Level Of Patient Satisfaction Research Articles

Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results.

Rectal eversion (RE) is a natural orifice specimen extraction (NOSE) method that allows anus-sparing resection in very low rectal tumors. This study aims to share the long-term results of RE in laparoscopic rectal resection performed with double stapling anastomosis. A single-center retrospective cohort study was conducted for patients who underwent laparoscopic low anterior resection with RE. Age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, type of surgery, distance of the tumor to the dentate line, specimen extraction site, cancer stage, preoperative chemoradiotherapy, postoperative complications, and postoperative clinical follow-up findings were recorded. Incontinence was assessed using the Wexner score (WS). Low anterior resection syndrome (LARS) is determined by the LARS score. A 7-point Likert scale was used to evaluate the satisfaction of the patients. A total of 17 patients underwent resection by RE for rectal tumors. Of the 11 patients included in the study, 4 were female and 7 were male. The mean age was 66.09±15.04 years. The mean follow-up was 64.18±16.83 months. The mean tumor diameter was 3.1cm (range: 0.9 to 7.2cm). The mean distance of the tumor from the dentate line was 2.7cm (range: 1.2 to 5.6cm). No anastomotic leak was observed in any patient. One patient had an anastomotic stenosis and was treated with balloon dilatation. The median LARS score was 16 (range 0 to 32) and 64% of the patients had no LARS. Two patients had minor LARS and 2 patients had major LARS. The median Wexner score was 3.5 (range 0 to 14). The median Likert scale was 7 (range 5 to 7). It was found that 55% of the patients were extremely satisfied, 18% were satisfied, and 27% were slightly satisfied with their surgery. There were no dissatisfied patients. RE is a safe NOSE technique in laparoscopic double stapling anastomosis for rectal resection. There is a high level of long-term patient satisfaction with anus-sparing procedures via RE, even in the presence of various symptoms.

Effects of a Virtual Trauma Clinic on admissions and length of stay for minor to moderate trauma.

To investigate the feasibility of a Virtual Trauma Clinic (VTC) for patients with minor to moderate trauma, and evaluate patient satisfaction and outcomes. One hundred VTC patients were matched 1:1 with historical patients from the hospital trauma registry who received conventional care. Matching was based on age ± 5 years, sex, mechanism of injury, Injury Severity Score ± 2, trauma team activation and day of week of presentation. VTC patients were sent surveys on experience and outcome measures. VTC was associated with reduced average hospital length of stay for admitted patients by 1.81 days (95% CI = -2.82, -0.79; P = 0.001) and reduced hospital admissions (odds ratio 0.26; 95% CI = 0.14, 0.48; P < 0.001). There was an avoidance of 199 inpatient bed days in total, with no trauma-related readmissions within 30 days post-hospital discharge. 92% of respondents (n = 22) rated the care they received from VTC as excellent or good. Patient-reported outcome surveys showed overall improvement in functional domains but evidence of ongoing disability, with persistent issues of pain and psychological distress at 1 month post-injury. Patients with minor to moderate trauma have ongoing care needs with high rates of pain, psychological distress and disability remaining prevalent long after discharge. VTC provided an innovative strategy for hospital avoidance with high levels of patient satisfaction and no adverse effects on safety. The overall quality of care for these patients was enhanced through the provision of standardised, patient-centred and multidisciplinary follow-up.

Client’s pre-operative expectations and outcome of cataract surgery at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria

Objectives: A cataract is an opacity of the natural crystalline lens that causes vision loss. It is the most common cause of blindness worldwide, accounting for 39% of the 42 million blind people in the world. The optimum outcome from a cataract surgery can be achieved if post-operative subjective outcomes meet pre-operative expectations. It is expressed in different ways including patient satisfaction. This study evaluated clients’ pre-operative expectations and the outcome of cataract surgery at Jos University Teaching Hospital. Materials and Methods: A quasi-experimental, prospective hospital-based study that consecutively recruited 109 participants aged 18 years and above for 6 months. Data regarding the sociodemographic characteristics, pre-operative visual function, and expected post-operative outcome were collected preoperatively, and the subjective outcome and level of patient satisfaction were also assessed 6 weeks after surgery using a visual function index questionnaire. Data were analysed using the Statistical Package for the Social Sciences’ version 23. Frequencies and percentages were determined for categorical variables; mean and standard deviation, median, and interquartile range were calculated for continuous variables. Correlation was used to measure the relationship between overall satisfaction and expected or achieved visual function. A significant level was determined at P &lt; 0.05. Results: A total of 109 participants were seen in this study, of which 60 (55%) were males. The mean age of participants in the study was 64.5 ± 11.1 years. The median (interquartile range) expected and actual post-operative outcome scores were 100 (80–100) and 98 (75–100), respectively. The majority of the participants, 86 (78.9%), were satisfied with the outcome of cataract surgery, and the predictors of satisfaction were insertion of posterior chamber intraocular lens, absence of complications, and absence of ocular comorbidities. We found a significant strong positive correlation between subjective outcome and satisfaction (r = 0.538, P ≤ 0.0001). Conclusion: The majority of the clients were satisfied with the outcome of their surgeries which meets the high expected outcomes from the clients pre-operative. Adequate counselling, training, and retraining of surgeons are key to improving and maintaining satisfaction with the outcome of cataract surgery.

