History Of Previous Surgery Research Articles

Неалкогольная (метаболически ассоциированная) жировая болезнь печени при воспалительных заболеваниях кишечника у детей: современное состояние проблемы

Non-alcoholic fatty liver disease (NAFLD) is becoming a common disease in both adults and children. Considering its multifactorial nature, a term “metabolically associated fatty liver disease” has been proposed, and new diagnostic criteria have been formulated to identify risk groups and to suspect the disease at early stages. Inflammatory bowel disease (IBD) is often associated with hepatobiliary manifestations. The prevalence of NAFLD among IBD patients is higher than in the general population, which is related to additional risk factors, such as history of previous intestinal surgery, long-term corticosteroid therapy, IBD severity and duration, parenteral nutrition, and sarcopenia. NAFLD can be combined with other liver pathologies, complicating them and worsening the course of IBD. NAFLD has an asymptomatic course and is often detected at late stages due to diagnostic difficulties. Clinical guidelines for the management of NAFLD in children with IBD have not been developed. The gold standard for diagnosis is liver biopsy with histological examination. Non-invasive methods of NAFLD diagnosis are being studied, including transient elastography and magnetic resonance imaging (MRI)-estimated proton density fat fraction (PDFF). In treatment, the first place is given to non-pharmacological methods: changing dietary habits, increasing physical activity. Data on pharmacological treatment methods are currently contradictory and continue to be studied. Key words: inflammatory bowel disease, non-alcoholic fatty liver disease, metabolically associated fatty liver disease

Quality of life in patients with glaucoma using the Glaucoma Quality of Life-15 Questionnaire

Purpose: The purpose of this study is to measure the quality of life (QoL) in patients with glaucoma using the Glaucoma QoL-15 (GQL-15) questionnaire. Methods: A cross-sectional study with a prospective enrollment of glaucoma patients was conducted. A total of 308 patients were participated in the study. Informed consent was obtained before the administration of the GQL-15 questionnaire. The QoL was assessed using an orally administered GQL-15 questionnaire. Patients' QoL was assessed based on their age, gender, visual field (VF) defect, severity of glaucoma, laterality of disease, history of previous glaucoma surgery, and the number of antiglaucoma medications (AGMs) they were taking. Participants were divided into mild, moderate, and severe glaucoma depending on the severity of VF defects using the Hodapp–Anderson–Parrish grading system. Results: A total of 308 glaucoma patients were interviewed. The mean age of participants was 57.7 ± 12.9 years; 173 (56.1%) of them were female. The average mean deviation (MD) of the patients was 7.8 ± 4.8 dB. There were 135 (43.8%) patients with mild, 122 (39.6%) with moderate, and 51 (16.6%) with severe glaucoma. In total, 114 (37%) patients had unilateral glaucoma, whereas 138 (44.4%) patients had previous glaucoma surgery. Sixty-two (22.1%) patients did not take any AGM. The correlation coefficient between VF MD and QoL was 0.7, which was significant at 0.01 level (two-tailed). Conclusion: The findings of this study demonstrated that the severity of VF defects has a negative impact on patient's QoL.

Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint

Objectives: The present study aims to investigate whether the dimple of Venus affects the anatomy of spinopelvic junction. Subjects and Methods: Inclusion criteria were having a lumbar MRI examination in the last 1 year, being older than 18 years of age and being able to radiologically evaluate the whole vertebral colon and pelvic girdle. Exclusion criteria were having congenital diseases of the pelvic girdle/hip/vertebral column and history of fracture or previous surgery in the same anatomic regions. The patients’ demographic data and low back pain were noted. At radiological examination, the pelvic incidence angle was measured by lateral lumbar X-ray. The facet joint angle, tropism, facet joint degeneration, intervertebral disc degeneration, and intervertebral disc herniation at the level of L5-S1 were examined on lumbar MRIs. Results: We included 134 male and 236 female patients with a mean age of 47.86 ± 14.50 years and 48.49 ± 13.49 years, respectively. We found that the patients with the dimple of Venus had higher pelvic incidence angle (p < 0.001) and more sagittally oriented facet joint (right facet joint p = 0.017, left facet joint p = 0.001) compared to those without the dimple of Venus. There was no statistically significant relationship between low back pain and the presence of the dimple of Venus. Conclusions: The dimple of Venus affects the anatomy of the spinopelvic junction and is associated with an increased pelvic incidence angle and a more sagittally oriented facet joint angle.

A Comparison between Pre-Incisional and Intraoperative Lidocaine Infiltration on Post-Incisional Surgical Pain in Microdiscectomy Surgery: A Randomized Clinical Trial Study.

