Risk Factors that Affect Morbidity and Mortality in Patients with Perforated Peptic Ulcer Diseases in a Teaching Hospital

Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting.Methods: A two years (January 1, 2016 - December 30, 2018) retrospective cross- sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa,Ethiopia.Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was <10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(2-30)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP <90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate.Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential.

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Patients With Perforated Peptic Ulcers: Risk Factors for Morbidity and Mortality

International Surgery ◽

10.9738/intsurg-d-15-00180.1 ◽

2019 ◽

Vol 103 (11-12) ◽

pp. 578-584

Author(s):

Fatih Ciftci ◽

Fazilet Erözgen

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Postoperative Period ◽

Perforated Peptic Ulcer ◽

Apache Ii ◽

Morbidity And Mortality ◽

Apache Ii Score ◽

Peptic Ulcers ◽

Presentation Time ◽

Independent Risk Factors

Perforated peptic ulcers continue to be an important problem in surgical practice. In this study, risk factors for peptic ulcer perforation-associated mortality and morbidity were evaluated. This is a retrospective study of patients surgically treated for perforated peptic ulcer over a decade (March 1999–December 2014). Patient age, sex, complaints at presentation, time lapse between onset of complaints and presentation to the hospital, physical findings, comorbidities, laboratory and imaging findings, length of hospitalization, morbidity, and mortality were recorded. The Mannheim peritonitis index (MPI) and Acute Physiology and Chronic Health Evaluation (APACHE) II score were calculated and recorded for each patient on admission to the hospital. Of the 149 patients, mean age was 50.6 ± 19 years (range: 17–86). Of these, 129 (86.5%) were males and 20 (13.4%) females. At least 1 comorbidity was found in 42 (28.1%) of the patients. Complications developed in 36 (24.1%) of the patients during the postoperative period. The most frequent complication was wound site infection. There was mortality in 26 (17.4%) patients and the most frequent cause of mortality was sepsis. Variables that were found to have statistically significant effects on morbidity included age older than 60 years, presence of comorbidities, and MPI (P = 0.029, 0.013, and 0.013, respectively). In a multivariate analysis, age older than 60 years, presence of comorbidities, and MPI were independent risk factors that affected morbidity. In the multivariate logistic regression analysis, age older than 60 years [P = 0.006, odds ratio (OR) = 5.99, confidence interval (CI) = 0.95] and comorbidities (OR = 2.73, CI = 0.95) were independent risk factors that affected morbidity. MPI and APACHE II scoring were both predictive of mortality. Age older than 60, presentation time, and MPI were independent risk factors for mortality. Undelayed diagnosis and appropriate treatment are of the utmost importance when presenting with a perforated peptic ulcer. We believe close observation of high-risk patients during the postoperative period may decrease morbidity and mortality rates.

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Detecting chronic kidney disease in diabetic adults by estimating glomerular filtration rate and Serum Creatinine

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v7i1.926 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Ahmed Kh. Mohammed Almaawi

Keyword(s):

Risk Factors ◽

Serum Creatinine ◽

Cross Sectional Study ◽

P Value ◽

Diabetic Patients ◽

Kappa Index ◽

Chi Square ◽

Cross Sectional ◽

Female Ratio ◽

Qualitative Variables

Objective: To assess CKD prevalence and risk factors including socio-demography among diabetics by estimating GFR rather than serum creatinine (sCr). Methods: A cross-sectional study was conducted in Dec. 15 2019 through Aug. 15 2020, among 800 diabetics attending tertiary diabetes centers, Baghdad. Data was collected by self-administered questionnaire. SPSS was used for data analysis by (mean, standard deviation and T-test) for quantitative variables and (frequency, percentage, Chi-square test and Kappa index) for qualitative variables. P-Value less than 0.05 was considered significant. Results: 800 diabetics for last 5-40 years, 95.6% with type2. Aged 52.1±13.2 years, with male: female ratio 1.03:1, 63.6% were with no income, sCr level was 0.86±0.3 mg/dl, and eGFR by Cockcroft Gault (CG) and CKD-EPI equations was 100.4±36.5 & 92.2±25.5 ml/min/1.73m2 respectively. CKD prevalence based on sCr, and eGFR assessed by above equations was 13.3%, 20% and 15.9% respectively (p<0.001). Those with CKD were hypertensive, females, and living in peripheries. Conclusions: Diabetic patients, mainly those with risk factors are more likely to develop CKD. It is better to detect CKD intially by estimating the GFR, rather than serum creatinine level alone. Furthermore, using CKD-EPI equation might be better than the CG formula to estimate the GFR.

