Retrospective Quantitative Study Research Articles

The intervention of the emergency psychologist: the SIPEM SoS Emilia Romagna during the first lockdown from COVID-19.

Background and purpose of this work:WHO 11 March 2020 declares that Sars-Cov-2 infection is not only a health emergency but must be considered a pandemic. Covid-19 required the urgency of a new psychological intervention model to better address the crisis and ensure a direct support response to the people involved in the pandemic. The present study aimed to detect the symptoms and reactions of the population with respect to the event. The survey was carried out by describing the clinical symptoms that emerged from the triage card used by SIPEM SoS Emilia Romagna (Italy), connoting the criteria of emergency psychology.Methods:A retrospective quantitative study was conducted on 288 psychological triage cards.Results:only 11% of users who ask for support say they are positive while 85% report not having contracted the virus. Of the total, 40.9% call for psychological support in the management of anxiety symptoms, a need also reported by 55% of the subsample who declared previous psychological problems. In reaction to the pandemic event, 51.1% of the total refers to coping resources and availability for help.Discussions:the need for support of the population to manage symptoms highlights the need for early interventions, also to facilitate that slice of the population that does not have effective individual coping strategies and resources available to help.Conclusions:it can be deduced that interventions during these types of emergencies must be timely and aimed not only at those affected but also at the general population. (www.actabiomedica.it)

Study on prevalence and the contributing factors of lower limb amputation in a tertiary health care centre

Aim and objectives: Lower Limb Amputation Is the Most Dreadful Complication of Various Factors for the patient as well as his families. This Study is to find the Prevalence of Lower Limb Amputations and factors contributing to amputation in our population. Method: The Retrospective quantitative study was conducted in Sree Mookambika Institute of Medical Sciences and hospital in the period of June 2018 to November 2019. Each patients are assessed periodically and evaluated. Following parameters are used to evaluate the contributing factors like age, sex, diabetes mellitus, systemic hypertension, chronic kidney disease, coronary heart disease, smoking, level of amputation and its post-operative complications. These parameters help to find the prevalence of lower limb amputations and study about the contributing factors which lead to amputation. Complications we encountered here are infections following the procedure, progression of gangrene due to inadequate blood supply or infective aetiology, uncontrolled diabetes mellitus. Infective cases are treated with appropriate antibiotics according to the culture and sensitivity report. In some cases where below knee amputations are converted to above knee amputations due to inadequate blood supply or progression of infection. Results: Over the period of 18 months, 124 lower limb amputation are performed (which includes ray amputation, below knee amputation and above knee amputation). Majority of patients in my study group belong to 41-50 years of age with 50% in total population. Male is more predominant with 64% comparing female gender with 34%. Among the total group diabetes were found in 75% of study population. Among those diabetic patients 58% were found to have HBA1C more than 10. Smoking is the only of the modifiable risk factors among the other risk factors which account for 54.8%. Chronic kidney disease with stage 4&5 were noted in 31 patients, majority of the patients were presented with non-healing chronic ulcer with 63%, where remaining presented with gangrene formations. Depending up on the mode of presentation and level of involvement, patients underwent amputation most common amputation we done are ray amputation for 67 patients followed by below knee amputation for 35 and above knee amputation for 14 patients, 8 patients who initially underwent below knee amputation due to inadequate blood supply and ascend of infections which was converted in to above knee amputation.

Profile of facial trauma in older adults cared for at a tertiary hospital of the Brazilian Federal District

OBJECTIVES: The phenomenon of population aging and the remarkable inclusion of older adults in the economically active population has increased their participation in injuries and accidents, including facial trauma. The purpose of this study was to analyze the prevalence, etiology, and treatment of facial trauma in the older population of the Brazilian Federal District, as well as the gender, etiology, type of trauma, and treatment strategy regarding different age groups (60–69 years, 70–79 years, and 80 years or older). METHODS: This is a retrospective quantitative descriptive study using electronic medical records (Trackcare system) of older patients (aged ≥ 60 years) assisted at the Emergency Department of a tertiary hospital of the Federal District between 2016 and 2017 due to facial trauma. RESULTS: Out of 2382 records of patients with facial trauma, 139 (5.8%) were aged over 60 years. The main causes of facial trauma were falls, both in male and female patients. Facial contusion was the main diagnosis of facial trauma (25.2%), followed by fractures of the jaw (16.5%) and zygomatic complex (15.8%). Conservative treatment was the most common strategy adopted in the Emergency Department of Oral and Maxillofacial Surgery and Traumatology. CONCLUSIONS: This study showed a high prevalence of facial trauma in the geriatric population. Etiological factors such as falls and car accidents were highlighted in the studied groups. Conservative treatment and local guidelines were the preferred therapeutic approaches. Owing to the growth trend of the older population in the upcoming decades, exposure to risk factors for facial trauma tends to grow, thus requiring greater attention and specific knowledge from health professionals.

