Annals of African Medicine最新文献

{"title":"Interstitial Capillary Congestion and Diffuse Alveolar Damage: Incidental or Factual Findings in the Lungs of Autopsy Cases Positive for Coronavirus Disease-19.","authors":"Preeti Agarwal, Shiuli Rathore, Anurag Singh, Poorvi Mathur, Anuragani Verma, Ravindra Kumar Garg, Anoop Kumar Verma, Amita Jain","doi":"10.4103/aam.aam_263_24","DOIUrl":"https://doi.org/10.4103/aam.aam_263_24","url":null,"abstract":"<p><strong>Background: </strong>Interstitial capillary congestion and diffuse alveolar damage (DAD) were frequently observed in patients who died from Coronavirus disease-19 (COVID-19). The research question pertains to observing these findings in COVID-19-positive patients lacking pulmonary symptoms. The histological examination of lung samples from COVID-19-positive patients who do not succumb to COVID-19-related pulmonary complications can provide an answer. This study analyzed postmortem lung autopsy samples from individuals who did not succumb to COVID-19-related pulmonary complications. The research article aimed to examine the morphological variations in postmortem lung samples of COVID-19 patients who did not succumb to the disease, and to compare these changes with those observed in cases of COVID-19-related deaths, utilizing existing English literature.</p><p><strong>Methodology: </strong>This prospective study included subjects who died without complications from COVID-19-related injuries, had positive real-time polymerase chain reaction throat swabs, and exhibited no pulmonary manifestation of COVID-19 disease. A comprehensive histomorphological analysis of the lung samples was conducted.</p><p><strong>Results: </strong>A total of 20 subjects were enrolled in this study. Capillary congestion was the most prevalent histomorphological change observed in lung autopsies, seen in 90% (18/20) of cases, followed by emphysema in 75% (15/20) and the acute phase of DAD in 25% (5/20) of cases. Acute bronchopneumonia and fibrotic nodules were identified in 20% (4/20) and 10% (2/20) of the study population, respectively.</p><p><strong>Conclusion: </strong>In postmortem lung autopsy of COVID-19-positive patients lacking symptomatic pulmonary issues, capillary congestion, diffuse alveolar destruction, and emphysema were prevalent. The findings indicate that COVID-19 exhibits varied responses to damage and inflammation that do not correlate with mortality. This study enhances the understanding of pathophysiological lung tissue variations in COVID-19 patients who have non-COVID-19-related deaths, potentially educating forensic pathologists and supporting future research endeavors.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of Intracranial Pressure Monitoring Postearly Decompressive Craniectomy in Traumatic Brain Injury Patients: An Institutional Study.","authors":"Anand Prakash, Saurav Kumar Besra, Md Habibullah Ansari","doi":"10.4103/aam.aam_237_24","DOIUrl":"https://doi.org/10.4103/aam.aam_237_24","url":null,"abstract":"<p><strong>Background: </strong>Intracranial pressure (ICP) monitoring after early decompression in postoperative period serves as a valuable tool in diagnosing postoperative intracranial hypertension/raised ICP which guides for more appropriate medical treatment to reduce ICP or even subsequent surgery which ultimately decides the outcome of the patients.</p><p><strong>Materials and methods: </strong>It is a prospective study from March 2023 to August 2023 in the Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi. This study includes 16 patients with severe traumatic brain injury with a Glasgow Coma Scale (GCS) score of <8 who underwent early decompressive craniectomy. Finally, 16 patients were included in this study and were divided into two groups. The following parameters were analyzed age, sex, initial GCS, pupillary response, blood pressure, pulse rate, and respiratory rate 2-week mortality. Two-week time frame was selected because in our institute, 85% of deaths occur in the 1st week after injury.</p><p><strong>Results: </strong>The statistical analysis was performed by SPSS 22.0 and differences were observed between the two groups.</p><p><strong>Conclusion: </strong>The present study suggests that ICP monitoring, in conjunction with postoperative treatment after early decompressive craniectomy, is associated with a significantly reduced risk of death.