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Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195941 ◽

2019 ◽

Vol 8 (1) ◽

pp. 344

Author(s):

Bushra . ◽

Ambreen Ghori ◽

Azra Ahmed ◽

Najma Dalwani ◽

Mushtaque Ali Shah ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Previous History ◽

Cross Sectional Study ◽

University Hospital ◽

Prior History ◽

Singleton Pregnancy ◽

Cross Sectional ◽

History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

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Prevalence of Eclampsia and its Maternal-fetal outcomes at Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019. Retrospective study

10.21203/rs.3.rs-33298/v1 ◽

2020 ◽

Author(s):

Addisu Yeshambel ◽

Walellign Anmut

Keyword(s):

Magnesium Sulfate ◽

Addis Ababa ◽

Fetal Outcome ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Morbidity And Mortality ◽

Memorial Hospital ◽

Fetal Outcomes ◽

Cross Sectional ◽

Sub Saharan

Abstract Background: Eclamptic disorder of pregnancy is one of the common problems in sub-Saharan countries and forms one of the deadly triads along with hemorrhage and infection which complicates maternal and fetal outcomes of pregnancy. To assess the prevalence of eclampsia and its maternal and fetal outcome in Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019.Methods: A descriptive retrospective cross-sectional study was used on randomly selected 185 women who attended delivery at Ghandi memorial Hospital from 1st of September 2017 to –last of August 2018. Data were analyzed using SPSS version 25 software. Descriptive statistics were used to calculate frequencies and percentages and data was presented using texts and, tables. Results: Out of the 2,973 deliveries, the prevalence of eclampsia was found to be 16.1%. About 89.7% had reported a history of prior pregnancy-induced hypertension and 73.5% induced their current pregnancy following eclampsia. From mothers required interventions to terminate the pregnancy by induction, 47.8% ended by cesarean section secondary to non-reassuring fetal status (29.2%). The majority (91.9%) had taken magnesium sulfate for the management of convulsion and 86.5% had taken hydralazine for hypertension management. Abruption of the placenta (96.2%), postpartum-hemorrhage (89.2%), and HEELP syndrome (83.8 %) were major maternal adverse outcomes reported, and 33% of pregnancy was ended as stillbirth followed by low birth weight (28.6%). Over 53.6% of delivered babies had an APGAR score of less 4 and 30.4% of neonates required admission to nursery/NICU referral. Conclusion: The prevalence of eclampsia was high, with corresponding high maternal and perinatal morbidity and mortality. Increasing early detection before pregnancy, antenatal screening, and use of magnesium sulfate to control convulsions will reduce the disorder and associated morbidity and mortality for both mother and fetus.

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Alcohol use disorder and its determinant factors among patients with schizophrenia attending treatment at mental specialized hospital, Addis Ababa, Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211048748 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110487

Author(s):