Incompleteness and inaccuracies in Certificates of Live Birth in a city in Southern Brazil.

To evaluate inadequacies in Certificates of Live Birth in a city in Southern Brazil between 2011 and 2015. This is a retrospective quantitative study based on Certificates of Live Birth of mothers living in Itapema, Santa Catarina, issued from 2011 to 2015, using data from the Live Birth Information System. Among 3,537 certificates, we found no mistakes in the variables newborn's sex, birth weight, maternal age, type of pregnancy, and type of delivery. Concerning incompleteness, the variable "cesarean section was performed before the start of labor" had a mean rate considered poor, while occupation was classified as good (above 6%), neighborhood as excellent (between 0.8 and 4.5%), and induction also as excellent (0.7 to 2.9%). Inaccuracies were greater in the ethnicity (up to 0.7%) and neighborhood (up to 1.3%) variables, both considered excellent. In the comparison between sections, the pregnancy and childbirth section was the most incomplete. Data completeness in Certificates of Live Birth was considered excellent for most variables, and the classification of inaccuracies was excellent for all variables, evidencing the quality of the information found in these certificates.

OPTICAL NEUROPATHY: ANTIGLAUCOMATOUS TREATMENTS OFFERED BY THE UNIQUE HEALTH SYSTEM IN BRAZIL, AN ANALYSIS OF THE LAST DECADE

Introduction: Optical neuropathy with progressive loss of visual field, glaucoma represents the main cause of irreversible blindness. Objectives: To analyze the frequency of antiglaucomatous procedures performed by the Unified Health System (SUS), in the last 10 years, requiring hospitalization and outpatient care. Methods: This is a cross-sectional quantitative retrospective study, carried out through consultations and data analysis of antiglaucomatous procedures in the DATASUS system, between January 2010 and December 2019. Results: In Brazil, trabeculectomy was the most performed procedure in the last 10 years. Outpatient care had an average of 10,661 per year, on the other hand, the need for hospitalization increased by 70%. The second procedure that generated the most hospitalizations was the implantation of an anti-glaucomatous prosthesis, which doubled in the corresponding period. Cyclodialysis was the least used procedure in the 10 years of analysis, both on an outpatient and hospital basis, and is reserved for the final stages of glaucoma. Surgical iridectomy, used for acute treatment, showed a reduction, in 2019 it represented less than a third compared to 2010. As for outpatient procedures using lasers, such as phototrabeculoplasty and iridotomy, they showed significant growth. Conclusion: Trabeculectomy is considered the gold standard, justifying its greater frequency, both on an outpatient and hospital basis. Procedures using laser are expanding, trabeculoplasty as an alternative to primary therapy, and iridotomy for greater safety in acute treatment. As the population ages, glaucoma tends to be increasingly prevalent, contributing to the progressive increase in trabeculectomies.

Prevalência da esclerodermia localizada em um serviço de referência em dermatologia do Estado do Ceará

