scholarly journals A Technique for Wound Cavity Closure after Coccyx Resection in Experiment

2019 ◽  
Vol 9 (2) ◽  
pp. 157-162
Author(s):  
I. I. Khidiatov ◽  
M. V. Gerasimov ◽  
R. R. Kudoyarov

Introduction. Closing the wound cavity after the coccyx resection in patients with posttraumatic coccygodynia remains an issue unresolved. Closing the wound cavity with local tissues often leads to the wound dehiscence due to excessive tension which in turn leads to suppuration and prolonged healing.This paper aims to assess experimentally the effectiveness of using ground autograft bone of the coccyx removed for the closure of the surgical wound.Materials and methods. In the animal experiment the coccyx resection was performed under a combined anaesthesia in six pigs (three in the study group and three in control). In the control group the wound edges were sutured to its floor. In the study group after the coccyx resection the ground bone mass made of the coccyx resected was implanted into the wound cavity.Results and discussion. In the control group the wound dehiscence was registered in all the animals. After the animals were taken out of the experiment it was established that in the study group a new consolidated bony conglomerate was formed without any pronounced inflammatory changes around the wound. In control the wound cavity healed with secondary intention.Conclusions. The study confirms the effectiveness of using ground autograft bone for the closure of the wound cavity.

Author(s):  
Lauri Laukkanen ◽  
Sanna Lahtinen ◽  
Janne Liisanantti ◽  
Timo Kaakinen ◽  
Ari Ehrola ◽  
...  

Abstract Background The SARS-CoV-2 coronavirus disease (COVID-19) has had a major impact on health care services globally. Recent studies report that emergency departments have experienced a significant decline in the number of admitted patients in the early phase of the pandemic. To date, research regarding the influence of COVID-19 on emergency medical services (EMS) is limited. The present study investigates a change in the number and characteristics of EMS missions in the early phase of the pandemic. Methods All EMS missions in the Northern Ostrobothnia region, Finland (population 295 500) between 1 March to 30 June 2020 were screened and analyzed as the study group. A control group was composed from the EMS calls between the corresponding months in the years 2016–2019. Results A total of 74 576 EMS missions were screened for the study. Within the first two months after the first COVID-19 cases in the study area, the decline in the number of EMS missions was 5.7% – 13% compared to the control group average. EMS time intervals (emergency call to dispatch, dispatch, en-route, on-scene and hospital handover) prolonged in the COVID-19 period. Dispatches concerning mental health problems increased most in the study period (+1.2%, p < 0.001). Only eleven confirmed COVID-19 infections were encountered by EMS in the study period. Conclusion Our findings suggest that the present COVID-19 pandemic and social restrictions lead to changes in the EMS usage. These preliminary findings emphasize the importance of developing new strategies and protocols in response to the oncoming pandemic waves.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 818
Author(s):  
Liat Korn ◽  
Gideon Koren ◽  
Ayelet Yaakov ◽  
Galit Madar ◽  
Ayala Blau

Background: This study examined the effectiveness of a birth preparation course on coping with childbirth among primigravid ultra-orthodox Jewish women in Israel. Methods: In total, 130 ultra-orthodox 25–35-week primigravid women were divided into a study (n = 100, participated in birth preparation courses) and a control (n = 30, did not participate in the courses) group. A questionnaire was delivered three times: T1—before the course/delivery, T2—two–three days after delivery, and T3—a month after delivery. Results: At T3, self-efficacy among the study group was higher than in the control group. Differences in self-efficacy were found over time regardless of the group (F(2,246) = 12.83, p < 0.001), as a time–group interaction effect (F(2,246) = 10.20, p < 0.01). Self-efficacy in the study group (Mean, M = 3.40, Standard deviation, SD = 0.63 at T1) dropped to M = 3.06, SD = 0.76 at T2 and rose to M = 3.34, SD = 0.64 at T3. In the control group, self-efficacy (M = 3.53, SD = 0.56 at T1) dropped to M = 3.26, SD = 0.63 at T2 and to M = 2.95, SD = 0.76 at T3. Discussion: The childbirth preparation course was found to be effective in raising self-efficacy among primigravid ultra-orthodox religious women when compared to the control group.


2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.