A narrative review on the performance and outcomes of penile and scrotal surgery in the ambulatory setting.

Following the COVID-19 pandemic, surgical wait times have surged, creating a backlog in elective urological procedures. This review aims to address the need to explore ambulatory care for penile and scrotal surgeries, which can offer benefits by shifting these procedures away from traditional inpatient settings. Recent studies confirm the safety and efficacy of performing penile and scrotal procedures in an ambulatory setting using local anesthesia (LA) or loco-sedative techniques. Of 616 reviewed cases, over 90% of patients expressed high satisfaction with LA and reported minimal postoperative complications. Pain management advancements, particularly the use of liposomal bupivacaine, reduced the need for opioids postoperatively. Importantly, no intraoperative complications or hospital admissions were reported, and adverse events were managed conservatively. The data highlighted in this review supports a move towards outpatient surgeries as a safe alternative to inpatient care for select cases. This review highlights the strong potential for ambulatory urological surgeries to alleviate surgical backlogs significantly, while reducing strain on hospital resources, and maintaining high levels of patient satisfaction. As evidence continues to grow on the safety, feasibility, and effectiveness of LA in office-based procedures, expanding ambulatory urological will be quintessential in modernizing patient care and reducing healthcare burdens.

Patient Satisfaction With Meal Service With Leftovers At Grandmed Hospital Lubuk Pakam

Food service is an important issue in the hospital environment, and patient satisfaction levels are often indicated by food consumption and waste. The current study compared patient satisfaction in hospital areas and other factors and determined the relationship between patient satisfaction and food waste. This quantitative study was conducted in RS. GrendMed Lubuk Pakam. Patients in these hospitals were asked to fill out a questionnaire consisting of three parts: general information, patient satisfaction questionnaire (Patient Satisfaction Questionnaire for Acute Care Hospital Food Service). A total of 74 patients participated. The results showed that overall, 18.9% (finished and satisfied), 39.2% (not finished and satisfied), and 41.9% (Not satisfied and not finished). Satisfaction with hospital food varies according to the service of each patient with health conditions. However, the results also showed that satisfaction with hospital food service was significantly associated with food waste (p value = 0.000). Various factors in hospital food service, especially food quality, should be improved to motivate patients to consume hospital food..

Comparison of the MIPPO technique and the modified Stoppa approach in the treatment of unstable anterior pelvic ring injuries: a retrospective cohort study

BackgroundAnterior pelvic ring injuries have gradually become common. Using a minimally invasive technique to treat this injury may be feasible if the reduction and stability can be effectively achieved. We describe a percutaneous technique, minimally invasive percutaneous plate osteosynthesis (MIPPO), to fixate the anterior pelvis via establishing a subperiosteal tunnel between two limited incisions over the iliac crest(s) and pubic ramus in this research.MethodsA retrospective cohort study comparing the MIPPO technique (n = 60) versus the modified Stoppa approach (n = 53) for anterior pelvic ring injuries with posterior ring instability was performed from September 2016 to January 2023. The relative surgery variables, follow-up function evaluation, and complications were compared in two groups. The reduction quality of fracture was assessed according to the Matta criterion, and the functional score was evaluated using the Majeed score.ResultsAll patients completed follow-up, with an average interval of 39.90 ± 17.53 months (range 12–78). In the MIPPO technique group, the surgery interval and blood losses were lower compared to the modified Stoppa approach group (P<0.05). The mean procedure times and intraoperative blood losses were 69.56 ± 14.04 min/side (range 50–110) and 156.23 ± 49.75 mL/side (range 90–250) for unilateral anterior ring MIPPO fixation separately. All patients got a satisfactory reduction of the fracture. In the follow-up, earlier ambulation, shorter postoperative hospital stays, and lower complication rates were observed for patients using the MIPPO technique compared to the modified Stoppa approach (P<0.05). However, there is no statistical difference in these indicators including fracture union interval, full load time, the Majeed score, patient satisfaction level, and return to pre-injured work rate between the two groups.ConclusionThis clinical experience gives support for the use of the MIPPO technique to stabilize the anterior pelvis. This minimally invasive technique was an effective and safe surgery method and could obtain satisfactory function results, particularly fitting to part of patients with resistance using the modified Stoppa approach.

