Patient Satisfaction Rate Research Articles

Gambaran tingkat kepuasan pasien terhadap fungsi pengunyahan gigi tiruan jembatan (Kajian pada pasien RSGM-P FKG Universitas Trisakti)

Background: Missing a tooth can lead to reduced masticatory efficiency. The solution to this problem is to use a dental bridge. However, based on research conducted by Geiballa, it is known that there are patients who are dissatisfied with the masticatory function of their fixed dentures. Dissatisfaction can have a detrimental effect on patients. So it is necessary to evaluate patient satisfaction, which focuses on masticatory function, to find out more about the patient's opinion on dental bridge treatment. Objectives: To describe the level of satisfaction of dental bridge users with masticatory function at RSGM-P FKG Trisakti University. Methods: This type of research is observational descriptive with a cross-sectional design. The study was conducted on 30 respondents who received dental bridge treatment at the negative room clinic of the RSGM-P FKG Trisakti University using a questionnaire. Results: The results showed that 90% of the patients were satisfied with the masticatory function of the dental bridge. Men who were satisfied were 94.6%, while women were only 84.6%. Based on age category, 100% of patients aged 17-25 years, 46-55 years, and 56-65 years were satisfied, while 81.8% aged 26-35 years and 75% aged 36-45 years. Based on the latest level of education, it is known that 100% of patients with primary education are satisfied, while 92.3% have secondary education, 71.4% have higher education. Conclusion: The majority of patients who receive bridge denture treatment at RSGM-P FKG Trisakti University are satisfied with their masticatory function.

Republication of "First Metatarsophalangeal Joint Arthrodesis: Functional Outcomes Using 2 Different Fixation Techniques. Is More Expensive Better?"

First metatarsophalangeal (MTP) joint arthrodesis can be fixed using either a dorsal plate or crossed screws. However, there is considerable difference in the cost of these implants, and it is not known if there is sufficient difference in outcome that might justify this cost difference. Our aim was to compare the functional results and patient satisfaction rates after first MTP joint arthrodesis in a group of patients using the same surgical technique except for the fixation devices. A prospective cohort of 27 patients who underwent first MTP joint fusion by the same surgeon using 2 crossed screws or a single screw with a dorsal plate was recruited over a 3-year period. Demographic information, patient satisfaction rates, complications, and union rates were evaluated. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scoring systems were used pre- and postoperatively to compare the functional outcomes. Thirty consecutive procedures (screws, n = 15; plate, n = 15) were performed. Age (55.8 ± 11.1 vs 63.3 ± 12.4 years for screws and plate respectively; P = .091) and female gender percentages (80% and 73%, P = .666) were similar between groups. The overall union rate was 93% with no differences between groups. AOFAS and VAS scores improved significantly postoperatively for each technique, and no differences were found between the two in the improvement in AOFAS (42.4 ± 8.0 vs 44.3 ± 8.2, screws and plate respectively; P = .520) and VAS scores (66.0 ± 5.4 vs 69.0 ± 6.9;P = .195). The implant cost for screws was $40 and for dorsal plate, $328. First MTP joint fusion using either screws or plate fixation results in an improvement in AOFAS and VAS scores. Functional improvement and patient satisfaction did not differ between the 2 techniques, despite a considerable difference in cost between the two methods of fixation. Level III, prospective comparative study.

Small Incision Upper Blepharoplasty in the Treatment of Upper Eyelid Solitary Nasal Pad Fat Protrusion.

The aim of this article is to investigate the efficacy of small incision blepharoplasty in the treatment of upper eyelid single nasal pad fat bulge. This is a prospective study of 43 eyes of 24 patients who underwent small incision upper blepharoplasty for the treatment of solitary nasal pad fat bulge. All patients underwent a comprehensive ophthalmic examination, periorbital evaluation, and patient satisfaction evaluation using Global Aesthetic Improvement Scale (GAIS) and Blepharoplasty Outcomes Evaluation (BOE) at baseline, 1 week, 3 months, and 6 months after the surgery. All patients underwent small incision upper eyelid blepharoplasty for excision of nasal fat pad bulge. Baseline nasal fat bulge was graded into grades 1, 2, and 3 in 4 (9.3%), 12 (27.9%), and 27 (62.8%) eyes, respectively. While at 6-month follow-up, grade 0 was recorded in 38 (88.4%) eyes, and grade 1 was recorded in 5 (11.6%) eyes. The mean operative time was 11.7 ± 1.9 min. GAIS showed degrees 1, 2, and 3 in 2 (8.3%), 19 (79.2%), and 3 (12.5%) patients at 6-month follow-up, respectively. Twenty-two patients (91.7%) reported a BOE scale of more than 95%, whereas two patients (8.3%) reported a scale of 80-90% at 6-month follow-up. Our cohort highlights the beneficial effects of small incision upper blepharoplasty in the treatment of upper eyelid solitary or lone nasal pad fat bulge, providing a safe, short-timing, and effective option.