Introdução: A esclerodermia abrange amplo espectro de manifestações clínicas, sendo subdividida em forma localizada e sistêmica. A forma localizada, com acometimento exclusivamente cutâneo e de tecidos circunvizinhos, apresenta fisiopatologia e epidemiologia parcialmente conhecidas pela comunidade científica, com a maioria dos estudos epidemiológicos se concentrando na forma generalizada e extrapolando seus resultados para a outra forma. Este estudo tem o intuito de esclarecer a epidemiologia da esclerodermia localizada no estado do Ceará, visando compreender seus fatores de risco na população brasileira. Trata-se do primeiro estudo epidemiológico brasileiro acerca da esclerodermia localizada. Metodologia: Delineou-se um estudo retrospectivo quantitativo, no qual foram analisados todos os registros das consultas médicas realizadas no Centro de Referência em Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, em 2015, através das variáveis: nome, sexo, idade, data da consulta, número do prontuário, diagnóstico presuntivo ou confirmado e a frequência do paciente no CDERM. Resultados: Dos 19.576 pacientes analisados, 124 pacientes foram diagnosticados com esclerodermia localizada, representando uma incidência aproximada de 0,62% no serviço. Dentre estes pacientes, 96 (77,42%) eram do sexo feminino e 28 (22,58%) do sexo masculino. A idade média dos pacientes foi de 29,7 anos. Discussão: A prevalência e distribuição por sexo obedeceram às tendências mundiais relatadas em outros trabalhos. Entretanto, constatou-se elevada prevalência de diagnóstico no sexo feminino na faixa etária pediátrica, o que contrasta com dados na literatura que afirmam que as diferenças na distribuição de gênero começam a existir no início da adolescência. Esta diferença pode dever-se a fatores culturais, subdiagnóstico na população masculina ou uma tendência regional na epidemiologia da esclerodermia localizada. Conclusão: Este estudo corresponde ao primeiro estudo epidemiológico brasileiro acerca da esclerodermia localizada, sendo necessários estudos mais amplos e multicêntricos que permitam entender melhor a doença na nossa população e, assim, possam servir de base para futuras ações assistenciais.

Profile on childbirth care at a public maternity hospital

Abstract Objectives: to describe the profile on childbirth care at a reference maternity hospital in the State of Piauí based on the 2018 World Health Organization Recommendations. Methods: retrospective cross-sectional quantitative study, descriptive documentary, population census, containing vaginal deliveries performed in 2017. The data was entered in Microsoft Excel for simple statistical analysis. Results: the percentages registered at the Centro Obstétrico Superior (Superior Obstetric Center) and Centro de Parto Normal (Normal Delivery Center) were, respectively, 85.5% and 98% with the presence of a companion, 34.2% and 94% used the partogram, 63.8% and 98% took non-pharmacological methods for pain relief, 74.8% and 98.7% received fluids during labor. Amniotomy at 15.2% and 17.2%, oxytocin was administered at 26.5% and 14.6% in the 1st and 2nd periods, non-lithotomic position at 39.7% and 93.4%, episiotomy 9.9% and 6.6%. After birth, 85.5% and 96% of newborns had skin-to-skin contact and, in 65.5% and 94% there were maternal breastfeeding promotion. Conclusions: this study comprehended the indicators on childbirth care service, which are, in general, better than the national and the northeast region ones. The importance of registering indicators to evaluate care is emphasized.

Retrospective Quantitative Genetic Analysis and Genomic Prediction of Global Wheat Yields.

Breeding for grain yield (GY) in bread wheat at the International Maize and Wheat Improvement Center (CIMMYT) involves three-stage testing at Obregon, Mexico in different selection environments (SEs). To understand the efficiency of selection in the SEs, we performed a large retrospective quantitative genetics study using CIMMYT’s yield trials evaluated in the SEs (2013–2014 to 2017–2018), the South Asia Bread Wheat Genomic Prediction Yield Trials (SABWGPYTs) evaluated in India, Pakistan, and Bangladesh (2014–2015 to 2017–2018), and the Elite Spring Wheat Yield Trials (ESWYTs) evaluated in several sites globally (2003–2004 to 2016–2017). First, we compared the narrow-sense heritabilities in the Obregon SEs and target sites and observed that the mean heritability in the SEs was 44.2 and 92.3% higher than the mean heritabilities in the SABWGPYT and ESWYT sites, respectively. Second, we observed significant genetic correlations between a SE in Obregon and all the five SABWGPYT sites and 65.1% of the ESWYT sites. Third, we observed high ratios of response to indirect selection in the SEs of Obregon with a mean of 0.80 ± 0.21 and 2.6 ± 5.4 in the SABWGPYT and ESWYT sites, respectively. Furthermore, our results also indicated that for all the SABWGPYT sites and 82% of the ESWYT sites, a response greater than 0.5 can be achieved by indirect selection for GY in Obregon. We also performed genomic prediction for GY in the target sites using the performance of the same lines in the SEs of Obregon and observed moderate mean prediction accuracies of 0.24 ± 0.08 and 0.28 ± 0.08 in the SABWGPYT and ESWYT sites, respectively using the genotype x environment (GxE) model. However, we observed similar accuracies using the baseline model with environment and line effects and no advantage of modeling GxE interactions. Overall, this study provides important insights into the suitability of the Obregon SEs in breeding for GY, while the variable genomic predictabilities of GY and the high year-to-year GY fluctuations reported, highlight the importance of multi-environment testing across time and space to stave off GxE induced uncertainties in varietal yields.

