scholarly journals Incisional Hernia of Elective Midline Caesarean Section: Incidence and Risk Factors

2013 ◽  
Vol 25 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Md Hasan Al-Dahamsheh
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Incisional Hernia ◽  
Wound Complications ◽  
Control Group ◽  
Postoperative Fever ◽  
Parity Number ◽  
Potential Risk Factors ◽  
Independent Risk Factors ◽  
And Control

Objective: To analyze the incidence and risk factors for development hernia after elective  lower midline caesarean section(ElMCS).Method: A prospective cohort study of 284 women for development of incisional hernia after  repeated elective midline CS. Patients enrollment done from April 13th 2001 and December  12th 2002. follow up to two years for hernia development. Hernias were identified radiographically  or during physical exam. 2-year hernia rates were calculated. Patients were distributed in two  groups, study group consisted of women who had incisional hernia and control group consisted  from women who had not within 2-years postoperatively. Within the two groups potential risk  factors (age, body mass index (BMI), parity, number of previous cesareans, chronic cough,  diabetes mellitus(DM), heart disease, low serum albumin, type of previous incision, anesthesia  type, presence of postoperative fever and wound complications) were collected and statistically  analyzed with the development of incisional hernia (IH).  Setting: Prince Hashem Ben Al-Hussein Hospital, Jordanian Royal Medical Services of Jordan  / Zarqa.  Results: The 2-year hernia was 5.6 % .Independent risk factors of IH development include:  increase in number of previous CSs, wound complications and obesity.  Conclusion: An incisional hernia is higher than previously estimated in women undergoing  ElMCS. Counseling on the family size will reduce the chance for further CS with its associated  risk. Also measures to reduce wound infection after surgery may reduce the incidence of  incisional hernia following ElMCS. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13724 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 9-14

Donepezil Improves Gait Performance in Patients with an Acute Cerebral Infarction: A Prospective Observational Cohort Study

2020 ◽  
Vol 17 (3) ◽  
pp. 304-311 ◽  
Author(s):  
Ying-Ying Lin ◽  
Shi-Jie Guo ◽  
Hui Quan ◽  
Yan-Xin Zhao ◽  
Dong-Ya Huang
Keyword(s):  
Risk Factors ◽  
Cerebral Infarction ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Observation Group ◽  
Gait Performance ◽  
Nihss Score ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
And Control

Background: Hemiplegia is a common symptom after acute cerebral infarction. Objective: This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction. Methods: A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent a 3- month assessment. At the study's conclusion, patients were divided into 2 groups-those who received donepezil daily (observation Group) and those who did not (Control Group). Results: There was a significant difference (t=3.269, P=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference in WGS scores between subgroups (P>0.05), respectively. The patient's admission National Institute of Health Stroke Scale(NIHSS) score had a strongly positive correlation with WGS score (r=0.850, P<0.001). Besides, age (r=0.218, P=0.024), glycosylated hemoglobin (r=0.274, P=0.004), MMSE (r=-0.261, P=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, P=0.005) had a weak correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.042~0.188, P=0.002), admission NIHSS score (95% CI: 2.405~3.137, P<0.001) and multiple sites infarction (95% CI: 0.044~2.983, P=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (P<0.001). At 3 months after admission, WGS score of the observation group was significantly lower than the control group (t=2.468, P=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (P>0.05) and WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (P<0.001), while there was no significant difference between two groups (P>0.05). Conclusion: Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with acute cerebral infarction.

scholarly journals Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Kheira Jolin-Dahel ◽  
Emanuela Ferretti ◽  
Carolina Montiveros ◽  
Renee Grenon ◽  
Nick Barrowman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Retrospective Chart Review ◽  
Control Group ◽  
Severe Liver Damage ◽  
Independent Risk Factors ◽  
And Control ◽  
To Receive ◽  
Surgical Condition

