ABDOMINAL HYSTERECTOMY

Objective:(1)To audit cases of abdominal hysterectomy performed by post graduate tainees. (2) Toevaluate mortality and morbidity rate. Study Design: An observational Study. Setting: Department of Obstetrics andgynaecology, Allied Hospital Faisalabad. Period: From 01-01-2005 to 30-06-2006. Material & Methods:120 casesof abdominal hysterectomies done for non obstetric and benign gynaecological conditions were selected for study.Results: The most common indications for hysterectomy was DUB (43.3%). Overall intra operative complicationsdeveloped in 5 patients (4.1%). Post operative complications developed in 9 patients (7.5%). The mean duration ofhospital stay was 5.5 days. No case of death was recorded in the study. Conclusion: This study demonstrates thatabdominal hysterectomy can be safely done even during the learning curve of the post graduate trainees with the lowcomplication rate, shorter hospital stay and without significant mortality.

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Open and laparoscopic approaches are associated with comparable 90-day morbidity and mortality following ERAS protocol

10.1101/2020.04.08.20057521 ◽

2020 ◽

Author(s):

Bhavin B. Vasavada ◽

Hardik Patel

Keyword(s):

Multivariate Analysis ◽

Operative Time ◽

Univariate Analysis ◽

Operating Time ◽

Morbidity And Mortality ◽

Morbidity Rate ◽

Blood Products ◽

Mortality And Morbidity ◽

The Mean ◽

Eras Protocol

ABSTRACTIntroductionThe aim of this study is to compare 90-day mortality and morbidity between open and laparoscopic surgeries performed in one centre since the introduction of ERAS protocols.Material and MethodsAll gastrointestinal surgeries performed between April 2016 and March 2019 at our institution after the introduction of ERAS protocols have been analysed for morbidity and mortality. The analysis was performed in a retrospective manner using data from our prospectively maintained database.ResultsWe performed 245 gastrointestinal and hepatobiliary surgeries between April 2016 and March 2019. The mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. The mean ASA score was 2.4, the mean operative time was 111 minutes and the mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall the 90-day mortality rate was 8.5% and the morbidity rate was around 9.79%. On univariate analysis morbidity was associated with a higher CDC grade of surgeries, a higher ASA grade, longer operating time, the use of more blood products, a longer hospital stay and open surgeries. HPB surgeries and luminal surgeries (non hpb gastrointestinal surgeries) were associated with 90 day post operative morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90-day mortality was predicted by the grade of surgeries, a higher ASA grade, longer operative time, the use of more blood products, open surgeries and emergency surgeries. However on multivariate analysis only the use of more blood products was independently associated with mortalityConclusionThe 90-day mortality and morbidity rates between open and laparoscopic surgeries after the introduction of ERAS protocol were similar.

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Serum calcium levels in newly detected essential hypertensive patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20213709 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1539

Author(s):

Arumugam Aashish ◽

Jayasingh Kannaiyan

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Serum Calcium ◽

Systemic Hypertension ◽

Total Serum ◽

Newly Diagnosed ◽

Mortality And Morbidity ◽

Total Serum Calcium ◽

The Mean ◽

Significant Mortality

Background: Systemic hypertension is global disease responsible for significant mortality and morbidity. Essential or primary hypertension accounts for the majority of people with hypertension. Although our understanding of the pathophysiology of essential hypertension has grown a lot, its aetiology still remains hypothetical. Few studies in literature have found some correlation with serum calcium levels and blood pressure of the individuals.Methods: A total 200 patients, 100 newly diagnosed essential hypertensive and 100 normotensive patients were included in the study. A detailed history and clinical profile was taken. Blood sample was collected and serum calcium, serum albumin were determined and corrected calcium was calculated and the results were tabulated and appropriate statistical analysis was done.Results: The mean total serum calcium and corrected calcium levels were significantly lowered in essential hypertensive compared to the normotensive individuals. There was no correlation between total serum and corrected calcium levels against systolic and diastolic blood pressure. There was also no difference in serum total and corrected calcium levels among different subsets in essential hypertensive group.Conclusion: Essential hypertension still remains the most common form of hypertension present worldwide causing significant mortality and morbidity. Despite increased advances in medicine and large number of studies done in context with the cause of essential hypertension, its aetiology still remains hypothetical. Even though studies have shown some correlation of calcium fractions with hypertension, the aetiology is still unclear.