Duração do aleitamento materno em mulheres atendidas no banco de leite humano

Objetivo: identificar a duração do aleitamento materno exclusivo e complementar entre mulheres atendidas no banco de leite humano. Método: estudo retrospectivo de abordagem quantitativa, realizado no período de fevereiro a maio de 2019. A amostra foi composta por 73 mulheres atendidas no banco de leite humano no ano de 2017. A coleta de dados ocorreu por questionário confeccionado no programa Google Docs. Os dados foram analisados no programa Epiinfo versão 3.5.3. A pesquisa foi aprovada pelo Comitê de Ética com parecer 3.265.618. Resultados: A faixa etária variou de 18 a 46 anos, prevalecendo mulheres casadas, primíparas, as quais foram submetidas a cesariana, sendo unânime a realização do pré-natal. A maioria das mulheres praticou o aleitamento materno exclusivo até os seis meses e o complementar por mais de dois anos. Conclusão: Percebe-se que o serviço especializado contribuiu de forma satisfatória e efetiva para a prática do aleitamento materno, considerando-se os percentuais apresentados em suas formas exclusivas e complementar.

RETROSPECTIVE EVALUATION OF PRE-ANALYTICAL ERRORS IN CLINICAL BIOCHEMISTRY LABORATORY AT A TERTIARY CARE CENTRE IN RAJSAMAND, RAJASTHAN.

Background: This study was carried out to identify the causes of pre-analytical errors in the clinical biochemistry laboratory and their percentage occurrence so as to formulate the strategy for necessary corrective and preventive actions.
 Methods: A retrospective quantitative study was conducted in the department of biochemistry to identify the different causes of pre-analytical errors in the outpatient and inpatient samples. The sample rejection register and test requisition forms for the period of May 2018 to April 2019 were analysed and the percentage occurrence of the different types of errors was calculated.
 Results: Data analysis revealed that the occurrence of different errors was as follows: hemolysis (46.43%), sample not received (28.32%), insufficient quantity (8.16%), improper collection technique (7.14%), delayed transport (5.87%), wrong container (1.79%), sample clotted (1.28%), lipemic sample (0.77%) and sample exchanged during separation in lab (0.26%).
 Conclusion: The decline in the errors during the analytical phase of sample processing has shifted the focus towards reducing errors occurring in the pre-analytical phase. This is necessary to ensure patient safety.
 Keywords: Pre-analytical errors, Biochemistry, hemolysis.

Clinical and ethical aspects of palliative sedation with propofol-A retrospective quantitative and qualitative study.

The anesthetic propofol is often mentioned as a drug that can be used in palliative sedation. The existing literature of how to use propofol in palliative sedation is scarce, with lack of information about how propofol could be initiated for palliative sedation, doses and treatment outcomes. To describe the patient population, previous and concomitant medication, and clinical outcome when propofol was used for palliative sedation. A retrospective study with quantitative and qualitative data. All patients who during a 4.5-year period received propofol for palliative sedation at the Department of palliative medicine, Akershus University Hospital, Norway were included. Fourteen patients were included. In six patients the main indication for palliative sedation was pain, in seven dyspnoea and in one delirium. In eight of these cases propofol was chosen because of the pharmacokinetic properties (rapid effect), and in the remaining cases propofol was chosen because midazolam in spite of dose titration failed to provide sufficient symptom relief. In all patients sedation and adequate symptom control was achieved during manual dose titration. During the maintenance phase three of 14 patients had spontaneous awakenings. At death, propofol doses ranged from 60 to 340mg/hour. Severe suffering at the end of life can be successfully treated with propofol for palliative sedation. This can be performed in palliative medicine wards, but skilled observation and dose titration throughout the period of palliative sedation is necessary. Successful initial sedation does not guarantee uninterrupted sedation until death. In palliative care, some patients at the end of life can reach a stage where there have been maximal analgesic and or anxiolytic treatments though without achieving comfort in the awake state. This report describes and discusses use of propofol in these infrequent cases to relieve suffering as part of palliative care.

