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Daljit Sahota

Publications and source records attributed to Daljit Sahota.

12 recordsLinked to original sources
PubMed2006

Psychological responses of pregnant women to an infectious outbreak: a case-control study of the 2003 SARS outbreak in Hong Kong.

OBJECTIVE: The aim of the present study was to examine the behavioral and psychological responses of pregnant women during the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong. METHODS: Ethnographic interviews were first conducted to identify the common psychological and behavioral responses to the outbreak. This was followed by a case-control study of 235 consecutive pregnant women recruited during the SARS epidemic, and a historical cohort of 939 pregnant women recruited a year before the outbreak. Both cohorts completed standardized rating scales on depression, anxiety, and social support. RESULTS: Women in the SARS cohort adopted behavioral strategies to mitigate their risk of contracting infection. However, pregnant women tended to overestimate the risk of contracting SARS and nearly a third of the women were homebound. The anxiety level of the SARS cohort was slightly higher than that of the pre-SARS control. No statistical difference was found between the depression levels of the two cohorts. CONCLUSION: The improved social support experienced by pregnant women during SARS might have buffered the stress associated with an outbreak. However, clinicians should monitor for overestimation of infectious risk among pregnant women.

Adult↗
PubMed2005

Cord blood thyroid-stimulating hormone level and risk of acidosis at birth.

OBJECTIVE: Cord blood thyroid-stimulating hormone level is elevated in neonates who had undergone more perinatal stresses. The present study aimed to evaluate the cord blood acid-base status in neonates with elevated thyroid-stimulating hormone level. STUDY DESIGN: The study population consisted of 2366 singleton, term pregnancies. Subjects were categorized by their cord blood thyroid-stimulating hormone level into four quartiles, and cord blood acid-base parameters were compared among the four groups. The correlations between cord acid-base parameters and thyroid-stimulating hormone level were also studied. RESULTS: Cord blood pH was significantly lower in the highest (arterial, 7.27+/-0.08; venous, 7.32+/-0.07) and second highest thyroid-stimulating hormone quartile groups (arterial, 7.29+/-0.07; venous, 7.34+/-0.06) compared to the lowest quartile group (arterial, 7.30+/-0.06; venous, 7.35+/-0.05). Incidences of cord arterial pH < or =7.20 were 4.7%, 6.8%, 10.9%, and 17.3% in lowest to the highest thyroid-stimulating hormone quartile groups, respectively. There was a significant negative correlation between cord blood thyroid-stimulating hormone level and cord arterial and venous pH (r=-0.26, P<0.001). When stratified according to the mode of delivery, the negative correlations remained significant in neonates delivered vaginally and by intrapartum emergency cesarean section but not in neonates delivered by elective cesarean section. CONCLUSION: Incidence of cord blood acidosis is significantly higher in neonates with elevated thyroid-stimulating hormone level. This findings support the postulation that stress-induced elevation of cord blood thyroid-stimulating hormone level may be mediated through intrapartum fetal hypoxia.

Acid-Base Equilibrium↗
PubMed2005

Screening test model using duration of labor for the detection of postpartum urinary retention.

AIMS: To construct a screening test model for postpartum urinary retention (PUR), using the duration of labor, which was shown to be the risk factor for PUR. METHODS: A group of 691 consecutive patients were recruited at postpartum day 1. Of the 691 patients, 101 (14.6%) had PUR. The 691 patients were computer-randomized into two groups, 'A' and 'B.' A receiver operating characteristic (ROC) curve was constructed for Group A to determine the optimum cutoff value for screening PUR using the duration of labor. The cutoff value was then applied to Group B to determine the screening test characteristics of the duration of labor: sensitivity, specificity, predictive values, and likelihood ratios. RESULTS: An ROC curve with an area under curve (AUC) of 0.63 (95% CI 0.57-0.69, P < 0.0001) was constructed. A range of cutoff values (with specificity ranging from 0.60 to 0.99) for the duration of labor was determined and the test characteristics computed. According to the test characteristics the optimal cutoff value for the duration of labor was 700 min. This cutoff value for the duration of labor has a specificity of 0.95, negative predicative value of 0.86, and likelihood ratio for a positive test of 0.88. CONCLUSION: A screening test model using the duration of labor can be constructed to predict PUR.

