scholarly journals Outcomes of Carotid Endarterectomy with Primary Closure

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Aamir Javid
Keyword(s):  
Carotid Endarterectomy ◽  
Postoperative Period ◽  
Primary Closure ◽  
Calculated Data ◽  
Military Hospital ◽  
Short Term ◽  
Cross Sectional ◽  
Study Duration ◽  
Repeat Operation ◽  
Study Participants

Background: Cerebrovascular ischemic cases are 3rd leading cause of fatality and neurologic dysfunction in adults. Atherosclerotic lesions outside the carotid cranial circulation are main cause of cerebral ischemia in almost 10-20 percent cases and carotid endarterectomy (CEA) has been proved beneficial for patients with severe carotid artery stenosis to prevent acute cerebrovascular events. Current study is conducted to assess the short-term outcomes of carotid endarterectomy among patients in terms of morbidities and mortalities at our institution during the study period. Material and Methods: This cross-sectional analytical study was carried out at Combined Military Hospital, Rawalpindi during August 2019 to July 2021 to analyze the short-term outcomes of carotid endarterectomy (CEA) with primary closure. All the patients who underwent carotid endarterectomy (CEA) with primary closure during study duration were included in the study. Patients who received selective shunting if Electro Encephalogram (EEG) changes noted were excluded from study. Data was collected after taking verbal consent by using preformed questionnaire. Frequency of morbidities like bleeding, infection, stroke, transient ischemic attacks (TIA), myocardial infarction, repeat operation and revision with stent were noted within postoperative period of one month. Frequency of mortalities in one-month postoperative period among patients undergoing carotid endarterectomy was also calculated. Data was entered and analyzed by using SPSS version 22. Results: Total 198 patients who underwent carotid endarterectomy with primary closure during study duration were included in the study. Age range of the study participants was between 35 to 80 years. Male patients were 107 (54.04%). The comorbidities evaluated in the study participants showed that 172 (86.87%) patients were hypertensive and 73 (36.87%) has diabetes mellitus. The most frequent postoperative morbidities among patients were bleeding and repeat operation. Conclusion: It is concluded that carotid endarterectomy with primary closure is a safe and effective surgical means of stroke prevention.

scholarly journals Outcomes of Carotid Endarterectomy with Primary Closure

2017 ◽  
Vol 26 (02) ◽  
pp. 083-088 ◽  
Author(s):  
Ivy Cheng ◽  
Krishna Vyas ◽  
Santhosh Velaga ◽  
Daniel Davenport ◽  
Sibu Saha
Keyword(s):  
Carotid Endarterectomy ◽  
Primary Closure ◽  
Complication Rates ◽  
Short Term ◽  
Specific Patient ◽  
Cross Clamp Time ◽  
Complication Risk ◽  
Duplex Imaging ◽  
Patch Angioplasty

AbstractCarotid endarterectomy (CEA) reduces the risk of stroke in patients with internal carotid artery stenosis, although the optimal surgical technique is debated. The literature suggests that patch angioplasty reduces complication risk, although primary closure shortens cross-clamp time and eliminates complications associated with grafts.The objective of this study was to assess the complication rate after CEA with primary closure.Retrospective review of 240 consecutive patients between 2002 and 2010. Of these patients, 70% returned for follow-up visits for at least 2 or more years.Primary closure was used in all patients. The average cross-clamp time was 18 minutes. Complications in the immediate postoperative period within 30 days were as follows: stroke (n = 3; 1.1%), transient ischemic attack (TIA; n = 4; 1.5%), myocardial infarction (MI; n = 3; 1.1%), and death (n = 1; 0.4%). Short-term follow-up revealed eight patients who were found to have significant restenosis (>80%) by carotid duplex imaging. Two to ten year postoperative complication rates were as follows: stroke (n = 7; 4.2%), TIA (n = 7; 4.2%), amaurosis fugax (n = 1; 0.6%), MI (n = 8; 4.8%), and death (n = 28; 17%). Mortality was due to stroke or heart attack (n = 2; 1.2%), cancer (n = 7; 4.2%), and unknown causes (n = 19; 11%).This study presents our experience with complications after primary closure after CEA. In our experience, CEA is a safe and effective surgical means of preventing stroke in the short term. Well-designed prospective studies are needed to confirm specific patient characteristics in which primary closure and patch angioplasty are indicated.