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight into \"Problem-based Learning\" in Medical Education - Students' Perceptions about its Facilitators and Barriers: A Cross-sectional Study.","authors":"Samir Dwidmuthe, Siddarth Dubhashi, Vinod Pusdekar, Vivek Tiwari, Samrat Sahoo","doi":"10.4103/aam.aam_140_24","DOIUrl":"https://doi.org/10.4103/aam.aam_140_24","url":null,"abstract":"<p><strong>Introduction: </strong>Problem-based learning (PBL), a method of small-group learning was introduced in 1969 at McMaster University and has been extensively used in various disciplines. PBL transforms the traditional teacher-centered approach to student-centered approach, thereby emphasizing on the necessity for student's participation in the discussion. The aim of the study was to assess the perception of students on PBL techniques, preparedness, and resource utilization for conducting PBL sessions.</p><p><strong>Methodology: </strong>This cross-sectional study was conducted at a medical college, wherein all the students who had attended a PBL session in any subject were included in the study. Questionnaires were used to record students' responses. Student's responses were assessed using a prevalidated questionnaire on, the perceived benefits of PBL sessions, the process of conduction of PBL and learning resources used for self-directed learning. Student feedback was recorded using a Google Forms. Each response was recorded using a three-point Likert scale (Agree/neutral/disagree). Data were compiled in a Microsoft Excel worksheet.</p><p><strong>Statistical analysis: </strong>Qualitative data were collected and were analyzed using appropriate statistical tests. The feedback data were obtained to analyze the effectiveness of programs and plan appropriate changes in the conduction of PBL sessions.</p><p><strong>Results: </strong>Students mentioned that PBL was useful in better understanding of the basic sciences. PBL enhanced collaborative learning and helped them recognize their strengths and weaknesses. Participating in the PBL sessions improved their communication, leadership skills and decision-making ability.</p><p><strong>Conclusion: </strong>PBL session was an effective teaching-learning method in MBBS curriculum and it encourages self-directed learning in students and also ensures better integration of the basic and clinical sciences particularly problem-solving skills. Preparedness of tutors and resources available for conducting PBL are important to ensure satisfactory outcomes of PBL sessions.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Rapid Intermittent Bolus versus Slow Continuous Infusion of Hypertonic Saline for Managing Symptomatic Severe Hyponatremia: A Systematic Review and Meta-analysis.","authors":"Deep Dutta, Manoj Kumar, Ameya Joshi, Meha Sharma","doi":"10.4103/aam.aam_249_24","DOIUrl":"https://doi.org/10.4103/aam.aam_249_24","url":null,"abstract":"<p><strong>Aims: </strong>Three percent hypertonic saline (3NS) is an established treatment for severe hyponatremia. The optimal regimen for administering 3NS for severe hyponatremia, with the aim to minimize side effects is not known. This systematic review and meta-analysis aimed to evaluate the safety profile of rapid intermittent bolus (RIB) versus slow continuous infusion (SCI) of 3NS for managing symptomatic severe hyponatremia.</p><p><strong>Methods: </strong>Databases were searched for studies evaluating the use of RIB versus SCI/conventional therapy of 3NS for managing symptomatic severe hyponatremia. The primary outcome was to evaluate the occurrence of overcorrection of hyponatremia. Secondary outcomes were to evaluate the need for relowering therapy, duration of hospital stay, changes in sodium levels, osmotic demyelination syndrome (ODS), and mortality.</p><p><strong>Results: </strong>Data from three studies (290 patients) with severe hyponatremia was analyzed. Patients receiving RIB had a similar occurrence of overcorrection (relative risk [RR]: 1.59 [0.40, 6.35]; I2 = 61%; P = 0.51), need for relowering treatment to bring down serum sodium back to the normal range (RR: 2.53 [0.32, 20.20]; I2 = 81%; P = 0.38), ODS (RR: 2.24 [0.09, 57.18]; P = 0.63) and mortality (RR: 0.51 [0.08, 3.30]; I2 = 31%; P = 0.48), as compared to those receiving SCI. Patients receiving RIB had a marginally higher duration of hospital stay, which approached statistical significance (mean difference: 3.71 days [-0.18, 7.59]; I2 = 0%; P = 0.06).