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  1. Article ; Online: Combined perineal massage and warm compress compared to massage alone during active second stage of labour in nulliparas: A randomised trial.

    Hong, Jesrine Gek Shan / Abdullah, Nadiah / Rajaratnam, Rajeev Kumar / Ahmad Shukri, Suriyanti / Tan, Sze Ping / Hamdan, Mukhri / Lim, Boon Kiong

    European journal of obstetrics, gynecology, and reproductive biology

    2022  Volume 270, Page(s) 144–150

    Abstract: Objective: To evaluate the effect of combined perineal massage and warm compress to the perineum (MassComp) compared to perineal massage alone during pushing in the second stage of labour in reducing perineal trauma requiring suturing in nulliparas.: ... ...

    Abstract Objective: To evaluate the effect of combined perineal massage and warm compress to the perineum (MassComp) compared to perineal massage alone during pushing in the second stage of labour in reducing perineal trauma requiring suturing in nulliparas.
    Study design: A randomised trial was performed in a University hospital, Malaysia from June 2020 to May 2021. 281 term nulliparas who were about to start pushing in the second stage of labour were randomised to combined perineal massage and warm compress or perineal massage alone to the perineum. Primary outcome was suturing for perineal injury (episiotomy or tear). The Chi-square test was used to analyse categorical data, Student t test to compare means and distributions for normally distributed continuous data and Mann Whitney U test for appropriate ordinal data.
    Results: Data from 277 participants (140 MassComp arm, 137 perineal massage alone arm) were analysed based on modified intention to treat basis. Perineal suturing rates were 133/140(95.0%) [MassComp] vs. 128/137(93.4%) [perineal massage alone] RR 1.02(95%CI 0.96-1.08), P = 0.615. Of the secondary outcomes, Likert scale response to recommend allocated treatment to a friend was 103/140(73.6%) vs. 84/137(61.3%) RR 1.20(95%CI 1.02-1.42)NNT
    Conclusion: Massage and warm compress during pushing did not decrease the likelihood of perineal injury requiring suturing in nulliparas when compared to perineal massage alone. Women were more likely to recommend massage and warm compress during pushing to a friend.
    MeSH term(s) Episiotomy ; Female ; Hot Temperature/therapeutic use ; Humans ; Infant, Newborn ; Labor Stage, Second/physiology ; Massage ; Obstetric Labor Complications/therapy ; Perinatal Care/methods ; Perineum/injuries ; Pregnancy ; Wounds and Injuries/prevention & control
    Language English
    Publishing date 2022-01-12
    Publishing country Ireland
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2022.01.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Speculum versus digital insertion of Foley catheter for induction of labor in Nulliparas with unripe cervix: a randomized controlled trial.

    Chia, Hang Min / Tan, Peng Chiong / Tan, Sze Ping / Hamdan, Mukhri / Omar, Siti Zawiah

    BMC pregnancy and childbirth

    2020  Volume 20, Issue 1, Page(s) 330

    Abstract: Background: Induction of labor (IoL) is an increasingly common obstetric procedure. Foley catheter IoL is recommended by WHO. It is associated with the lowest rate of uterine hyperstimulation syndrome and similar duration to delivery and vaginal ... ...