scholarly journals Frequency of Cryptosporidiosis in Children having Persistent Diarrhea

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Mariam Danish Iqbal ◽  
Tahir Naeem ◽  
Umar Khurshid ◽  
Fatima Hameed
Keyword(s):  
Intestinal Parasites ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Persistent Diarrhea ◽  
Cross Sectional ◽  
Creative Commons ◽  
Stool Samples ◽  
Stool Specimens ◽  
Study Participants ◽  
Open Access Article

Objective: Globally childhood diarrheal diseases continue to be the second leading cause of death. Cryptosporidium spp are important intestinal parasites that cause diarrhea in humans and animals particularly in developing countries. This investigation was carried out to find out the frequency of cryptosporidiosis in children presenting with persistent diarrhea. Methods: Two hundred stool samples were collected in this descriptive cross-sectional study conducted at Microbiology Department, Combined Military Hospital, Lahore Pakistan between the months of July to Dec 2014. Children aged five years to 12 years who presented with persistent diarrhea were included in the study. Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection. Results: The average age of study participants was 7.95 with a standard deviation of 2.21 years. Among the participants 66% were males whereas 34% were females. Twenty eight percent had presence of oocysts in stool samples. Conclusions: The frequency of Cryptosporidiosis among children with persistent diarrhea was 28%. This high frequency indicates that this population is uniquely susceptible to infection. It also highlights the need for education about hygiene, accurate diagnosis, and treatment of Cryptosporidiosis. There is also a need for additional studies regarding the occurrence of this pathogen. doi: https://doi.org/10.12669/pjms.37.1.2700 How to cite this:Iqbal MD, Naeem T, Khurshid U, Hameed F. Frequency of Cryptosporidiosis in Children having Persistent Diarrhea. Pak J Med Sci. 2021;37(1):121-124. doi: https://doi.org/10.12669/pjms.37.1.2700 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Short-Term Complications of Emergency and Elective Tracheostomy; A Comparative Study

2021 ◽  
Vol 2 (2) ◽  
pp. 5
Author(s):  
Zaheer Ul Hassan ◽  
Farhan Akbar ◽  
Tarique Ahmed Maka
Keyword(s):  
Cardiac Arrest ◽  
Neck Surgery ◽  
Postoperative Hemorrhage ◽  
Military Hospital ◽  
P Value ◽  
Short Term ◽  
Cross Sectional ◽  
Emergency Tracheostomy ◽  
Increased Risk ◽  
Surgical Emphysema

Objective: To compare short-term complications in elective and emergency tracheostomy.Study Design: Comparative cross sectional. Place Duration of Study: The study was conducted in the Department of ENT, Head and Neck Surgery at Combined Military Hospital (CMH) Peshawar from 21th October 2018 to 20th October 2019. Materials and Methods: In this study 60 patients undergoing tracheostomy were included. Patients were divided into two groups, each with 30 participants. Patients in group A had elective whereas group B had emergency tracheostomy. Short term complications including hemorrhage, surgical emphysema, cardiac arrest and stomal infection were noted in both groups. Chi-square test was applied as test of significance to compare the two groups. Results: Emergency tracheostomy is associated with significantly increased risk of hemorrhage and surgical emphysema (p value being <0.05. There was no statistical difference in occurrence of stomal infection and cardiac arrest between the two groups. Conclusion: Tracheostomy performed in emergency is fraught with complications. Our study validates the fact that emergency tracheostomy is associated with significantly increased risk of postoperative hemorrhage and surgical emphysema.

scholarly journals Evaluation of Side Effects Associated with COVID-19 Vaccines in Saudi Arabia

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 674
Author(s):  
Abdulaziz Alhazmi ◽  
Edrous Alamer ◽  
Dalia Daws ◽  
Mashael Hakami ◽  
Majid Darraj ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Saudi Arabia ◽  
Side Effects ◽  
Demographic Data ◽  
Short Term ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Post Vaccination ◽  
Final Sample ◽  
Study Participants

