scholarly journals Outcome of one year’s experience of thyroid surgery in a high volume center.

2020 ◽  
Vol 27 (10) ◽  
pp. 2081-2087
Author(s):  
Mohammad Sohail Asghar ◽  
Ahmad Kaleem ◽  
Ameer Afzal ◽  
Usama Shabbir ◽  
Jamal Anwar ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
High Volume ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Safe Procedure ◽  
Cross Sectional ◽  
Modes Of Presentation ◽  
Time Period ◽  
High Volume Center ◽  
Volume Unit

Objectives: This study was performed to take an overview of the modes of presentation of these disorders, demographic factors of presenting patients, procedures to deal with these disorders and complications associated with them in our surgical ward. Study Design: Cross Sectional Study. Setting: Department of North Surgery, Mayo Hospital Lahore Pakistan. Period: September 2018 to September 2019. Material & Methods: All adult patients of either gender who presented with benign or malignant thyroid disorders and were managed surgically during the study period were included. The data was recorded on a pre-designed proforma maintained at the department. Results: Out of 156 patients, there were 146(93.6%) females and 10(6.4%) males. The most commonly performed procedure was total thyroidectomy i.e 102 (65.3%) while hemi thyroidectomies being 41 (26.1%). We performed 4 neck dissections in this time period for malignancies. The mean hospital stay ranged from 1-12 days with a mean of 2.88±1.99 days. There was no in-hospital mortality. Temporary hypocalcemia was the most common early complication found in 32(20.5%) patients. Conclusion: Thyroid surgery is a safe procedure to be performed for teaching purposes in a high volume unit like ours with complication rates reaching near zero.

scholarly journals 33. Concerning Trends of Pediatric Leprosy in Minas Gerais, Brazil and Associations with Number of Municipality Medical Facilities

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Taylor Landay ◽  
Julie A Clennon ◽  
José A Ferreira ◽  
Lucia A Fraga ◽  
Maria Aparecida F Grossi ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Minas Gerais ◽  
Chi Square ◽  
Cross Sectional ◽  
Period 2 ◽  
Time Period ◽  
Medical Facilities ◽  
Age Of Diagnosis ◽  
Using Data ◽  
Incident Cases

Abstract Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: < 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p < 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with > 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with < 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures

Sick on the Frontlines:A Cross Sectional Study on COVID-19 Infection, Symptom Severity Amongst Emergency Medicine Residents and Fellows in Urban Academic Hospital Settings (Preprint)

2021 ◽  
Author(s):  
Stacey Frisch ◽  
Sarah Jones ◽  
James Willis ◽  
Richard Sinert
Keyword(s):  
New York ◽  
Emergency Medicine ◽  
Cross Sectional Study ◽  
The Novel ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Time Period ◽  
High Infection ◽  
Novel Coronavirus ◽  
Specific Symptoms

BACKGROUND COVID-19, an illness caused by the novel coronavirus SARS-CoV-2, affected many aspects of healthcare worldwide in 2020. From March to May of 2020, New York City (NYC) experienced a large surge of cases. OBJECTIVE The authors aimed to characterize the amount of illness experienced by residents and fellows in 2 NYC hospitals during this time period. METHODS This was a cross-sectional observational study. An IRB-exempt survey was distributed to emergency medicine housestaff in May 2020 and submissions were accepted through August 2020. RESULTS 64 residents and fellows responded to our survey (a 62% response rate). 42% of responders tested positive for SARS-CoV-2 antibodies. Most residents experienced symptoms that could be consistent with COVID-19 however few received PCR testing. Fevers and/or chills along with loss of smell and/or taste were the most specific symptoms for COVID-19, with p-values <0.05. All 13 housestaff who reported no symptoms during the study period tested negative for SARS-CoV-2 antibodies. CONCLUSIONS Our study demonstrated that the rate of COVID-19 illness among emergency department housestaff is much higher than previously reported. Further studies are needed to characterize illness among medical staff in emergency departments across the nation. The high infection rate among emergency medicine trainees stresses the importance of supplying adequate PPE for healthcare professionals.

