Rate of Prophylaxis Oophorectomy and Associated Factors at the Time of Hysterectomy in Premenopausal Women with Benign Diseases

2021 ◽  
Vol 104 (5) ◽  
pp. 709-714

Objective: To determine the rate of oophorectomy and associated factors at the time of hysterectomy in premenopausal women with benign diseases. Materials and Methods: The medical records of the premenopausal women that underwent hysterectomy with or without oophorectomy due to benign gynecologic conditions between January 1, 2012 and December 31, 2017 at Khon Kaen University Hospital (Thailand) were retrospectively reviewed. The data collected included age, BMI, parity, indication for surgery, family history of carcinoma, route of hysterectomy, procedure, specialization of the surgeon, operative notes, and histopathological reports of the ovaries. Results: Six hundred thirty-eight subjects underwent hysterectomy due to benign gynecologic conditions. Bilateral salpingo-oophorectomy (BSO) was performed in 57.37% (366) of the cases. In 81.97% (300) of these cases, either one or both patient’s ovaries were grossly normal. The rate of prophylactic oophorectomy among all cases was 47.02% (300 in 638). The strongest associated factor with BSO was age (odds ratio 8.421, 95% CI 5.488 to 12.921). Other associated factors were irregular menstrual history, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. No cases of ovarian cancer were found. Conclusion: Nearly half of premenopausal women that underwent hysterectomy due to benign conditions underwent prophylactic oophorectomy. Associated factors were age, irregular menstruation, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. Keywords: Hysterectomy, Premenopausal women, Prophylactic oophorectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Shadi S. Yarandi ◽  
Thomas Runge ◽  
Lei Wang ◽  
Zhijian Liu ◽  
Yueping Jiang ◽  
...  

Despite using imaging studies, tissue sampling, and serologic tests about 5–10% of surgeries done for presumed pancreatic malignancies will have benign findings on final pathology. Endoscopic ultrasound (EUS) is used with increasing frequency to study pancreatic masses. The aim of this study is to examine the effect of EUS on prevalence of benign diseases undergoing Whipple over the last decade. Patients who underwent Whipple procedure for presumed malignancy at Emory University Hospital from 1998 to 2011 were selected. Demographic data, history of smoking and drinking, history of diabetes and pancreatitis, imaging data, pathology reports, and tumor markers were extracted. 878 patients were found. 95 (10.82%) patients had benign disease. Prevalence of benign finding had increased over the recent years despite using more EUS. Logistic regression models showed that abdominal pain (OR: 5.829, 95% CI 2.681–12.674, P ≤ 0.001) and alcohol abuse (OR: 3.221, CI 95%: 1.362–7.261, P: 0.002) were predictors of benign diseases. Jaundice (OR: 0.221, 95% CI: 0.084–0.58, P: 0.002), mass (OR: 0.145, 95% CI: 0.043–0.485, P: 0.008), and ductal dilation (OR: 0.297, 95% CI 0.134–0.657, P: 0.003) were associated with malignancy. Use of imaging studies, ERCP, and EUS has not decreased the percentage of benign findings after surgery for presumed pancreatic malignancy.


Mediscope ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 33-35
Author(s):  
Razia Sultana ◽  
Rowshan Ara Begum ◽  
Ferdousi Begum

Chronic pelvic pain is a common gynecological problem with many causes and may account for approximately 10% outpatient gynecological visit. Pelvic Congestion Syndrome (PCS) is defined as a condition characterized by congestion of the pelvic veins visible on selective ovarian venography in multiparous premenopausal women with a history of chronic pelvic pain for more than six months. We report a case of PCS in 35 years old multiparous lady complaining of chronic pelvic pain for one year. The pain was worsened by sitting and standing position. Other general symptoms were present such as dysmenorrhea, rectal discomfort and urinary frequency. On examination patient was depressed, there was abdominal and pelvic tenderness. Pelvic ultrasound and Doppler examination showed dilated and tortuous ovarian veins and dilated tortuous arcuate veins in the myometrium. An ovarian cyst was present and uterus was enlarged. In this case total abdominal hysterectomy was done although ideal treatment for PCS is ovarian vein embolisation by interventional radiology which is not available in our country. DOI: http://dx.doi.org/10.3329/mediscope.v1i1.21635 Mediscope Vol. 1, No. 1: 2014, Pages 33-35


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Kacem ◽  
H Abroug ◽  
C Bennasrallah ◽  
M Ben Fredj ◽  
I Zemni ◽  
...  