Functional and sexual outcomes following surgical vaginal introital reduction.

Surgical introital reduction procedures are commonly performed for the treatment of vaginal laxity (VL), yet poorly studied. The aim of this study was to assess clinical outcomes following surgical vaginal introital reduction for VL. This was an ambidirectional cohort study conducted in a single urogynecology center. All sexually active women who had vaginal introital surgical reduction for VL between March 2015 and September 2020 were included in this study. VL was defined as a genital hiatus distance ≥4cm according to the POP-Q classification, associated with symptoms of laxity. The primary endpoint was sexual health assessed by the Pelvi-Perineal Surgery Sexuality Questionnaire (PPSSQ), while the secondary endpoints included postoperative pain, perioperative complications, rate of dyspareunia, patient satisfaction and success rate based on the Patient Global Improvement Index (PGI-I) and Vaginal Laxity Questionnaire (VLQ). Of the 27 patients sent the questionnaires, 23 sexually active patients returned the completed ones and were included in the study. Participants had a mean age and BMI of 41 years (range 24-74) and 21.3 (range 17.6-31.9) respectively. The most prevalent preoperative symptom was feeling of VL in 82.6% followed by bulging sensation in 47.8%. Preoperative dyspareunia was reported in 8/23 (34.8%). Surgical interventions involved perineorrhaphy with (n=14) or without (n=9) levator ani plication. The PPSSQ mean sexual health score was 86.7/100 (SD 5.8; range 16.7-93.3) and the mean discomfort and pain score was 27.5/100 (SD 26.0; range 0-80). Postoperative sexuality was reported to better, identical or worse in 16 (69.6%), 2 (8.7%) and 5 (21.7%) patients respectively. On PGI-I, patients reported feeling much better, better, slightly better and no change in 10 (43.5%), 5 (21.7%), 5 (21.7%) and 3 (13.0%) respectively. None of the women reported feeling worse. The overall post-operative complication rate was 3/23 (13.0%), including a perineal hematoma, and two cases of reoperation for narrow introitus. De novo dyspareunia was reported by 11/18 (61.1%) patients, occurring often or more in 4/18 (22.2%) patients, due to narrow introitus (n=2), enlarge introitus (n=1) and vaginal dryness (n=1). Vaginal introital reduction surgery is a viable treatment option for symptoms of vaginal laxity after failure of conservative measures. However, patients should be made aware of the risk of de novo dyspareunia.

Poster 234: Minimum 10-Year Clinical Outcomes and Survivorship of Meniscal Allograft Transplantation with Bone Fixation