2018 ◽  
Vol 12 (3) ◽  
pp. 94-97
Author(s):  
D. M. Bichurina ◽  
I. Z. Gaydukova ◽  
D. А. Patrikeeva ◽  
A. P. Rebrov

Objective: to evaluate kidney function in patients with spinal degenerative-dystrophic diseases (SDDDs) who take nonsteroidal anti-inflammatory drugs (NSAIDs) as repeated short cycles of treatment for severe back pain.Patients and methods. The investigation enrolled 97 patients with SDDDs who took NSAIDs for back pain (a study group). A control group consisted of sexand age-matched healthy individuals who had not used NSAIDs within the past year (n=40). Glomerular filtration rate (GFR) was estimated using the CKD-EPI equation and markers of kidney injury (albuminuria and globulinuria) were measured.Results. In the study group, GFR was decreased to <90 ml/min/1.73 m2 in 61 (62.9%) patients, to <60 ml/min/1.73 m2 in 11 (11.3%); the mean GFR was 77.5 [68.0; 89.0] ml/min/1.73 m2; in the control group, a decline in GFR to 89–60 ml/min/1.73 m2 was recorded in 35 (62.5%) cases; this indicator was >90 ml/min/1.73 m2 in the remaining 15 (37.5%) cases; the mean GFR was 82.5 [70.8; 90.0] ml/min/1.73 m2 (p≥0.05 for all pairwise comparisons). A decrease in GFR to <60 ml/min/1.73 m2 was found in 11 (11.3%) patients in the study group and in nobody in the control group (p=0.026). Elevated albuminuria was noted in 74 (76.3%) patients with SDDDs and in 9 (22.5%) healthy individuals (p<0.05). Albumin/creatinine ratio was 57.1 [33.8; 82.4] mg/g in the study group and 25.0 [17.5; 32.9] mg/g in the control group (p<0.0001). Increased globulinuria was established in all the patients with SDDDs and only in 3 (7.5%) healthy examinees. Globulin/creatinine ratio was 134.7 [77.5; 197.7] mg/g in the study group and 12.9 [0.5; 18.1] mg/g in the control group (p<0.0001).Conclusion. A decline in GFR to <60 ml/min/1.73 m2 was more often seen in the patients taking NSAIDs for spine pain caused by SDDDs than in the healthy individuals. In case of comparable GFR, the level of kidney injury markers was significantly higher in the study group than that in the control group, which suggests that patients with SDDDs who take NSAIDs have subclinical tubulointerstitial and glomerular changes.


2021 ◽  
Vol 81 (01) ◽  
pp. 5-12
Author(s):  
Eduardo Reyna-Villasmil ◽  
◽  
Jorly Mejía-Montilla ◽  
Nadia Reyna-Villasmil ◽  
Duly Torres-Cepeda ◽  
...  

Objective: To establish the diagnostic utility of the platelet-lymphocyte ratio in pregnant women with preeclampsia. Methods: A case-control study was carried out at the Hospital Central “Dr. Urquinaona” Maracaibo, Venezuela. A total of 180 pregnant women were selected. Ninety preeclamptic women were included as the study group (group A) and a control group selected for their age and body mass index similar to the study group, which consisted of 90 healthy normotensive pregnant women (group B). The general characteristics, platelet-lymphocyte ratio values and diagnostic efficacy were determined. Results: Group A patients presented lower platelet and lymphocyte values compared to group B patients (p <0.001). However, no statistically significant differences were found in platelet-lymphocyte ratio between group A patients (115.2 ± 32.7) and group B patients (122.3 ± 23.8; p = 0, 0971). A cut-off value of the platelets-lymphocyte ratio of 117 presented a value below the curve of 0.57, the sensitivity of 47.8%, the specificity of 50.0%, the positive predictive value of 48.9%, and the negative predictive value of 52.2%, with a diagnostic accuracy of 48.9%. Conclusion: Platelet-lymphocyte ratio is not a useful tool in the diagnosis of preeclampsia, since patients with the syndrome present similar values to normotensive pregnant women. Keywords: Platelet-lymphocyte ratio, Preeclampsia, Diagnosis, Pregnancy.


2021 ◽  
Vol 9 (4) ◽  
pp. 89
Author(s):  
Jing Luo

<p><span lang="EN-US">Objective: to explore the application value of coagulation function test in the prognosis of patients with cardiovascular and cerebrovascular diseases. Methods: from December 2018 to December 2019, 100 patients with cardiovascular and cerebrovascular diseases were randomly selected as the study group. According to the follow-up results of patients, they were divided into study group A (good prognosis, n = 64) and study group B (disability or death, n = 36) 100 subjects served as the control group. The test results of coagulation function of the two groups were analyzed retrospectively. The test results of the study group before and after treatment were compared with those of the control group, and the test results of the study group A and study group B after treatment were compared. Results: the coagulation function of the study group after treatment was significantly improved compared with that before treatment (P &lt; 0.05), and there was a significant difference between the two groups before treatment (P &lt; 0.05), and there was no difference after treatment (P &gt; 0.05); after treatment, the coagulation function of study group A and study B was significantly different (P &lt; 0.05). Conclusion: coagulation function test has a certain application value for the prognosis of patients with cardiovascular and cerebrovascular diseases, and can be used as an index to judge the patient’s condition and treatment effect, which has good application value in clinical practice.</span></p>