    Abstract Background: Induction of labor (IoL) is an increasingly common obstetric procedure. Foley catheter IoL is recommended by WHO. It is associated with the lowest rate of uterine hyperstimulation syndrome and similar duration to delivery and vaginal delivery rate compared to other methods. Insertion is typically via speculum but digital insertion has been reported to be faster, better tolerated and with similar universal insertion success compared to speculum insertion in a mixed population of nulliparas and multiparas. Transcervical procedure is more challenging in nulliparas and when the cervix is unripe. We evaluated the ease and tolerability of digital compared to speculum insertion of Foley catheter for induction of labor in nulliparas with unripe cervixes.
    Methods: A randomized trial was performed in a university hospital in Malaysia. Participants were nulliparas at term with unripe cervixes (Bishop Score ≤ 5) admitted for IoL who were randomized to digital or speculum-aided transcervical Foley catheter insertion in lithotomy position. Primary outcomes were insertion duration, pain score [11-point Visual Numerical Rating Scale (VNRS)], and failure. All primary outcomes were recorded after the first insertion.
    Results: Data from 86 participants were analysed. Insertion duration (with standard deviation) was 2.72 ± 1.85 vs. 2.25 ± 0.55 min p = 0.12, pain score (VNRS) median [interquartile range] 3.5 [2-5] vs. 3 [2-5] p = 0.72 and failure 2/42 (5%) vs. 0/44 (0%) p = 0.24 for digital vs speculum respectively. There was no significant difference found between the two groups for all three primary outcomes. Induction to delivery 30.7 ± 9.4 vs 29.6 ± 11.5 h p = 0.64, Cesarean section 25/60 (64%) vs 28/64 (60%) RR 0.9 95% CI p = 0.7 and maternal satisfaction VNRS score with the birth process 7 [IQR 6-8] vs 7 [7-8] p = 0.97 for digital vs. speculum arms respectively. Other labor, delivery and neonatal secondary outcomes were not significantly different.
    Conclusion: Digital and speculum insertion in nulliparas with unripe cervixes had similar insertion performance. As digital insertion required less equipment and consumables, it could be the preferred insertion method for the equally adept and the insertion technique to train towards.
    Trial registration: This trial was registered with ISRCTN registration number 13804902 on 15 November 2017.
    MeSH term(s) Adult ; Cervical Ripening ; Cesarean Section/methods ; Female ; Humans ; Infant, Newborn ; Labor Pain ; Labor, Induced/methods ; Malaysia ; Pain Measurement ; Parity/physiology ; Patient Satisfaction ; Pregnancy ; Surgical Instruments ; Urinary Catheterization/methods ; Urinary Catheters
    Language English
    Publishing date 2020-05-29
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ISSN 1471-2393
    ISSN (online) 1471-2393
    DOI 10.1186/s12884-020-03029-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Systematic review of deep learning image analyses for the diagnosis and monitoring of skin disease.

    Choy, Shern Ping / Kim, Byung Jin / Paolino, Alexandra / Tan, Wei Ren / Lim, Sarah Man Lin / Seo, Jessica / Tan, Sze Ping / Francis, Luc / Tsakok, Teresa / Simpson, Michael / Barker, Jonathan N W N / Lynch, Magnus D / Corbett, Mark S / Smith, Catherine H / Mahil, Satveer K

    NPJ digital medicine

    2023  Volume 6, Issue 1, Page(s) 180

    Abstract: Skin diseases affect one-third of the global population, posing a major healthcare burden. Deep learning may optimise healthcare workflows through processing skin images via neural networks to make predictions. A focus of deep learning research is skin ... ...

    Abstract Skin diseases affect one-third of the global population, posing a major healthcare burden. Deep learning may optimise healthcare workflows through processing skin images via neural networks to make predictions. A focus of deep learning research is skin lesion triage to detect cancer, but this may not translate to the wider scope of >2000 other skin diseases. We searched for studies applying deep learning to skin images, excluding benign/malignant lesions (1/1/2000-23/6/2022, PROSPERO CRD42022309935). The primary outcome was accuracy of deep learning algorithms in disease diagnosis or severity assessment. We modified QUADAS-2 for quality assessment. Of 13,857 references identified, 64 were included. The most studied diseases were acne, psoriasis, eczema, rosacea, vitiligo, urticaria. Deep learning algorithms had high specificity and variable sensitivity in diagnosing these conditions. Accuracy of algorithms in diagnosing acne (median 94%, IQR 86-98; n = 11), rosacea (94%, 90-97; n = 4), eczema (93%, 90-99; n = 9) and psoriasis (89%, 78-92; n = 8) was high. Accuracy for grading severity was highest for psoriasis (range 93-100%, n = 2), eczema (88%, n = 1), and acne (67-86%, n = 4). However, 59 (92%) studies had high risk-of-bias judgements and 62 (97%) had high-level applicability concerns. Only 12 (19%) reported participant ethnicity/skin type. Twenty-four (37.5%) evaluated the algorithm in an independent dataset, clinical setting or prospectively. These data indicate potential of deep learning image analysis in diagnosing and monitoring common skin diseases. Current research has important methodological/reporting limitations. Real-world, prospectively-acquired image datasets with external validation/testing will advance deep learning beyond the current experimental phase towards clinically-useful tools to mitigate rising health and cost impacts of skin disease.
    Language English
    Publishing date 2023-09-27
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2398-6352
    ISSN (online) 2398-6352
    DOI 10.1038/s41746-023-00914-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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