Adult↗
PubMed2004

A study of female urinary tract infection caused by urodynamic investigation.

OBJECTIVE: The purpose of this study was to assess the prevalence of female urinary tract infection before and after urodynamic investigation and to identify the risk factors for urinary tract infection after urodynamic investigation. STUDY DESIGN: Eight hundred twenty-two consecutive incontinent women were recruited. All women were "double-screened" and treated for urinary tract infection before urodynamic investigation: first by mid stream urine culture 4 to 6 weeks before investigation and then by reagent strips for urine leukocytes and nitrites at the time of investigation. The investigation was postponed until the urinary tract infection had been treated. All women then received a standard urodynamic investigation. RESULTS: The prevalence of urinary tract infection before urodynamic investigation was 5.1% (95% CI, 3.6-6.6), and the prevalence after the investigation was 8.4% (95% CI, 6.5-10.3). Three independent risk factors were identified: age >or=70 years (odds ratio, 1.99; 95% CI, 1.14-3.48), previous continence surgery (odds ratio, 1.90; 95% CI, 1.05-3.43), and urinary tract infection before urodynamic investigation (odds ratio, 3.13; 95% CI, 1.43-6.83). The 3 most common uropathogens in the urinary tract infections after the urodynamic investigation were Escherichia coli (46.3%), Enterococcus spp (16.4%), and Enterococcus faecalis (11.9%). CONCLUSION: Despite a stringent screen-and-treat protocol before urodynamic investigation, patients still experienced urinary tract infection.

Adult↗
PubMed2003

Accuracy of clinical diagnostic methods of threatened abortion.

OBJECTIVE: To examine the accuracy of clinical diagnostic methods in assessing vaginal bleeding in pregnant women before 28 weeks' gestation. METHODS: 772 consecutive women who presented with threatened abortion before 28 weeks' gestation were studied. Structured history and physical examination were performed on each woman as initial clinical assessment. This was followed by transvaginal sonography to determine the status of pregnancy. The accuracy of diagnoses at different clinical stages (history, physical examination, and transvaginal sonography) relative to the final diagnosis was compared using the kappa coefficient (kappa). RESULTS: Clinicians were unable to accurately diagnose or predict the status of the pregnancy from history alone (kappa = 0.33; 95% CI 0.28, 0.38) or after physical examination (kappa = 0.57; 95% CI 0.52, 0.62). Transvaginal sonography led to an accurate diagnosis of pregnancy status (kappa = 0.96; 95% CI 0.95, 0.98) in most cases, except where an ectopic pregnancy existed. Absence of abdominal tenderness (p = 0.04), cervical excitation (p = 0.02), and incorrect identification of retained products of conception on transvaginal sonography (p = 0.01) were features of missed ectopic pregnancy. CONCLUSIONS: The clinical assessment of threatened abortion by history and physical examination is unreliable in most cases. The diagnostic accuracy is improved by the addition of transvaginal sonography. Even with the help of transvaginal sonography, a small proportion of ectopic pregnancies will be missed.

Abortion, Threatened↗
PubMed2003

Determining the reliability of ultrasound measurements and the validity of the formulae for ultrasound estimation of postvoid residual bladder volume in postpartum women.

AIMS: To determine the reliability and validity of ultrasonic assessment of the postvoid residual bladder volume (PVRBV) in postpartum women. METHODS: Ultrasound estimated PVRBVs were performed on 99 consecutive women with postpartum urinary retention, to validate 12 published bladder volume-estimation formulae. This ultrasound-predicted volume was compared with the immediately collected catheterized volume. Comparison of individual formula with the catheterized volumes was performed by using the Intraclass Correlation Coefficient (concordance), and difference plots (bias, linearity of the difference). All volumes were transformed logarithmically to ensure a normal distribution. RESULTS: The postpartum bladder maintained its ellipsoid appearance. One-way analysis of variance showed the variance of the individual formulae ranged from 83.42 to 3463.66 (SD 9.13 to 58.85). The four formulae with the least variance had an intraclass correlation coefficient ranging from 0.93 to 0.96, and a mean difference between volume estimated by the formula and catheterized volume ranging from -0.05 to -0.11 (SD 0.09 to 0.11). The error between the value predicted by the formulae and that of the catheterized volume was linear in only one formula: Volume = (pi x W x Dl x H) / 6. CONCLUSIONS: The results of this study have shown that ultrasonic assessment of the PVRBV in the postpartum period is accurate, and it can be used as a guide to whether transurethral catheterization is necessary.