A Randomized Controlled Trial Comparing "Early" Versus "Late" Periosteal Patch Attachment to Knee Chondral Defects in Autologous Chondrocyte Implantation.

Traditional autologous chondrocyte implantation (ACI) involves arthroscopically harvesting a cartilage biopsy (stage 1), followed by arthrotomy 3 to 4 weeks later to apply a periosteal patch and implant culture-expanded chondrocytes underneath (stage 2). This study aimed to determine if patch application during stage 1 rather than stage 2 improved clinical outcome. A randomized controlled trial was conducted from 1998 to 2001. Patients were randomized to receive either traditional ACI (control/late) or ACI with "early" patch during stage 1 (intervention/early). Clinical outcome (Lysholm score) was assessed pre-operatively and annually post-operatively. Seventy-seven patients were recruited, with 40 patients randomized to the early and 37 to the late patch group. The overall mean pre-operative Lysholm score was 51.8 (range 11-89) and significantly improved by 11.1 points (95% confidence interval [CI] = 4.8 to 17.4) at mean 12.7 years (range 1.5-23.7) follow-up. Latest mean Lysholm scores for the early and late groups were 68.4 (95% CI = 19 to 100) versus 56.7 (95% CI = 18 to 98). Adjusted for covariate imbalances, no evidence was found for a difference between the groups (mean difference = 8.5, 95% CI = -5.2 to 22.2, P = 0.22). Twenty-year survival until any re-operation or arthroplasty was 59.6%/82.1% for the early and 56.8%/69.5% for the late group, with no evidence for a difference. ACI is an effective durable treatment for cartilage defects, with high levels of patient satisfaction and low failure rates. No evidence was found that applying the periosteal patch at the time of chondrocyte harvest improved long-term Lysholm scores or survival until any re-operation or arthroplasty.

Discovering a “sense of community”: patient experiences of connection in intentionally remote eating disorder care

BackgroundWhile some findings indicate high levels of patient satisfaction with remote eating disorder treatment, others reflect feelings of disconnection due to unique telehealth treatment challenges. The COVID-19 pandemic presented circumstances that likely impacted the findings established thus far. As such, the present study sought to understand patient experiences of connection in an intentionally remote eating disorder treatment program, specifically in a context outside of pandemic transition.MethodsA secondary analysis of de-identified qualitative data previously obtained for quality improvement purposes via a client satisfaction survey was conducted. Adult patient responses (N = 38) were analyzed via reflexive thematic analysis within a critical realist framework.ResultsFour themes were generated from the data: (1) Embracing one’s humanity paves the way for connection, (2) Discovering a “sense of community” in remote care, (3) “They made me feel I was worth recovering”: connection as a vehicle for healing, and (4) Aligning expectations and reality: reconceptualizing the journey to connection in remote eating disorder care.ConclusionsOverall, findings suggest that it is possible for patients to form strong, impactful connections in remote treatment. Importantly, patient perspectives indicated that there were shifts in how these connections were experienced as a result of the remote care environment (e.g., how support could be provided and by whom). Considerations unique to remote care (e.g., offering training to improve clients’ comfort with technology) may be important to fostering connection, thereby contributing to improved patient experiences and treatment outcomes.