Effective postoperative pain control in microdiscectomy surgery is crucial to managing the disease and improving the patient's quality of life. Therefore, this study aimed to assess the potential effectiveness of 2% lidocaine in reducing pain immediately after discectomy surgery. A total of 60 patients who underwent microdiscectomy surgery were enrolled in this randomized clinical trial study. They were randomly assigned to three groups: one group received lidocaine just before the incision, another group received lidocaine just before closing the incision, and the third group served as the control. Pain scores were measured at 1, 2, 3, 4, 8, and 12 h after the surgery using a Visual Analogue Scale. The demographic and clinical characteristics of the study population, including age, weight, length of surgery, gender, and history of diabetes, hypertension, and previous surgery, were comparable across all three groups (P>0.05). There was a significant reduction in pain scores over time in the groups that received lidocaine before (P<0.001) and during surgery (P=0.002). Moreover, there were significant differences in pain scores at all time points among the three groups. Both groups receiving lidocaine showed significantly lower pain scores than the control group (Pbefore surgery=0.005 and Pduring surgery<0.001). However, no significant difference was observed between the groups receiving lidocaine (P=0.080). These findings highlight the effectiveness of a local injection of 2% lidocaine either before or during the surgery in managing post-incisional surgical pain after discectomy.

Treatment of patients with periprosthetic infection

The review article presents the main questions of pathogenesis, early diagnosis, and surgical management of patients with paraprosthetic infection that developed after surgery for fractured limb bones and deforming arthrosis. The main factors that influenced the occurrence of purulent complications and the ways of their prevention, treatment, taking into account the current ideas about wound infection, are indicated. Pathogenetic mechanisms of paraprosthetic infection development are directly related to the presence of hematoma in the operated joint. Risk factors for large joint arthroplasty can be divided into three conditional types: general and local patient status; conditions for the operation; features of surgery. To detail the risk factors associated with the general or local status of the patient, two subtypes are highlighted — primary and secondary. The main subtype includes: 1) focus infection, located in the operated joint; 2) focus infection, located in the paraarticular tissues of the operated joint; 3) generalization of the infectious process — sepsis. The additional subtype includes: 1) history of previous joint surgery; 2) critical changes in body mass index; 3) uncontrolled diabetes mellitus; 4) presence of systemic diseases associated with prolonged administration of glucocorticosteroids and cytostatics and others. Two-stage revision endoprosthesis in patients with chronic periprosthetic infection is the gold standard to date. In many ways, the success of treatment depends on the correctness of all stages, on the adequacy of diagnostic measures, the scrupulousness of compliance with surgical technique and is determined by the surgeon’s experience, as well as the equipment of the hospital.

Spontaneous Deltoid Tear in Cuff Tear Arthropathy and Its Effect on the Outcome of Reverse Total Shoulder Arthroplasty: A Comparison Using Propensity Score Matching.

Deltoid function critically influences the results of reverse total shoulder arthroplasty (RTSA), and spontaneous deltoid attrition tears are frequently detected in cuff tear arthropathy (CTA) patients; however, the clinical impacts of these tears on RTSA outcomes are undetermined. Our aim was to determine the effect of spontaneous deltoid attrition tears on postoperative outcomes after RTSA without an additional deltoid procedure. Seventy-two patients who underwent RTSA for CTA with preoperative magnetic resonance imaging (MRI) and a minimum clinical follow-up of 1 year (mean, 32 months) were retrospectively reviewed in the study. Patients with a history of previous shoulder surgery or injury were excluded. The presence and location of deltoid attrition tears were determined in preoperative MRI. Propensity score matching (1:1) was performed to construct tear and no-tear groups. Finally, 21 patients, matched with respect to age, sex, hand dominance, symptom duration, medical comorbidity (obesity, diabetes mellitus, and coronary artery disease), Hamada grade, and implant type, were assigned to each group. Clinical outcomes (functional scores, isometric power, and range of motion) in the two groups were compared. Deltoid attrition tears were detected in 21 of the 72 enrolled cases (29.1%). Anterolateral deltoid was the most frequent location and no tear was detected in the posterior deltoid. The tear rate increased with disease severity (Hamada G2, 4.8%; G3, 23.8%; > G4, 71.4%). No pre- or postoperative clinical variables differed significantly between the tear and no tear groups. Deltoid attrition tears were detected in 29% of CTA patients who underwent RTSA. The most common site was the anterolateral region and tear prevalence tended to increase with CTA progression. However, RTSA was found to provide satisfactory outcomes regardless of the presence of a deltoid attrition tear.

