Longitudinal Descriptive Study Research Articles

Mentalising severe self‐harm: A longitudinal single case study of an add‐on AMBIT program

AbstractBackgroundMentalization‐based treatment (MBT) has been proposed as a promising approach when treating patients suffering from borderline personality disorder (BPD) and severe self‐harm. Though study findings on MBT for patients who self‐harm are convincing, a meta‐analysis showed mixed results, calling for further research and the development of treatment protocols (Gross et al., 2024).AimThe aim of this study was to describe an add‐on AMBIT intervention for adult patients suffering from severe self‐harm. To demonstrate the add‐on AMBIT’s potential, a descriptive longitudinal study design was facilitated and illustrated with a single case of a woman in her mid‐twenties suffering from BPD and severe self‐harm.Materials and MethodsMultiple data sources were applied to show the longitudinal development of the patient one year before entering treatment, during treatment, and one year after treatment including calculation of number of hospitalized bed days, coercion episodes, and suicide attempts. Additionally, the Deliberate Self‐Harm Inventory, the Affect Integration Inventory, the Inventory of Interpersonal Problems, the Hopkins Symptom Checklist, and the WHO’s Quality of Life questionnaire were measured every third month during a 2‐year treatment period to examine trajectories of change across time.ResultsResults revealed significant improvements on all measured parameters including a reduction in the patient’s number of bed days (from 166 to 0), hospitalizations (from 4 to 0), coercion episodes (from 22 to 0), and suicide attempts (from 2 to 0). Furthermore, measures during the treatment period showed reduced self‐harm, decreased symptomatology, increased affect integration, better interpersonal functionality, and improved everyday functioning. Measures 1 year after treatment suggested lasting effects.DiscussionThe potential of the add‐on AMBIT intervention is discussed, including limitations and future research recommendations.

Access to psychological therapies amongst patients with a mental health diagnosis in primary care: a data linkage study.

Significant numbers of people in England have fallen into a gap between primary care psychological therapies and specialist mental health services. We aim to examine pathways to care by looking at demographic variation in detection and referral to primary and secondary psychological services in south London. Longitudinal descriptive study using a record linkage between a primary care database (Lambeth DataNet) and a secondary care mental health database (CRIS). We extracted data on mental health diagnosis, prescriptions and episodes of care in mental health services for all patients of working age registered from 1 January 2008 to 1 March 2018 (pre-covid era). Of those with a mental disorder detected in primary care (n = 110,419; 26.8%); 33.7% (n = 37,253) received no treatment; 21.3% (n = 23,548) exclusively accessed psychological treatment within NHS Talking Therapies and 7.6% accessed secondary care psychological therapies. People from minoritised groups were more likely to be prescribed psychotropic medication as the only treatment offered compared to the White British group. Men, Black African and Asian groups were less likely to access NHS Talking Therapies. People with a personality disorder diagnosis had the highest prevalence and number of NHS Talking Therapies treatment episodes (48.0%, n = 960), a similar percentage (44.1%, n = 881) received secondary care psychology treatment. Our study highlights marked inequalities in access to psychological therapies for men and people from some minoritised ethnic groups across primary and secondary care and how individuals with personality disorders are offered multiple short-term courses in NHS Talking Therapies even where this is not recommended treatment.

Healthcare Costs of Hospitalizations Due to Aspergillosis and 25-Year Trends in Spain, 1997–2021

In the last 40 years, a significant increase in the incidence of lung infections by Aspergillus has been reported. The scarcity of studies that describe the costs of aspergillosis indicates that the economic impact of aspergillosis in the hospital environment is greater than that of other fungal infections. The objective of the study was to evaluate the direct healthcare costs associated with aspergillosis in the Spanish National Health System from 1997 to 2021. A retrospective nationwide longitudinal descriptive study was designed to review hospital records from the Minimum Basic Data Set of patients admitted to hospitals of the National Health System from 1997 to 2021, with a diagnosis of aspergillosis. A total of 44,586 patients were admitted for aspergillosis in the Spanish National Health System. There was a progressive increase in the average annual cost from 1997 to 2012, which reached a maximum peak, EUR 1,395,154.21 (±2,155,192.87). It decreased between 2014 and 2019, but increased again in 2020 and 2021, EUR 28,675.79 (±30,384.12). The Pearson correlation coefficient revealed a weak negative correlation between age and hospital costs and a moderate positive correlation between average length of stay and hospital costs. Our data show that the economic impact of hospitalizations for aspergillosis is significant and increasing at a rate proportionally higher than that of other prevalent diseases. Costs related to Aspergillus infection are associated mainly with respiratory diseases. The results of this economic evaluation may be useful for health authorities to develop a future economic strategy for managing this fungal infection.