</p><p><strong>Conclusion: </strong>Both RIB and SCI of hypertonic saline were safe and effective for managing severe symptomatic hyponatremia. The reduced duration of hospital stay with SCI of hypertonic saline may suggest this may be the optimal way of administering hypertonic saline.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Study and Clinical Significance of Atlanto-occipital and Atlantoaxial Assimilation Anomaly in Asian Population.","authors":"Kosuri Kalyan Chakravarthi, Venumadhav Nelluri, Raju Sugavasi, Deepthynadh Reghunadhan","doi":"10.4103/aam.aam_291_24","DOIUrl":"https://doi.org/10.4103/aam.aam_291_24","url":null,"abstract":"<p><strong>Background: </strong>Atlanto-occipital and atlantoaxial assimilation are rare congenital abnormalities characterized by abnormal fusion of the atlas vertebra with the occipital bone or the axis vertebra, respectively, within the craniovertebral junction. These anomalies can significantly alter the biomechanics and structural integrity of the cervical spine, leading to diverse clinical presentations ranging from restricted neck mobility to neurological deficits. Accordingly, this study aims to investigate the prevalence, anatomical abnormalities, and clinical significance of atlanto-occipital and atlantoaxial assimilation in the Asian population.</p><p><strong>Materials and methods: </strong>A total of 82 human dry skulls and 82 sets of dry cervical vertebrae were examined for the presence of atlanto-occipital and atlantoaxial assimilation. Detailed morphometric analysis was performed to document the fusion patterns and variations in anatomical structures. The data were analyzed to determine the prevalence of these congenital anomalies and their implications for craniovertebral stability and neurological function.</p><p><strong>Results: </strong>Among the 82 skulls and 82 cervical vertebrae examined, atlanto-occipital assimilation was identified in 3 skulls (3.65%), whereas atlantoaxial assimilation was observed in 2 cases (2.43%). Combined occurrences of both anomalies were found in 2 skulls (2.43%) of the sample.</p><p><strong>Conclusion: </strong>A thorough understanding of atlanto-occipital and atlantoaxial assimilation is clinically crucial due to its potential impact on the structural and functional dynamics of the craniovertebral junction. These congenital anomalies, though infrequent, can pose considerable clinical challenges, including compromised craniovertebral stability and an increased risk of neurological symptoms. Early diagnosis and careful clinical evaluation are crucial for managing potential complications associated with these conditions.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Trial Comparing Outcome of Expert Tibial Nail versus Proximal Tibial Plate in the Management of Fractures of Proximal Tibia in Adults.","authors":"Vinay Prabhat, Rohit Topno, Sabyasachi Kundu, Amit Kumar, Verma Dipak Kumar Prakash Prasad","doi":"10.4103/aam.aam_209_24","DOIUrl":"https://doi.org/10.4103/aam.aam_209_24","url":null,"abstract":"<p><strong>Background: </strong>Extra-articular fracture of the proximal tibia frequently results in functional impairment of the knee and lower limb if not managed properly. Any treatment method must achieve the desired anatomical reduction and stable fixation to permit early weight-bearing and joint motion. This type of fracture can be treated using a variety of methods, from conservative casting to surgical management. It is still for debate that, which surgical procedure is best for treating extra-articular proximal tibia fractures.</p><p><strong>Aim: </strong>This study aims to compare the functional and radiological outcome of expert tibia nailing and proximal tibia plating in extra-articular proximal tibia fractures.</p><p><strong>Methodology: </strong>This study was carried out in Rajendra Institute of Medical Sciences, Ranchi. This is a prospective study, from November 2021 to October 2022. Forty patients were selected in our study after fulfilling the inclusion criteria. Patients were randomized into two equal groups using computer-generated random numbers. Of 40 patients, 20 patients underwent surgical intervention using expert tibial interlocking nail and 20 with using plate and screws after approval from the Institutional Ethics Committee. All patients were examined preoperatively, postoperatively, and in follow-up period. The data regarding different parameters including the timing of surgery after trauma, operating time, intraoperative blood loss, duration of hospital stay, any postoperative complications, radiological, and functional outcomes were recorded and analyzed.