scholarly journals Axillary Artery Injuries Surgical experience review in a single vascular trauma center

2020 ◽  
Vol 16 (1) ◽  
pp. 4-9
Author(s):  
Bahaa I. Hamza

Background: Injuries to blood vessels are among the most dramatic challenges facing trauma surgeons because repair is often urgent, the surgeon has to decide between management options (open or endovascular), and gaining control and reconstructing a major arterial injury can be technically demanding .Objective:,To analyze the cause of injury, surgical approach, outcome and complications of axillary artery injuries.Methods A descriptive cross-sectional study on fifty patients at Ibn-Alnafees hospital in Baghdad from January 2005 to December 2010Results Males were more commonly affected than female with ratio of 6.1:1. Most injuries were caused by bullet and shell (84%), followed by stab wounds (10%) and blunt trauma (6%). Patients were divided into three groups according to the involved part of the axillary artery: the first part, the second part and the third part. The second part represents most of the cases (48%), the third part account for (30%), while the least is the first part (22%). Resection and end to end anastomosis was done in 80% of the cases, lateral repair in 8%, graft interposition in 8 % and ligation in 4%.Conclusion: The outcome of the injury in this study was in general good. The morbidity of the patients due to nerve injury and wound infection still problem. Mortality due to associated injury and delayed presentation was 4% which is acceptable as compared with other studies.

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2380
Author(s):  
Eduardo Sánchez-Sánchez ◽  
Jara Díaz-Jimenez ◽  
Ignacio Rosety ◽  
Maria José M. Alférez ◽  
Antonio Jesús Díaz ◽  
...  

The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the “third wave” of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress—more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the ‘third wave’ of this pandemic increased food consumption.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.


2021 ◽  
Vol 17 ◽  
Author(s):  
Mansoureh Refaei ◽  
Soodabeh Aghababaei ◽  
Mansoureh Yazdkhasti ◽  
Farideh Kazemi ◽  
Fatemeh Farahmandpour

Background: Several risk factors have been identified for postpartum hemorrhage, one of which being the duration of the third stage of labour. This stage refers to the interval between the expulsion of the fetus to the expulsion of the placenta. Some bleeding occurs in this stage due to the separation of the placenta Objective: This study aimed to identify the factors associated with the length of the third stage of labour. Methods: In this cross-sectional study, 300 women hospitalized for vaginal birth were selected via convenience sampling. The study data were collected using a researcher-made questionnaire. Then, the data were analyzed using univariate and multivariate linear regression analyses. Results: The mean (SD) age of the participants was 26.41 (6.26) years. Investigation of the relationship between the study variables and the time of placental separation indicated that a minute increase in the length of membranes rupture caused a 0.003minute decrease in the time of placental separation. However, this time increased by 2.75, 6.68, and 2.86 minutes in the individuals without the history of abortion, those with the history of stillbirth, and those who had not received hyoscine, respectively. The results of multivariate analysis indicated that suffering from preeclampsia or hypertension, history of stillbirth, not receiving hyoscine, and not receiving misoprostol increased the length of the third stage by 4.40, 8.55, 2.38, and 6.04 minutes, respectively. Conclusion: Suffering from preeclampsia and having the history of stillbirth increased and using hyoscine and misoprostol decreased the length of the third stage of labour. However, no significant relationship was found between the length of the third stage of labour and mother’s age, gestational age, parity, mother’s body mass index, mother’s chronic disorders, history of manual placenta removal, length of the first and second stages, membranes rupture, induction, amount of oxytocin after delivery, and infant’s weight and gender.


Author(s):  
Marta Makara-Studzińska ◽  
Kornelia Zaręba ◽  
Natalia Kawa ◽  
Dorota Matuszyk