Background. Parenteral nutrition (PN) is an effective method of nourishing the neonate who is unable to receive full enteral feeds. Cholestasis can be a complication of PN and can lead to severe liver damage.Aim. We describe our patient population and determine risk factors for developing PN cholestasis.Methods. Retrospective chart review of newborns admitted from January 2006 to May 2011 to the Neonatal Intensive Care Unit at our institution and received PN >14 days. Cholestasis was defined as serum conjugated bilirubin >50 μmol/L.Results. Eighty-seven newborns were included; 18 (20.7%) developed PN cholestasis. The most frequent surgical condition for both groups was gastroschisis (8/87; 9.2%). No significant differences were found between the cholestasis and control groups for the following parameters: birth weight, gestational age, intrauterine growth restriction, Apgar scores, and day of life at initiation of enteral feeds. Duration of PN in days and dosage of carbohydrates in g/kg/day were significantly higher in the cholestasis group than the control group.Conclusion. PN-related cholestasis presented in one-fifth of neonates receiving PN for more than two weeks. Longer duration of PN and higher dosage of carbohydrates were independent risk factors for the development of PN cholestasis in this population.

PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Amniotic Membrane ◽  
Healing Time ◽  
Cost Of Care ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
And Control ◽  
Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

scholarly journals Epidemiology, Risk Factors, and Outcomes of Opportunistic Infections after Kidney Allograft Transplantation in the Era of Modern Immunosuppression: A Monocentric Cohort Study

2019 ◽  
Vol 8 (5) ◽  
pp. 594 ◽  
Author(s):  
Philippe Attias ◽  
Giovanna Melica ◽  
David Boutboul ◽  
Nathalie De Castro ◽  
Vincent Audard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Opportunistic Infections ◽  
Control Group ◽  
Kidney Allograft ◽  
Extended Criteria Donor ◽  
Allograft Transplantation ◽  
Kidney Recipients ◽  
Independent Risk Factors ◽  
Kidney Transplantations

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

scholarly journals Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection

2021 ◽  
Vol 10 (5) ◽  
pp. 928
Author(s):  
Takuya Okugawa ◽  
Tadayuki Oshima ◽  
Keisuke Nakai ◽  
Hirotsugu Eda ◽  
Akio Tamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Colorectal Polyp ◽  
Control Group ◽  
Single Center ◽  
Antithrombotic Agents ◽  
Delayed Bleeding ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
Continuous Use

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6–2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding (DPPB). Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection. Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of DPPB. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of historical control patients and patients after instruction were compared. Results: A total of 3318 polyps in 1002 patients were evaluated. The control group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. DPPB occurred in 1.1% of polyps in control, and 0.4% in after-instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for DPPB even after instruction. Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

Optimization of tactics of auxiliary genesial technologies at married couples with the burdened genetic anamnesis

2018 ◽  
pp. 103-106
Author(s):  
O.S. Darii ◽  
Keyword(s):  
Risk Factors ◽  
Correlation Analysis ◽  
Clinical Laboratory ◽  
Genetic Research ◽  
Married Couples ◽  
Control Group ◽  
Scientific Justification ◽  
Sterility Treatment ◽  
Laboratory Tool ◽  
And Control

The objective: rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis on the basis of scientific justification and introduction of advanced algorithm of prognostic and treatment-and-prophylactic actions. Materials and methods. For the purpose of detection of risk factors of development of sterility and carrying out the correlation analysis were allocated the main group – 100 married couples with sterility in the anamnesis and control group of patients who had labors (n=100) in the anamnesis. The complex of the conducted researches included clinical, laboratory, tool and statistical methods of research. Results. Rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis requires carrying out medicogenetic consultation with simultaneous planned preimplantation genetic research in programs of auxiliary genesial technologies. At a choice of this or that method of auxiliary genesial technologies at women with the burdened genetic anamnesis it is necessary to use a technique at which one spermatozoon is entered into an oocyte cytoplasma by means of equipment of a micromanipulation. In the program of training of doctors the obstetrician-gynecologists and urologists of an out-patient link it is necessary to loop thematic improvement concerning sterility treatment at married couples with use of auxiliary genesial technologies. Conclusion. Results of the conducted researches testify to need of rising of efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis. Use by our algorithm of prognostic and treatment-and-prophylactic actions allows to increase efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis for 26.7%. Key words: sterility at married couples, the auxiliary genesial technologies, the burdened genetic anamnesis.