Habtamu Tadesse ◽

Yohannes Mirkana ◽

Tadesse Misgana

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Addis Ababa ◽

Previous History ◽

Cross Sectional Study ◽

Cross Sectional ◽

Duration Of Illness ◽

Specialized Hospital ◽

Audit Score ◽

History Of

Background: Alcohol use disorder is one of the primary causes of avoidable death, illness, and injury in many societies throughout the world. Although alcohol use disorder can influence the natural history of a disease, disease recurrence, quality of life, and treatment adherence in psychiatric patients, the data on its magnitude is scarce. Objectives: This study was aimed to determine the magnitude of alcohol use disorder and its determinants among patients with schizophrenia attending a mental specialized hospital in Addis Ababa, Ethiopia. Methods: An institutional-based cross-sectional study was conducted from May 15 to June 15, 2018. An alcohol use disorder identification test was employed among a sample of 414 randomly selected patients with schizophrenia. Alcohol use disorder was categorized as hazardous drinking (Alcohol Use Disorders Identification Test (AUDIT) score of 8–15), harmful drinking (AUDIT score of 16–19), and alcohol dependence (AUDIT score of 20 or above). The data were entered into Epi-Data 3.1 and exported to SPSS 20 for analysis. Logistic regression was fitted to identify factors associated with alcohol use disorder. Results: The prevalence of alcohol use disorder was 38.4% (95% confidence interval (CI) 33.7, 42.9). Of this, 22.4% of the patients had hazardous drinking, 8.4% harmful drinking, and 7.6% alcohol dependence. Factors associated with alcohol use disorder were male sex (adjusted odds ratio (AOR) = 5.8, 95% CI 2.55, 13.19), being single (AOR = 3.0, 95% CI 1.63, 5.51), divorced (AOR = 4.3, 95% CI 1.95, 9.47) and widowed (AOR = 3.5, 95% CI 1.39, 8.81), having family history of alcoholism (AOR = 3.8, 95% CI 1.98, 7.19), longer duration of illness (AOR = 3.9, 95% CI 1.83, 8.36), previous history of psychiatric diagnosis (AOR = 2.2, 95% CI 1.1, 4.34), and concomitant use of non-alcoholic substances (AOR = 3.7, 95% CI 2.06, 6.74). Conclusions: Almost four in ten patients with schizophrenia had alcohol use disorder. Male sex, single, divorced, and widowed, family history of alcohol use, long duration of illness, previous history of psychiatric diagnosis, and concomitant use of non-alcoholic substances were significantly associated with alcohol use disorder. Continuous counseling of at risk populations about alcohol consumption should be strengthened.

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Prevalence and Associated Factors of Utero-Vaginal Prolapse in AddisAbaba, Ethiopia: A Cross-Sectional Study.

10.21203/rs.3.rs-144888/v1 ◽

2021 ◽

Author(s):

Zelalem Mekuria ◽

Abdu Mengesha ◽

Girma Seyoum

Keyword(s):

Risk Factors ◽

Addis Ababa ◽

Cross Sectional Study ◽

Home Delivery ◽

Health Concern ◽

Uterovaginal Prolapse ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

Abstract Background: Uterovaginal prolapse (UVP) is a major women’s health concern throughout the world. Globally, 2-20% of all women are affected by UVP. The mean prevalence of pelvic organ prolapse in developing countries is 19.7%. The prevalence of UVP in Ethiopia is 18.55% among all gynecological operations. UVP is a source of severe morbidity and psychological upheaval to the patient, who is often socially withdrawn and stigmatized. UVP negatively affects socioeconomic and reproductive activity of affected women. It is, therefore, of interest to study its prevalence and factors associated with the condition.Methodology: Institution-based retrospective cross-sectional study was conducted in selected Addis Ababa city governmental hospitals and the medical record charts of women admitted in the respective gynecology wards were reviewed. The medical records included in this study were those from March 2017 to February 2019 G.C. and 400 records of admitted women were randomly selected. The data were analyzed using SPSS version 24 statistical package. Bivariate and multivariate logistic regression analyses were carried out to determine factors associated with UVP. A p-value < 0.05 was considered as significant.Result: Out of the3,949 admitted women, the prevalence of UVP was 12.8%. The leading determinants of UVP were menopause (OR = 2.611 (at 95 % CI: 1.531, 3.838), age > 40 years (OR = 2.143 (at 95 % CI:1.496, 6.602), parity of > 4 (OR = 4.201 (at 95 % CI 1.652, 10.685), age at first delivery of < 20 years old (OR = 7.988(2.682, 23.792) and home delivery (OR = 1.380 (at 95 % CI:1.212, 2.572). Conclusion: The prevalence of UVP in this study was relatively high. The major risk factors of UVP were menopause, having > 4 deliveries, age > 40 years, age at first delivery < 20 years old and home delivery. Therefore, the findings of this investigation, especially identification of risk factors of UVP, could serve as a basis for taking steps for preventing or reducing the prevalence of UVP and related complications.

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Patient’S Knowledge of Cardiovascular Diseases Risk Factors and Associated Factors Among Adult Cardiac Patients in Selected Health Institutions; A Cross Sectional Study, Addis Ababa, Ethiopia 2021 G.C.