Most Individuals Are Seen in Outpatient Medical Settings Prior to Intentional Self-Harm and Suicide Attempts Treated in a Hospital Setting.

The objective of this quantitative retrospective study is to understand healthcare patterns prior to self-harm, which may inform prevention efforts and identify intervention sites. Medicaid claims within 30, 60, 90, and 365days prior to hospital-treated self-harm between 11/1/2015 and 11/1/2016 in New York State (N= 7492) were examined. Numbers and proportions were calculated for all service types. Participants were predominately 15-34, female, and White. Most (97%) had prior-year services, 94% outpatient care (73% behavioral health, 90% medical), 69% emergency department (37% behavioral health, 59% medical), and 42% inpatient services (34% behavioral health, 20% medical). About 86% received services within 90days and 80% within 60days. Utilization was high within 30days prior, with 69% having one or more services. Medical services were more common than behavioral health (94% versus 79% in prior year); outpatient (94%) was more common than emergency (69%) and inpatient (42%) care. Given that most patients received health services within 30days and almost all saw providers within the year prior, the findings indicate that improved prevention efforts within the healthcare system can reduce the incidence of self-harm.

Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

BackgroundElderly trauma patients constitute a vulnerable group, with a substantial risk of morbidity and mortality even after low-energy falls. As the world’s elderly population continues to increase, the number of elderly trauma patients is expected to increase. Limited data are available about the possible patient safety challenges that elderly trauma patients face. The outcomes and characteristics of the Norwegian geriatric trauma population are not described on a national level.ObjectiveThe aim of this project is to investigate whether patient safety challenges exist for geriatric trauma patients in Norway. An important objective of the study is to identify risk areas that will facilitate further work to safeguard and promote quality and safety in the Norwegian trauma system.MethodsThis is a population-based mixed methods project divided into 4 parts: 3 quantitative retrospective cohort studies and 1 qualitative interview study. The quantitative studies will compare adult (aged 16-64 years) and elderly (aged ≥65 years) trauma patients captured in the Norwegian Trauma Registry (NTR) with a date of injury from January 1, 2015, to December 31, 2018. Descriptive statistics and relevant statistical methods to compare groups will be applied. The qualitative study will comprise focus group interviews with doctors responsible for trauma care, and data will be analyzed using a thematic analysis to identify important themes.ResultsThe project received funding in January 2019 and was approved by the Oslo University Hospital data protection officer (No. 19/16593). Registry data have been extracted for 33,344 patients, and the analysis of these data has begun. Focus group interviews will be conducted from spring 2020. Results from this project are expected to be ready for publication from fall 2020.ConclusionsBy combining data from the NTR with interviews with doctors responsible for treatment and transfer of elderly trauma patients, we will provide increased knowledge about trauma in Norwegian geriatric patients on a national level that will form the basis for further research aiming at developing interventions that hopefully will make the trauma system better equipped to manage the rising tide of geriatric trauma.International Registered Report Identifier (IRRID)PRR1-10.2196/15722

Procedimentos invasivos em usuários em internação domiciliar

OBJETIVO: Descrever os procedimentos invasivos predominantes nos usuários em internação domiciliar. MÉTODO: Estudo quantitativo descritivo retrospectivo a partir de um banco de dados de pacientes que estiveram internados em uma unidade privada de assistência domiciliar na cidade de Salvador, BA, Brasil. A amostra foi constituída de 110 prontuários. Para a coleta de dados foi utilizado um formulário com as seguintes variáveis: dados sociodemográficos, suporte terapêutico; suporte ventilatório e terapia nutricional. Os dados foram analisados em frequências absolutas e relativas. RESULTADOS: Observou-se a ocorrência de 152 procedimentos invasivos nos 110 pacientes. Dentre os suportes terapêuticos, predominou o cateter central de inserção periférica (92,0%), seguido do cateter venoso central (33,0%). Em relação ao suporte ventilatório, traqueostomia foi a mais frequente (25,0%), e quanto à terapia nutricional prevaleceu a gastrostomia (46,1%). Dentre os dispositivos de eliminação vesical, a sonda vesical de demora apresentou percentual de 10,5%. CONCLUSÃO: os procedimentos invasivos mais recorrentes nos pacientes na atenção domiciliar foram a PICC (Cateter Central de Inserção Periférica), a traqueostomia e a gastrostomia. Delimitar o perfil de procedimentos realizados na atenção domiciliar possibilita a construção de protocolos relacionados a estes procedimentos, criação de estratégias de cuidados no domicílio e de prevenção de eventos adversos e orientação dos pacientes e familiares/cuidadores.