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Changes in liver function in patients with covid-19 and the demographics of the disease in a mid-sized city of Turkey: A retrospective analysis

Medical Science and Discovery ◽

10.36472/msd.v7i12.442 ◽

2020 ◽

Vol 7 (12) ◽

pp. 739-744

Author(s):

Huseyin Avni Demir

Keyword(s):

Liver Function ◽

Clinical Characteristics ◽

Severe Disease ◽

Close Monitoring ◽

Test Results ◽

Laboratory Findings ◽

Icu Patients ◽

Mortality And Morbidity ◽

The Mean ◽

Significant Mortality

Objective: To define the clinical characteristics of patients hospitalized with COVID-19 in ICU and ward and to evaluate the significance of liver function test results. A new disease caused by SARS-CoV-2 has been devastating the world affecting millions of patients worldwide and leading the significant mortality and morbidity. Material and Methods: The demographic features of a cohort of 125 hospitalized patients between March 2020 and May 2020 were recorded. The clinical characteristics, laboratory findings, and mortality rates were analyzed. Results: A total of 125 patients hospitalized for COVID-19 diagnosis where 113 (90.4%) were followed-up in the ward and 12 (9.6%) were in ICU were included in the study. The mean age of the patients was 44.05±16.95 and 88 (70.4%) of the patients were male. The most common symptoms were in the following order: cough in 80 patients (64%), dyspnea in 40 (32%) and fever in 33 (26.4%). The leukocyte and neutrophil counts were significantly higher in ICU patients with COVID-19 compared to patients in the ward (p=0.002, p<0.05; respectively). The CRP and D-Dimer levels were found elevated in ICU patients with COVID-19 than in the ward (p<0.05; p<0.05, respectively). The AST level of patients with COVID-19 in ICU was significantly heightened than patients in the ward. Conclusion: The present study revealed that patients with elevated AST level were at great risk of progressing to severe disease those require close monitoring.

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Systematic Review of Laparoscopic versus Robotic Hiatal Hernia Repair

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5126 ◽

2021 ◽

Vol 9 (F) ◽

pp. 186-188

Author(s):

Danilo Coco ◽

Silvana Leanza

Keyword(s):

Hernia Repair ◽

Hiatal Hernia ◽

Morbidity Rate ◽

Hiatal Hernia Repair ◽

Mortality And Morbidity ◽

Laparoscopic Hiatal Hernia Repair ◽

Operative Complications ◽

Robotic Hiatal Hernia Repair ◽

Rate Conversion

To investigate, the results which contrasted robotic assisted hiatal hernia repair (RA-HHR) against laparoscopic hiatal hernia repair (LPHHR) we conducted a review. The results indicated feasibility and safety associated with the robotic method. The comparison of studies did not reveal variations in mortality and morbidity rate, conversion rate, ICU stay, 1-month mortality, and post-operative complications, quality of life between the RA-HHR cohort and LPHHR cohort.

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Small bowel volvulus (SBV) in Northcentral Ethiopia

10.21203/rs.3.rs-33522/v2 ◽

2020 ◽

Author(s):

Atalel Fentahun Awedew ◽

Woldemariam Beka Belay ◽

Bedemariam Tadesse Amsalu ◽

Dawit Zerihun Yalewu

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Occurrence Rate ◽

Morbidity Rate ◽

Cross Sectional ◽

Small Bowel Volvulus ◽

Mortality And Morbidity ◽

The Mean ◽

Epidemiological Profile

Abstract Background: Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia Method: The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4-year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.Result: There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within four years. The annual occurrence rate was 35cases per year. It represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority were males (N=125, 84.5%) and females were (N=23, 15.5%). The age ranged from 15-78 years. The mean age was 41.14±(SD=15.4) .The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR=2).The mean duration of illness before hospital admission was 2 days (± SD=1.4) and median was 1 day (± IQR=2). The morbidity rate was 5.4% (N=8) and the mortality rate was 3.4 %( N=5) Conclusion: Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.

