scholarly journals Outcome of Minigrafting In Stable Vitiligo: An Insight from Libya

2020 ◽  
Vol 4 (2) ◽  
pp. 15-22
Author(s):  
Fauzia Musbah

Background and aims. Autologus with punch minigrafting has been suggested as an alternative surgical method for treating stable vitiligo in refractory patients to induce regimentation. The current study was conducted to evaluate the long-term results of surgical punch minigrafting in patients with resistant vitiligo vulgaris, segmental and focal vitiligo. Methods: Case series prospective exploratory study design was performed in Tripoli central hospital (TCH) and private clinic among patient with confirmed vitiligo vulgaris, segmental and focal vitiligo, during the period from 2009 -2019. Data were presented as descriptive statistics using SPSS version 22. Chi-square test was used to test the significance of data with the level of 0.05 considered as significant level. Results: A total of 28 patients presented with vitiligo, of them 26 (92.9%) were females and 2 (7.1%) were males, with age ranging from 11-46 years old. The re-pigmentation of vitiligo was (53.6%) vulgaris, (28.6%) segmental, and (17.9%) focal vitiligo, with stable disease that did not have any new lesions at least 12 months with the disease ranging from one year (7.2%) and up to 30 years. The main instruments used with these cases were; skin punch size between 2mm (28.6%), 2.5mm (32.1%), and 4 to 6mm (10.7 %). The donor sites where selected to match the recipient sites either behind ear 39.3%, thighs 43%, while 3.6% were not previously affected by the disease. Conclusion. It has been suggested that mini grafting is a proper treatment option for treating patients with stable vitiligo, by using a small size punch, that is less than 2mm.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Macedo ◽  
P Rueda ◽  
L Serafim ◽  
E Oliveira ◽  
S Santos ◽  
...  

Abstract Background AF is reported in up to 20% of patients with Chagas, a prevalent disease in Latin-America. PV isolation (PVI) in the cornerstone of AF ablation. However, in Chagas cardiopathy (ChC), microvascular and autonomic abnormalities, atrial fibrosis and sinoatrial dysfunction are possible mechanisms of AF. Therefore, the results of PVI may be different in this subgroup. Objectives To describe long-term results of AF ablation in pts with Chagas versus non-Chagas disease (ChC x NonCh) and evaluate risk factors for post-ablation recurrence. Methods This is a prospective, single-center study that included pts with nonvalvular AF who underwent PVI between 2013 and 2016. All procedures were guided by eletroanatomic mapping and intracardiac echocardiogram. Categorical variables were analyzed using chi-square test and numerical variables with t-student test. Binary logistic regression was performed to identify independent predictors of recurrence of any sustained atrial tachyarrhythmias. Results Ablation was performed in 160 pts (54±15 yo, 59% male): 42 pts with ChC (26%, 62±8 yo) and 118 NonChC (74%, 53±15 yo; p<0,001)). There was no difference in AF type (38x34% paroxysmal, 42x43% persistent, and 19x23% long-term persistent, p=NS) and left atrium diameter (38±5 vs 40±8mm, p=NS). In ChC the mean CHADSVASC score was higher (2.4 vs 1.4, p<0,001) and LVEF was lower (52±18% vs 64±8%, p=0.02). After a follow-up of 31±14 mo and 1.1 ablation per group, recurrence of AF/AT was higher in ChC (33% vs 14%, p=0.03) although more pts with Chagas were on AAD (71 vs 31%, p<0,001). During follow-up, occurrence of embolic events and cardiac or all-cause mortality were not different between groups (0% vs 1.7%, p=NS and 2.4 vs 1.7% p=NS; for ChC vs and NonChC, respectively). At multivariate analysis, long-term persistent AF, hypertension and Chagas disease (HR= 2.21, 3.36 and 3.16, respectively) were independent predictors of recurrence. Conclusions Chagas disease is an independent predictor of recurrence after PVI. Further studies should address which strategy is more appropriate to this group of patients.


2021 ◽  
Vol 29 (3) ◽  
pp. 143-148
Author(s):  
DAVI DE PODESTÁ HAJE ◽  
SYDNEY ABRÃO HAJE ◽  
JOSÉ BATISTA VOLPON ◽  
ANA CAROLINA OLIVEIRA DA SILVA ◽  
LEONARDO FERREIRA BRAZ LIMA ◽  
...  