10.21203/rs.3.rs-1119085/v1 ◽

2021 ◽

Author(s):

Bezina Damtew ◽

Yoseph Tsige ◽

Ketema Bizuwork ◽

Sosina Workineh

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Health Care Policy ◽

Addis Ababa ◽

Sampling Technique ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Sufficient Knowledge

Abstract Background cardiovascular related disorders are a major public health challenge in globally as well as in Ethiopia. It is crucial to improve the life style of the community at the same time it is a key for health care policy to give emphasis for prevention by educating the community by different ways. Therefore, the current study patient’s knowledge about risk factors related to those diseases. Method A facility-based descriptive cross-sectional study design was conducted. 420 Participants selected by systematic random sampling technique from April 01, 2021 until Jun 28, 2021 and met the criteria were included. Data was collected by interviewer-administered questionnaire. Level of knowledge was assessed by the Heart Disease Fact Questions. Bivariate and multivariate logistic regression was done to identify factors associated with identified class of knowledge. P-value less than 0.05 was considered as to indicate statistical significances. Result The result showed that most of the study subjects were in the age range of >54. The mean age was 48.7 ± 13 years. 255(62.7%) were females. 300(71.6%) of participants have sufficient knowledge toward cardiovascular diseases risk factors. Age, Sex, Place of residence, Status of education and Marital status was significantly associated with Participant’s knowledge (p<0.05, 95% C. I). Conclusion The majority of participants had sufficient knowledge regarding cardiovascular diseases risk factors. Maintaining good status, implementation of innovative interventions and structured, nurse-led lifestyle counseling would be required to effectively guide patients.

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Acute Mountain Sickness in the Pyrenees: an observational cross-sectional study

10.21203/rs.3.rs-37886/v1 ◽

2020 ◽

Author(s):

Clara Weisweiler ◽

Marc Ayala ◽

Iñigo Soteras ◽

Enric Subirats ◽

Joan Carles Trullàs

Keyword(s):

Risk Factors ◽

Physical Condition ◽

Acute Mountain Sickness ◽

Previous History ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Inflammatory Drugs ◽

Mountain Sickness

Abstract Background The prevalence of acute mountain sickness (AMS) ranges between 15% and 80% depending on the absolute altitude reached, speed of ascent, and individual susceptibility. However, there is a lack of information regarding AMS at moderate to high altitudes (2,500-3,500 m) and, even less, in the Pyrenees. Our aim is to determine the prevalence and risk factor of AMS in the Pyrenees. Methods A cross-sectional study including mountaineers who climbed a mountain with a height greater than 2,500 m in the Pyrenees region during July and August 2019. Sociodemographic data, medical history and activity information were collected using a questionnaire. The diagnosis of AMS was based on the 2018 modified Lake Louise Score. A logistic regression analysis was performed to examine the association of different variables (risk factors) and AMS. Results From 437 participants, 117 met diagnostic criteria of AMS, establishing a prevalence of 26.7% (95% confidence interval: 22.6%-30.9%). Individuals affected by AMS had mild (88%) or moderate (12%) affection. The most common symptoms (in addition to headache which is mandatory for AMS diagnosis) were fatigue or weakness, gastrointestinal symptoms and dizziness. In an adjusted multivariate analysis, heavy perceived exertion, bad physical condition, nonsteroidal anti-inflammatory drugs use and previous history of altitude illness were independent risk factors for developing AMS. Conclusions One fourth of climbers in the Pyrenees experienced mild or moderate AMS. Previous history of AMS, nonsteroidal anti-inflammatory drugs use and other modifiable risk factors such as physical exertion and physical condition were strong and independent predictors of AMS. These findings suggest that educational/informational programs for individuals planning to climb to moderate-high altitudes in the Pyrenees may contribute to prevent AMS.

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Prevalence of Perinatal Asphyxia with Evaluation of Associated Risk Factors in a Rural Tertiary Level Hospital

KYAMC Journal ◽

10.3329/kyamcj.v8i1.33873 ◽

2017 ◽

Vol 8 (1) ◽

pp. 43-48 ◽

Cited By ~ 4

Author(s):

Mohammed Solayman ◽

Sayama Hoque ◽

Taslima Akber ◽

Md Imtiajul Islam ◽

Md Anwarul Islam

Keyword(s):