Prevalence and Risk Factors of work Related Musculo Skeletal Disorders (wrmsd’s) Among Doctors - A Cross Sectional Study

2021 ◽  
pp. 1-4
Author(s):  
Biju Azariah ◽  
◽  
Geethu Babu ◽  
Keyword(s):  
Risk Factors ◽  
Service Sector ◽  
Care Delivery ◽  
Tertiary Care ◽  
Health Sector ◽  
High Volume ◽  
Cross Sectional Study ◽  
Working Environment ◽  
Cross Sectional ◽  
Work Related

Work related musculoskeletal disorders (WRMSDs) have not only shown to impact the physical and pschycological comfort of the employee but also deteriorate the prospects of any production or service sector. The prevalence of WRMSDs, though studied extensively in various sectors, has been understudied in health sector, especially among doctors. This study which evaluated the prevalence and risk factors of these disorders among fifty cancer treating Radiation Oncologist at a Tertiary Care Cancer Centre in India had exposed out an alarming 68% prevalence of these disorders in the study population, with neck pain being the commonest site of these Muscloskeletal Disorders (MSDs). Several factors which could impact the development of MSDs were analysed. This higher incidence of MSDs is presumed to be because of extreme physical and mental stress of working in a high volume cancer care centre, persistent unhealthy postures during work, inadequate micropauses between works and uncomfortable working atmosphere. Adequate physician patient ratio, restricting the patient load, providing good physician friendly working environment and adequate mandatory breaks might significantly reduce the incidence of these disorders and can prevent the sagging of health care delivery.

Early report on percutaneous endoscopic gastrostomy at Owerri, Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Christopher Nonso Ekwunife ◽  
Kelechi E. Okonta ◽  
Stephen E. Enendu
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Early Report ◽  
Cross Sectional Study ◽  
Tube Placement ◽  
Safe Procedure ◽  
Cross Sectional ◽  
Endoscopic Gastrostomy ◽  
Neurologic Disorders ◽  
Superficial Skin ◽  
Peg Tube

Objectives: Percutaneous endoscopic gastrostomy (PEG) is a well-established endoscopic procedure that is used predominantly to create enteral access for feeding. Its use has not been widespread in Nigeria despite its efficacy. This study is done to review the early experiences in the use of PEG in Federal Medical Centre, Owerri and Carez Clinic, Owerri. Material and Methods: This is a 4-year retrospective cross-sectional study of patients who had PEG from January 2015 to December 2018. The indications, complications, and outcomes of the procedure were analyzed. Results: A total of 13 patients had pull-type gastrostomy during this period. Six (46.1%) patients had the procedure on account of neurologic disorders, 4 (30.8%) patients had esophageal tumors, while 3 (23.1%) patients had esophageal motility disorders. The overall success rate for PEG tube placement was 100%. The most common complication was superficial skin infection 30.8% (4/13). No mortality was attributable to the procedure. Conclusion: PEG is still not commonly done in our setting, but it is a relatively safe procedure. Physicians should be encouraged to offer it to our teeming patients with neurologic disorders who may benefit from it.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Anti-mullerian hormone as an emerging promising marker in the prognosis of PCOS

2021 ◽  
Vol 16 (1) ◽  
pp. 111-114
Author(s):  
Anu Meena ◽  
Amit Kyal ◽  
Partha Mukhopadhyay ◽  
Pragati Sharma
Keyword(s):  
Prognostic Marker ◽  
High Specificity ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Indian Women ◽  
Specificity And Sensitivity ◽  
Time Period ◽  
Ultrasound Findings

Aims: To correlation of AMH with clinical, hormonal and ultrasound findings; and determine the role of AMH as prognostic marker. Methods: This was a prospective cross sectional study on women attending Gynaecology outpatient department of Medial College and Hospital, Kolkata, from January 2018 to June 2019. Study comprised of 70 newly diagnosed cases of PCOS using Rotterdam criteria 2003. Clinical history included menstrual complaint, hirsutism and weight gain; examination included BMI and Ferriman-Gallwey score; and investigations included FBS, 2hr PPBS, TSH, Prolactin, total testosterone, LH, AMH level and pelvic USG before starting intervention and same parameters were rechecked after 3 months of treatment completion. Results: A total of 70 PCOS patients were included in a study conducted within 1 year time period. The most common Phenotype in our study is Phenotype A (O+H+P) which was almost 85.71%, followed by Phenotype B (O+H) 7.14% and the least we got Phenotype C (H+P) that is 2.86%. There was statistically significant (p<0.05) decrease in AMH level following treatment of PCOS (before treatment mean AMH level was 9.634.42 and after treatment the level was 5.812.77). Conclusions: The most frequent PCOS phenotype in Indian women is A (O+H+P). Therapy in PCOS women with raised AMH reduces the AMH levels. Measurement of serum AMH provides a high specificity and sensitivity by which it can act as a prognostic marker for PCOS.