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Troponin T in Hip Fracture Patients: Prognostic Significance for Mortality at One Year

Hip International ◽

10.5301/hip.2011.8840 ◽

2011 ◽

Vol 21 (6) ◽

pp. 757-761 ◽

Cited By ~ 10

Author(s):

Edward Spurrier ◽

David Wordsworth ◽

Steven Martin ◽

Rory Norris ◽

Martyn J. Parker

Keyword(s):

Hip Fracture ◽

Troponin T ◽

Prognostic Significance ◽

The Elderly ◽

Cardiac Complications ◽

Mortality And Morbidity ◽

The Mean ◽

One Year ◽

Acute Cardiac Event ◽

Significant Mortality

Hip fractures are common injuries in the elderly, with significant mortality and morbidity from several factors. Many of these patients have cardiac disease, and some develop cardiac complications which may increase mortality. Troponin T is a marker of myocardial injury but can be raised in other conditions. Patients over 60 years admitted with hip fracture during the study period had their troponin T measured on admission and postoperatively. Assay was performed after the patient had completed their treatment. We report the results of this study one year after the last patient was admitted. 108 patients were recruited. The average age was 84 years, 86% were female. The mean hospital stay was 20 days. This study found that 27% of hip fracture patients had some increase in the troponin T levels in the peri-operative period. This increase was not associated with an increase in early mortality, but there was an increase in one-year mortality for those with an increase in troponin T (45% versus 22%, p=0.03). These findings indicate that the routine measurement of troponin T does not correlate with acute mortality and is not necessary without evidence of an acute cardiac event.

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Correlation between CRP Level and Neutrophil Extracellular Traps in Malignancy Patients with Neutropenic Fever

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v26i3.1595 ◽

2020 ◽

Vol 26 (3) ◽

Author(s):

Phey Liana ◽

Kemas M. Yakub ◽

Eny Rahmawati ◽

Berliana Agustin

Keyword(s):

Neutrophil Extracellular Traps ◽

Neutropenic Fever ◽

Morbidity Rate ◽

C Reactive Protein ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Reactive Protein ◽

Extracellular Traps ◽

Neutropenic Patients ◽

The Mean

The mortality and morbidity rate of neutropenic fever is quite high. The source and severity of infection must be evaluated quickly in neutropenic patients. C-Reactive Protein (CRP) and Neutrophil Extracellular Traps (NETs) are known as markers for severeinfection. Besides, NETs also play a role in the development and metastasis of cancer but the mechanism is still unclear. C-reactive protein is a marker that is routinely used for infection. However, the correlation between CRP levels and NETs in malignant patients with neutropenia is unknown. Therefore this study was conducted to determine the correlation between CRP levels and NETs in malignant patients with neutropenia. This research was a cross-sectional observational study. The samples were malignant patients with neutropenia who were treated in the Pediatric Ward of Dr. Mohammad Hoesin Hospital, Palembang and met the inclusion and exclusion criteria. Sampling was done by consecutive sampling. C-reactive protein level and NETs weretested by immunoturbidimetry and ELISA methods. Data were analyzed with the Pearson test (p <0.05). The mean of CRP and NETs level were 170.17±121.52 mg/L and 0.77±0.39 ng/mL, respectively. The correlation test between CRP level and NETs in malignancy patients with neutropenic fever showed r=0.228 and p=0.362. The results showed no significant correlation between CRP level and NETs in malignant patients with neutropenic fever.

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Frequency of dyslipidemia in patients undergoing maintenance hemodialysis at Bahawal Victoria Hospital, Bahawalpur.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.09.3975 ◽

2020 ◽

Vol 27 (09) ◽

pp. 1829-1833

Author(s):

Suhail Iqbal Malik ◽

Raheel Khan ◽

Ali Imran ◽

Mohammad Akram ◽

Sidra Maqbool ◽

...

Keyword(s):