Three-Month Mortality in Nonhaematological Patients with Chronic Pulmonary Aspergillosis: Differences between Subtypes.

Objectives: Chronic pulmonary aspergillosis (CPA) is a fungal lung infection characterised by the slowly progressing destruction of the lung parenchyma and has four main subtypes. The objective of this work was to evaluate the epidemiology of CPA in our area and evaluate the involvement of the different subtypes in mortality. Methods: This was a descriptive longitudinal retrospective study developed in three tertiary hospitals in Spain. Among all patients admitted with a pulmonary aspergillosis diagnosis, we selected those who fulfilled the criteria for chronic aspergillosis according to the criteria of Denning, excluding those with a haematological disorder. Results: Among 409 inpatients recorded as having a pulmonary aspergillosis infection, only 76 (18.5%) fulfilled the criteria for CPA, with an estimated incidence of 0.67 cases/100,000 inhabitants/year. The subtypes detected were subacute invasive aspergillosis (SAIA) in 33 (43.4%) patients, simple aspergilloma (SA) in 25 (32.9%) patients, cavitary chronic aspergillosis (CCPA) in 13 (17.1%) patients, and chronic fibrosis (CFPA) in five (6.5%) patients. The overall three-month mortality rate was 23%, which was higher in SAIA patients. The predictors of early mortality were age > 65 years (OR 3.0 CI 95 1.0-9.5 p = 0.043) and the SAIA subtype vs. other subtypes (OR 3.1 CI 95 1.0-9.5 p = 0.042). Conclusions: The incidence rate estimated was inferior to that previously reported. The three-month mortality in patients with CPA was high, with older age and the SAIA subtype being the variable independent predictors of a worse prognosis.

The perceived long-term impact of peer teaching in the skills lab. A descriptive interview study

ABSTRACT Teaching is an essential skill for future doctors. Peer-assisted learning (PAL)–where students take up a teaching role at an early stage of their training–is widely used in medical curricula. No studies have explored the long-term perceived impact of peer teaching. Therefore, we aimed to determine how former peer teachers reflected on PAL and its perceived long-term impact. In this longitudinal descriptive study, we conducted 42 semi-structured interviews with 11 former peer teachers at the University of Antwerp. Five of them were interviewed 6 months after PAL; 6 of them 9 years after PAL. This latter group was also interviewed during PAL in a previous study. We conducted secondary analyses of previously collected interviews, consistently comparing the findings with new data gathered from the current interviews. Using realist thematic analysis, topic summary themes were generated. Former peer teachers reflected on their PAL experience with a lot of satisfaction. Those meanwhile working as residents are still passionate about teaching. Peer teachers experienced a gain in clinical examination- and professional skills in the long-term, facilitating a smoother transition to their internship. Our findings suggest that PAL selects diverse but committed students. The longitudinal data demonstrate how PAL initiates or stimulates different skills in diverse students, including public speaking, teaching, time management, and self-efficacy in specific clinical skills. Regarding the chicken-and-egg question, our study encompasses both longitudinal cases illustrating the pre-existing skill theory and cases demonstrating how achieved competences were induced by PAL. Former peer teachers experienced long-term benefits of PAL, which eased their transition into the internship. PAL has the potential to ignite a lasting passion for teaching, providing diverse and unique learning opportunities not only for the most talented and ‘pre-selected’ medical students but also for a range of dedicated future clinicians.

Persistent Symptoms at the End of 3 Months after Acute COVID-19 Infection among Adult Patients Admitted to a Tertiary Care Centre: A Descriptive Longitudinal Study

Persistent Symptoms at the End of 3 Months after Acute COVID-19 Infection among Adult Patients Admitted to a Tertiary Care Centre: A Descriptive Longitudinal Study

Dollars and Disparities: Unraveling Executive Compensation Patterns in American Non-Profit Healthcare.

