scholarly journals Indications and outcomes of emergency obstetric hysterectomy; a 5-year review at the Bafoussam Regional Hospital, Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mbakwa Rickeins Mbakwa ◽  
Nicholas Tendongfor ◽  
Yannick Lechedem Ngunyi ◽  
Ekongefeyin Sintieh Nchinda Ngek ◽  
Frank Alemkia ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Statistical Significance ◽  
Epidemiological Data ◽  
Regional Hospital ◽  
Adverse Outcomes ◽  
Bivariate Analysis ◽  
Negative Clinical Outcome ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Postpartum Hysterectomy

Abstract Background Emergency Obstetric Hysterectomy (EOH) is removal of the uterus due to life threatening conditions within the puerperium. This life saving intervention is associated with life threatening complications. In our setting, little is known on EOH. Objectives To determine the prevalence, indications and outcomes of emergency obstetric hysterectomy while comparing both postpartum hysterectomy and caesarean hysterectomy. Methods A 5-year hospital-based retrospective cohort study involving medical records of patients who underwent emergency obstetric hysterectomies between 1st January 2015 and 31st December 2019, was carried out at the Bafoussam Regional Hospital (BRH) from 1st February 2020 to 30th April 2020. Cases were classified as caesarean hysterectomy (CH) or postpartum hysterectomy (PH). Epidemiological data, indications, and complications of EOH were collected and analyzed in EPI-INFO 7.2.2.1. The chi-squared test was used to compare the two groups, and bivariate analysis was used to identify indicators of adverse outcomes of EOH. Statistical significance was set at p < 0.05. Results There were 30 cases of emergency obstetric hysterectomy (24 caesarean hysterectomies and 6 postpartum hysterectomies), giving a prevalence rate of 3.75 per 1000 deliveries. The most common indication for CH, was intractable postpartum haemorrhage and uterine rupture (33.33% each), while abnormal placentation (50%) was commonly indicated for PH. Anaemia (both groups) (p = 0.013) and sepsis (PH group only, 33.33%) (p = 0.03) were the most statistically significant complications of EOH respectively. Absence of blood transfusion prior to surgery (p = 0.013) and prolonged surgery lasting 2 or more hours (p = 0.04), were significantly associated with a negative clinical outcome. Conclusion The prevalence of EOH is high. There were no differences in the sociodemographic profile, risk factors and indications of both groups. PH group was more likely to develop sepsis as complication. Lack of blood transfusion prior to surgery and prolonged surgeries were significantly associated to complication. Meticulous care and timely recognition of negative prognostic factors of delivery as well as those of EOH will help improve maternal outcomes of pregnancy.

Indications and Outcomes of Emergency Obstetric Hysterectomy; a 5-Year Review at the Bafoussam Regional Hospital, Cameroon

2021 ◽  
Author(s):  
Mbakwa Rickeins Mbakwa ◽  
Nicholas Tendongfor ◽  
Yannick Lechedem Ngunyi ◽  
Ekongefeyin Sintieh Nchinda Ngek ◽  
Frank Alemkia ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Statistical Significance ◽  
Epidemiological Data ◽  
Regional Hospital ◽  
Adverse Outcomes ◽  
Bivariate Analysis ◽  
Negative Clinical Outcome ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Postpartum Hysterectomy

