= 0.0005). Indeed; there is significant difference between mean changes of FVC (2-1) with (P=0.05) and FEV1 (2-1) in two groups with (P=0.04). Conclusion: According to the obtained results, daily massage can improve airway tonicity, decrease airway sensitivity, and better control of asthma. Applying this method can decline the use of non reasonable drugs and can be considered as a complementary method to pharmaceutical methods.
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