This study examines trends in executive compensation at non-profit hospitals across the United States from 2018 to 2022. The research aims to address gaps in the current literature by providing an up-to-date analysis of compensation practices and their relationship to hospital financial metrics. A descriptive longitudinal study was conducted using data from Form 990 filings of 20 randomly selected non-profit hospitals across four U.S. regions. Executive compensation data, along with hospital financial metrics, were extracted and analyzed. Statistical analyses included descriptive statistics, non-parametric tests for trend analysis, and correlation studies using Kendall's Tau B. The median increase in executive compensation over the five-year period was 23.4%, with a median annual increase of 6.2%. Significant positive correlations were found between executive compensation and hospital revenue (τ = 0.676, p < 0.001), net assets (τ = 0.600, p < 0.001), and net income (τ = 0.273, p < 0.001). However, percentage changes in these variables over time were not significantly correlated. The study reveals significant growth in executive compensation at non-profit hospitals, with notable regional variations. While compensation correlates strongly with hospital financial metrics, the lack of correlation in their respective changes over time suggests a complex relationship. These findings raise important questions about resource allocation and compensation practices in non-profit healthcare institutions, highlighting the need for further research and policy discussions.

Male factor infertility and implication of fertility treatment in low resource settings

Introduction: The prevalence of infertility has increased worldwide. The etiological factors are also changing in trend and prominence. Male infertility is driving the epidemic in many regions of the world. Therefore, the aim of this study was to explore male factor infertility in the Gambia. Methodology: The design was a longitudinal descriptive study of subfertile couples at a specialist tertiary hospital in Banjul, the Gambia, from August 2022 to May 2023. Data were extracted from patients folders and entered into a computer database. Descriptive statistics were used to analyze the data and results expressed in tables, graphs, and percentages. Results: Total number of subfertile couples analyzed was 152: male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21 (13.8%). The median age of male folk was 50 years, with an age range of 31 to 64 years. The rates of asthenoteratozospermia, oligospermia, and azospermia were 37.8%, 36.2%, and 26%, respectively. In azoospermic males, over 75% had elevated FSH (12–44 miu/mL). Conclusions: The prevalence of male infertility is at 45.4%, which is 3-fold and 2-fold higher than tubal and ovarian factors, respectively. Male infertility is a problem with obvious implications. The predominant types of male infertility we observed in this study will almost always require multidisciplinary care and ICSI.

Visual, Refractive, Functional, and Patient Satisfaction Outcomes After Implantation of a New Trifocal Diffractive Intraocular Lens.

To describe the visual, refractive, functional, and patient satisfaction outcomes of the Clareon® PanOptix® trifocal intraocular lens (IOL). This was a prospective longitudinal descriptive study. Patients who underwent cataract surgery with implantation of Clareon® PanOptix® (Alcon Laboratories, Inc.) were included. Monocular refractive outcomes and visual acuity at distance, intermediate, and near were evaluated 1- and 6-months post-op. Binocular contrast sensitivity (M&S® Technologies), binocular defocus curve, and patient satisfaction with the IOL Satisfaction (IOLSAT) and Questionnaire for Visual Disturbance (QUVID) questionaries were assessed at 6-month post-op. Seventy-six Clareon® PanOptix® were implanted bilaterally in 38 patients. The mean age of the patients was 67.63±5.18 years. At 1-month post-op, the monocular Corrected Distance Visual Acuity (CDVA), CIVA and CNVA were 0.00±0.09, 0.02±0.17, and 0.12±0.12 LogMAR, respectively, and CDVA and CNVA were stable at 6-month post-op (p>0.05). No statistical differences were found in post-op spherical equivalent at 1 and 6 months (-0.08±0.27 D and -0.05±0.24 D; p=0.351). A 100% of eyes were within ±0.5 D at 1 month and 6-month post-op. Binocular defocus curve shows three peaks of maximum visual acuity (VA) at 0D (-0.04±0.08 LogMAR), at -1.50D, and -2.50 D (0.01±0.10 LogMAR and 0.03±0.07 LogMAR, respectively). Contrast sensitivity decreased at high spatial frequencies. In patient satisfaction, IOLSAT questionary reveals 78.94% patients "Never" or "Rarely" Needing Glasses and according QUVID questionnaire, 100% of patients report no hazy vision. The PanOptix® IOL platform with the new material Clareon® provides good visual outcomes for distance, intermediate, and near vision, with adequate contrast sensitivity and low visual disturbances.