Abstract Background: Emergency Obstetric Hysterectomy (EOH) is removal of the uterus due to life threatening conditions within the puerperium. This life saving intervention is associated with life threatening complications. In our setting, little is known on EOH. Objectives: To determine the prevalence, indications and outcomes of emergency obstetric hysterectomy while comparing both postpartum hysterectomy and caesarean hysterectomy. Methods: A 5-year hospital-based retrospective cohort study of medical records of patients who underwent emergency obstetric hysterectomies was carried out at the Bafoussam Regional Hospital (BRH) from 1 st January 2015 to 31 st December 2019. Cases were classified as caesarean hysterectomy (CH) or postpartum hysterectomy (PH). Epidemiological data, indications, and complications of EOH were collected and analyzed in EPI-INFO 7.2.2.1. The chi-squared test was used to compare the two groups, and bivariate analysis was used to identify indicators of adverse outcomes of EOH. Statistical significance was set at p < 0.05 Results: There were 30 cases of emergency obstetric hysterectomy (24 caesarean hysterectomies and 6 postpartum hysterectomies), giving a prevalence rate of 3.75 per 1000 deliveries. The most common indication for CH, was intractable postpartum haemorrhage and uterine rupture (33.33% each), while abnormal placentation (50%) was commonly indicated for PH. Anaemia (both groups) (p=0.013) and sepsis (PH group only, 33.33%) (p=0.03) were the most statistically significant complications of EOH respectively. Absence of blood transfusion prior to surgery (p=0.013) and prolonged surgery lasting 2 or more hours (p=0.04), were significantly associated with a negative clinical outcome. Conclusion: The prevalence of EOH is high. There were no differences in the sociodemographic profile, risk factors and indications of both groups. PH group was more likely to develop sepsis as complication. Lack of blood transfusion prior to surgery and prolonged surgeries were significantly associated to complication. Meticulous care and timely recognition of negative prognostic factors of delivery as well as those of EOH will help improve maternal outcomes of pregnancy.

scholarly journals Associated risk factors with seroprevalence of HIV and HBV co-infection among Pregnant women attending guelendeng health District in the Mayo-kebbi East Region of Chad

2020 ◽  
Vol 6 (6) ◽  
pp. 155-160
Author(s):  
Salomon Philippe Nguwoh
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Pregnant Women ◽  
Epidemiological Data ◽  
Health District ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
East Region ◽  
History Of ◽  
Associated Risk Factors

Background: In Republic of Chad, the seroprevalence of HIV among antenatal pregnant women is known as decreasing over years meanwhile the epidemiological data among pregnant women for hepatitis B virus are scarce. The co-infection HIV/HBV increases the risk of mother to child transmission of both viruses. This study aimed to determine the rate of HIV, HBV co-infection and to identify the associated risk factors among pregnant women attending Guelendeng health district (GHD). Methods: A cross-sectional and descriptive study was conducted from March to May 2019 among pregnant women attending GHD. The questionnaire included demographics, AIDS and HBV knowledge, behavior factors and history of blood transfusion. Blood samples were obtained and tested serologically for HIV and HBV. The study of associations between exposure and outcome variables was sought with the odds ratio (OR), expressed with 95% confidence interval. Tests were performed using Epi info 7.0 with p<0.05 considered as significant. Results: Out of 200 enrolled pregnant women, the median age was 25years old with interquartile range from 20.5 to 30 years old. The seroprevalence of HIV, HBV and the co-infection HIV/HBV were 4.5% (95% CI: 2.1%-8.4%; 9/200), 13% (95% CI: 8.7%-18.5%; 26/200) and 2% (95 % IC: 0.6%-5%; 4/200) respectively. The antenatal age was associated to HBV infection (p=0.04) unlike HIV infection (p=0.4) and HIV/HBV co-infection (p=0.52). Women aged more than 29 years were most affected. Bivariate analysis identified that the non-use of condom (OR 7.79, 95% CI: 1.9-32.6, p=0.004) and blood transfusion history (OR 17.9, 95% CI: 2.6-124.8, p=0.01) were associated risk factors of contracting HIV. Conclusion: The seroprevalence of HIV and HBV remains high among pregnant women attending antenatal ward in Guelendeng Health District with associated risk factors such as age, blood transfusion and the non-use of condom with new sexual partners.

OPERATIONS FOR ANEURISM OF THE ABDOMINAL AORTIC DEPARTMENT - RESECTION WITH THE FOLLOWING PROSTHETICS AND ENDOPROSTHETICS: A COMPARATIVE ANALYSIS OF COMPLICATIONS

2020 ◽  
pp. 43-49
Author(s):  
Андрей Анатольевич Иванов ◽  
Александр Иванович Жданов ◽  
Максим Сергеевич Шевелин ◽  
Александр Сергеевич Брежнев
Keyword(s):  
Comparative Analysis ◽  
Postoperative Complications ◽  
Statistical Significance ◽  
Aortic Aneurysms ◽  
Surgical Interventions ◽  
Vein Thrombosis ◽  
Scientific Hypothesis ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
High Level