Objectives: Meniscal allograft transplantation (MAT) can reliably reduce pain and improve function in symptomatic patients with meniscal insufficiency without diffuse chondral wear. Ten-year survival rates following MAT have been estimated to be as high as 74%, though previous studies have been limited to small sample sizes or pooled outcomes including patients who have less than 10-year minimum follow- up. The purpose of this study was to report on clinical outcomes and survivorship following primary meniscal allograft transplantation in a large cohort of patients with 10-year minimum follow-up. Methods: A retrospective review of prospectively collected data was performed to identify patients undergoing primary MAT from 1999-2012. Lysholm, International Knee Documentation Committee (IKDC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were collected preoperatively and at 1-, 2-, 5-, and minimum 10-year follow-up. Cox proportional hazards modelling was utilized to identify variables associated with reoperation and failure. Failure was defined as revision MAT or conversion to unicompartmental or total knee arthroplasty (UKA and TKA, respectively). Reoperation was defined as a subsequent surgical intervention of the transplanted meniscus, including partial or total meniscectomy, meniscal repair, or failure as defined above. Results: A total of 143 patients undergoing primary MAT met inclusion criteria and were followed for a mean of 12.8 ± 2.7 years (range: 10.0 - 21.0). Concomitant procedures were performed in 96 (67%) patients, the most common being osteochondral allograft transplantation (n=50, 35%) (Table 1). Patients demonstrated statistically significant (p ≤ .037) postoperative improvements in all patient- reported outcome measures at all time points, compared to baseline (Figure 1). Fifty-four patients (38%) underwent a meniscal reoperation at a mean time of 6.5 ± 5.4 years (range: 0.3 – 16.7) postoperatively, with the most common reoperation procedure being partial meniscectomy (n=27, 19%). Thirty-five (24%) patients met criteria for failure at a mean time of 7.2 ± 4.9 years following MAT (range: 1.0 - 16.5). Twelve (8%) patients underwent revision MAT, and 23 (16%) underwent conversion to arthroplasty. MAT survival free of meniscal reoperation and failure was 73% and 83% at 10 years and 58% and 69% at 15-years, respectively (Figure 2). At the time of final follow-up, 88% of patients reported being satisfied with their overall postoperative condition. Conclusions: Primary MAT demonstrates efficacy and durability with high rates of patient satisfaction at minimum 10-year follow-up. Patients should be counseled that while reoperation rates may approach 42% at 15 years, overall revision rates (8%) and conversion to arthroplasty (16%) remain low at long- term follow-up. [Table: see text]

Implementation and evaluation of a longitudinal diabetes educational programme for adolescents

IntroductionInternational guidelines recommend structured and continuous educational programmes to expand diabetes knowledge and self-efficacy in youth. To address these recommendations within a paediatric diabetes clinic, we conducted a three-phase quality...

Implant-Based Breast Reconstruction in the Elderly: Complications and Patient-Reported Outcomes in Women Older Than 70 Years.

Advanced age is considered by many to be a relative contraindication to breast reconstruction. However, despite increased medical comorbidities and a perception that elderly patients are less concerned with body image, more women older than 70 years are choosing to undergo breast reconstruction. There is a paucity of data to guide reconstructive decision-making and counseling in this population. The aim of this study was to evaluate patient satisfaction, complication rates, and long-term outcomes in women older than 70 years undergoing implant-based breast reconstruction. A total of 400 patients were identified at the authors' institution and divided into 2 groups: ≥70 and <70 years old. Medical comorbidities, surgical outcomes, and patient-reported outcomes as defined by the BREAST-Q were compared using the χ2 tests for categorical variables and t tests for continuous variables. The cohort of patients older than 70 years was made up of 25 women, with a mean age of 73 years, and the cohort of patients younger than 70 years was made up of 375 women, with a mean age of 50 years. There was no significant difference in body mass index (P = 0.373), smoking status (P = 0.360), or history of prior ipsilateral radiation (P = 0.508) between the 2 cohorts; however, the elderly cohort was significantly more likely to have diabetes (P = 0.026). Although elderly patients were less likely to undergo bilateral mastectomy (P < 0.001), there was no significant difference in the type of mastectomy, pathological diagnosis, or method of reconstruction. There was no significant difference in complication rates when looking at minor infection (P = 0.553) or major infection (P = 0.553). The 2 groups were equally likely to undergo secondary procedures (P = 0.192). Overall satisfaction rates were high in all BREAST-Q categories in the elderly group and not significantly different when compared with the group of patients younger than 70 years. Matched-pair analysis showed a significant difference with the group of patients older than 70 years having higher levels physical well-being (P < 0.001). Immediate breast reconstruction can be performed safely and with similar high satisfaction rates in the elderly population as their younger counterparts. Age alone should not be used as a reason for excluding women from these life-changing operations.