Incidence of serious maternal Morbidity at the RUASHI military hospital (DRC)

Maternal morbidity is a public health problem in developing countries. The aim of our study was to determine the frequency of serious maternal morbidity at the Ruashi military hospital (DRC) with a view to ensuring good care and monitoring of pregnant women. A longitudinal descriptive study was conducted among 154 pregnant women in a prospective manner, data entry and analysis of results were carried out using Microsoft office 2016 and statistical test parameters were made using of Epi Info 7.2. The incidence of maternal morbidity was 24.2%, of which 32.4% had anemia followed by hemorrhage with 27% and finally sepsis and uterine subinvolution with 5.4% each. However, 94.6% had followed the prenatal consultation against 5.4% and 29.7% had a frequency of 3 participations in the prenatal consultation and finally 8.1% had a frequency of 6 participations in the CPN. The analysis showed that the frequency of prenatal consultation and postnatal visits, literacy and socio-economic level are statistically associated with maternal morbidity. Improving the socio-economic level of households, combating illiteracy and monitoring prenatal consultation are among the factors that will determine maternal morbidity.

Working Status in Patients With Untreated Unruptured Intracranial Aneurysms: A Descriptive Longitudinal Study

BACKGROUND AND OBJECTIVES: Many patients with unruptured intracranial aneurysms (UIAs) remain untreated if the risk of treatment exceeds the estimated risk of aneurysm rupture, potentially leading to diagnosis-related stress and anxiety. Working status may serve as a marker for the total level of function including mental health and psychological burden of the condition. The aim of the study was to assess the working status before and after a diagnosis of an untreated UIA. METHODS: This was a retrospective nationwide registry-based descriptive longitudinal study. It included all working-age patients diagnosed with an UIA in Norway between 2008 and 2018 and 1:1 age-matched and sex-matched controls without a diagnosis of an intracranial aneurysm that were randomly selected from the Norwegian population. The history of sickness absence in the period of 1 year before and after diagnosis was retrieved from The Norwegian Labour and Welfare Administration records and compared between the groups. RESULTS: In total, 2141 patients and 2141 controls were included in the study. Proportion of working patients decreased from 62.1% (95% CI 60.0%-64.1%) 1 year before the diagnosis to 51.3% (95% CI 49.1%-53.4%) 1 year after the diagnosis (P &lt; .001). In comparison, the proportion of working controls decreased from 77.9% (95% CI 76.1%-79.6%) 1 year before day 0 to 73.4% (95% CI 71.5%-75.2%) 1 year after day 0 (P = .001). The odds of working were 86.7% lower among the patients than among the controls (odds ratio 0.133, 95% CI 0.091-0.194; P &lt; .001) when controlled for the baseline working status. The older the individuals, the less likely they were to work (odds ratio 0.908, 95% CI 0.889-0.926; P &lt; .001). CONCLUSION: The work participation of patients diagnosed with UIA is low prediagnosis compared with the general population and decreases significantly postdiagnosis.

Practical evaluation of risk factors in patients with osteoporosis-induced thoracic and lumbar vertebral compression fractures requiring surgery

This descriptive longitudinal study aims to assess the risk factors for severe thoracic and lumbar vertebral compression fractures before and after surgery, contributing to preventive knowledge enhancement in communities and effective treatment management. The study involved 34 patients diagnosed with thoracic and lumbar vertebral compression fractures requiring surgery with bio-cement-augmented pedicle screws between June 2021 and June 2022. Postoperative complications, notably adjacent segment injury, were monitored, and patients received osteoporosis management post-surgery.The majority of patients were female (61.8 %), with an average age of 66.4 ± 9.2 years. Daily life accidents were the most common cause of injuries (88.2 %). Most patients underwent surgery more than 3 months after injury (58.8 %), with a notable percentage seeking examination and treatment post-injury. Osteoporosis prevalence was high among patients at the time of spinal injury, indicating a need for improved osteoporosis management strategies post-surgery. Various comorbidities were observed, with a portion of patients having pre-existing conditions like diabetes, hypertension, and kidney failure. Changes in bone mineral density correlated with age, highlighting the increased fracture risk seen in older individuals. Two patients required vertebral body reconstruction due to adjacent vertebra damage post-surgery. A significant proportion of patients received osteoporosis treatment after the surgical intervention.Patients with lumbar-thoracic osteoporosis fractures need a comprehensive assessment of clinical and paraclinical factors to select appropriate and effective treatment methods. Postoperatively, these patients also require osteoporosis management, regular monitoring, and evaluations to reduce postoperative complications, including the risk of adjacent segment injury and other vertebral compression fractures.