</p><p><strong>Results: </strong>Both the groups had excellent outcomes, and no statistically significant difference was found between both the groups in terms of functional outcome using the Oxford Knee Score. However, there was statistically significant difference present in mean union time (in weeks) with lesser duration in the Expert ILN group using the Radiographic Union Scale for Tibia score (P < 0.001).</p><p><strong>Conclusions: </strong>Both plating and expert tibial nailing offer no significant advantages over each other in terms of functional outcome in the management of proximal tibia fracture. However, Expert ILN is associated with lesser union time but with higher risks of malunion, and plating is associated with more intra-operative blood loss, higher rate of postoperative infection, and a longer length of hospital stay.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute Eosinophil Counts as a Prognostic Marker in Patients with Sepsis.","authors":"S Shravani, Ashwin Kulkarni, Shaikh Mohammed Aslam, K Mohammed Suhail, Rafi Mohammed Shaji","doi":"10.4103/aam.aam_203_24","DOIUrl":"https://doi.org/10.4103/aam.aam_203_24","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a leading cause of mortality and morbidity in critically ill patients. It is necessary to have markers of severity that are easily accessible and useful to guide treatment in a timely manner. Eosinophil count could be a potential biomarker in sepsis, and it is routinely checked in clinical practice.</p><p><strong>Aims and objectives: </strong>To assess absolute eosinophil count (AEC) as prognostic marker in patients with sepsis.</p><p><strong>Methodology: </strong>This observational study was conducted in a tertiary care hospital in South India. A total of 100 patients admitted with sepsis were included. AEC and Sequential Organ Failure Assessment (SOFA) score were calculated at admission and after 72 h. AEC was correlated with the SOFA score. These patients were clinically followed up during their hospital stay. A receiver operating characteristic curve was developed to determine the optimum AEC cutoff point for predicting mortality.</p><p><strong>Results: </strong>Decreasing trend of AEC during the course of hospital stay (after 72 h) of admission was found to have a strong negative correlation with SOFA score. AEC cutoff <50 cells/mm 3 after 72 h of admission was associated with increased mortality. Low AEC after 72 h of admission and decreasing trend of AEC were associated with increased risk of requirement of ionotropic support, dialysis, ventilator, and mortality.</p><p><strong>Conclusion: </strong>A decline in AEC after 72 h of admission was linked to increased mortality. Therefore, eosinophil count can be used as a cost-effective marker for assessing severity and prognosis in patients with sepsis.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Postoperative Analgesia in Modified Radical Mastectomy Following Instillation of Bupivacaine through Surgical Drains.","authors":"R Sneha, R K Ranjan, Mahesh Nayak, Shilpa A Naik, Ashna Shetty, B Prathvi","doi":"10.4103/aam.aam_151_24","DOIUrl":"https://doi.org/10.4103/aam.aam_151_24","url":null,"abstract":"<p><strong>Background: </strong>Globally, breast cancer is a significant public health concern in women. Modified radical mastectomy (MRM) is a commonly used surgical treatment. Postmastectomy pain is a serious concern because, if left untreated, can have psychological effects, resulting in postoperative complications. This observational study aimed to assess the effectiveness of bupivacaine for postoperative analgesia administered using surgical drains after MRM.