scholarly journals Open Technique Versus Blind Technique in Placement of Primary Ports in Laparoscopic Procedures- A Prospective Cohort Study

2021 ◽  
Author(s):  
Vivek Pahuja ◽  
Nisha Rani ◽  
Hershdeep Singh ◽  
Kuldip Singh ◽  
Pankaj Dugg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Peritoneal Cavity ◽  
Prospective Cohort ◽  
P Value ◽  
Open Technique ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Primary Port

Introduction: Laparoscopic access has always been a challenge because it has been associated with severe complications and sometimes fatal also. Aim:Tocompareopentechniqueversusblindtechniqueinplacement of primary port in various laparoscopic procedures in terms of operative time, complications, ease of use and acceptability. Materials and Methods: This prospective cohort study was conducted at Government Medical College, Patiala, Punjab, India, between June 2014 to August 2016. The study included 100 patients, which were divided into two groups. Group A (n=50) received placement of primary port by open technique and Group B (n=50) received placement of primary port by blind technique. The time taken for access into peritoneal cavity and duration of surgery was noted. Multivariate analysis done using Chi-square test, p-value of less than 0.05 was considered significant. Results: Mean age of patients in group A and group B was 42.66±12.37 years and 43.06±14.67 years, respectively. Majority of patients were females in both groups (n=45 in group A and n=39 in group B). There was no significant difference in time taken for access into peritoneal cavity (p-value>0.05). The duration of hospital stay (in hours) of the patients was 36.96 in Group A and 34.42 in Group B which was not statistically significant. The incidence of intraoperative and postoperative complications was not significant. Most common complication port site infections 3 (6%) in Group A. Conclusion: There was no significant difference between the two techniques with respect to time taken for peritoneal access and complications. In expert hands, both methods are comparable.

scholarly journals Clinical and Epidemiological aspects of SARS-CoV-2 infection among pregnant and postpartum women in Mozambique: a prospective cohort study

2021 ◽  
Author(s):  
Charles M'poca Charles ◽  
Nafissa Bique Osman ◽  
Domingos Arijama ◽  
Benjamim Matingane ◽  
Tomás Sitoé ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
P Value ◽  
Postpartum Women ◽  
Increased Risk ◽  
Significant Difference ◽  
Obstetric Population

Abstract Background Although there is a significant increase of evidence regarding the prevalence and impact of COVID-19 on maternal and perinatal outcomes, data on the effects of the pandemic on the obstetric population in sub-Saharan African countries are still scarce. Therefore, the study aims were to assess the prevalence and impact of COVID-19 on maternal and neonatal outcomes in the obstetric population at Central Hospital of Maputo (HCM), Mozambique. Methods Prospective cohort study conducted at teaching and referral maternity, HCM, from 20 October 2020 to 22 July 2021. We collected maternal and perinatal outcomes up to six weeks postpartum of eligible women (pregnant and postpartum women - up to the 14th day postpartum) screened for COVID-19 (individual test for symptomatic participants and pool testing for asymptomatic). The primary outcome was maternal death, SARS and UCI admission. We estimated the COVID-19 prevalence and the unadjusted RR (95% CI) for maternal and perinatal outcomes. We used the chi-square or Fisher's exact test to compare qualitative variables (two-sided p-value < 0.05 for statistical significance). Results We included 239 participants. The overall prevalence of COVID-19 was 9.2% (22/239) and in the symptomatic group was 32.4 % (11/34). About 48% of the participants with COVID-19 were asymptomatic. Moreover, the most frequent symptoms were dyspnoea (33.3%), cough (28.6%), anosmia (23.8%), and fever (19%). Not having a partner, being pregnant, and consuming alcohol were vulnerability factors for SARS-CoV-2 infection. COVID-19 among pregnant and postpartum women was associated with an increased risk of adverse maternal outcome, foetal death (RR = 4.0 [1.19–13.48]) and abortion/stillbirth 12.0 [7.7–18.7]). Conversely, we did not observe a significant difference in the primary outcomes between exposed and non-exposed groups. Conclusion The prevalence of COVID-19 in the obstetric population is higher than in the general population, and most pregnant and postpartum women with COVID-19 infection are asymptomatic. Being pregnant, not having a partner and alcohol consumption were factors of greatest vulnerability to SARS-COV-2 infection. Data suggest that pregnant women with COVID-19 may have a higher risk of adverse gestational outcomes, reinforcing the need for universal testing and monitoring of this population group. However, more prospective and robust studies are needed to assess these outcomes.