Post-dural Puncture Headache: A Comparative Study Using 25 G Quincke's Needle in Midline and Paramedian Approaches in Patients Undergoing Elective Cesarean Section.

Background and objectives Spinal anesthesia (SA) has become a preferred anesthetic technique for elective cesarean sections due to its rapid onset, profound sensory and motor blockade, and minimal impact on the newborn. It lowers the risk of development of thrombus in the veins and pulmonary vessels and permits early ambulation. The most popular technique used to reach the subarachnoid space is the midline technique, though it can be challenging to use in some cases, including those involving elderly patients with degenerative abnormalities in the vertebral column, patients who are unable to flex the vertebral column, noncooperative patients, and hyperestheticpatients. The paramedian technique resolves the challenges posed by the midline technique. It is also relatively easy to carry out. Based on the midline technique's inadequacies, we hypothesized that the paramedian method of SA would be less complicated than the midline approach, with a relatively low occurrence of post-dural puncture headaches (PDPH). Methodology Using the midline and paramedian approaches during cesarean surgeries, we performed an observational descriptive longitudinal study to assess the occurrence and magnitude of PDPH. During an elective cesarean delivery, the seated patient received 2.0-2.5 ml of hyperbaric bupivacaine using the midline or paramedian approaches and a 25 G Quincke's needle at the L3-L4 level. Eighty-four pregnant females with American Society of Anesthesiologists (ASA) physical status II, aged 18 to 35 (n = 42 in each group), were included in this research. The occurrence and severity of PDPH were compared among thegroups during a period of five days. Result In comparison to the paramedian group (7.1%), the midline group had a higher incidence of PDPH (14.3%). There was a significant correlation between the technique and the occurrence of PDPH (p = 0.041). The visual analogue scale (VAS) was employed to quantify pain five days after surgery. Pain levels in Group B (paramedian) were consistently less than those in Group A (midline). On day 1, Group B had a mean score of 0.49 ± 1.16 (p = 0.030) compared to Group A's mean VAS score of 1.27 ± 1.95. Day 5 (p = 0.032): Because this tendency persisted through day 5, the p-values for days 2, 3, 4, and 5 remained significant. These findings suggest that the midline technique is linked to a higher occurrence and magnitude of PDPHthan the paramedian approach. Conclusion Employing a paramedian technique has been associated with a noteworthy decline in the frequency of PDPH and a decrease in the need for additional analgesics, which could lead to a less severe case of PDPH. The paramedian approachneeded fewer attempts and needle passes, which leads to a lower incidence of headache, backache, and injection site pain and better patient satisfaction.

Addressing Missing Data Due to COVID-19: Two Early Childhood Case Studies

One part of COVID-19’s staggering impact on education has been to suspend or fundamentally alter ongoing education research projects. This article addresses how to analyze the simple but fundamental example of a multi-cohort study in which student assessment data for the final cohort are missing because schools were closed, learning was virtual, and/or assessments were canceled or inconsistently ­collected due to COVID-19. We argue that current best-practice recommendations for addressing missing data may fall short in such studies because the assumptions that underpin these recommendations are violated. We then provide a new, simple decision-making framework for empirical researchers facing this situation and provide two empirical examples of how to apply this framework drawn from early childhood studies, one a cluster randomized trial and the other a descriptive longitudinal study. Based on this framework and the assumptions required to address missing data, we advise against the standard recommendation of adjusting for missing outcomes (e.g., via imputation or weighting). Instead, we generally recommend changing the target quantity by restricting to fully observed cohorts or by pivoting to focusing on an alternative outcome.

Monitoring Multi-Drug Resistant Klebsiella pneumoniae in Kitagata Hot Spring, Southwestern Uganda: A Public Health Implication.

The concerning frequency of K. pneumoniae in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR-K. pneumoniae in the Kitagata hot spring, Southwestern Uganda. A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes viz. bla TEM, bla CTX-M and bla KPC. Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis. K. pneumoniae accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored bla TEM gene alone and both bla TEM and bla CTX genes, followed by bla KPC alone (33.3%), with 25% harboring all three resistance genes. During the dry season, K. pneumoniae had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR-K. pneumoniae significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either bla TEM alone or bla TEM+KPC+CTX genes. Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR-K. pneumoniae harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.