Avascular Necrosis of HIP After Active Covid-19 Infection

AbstractBackground and objectives: The exact course of SARS -2(COVID-19) and its complications on multiorgan systemare complex and still under studies. Musculoskeletal system has also been affected post covid in various forms.This study was taken up to analyse the effects of covid-19 disease on the hip bone and join tissue.Materials and Methods: Retrospective analysis of ten patients was done who had been hospitalised with covid-19infection and later complained of hip pain. They underwent MR imaging and were found to have degenerativechanges characterizing with avascular necrosis (AVN) of head of femur .One of them had history of previoussurgery of femur with PFN, doin well but developed AVN after covid.Results: Observation of this group showed a clear correlation among the history of COVID-19 disease in thepatients, moderately severe symptoms, high levels of IgG antibodies, and the time of occurrence of joint changes.No other risk factors for AVN or auto-immune or degenerative diseases were found in the study group. The groupof patients responded well to empirical treatment with anti-inflammatory drugs ans supportive therapy, whichsubsided acute inflammatory symptoms and pain in the joints.Conclusions: It is concluded that there have been obvious musculoskeletal complications in covid patientsincluding AVN which could be attributed to the high use steroids and microembolism leading to bone necrosis.Hence more studies and long follow-up is suggested.

Histerosalpingografide Kullanılan İyotlu Kontrast Maddenin Vücut Sıcaklığında ya da Oda Sıcaklığında Uygulanmasının Vizüel Analog Skala Skorlarına Etkisi

Aim: To compare pain scores of infertile patients during and after hysterosalpingography (HSG) procedure using visual analoge scale (VAS) between cold and warm contrast medium and to investigate whether using warm contrast can alter spontaneous pregnancy rate.&#x0D; Materials and Methods: Prospective randomized study between March-September 2017. Primary infertile patients undergoing HSG procedure. Patients’ age, body mass index (BMI), history of previous surgery, duration of infertility and pain levels during the most painful menstrual period were recorded. The pain severity was questioned during and at the 30th minute after the procedure using VAS. While patients who underwent HSG using a contrast medium at body temperature 37 °C were defined as warm group(n:55), patients who underwent HSG using a contrast medium at room temperature 23 °C were defined as cold group (n:55). &#x0D; Results: There were no significant differences between the groups in terms of age, BMI, duration of infertility, previous surgery and VAS during menstruation. The mean duration of HSG of warm group patients was significantly lower(p=0.001). Warm group patients’ mean VAS score during and 30 minutes after HSG were significantly lower than in the control group ( 5.3±4.2 vs 7.5±2.0), (1.1±0.9 vs 2.4±1.4), respectively. While severe pain percentage during HSG in warm group was 25.5%, it was 66.7% in the control group. In logistic regression analysis, warm and cold groups were only found as significant related factors for severe pain felt during procedure (p

Fetal and Maternal Outcome in Women with Placenta Accreta

Objective: To determine the frequency of fetal and maternal outcome in women with placenta accrete presenting at Liaquat University Hospital Hyderabad / Jamshoro. Materials and Methods: Descriptive Cross sectional conducted at Department of Obstetrics and Gynaecology Liaquat University Hospital Hyderabad for Six months (January 2021 to July 2021). A total of 148 relevant ladies with placenta accreta were recruited and entered in the study and were explored for fetal outcome and maternal outcome. All the maneuvers was performed. The data was collected on pre-designed questionnaire. Results: Study participant’s average age was 26.07±4.49 years. In our study, maternal outcome were history of previous cesarean section (33.1%), emergency surgery (58.1%), elective surgery (41.9%) cesarean hysterectomy (54.1%), urinary tract injuries (19.9), received blood transfusion (79.1%), maternity high dependency unit - HDU admission (61.5%), ICU admission (31.8%) and prolonged hospital stay (59.5%) and hemorrhage (14.2%) while the fetal outcome includes low birth weight (41.2%), preterm births (50%), NICU admission (52%), low APGAR score (&lt;7at 5 min) (29.7%), and neonatal hypoxia (9.5%) respectively. Conclusion: To counter the increased risk of maternal morbidity or mortality, placenta accreta should be confiscated in every single case of placenta previa, especially in those with previous history of uterine surgery, high parity, and advanced maternal age as risk. Proper arrangement should be made for planned delivery by trained placenta accreta team in tertiary care hospitals where all required facilities available to manage morbidly adherent placenta. Keywords: Placenta Accreta, Aqusa Baloch, Maternal and Fetal Outcome