ABSTRACT Objective: Pectus excavatum is a deformity that affects aesthetics and causes emotional disorders. Surgical correction is well established, but conservative treatment is less common. We investigated the long-term results of using a brace and performing specific physical exercises to treat localized pectus excavatum, a type of deformity in which the depressed area is restricted to the midline region along the nipple line. Methods: We selected 115 patients (mean age 12.8 years), with a minimum follow-up of 36 months, who were evaluated more than one year after the end of treatment and skeletal maturity. Results were correlated with deformity flexibility, severity, regular use of the device, and performance of specific exercises. The chi-square (χ2) and the Cochran-Mantel-Haenszel tests were used for statistical analysis. Results: Treatment was successful in 58% of patients, however, when exercises were performed and the brace was used regularly by patients with flexible deformities, the rate increased to 83% (p = 0.005). Severity and adherence to treatment greatly impacted successful treatment (p = 0.009 and < 0.001, respectively). Conclusion: The proposed treatment method was effective for correction or partial correction of the deformity in motivated patients followed up until skeletal maturity, especially when started early in milder and more flexible deformities. Level of Evidence V, Expert opinion.


2021 ◽  
Author(s):  
sahar ahmadi ◽  
azam maleki

Abstract Background: It is important to evaluate the long-term effects of the Covid 19 epidemic on the tendency of midwives to leave their jobs. The study was aimed to examine the intention to leave work and its relationship with job burnout among midwives working at Ayatollah Mousavi hospital of Zanjan one year after the Covid-19 disease. In a descriptive-analytical study, the tendency of 88 midwives to leave their jobs was evaluated one year after the outbreak of Covid disease in 2021. The midwives were selected by convenience sampling methods. Data were collected using the Maslach burnout questionnaire and Attwood and Hinshaw tendency to leave the job. Data analyzed by descriptive statistics, Chi-square test, Pearson correlation coefficient, multiple linear regression model with the stepwise method at 95% confidence level.Results:The mean tendency to leave the job was 29.71 ± 6.75. Most of the midwives have a moderate level of the tendency to leave the job (47.7%). There was a significant positive correlation between all three components of burnout and the tendency to leave the job. The odds of leaving the job were 0.344 times higher in people with high emotional fatigue and 0.276 times in people with rotational shift work.Conclusion:It can be concluded that the tendency to leave the job was moderate. Given the relationship between emotional fatigue and the tendency to leave the job, planning to increase the mental strength and resilience of midwives during the epidemic of COVID-19 seems necessary.


2020 ◽  
Vol 13 (52) ◽  
pp. 102-106
Author(s):  
Ana de Lourdes Sá de Lira ◽  
Cassius Wander Coelho Martins ◽  
Luis Paulo da Silva Dias ◽  
Tito Cacau Sousa Santos

Objective: To assess primary molars early loss in mixed dentition prevalence. Method: A study was carried out in children aged 6 to 12 years. Deciduous molar loss was considered early when it occurred before Nolla stage 6 (full formed crown) of the permanent successor or one year before its physiological exfoliation. Periapical radiographs were obtained to verify the presence of the permanent successor and the level of root formation, as well as the need for placement of fixed space maintainer lingual arch or Nance button. For the study of frequency distribution of early dental loss in relation to gender and dentition, we used the Chi-square test of 5% probability level and the non-parametric Mann-Whitney test for adequate statistical analysis. Results: Of the 315 children examined, 159 (50.47%) were male and 156 (49.52%) were female. Only 25 (7.9%) presented multiple dental losses in the posterior region, 19 in the lower arch and 6 in the upper arch. In the inferior one there was predominance of first and second deciduous molars loss. There was no difference in the association between genders and the occurrence of multiple dental losses (χ² (1) = 0.03, p>0.05). Conclusion: The prevalence of deciduous teeth premature loss was of 7.9% and the most affected teeth were the first and second molars in the lower arch. Lingual arch space holders were installed in 6 children, who will remain with it until the permanent successors erupt into the oral cavity.