scholarly journals Risk Factors for Failure of Direct Current Cardioversion in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Handrean Soran ◽  
Moulinath Banerjee ◽  
Jamal B. Mohamad ◽  
Safwaan Adam ◽  
Jan Hoong Ho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Left Atrial ◽  
Control Group ◽  
Left Atrial Size ◽  
Direct Current Cardioversion ◽  
Atrial Size ◽  
Independent Risk Factors ◽  
Lv Ejection Fraction

Introduction. Type 2 diabetes mellitus (T2DM) is a well-recognised risk factor for cardiovascular disease and the prevalence of atrial fibrillation (AF) is higher among patients with T2DM. Direct current cardioversion (DCCV) is an important management option in persistent AF. We sought to determine independent risk factors for immediate and short-term outcomes of DCCV for treatment of AF in patients with T2DM. Methods. Retrospective outcome analysis of DCCV for persistent AF in 102 T2DM patients compared with 102 controls. Results. DCCV was successful in 68 (66.6%) people with T2DM compared to 86 (84.3%) in the control group (P=0.003). After initial successful cardioversion, only 38 (37.2%) T2DM patients remained in sinus rhythm compared to 63 (61.8%) in the control group (P=0.007) at a median follow-up of 74.5 days (IQR 69.4–77.4). Multiple logistic regression analysis showed that the presence of T2DM (P=0.014), digoxin use (P=0.01), statin use (P=0.005), left-atrial size (P=0.01), and LV ejection fraction (P=0.008) were independent risk factors for immediate DCCV failure. T2DM (P=0.034) was an independent risk factor for AF relapse. Among patients with T2DM, previous DCCV (P=0.033), digoxin use (P=0.035), left-atrial size (P=0.01), LV ejection fraction (P=0.036), and HbA1c (P=0.011) predicted immediate failure of DCCV whilst digoxin use (P=0.026) was an independent risk factor for relapse of AF. Conclusion. T2DM, higher HbA1c, digoxin treatment, and structural and functional cardiac abnormalities are independent risk factors for immediate DCCV failure and AF relapse.

scholarly journals Risk factors for methicillin-resistantStaphylococcus aureusbacteraemia differ depending on the control group chosen

2013 ◽  
Vol 141 (11) ◽  
pp. 2376-2383 ◽  
Author(s):  
M. POGORZELSKA-MAZIARZ ◽  
E. Y. FURUYA ◽  
E. L. LARSON
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Organ Transplant ◽  
Severity Of Illness ◽  
Venous Catheter ◽  
Case Control ◽  
Control Group ◽  
Major Organ ◽  
Independent Risk Factors ◽  
Nested Case Control

SUMMARYMethicillin-resistantStaphylococcus aureus(MRSA) bacteraemia cause significant morbidity and mortality in hospitalized patients. Using a nested case-control design, 204 MRSA bacteraemia cases were compared to 301 unmatched methicillin-susceptibleStaphylococcus aureus(MSSA) bacteraemia controls and were matched 1:2 with non-infected controls. The independent risk factors for MRSA bacteraemia compared to MSSA bacteraemia were older age (P = 0·048), major organ transplant during current hospital stay (P = 0·016) and quinolone use (P = 0·016). Cases were more likely than non-infected controls to have renal failure (P = 0·003), cirrhosis (P = 0·013), and a central venous catheter (P = 0·003) after controlling for other risk factors. This large case-control study made it possible to assess risk factors for MRSA bacteraemia using two sets of controls and showed that risk factors differed greatly depending on the control group chosen. These results confirm the need for careful selection of appropriate control groups and the need to carefully adjust for underlying severity of illness.