Association between diverticular disease and prevalence of colorectal adenomatous polyps or adenocarcinomas

Background/Aim: Although the link between diverticular disease (DD) of the colon and colon polyp is known, the relationship between colon adenocarcinoma is not clear. This study evaluated the association between DD and adenomatous polyp or colon adenocarcinoma. Methods: Patients who underwent colonoscopy for the first time in 2020-2021 were evaluated and included in this retrospective cohort study. Patients with a previous history of cancer diagnosis, colon surgery, DD, and inflammatory bowel disease were excluded from the study. Age, gender, colonoscopy indications, colonoscopy diagnoses, presence of DD, characteristics of polyps (pathology, diameter, number, localization), and presence of adenocarcinoma were recorded. Obtained data were analyzed between DD and non-DD groups. Results: A total of 2633 patients were included in the study. The prevalence of DD was 16.4%. Colon adenocarcinoma was detected in 4.7%. The adenomatous polyp rate was 14.1%. A significantly higher rate of adenomatous polyps was detected in the DD group compared to the non-DD group (19.7% vs. 12.9%; P = 0.001). Higher rates of high-grade dysplasia (3.0 vs. 1.1%; P = 0.002) and colon adenocarcinoma (7.2% vs. 4.2%; P = 0.008) were observed in the DD group also. In logistic regression analyses, it was observed that the presence of concomitant DD increases the risk of adenomatous polyps (OR: 1.469, 95% CI: 1.158–1.865), the risk of adenomatous polyps with positive villous component (OR: 2.378, 95% CI: 1.437–3.934), the risk of adenomatous polyps with high-grade dysplasia (OR: 2.822, 95% CI: 1.426–5.582), and the risk of colon adenocarcinoma (OR: 2.953, 95% CI: 1.445–6.533). Conclusion: DD is associated with precancerous lesions of the colon (adenomatous polyp, villous adenoma, high-grade dysplasia) and colon adenocarcinoma. Further studies are needed to investigate its association with colon carcinogenesis and its role and value in cancer screening.

XEN Gel Stent Implantation in Eyes With Previous Glaucoma Filtering Surgeries: A Case Series.

Background In this study, we aimed to analyze the efficacy and safety of ab interno XEN® gel stent (Allergan Inc., Dublin, Ireland) implantation in a series of eyes with open-angle glaucoma and a history of previous filtering glaucoma surgeries. Methodology This retrospective, single-center study included all eyes that underwent XENgel implantation with a minimum follow-up of 18 months that had previously undergone a filtering glaucoma surgery. The main outcomes were intraocular pressure (IOP) variation (baseline, first day, first week, and first, third, sixth, 12th, and 18th months), the number of hypotensive eyedrops at 18 months, intraoperative and postsurgical complications, and the need for subsequent glaucoma surgery. Results A total of 10 eyes from nine patients were enrolled in the study. IOP significantly decreased from 24.0 ± 2.4 mmHg to 7.8 ± 1.6 mmHg on the first day, 9.4 ± 2.2 mmHg in the first week, and 12.3 ± 4.8 mmHg, 14.7 ± 4.3 mmHg, 13.3 ± 3.8 mmHg, 11.7 ± 1.9 mmHg, and 12.3 ± 1.9 at the first, third, sixth, 12th, and 18th month, respectively (p < 0.001), with a 49.5% reduction in IOP at the end of the follow-up. The number of hypotensive eyedrops decreased significantly from 3.5 ± 0.5 (3-4) to 0.7 ± 0.7 (0-2) (p = 0.026). No intraoperative or postsurgical complications were recorded. In total, seven (70%) eyes achieved controlled IOP of <18 mmHg without any anti-glaucomatous medications, and one (10%) eye with the use of topical prostaglandin. One (10%) eye was submitted to a surgical revision, and another needed an additional glaucoma surgery during follow-up, with appropriate IOP control at the last follow-up. Conclusions This case series aims to highlight that the XEN implant can be an option in eyes with IOP levels in the low 20s and previously failed filtering surgeries, with satisfactory efficacy and high safety.