Emergency Department Patient Satisfaction Survey in a Tertiary Care Hospital of Eastern Nepal

Background: Patient satisfaction is one of the most important indicators of the quality of emergency care. This hospital-based cross-sectional study was performed to assess patient satisfaction in the Emergency department of a tertiary care hospital and identify the factors associated. Methods: The study was performed on 785 patients visiting Emergency department. Variables under study were satisfaction level, triage score, waiting times, and socio-demographic characteristics. Satisfaction level was measured using a 5-point Likert scale, Cronbach’s alpha (α= 0.86 overall, inter-item α = 0.842-0.859). A score of 47 and above was cut off to denote satisfaction with a sensitivity of 75% and specificity of 81%. Descriptive analysis and Chi-square test was performed to see the association of variables of interests with patient satisfaction. A p-value &lt;0.05 was considered statistically significant. Results: Median age of the patients was 47 years among which 51% were male. Medical emergencies were the most common problems reported (68.7%). The median (Q1, Q3, maximum) time to first contact with the doctor was 10 (5,15, 240) minutes. The patient satisfaction rate towards the Emergency services was 69%. Behavior of doctors (54%) and nurses’ care (44%) were rated as excellent services while poorer ratings were given for toilet condition (27%) and crowd control (14%). Weekends vs weekdays had a significant association with satisfaction (p = 0.04). Conclusion: Overall acceptable patient satisfaction rate was found in the services provided by the Emergency department. Areas needing improvement were identified.

Patient’s satisfaction with clinical laboratory services in a tertiary health care hospital of Jammu and Kashmir, India

Background: A patient’s satisfaction level is a crucial aspect of quality management in clinical laboratories. Satisfaction is the client’s perception of care received compared with the care expected. Accreditation from an organization such as NABL or NABH is necessary. This study aimed to evaluate patient satisfaction with laboratory services in a tertiary care hospital in Jammu, UT of Jammu and Kashmir, India. Methods: The study conducted a prospective cross-sectional patient satisfaction survey over six months w.e.f. April 2022 to September 2022 at 05 patients/day with monthly data (05×30=150). A total of 900 patients were selected randomly at 150 patients/month (150×6=900). Data was collected using structured questionnaire, entered in Epi Info and analysed with SPSS software. A p value of less than 0.05 was taken as statistically significant. Results: The study found that 76.55% of patients were satisfied, while 11% were mildly dissatisfied and 17.94% were dissatisfied with laboratory services. Patients were dissatisfied with cleanliness of latrines (47%), long waiting times (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%), latrine location (20%), availability of requested service (18%), unfair payment of service (17%), and missing results (12%). Conclusions: The study concluded that despite most patients being satisfied, there were gaps. The study recommends that the concerned departments to improve the identified gaps and meet patients’ needs. Educational status and distance were found to be significantly associated with the overall satisfaction level of clients.

Endometrial ablation and resection versus hysterectomy for heavy menstrual bleeding: an updated systematic review and meta-analysis of effectiveness and complications.

To evaluate the clinical efficacy, safety, and cost-effectiveness of endometrial ablation or resection (E:A/R) compared to hysterectomy for the treatment of heavy menstrual bleeding (HMB). Literature-search was performed for all the randomized control trials (RCTs) comparing (E:A/R) versus hysterectomy for the treatment of HMB. The literature-search was last updated in November 2022. The primary outcomes were objective and subjective reduction in HMB and patient-satisfaction rates in improving the bleeding symptoms at 1-14 years. The data were analyzed using Review Manager software. Twelve RCTs with 2,028 women (hysterectomy: n=977 vs. E:A/R: n=1,051) were included. Hysterectomy was compared with endometrial ablation in 5 studies, endometrial resection in 5 studies, and both ablation and resection in 2 studies. The meta-analysis revealed that the hysterectomy group showed improved patient-reported and objective bleeding-symptoms more than those of the EA/R group with risk ratios (RR) of (MD, 0.75; 95% CI, 0.71 to 0.79) and (MD, 44.00; 95% CI, 36.09 to 51.91), respectively. The patient-satisfaction was higher post-hysterectomy up to a follow-up period of 2 years (RR, 0.90; 95% CI, 0.86 to 0.94) but this effect was absent with long term follow-up. This meta-analysis shows that E:A/R offers alternatives to hysterectomy. Although both procedures are highly effective, safe, and improve the quality of life, hysterectomy is significantly superior at improving the bleeding symptoms and patient satisfaction up to two-years. However, hysterectomy is associated with longer operating times and recovery periods and has a higher rate of postoperative complications. The initial cost of E:A/R is less than that of hysterectomy but further surgical requirements are common, therefore there is no difference in the cost for the long term follow-up.