SARS-CoV-2 coronavirus emerged in the world at the end of 2019. The introduction of a number of restrictions had a significant effect on numerous aspects of human life with particular influence being exerted on pregnant women and their sense of security. The study aimed to assess the level of anxiety and its main determinants in women in the third trimester of pregnancy during the coronavirus pandemic. The study technique included the present purposely designed questionnaire, Labor Anxiety Questionnaire (KLPII), and the State-Trait Anxiety Inventory (STAI). The study was conducted in a group of 315 women in the third trimester of pregnancy. A total of 258 women (81.9%) completed the questionnaire in May 2020, and 57 of them (18.1%) completed it in October 2020. The overall analysis of the Labor Anxiety Questionnaire and the STAI inventory revealed a high level of anxiety, particularly situational anxiety, in pregnant women during the SARS-CoV-2 pandemic. The age and financial status of the women were the factors which contributed to the intensification of tokophobia. Women interviewed in October 2020 were characterized by higher tokophobia levels compared to the respondents included in May 2020. It seems justified to in-crease the vigilance in the diagnostics of possible mental disorders in the perinatal period during pandemic.


2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Nebyou Seyoum ◽  
Daba Ethicha ◽  
Zelalem Assefa ◽  
Berhanu Nega

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.


2019 ◽  
Author(s):  
Samson Udho ◽  
Joyce Nankumbi ◽  
Mariam Namutebi ◽  
Grace Ndeezi ◽  
Joshua Epuitai ◽  
...  

Abstract Background Iron deficiency is a leading cause of anemia among pregnant women in Uganda. However, due to the high cost of biochemical tests required to determine iron deficiency, the prevalence and factors associated with iron deficiency remain largely unstudied in our setting. Therefore, this study aimed at determining the prevalence of iron deficiency and its associated factors among pregnant women attending an antenatal clinic, Lira District-Uganda.Methods A cross-sectional study was conducted among 320 pregnant women attending an antenatal clinic at Lira Regional Referral Hospital. Maternal serum ferritin was used as a measure of iron deficiency and was determined using a Cobas 6000 Automated Analyzer. Iron deficiency was based on serum ferritin of <30 μg/L. A semi-structured questionnaire was used to obtain the characteristics of the study participants. Binary and multivariate logistic regression were performed to identify the associated factors.Results The prevalence of iron deficiency was 45%. Non-adherence to iron supplements (AOR: 2.05 95% CI: 1.02-4.12) & third trimester pregnancy (AOR: 1.88 95% CI: 1.20-2.94) were significantly associated with iron deficiency during pregnancy.Conclusion Nearly 5 in 10 of the participants had iron deficiency. Iron deficiency during pregnancy was associated with non-adherence to iron supplements and being in the third trimester of pregnancy. Midwives should encourage pregnant women to adhere to iron supplements during pregnancy especially pregnant women who are in the third trimester.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S52-S53
Author(s):  
Jamie Sin Ying Ho ◽  
Vikram Rohra ◽  
Laura Korb ◽  
Bhathika Perera

AimsThe prevalence of cardiovascular diseases (CVD) in people with intellectual disability (ID) is around 14%, higher than the general population. However, CVD risk assessments are not consistently performed. Given the high risk of premature deaths in people with ID, it is important to identify preventable risk factors and follow evidence-based interventions. QRISK-3 is a validated risk-stratification tool, which calculates the 10-year risk of developing a heart attack or stroke (https://qrisk.org/three/index.php). There are no published studies on the use of QRISK-3 in people with ID. This project aimed to understand the use of QRISK-3 in an ID clinic and to quantify individual CVD risks to recommend appropriate management options.MethodA cross sectional study was performed on 143 patients open to an ID psychiatry clinic. Patients and carers were sent an accessible information leaflet on this study. Basic demographic data and information on psychiatric diagnoses were collected. Patients were grouped according to the presence of severe mental illness (SMI) defined as schizophrenia, bipolar disorder and other psychotic illnesses. QRISK-3 ≥ 10% was defined as elevated risk in accordance with NICE guidelines. Patients who had a high QRISK-3 score were advised to contact their GP.ResultOf 143 patients, 73 (51.0%) had a mild ID and the remaining had a moderate to severe ID. The mean age was 43.3 years, 53.1% were male. Overall, 28 (19.6%) participants had an elevated CVD risk, of whom 16 (57.1%) were not on statins, which is the recommended treatment. The mean QRISK-3 score was 6.31 (standard deviation [SD] 8.95), and the relative risk is 3.50 (SD 7.13). The proportion of QRISK-3 ≥ 10% and mean score were not significantly different in those with SMI, but those with SMI were more likely to be prescribed statins than those without (14 [31.1%] vs 10 [10.2%], p = 0.002). Statins were given to 24 (16.8%) participants, of whom 12 (50%) had elevated CVD risk. 89% had a blood pressure recording within the past 5 years, 87% had height and 88% had weight recorded. 73% had lipid serology results recorded.ConclusionElevated CVD risk was common in this ID study population, and more than half with elevated QRISK-3 were not on the medical treatment recommended by national guidelines. QRISK-3 could feasibly be implemented in the outpatient setting. Increased routine CVD risk assessment and management should be considered as another measure to reduce morbidity and mortality.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Mequanent Tariku