Ventricular Fibrillatory Arrest: A Safe Option in Robotic Totally Endoscopic Intracardiac Surgery

BackgroundModerate hypothermic ventricular fibrillatory arrest during heart surgery is an alternative to cardioplegic arrest in selected patients. We reviewed our experience using a ventricular fibrillatory arrest technique in robotic totally endoscopic intracardiac surgery. MethodsFrom February 2014 through July 2022, 128 patients who underwent robotic totally endoscopic intracardiac surgical procedures performed using moderate hypothermic ventricular fibrillatory arrest were reviewed. Patients were chosen based on the risk of aortic manipulation, complexity of the procedure, grade of aortic valve insufficiency and comorbidities, including history of prior cardiac surgery and peripheral vascular disease. ResultsPatients were a mean age of 65 ± 14 years, and the mean The Society of Thoracic Surgeons score was 2.7 ± 2.9. Fourteen patients (11%) had a history of previous cardiac surgery. The intracardiac procedures were mitral valve surgery in 84 patients (66%), isolated cryomaze procedure in 27 (21%), and other in 17 (13%). The mean ventricular fibrillatory arrest time was 79 ± 26 minutes, and the mean cardiopulmonary bypass time was 174 ± 49 minutes. There was no conversion to sternotomy. Seven patients (5.5%) required inotropic support, and 2 patients (1.6%) needed an intra-aortic balloon pump. There was no incidence of postoperative stroke or clinical myocardial infarction. The mean hospital and intensive care unit lengths of stay were 3.1 ± 1.7 and 1.4 ± 0.7 days, respectively. One death (0.78%) occurred due to respiratory failure. ConclusionsModerate hypothermic ventricular fibrillatory arrest in robotic intracardiac surgery may be a safe and effective alternative in selected patients.

Multiparametric Magnetic Resonance Imaging of the Prostate and Prostate-specific Membrane Positron Emission Tomography Prior to Prostate Biopsy (MP4 Study)

BackgroundProstate-specific membrane antigen (PSMA) positron emission tomography/computerised tomography (PET/CT) is increasingly being utilised in the diagnostic pathway for prostate cancer (PCa). Recent publications have suggested that this might help identify those who can avoid biopsy. ObjectiveThe primary objective of this study was to determine whether PET magnetic resonance imaging (MRI) fusion could negate the need to biopsy prior to prostatectomy in a selected population of men. Design, setting, and participantMultiparametric MRI (mpMRI) for PCa is our standard of care prior to prostate biopsy. Biopsy-naïve men with one or more Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesions ≥10 mm on mpMRI were invited to undergo PSMA PET/CT prior to biopsy. Following ethics approval, 60 men were recruited between September 2020 and March 2021. The key exclusion criteria included a previous history of PCa and previous prostate surgery or biopsy. Outcome measurements and statistical analysisA positive PET MRI fusion scan was defined as “consistent with” as per the Memorial Sloan Kettering Cancer Center lexicon of certainty, and concordance with biopsy results was analysed. Clinically significant PCa (csPCa) was defined as grade group (GG) ≥2 on pathology. A chi-square analysis was performed with statistical significance defined at p < 0.05. Results and limitationsA total of 71 mpMRI lesions were positive on 61 (86%) PET MRI fusion scans. Fifty-nine of 61 lesions biopsied confirmed csPCa in 54 (92%). Of five of 59 lesions for which either biopsy was negative or low-grade cancer was found, three had rebiopsy of which two were confirmed to have csPCa corroborating with PET MRI fusion and one was reconfirmed to have GG1 only. For the remaining two, both had another lesion elsewhere in the gland confirming csPCa, and hence rebiopsy was not performed. Ultimately, 56 of 59 (95%) lesions with a positive PET MRI fusion scan were confirmed to have csPCa. All GG ≥3 cancers had a positive PET MRI fusion scan. ConclusionsThis prospective study of PET MRI fusion assessment of men with PI-RADS 4 or 5 lesion ≥10 mm on mpMRI confirms that the majority of men (95%) with a positive PET MRI fusion scan will have csPCa. This supports recently published retrospective data suggesting that selected men might avoid prostate biopsy prior to radical prostatectomy. Patient summaryIn this research, we have confirmed that prostate-specific membrane antigen positron emission tomography/computerised tomography in combination with magnetic resonance imaging could have an important role in enabling a diagnosis of prostate cancer. Using the combination of these scans, we could confidently predict the presence of aggressive prostate cancer in some men for which treatment is warranted. This means that there are some men who could possibility proceed directly to having prostate cancer surgery without the need for a confirmatory prostate biopsy.