Abstract Background Occupational exposures to blood and body fluid are among the most frequent occupational accidents in healthcare. They put healthcare workers (HCWs) at high risk of transmission of many blood borne pathogens mainly hepatitis B virus (HBV), hepatitis C virus HCV and HIV. The aim of this study was to determine the prevalence of occupational exposures to blood and body fluids and its associated factors among HCWs at the university hospital of Monastir (Tunisia) in 2017. Methods An exhaustive cross-sectional study was conducted from 01 June 2017 to 31 August 2017 at the university hospital in Monastir Governorate (Tunisia). An anonymous self-administered questionnaire was used to collect data on demographic characteristics, self-reported exposures and their circumstances. We performed a multivariate analysis to determine the associated factors to these occupational exposures. Results A total of 1493 HCWs (34.6% nurses 22% technicians and 21.6% doctors) were included corresponding to a response rate of 74%. The median age of the participants was of 36 years (IQR: 31- 46 years). The sex ratio was of 0.36. Responders from medical and surgical departments represented respectively 40.5% and 39%. Among interviewed HCWs, 56.7% reported having at least one exposure to blood or body fluid with 35.4% of them exposed twice or more. Almost half (48.3%) of the respondents had a history of needle stick injury and 32.1% had a history of blood or body fluid splash into the face.The multivariate analysis showed that doctors had the highest risk of exposure comparing to other HCWs with (AOR = 12.425; 95% CI: 05.310 - 29.075) and participants working at surgical departments were at higher risk of exposure than those at others departments (AOR=7.440; 95% CI: 4.461 - 12.408). Conclusions Health occupational exposures to blood and body fluids are a serious problem at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem. Key messages Doctors had the highest risk of exposure to blood and body fluids comparing to other HCWs at the university hospital of Monastir. Preventive measures should be strengthened to alleviate this problem.


2020 ◽  
Author(s):  
Hae Nam Lee ◽  
Ji Min Seo ◽  
Gi Soo Um ◽  
Min Jeong Kim

Abstract Background: Abnormal uterine bleeding (AUB) is defined as an abnormality in menstrual bleeding and is common gynecological problem in premenopausal women. Anxiety and depressive disorders were frequently observed in patients with AUB. This study was conducted to investigate the prevalence and the relationship of anxiety and depression in Korean women with AUB.Methods: The study was a questionnaire study of 124 Korean women aged 15–55 who admitted a single university hospital due to AUB between September 2015 and December 2019. Anxiety, depression were assessed using the Korean Beck Anxiety Inventory (K-BAI), the Korean Beck Depression Inventory-II (K-BDI-II). The obstetrical and clinical data were analyzed to assess the association of anxiety and depression with AUB.Results: Out of 124 patients, 47 (37.9%) met the criteria for anxiety, and 24 (19.5%) met the criteria for depression. The most common menstrual problems seen were heavy menstrual bleeding (80.7%), followed by irregular bleeding (62.9%), dysmenorrhea (55.7%), and irregular menstrual cycles (33.9%). More women with AUB in our study had anxiety as measured by the K-BAI and depression as measured by the K-BDI-II. A history of abortion and cesarean section were related with anxiety, whereas a history of minor surgery was related to depression. Anxiety and depression (r = 0.629, p < 0.001) were correlated with AUB.Conclusions: Anxiety and depression are underdiagnosed and undertreated in Korean women with AUB symptoms. Screening and appropriate mental health management are needed for women with AUB for women’s health.


2019 ◽  
Vol 64 (No. 8) ◽  
pp. 362-366 ◽  
Author(s):  
R Sato ◽  
K Yamada ◽  
Y Shinozuka ◽  
H Ochiai ◽  
K Onda

A 6-month-old crossbred of a Holstein and Japanese Black heifer calf weighing 95 kg presented with a history of intermittent abdominal distension and failure to thrive. The physical examination identified a pinging sound over the dorsal left flank. The abdominal radiography showed a huge gas-filled mass. The intravenous urography revealed no communication between the mass and the urinary bladder. Although the visual examination and palpation of the umbilicus did not reveal visible abnormalities, an umbilical disease was suspected because the animal exhibited poor growth, depression, and a hunched back posture. When the eschar adhering to the centre of the umbilicus was removed, the presence of a fistulous tract was revealed. The umbilical ultrasound examination revealed an intra-abdominal abscess and the fistulography demonstrated that the abscess communicated with the umbilicus. The abscess, compressing into the rumen, was observed by computed tomography. From these images, it was diagnosed as an umbilical cord remnant abscess and a definitive diagnosis of a urachal abscess was obtained by open abdominal surgery and the subsequent removal of the mass. The calf was discharged from the university hospital on day 14 after the operation. This case shows that a urachal abscess should be considered when a pinging sound is present, even if the animal exhibits no swelling or pain of the umbilicus.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.