Comparative study between intrathecal fentanyl and dorsal penile nerve block for controlling postoperative pain after inflatable penile prosthesis implanation

Objectives: To compare the efficacy of intrathecal fentanyl and dorsal penile nerve block for postoperative pain management in patients undergoing inflatable penile prosthesis (IPP). Patients and methods: A prospective single-center study included 80 patients amenable to IPP. Patients were divided equally into two groups. Group I included 40 patients who were managed with spinal anesthesia with intrathecal fentanyl before undergoing IPP. Group II comprised 40 patients who received spinal anesthesia with dorsal penile block before IPP. Study groups were compared regarding postoperative VAS (Visual Analog Scale) scores, total narcotics consumption, patient satisfaction levels, and perioperative complications. Results: The study groups were comparable regarding baseline patients’ criteria. The operative time was comparable between the study groups, with group I and group II having respective median times of 64 minutes (interquartile range: 55-78) and 67 minutes (interquartile range: 56-81) (p = 0.65). Additionally, both groups demonstrated similar distributions in IPP implant cylinder and reservoir size (p = 0.9). Postoperative pain was higher in group I, with a statistically significant difference (p &lt; 0.001). Eight patients in group I (20%) called the physician’s office asking for pain medication, compared to two patients in group II (5%) (p = 0.04). 85% of patients in group II were highly satisfied compared to 50 % in group I (p = 0.003). We reported a 5% complication rate in group I compared to 2.5% in group II (p = 0.6). Conclusions: The present study found that the dorsal penile nerve block offers superior postoperative pain control and patient satisfaction compared to intrathecal fentanyl for patients undergoing inflatable penile prosthesis insertion.

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

Improvement in pain by using lidocaine combined with esketamine in elderly patients receiving local anaesthesia for percutaneous kyphoplasty: a randomized controlled study

BackgroundElderly patients often experience severe pain during percutaneous kyphoplasty under local anaesthesia. The aim of this work was to evaluate the effect of lidocaine combined with esketamine on pain improvement in elderly patients receiving local anaesthesia via percutaneous kyphoplasty.MethodsThis prospective, randomized comparative trial was conducted on 66 elderly patients, aged 60–80 years, with an American Society of Anaesthesiologists (ASA) grade of I-III, I‒III and a BMI of 18.5–25 kg/m2, who underwent single-level lumbar percutaneous kyphoplasty under local anaesthesia. Patients were divided into two equal groups (33 per group). Group LE received 200 mg of 1% lidocaine and 25 mg of esketamine (total volume of 20 ml), and Group L received 200 mg of 1% lidocaine (total volume of 20 ml). Patient characteristics, surgery, VAS scores, MAP, HR, MOAA/S scores, patient satisfaction and related adverse reactions were compared for the groups. The VAS scores during and after surgery were considered the primary outcome.ResultsThere were statistically significant differences in the VAS score between the two groups at the following time points: channel establishment by the puncture needle, balloon dilation, bone cement injection and postoperative period (P < 0.05). The VAS score decreased in the LE group, but the MAP and HR were more stable, and the difference was statistically significant (P < 0.05). The difference in the MOAA/S score between the two groups was statistically significant (P < 0.05), and the MOAA/S score in the LE group decreased. The patient satisfaction level in the LE group was 100% and 48.48% in the L group (P < 0.05). There were no related complications or adverse reactions in either group.ConclusionThe application of lidocaine combined with esketamine in local episcopal percutaneous vertebral kyphoplasty in elderly patients not only provides an effective analgesic effect but also improves surgical safety and patient comfort, which has important clinical value in promoting the optimization of surgical anaesthesia management in elderly patients.Trial registrationThe study was registered at Chictr.org.cn with the number ChiCTR2400083466 on 06/12/2023.

New protocol for early robot-assisted gait training after spinal surgery.

