Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

COVID-19 Dashboard

Due to the comprehensive examination of 50 patients with ovarian polycystosis the authors suggested that ultrasound, laparoscopic, hormonal and endometrial parameters should be employed as diagnostic criteria.

Diagnostic criteria for polycystic ovary syndrome

Os resultados laboratoriais que mostram inflamacao e lesao hepatica indiretamente suportam a possibilidade de transmissao vertical. Embora a infeccao no momento do parto nao possa ser descartada, os anticorpos IgM geralmente nao aparecem ate 3 a 7 dias apos a infeccao.

Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA, March (online).

https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/180385/1/T202004676.pdf

Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis.

OBJECTIVE To know the causes for the abnormal uterine bleeding in Women at Chitwan Valley and to compare the histopathological findings between the pre-menopausal and postmenopausal women. DESIGN A descriptive study of patients who have had vaginal bleeding during the period from January 2000 to July 2002. SETTING Department of Gynaecological Oncology of BP Koirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. SUBJECTS Eighty-four women (aged 45 year and above) having abnormal vaginal bleeding managed at BPKMCH. MAIN OUTCOME MEASURED Various characteristics of the patients including age, menopausal status, histopathological findings. RESULTS A total of eighty-four patients were studied. Majority (53.5%) of them were postmenopausal ladies presenting with abnormal vaginal bleeding. The age range was 45 to 81 years, with an average of 63. Only 37% had pathological bleeding including malignancy and about 16.6% of all had malignancies. Malignant diseases were found in 7.7% cases in the pre-menopausal ladies whereas it was 24.3%, three times higher, in the post-menopausal ladies. CONCLUSION Carcinoma of the cervix and of the endometrium occurred with increasing frequency with increasing age in this study. So, a thorough work-up is needed for the perimenopausal/postmenopausal women presenting with an abnormal vaginal bleeding especially to rule out malignancies.

A study of endometrium of patients with abnormal uterine bleeding at Chitwan Valley.

Teenage pregnancy, which is detrimental to the health of mother and child, is a common public health problem worldwide. It is a problem that affects nearly every societydeveloped and developing alike. It is one of the key issues concerning reproductive health of women not only in developing but also in developed countries. There is a growing awareness that early child bearing has multiple consequences in terms of maternal health, child health and over all well-being of society. Although prevention of unwanted teenage pregnancy is our primary goal, many adolescents continue to become pregnant. The purpose of this article is to review current trends and issues on adolescent pregnancy to update the practitioners. The readers are provided with more recent data on adolescent sexuality, contraceptive use, and childbearing as well as suggestions for addressing the challenges of teenage pregnancy.

https://print.ispub.com/api/0/ispub-article/5586

An Update on Teenage Pregnancy

Coronavirus disease 2019 (COVID-19) is a newly emerged disease that has become a global public health concern as it rapidly spread around the world. The etiologic agent responsible for this disease has been named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses as it shows similar genomic features to that of SARS-CoV which caused a pandemic in 2002. This disease first appeared in Hubei province of China and it follows human-to-human transmission but the path this virus took to set up human infection remains a mystery. By 17 April 2020, globally there have been 2,074,529 confirmed cases with 139,378 deaths because of COVID-19. SARS-CoV-2 shows several similarities with SARS?CoV, and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) with its clinical presentations. This can vary from asymptomatic infection to severe disease and mortality. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) screening is considered as the standard laboratory test for the diagnosis of COVID-19. There is no proven antiviral agent against SARS-CoV-2 so the treatment for COVID-19 is symptomatic, aiming for the management of the symptoms and prevention of the complications. The outbreak of COVID-19 has led to the implementation of extraordinary public health measures throughout the world. Numerous antiviral compounds used to treat other infections are being clinically researched to find possible treatment. Similarly, the traditional public health outbreak response strategy of isolation, quarantine, social distancing and community containment has been implemented in multiple countries and has played an important role in the prevention of new outbreaks. This review aims to enhance our understanding of COVID 19. Keywords: Coronavirus disease 2019; COVID-19; SARS-CoV-2; novel coronavirus 2019; severe acute respiratory syndrome-2.

The Coronavirus Pandemic: What Does the Evidence Show?

Pelvic organ prolapse (POP) is a common gynecological condition that can affect quality of life (QOL) in women. In Nepal, the prevalence of POP is high, but many affected women are still deprived of treatment. Vaginal hysterectomy with pelvic floor repair is one of the common treatment options for advanced POP. However, QOL outcomes after surgery have not been reported in low-income countries. Thus, we aimed to examine changes in QOL among Nepalese women with POP after such surgery. This longitudinal study was conducted in the selected central and peripheral hospitals in Nepal where vaginal hysterectomy was being performed free of cost for POP. A baseline study first measured the QOL domains (physical, psychological, social relationships and environment) among 252 women with advanced POP. Follow-up data was then collected at six weeks and three months after surgery. Among the 177 women that were available at six weeks post-surgery, 166 participated in the follow-up study at three months post-surgery. To evaluate QOL at baseline, 142 women with no history of POP were included as a comparison group. The mean scores across QOL domains improved from baseline to 3 months after surgery. The baseline score for the physical domain increased from 11.2 to 12.8 at six weeks and 13.5 at three months post-surgery (p < 0.001); the psychological domain score increased from 11.6 to 13.1 at six weeks and 13.8 at three months post-surgery (p < 0.001); the social relationships domain score increased from 13.6 to 14.4 at six weeks and 15.0 at three months post-surgery (p < 0.001); and the environmental domain score increased from 12.9 to 13.9 at six weeks and 14.0 at three months post-surgery (p < 0.001). QOL progressively improved among women undergoing surgery for POP. Such surgical services need to be scaled up for treatment of advanced POP in low-income countries.

/pdf/improved-quality-of-life-after-surgery-for-pelvic-organ-38idz788u7.pdf

Improved quality of life after surgery for pelvic organ prolapse in Nepalese women

The partograph can be used to assess the progress of labor and to identify when intervention is necessary. Studies have shown that using the partograph can be highly effective in reducing complications from prolonged labor for the mother (postpartum hemorrhage, sepsis, uterine rupture, etc.) and for the newborn (death, anoxia, infections, etc.). It has shown to be effective in preventing prolonged labour, in reducing operative intervention and in improving the neonatal outcome. Prolonged labour, augmented labor, caesarean sections and intrapartum fetal deaths were reduced with the use of the partograph.

https://print.ispub.com/api/0/ispub-article/3142

Ganesh Dangal

Papers

A study of endometrium of patients with abnormal uterine bleeding at Chitwan Valley.

An Update on Teenage Pregnancy

The Coronavirus Pandemic: What Does the Evidence Show?

Improved quality of life after surgery for pelvic organ prolapse in Nepalese women

Preventing Prolonged Labor by Using Partograph