Background: Pfizer-BioNTech and Oxford-AstraZeneca are recently introduced vaccines to combat COVID-19 pandemic. During clinical trials, mild to moderate side effects have been associated with these vaccines. Thus, we aimed to evaluate short-term post-vaccination side effects. Methods: Cross-sectional, retrospective study using an online questionnaire was conducted among COVID-19 vaccines recipients in Saudi Arabia. General and demographic data were collected, and vaccine-associated side effects after receiving at least one dose of each vaccine were evaluated. Results: Our final sample consisted of 515 participants with a median age of 26 years. Most of the study participants were female (57%). Nearly 13% of the study subjects have reported previous infections with SARS-CoV-2. Oxford-AstraZeneca and Pfizer-BioNTech vaccines have been received by 75% and 25% of the study participants, respectively. Side effects associated with COVID-19 vaccines have been reported by 60% of the study subjects, and most of them reported fatigue (90%), pain at the site of the injections (85%). Conclusion: Side effects that are reported post Oxford-AstraZeneca and Pfizer-BioNTech vaccines among our study participants are not different from those that were reported in the clinical trials, indicating safe profiles for both vaccines. Further studies are needed to evaluate the effectiveness of the current vaccines in protection against SARS-CoV-2 reinfections.

scholarly journals Anaesthesia and anaesthesiologist speciality's knowledge assessment of paramedics in armed forces hospital: a questionnaire study

2021 ◽  
Author(s):  
Amit Kumar Kamewad ◽  
Shambhu Prasad Sharma ◽  
Sunny Eapen ◽  
Tarun Gupta
Keyword(s):  
Wide Spectrum ◽  
Armed Forces ◽  
Pain Clinic ◽  
Military Hospital ◽  
Current Investigation ◽  
Cross Sectional ◽  
Related Services ◽  
Paramedical Staff ◽  
Study Participants

Background: Science of anaesthesia has revolutionized from traditional only application of relieving patient from pain induced during surgery to wide spectrum approaches like palliative care, critical care, perioperative care along with pain management. Despite of such critical roles in health care sector there is still a lack of awareness about anaesthesiology and anaesthesiologists. Current investigation was aimed towards assessing the awareness of paramedical staff regarding the role of anesthesiology.Methods: Current investigation was a prospective cross-sectional questionnaire-based study conducted on 100 paramedical staff posted in different departments of military hospital Jaipur.  All the study participants were interviewed face to face orally by an investigator using the set of questions listed in the questionnaire. Participants responses were documented and statistically represented as percentage.Results: Current study findings reveal that even though majority of the study participants (91) had experience more than 5 years in the hospital and most of them (˃90%) of participants were having educational level of higher secondary or graduation still the role of anaesthesiologist outside operation theatre was poorly known to paramedical staff. It was also observed in current investigation that role of anesthetist in pain clinic was poorly known to most of the participating paramedical staff.Conclusions: Providing knowledge about expertise of anesthesiologist among paramedical staffs by incorporating anaesthesia in the curriculum, in house training programs, use of pamphlets, internet and other easily assessable techniques is highly desirable for spreading awareness of anaesthesia and anesthetist among paramedical staff, so that patient can avail anaesthesia related services effectively.

A View of the Lexical–Grammatical Link in Young Latinos With Specific Language Impairment Using Language-Specific and Conceptual Measures

2019 ◽  
Vol 62 (6) ◽  
pp. 1775-1786 ◽  
Author(s):  
Lucía I. Méndez ◽  
Gabriela Simon-Cereijido
Keyword(s):  
Low Income ◽  
Language Impairment ◽  
Specific Language Impairment ◽  
L2 Acquisition ◽  
Cross Sectional ◽  
Specific Language ◽  
Vocabulary Skills ◽  
In The Beginning ◽  
Study Participants ◽  
L1 And L2

Purpose This study investigated the nature of the association of lexical–grammatical abilities within and across languages in Latino dual language learners (DLLs) with specific language impairment (SLI) using language-specific and bilingual measures. Method Seventy-four Spanish/English–speaking preschoolers with SLI from preschools serving low-income households participated in the study. Participants had stronger skills in Spanish (first language [L1]) and were in the initial stages of learning English (second language [L2]). The children's lexical, semantic, and grammar abilities were assessed using normative and researcher-developed tools in English and Spanish. Hierarchical linear regressions of cross-sectional data were conducted using measures of sentence repetition tasks, language-specific vocabulary, and conceptual bilingual lexical and semantic abilities in Spanish and English. Results Results indicate that language-specific vocabulary abilities support the development of grammar in L1 and L2 in this population. L1 vocabulary also contributes to L2 grammar above and beyond the contribution of L2 vocabulary skills. However, the cross-linguistic association between vocabulary in L2 and grammar skills in the stronger or more proficient language (L1) is not observed. In addition, conceptual vocabulary significantly supported grammar in L2, whereas bilingual semantic skills supported L1 grammar. Conclusions Our findings reveal that the same language-specific vocabulary abilities drive grammar development in L1 and L2 in DLLs with SLI. In the early stages of L2 acquisition, vocabulary skills in L1 also seem to contribute to grammar skills in L2 in this population. Thus, it is critical to support vocabulary development in both L1 and L2 in DLLs with SLI, particularly in the beginning stages of L2 acquisition. Clinical and educational implications are discussed.