Background. Abortion-related mortality is decreasing, but the complication is still causing a significant morbidity to mothers especially in developing countries. Recently, suitable criteria to assess maternal near miss for sub-Saharan countries were adapted in harmony with the previous World Health Organization near-miss criteria. The aim of this study was to assess the magnitude of severe acute maternal morbidity and associated factors related to abortion in Hawassa University Comprehensive Specialized Hospital, Ethiopia. Method. An institution-based cross-sectional study was conducted among 337 women who sought abortion services at Hawassa University Comprehensive Specialized Hospital from January 1 to October 30, 2019. The participants were selected conveniently. Data was collected by using prospective morbidity methodology with pretested anonymous structured English questionnaire. The collected data were then entered into SPSS version 20 for analysis. Variables with p value ≤ 0.2 in the bivariate analysis, not collinear, were entered to multivariable regression. The strength of association is presented by odds ratio and 95% confidence interval. p value less than 0.05 was used as a cut-off point to determine statistically significant association. Results. The magnitude of severe acute maternal morbidity and maternal near miss is found to be 35.6 and 17.7%, respectively. Factors significantly associated with severe acute maternal morbidity were as follows: women uneducated (AOR: 3.02; 95% CI 1.24-7.33), second-trimester pregnancy (1.89-9.14), and delayed presentation (AOR: 4.32, 95% CI 1.76-10.59). Conclusion. Severe acute maternal morbidity and maternal near miss related to abortion are high despite the availability of safe termination. Near-miss cases could be better traced by using reasonably adapted World Health Organization near-miss criteria for sub-Saharan countries. Lack of education, increased gestational age, and delayed presentation had increased severe acute maternal morbidity associated with abortion which may need further education on health care seeking culture of the community.


PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217583 ◽  
Author(s):  
Billie F. Bradford ◽  
Robin S. Cronin ◽  
Christopher J. D. McKinlay ◽  
John M. D. Thompson ◽  
Edwin A. Mitchell ◽  
...  

1990 ◽  
Vol 78 (1) ◽  
pp. 75-80 ◽  
Author(s):  
M. D. Kilby ◽  
F. Broughton Pipkin ◽  
S. Cockbill ◽  
S. Heptinstall ◽  
E. M. Symonds

1. The intracellular free calcium concentration ([Ca2+]i) in washed human platelets was measured using the fluorescent indicator, fura-2, in a cross-sectional study of 36 normotensive, primigravid volunteers, 12 in each trimester of pregnancy and a further 12 at 6 weeks post partum. The results were compared with those obtained from 30 normal female volunteers not using oral contraception. 2. The mean basal [Ca2+]i in the platelets of the pregnant women in the first two trimesters (115.6 ± 6.7 and 120.1 ± 5.7 nmol/l, respectively) was not shown to differ significantly from that of normal non-pregnant volunteers (112.3 ± 2.9 nmol/l). However, during the third trimester a significant increase in [Ca2+]i was noted (134.0 ± 4.9 nmol/l; P < 0.05), with a return to normal values in the post-partum period (108.2 ± 6.1 nmol/l). 3. [Ca2+]i was also measured in the platelets of a group of 12 primigravid pregnant women in the third trimester whose pregnancies were complicated by gestational hypertension (pregnancy-induced hypertension and preeclampsia). A significant rise in basal [Ca2+]i was noted in the platelets of primigravidae whose pregnancies were complicated by pre-eclampsia (163.6 ± 8.8 nmol/l) as compared with normotensive, third-trimester primigravidae (P < 0.02). However, no correlation could be demonstrated between [Ca2+]i and systemic blood pressure.


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