В статье представлены данные оригинального исследования по улучшению хирургического лечения аневризм брюшного отдела аорты. С этой целью произведен сравнительный анализ двух альтернативных друг другу операций: 1) резекции аневризмы с последующим протезированием аорты; 2) эндопротезирования аорты. Сформулировано научное предположение о том, что замена «классических» операций резекции аневризмы на «альтернативные» операции эндопротезирования приведет к принципиальному снижению уровня послеоперационных осложнений. В независимых группах пациентов с использованием сравниваемых хирургических вмешательств произведена точная качественная и количественная оценка послеоперационных осложнений: нетромботических - кардиальных, пульмональных, ренальных и тромботических - тромбозов глубоких вен и тромбозов браншей протеза. После реализации исследования было установлено, что замена «классических» операций на «альтернативные» достоверно приводит к принципиальному снижению уровня наиболее жизнеопасных осложнений - кардиальных (острых форм ишемической болезни сердца, нарушений сердечного ритма), пульмональных (пневмоний, тромбоэмболии легочной артерии, респираторного дистресс-синдрома взрослых) и ренальных (острой почечной недостаточности). Некоторое исключение составили менее жизнеопасные тромботические осложнения. Полученные результаты имеют высокий уровень статистической значимости, что позволяет рекомендовать их к рассмотрению к использованию в практике сосудистой хирургии The article presents data from an original study to improve the surgical treatment of abdominal aortic aneurysms. For this purpose, a comparative analysis of two alternate operations was performed: 1) aneurysm resection followed by aortic prosthetics; 2) aortic endoprosthetics. The scientific hypothesis is formulated that the replacement of the «classical» operations of resection of the aneurysm with «alternative» operations of endoprosthetics will lead to a fundamental decrease in the level of postoperative complications. In independent groups of patients using the compared surgical interventions, an accurate qualitative and quantitative assessment of postoperative complications was made: non-thrombotic - cardiac, pulmonary, renal and thrombotic - deep vein thrombosis and prosthetic jaw thrombosis. After the study was completed, it was found that the fundamental replacement of «classical» operations with «alternative» reliably leads to a fundamental decrease in the level of the most life-threatening complications - cardiac (acute forms of coronary heart disease, cardiac arrhythmias), pulmonary (pneumonia, pulmonary thromboembolism, respiratory distress syndrome of adults) and renal (acute renal failure). Some exceptions were less life-threatening thrombotic complications. The results obtained have a high level of statistical significance, which allows us to recommend them for consideration in the practice of vascular surgery

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals Perceived Loneliness and Severe Sleep Disorders in Adult Women during the Covid-19 Quarantine: A Cross-Sectional Study in Colombia

2021 ◽  
Vol 12 ◽  
pp. 215013272110251
Author(s):  
Álvaro Monterrosa-Castro ◽  
Angélica Monterrosa-Blanco ◽  
Andrea González-Sequeda
Keyword(s):  
Sleep Disorders ◽  
Rating Scale ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Adult Women ◽  
Sectional Study ◽  
Cross Sectional ◽  
Emotional Loneliness ◽  
Social Loneliness

Background: Quarantine is a measure to control COVID-19 spread, resulting in an increased perception of loneliness. In turn, sleep disorders (SD) may be more frequently reported in uncertain circumstances. Objectives: To identify the association between loneliness and severe SD, in women quarantined due to the COVID-19 pandemic. Methods: A cross-sectional study carried out in women, between 40 and 79 years and living in Colombia. The women were invited through social network to complete 5 digital instruments: de Jong Gierveld Loneliness Scale, Menopause Rating Scale, Fear of COVID-19 Five-item Version, Coronavirus Anxiety Scale, and Francis Religion Scale. Bivariate analysis and adjusted logistic regression between loneliness and SD were performed. Results: 1133 women participated, half of them under 50 years old. 43.1% had emotional loneliness, 39.9% social loneliness and 43.3% general loneliness. SD were identified in 6 out of 10 women, those with mild SD presented an OR of 1.84, 1.85, and 1.64, for emotional, social and general loneliness, respectively. Loneliness was associated twice with moderate SD, and more than twice with severe SD. Very severe SD reached OR:5.81 for emotional loneliness, OR:4.38 social loneliness and OR:4.02 general loneliness. In the presence of religiosity, fear and anxiety due to COVID-19, statistical significance was retained for associations, except intense SD with general loneliness. Conclusions: SD were significantly associated with loneliness in our study population. It is important to assess sleep quality and perception of loneliness in middle-aged women, especially during periods of quarantine due to a pandemic to avoid health implications.