Intraocular lens power calculation using shammas pl no history formula in eyes with previous laser in situ keratomileusis

The study evaluated the results of IOL power calculation using Shammas PL no history formula in eyes with previous laser in situ keratomileusis (LASIK). This was a longitudinal follow-up descriptive analysis study. IOL power was calculated with Shammas PL formula with the ASCRS online calculator. Results: 41 eyes of 27 patients matched the inclusion and exclusion criteria. The mean uncorrected distance vision acuity (UDVA) and corrected distance vision acuity (CDVA) 3 months after surgery were 0.42 ± 0.23; 0.25 ± 0.19 logMAR, respectively. The number of eyes within ± 0.5 D; ± 1.0 D accounted for 48.8%, 75.6%, respectively. Mean absolute error (MAE) 3 months after surgery was 0.68 ± 0.59. Of the 41 eyes, 20 eyes were relatively myopic-shifted (&lt;-0.5 D), 20 eyes showed an emmetropic shift (-0.5 D ◊ +0.5 D), and one eye showed a hyperopic shift (&gt; 0.5 D). There was no statistically significant difference in MAE between axial length groups. 82.7% were satisfied and very satisfied. Conclusion: Shammas PL formula may be a suitable option for eyes after previous LASIK with all different axial length with the high rate of satisfaction. With Shammas PL no history formula, myopic shifting was more common than emmetropic and hyperopic shifting.

Experience of percutaneous closure of small to large patent ductus arteriosus with Nit-Occlud® device in a tertiary referral hospital in Colombia.

The decision to close patent ductus arteriosus should always be individualized and taken together with the child's family once the risks and benefits of both choices have been exposed. This study aims to report the experience and outcomes in patients undergoing endovascular closure of small to medium-size PDA with a Nit-Occlud® device in a tertiary referral hospital in Colombia. Longitudinal descriptive study, which included all patients under 18 years of age who underwent percutaneous ductal closure with Nit-Occlud® device between January 1, 2011, and February 1, 2023. Patients with associated complex congenital heart disease requiring surgical management, pregnant patients, and patients with incomplete data regarding studied variables were excluded from the study. Eighty-seven patients were documented, with a mean age, weight, and height at closure of 51 months, 14 kg, and 95.83 cm, respectively. About 70% of the patients (n = 61) were female, 76% were under 6-years-old and only one patient was over 15. The average size of the ductus at the pulmonary end was 2 mm. Four of the total number of patients did not achieve PDA closure during the procedure. Of the remaining 83, complete immediate closure was achieved in 81 patients. A device exchange for a larger device was required during the same procedure in one of the cases. Two patients presented residual shunt of 0.5 mm during follow-up, and one required a new procedure for device closure 10 months later. Only one device presented repeatedly embolization to the aorta, requiring surgical removal. As a technical difficulty, one device presented repeated passage into the aorta, so it was decided to remove it before releasing it to avoid complications, and given the complex anatomy of the ductus, surgical closure was indicated. Among the complications, one patient presented a hematoma of the subcutaneous tissue in the right thigh, which improved with medical management, and no deaths related to the procedure were registered. Using the Nit-Occlud® device to close small to moderate-sized ductus remains a safe and effective strategy with successful closure rates at 1-year follow-up irrespective of age, weight, height, or whether it involves a small or medium-sized duct. Despite our limitations, results concerning adverse effects are comparable to those observed in multicentric studies conducted in other regions.