A Case of Optic Disc Pigmentation in a Nevus of Ota Patient

Purpose: To report a case of optic disc pigmentation in a nevus of Ota patient.Case summary: A 56-year-old female was referred to our clinic with suspected glaucoma in the left eye. She had no previous history of ocular surgery or treatment. The best corrected visual acuity and intraocular pressure were 0.7 and 15 mmHg in both eyes, respectively. Slit lamp microscopy demonstrated nevus of Ota in the right sclera and increased iris pigmentation. Gonioscopy demonstrated increased trabecular meshwork pigmentation in the right eye. Fundus examination showed pigmentation of the choroid and optic disc in the right eye; choroidal thickness of the right eye was greater than that of the left eye on optical coherence tomography. However, there were no glaucomatous changes in the right eye. There were no specific findings in the left eye.Conclusions: To the best of our knowledge, this was the first reported case of optic disc pigmentation in a Korean nevus of Ota patient.

1447. Retrospective Study Comparing the Characteristics of NTM Vertebral Osteomyelitis and Tuberculous Vertebral Osteomyelitis

Abstract Background Nontuberculous mycobacteria (NTM) species rarely cause vertebral osteomyelitis (VO). The clinical characteristics and radiological findings of NTM VO are not well described since the number of cases are limited. Here we present the clinical characteristics of culture positive NTM VO, compared to those of tuberculous (TB) VO. Methods We performed a retrospective, multicenter study at 5 hospitals. Patients with radiologic findings consistent with VO, and positive NTM or TB cultures on biopsy were included. Demographic characteristics and symptoms were collected, along with laboratory, radiologic, and pathologic findings. Results Nineteen patients with NTM VO and 105 patients with TB VO were included. M. intracellulare (52.6%) and M. abscessus (26.3%) were the most common NTM pathogens. The mean age of patients was significantly older in the NTM VO group (68.0 vs. 58.5 years, P = .01). Previous steroid or immunosuppressant use was more frequent in the NTM VO group (21.1% vs. 2.9%, P = .01; 15.8% vs. 2.9%, P = .046, respectively), as was a history of vertebral surgery (47.4% vs. 13.3%, P &amp;lt; .001). Symptoms and laboratory findings were similar between the 2 groups, although the proportion of patients with positive interferon-gamma release assays (IGRA) was significantly higher in the TB VO group (14.3% vs. 86.4%, P &amp;lt; .001). Radiologic findings were also similar, with lumbar involvement being the most common (57.9% and 44.8%, respectively). Chronic granulomatous inflammation was more frequently seen in TB VO patients (33.3% vs. 64.0%, P = .04), while inflammation alone was more common in NTM VO. Although there was no significant difference in survival after 1 year, survival at last follow-up (median, 24 months) was significantly lower in the NTM VO group (75.0% vs. 98.8%, P = .02). Conclusion NTM VO should be considered in older patients with a history of immunosuppression or previous vertebral surgery. The pathologic findings and radiologic findings of NTM VO were similar to that of TB VO. Granulomatous inflammation and positive IGRA tests were more common in TB than NTM VO. Disclosures All Authors: No reported disclosures.

Prevalence and Determinants of Hepatitis B Virus Antigenemia among Pregnant Women Attending Antenatal Clinics in Some Hospitals in Bauchi Metropolis

Background: Hepatitis B virus infection is a significant public health problem in the world and is more common among most vulnerable individuals such as pregnant women in developing countries.&#x0D; Design and Duration: This is a cross-sectional study involving pregnant women attending antenatal clinics in some hospitals in the Bauchi metropolis, from January 2021 to February 2022.&#x0D; Aim: The aim of this study is, therefore, to assess the seroprevalence and determinants of the hepatitis B virus among pregnant women attending some hospitals in Bauchi Metropolis, Nigeria.&#x0D; Materials and Methods: A total of 394 blood specimens were collected from the fingertip of the randomly selected pregnant women. A structured questionnaire was administered and interviews were conducted for data collection. The participants were screened for HBsAg status by the rapid diagnostic test.&#x0D; Results: The overall prevalence of the disease was 11.7% (46 of 394). The infection was more common (39.1%) among the women in the 31 to 35 years age group, followed by 23.9% (26-30) years. The majority are married (67.4%), business owners (30.4%), then civil servants (26.1%), and had attended tertiary education (52.1%). The highest frequency (63.0%) was found among the antenatal women at primiparous and mainly (50%) started visiting in the 3rd trimester, with 2 children as the highest number of live births (45.7%). Risk factors analysis revealed that most of the women positive (78.3%) have no history of previous surgery, or blood transfusion (61.20%). but 52.2% are co-infected with HIV/AIDS.&#x0D; Conclusion: This study found a relatively low prevalence of HBV infection (11.7%) among pregnant women in this area, but it was very high, especially among the unvaccinated and those co-infected with HIV.

The Impact of Snapchat Use on Self-Image and Inclination Toward Cosmetic Procedures in Saudi Arabia.