Motivos da recusa familiar para a doação de córneas

O presente estudo tem como objetivo identificar os motivos que levam a recusa familiar para a doação de córneas numa Instituição do Sul do país. Foi realizado um estudo quantitativo retrospectivo de caráter documental, com coleta de dados por meio de 102 prontuários dos pacientes cujos familiares foram entrevistados para doação de córneas entre os meses de julho a dezembro de 2013. Quanto ao consentimento familiar, pode-se constatar um total de 70 negativas e 30 positivas familiares para a doação de córneas, obtendo-se como justificativa de maior frequência para a recusa familiar, a convicção prévia do potencial doador em não ser doador de órgãos, o desconhecimento da decisão do potencial doador, seguida do desacordo entre os familiares. De acordo com a pesquisa, os resultados sugerem a importância de se explorar e implementar estratégias com o objetivo de atribuir mais valor social à doação, visto que não basta apenas sensibilizar a população, é necessário também que existam profissionais de saúde capacitados para coordenar eficientemente todo o processo, e que possam contribuir para o planejamento e desenvolvimento de intervenções que estimulem a doação de tecidos e órgãos.

Loss of Potential Donors Due to Hemodynamic Maintenance

BackgroundStatistics indicate low utilization of potential donors, where only about one-third are converted into actual donors. In this context, it is plausible to argue that many potential donors are not hemodynamically stable for harvesting multiple organs since the procedures for maintaining parameters of stability may not be a priority in all critical care units in the country. Thus, it is necessary to identify losses of potential donors due to hemodynamic maintenance since reversing this situation enable minimizing mortality on waiting lists. MethodsThis was a retrospective quantitative study, based on information sent to Notification, Organ Procurement, and Distribution Centers by reporting hospitals in the state of São Paulo, using the Death Information Form regarding the specifics of each death registered in their intensive care units and emergency rooms. ResultsHemodynamic instability contributed to a loss of 537 potential donors, corresponding to 61.9% of failures to obtain potentially transplantable organs. ConclusionOf the 33,175 cases of death reported, 867 fulfilled the criteria to be possible and potential donors (ie, patients diagnosed with brain death). Among these cases, 38.1% fulfilled Criterion 3 (ie, they were hemodynamically stable and in ideal organ donation condition). Therefore, this study concludes that losses due to maintenance occurred in 537 brain dead patients. This finding highlights the importance of investing in the development of competencies of professionals who work in critical care units to increase the number of multiple organ and tissue donors and reduce waiting lists.

Comparison of outcomes between primary and secondary lung decortication

BackgroundWith the view to compare the outcomes between primary and secondary lung decortication, we examined all the patients admitted with empyema thoracis in our unit. The primary decortication was defined as a primary procedure, without prior attempt of pleural space evacuation with either chest tube or previous decortication. Secondary decortication was defined as a failed lung re-expansion after initial pleural space drainage or failed primary decortication. Anecdotally, secondary decortication is associated with increased complications and length of hospital stay. From literature search, there is currently no study that directly compared outcomes of these two procedures; hence, the rationale to conduct this study.MethodsAll patients presented to our unit with empyema thoracis from 1st January 2011–31st December 2014, were included in a retrospective quantitative descriptive study. A total number of 160 patients were analyzed and eighty patients underwent each of the procedures (primary and secondary decortication). A comparison of prospective outcomes of the two groups was made. Fisher Exact test was used to compare percentages including the rates of complications between primary and secondary decortication. Mean values were compared using the t-test. The frequencies of other variables were also determined.ResultsThere was significant statistical difference in the length of hospital stay (ICU and Ward) and between patients who underwent primary as opposed to secondary decortication. The frequencies of complications (chest wall abscess, recurrent empyema, wound sepsis and wound dehiscence) were higher for secondary decortication, but without statistical significance. There was significant statistical difference in terms of age, CD4 count (only for HIV patients) and Adenosine deaminase (ADA) between patients who underwent primary instead of secondary decortication.ConclusionsThe patient who underwent secondary lung decortication had a more prolonged hospital stay than those who had primary decortication. There were increased frequencies of complication in secondary decortication group, though without statistical significant difference (P=0.456). The patients who underwent secondary decortication had poor nutritional state compared to those who had primary decortication, with significant statistical difference (P=0.0370).