P27 An innovative multidisciplinary approach to optimizing the dermatology service for patients with chronic spontaneous urticaria, psoriasis and atopic dermatitis

Abstract The aim of this work was to optimize multidisciplinary practice in the dermatology department of our teaching hospital and to integrate pharmacist independent prescribers (PIPs) into the dermatology team, establish multidisciplinary patient pathways and evaluate patient satisfaction with pharmacist-led clinics. One dermatology lead pharmacist and three specialist pharmacists completed training in dermatologist-led clinics, and multidisciplinary patient pathways were developed. A pharmacist-led clinic for patients with chronic spontaneous urticaria (CSU) was established and delivered under the indirect supervision of a dermatologist. Pharmacist-led eczema and psoriasis clinics were then established, in which care is delivered by PIPs working alongside dermatologists to facilitate medical input when required. Patient satisfaction with the PIP service was evaluated by the administration of anonymized questionnaires sent to patients seen by PIPs over a 1-month period. Patients rated (poor, fair, good, excellent) 11 items and provided free-text comments. Over an 18-month period, dermatologists referred 53 of their 63 patients (84%) with CSU to the pharmacist-led clinic and PIPs delivered 150 CSU appointments. In the 12 months since establishing eczema and psoriasis multidisciplinary pathways, PIPs have delivered 279 eczema and 342 psoriasis appointments. PIPs have 30-min appointments for patients to discuss medication-related issues, assess response to treatments and demonstrate a holistic approach to patient care, including cardiovascular risk assessments. An estimated 400 h of dermatologist time was released over an 18-month period of gradual rollout of clinics as PIPs reviewed return patients, managed repeat prescribing for approximately 550 patients with CSU, psoriasis and eczema (homecare), and supported drug protocol development. In turn, PIPs reported increased job satisfaction. PIP consultations were rated excellent by 85% of eczema responders [85% response rate; 43% female, median age 38 years (range 19–84)] and 89% of psoriasis responders [90% response rate; 44% female, median age 50 years (range 15–77)]. All free-text comments (n = 34) were positive, with two suggestions for improvement (better explanation of pharmacist appointment, online appointments). Thematic analysis of comments revealed appreciation of ‘care and compassion’ (n = 20), ‘multidisciplinary team service delivery’ (n = 15), ‘ensuring patient understanding’ (n = 17), ‘pharmacist knowledge’ (n = 13), ‘professionalism’ (n = 8) and ‘medical team input’ (n = 4). There have been no patient complaints or adverse outcomes related to pharmacist-led clinics since the clinics were launched. Dermatology PIPs have successfully integrated into the dermatology multidisciplinary team, receiving support to develop their clinical roles. Pharmacist-led clinics substantially increase the overall capacity of the dermatology service, while patients report high satisfaction and appreciation of PIP consultation skills and the quality of the service.

Surgical outcome of “Neurogenic claudication and walking limitation” due to degenerative Lumbar spinal canal stenosis

Objectives: This study aimed to evaluate the efficacy of surgical decompression of the lumbar spinal canal, a procedure involving the removal of ligamentum and other degenerated elements causing pressure on the thecal sac, nerve roots, and neurovascular structures. The procedure is considered essential for patients experiencing neurogenic claudication, low back pain, lower limb pain and paresthesia, and decreased walking performance, to effectively decompress the lumbar canal.&#x0D; Methods: A retrospective analysis was conducted on patients who underwent surgical decompression at Shar hospital between 2018 and 2020. A total of 57 eligible patients were followed up to assess the outcomes related to neurogenic claudication and walking ability after 12-24 months postoperatively.&#x0D; Results: The postoperative results for neurogenic claudication and walking ability were found to be satisfactory in nearly three-quarters of the cases. The duration of symptoms significantly influenced the results, while factors such as gender, body mass index, smoking history, the number of stenosed levels operated, and the type of stenosis did not show significant impact.&#x0D; Conclusion: Surgical decompression for degenerative lumbar canal stenosis is a relatively low-risk procedure with a very high rate of postoperative patient satisfaction regarding neurogenic claudication and improved walking distance. These positive outcomes are particularly evident when the procedure is performed promptly, by an experienced surgeon, and with appropriate patient selection.