scholarly journals Comparative Effectiveness of the Deqi Sensation and Non-Deqi by Moxibustion Stimulation: A Multicenter Prospective Cohort Study in the Treatment of Knee Osteoarthritis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Rixin Chen ◽  
Mingren Chen ◽  
Jun Xiong ◽  
Tongsheng Su ◽  
Meiqi Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Scientific Evidence ◽  
Control Group ◽  
Acupuncture Points ◽  
Significant Difference ◽  
Multicenter Prospective Cohort Study ◽  
Group B ◽  
Multicenter Prospective Cohort

Substantial evidence has supported that moxibustion stimulates a unique phenomenon of Deqi, heat-sensitive moxibustion sensation. This study consisted of a multicenter, prospective cohort study with two parallel arms (A: heat-sensitive moxibustion sensation group; B: nonheat-sensitive moxibustion sensation group). All forms of moxibustion were applied unilaterally on the right leg with a triangle shape of three acupuncture points simultaneously (bilateral Xi Yan (EX-LE5) and He Ding (EX-LE2)). After one month the primary outcome parameter GPCRND-KOA showed significant differences between groups: trial group 5.23 ± 2.65 (adjusted mean ± SE) 95% CI [4.44~6.01] versus control group 7.43 ± 2.80 [6.59~8.26],P=0.0001. Significant differences were manifested in total M-JOA score during the follow-up period (P=0.0006). Mean knee circumference indicated significant difference between the groups (P=0.03;P=0.007). Overall, this evidence suggested that the effectiveness of the Deqi sensation group might be more superior than the non-Deqi sensation one in the treatment of KOA. This study was aimed at providing scientific evidence on the Deqi sensation of moxibustion and at showing that heat-sensitive moxibustion sensation is essential to achieve the preferable treatment effects of KOA.

scholarly journals Early versus delayed surgical evacuation of spontaneous supratentorial intracerebral hematoma: A prospective cohort study

2020 ◽  
Vol 11 ◽  
pp. 145 ◽  
Author(s):  
Mostafa Raafat ◽  
Omar Abdelaleem Ragab ◽  
Osama Mohamed Abdelwahab ◽  
Mohamed Mamdouh Salama ◽  
Mohamed Ahmed Hafez
Keyword(s):  
Cohort Study ◽  
Clinical Outcome ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intracerebral Hematoma ◽  
Time Interval ◽  
Surgical Evacuation ◽  
Group A ◽  
Group B

Background: The optimum timing for surgical evacuation of spontaneous supratentorial intracerebral hematoma (ICH) is still controversial. The aim of this study was to compare the clinical outcome following early versus delayed surgical evacuation of spontaneous supratentorial ICH. Methods: This is a prospective cohort study including 70 patients with spontaneous supratentorial ICH ≥30 cc in volume and Glasgow Coma Scale 8–12. Patients were divided into two groups based on the time interval between ictus and surgery; Group A (evacuated within 8 h from ictus) and Group B (evacuated >8 h from ictus). Outcome was assessed at discharge and at 2 months postoperative using extended Glasgow Outcome Scale. Results: The early evacuation group (Group A) included 44 patients and the late evacuation group (Group B) included 26 patients. Favorable outcome was achieved in 20.5% of the patients in Group A and in 11.5% of the patients in Group B. Mortality rate was 18.2% in Group A and 26.9% in Group B. Three patients in Group A and one patient in Group B required reoperation. The mean hospital stay was 17.18 days and 14.54 days in Groups A and B, respectively. Conclusion: Early surgical evacuation of spontaneous supratentorial ICH in patients with good preoperative conscious level is associated with better clinical outcome, particularly in the early postoperative period. Early surgical evacuation has no significant impact on the rate of reoperation or the length of hospital stay.