scholarly journals Conflict of interest policies and disclosure requirements in neurosurgical journals

2019 ◽  
Vol 131 (1) ◽  
pp. 264-270 ◽  
Author(s):  
Madeleine P. de Lotbiniere-Bassett ◽  
Jay Riva-Cambrin ◽  
Patrick J. McDonald
Keyword(s):  
Conflict Of Interest ◽  
Cross Sectional Study ◽  
International Committee ◽  
Impact Factors ◽  
Cross Sectional ◽  
Medical Journals ◽  
Time Period ◽  
Biomedical Journals ◽  
Policy Statements ◽  
Journal Policies

OBJECTIVEAn increasing amount of funding in neurosurgery research comes from industry, which may create a conflict of interest (COI) and the potential to bias results. The reporting and handling of COIs have become difficult, particularly as explicit policies themselves and definitions thereof continue to vary between medical journals. In this study, the authors sought to evaluate the prevalence and comprehensiveness of COI policies among leading neurosurgical journals.METHODSThe authors conducted a cross-sectional study of publicly available online disclosure policies in the 20 highest-ranking neurosurgical journals, as determined by Google Scholar Metrics, in July 2016.RESULTSOverall, 89.5% of the highest-impact neurosurgical journals included COI policy statements. Ten (53%) journals requested declaration of nonfinancial conflicts, while 2 journals specifically set a time period for COIs. Sixteen journals required declaration from the corresponding author, 13 from all authors, 6 from reviewers, and 5 from editors. Four journals were included in the International Committee of Medical Journal Editors (ICMJE) list of publications that follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (currently known as Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals). Five journal policies included COI declaration verification, management, or enforcement. The neurosurgery journals with more comprehensive COI policies were significantly more likely to have higher h5-indices (p = 0.003) and higher impact factors (p = 0.01).CONCLUSIONSIn 2016, the majority of, but not all, high-impact neurosurgical journals had publically available COI disclosure policies. Policy inclusiveness and comprehensiveness varied substantially across neurosurgical journals, but COI comprehensiveness was associated with other established markers of individual journals’ favorability and influence, such as impact factor and h5-index.

scholarly journals Health Canada’s use of expedited review pathways and therapeutic innovation, 1995–2016: cross-sectional analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023605 ◽  
Author(s):  
Joel Lexchin
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Cross Sectional Study ◽  
New Drugs ◽  
Cross Sectional ◽  
Time Period ◽  
Therapeutic Value ◽  
Kappa Value ◽  
Innovative Drugs ◽  
Sectional Analysis ◽  
Health Canada

ObjectivesThis study examines the use of expedited approval pathways by Health Canada over the period 1995 to 2016 inclusive and the relationship between the use of these pathways and the therapeutic gain offered by new products.DesignCross-sectional study.Data sourcesTherapeutic Products Directorate, Biologics and Genetic Therapies Directorate, Notice of Compliance database, Notice of Compliance with conditions web site, Patented Medicine Prices Review Board, La revue Prescrire, WHO Anatomical Therapeutic Chemical classification system.Primary and secondary outcomesPercent of new drugs evaluated by Health Canada that went through an expedited pathway between 1995 and 2016 inclusive. Kappa values comparing the review status with assessments of therapeutic value for individual drugs.ResultsOf 623 drugs approved by Health Canada between 1995 and 2016, 438 (70.3%) drugs went through the standard pathway and 185 (29.7%) an expedited pathway. Therapeutic evaluations were available for 509 drugs. Health Canada used an expedited approval pathway for 159 of the 509 drugs, whereas only 55 were judged to be therapeutically innovative. Forty-two of the 55 therapeutically innovative drugs received an expedited review and 13 received a standard review. The Kappa value for the entire period for all 509 drugs was 0.276 (95% CI 0.194 to 0.359) indicating ‘fair’ agreement between Health Canada’s use of expedited pathways and independent evaluations of therapeutic innovation.ConclusionHealth Canada’s use of expedited approvals was stable over the entire time period. It was unable to reliably predict which drugs will offer major therapeutic gains. The findings in this study should provoke a discussion about whether Health Canada should continue to use these pathways and if so how their use can be improved.

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