PD02 Home daylight photodynamic therapy

Abstract Actinic keratoses (AK) on the face and scalp are often extensive and are a major cause of morbidity and associated with increased risk of skin cancer. Field-directed treatment approaches, such as daylight photodynamic therapy (DPDT) are required, and this has been shown to be effective, well-tolerated and feasible in the UK between April and September. We have used DPDT since 2013, with good outcomes. Patient engagement indicated that convenience and tolerability were rated as highly as efficacy, and we therefore developed an entirely home-based approach ‘home DPDT (H-DPDT)’ in 2021. Working with an art-and-design student, we developed a fully recyclable home kit to enable patients to self-treat with H-DPDT entirely in their home environment. Patients were selected by a dermatologist and then received nurse-led training prior to treatment. In-person review after the second treatment was undertaken to assess response and decide if further treatment was needed, and telephone follow-up was undertaken after the first and third treatments. Final clinician review was undertaken 3–6 months after the last treatment. We reported on implementation in 2021 and introduced this into our routine PDT service options, and we now wish to report our findings from 2021–22. Seventeen patients (82% male) were treated in 2021–2022 for AK on the head and neck. Each patient completed an average of four (range 2–5) treatments. Clinical response was good (≥ 75% response) in nine of 15 (60%) patients assessed. Response was moderate in one (7%) patient (50–75% response) and the remaining five (33%) had a poor response (&amp;lt; 50% response). Treatment success correlated with grade of disease. Patients with more hyperkeratotic disease had poorer outcomes. In 2022, five patients responded to the routine daylight PDT questionnaire. Of these, two rated the H-DPDT as Excellent and the other three rated it as Good. Four patients stated that they had tried other AK treatments, two of which thought that H-PDT was better. One patient felt alternative treatments were more effective but they tolerated H-PDT better. Three of the five patients expressed a preference for H-DPDT for repeat treatment and would recommend it. This innovative H-DPDT service enables patients to self-treat in their home environment, and the initial results showed high rates of patient satisfaction. Treatment outcomes were better for those with milder disease, highlighting the need for careful patient selection and good surface preparation. As a proof of concept, H-DPDT is a feasible therapeutic option and empowers patients, but it may have more of a place in the treatment of milder AK disease, and further work to optimize this approach is indicated.

Short- and mid-term results of diode laser treatment in pilonidal sinus disease and the role of endoscopic camera use on outcomes.

Nowadays, surgical treatment of pilonidal sinus disease (PSD) with novel techniques is a topic of interest since conventional methods are associated with longer return to daily life and higher complication and recurrence rates. Recently, use of laser as a minimally invasive approach has become popular in the surgical treatment of PSD. In this study, we analyze the short- and mid-term results after laser treatment and the effect of endoscopic camera use on outcomes. A total of 106 patients with PSD who underwent laser treatment between November 2017 and September 2021 were included in this study. All patients were treated with a 1470-nm diode laser. Endoscopic camera was used in 73 patients and results of these were compared with those in whom camera was not used. Follow-up period was determined as a minimum of 1year. Data were analyzed retrospectively. There were 80 (75%) male and 26 female patients. The median age was 26 (range 13-50) years. On the first postoperative day, 26 (26.5%) patients did not have any pain and 42(42.8%) patients reported low-grade pain. The mean time to return to daily life was 4.5 ± 5.5 (median 2, range 1-30) days. The complication rate was 10.4%. Eighty-six (87.8%) patients completely recovered and the mean complete recovery time was 27.4 ± 15.9days. The patient satisfaction rate was 99.0%. The recurrence rate was 11.0%. Neither history of previous surgery nor abscess was associated with recurrence. Use of an endoscopic camera had no effect on postoperative pain, complete recovery, complications, patient satisfaction, and recurrence (p < 0.05). Laser treatment for PSD is a promising approach with the advantages of less postoperative pain, early return to daily life, high patient satisfaction, and acceptable complication and recurrence rates. Nevertheless, further studies are needed to investigate the role of endoscopic camera use in this procedure since its possible advantages could not be clarified.

Holmium laser enucleation of the prostate (HoLEP) as same-day surgery: A safe and feasible option

ObjectiveTo study the feasibility of holmium laser enucleation (HoLEP) performed as a same-day surgery. Material and methodsProspective observational study including 25 patients submitted to HoLEP. Patients were discharged the same day if they met the established criteria. ResultsThe mean age of the patients was 65.1 years and prostate volume was 45.8cc. All patients were discharged the same day of surgery. The overall complication rate at 30 days was 12% (Clavien I 100%). The rate of re-hospitalization was 0%. Patient satisfaction rate with the day surgery pathway was 95%. ConclusionsThe initial analysis of our results suggests that outpatient HoLEP is a safe and effective alternative with low rate of complications. According to satisfaction rates, patients prefer the day surgery pathway for the performance of HoLEP.