Health-related quality of life and arrhythmia frequency following coronary artery bypass grafting surgery: a descriptive study

Abstract Introduction Coronary Artery Bypass Grafting (CABG) surgery is the preferred method in Coronary Artery Disease, particularly in patients with multi-vessel disease and impaired left ventricular function. Besides the success of surgical intervention, achieving a good level of Health-Related Quality of Life (HRQoL) is the primary goal of the entire process. Objective The aim of our study is to evaluate HRQoL before and after CABG surgery and to assess the adherence to pharmacotherapy and the frequency of arrhythmias postoperatively during a 6- month follow-up period. Methods The study design involves a descriptive longitudinal study. The study was conducted in one public hospital and two private hospitals of Cyprus. The follow-up period for participants was determined at 6 months post-CABG surgery. HRQoL assessment was conducted using the MacNew questionnaire, and the evaluation of arrhythmias and other clinical data was performed using a Clinical Data Evaluation Form created for the study purposes. Results Our study included 103 people who had undergone CABG surgery. HRQoL decreased at 3 months post-CABG surgery compared to the preoperative period (Mean: 5.03, SD: ±1.02 vs Mean: 4.75, SD: ±1.00) but improved at 6 months post-surgery (Mean: 6.19, SD: ±0.67). Among the total of patients, 21 (20.6%) developed Atrial Fibrillation (AF) postoperatively. All patients with AF received immediate treatment, and sinus rhythm was restored. Additionally, 6 patients developed other types of arrhythmias, among whom 1 patient experienced cardiac arrest with an initial asystole rhythm and eventually passed away. Conclusion CABG significantly affects HRQoL, showing a temporary decline postoperatively followed by improvement. Arrhythmias and compliance with pharmacotherapy are crucial aspects of postoperative care.

The Efficacy of the B-Lynch Procedure in Reducing Labor-Related Mortality and Morbidity in Low-Income Health Facilities in Low Setting Health Facilities

Purpose: Postpartum hemorrhage is a preventable cause of maternal death, yet it is rising in underdeveloped nations with low health resources. So, this study looked into whether B-Lynch and modified B-Lynch uterine compression sutures could stop major postpartum bleeding caused by uterine atonia in EL-Obeid, Sudan. Methodology: This is a descriptive longitudinal study undertaken at the Obstetrics and Gynecology hospitals in El-Obeid and Alfayhaa, located in North Kordofan State, Sudan. The study took place from January 2019 to December 2023. This study has registered a total of 218 individuals for participation. Findings: Using uterine compression sutures resulted in a remarkably low rate of problems, with only 2.3% of individuals experiencing adverse effects. About 71.5% of the study population did not have a blood transfusion. Only 0.9% of patients undergo peripartum hysterectomy. Registrars performed surgery on around 18.8% of the patients. The majority, approximately 45.4% of the patients, underwent elective cesarean sections for delivery. The majority of the cases, amounting to 66.5%, occurred in metropolitan areas. Individuals at the primary level of education reported the majority of the instances, accounting for 36.6%. The majority of events occurred within the age range of 21 to 25 years, accounting for 24.3% of the total. Unique contribution to theory, practice and policy: When uterotonic medications fail, uterine compression sutures are a safe, effective, and simple conservative surgical method for atonic postpartum hemorrhage. Well-trained doctors, including early careerists, can execute these simple procedures

Evaluation of Postoperative Pain in Posterior Segment Surgery of the Eye at the CHU-IOTA

Postoperative pain is predictable and therefore preventable; its management should be a priority. Posterior segment surgery is an underestimated source of pain. The objective of this work is to highlight the intensity of postoperative pain in this type of surgery. This was a 6-month prospective descriptive longitudinal study. Involving 67 patients operated for a pathology of the posterior segment. The simple verbal scale was used to assess pain in the postoperative period at HO, H8, H16 and H24. During the period, posterior segment surgery accounted for 1.88% of the institute's surgical activities. Male predominates with 88%; The mean age was 45.7 years with extremes of 7 and 75 years, vitrectomy accounted for 71.6% and scleral cryoindentation 28.4%. Peribulbar anaesthesia combining bupivacaine and xylocaine was the most commonly used with 80.6%. Intravenous injection of morphine intraoperatively was associated with peribulbar anesthesia in 19.4% of cases of scleral cryoindentation. In the immediate postoperative period (H0), pain was intense in 37%, moderate in 52% and low in 11% of patients after cryoindentation while it was absent in 52% and low in 48% of patients after vitrectomy. At H8 and H16, severe pain was reported in 47% of cryoindentations; It was reported as weak to moderate after vitrectomy in 91.66%. At H24, after treatment, patients had moderate pain in 69%, and low pain in 31% after cryoindentation; It was low in 85.71% after vitrectomy. This work allowed us to highlight the feelings of patients operated on in the posterior segment and to propose a postoperative management protocol. Keywords: Pain, Posterior segment, Locoregional anesthesia, Verbal scale.