scholarly journals HIV diagnosis period influences ART initiation: findings from a prospective cohort study in China

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tinglong Yang ◽  
Xueying Yang ◽  
Linghua Li ◽  
Huifang Xu ◽  
Lirui Fan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Hiv Diagnosis ◽  
Initiation Rate ◽  
Art Initiation ◽  
Significant Difference ◽  
New Strategy ◽  
New Treatment

Abstract Background We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p < 0.001). A significant difference of mean score was detected in each HBM construct between pre- and post-scaleup groups (p < 0.05). After adjusting for significant background variables, among all participants, only the self-efficacy [adjusted HR (HRa) = 1.23, 95% CI 1.06 to 1.43, p = 0.006], has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa = 0.71 to 1.83, p < 0.05), while in post-scaleup group, no significant difference was found in each construct (p > 0.05). Conclusions The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals Clinical outcomes of colistin in combination with either 6-g sulbactam or carbapenems for the treatment of extensively drug-resistant Acinetobacter baumannii pneumonia with high MIC to sulbactam, a prospective cohort study

2019 ◽  
Author(s):  
Chutchawan Ungthammakhun ◽  
Vasin Vasikasin ◽  
Dhitiwat Changpradub
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Acinetobacter Baumannii ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Mortality Rates ◽  
P Value ◽  
Drug Resistant ◽  
Extensively Drug Resistant

Abstract Background: Extensively drug-resistant Acinetobacter baumannii (XDRAB) is an important cause of nosocomial pneumonia with limited therapeutic options. Colistin based regimen is recommended treatment. Which drugs should be combined with colistin remains uncertain. The aim of this study was to investigate the clinical outcomes of patients with XDRAB pneumonia who were treated with colistin, combined with either 6-g sulbactam or carbapenems, in the setting of high MIC to sulbactam. Methods: In this prospective cohort study, hospitalized patients diagnosed with XDRAB pneumonia in Phramongkutklao Hospital were enrolled. The primary outcome was the 28-day mortality. Secondary outcomes were 7 and 14-day mortality, length of stay, ventilator days and factors associated with mortality. Results: From 1 July 2016 to 30 September 2017, 192 patients were included; 92 received colistin plus sulbactam and 90 received colistin plus carbapenems. Most of the patients were male diagnosed with ventilator associated pneumonia in medical intensive care unit. Overall mortality rates at 7, 14, 28 days were 24.2%, 37.4%, 53.3%, respectively. Mortality rates did not differ between sulbactam group and carbapenems groups at 7 days (19.6% vs. 28.9%, p-value 0.424, adjusted HR 1.277; 95% CI = 0.702-2.322), 14 days (34.8% vs. 40%, p = 0.658, adjusted HR 1.109; 95% CI = 0.703-1.749) and 28 days (51.1% vs. 55.6%, p = 0.857, adjusted HR 1.038; 95% CI = 0.690-1.562). Length of stay, ICU days and ventilator days did not differ. Complications of treatment including acute kidney injury were not statistically different. Conclusions: In XDRAB pneumonia with high MIC to sulbactam, mortality rates were not statistically significant between colistin plus 6-g sulbactam and colistin plus carbapenems. Keywords: XDR A. baumannii pneumonia, mortality rate, colistin based, sulbactam, carbapenems

scholarly journals Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Recovery Time ◽  
Controlled Trial ◽  
P Value ◽  
Time Data ◽  
Endoscopic Retrograde ◽  
Intravenous Anesthetic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

Gestational metabolic syndrome and neonatal anthropometric indices: a prospective cohort study