Evaluation of patient satisfaction about the use of regional anesthesia for cesarean section in the Kingdom of Saudi Arabia.

Regional anesthesia for cesarean delivery has become a popular choice due to with its immediate effect and high frequency of effective blockage. However, patient satisfaction is a critical indicator of anesthetic care quality. This research aimed to determine the mothers' satisfaction levels after they had an elective or emergency cesarean section under regional anesthesia. This noninterventional, descriptive, cross-sectional questionnaire-based study included 327 participants to evaluate patients' satisfaction with regional anesthesia for cesarean section in Saudi Arabia. The research employed descriptive analysis and a modified Likert scale to assess maternal satisfaction. The study considered a P value of ≤0.05 to decide statistical significance. The respondents' overall satisfaction with regional anesthesia services were rated high, and 198 (60.6%) were satisfied with recommending regional anesthesia to others, while only 28 (8.6%) disagreed with recommending regional anesthesia to others. Most participants scored higher satisfaction rates in all areas of the study. About 233 (71.7%) reported satisfaction concerning the anesthesia staff for patients' privacy; nearly 226 (69.1%) agreed with the level of professionalism of the anesthesia team. Also, 253 (77.4%) were satisfied with the anesthesia team's politeness. Our study concluded that a higher satisfaction rate is associated with regional anesthesia among participants who underwent cesarean section.

419 Patient satisfaction with treatments for moderate-to-severe atopic dermatitis according to degree and speed of skin and itch improvements: results from a patient survey in the United States

Abstract Atopic dermatitis (AD) is a chronic, inflammatory disease characterized by sensitive and dry skin, eczematous lesions and intense pruritus. Patients with moderate-to-severe AD often require systemic treatments if their symptoms are insufficiently controlled with topical treatments or phototherapy. While numerous systemic therapies are currently available for moderate-to-severe AD, more data evaluating patient satisfaction with various characteristics of these treatments are needed to help guide physicians and their patients with joint treatment decision-making. This study aims to investigate patient satisfaction with AD treatments according to the degree and speed of itch improvement and the degree of skin clearance. A cross-sectional, web-based survey was used to evaluate patient preferences for characteristics associated with systemic AD therapies. Respondents were required to have a physician-confirmed diagnosis of AD (currently moderate or severe), to be aged ≥18 years, to be a US resident, and to read and understand English. Assessments included worst itch experienced in the past 24 h (using a scale from 0 to 10, with 0 defined as no itch and 10 defined as the worst imaginable itch), time to noticeable itch reduction following initiation of their current treatment (1–6 days, 7–13 days or ≥14 days) and the amount of body surface area still affected by AD (≤2%, 3–10% or &amp;gt;10%; patient-assessed). Patient satisfaction with itch improvement, speed of itch improvement and skin clearance with their current treatment was also assessed and classified into three categories: satisfied, dissatisfied or neither. P values were determined by Chi-square tests (or Fisher’s exact test where appropriate). Of the 213 individuals recruited by physicians to participate in the survey, 200 respondents fulfilled the eligibility criteria, consented to participate and completed surveys. A total of 186 respondents indicated that they were currently receiving treatment for their AD; treatments included over-the-counter creams, ointments or medicines (26.9%, n = 50), prescription creams (72.0%, n = 134), oral corticosteroids (16.7%, n = 31) or dupilumab (11.3%, n = 21). Treatment satisfaction differed based on the patient's itch level within the past 24 h (P &amp;lt; 0.001): 85.2% (n = 23) of the 27 patients reporting the lowest levels of itch (0–1) indicated they were satisfied with their current treatment, whereas only 7.1% (n = 1) of the 14 patients reporting the worst levels of itch (8–10) were satisfied with their current treatment. Among the 73 respondents who experienced the fastest itch reduction (within 1–6 days), 65.8% (n = 48) were satisfied with their treatment. For the 36 respondents experiencing itch reduction ≥14 days post treatment, 13.9% (n = 5) were satisfied with their treatment (P &amp;lt; 0.001). Of the 75 respondents with the highest degree of skin clearance (≤2% of body surface area still affected), 65.3% (n = 49) were satisfied with their treatment. Among the 21 respondents with the lowest degree of skin clearance (&amp;gt;10% of body surface area still affected), 14.3% (n = 3) were satisfied with their treatment (P &amp;lt; 0.001). Safety was not evaluated, which may limit the findings in this analysis. In patients with moderate-to-severe AD, the majority of respondents experiencing the lowest levels of itch, the fastest onset of itch improvement and the highest degree of skin clearance also reported satisfaction with their current treatment. These findings underscore the stringent thresholds for both the degree and speed of symptom improvement required to achieve patient satisfaction. This highlights patients’ desire for treatments offering both rapid and extensive itch reduction and skin clearance and may help broaden physicians’ understanding of patient preferences and inform treatment decisions.