Background Exposure to social media gives individuals more significant body image concerns, and many studies have emphasized that people with a negative body image are more interested in cosmetic surgery. So, increased exposure to celebrities with aesthetic images and exposure to cosmetic Surgery information and advertisements lead to negative body image in the exposed populations. Aim This study aimed to determine the impact of social media on self-image inclination toward cosmetic procedures. Subjects and methods This is a cross-sectional study conducted among an adult population in the Kingdom of Saudi Arabia. A self-administered questionnaire was distributed among participants using social media platforms. the questionnaire was sought information on socio-demographic characteristics (age, gender, education, etc.), the influence of social media on the decision to undergo cosmetic surgery, and the Acceptance of Cosmetic Surgery Scale (ACSS). Results Among the 1064 participants recruited, 41.4% were aged less than 25 with females outnumbering men substantially (82.1). Twenty-seven of the respondents increased their desire to undergo a cosmetic procedure due to advertisements or publications posted on social media. The total mean ACSS score was 3.36 (SD 1.69) out of 10 points, indicating lower acceptance. The socio-demographic variables associated with increased ACSS scores were being older, female, educated, having been married, and previous history of cosmetic surgery. Conclusion Despite the influence of Snapchat on body image, there was a low inclination to undergo cosmetic surgery among the general population in Saudi Arabia. The tendency to undergo cosmetic surgery tends to increase due to the influence of increased social media following, social media influencers, and advertisements and publications posted on social media platforms. More research is warranted to determine the perspectives of the general public regarding the influence of social media platforms on the inclination to undergo cosmetic surgery procedures for the enhancement of body appearance.

Predictors of five-repetition sit-to-stand test performance in patients with lumbar degenerative disease

BackgroundThe five-repetition sit-to-stand test (5R-STS) has recently been validated as an objective measure of functional impairment in patients with lumbar degenerative disease (LDD). Knowledge of factors influencing 5R-STS performance is useful to correct for confounders, create personalized adjusted test times, and potentially identify prognostic subgroups. We evaluate factors predicting the 5R-STS performance in patients with LDD.MethodsPatients with LDD requiring surgery were included. Each participant performed the 5R-STS and completed a questionnaire that included their age, gender, weight, height, body mass index (BMI), smoking status, education level, employment type, ability to work, analgesic drug usage, history of previous spinal surgery, and EQ5D depression and anxiety domain. Surgical indication and index level of the spinal pathology were also recorded. Predictors of 5R-STS were identified through multivariable linear regression.ResultsThe cohort consisted of 240 patients, 47.9% being female (mean age, 47.7 ± 13.6 years). In the final multivariable model incorporating confounders, height (regression coefficient (RC), 0.08; 95% confidence interval (CI), 0.003/0.16, p = 0.042) and being an active smoker (RC, 2.44; 95%CI, 0.56/4.32, p = 0.012) were significant predictors of worse 5R-STS performance. Full ability to work (RC, − 2.39; 95%CI, − 4.39/ − 0.39, p = 0.020) was associated with a better 5R-STS performance. Age, height, surgical indication, index level of pathology, history of previous spine surgery, history of pain, analgesic drug use, employment type, and severity of anxiety and depression symptoms demonstrated confounding effect on the 5R-STS time.ConclusionsGreater height, being an active smoker, and inability to work are significant predictors of worse 5R-STS performance in patients with LDD.Trial registrationClinicalTrials.gov Identifier: NCT03303300 and NCT03321357.

The influence of two kinds of transnasal endoscopic surgery on the outcome status of sinus cavity in patients with eosinophilic chronic rhinosinusitis with nasal polyps