Early rehabilitation post-spinal surgery is vital for patients' recovery. Robot-assisted gait training (RAGT) shows promise but requires further study to establish a specific protocol and gauge its effects on both patients and physical therapists. This study aimed to determine the impact of a newly developed protocol for early RAGT on patients' functional enhancement and satisfaction levels after spinal surgery, as well as on the physical therapists who implemented the therapy. First, we developed the protocol in collaboration with three physiatrists and two physical therapists with extensive experience in musculoskeletal rehabilitation. The protocol was updated three times, each after three rounds of face-to-face meetings. Afterward, we conducted a cross-sectional study involving five physical therapists and 32 post-spinal surgery patients at a tertiary hospital rehabilitation center. The intervention consisted of five sessions of RAGT. Main outcome measures included the Functional Ambulation Category (FAC), the ambulation item of the Modified Barthel Index (MBI ambulation), and satisfaction surveys for both patients and physical therapists. RAGT typically started 17.91 ± 9.76 days postoperatively and was successfully applied with no remarkable adverse effects. The FAC scores increased from 2.65 ± 1.21 to 3.78 ± 0.71 (p = 0.006), and MBI ambulation increased from 7.69 ± 2.71 to 10.66 ± 2.90 (p < 0.001) between transfer and discharge. Satisfaction with the robot, RAGT, and treatment, assessed using a 5-point Likert scale, were 3.30 ± 0.79, 3.72 ± 0.85, and 3.08 ± 0.84, respectively. Satisfaction was notably the highest for alleviating fear of falling, whereas managing pain and discomfort during position changes scored the lowest. Physical therapists rated RAGT satisfaction, impact on the working environment, and treatment stability at 3.0 ± 0.65, 2.80 ± 0.67, and 3.50 ± 0.61, respectively. Early spinal surgery rehabilitation with RAGT improved patients' functionality and gait satisfaction. While physical therapists considered RAGT safe, its impact on their work environment was limited. Integrating RAGT into post-spinal surgery rehabilitation demands ongoing protocol refinement, custom robot development, and efficacy evaluations.

Роль и место медицинской информационной системы при оказании дерматологической помощи в частной медицинской организации

Dermatological diseases retain statistically significant positions in the structure of modern somatic pathology and are often characterized by severe medical and social consequences. The latter include an unreasonably high number of unsatisfactory treatment results, high level of expenses for diagnostics and treatment, low level of patient satisfaction. Taken together, this allows us to consider the comprehensive quality of dermatological care as a whole insufficient. Medical organizations in the private healthcare segment are no exception in this regard. One of the modern effective directions in improving the quality of a wide variety of types of medical care for the population is the widespread use of the so-called medical information systems (MIS). However, at the level of dermatological organizations in the private healthcare segment, this direction has not been practically worked out to date. Purpose of the study: improving the quality of dermatological care for the population in a private medical organization based on the development and implementation of a medical information system. Materials. The study included 2000 dermatological patients of a private medical organization. The control group (1000 people) consisted of patients in the period before the implementation, the main group (1000 people) – patients in the period after the implementation of the developed system. The duration of the compared periods was 2,5 years. Мethods. To obtain the results, the methods of objective examination, specialized patient questionnaires, simple and extended dermatoscopy, content analysis of medical documentation and databases of the medical organization, pharmacoeconomic analysis were used. The system of integrated assessment of the quality of medical care was applied. The methods of variation statistics were used to analyze the results. The exact level of statistical significance of differences in the results before and after the implementation of the developed MIS was calculated.. Subject. The study is at the intersection of two subject areas: «Organization of dermatological care for the population» and «Medical information systems». Results. As part of this study, a MIS was developed aimed at improving the organization of dermatological care for the population. The system was implemented in a medical organization in the private healthcare segment. The main results of such implementation were: an increase in the number of successful treatment results, the level of patient satisfaction with the quality of dermatological care, the level of its standardization, a decrease in direct economic costs for diagnostics and treatment. The integrated and comprehensive indicators of the quality of dermatological care have been increased.. Conclusion. Improving the quality of dermatological care for the population in a medical organization of the private healthcare segment based on the development and implementation of a medical information system has been achieved. The results obtained have a high level of statistical and medical-social significance.

Utilisation of the minimally invasive chevron akin (mica) osteotomy for severe hallux valgus: a systematic review.

Hallux valgus is the most common forefoot disease that can cause pain and be disabling for the patient. Many surgical procedures have been described to correct this deformity; over the last years, the minimally invasive Chevron and Akin osteotomies (MICA) technique has become very popular. The aim of this review was to assess if MICA technique is a reliable procedure for treating severe hallux valgus. A systematic review was performed according to the Preferred Reporting Items for systematic Reviews and Meta-Analysis (PRISMA) guidelines. The keywords were searched in PubMed Medline and Cochrane library. To minimise the number of missed studies, no filters were applied to the search strategy. To be considered for this review, the articles needed to comply with the following inclusion criteria: Minimally invasive Chevron and Akin osteotomy (MICA) for severe hallux valgus (HVA > 40°, IMA > 16°), patient age over 18years and minimum follow-up of 6months. Following the PRISMA flow chart 7 studies met the inclusion criteria and were taken into consideration in the review. We reached a population of 582 patients for a total of 676 feet. Males and females were 64 and 518, respectively. The mean age was 54.15 ± 8.25. The mean follow-up was 23.74 ± 9.60months. All the studies reported an improvement in clinical results, in terms of function and quality of life. Radiological variables, mostly IMA and HVA, assessed pre- and postoperatively showed significant improvement in all studies included. Despite the limited number of published studies in the literature, the available evidence reveals good clinical outcomes and high levels of patient satisfaction. Percutaneous surgery for severe hallux valgus can achieve great deformity correction with reasonable rates of residual deformity. Patient satisfaction and quality of life following third-generation MICA surgery is very high.