A Multicenter Phase II Study Evaluating the Safety and Efficacy of Botulax in Asian Patients with Benign Masseteric Hypertrophy.

Benign masseteric hypertrophy (BMH) is a condition in which the thickness of the masseter muscle is increased, resulting in jawline prominence with an undesirable cosmetic appearance. Botulinum toxin type A (BTA) injection is a promising treatment option, but its effective dose remains debated. Adults older than 19 diagnosed with BMH through visual examination and palpation related to a masseter muscle prominence were selected, and 80 patients were randomly assigned into five groups (placebo group and four groups with different doses of BTA: 24 U, 48 U, 72 U, or 96 U, on both sides of the jaw) and treated with placebo or BTA once at their baseline visit. During each follow-up, the treatment efficacy was evaluated with ultrasound examination of the masseter muscle, three-dimensional facial contour analysis, visual evaluation by the investigator, and patient satisfaction evaluation. The mean age of the 80 patients was 42.7 ± 9.98 years; 68.75% were women. The mean change in masseter muscle thickness during the maximum clenching state after 12 weeks of drug administration compared with baseline in the 24-U, 48-U, 72-U, and 96-U groups were -2.33 ± 0.41 mm, -3.35 ± 0.42 mm, -2.86 ± 0.42 mm, and -3.79 ± 0.42 mm, respectively. All treatment groups showed a statistically significant decrease compared with placebo. Regarding subjective satisfaction, all treatment groups, except the 24-U group at 4 weeks, showed higher satisfaction than the placebo group during all visits. No significant adverse events were noted. BTA administration of at least 48 U for BMH is more cost-effective than high-dose units and has a low risk of side effects. Therapeutic, II.

Efficacy of virtual reality distraction technique for anxiety and pain control in orthopedic forearm surgeries performed under supraclavicular brachial plexus block: A randomized controlled study

ABSTRACT Background Virtual reality (VR) distraction has been considered an alternative to medication to treat acute pain related to different procedures. This study aimed to evaluate the safety and efficacy of VR in reducing anxiety and pain in patients having orthopedic forearm operations under supraclavicular brachial plexus block. Methods This was an open-label, parallel-group, randomized trial. Thirty adult patients with American Society of Anesthesiologists physical status I or II were enrolled for orthopedic forearm operations performed under supraclavicular brachial plexus block. The patients were randomized into two equal groups. In the VR group, 15 patients performed the procedure with the use of VR and administration of midazolam according to the patient’s request, while in the control group, 15 patients received 2 mg midazolam followed by a titration dose according to the patient’s request. The primary outcome was the total intravenous sedation needed for the patient. Secondary outcomes included total perioperative analgesic utilization, incidence of harmful effects, patient satisfaction rating, and hemodynamic parameters. Results Virtual distraction technique significantly reduced the intraoperative midazolam consumption (2.00 ± 0.00 vs 6.67 ± 2.09 mg, respectively, p < 0.001) compared to the control group. The total perioperative analgesic consumption, incidence of adverse effects, and hemodynamic parameters were not significantly different in both groups. Patients who performed the block with the VR distraction technique showed better satisfaction scores compared to the control group (9.60 ± 0.51 vs 8.53 ± 0.92, respectively, p = 0.001). Conclusion In orthopedic forearm surgeries under supraclavicular nerve block, the VR distraction technique can reduce intraoperative sedation requirements and improve patient satisfaction.

Short- and mid-term effectiveness of unicompartmental knee arthroplasty for post-traumatic arthritis of knee

To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee. The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m 2 (range, 19.8-35.6 kg/m 2). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb. The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision. For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.