scholarly journals Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position

2020 ◽  
Vol 73 (6) ◽  
pp. 542-549
Author(s):  
Taeha Ryu ◽  
Baek Jin Kim ◽  
Seong Jun Woo ◽  
So Young Lee ◽  
Jung A Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Odds Ratio ◽  
Arthroscopic Surgery ◽  
Sitting Position ◽  
Past Medical History ◽  
Frequent Adverse Event ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Independent Risk Factors

Background: Hypotensive bradycardic events (HBEs) are a frequent adverse event in patients who underwent shoulder arthroscopic surgery under interscalene block (ISB) in the sitting position. This retrospective study was conducted to investigate the independent risk factors of HBEs in shoulder arthroscopic surgery under ISB in the sitting position. Methods: A total of 2549 patients who underwent shoulder arthroscopic surgery under ISB and had complete clinical data were included in the study. The 357 patients who developed HBEs were included in the HBEs group, and the remaining 2192 in the non-HBEs group. The potential risk factors for HBEs, such as age, sex, past medical history, anesthetic characteristics, and intraoperative medications were collected and compared between the groups. Statistically significant variables were included in a logistic regression model to further evaluate the independent risk factors for HBEs in shoulder arthroscopic surgery under ISB. Results: The incidence of HBEs was 14.0% (357/2549). Logistic regression analysis revealed that the intraoperative use of hydralazine (odds ratio [OR] 4.2; 95% confidence interval [CI] 2.9–6.3), propofol (OR 2.1; 95% CI 1.3–3.6), and dexmedetomidine (OR 3.9; 95% CI 1.9–7.8) before HBEs were independent risk factors for HBEs in patients who received shoulder arthroscopic surgery under ISB. Conclusions: The intraoperative use of antihypertensives such as hydralazine and sedatives such as propofol or dexmedetomidine leads to increased risk of HBEs during shoulder arthroscopic surgery under ISB in the sitting position.

scholarly journals Prevalence of diarrhoea, and associated risk factors, in children aged 0-5 years, at two hospitals in Umuahia, Abia, Nigeria

2017 ◽  
Vol 9 (1) ◽  
pp. 7-14
Author(s):  
Adanma Florence Nwaoha ◽  
Camelita Chima Ohaeri ◽  
Ebube Charles Amaechi
Keyword(s):  
Risk Factors ◽  
Health Workers ◽  
Age Groups ◽  
Medical Centers ◽  
Faecal Samples ◽  
Potential Risk Factors ◽  
Stool Samples ◽  
The Government ◽  
Associated Risk Factors ◽  
And Control

Diarrhoea is the second leading cause of infectious mor­bidity and mortality in children under five years of age. This study aimed at identifying the most common parasites and potential risk factors for diarrhoea among children 0-5 years attending Abia State Specialist hospital and Federal Medical Centre, Umuahia, in south east­ern Nigeria. We used 400 faecal samples from children with diarrhoea –and 200 without– in combination with hospital-based case control and a questionnaire Stool samples were processed with direct normal saline and formal-ether sedimentation method for parasitological stud­ies. More males than females were infected in nearly all age groups in both diarrhoeal and control groups (X2=23.04, df=1, P<0.05: X2=11.52, df=1, P<0.05 respectively). Amachara had more infections (X2=0.15, df=1, P< 0.05). January had the highest rate of infection (22.5%). Main clinical features were watery depositions over 3 times a day, diarrhoea lasting for days, fever, vomiting, and dehydration. Mothers learned about the problem through health workers, television and in medical centers. Risk correlated with mother’s education, occupation, latrine type, waste water disposal, hand washing, kitchen cleaning; sources and storage of water; and bottle milk (P< 0.05).Ignorance greatly con­tributed to the spread of parasitic disease in the area: the government should improve education and other strategies to alleviate the spread of the disease..

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