Objective: To investigate the trend of postoperative cavity status in patients with eosinophilic chronic sinusitis with nasal polyps (eCRSwNP) who underwent total nasalization surgery and partial reboot surgery. And to discuss the relationship between tissue eosinophil counts and status of postoperative cavity. Methods: Patients with eCRSwNP in four tertiary medical centers (Longgang ENT Hospital, Xiamen Humanity Hospital, Guangdong Clifford Hospital and the First Affiliated Hospital of Sun Yat-Sen University) from March 2018 to October 2021 were divided into 2 groups. The group without previous surgery history was performed for the nasalization surgery, and another group with previous surgery history underwent the part-reboot surgery. The follow-up time after operation was defined as the following 5 stages: 6, 12, 20-24, 36 and more than 42 months. According to FESS-95 Guangzhou standard, status of sinus cavity was assessed and classified into 3 categories: good, better and bad. The association between the sinus cavity status and tissue eosinophil counts in the above 5 stages was analyzed by one-way ANOVA, and P<0.05 was considered statistically significant. Results: A total of 72 eCRSwNP patients finished the follow-up in this study. There were 47 males and 25 females in these patients, aged from 11 to 67 years. A total of 50 cases underwent nasalization surgery and 22 cases underwent partial reboot surgery. With the follow-up time from 6 to 48 months, there were 72 cases (100.0%) who completed 6 months and 12 months follow up, 46 cases (63.9%) for 20-24 months, 36 cases (50.0%) for 32-36 months and 16 cases (22.2%) with the follow-up time more than 42 months. No matter what kind of surgery, there was no "bad" situation of the surgical cavity status 6 months after the operation, and the differentiation gradually occurred more than 12 months after the surgery. Moreover, the rates of "good" cavity status for the 5 stages in the group of nasalization surgery were 78.0%, 66.0%, 56.7%, 47.6% and 42.9%, and were 63.6%, 45.5%, 25.0%, 20.0% and 11.1% in the partial reboot surgery group, respectively, suggesting that the status of nasal cavity in nasalization surgery group was always better than that in partial reboot surgery group in every period. In addition, the "bad" rate was 0, 8.0%, 10.0%, 14.3% and 28.6% in the group of nasalization surgery, and was 0, 27.3%, 18.8%, 33.3% and 55.6% in the partial reboot surgery group, respectively. The average percentage of tissue eosinophil counts in the 72 cases was 42.1%, which had no obvious effect on the status of the surgical cavity (P>0.05). Conclusions: For eCRSwNP patients, the operative cavity status in the patients without previous operation history treated with nasalization surgery is good. The time of 1-2 years after surgery is the main period for sinus lesions. The counts of tissue eosinophils has no significant influence on surgical sinus cavity status in the eCRSwNP patients.

Incidence of and Risk Factors for Prolonged Intensive Care Unit Stay After Open Heart Surgery Among Elderly Patients.

Open heart surgery (OHS) is frequently performed on elderly patients. We aimed to investigate the risk factors associated with prolonged intensive care unit (ICU) stay in elderly patients undergoing open heart surgery. Medical records of all patients ≥ 75 years who underwent OHS (coronary artery bypass grafting (CABG) and/or heart valve surgery) between June 1, 2013, and December 31,2020, were retrospectively analyzed. Those staying in the ICU longer than five days were determined as prolonged ICU stay. Patients were divided into two groups, according to ICU stay <5 days and ≥5 days. Out of the 198 patients included in the study, 130 (65.7%) were male. Seventy patients (35.4%) had prolonged ICU stay. The mean age was higher in patients within the prolonged ICU stay group when compared to the other group (79.9±3.5 years vs.78.1±2.7 years, p<0.001). The patients who used statins and angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) in the preoperative period had a shorter ICU stay compared to those who did not (45% vs 31.4%, p=0.04; 57% vs 42.9%, p=0.03). The history of previous thoracic surgery (2.3% vs 10% p=0.03), emergency surgery (12.5% vs 24.5% p=0.04), and preoperative pacemaker usage (0.8% vs 7%, 1 p=0.01) were higher in the group of patients with prolonged ICU stay compared to the other group. Preoperative ejection fraction (EF)% (47.7±11.3 vs 51.1±8.8, p<0.001) and hemoglobin level (11.8±1.9 mg/dL vs 12.9±1.6, p<0.001) were lower in the group with prolonged ICU stay compared to the other group. Incidence of cardiac arrest (3.9% vs 15.7% p=0.006), presence of arrhythmia (16.4% vs 41.6%,p<0.001), frequency of pacemaker and intra-aortic balloon pump (IABP) usage (0 vs 10% p=0.002; 1.6% vs 8.6% p=0.02), and need for renal replacement therapy (3.1% vs 12.9%,p=0.02) were higher in the group with prolonged ICU stay compared to the other group. According to the logistic regression analysis; higher age (OR: 1.225, 95%CI 1.104-1.360, p<0.001), preoperative pacemaker usage (OR: 0.100, 95%CI 0.01-0.969, p<0.04), preoperative statin non-use (OR: 2.056, 95%CI 1.040-4.066, p<0.03) and preoperative low EF (OR: 0.947, 95%CI 0.915-0.981, p=0.002) were determined as independent risk factors for prolonged ICU stay. The incidence of prolonged ICU stay after OHS among patients ≥75 years was 35.4% in our cohort. Higher age, preoperative pacemaker usage, preoperative statin non-use, and low preoperative EF were associated with prolonged ICU stay.