</p><p><strong>Methods: </strong>Sixty female patients who underwent MRM were included in the study. Patients in Group A received 40 mL of 0.25% bupivacaine, 20 mL through each drain placed in the axilla and chest wall below flap. Patients in Group B received standard postoperative pain management. The postoperative visual analog scale (VAS) score was evaluated every 4 h for 24 h. When the patient's VAS score was higher than 3 at any point during the treatment, they received slow intravenous injections of 1 mg/kg tramadol. The period of analgesia was measured from the point when the analgesic was introduced until the onset of the first rescue analgesia. Both the total number of times the medication was administered, and the total number of analgesics needed were recorded.</p><p><strong>Results: </strong>The median total dose of rescue analgesia given to Group B (median = 113.0 mg tramadol) was higher compared to Group A (median = 47.5 mg tramadol) with P = 0.001.</p><p><strong>Conclusion: </strong>Patients who received bupivacaine through surgical drains experienced longer and more effective analgesia. It is an easy, economical way to get good analgesia following surgery with minimal adverse reactions.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Smokeless Tobacco Use on the Upper Gastrointestinal Tract Mucosa: Gross and Histopathological Changes.","authors":"Bhumika Vaishnav, Anjitha S Valiyil, Shubhangi Anand, Anushka Ghosal, Ruchitha Pailla, Gayatri R Nair","doi":"10.4103/aam.aam_292_24","DOIUrl":"https://doi.org/10.4103/aam.aam_292_24","url":null,"abstract":"<p><strong>Background/aim: </strong>Tobacco addiction is prevalent in South and Southeast Asia. This study aimed to assess upper gastrointestinal (GI) tract changes in smokeless tobacco (SLT) users through upper GI endoscopy (UGIE).</p><p><strong>Materials and methods: </strong>A cross-sectional observational study, including 108 SLT users and 90 controls who did not use tobacco, was conducted at an Indian tertiary care hospital from March 2022 to February 2023. Participants were categorized into three groups: Non-SLT users (Group A), SLT users for <10 years (Group B), and SLT users for >10 years (Group C). UGIE and biopsies from the lower esophagus, stomach, and duodenum were performed, noting gross and pathological findings.</p><p><strong>Results: </strong>There were 89 males and 19 females. More than 60% of patients used SLT for more than 10 years. Grossly, erosive and ulcerative lesions of the esophagus and stomach were the most common findings. Barrett's esophagus (14/108 patients) and esophageal neoplasms (5/108 patients) were found in 19/108 patients (17.59%). Common biopsy findings were chronic gastritis and duodenitis. Group C had a significantly high finding of gastric ulcers compared to other 2 groups. A total of 68/108 SLT users (62.96%) had Helicobacter pylori infection which was significantly higher compared to the controls (P < 0.05).</p><p><strong>Conclusion: </strong>Chronic SLT use was found to be associated with gross and histological changes in the upper GI tract such as chronic erosions, peptic ulcers, and neoplastic growths. UGIE must be done routinely in all these patients whenever they develop chronic dyspepsia for early diagnosis and management.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic Management of Cesarean Sections in Parturients with Valvular Heart Disease.","authors":"Shilpa A Naik, Kavya M Prabhu, Julie C R Misquith, Priyanka Mahanta, R K Ranjan","doi":"10.4103/aam.aam_124_24","DOIUrl":"https://doi.org/10.4103/aam.aam_124_24","url":null,"abstract":"<p><strong>Abstract: </strong>Valvular heart disease during pregnancy and labor poses a significant threat to maternal and fetal outcomes, increasing morbidity. The physiological changes of pregnancy in a parturient with stenotic and regurgitant lesions increases the risk of cardiac decompensation. Moderate-to-severe stenotic lesions can deteriorate in pregnancy due to an increase in workload on the heart, leading to complications such as congestive heart failure, atrial fibrillation, and thromboembolism. Maintaining uteroplacental perfusion and systemic vascular resistance in a fixed output state is quite challenging during the perioperative period. There is no single best technique for the management of such patients for labor or cesarean section. A good understanding of the normal physiological changes with their impact on the pathophysiology and the severity of the lesion will help in successful perioperative management. We describe the anesthetic management of parturients with known valvular heart disease posted for emergencies as well as elective lower segment cesarean section.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}