Cross Sectional Study ◽

Maintenance Hemodialysis ◽

Cross Sectional ◽

Dialysis Unit ◽

Mortality And Morbidity ◽

Increased Risk ◽

Low Hdl ◽

History Of ◽

The Mean ◽

Study Setting

One of the risk factor of cardiovascular disease in patients of maintenance hemodialysis is abnormalities in lipid profile. Deranged levels of cholesterol are related to increased risk of cardiovascular mortality and morbidity in hemodialysis patients. Objectives: To determine the frequency of dyslipidemia under going maintenance hemodialysis at BVH, Bahawalpur. Study Design: Cross Sectional study. Setting: Dialysis unit at Bahawal Victoria Hospital, Bahawalpur. Period: January to May 2019. Material & Method: A total of 220 patients who were undergoing maintenance hemodialysis at dialysis unit BVH, Bahawalpur were included in the study. Pre-dialysis blood samples were taken for assessment of Sr. Cholesterol (Total), Sr. Triglycerides & Sr. HDL and were sent to Chemical Pathology Lab of QAMC, Bahawalpur on same day for processing. Results: Out of 220 patients, most of the patients were male (66.8%), history of smoking was present in 7.3% & mean duration of dialysis was 27.12 + 25.85 months. The mean of Sr. Cholesterol (Total), Sr. Triglycerides, Sr. HDL were 155.51+37.72 mg/dl, 135.54+89.27 mg/dl & 35.22+7.77 mg/dl respectively. Dyslipidemia was present in 80% of patients with most common being low HDL (71.8%). Conclusion: Patients of maintenance hemodialysis are having significant number of dyslipidemia leading to inflammation, accelerated atherosclerosis and increased cardiovascular events.

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Factors associated with mortality after decompressive craniectomy in large basal ganglia bleeds

Journal of Neuroscience and Neurological Disorders ◽

10.29328/journal.jnnd.1001048 ◽

2021 ◽

Vol 5 (1) ◽

pp. 029-033

Author(s):

Thotakura Amit Kumar ◽

Marabathina Nageswara Rao ◽

Mareddy Rama Krishnareddy ◽

Yeddanapudi Sivaramanjaneyulu

Keyword(s):

Basal Ganglia ◽

Decompressive Craniectomy ◽

Midline Shift ◽

Hematoma Volume ◽

Mortality And Morbidity ◽

Factors Associated ◽

Mri Brain ◽

Number Of Patients ◽

Operative Complications ◽

The Mean

Aim: To assess the efficacy of decompressive craniectomy in patients with large basal ganglia (BG) bleed. To establish predictive criteria of mortality after surgery in patients with BG bleed. Materials: This prospective study includes all patients of large spontaneous BG bleed operated by decompressive craniectomy without hematoma evacuation from October 2012 to September 2015. Data was collected on patient age, gender, distribution of bleed, affected hemisphere dominancy, preexisting medical conditions, admission Glasgow Coma Score (GCS), midline shift on CT or MRI Brain, hematoma volume and anisocoria, duration (hours) between the onset of stroke and operation, post-operative complications, and the duration of hospital stay. This data was correlated with one month mortality of the patients. Results: Total number of patients were 27. Mean age was 51 years and mean GCS was 7.55(range 5-11). The mean volume of the bleed was 68.51 ml. Mortality was noted in 17 out of 27 patients (63%) in 30 days. Thirteen of the 16 patients with intraventricular extension of BG bleed had mortality. The factors that showed statistically significant correlation with one month mortality were age, GCS at admission, volume of the bleed and the intraventricular extension. Conclusion: Large BG bleed was associated with high mortality and morbidity. Age of 50 years or more and GCS ≤ 8 at presentation were poor prognostic factors for decompressive craniectomy in patients with BG bleed. Patients with large BG bleed of volume > 60 ml and intraventricular extension had poor prognosis.

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Small bowel volvulus (SBV) in Northcentral Ethiopia

BMC Surgery ◽

10.1186/s12893-020-00886-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Atalel Fentahun Awedew ◽

Woldemariam Beka Belay ◽

Bedemariam Tadesse Amsalu ◽

Dawit Zerihun Yalewu

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Occurrence Rate ◽

Morbidity Rate ◽

Cross Sectional ◽

Small Bowel Volvulus ◽

Mortality And Morbidity ◽

The Mean ◽

Epidemiological Profile

Abstract Background Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia. Method The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4-year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV. Result There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within 4 years. The annual occurrence rate was 35cases per year. It represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority were males (N = 125, 84.5%) and females were (N = 23, 15.5%). The age ranged from 15 to 78 years. The mean age was 41.14 ± (SD = 15.4). The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR = 2). The mean duration of illness before hospital admission was 2 days (± SD = 1.4) and median was 1 day (± IQR = 2). The morbidity rate was 5.4% (N = 8) and the mortality rate was 3.4%(N = 5). Conclusion Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.

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