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hasan Acar ◽  
Ayse Ulgen

Various factors cause aggression, which can be related to imbalance of T3 and T4 hormones, which can act as neurotransmitters and are reported to be elevated during aggression. This indicates changes in the hypothalamic-pituitary-thyroid axis that cause long-term changes in aggressive behaviour, especially in criminals. Moreover, mental and behavioural disorders possibly occur in individuals with impairment in thyroid hormone balance. The main rationale for this study was to asses if high T3, high T4, and low TSH hormones may have an effect on aggression-related crime tendency. Furthermore, the study aimed to measure levels of thyroid hormones in prisoners and to examine relationships of the hormone levels with crime rates. Our study was conducted in Ankara Sincan Closed Prisons. The study group consisted of 208 male volunteers who were imprisoned and the control group included 82 male volunteers who were not imprisoned. Prisoners in the study group were divided into two groups: those who committed aggression-related crime (Group A, n = 96) and prisoners convicted of other crimes (Group B, n = 112). Pulse rates, T3, T4, and thyroid-stimulating hormone (TSH) levels, and theT3/T4 ratio were measured in these prisoners. Data were analysed using the Wilcoxon rank sum test and chi-square Fisher’s exact test to test for any statistically significant differences. Results showed that toxic goitre rates, T3 and T4 values, and pulse rates were significantly higher in Group A than in the control group. Significant increase in T3 and T4 levels and the presence of toxic goitre were associated with aggression-related crime. These examinations should be performed on prisoners in general, especially those convicted of violent crimes. Additional rehabilitation and research programs should also be developed for such patients.


Author(s):  
Balabanov A.S. ◽  
Tupitcyn V.V. ◽  
Tassybayev B.B.

Relevance. Acute kidneys injury (AKI) negatively affects the prognosis of myocardial infarction (MI). Aim. To evaluate MI clinical features (CF) in men under 60 years old (y.o.) with AKI during MI to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with ACI - 25 patients; II - control, without it - 486 patients. A comparative assessment of the MI CF frequency in selected groups were performed. Results. In patients of the study group more often than in the control group, a combination of MI complications (64.0 and 36.9%; respectively; p = 0.009), psychic disorders (20.0 and 6.9%; p = 0.01), chronic heart failure (CHF) of the second functional class and above (NYHA) at the end of the eighth MI week (72.0 and 43.2%; p = 0.005), with a predominance of newly diagnosed CHF forms (36.0 and 28.0%; p = 0.006). In the study group, less often than in the control group, pulmonary hypertension was noted in the first 48 hours of MI (44.0 and 66.0%; p = 0.02) and at the end of the third MI week (38.1 and 60.3%; p = 0.04). Conclusions. There were no specific clinical signs of AKI in men under 60 y.o. with MI. At the same time, the study group has the worst prognosis during the observation period in terms of the frequency of MI complications combinations and CHF, which requires the start of prophylactic therapy from the moment of AKI verification.


2021 ◽  
Vol 19 (1) ◽  
pp. 27-30
Author(s):  
Y Satish Reddy ◽  

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students


2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A1.4-A2
Author(s):  
Mark Jenkins

Introduction: BackgroundThe standard treatment for lacerations in the Emergency Department is to use local anaesthetic to aid cleaning, analgesia and wound repair. The use of topical anaesthesia has not been widely accepted within clinical practice in the UK due to the lack of an appropriate delivery system. A new putty has been developed to deliver topical anaesthesia that can deliver lidocaine and then be removed intact from the wound in its entirety.AimTo assess the safety and efficacy of new topical Lidocaine putty in anaesthetising lacerations compared with standard Lidocaine injection. A secondary aim was to compare rates of wound infection and dehiscence between two groups.MethodsA non-inferiority randomised controlled trial comparing the anaesthesia obtained following application of topical anaesthetic gel to a laceration for 20 min compared with that obtained 10–15 min after infiltration with 1% w/v Lidocaine into the wound edges. Pain scores were assessed for the wound repair using visual analogue scales. Follow-up information regarding wound infection, wound dehiscence and wound appearance was performed 7–10 days later.ResultsSixty seven patients were recruited. Thirty four were in the Lidocaine gel group and 33 in the Lidocaine infiltration group. Pain scores were collected for both groups: the study group (range 0–7, mean 1.5) and control group (range 0–5, mean 1.1) showed no significant difference (p=0.29). Three patients in the control group required rescue anaesthesia and three patients in the study group required rescue anaesthesia. Two patients in the control group developed wound infection and one patient in the control group had wound dehiscence. In the study group two patients developed wound infection.ConclusionThe use of a new topical anaesthetic putty is as effective for analgesia and wound repair as infiltration with 1% Lidocaine.


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