scholarly journals Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ajibola Idowu ◽  
Samuel Anu Olowookere ◽  
Aderonke Tolulope Fagbemi ◽  
Olumuyiwa Ayotunde Ogunlaja
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Statistical Significance ◽  
Effective Control ◽  
Bivariate Analysis ◽  
North Central ◽  
Nigerian Women ◽  
Screening Uptake ◽  
Cancer Of The Cervix

Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women.Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set atp<0.05.Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%,p=0.001), respondents who were aware of the disease (100.0%,p=0.001), and those who were aware of cervical cancer screening (88.9%,p=0.001). Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28).Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

Retrolental Fibroplasia and Blood Transfusion in Very Low-Birth-Weight Infants

PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 770-774 ◽  
Author(s):  
Linda M. Sacks ◽  
David B. Schaffer ◽  
Endla K. Anday ◽  
George J. Peckham ◽  
Maria Delivoria-Papadopoulos
Keyword(s):  
Birth Weight ◽  
Blood Transfusion ◽  
Low Birth Weight ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Very Low Birth Weight ◽  
Statistical Significance ◽  
Low Birth Weight Infants ◽  
Retrolental Fibroplasia ◽  
Packed Red Blood Cells

The relative contribution of transfusions of adult blood to the development of retrolental fibroplasia (RLF) in very low-birth-weight infants was examined. Five years of experience with the expanded use of replacement and exchange transfusions in 90 infants with birth weight ≤1,250 gm was reviewed. Twenty percent of the infants developed cicatricial RLF. Exchange transfusion was not related to development of cicatricial RLF. The incidence of RLF in infants receiving ≥130 ml of packed red blood cells per kilogram of birth weight as replacement blood transfusion (RBT) was significantly higher (42.9%) than that in infants receiving 61 to 131 ml of packed red blood cells per kilogram (15.4%) and infants receiving ≤60 ml of packed red blood cells per kilogram (0%), P &lt; .001. The need for RBT, however, was strongly correlated (r = .85, P &lt; .001) with increasing duration of O2 therapy. When O2 therapy was controlled for, the association between RBT and RLF did not achieve statistical significance (P = .07). The association between RBT and RLF remained significant when adjusted for duration of therapy in fractional inspired oxygen (FIO2) &gt;0.4. Further detailed studies of large numbers of susceptible infants are warranted to assess the magnitude of the contribution of transfusions of adult blood to development of RLF.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

INTENSIVE CARE OF LIFE-THREATENING CONDITIONS IN PEDIATRIC ONCOHEMATOLOGY

2021 ◽  
Vol 100 (5) ◽  
pp. 138-144
Author(s):  
N.V. Matinyan ◽  
◽  
T.T. Valiev ◽  
K.I. Kirgizov ◽  
S.R. Varfolomeeva ◽  
...  
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Adverse Outcomes ◽  
Malignant Neoplasms ◽  
Neutropenic Enterocolitis ◽  
Compression Syndrome ◽  
Life Threatening ◽  
Spinal Cord Compression Syndrome

Malignant neoplasms of the blood system in children are represented by highly aggressive variants, which at the stage of diagnosis and program chemotherapy can be complicated by the development of life-threatening conditions. Understanding the risk of possible complications allows you to effectively carry out preventive and therapeutic measures, to minimize adverse outcomes. This article presents modern approaches to the diagnosis and treatment of the most common life-threatening conditions in pediatric oncohematology: acute tumor lysis syndrome, typhlitis and neutropenic enterocolitis, superior vena cava syndrome, malignant airway compression syndrome, acute impairment of consciousness, spinal cord compression syndrome, thrombosis, methemoglobinemia.

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