A Bird in the Hand Isn’t Good for Long

2018 ◽  
Vol 65 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Stefan Scherbaum ◽  
Simon Frisch ◽  
Maja Dshemuchadse
Keyword(s):  
Decision Making ◽  
Cognitive Control ◽  
The Other ◽  
Decision Task ◽  
Short Term ◽  
Additional Time ◽  
Control Processes ◽  
Folk Wisdom ◽  
Study Participants ◽  
Insight Into

Abstract. Folk wisdom tells us that additional time to make a decision helps us to refrain from the first impulse to take the bird in the hand. However, the question why the time to decide plays an important role is still unanswered. Here we distinguish two explanations, one based on a bias in value accumulation that has to be overcome with time, the other based on cognitive control processes that need time to set in. In an intertemporal decision task, we use mouse tracking to study participants’ responses to options’ values and delays which were presented sequentially. We find that the information about options’ delays does indeed lead to an immediate bias that is controlled afterwards, matching the prediction of control processes needed to counter initial impulses. Hence, by using a dynamic measure, we provide insight into the processes underlying short-term oriented choices in intertemporal decision making.

Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Risk Behaviors ◽  
Digital Health ◽  
Monitoring Program ◽  
Prescription Opioid ◽  
Research Database ◽  
Cross Sectional ◽  
Study Duration ◽  
Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

scholarly journals Undernutrition and associated factors in orphan children aged 6–59 months in Gambella Southwest, Ethiopia: A community-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045892
Author(s):  
Solomon Feleke ◽  
Gudina Egata ◽  
Firehiwot Mesfin ◽  
Gizachew Yilak ◽  
Abebaw Molla
Keyword(s):  
Associated Factors ◽  
Wealth Index ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Orphaned Children ◽  
Access To Health ◽  
Study Participants ◽  
Children Under 5

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.

scholarly journals Association of breastfeeding and risk of metabolic syndrome and its components in postmenopausal parous women: Korea national health and nutrition examination survey (2010 ~ 2016)

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Jusuk Lee ◽  
Taehong Kim
Keyword(s):  
Metabolic Syndrome ◽  
Laboratory Data ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Korean Women ◽  
Cross Sectional ◽  
Increased Risk ◽  
Nationally Representative ◽  
Study Participants

Abstract Background Understanding the relationship between breastfeeding (BF) and metabolic syndrome (Mets) is important for maternal long-term health benefits and disease prevention. This study aimed to examine the association between BF and Mets and its components among postmenopausal parous Korean women. Methods This cross-sectional study on 10,356 Korean women used nationally representative data from the KNHANES from 2010 to 2016. Anthropometric, laboratory data and manual BP were measured. A multivariate logistic regression analysis was conducted to examine the association of BF with Mets and its components after adjusting for potential confounding variables. A p-value < 0.05 was to be considered statistically significant. Results Mets was present in 42% of the study participants. The BF group had low household income and education level. The prevalence of Mets in the BF group was higher than that in the non-BF group (42.69% vs. 34.76%, p <  0.001). BF was associated with increased risk of Mets (odds ratio [OR]: 1.4, 95% confidence interval [CI]: 1.18–1.65, p <  0.001). The BF group was at higher risks for diabetes (OR: 1.5, 95%CI: 1.14–1.98), hypertension (OR: 1.32, 95%CI: 1.03–1.68), hypertriglyceridemia (OR: 1.42, 95%CI: 1.02–1.99) and low high-density lipoprotein cholesterol (OR: 1.32, 95%CI: 1.06–1.65). Conclusion In this study, BF did not affect decreasing the prevalence of Mets and its components.

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