The Microneedle Revolution: Transforming Vitiligo Treatment Landscapes-A Comprehensive Review of the Literature.

Vitiligo is characterized by the emergence of depigmented patches on the skin, posing significant therapeutic challenges. Microneedling, a novel treatment strategy, capitalizes on its potential to invigorate skin regeneration and facilitate melanocyte migration. This review critically evaluates the efficacy, safety, and patient satisfaction associated with microneedling for vitiligo treatment, juxtaposing it with traditional therapies to elucidate its viability as either a standalone or complementary treatment modality. A comprehensive literature review was conducted across major databases, including PubMed and Cochrane Library, using keywords like "microneedling" and "vitiligo," encompassing studies up to January 2024. This review focused on microneedling's effectiveness, safety, and patient satisfaction, including both solo and combined treatments. Data synthesis emphasized repigmentation rates, side effects, and patient feedback. An exhaustive review of studies pertaining to microneedling for vitiligo, especially focusing on outcomes when administered alone or in conjunction with agents such as tacrolimus and 5-fluorouracil, was undertaken. Key evaluation metrics included repigmentation success rates, adverse effects, and patient-reported outcomes. Microneedling demonstrates a favourable safety profile, with mild and manageable side effects such as pain, erythema, and temporary hyperpigmentation. Severe adverse events are rare, further supporting its safety as a treatment option for vitiligo. The evidence amassed suggests that microneedling significantly augments repigmentation rates, particularly in synergy with topical treatments. It is generally well-tolerated, manifests minimal adverse effects, and has garnered high patient satisfaction levels. Nonetheless, the absence of standardized treatment protocols and paucity of long-term efficacy data underscore the imperative for further empirical inquiry. Microneedling emerges as a propitious treatment alternative for vitiligo, demonstrating both safety and efficacy, notably when used in tandem with topical agents. Future investigations should aim at protocol standardization and long-term efficacy evaluation to firmly establish its therapeutic stature within vitiligo management paradigms.

Factors Affecting Satisfaction With the Process of Orthodontic Treatment in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife

Objectives: This study aims to determine the factors contributing to patient satisfaction with orthodontic treatment at Obafemi Awolowo University Teaching Hospital Complex. The specific objectives were to identify factors improving and negatively impacting patient satisfaction, and determine the level of patient satisfaction. Methods: A cross-sectional study design was employed, which involved patients attending the orthodontic clinic at Obafemi Awolowo University Teaching Hospital Complex. A self-administered questionnaire assessed patient demographics, satisfaction levels, and factors influencing satisfaction. Data analysis was performed using descriptive statistics, chi-square tests, and mean scores. Results: Of the 67 respondents, 91% reported satisfaction with their orthodontic treatment. The doctor-patient relationship received the highest mean satisfaction score, while psycho-social improvement received the lowest. Dissatisfied patients were predominantly females in the 21-30 age group. Factors such as dento-facial and dental function improvements significantly affected satisfaction levels. Conclusion: The majority of orthodontic patients at Obafemi Awolowo University Teaching Hospital Complex reported satisfaction with their treatment. Improving patient communication, managing expectations, and addressing dento-facial and dental function improvements can enhance satisfaction levels. Strengthening the doctor-patient relationship and optimizing clinic experiences can improve patient satisfaction.

Real-world usage pattern, effectiveness and safety of oral tramadol/dexketoprofen trometamol fixed-dose combination in moderate-to-severe acute pain in Asia: a prospective, multicentre, observational study

ObjectivesThis study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of...