2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.


Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.


Author(s):  
Demeke Demilew ◽  
Berhanu Boru ◽  
Getachew Tesfaw ◽  
Habtamu Kerebih ◽  
Endalamaw Salelew

Abstract Background Alcohol use disorder increase the risk of physical harm, mental or social consequences for patients and others in the community. Studies on alcohol use disorder and associated factors among medical and surgical outpatients in Ethiopia are limited. Therefore, this study is meant to provide essential data on alcohol use disorder and associated factors among alcohol user medical and surgical outpatients to intervene in the future. Methods An institution-based cross-sectional study was conducted by using the systematic random sampling technique. Alcohol use disorders were assessed using the World Health Organization’s 10-item Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Bivariate and multivariate logistic regression analyses were performed, a P-value less than 0.05 were considered statistically significant in the multivariate analysis and the strength of association was measured at a 95% confidence interval. Results The prevalence of alcohol use disorder was 34.5% with a 95% CI (29.20, 39.80) among study participants. In the multivariate logistic regression analysis, male sex (AOR = 3.33, 95%CI: 1.40, 7.93), history of mental illness (AOR = 2.68, 95%CI: 1.12, 6.38), drinking for relaxation (AOR = 1.88, 95%CI: 1.02, 3.48) and history of lifetime tobacco use (AOR = 5.64, 95%CI: 1.95, 16.29) were factors significantly associated with alcohol use disorder. Conclusion The prevalence of alcohol use disorders among medical and surgical outpatients was found to be high. Male sex, history of mental illness, alcohol use for relaxation and lifetime cigarette smoking need more attention during the assessment of patients in the medical and surgical outpatient departments.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanan M. Ghoneim ◽  
Mohamed Elprince ◽  
Tamer Yehia M. Ali ◽  
Waleed F. Gharieb ◽  
Amal A. Ahmed

Abstract Background Depression is a serious mental health disorder that might affect women in the childbearing period. Incidences increase during pregnancy as well as after delivery. Its association with intimate partner violence (defined as physical, sexual, or psychological harm by a current or former partner) has been reported in many countries. Data about this sensitive issue are lacking in Egypt. The aim of the study was to determine the relation between intimate partner violence and depression during pregnancy. Methods This was a case control study conducted at the outpatient clinics in Suez Canal University hospital, from January 2019 to March 2020. The study included two groups, the study group included women exposed to violence during the current pregnancy and a control one included women with no history of violence. Both groups were recruited according to the predetermined inclusion criteria (women aged 18-45 years, continuous marital relationship, no history of depression in current or previous pregnancies, and singleton pregnancy). Women were asked to complete the Arabic validated NorVold Domestic Abuse Questionnaire (measuring four types of abuse: emotional, physical, sexual, and violence in the health care system, the last one being excluded). Depression was evaluated using the Arabic validated form of the Edinburgh Postnatal Depression Scale (comprises 10 questions that represent patients’ feelings in the last 7 days). The main outcome measure was to assess the association between intimate partner violence and depression. Results We recruited 158 women in each group. Both groups were matched in their demographic characters. Although emotional violence was reported prominently among women exposed to IPV 87.9% (139/158), it was not significantly reported in depressed women (P value 0.084). Physical and sexual violence were significantly reported among depressed women (P value 0.022 and 0.001, respectively). There was a significant difference between women exposed to violence and those who were not exposed to violence in the total depression scores (13.63 ± 5.47 and 10.65 ± 5.44, respectively with a p value < 0.001). Emotional (p value < 0.001) and sexual violence (mild and severe with p value of 0.026 and 0.002 respectively) had significant roles as risk factors for depression during pregnancy in single regression and after control of other confounders. Conclusion There was a strong association between intimate partner violence and depression during pregnancy.


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