Female↗
PubMed2003

Effect of one interval vaginal delivery on the prevalence of stress urinary incontinence: a prospective cohort study.

AIMS: To analyze the effect of one interval vaginal delivery on the prevalence of stress urinary incontinence amongst a cohort of nulliparous women. METHODS: A cohort of 276 nulliparous women without incontinence was recruited consecutively in 1996, after they had vaginal delivery, and were followed-up for urinary incontinence in 2000. The age, obstetric variables of the 1996 delivery (mode of delivery, genital tract trauma, birth weight, epidural analgesia, episiotomy, durations of labor, postpartum urinary retention), and the presence of interval vaginal delivery during the follow-up period were recorded. The obstetric factors and the prevalence of urinary stress incontinence at follow-up were then compared between women with and without interval vaginal delivery. Logistic regression analysis was performed to test the independence of the obstetric variables in the index pregnancy and the presence of one interval vaginal delivery, with urinary stress incontinence being the dependent variable. RESULTS: A total of 148 (53.6%) women were followed-up. The prevalence of urinary incontinence was 28.6% in women without interval delivery and 21.1% in women with one interval delivery. There was no significant difference in the prevalence of urinary incontinence between the two groups (chi(2) test, P = 0.31). Logistic regression showed that none of the obstetric variables or the presence of one interval vaginal delivery was significantly associated with urinary incontinence. CONCLUSIONS: One interval vaginal delivery does not increase risk of urinary stress incontinence 4 years after the index vaginal delivery.

Adult↗
PubMed2003

Relationship between umbilical cord morphology and nuchal cord entanglement.

OBJECTIVE: To determine whether tightening of nuchal cord entanglement is more likely to occur where normal cord coiling is absent and there is deficient Wharton's jelly. The study was carried out in the delivery suite of a university teaching hospital, using a prospective matched controlled-pairs survey. METHODS: Midwives identified index cases with nuchal cord entanglement at the time of delivery. The next delivery of equivalent gestation (+/- 1 week) without cord entanglement was taken as the control. Only singleton pregnancies with cephalic presentation undergoing spontaneous labor were studied. Placental insertion, nuchal entanglement (tight or loose), length, presence of knots, umbilical coiling index (UCI), and the amount of Wharton's jelly were recorded. RESULTS: Longer cords were more frequent amongst male infants and were predisposed towards entanglement. There were no significant differences in the amount of Wharton's jelly, or in the UCI between tight and loose nuchal cord groups. The only measurement that differed significantly was the total cord length, with shorter cords predisposed towards tightening. CONCLUSION: Whilst nuchal cord entanglement amongst male babies is frequently associated with long and straight umbilical cords, tightening is more likely to occur if the cord is of short or normal length. Neither low UCI nor low percentage of Wharton's jelly are predisposed towards tightening of cord entanglement.

Adolescent↗
PubMed2002

Four-year follow-up of women who were diagnosed to have postpartum urinary retention.

OBJECTIVE: The purpose of this study was to evaluate the long-term prevalence of urinary incontinence in women with postpartum urinary retention. STUDY DESIGN: A telephone interview was conducted by contacting a cohort of 691 women who delivered vaginally 4 years ago, of which 101 women had been diagnosed as having postpartum urinary retention. A structured telephone interview consisted of 9 questions on the possible outcomes of postpartum urinary retention. RESULTS: Of the original cohort of 691 women, 394 women were contacted. Seventy-three women had had postpartum urinary retention, and 321 women had not. In women who had had postpartum urinary retention, the prevalence of the outcome variables were urinary stress incontinence (28.8%), fecal incontinence (2.7%), frequency (39.1%), nocturia (65.2%), urgency (26.1%), urge incontinence (26.1%), and coital incontinence (13%). Analyses showed that there was no significant difference between women with and without urinary retention. CONCLUSION: Women who had had postpartum urinary retention did not have a higher prevalence of urinary stress incontinence.

Female↗