Risk Factors ◽

Perinatal Asphyxia ◽

Cross Sectional Study ◽

Neonatal Unit ◽

Cross Sectional ◽

Socioeconomic Condition ◽

Female Ratio ◽

Mortality And Morbidity ◽

Fetal Risk ◽

Associated Risk Factors

Background: Perinatal asphyxia (PNA) is one of the most important causes of perinatal mortality and morbidity which can be preventable and managable.Objectives: The purpose of the study was to determine the prevalence of perinatal asphyxia and to explore the factors influencing or related to the development of the PNA.Materials and Methods: It is a cross-sectional study conducted in the neonatal unit of department of pediatrics, KYAMC hospital from January 2015 to December 2016. Two hundred eleven neonates admitted in neonatal unit including SCABU were enrolled in the study considering inclusion criteria. Necessary information about sociodemography, peri-natal history (including antepartum, intrapartum and fetal risk factors) were collected by detailed history taking on a pre-designed questionnaire. Clinical examinations and outcomes were also recorded. We used Student's t-test and ?2-test to determine the association of PNA with various risk factors.Results: The male to female ratio was 1.6:1. The mean age of the neonates during admission time was 3.66 (±5.506) days (in PNA 1.8±2.803 days and in normal group 6.11±7.047 days). The overall prevalence of PNA was 56.9% (120); male 60.8% (73) and female 39.2% (47). Identified significant materno-fetal risk factors were maternal young age (p= .038), low socioeconomic condition (p = .000,) primiparity (p = .003), muconium stained amniotic fluid (p = .004), obstructed labour (p = .019), low birth weight (p = .009) and home vaginal delivery by local dai and midwives (p = .017). Serious neonatal complications noted among the asphyxiated babies were hypoxic ischemic encephalopathy with convulsion, neonatal jaundice, septicemia, transient tachypnoea of neonate, hypoglycemia, respiratory distress syndrome, caput succedaneum and feeding problem.Conclusions: Findings of this study highlight the need for the better obstetrical care and awareness of the possible presence of the risk factors of PNA among mothers and fetus, so that the occurrence and worsening of PNA could be prevented or at least appropriately managed. It can reduce the high incidence of morbidity and mortality due to birth asphyxia.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 43-48

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Post-dural (post-lumbar) puncture headache: Risk factors and clinical features

Cephalalgia ◽

10.1177/0333102412453951 ◽

2012 ◽

Vol 32 (12) ◽

pp. 916-923 ◽

Cited By ~ 69

Author(s):

Jane A Amorim ◽

Mauro V Gomes de Barros ◽

Marcelo M Valença

Keyword(s):

Risk Factors ◽

Lumbar Puncture ◽

Elective Surgery ◽

Previous History ◽

Cross Sectional Study ◽

Binary Logistic Regression Analysis ◽

Neck Stiffness ◽

Cross Sectional ◽

Number Of Patients ◽

Headache Onset

Objective: This is an analytic, interventional, cross sectional study to evaluate the risk factors of post-dural (post-lumbar) puncture headache (PDPH) and the validity of the diagnostic criteria for PDPH from the ICHD II. Methods: Six-hundred-and-forty patients (332 non-pregnant women and 308 men) aged 8–65 years underwent spinal anesthesia with Quincke 25G or 27G needles in elective surgery. Results: Forty-eight (7.5%) of the patients developed PDPH. The binary logistic regression analysis identified as risk factors: gender [11.1% female vs. 3.6% male, OR 2.25 (1.07–4.73); p = 0.03], age [11.0% 31–50 years of age vs. 4.2% others, OR 2.21 (1.12–4.36); p = 0.02], previous history of PDPH [26.4% positive vs. 6.2% negative, OR 4.30 (1.99–9.31); p < 0.01] and bevel orientation [16.1% perpendicular vs. 5.7% parallel, OR 2.16 (1.07–4.35); p = 0.03]. The period of latency between lumbar puncture and headache onset range from 6 to 72 hours and the duration from 3 to 15 days. In 34/48 (71%) patients with PDPH, at least one of the following was present: neck stiffness, tinnitus, hypoacusia, photophobia, or nausea. Conclusion: In conclusion, 14/48 patients (29%) suffered none of the above-mentioned symptoms, indicating that a significant number of patients may suffer from PDPH in the absence of any symptoms apart from the headache itself. This suggests that a further analyses of existing studies should be made to determine if a criteria change may need consideration.

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