Prevalence of cancers diagnosed in Jamhuriyat Hospital, Kabul, Afghanistan

BackgroundsThroughout the world, there exists a clear need for the maintenance of cancer statistics, forming an essential part of any rational programme of cancer control, health-care planning, etiological research, primary and secondary prevention, benefiting both individuals and society. The present work reports only on the prevalence of cancers in the Oncology Department of Jamhuriyat Hospital, Kabul, Afghanistan following several decades of war. Materials and methodsA quantitative retrospective cross-sectional study was conducted using the medical records of patients diagnosed and treated from October 2015 to December 2017. Data includes information on gender, age, economic status, address and types of cancer diagnosed. The data was transferred to a customized form and analysed using Microsoft Excel program to classify cancer types. ResultsThe total number of patients with completed documents were 1025. Of these, 403 (39.3%) were male and 622 (60.7%) female. Most of the patients were in the age range of 20–70 years old. The most common cancers in women were breast cancer (45.8%), followed by oesophagus (12.5%), colorectal (4.8%), Non-Hodgkin Lymphoma (4.7%), sarcoma (4.7%), ovary (3.8%), both stomach and liver (2.6%) and cervix uteri (1.9%). Contrarily to men, esophageal cancer was highest (21.8%), followed by stomach (12.2%), Non-Hodgkin Lymphoma (9.4%), sarcoma (8.9%), gastroesophageal junction (8.9%), colorectal (8.6%), Hodgkin lymphoma (4.7%), testis (4.2%), liver (3.2%), lung (2.7%) and Nonmelanoma skin squamous cell carcinoma 9 (2.2%). ConclusionResults showed that the most frequent cancers among Afghans were breast and oesophagus. The most common cancer in men was oesophagus and stomach at the age range of 50–70 years while in women, breast and oesophagus cancers were common and within the age range of 25–65 years old.

Peer Assessment in the Context of Team-Based Learning in Undergraduate Education: How Far Can We Go?

In medical education, the team-based learning method (TBL) is a teaching strategy used to intensify interactive learning in small groups, in which the student is given the role of evaluating his/her peers - peer assessment (PA). To investigate the interference of the students' interpersonal relationships in awarding their peers grades (''halo effect''). A qualitative and quantitative retrospective study. The study participants were 78 first-year medical students, divided into 17 teams for the TBL. The final grade of the PA for each member was calculated by the average of the grades received from their peers. Results: The comparison between the average of the evaluations in the TBL method (MTBLs) and the PA showed that 17.64% of the teams showed a significant difference between the grades, thus having the “halo effect”. In the qualitative analysis, the “halo effect” was evidenced in only one of these teams. Although many studies corroborate the idea that using PA in the formative assessment is appropriate, advancing in the use of PA in the summative assessment is necessary, integrating it into the institution's evaluation system. Data presented here can help in continuing its use and in increasing its reliability.

Breast disease in Timor-Leste.

Surgically treatable conditions are well documented in high-income countries. There is a gap in epidemiological understanding of breast pathology in many developing countries, Timor-Leste among them. This study was conducted to determine the burden of breast disease and to inform public health measures to address early detection, diagnosis and management. A retrospective quantitative case-control study was conducted at Guido Valadares National Hospital in Dili. Patients were included if they attended surgical outpatients or had a pathology specimen recorded between 1 September 2016 and 1 September 2017. There were 444 female patients with a clinical diagnosis of breast disease over the 12-month period. The average age was 33.7 years. There were 188 (42.3% of total sample) cases of fibroadenoma and 122 (27.4% of total sample) diagnoses consistent with non-specific lumps. Of the 116 female patients presenting to Guido Valadares National Hospital who had a biopsy, 62.6% were malignant or hyperplastic in nature, and 86% of those with a malignant biopsy had clinically locally advanced disease. Breast conditions including cancer in Timor-Leste are relatively common and occur in young women in the prime of their lives (37 years of age). Developing a national cancer registry and funding directed towards improving early presentation and good clinical care of breast cancer patients will be critical for reducing early morbidity and mortality and improving other patient outcomes including income loss, gender health inequality and the intergenerational effects of early parental death.