2019 ◽  
Author(s):  
Leila Ahmadian ◽  
Reza Khajouei ◽  
Sudabeh Kamali ◽  
Moghaddameh Mirzaee ◽  
Arefeh Ameri

BACKGROUND Today, the Internet may be a promising tool for interventions for pregnant women. However, these kinds of tools are only helpful if users are ready to use them. OBJECTIVE The present study was conducted with the aim of readiness assessment of pregnant women to use the Internet to access health information about pregnancy and childbirth. METHODS This study was carried out on a sample of 384 pregnant women. Data were collected using a valid and reliable questionnaire. The first section of this questionnaire collected demographic characteristics of the participants. The second part of the questionnaire contains 27 questions covering the following components: infrastructure readiness (6 questions); affordability readiness (3 questions); and skill readiness (12 questions). Data were analyzed with SPSS 19.0 using descriptive statistics, Chi-square test, and T-test. RESULTS This study was carried out on a sample of 384 pregnant women. Data were collected using a valid and reliable questionnaire. The first section of this questionnaire collected demographic characteristics of the participants. The second part of the questionnaire contains 27 questions covering the following components: infrastructure readiness (6 questions); affordability readiness (3 questions); and skill readiness (12 questions). Data were analyzed with SPSS 19.0 using descriptive statistics, Chi-square test, and T-test. CONCLUSIONS The use of the Internet by pregnant women depends on factors such as infrastructure, affordability, and skills readiness. This study showed that speed and the quality of the Internet, hardware and software availability, affordability of the Internet, and access to the Internet training were factors in measuring E-health readiness assessment. CLINICALTRIAL Not applicable


2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koech Irene ◽  
Poli Philippe Amubuomombe ◽  
Richard Mogeni ◽  
Cheruiyot Andrew ◽  
Ann Mwangi ◽  
...  

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Etsuko Tsuda ◽  
Shinsuke Hoshino ◽  
Yasuhide Asaumi ◽  
Yosuke Hayama ◽  
Osamu Yamada

We report the results of percutaneous transluminal coronary rotational atherectomy (PTCRA) for localized stenosis caused by Kawasaki disease (KD). Thirteen male and a female, aged 5 to 29 years (median 13 years), underwent PTCRA and the interval from the PTARA to the latest angiogram ranged from 3 months to 16 years (median 6 years). The target vessels were the left anterior descending artery (3 patients), the left circumflex (2), left main trunk (2) and the right coronary artery (7). The immediate results of PTCRA were successful in all patients, and the mean stenosis degree improved from 86 ± 11% to 36 ± 13%. Five cardiac events occurred within one year (acute myocardial infarction 2, transient complete atrioventricular block 1 and re-PTCRA 2). The survival rate and cardiac event free rate at 15 years after PTCRA were 93% and 71%, respectively. For the graft patency, 4 pts who underwent PTCRA within 10 yeas old, had asymptomatic occlusion within 1 year. The patency rate at 15 years after PTCRA was 69%, in 10 pts who underwent it more than 10 years old. Cardiac events and restenosis occurred within a year after PTCRA. The results in patients less than 10 years old was poor. If a graft is patent in one year after procedure, long-term patency may be expected in patients more than 10 years old.


2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.


Author(s):  
Ana Clariza Natanauan ◽  
Jenmart Bonifacio ◽  
Mikael Manuel ◽  
Rex Bringula ◽  
John Benedic Enriquez

This descriptive-exploratory study attempted to give the readers a portrait of cyber café gamers in Manila. It determined the profile of gamers, their gaming usage, and their purposes of cyber café gaming. Descriptive statistics revealed that most of the respondents were Manila settlers, students, pursuing or had obtained college degrees, male, young, Roman Catholic, single, belonged to middle-income class, and played games in cyber cafés in the afternoon once to twice a week. One-way chi-square showed that frequency of gaming was not equally distributed in a week and gamers showed tendency to play games in a cyber in a particular time of the day. Real-time strategy games were the most frequently played games in cyber cafés. To recreate, to relieve boredom, and to have fun were the top three reasons in playing games in cyber cafés. Conclusions and directions for future research were also presented.


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