The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study

Objective: To explore the efficacy of Traditional Chinese Medicine (TCM) acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke. Methods: This is a retrospective study using clinical records of 180 patients with ischemic stroke, hospitalized in the Department of Neurology of the Zhejiang Province Tertiary Class A Hospital, Huzhou, China from July 2022 to June 2023. The patients were divided into two groups on the basis of the nasogastric tube insertion method. We selected 90 patients for each group from the database of records by using a random list method. Patients in the observation group underwent TCM acupuncture-assisted blind insertion of nasointestinal tube and those in the control group underwent the traditional bedside blind insertion of bullet nasointestinal tube. Success rate of tube insertion, average tube insertion time, intragastric insertion time, stomach time to jejunal insertion, patient comfort, and patient satisfaction in both groups were compared. Results: The success rate of nasointestinal tube insertion was significantly higher in the observation group compared to the control group (96.6% and 88.9%, p&lt;0.05). There was no statistically significant difference in the time of nasoenteral tube insertion into the stomach (p&gt;0.05). The insertion time from stomach to jejunum in the observation group was significantly shorter than in the control group (p&lt;0.05). The patient comfort and satisfaction levels were significantly higher in the observation group compared to the control group (p&lt;0.05). Conclusion: TCM acupuncture-assisted blind insertion of bullet nasointestinal tube method improves the success rate of tube insertion, shortens the average catheterization time from the stomach to the jejunum and improves patient’s comfort and satisfaction. doi: https://doi.org/10.12669/pjms.40.10.9936 How to cite this: Zhao H, Chen J, Chen H, Lv X, Lu Z, Sun Y. The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study. Pak J Med Sci. 2024;40(10):2208-2212. doi: https://doi.org/10.12669/pjms.40.10.9936 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Modern Aspects of Closed and Open Rhinoplasty (Literature Review)

Open and closed rhinoplasty are two primary approaches to nasal modification. According to the current literature, there is no consensus among plastic surgeons and otolaryngologists regarding the preferred method in terms of aesthetic outcomes, complications, and patient satisfaction. This review aims to analyze published scientific materials to determine whether open or closed rhinoplasty leads to more favorable patient outcomes. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a literature search across four databases according to our search strategy. The articles were then imported into COVIDENCE, where they underwent primary screening and full-text review. A total of twenty studies were selected for this review after analyzing 243 articles. Among them, there were four case series, twelve retrospective cohort studies, one prospective cohort study, one case-control study, and two outcome studies. The analysis included three cosmetic studies, eight functional studies, and nine studies that addressed both cosmetic and functional components. Sixteen studies used both open and closed rhinoplasty techniques, while four focused exclusively on open rhinoplasty. Both methods demonstrated high satisfaction rates among patients and professionals, with no significant advantage found for either technique. Based on the available studies, we cannot conclude the superiority of either open or closed rhinoplasty in achieving better patient outcomes. Several studies indicated that both open and closed rhinoplasty resulted in comparable levels of patient satisfaction. To enhance the reliability and consistency of outcome reporting, authors should focus on using the Nasal Obstruction Symptom Evaluation (NOSE) scale and other standardized rhinoplasty outcome assessments.

Symptomatology and level of satisfaction in patients using the double‐J ureteral stent

AbstractBackgroundUreteral stents are used as temporary or permanent drainage measures for intrinsic or extrinsic occlusions of the upper urinary tract. Their use can cause complications such as urinary symptoms, which consequently impact the quality of life. Therefore, the aim of this study was to analyze the symptoms and level of satisfaction of patients who used the double‐J ureteral stent.MethodsThis article is a cross‐sectional study involving 40 volunteers who had previously undergone a urological procedure that required the insertion of a double‐J ureteral stent. Subsequently, they consulted the urology outpatient clinic and answered a questionnaire designed by the authors.ResultsAccording to the results, the average age of the patients was 43 years old, 75% were female, and 42.5% reported comorbidities, with hypertension being the most prevalent. The wired double‐J ureteral stent was used in 72.5% of patients, and the average length of stay was 6 days. 95% of the patients had complaints related to the use of the double‐J ureteral stent, with colicky abdominal pain being the most frequent symptom (77.5%) and hematuria being the most common urinary symptom (65%), followed by dysuria (62.5%) and urgency (52.5%). Analysis of the level of satisfaction showed that 55% of patients were satisfied and 22.5% were dissatisfied. No statistical significance was found between the incidence of symptoms related to the double‐J ureteral stent and the groups analyzed.ConclusionThis study was able to highlight important features of the symptomatology of patients using the double‐J ureteral stent and the repercussions on satisfaction with its use. Furthermore, it was possible to concluded that the experience of using the double‐J ureteral stent was satisfactory for 55% of the patients.