2021 ◽  
Vol 29 (7) ◽  
pp. 386-391
Author(s):  
Zeinab Hatamian ◽  
Lida Moghaddam-Banaem ◽  
Samira Mokhlesi ◽  
Marzieh Saei Ghare Naz
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Birth Weight ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Linear Regression Analysis ◽  
First Trimester ◽  
P Value ◽  
Anthropometric Parameters ◽  
First Trimester Of Pregnancy

Background and aim There is limited knowledge about the effect of maternal metabolic syndrome (MetS) on the anthropometric parameters of newborns. Therefore, the authors aimed to evaluate the association between MetS in the first trimester of pregnancy with weight and height of the newborn. Methods This prospective cohort study was conducted on 455 pregnant women in Tehran during their first trimester of pregnancy. MetS was defined as the coexistence of three or more of the following criteria: fasting blood sugar (FBS) level ≥92 mg/dl, blood pressure ≥130.85 mm/hg, triglyceride ≥150 mg/dl, high density lipoprotein ≤50 mg/dl, and body mass index (BMI) ≥30 kg/m2. All participants were followed up to childbirth. After birth, the baby's weight and height data were collected from the birth certificate. Results Linear regression analysis showed FBS (ß: 0.100, p-value: 0.038), BMI (ß: 0.139, p-value: 0.004), and MetS (ß: -0.122, p-value: 0.015) were significantly associated with birth weight but no statistically significant results were found for birth height. Conclusion MetS and some of its components in pregnancy can affect birth weight of neonates.

The economic costs of Group B Streptococcus (GBS) disease: prospective cohort study of infants with GBS disease in England

2008 ◽  
Vol 10 (3) ◽  
pp. 275-285 ◽  
Author(s):  
Elizabeth-Ann Schroeder ◽  
◽  
Stavros Petrou ◽  
Gail Balfour ◽  
Oya Edamma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Group B Streptococcus ◽  
Economic Costs ◽  
Group B

scholarly journals Prevalence and clinical predictors for early post-operative urinary retention in patients undergoing pelvic reconstructive surgeries: a prospective cohort study

2018 ◽  
Vol 7 (4) ◽  
pp. 1452
Author(s):  
Annie P. Vijjeswarapu ◽  
Vaibhav Londhe ◽  
Mahasampath Gowri ◽  
Aruna Kekre ◽  
Nitin Kekre
Keyword(s):  
Cohort Study ◽  
Pelvic Organ Prolapse ◽  
Urinary Retention ◽  
Prospective Cohort Study ◽  
Reconstructive Surgery ◽  
Prospective Cohort ◽  
Pelvic Organ ◽  
P Value ◽  
Pelvic Reconstructive Surgery ◽  
Clinical Predictors

Background: Pelvic organ prolapse (POP) has a significant impact on quality of life. Post-operative voiding dysfunction is seen in 2.5 to 24% of patients following pelvic reconstructive surgery. Risk factors like age of the patient, size of the genital hiatus and stage of prolapse are known to be associated with early post-operative voiding disorders.Methods: This is a prospective cohort study done in Christian Medical College, Vellore over one year. Patients with stage II to IV pelvic organ prolapse who underwent pelvic reconstructive surgery were observed post operatively for covert and overt urinary retention. Inability to void accompanied by pain and discomfort is defined as overt retention. Early post-operative urinary retention (POUR) is retention of urine in the first 72 hours postoperatively. Covert retention is defined as a non-painful bladder with chronic high post void residue. Chi- square test or Fisher’s exact test was used to assess the association between the clinical predictors and early post-operative urinary retention in univariate analysis.Results: In this study, 75 patients were recruited. Nine patients had POUR. Among the patients who had post-operative urinary retention, 77.78% had stage III pelvic organ prolapse (n=7). P value was 0.042. The prevalence of early POUR after pelvic reconstructive surgery was 12.85 % (n=9). A 55.55% had covert retention (n=5) and 44.44% patients had overt retention (n=4).Conclusions: The prevalence of early POUR after pelvic reconstructive surgery was 12.85%. Stage of the prolapse was an independent predictor for early postoperative urinary retention.

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