The first Expressway in Sri Lanka was declared open recently, connecting the financial capital with southern towns of Sri Lanka. Known as the Southern Expressway (E01), the already commissioned first stage spans close to 100 km with eight interchanges. With the speed limit stipulated at 100 km/h, which is about 25% higher than comparable expressways of other countries in the region, destination transit times are reduced by more than 50% as compared to other routes. While the gain through reduced transit times is presently confined mainly to commuters, advantage of this rapid transit facility in true sense could only be derived by directing value addition to economic activities.
{"title":"From the Editor","authors":"A. Husari","doi":"10.5742/meim.2018.93395","DOIUrl":"https://doi.org/10.5742/meim.2018.93395","url":null,"abstract":"The first Expressway in Sri Lanka was declared open recently, connecting the financial capital with southern towns of Sri Lanka. Known as the Southern Expressway (E01), the already commissioned first stage spans close to 100 km with eight interchanges. With the speed limit stipulated at 100 km/h, which is about 25% higher than comparable expressways of other countries in the region, destination transit times are reduced by more than 50% as compared to other routes. While the gain through reduced transit times is presently confined mainly to commuters, advantage of this rapid transit facility in true sense could only be derived by directing value addition to economic activities.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132029325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical Treatment of Metabolic Syndrome in the Fourth Decade","authors":"M. Helvaci, A. Abyad, Lesley Pocock","doi":"10.5742/MEIM.2018.93397","DOIUrl":"https://doi.org/10.5742/MEIM.2018.93397","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121445807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study was designed to assess the relation between maternal anaemia in the third trimester and premature birth. Methods: A case-control study was conducted in Prince Hashim hospital and Prince Ali Hospital in the period between August 2015 and July 2016. A total of 200 women were included in the study and divided into two groups. Group A consisted of patients delivered between 24-37 weeks of gestation (case group), while Group B consisted of patients delivered after 37 weeks (control group). Maternal anaemia was defined as haemoglobin level < 11g/ dL and preterm delivery was defined as delivery prior to 37 weeks of gestation. Patients with haemoglobinopathies, systemic diseases, Antepartum haemorrhage and multiple gestations were excluded from the analysis. Results: In Group A, 47 patients were found to be anaemic while 53 patients had normal haemoglobin. In Group B, 29 patients were found to be anaemic while 71 patients had normal haemoglobin. Conclusion: It was observed that maternal anaemia in the third trimester, at labour, was associated with an increased risk of prematurity.
{"title":"Association between Maternal Anaemia and Premature Birth","authors":"Rema Khlaif Omosh, N. Alfayez, I. Fayez","doi":"10.5742/MEIM.2017.93041","DOIUrl":"https://doi.org/10.5742/MEIM.2017.93041","url":null,"abstract":"Objective: This study was designed to assess the relation between maternal anaemia in the third trimester and premature birth. Methods: A case-control study was conducted in Prince Hashim hospital and Prince Ali Hospital in the period between August 2015 and July 2016. A total of 200 women were included in the study and divided into two groups. Group A consisted of patients delivered between 24-37 weeks of gestation (case group), while Group B consisted of patients delivered after 37 weeks (control group). Maternal anaemia was defined as haemoglobin level < 11g/ dL and preterm delivery was defined as delivery prior to 37 weeks of gestation. Patients with haemoglobinopathies, systemic diseases, Antepartum haemorrhage and multiple gestations were excluded from the analysis. Results: In Group A, 47 patients were found to be anaemic while 53 patients had normal haemoglobin. In Group B, 29 patients were found to be anaemic while 71 patients had normal haemoglobin. Conclusion: It was observed that maternal anaemia in the third trimester, at labour, was associated with an increased risk of prematurity.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115405630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. M. Haddad, Jafar A. Al-Momani, Adnan S. Al Suleihat
{"title":"Local Side Effects of Inhalers in Patients with COPD in KHMC","authors":"R. M. Haddad, Jafar A. Al-Momani, Adnan S. Al Suleihat","doi":"10.5742/meim.2017.93040","DOIUrl":"https://doi.org/10.5742/meim.2017.93040","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120961750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Lung cancer is considered as the leading cause attributed to cancer related deaths and approximately 85% of lung cancer patients have non-small-cell lung cancer (NSCLC) and Vascular endothelial growth factor (VEGF) is used to play the major role in regulation of angiogenesis in malignancies. Aim: The aim of this study was to compare chemotherapy alone in comparison with addition of anti -vegf (bevacizumab) to chemotherapy and assessment of response rate , progression free survival, overall survival in patients diagnosed with nonsquamous non small cell lung cancer in Saudi German hospitals in the period between March 2013 and February 2016. Patients and methods: This study was held between March 2013 and February 2016 in Saudi German hospitals when we performed a randomized study in which 40 patients with recurrent or advanced nonsmall-cell lung cancer (stage IIIB or IV) received paclitaxel and carboplatin (paclitaxel-carboplatin arm) (20 patients) paclitaxel and carboplatin in addition to bevacizumab (paclitaxel-carboplatin-bevacizumab arm) (20 patients). Results: The median overall survival was 15.5 months in the paclitaxel-carboplatin-bevacizumab arm as compared with 10.5 months in the paclitaxelcarboplatin arm ( P=0.002) and the median progression-free survival was also significantly improved in the paclitaxel-carboplatin-bevacizumab arm reaching (8.4 months versus 5.9 in the paclitaxel-carboplatin arm) for a hazard ratio for disease progression of 0.67 (95% CI, 0.57 to 0.77; P<0.001) and the addition of bevacizumab to paclitaxel and carboplatin improved the response rate as (25 %) in the paclitaxel-carboplatin arm had a response versus (65%) in the paclitaxel-carboplatin-bevacizumab arm (P<0.001) and the rates of hypertension, bleeding, thrombocytopenia, neutropenia, febrile neutropenia, proteinuria were significantly higher in the paclitaxel-carboplatin-bevacizumab arm than in the paclitaxel-carboplatin arm. (P<0.05). Conclusion: The addition of bevacizumab to the chemotherapy added a significant value to the patients with non squamous NSCLC in terms of response rate, progression free survival and overall survival however with significant side effects.
{"title":"Paclitaxel-Carboplatin versus Bevacizumab Paclitaxel-Carboplatin for Treatment of Non-Small-Cell Lung Cancer","authors":"Waleed Hammam, Y. Saleh","doi":"10.5742/MEIM.2017.93042","DOIUrl":"https://doi.org/10.5742/MEIM.2017.93042","url":null,"abstract":"Background: Lung cancer is considered as the leading cause attributed to cancer related deaths and approximately 85% of lung cancer patients have non-small-cell lung cancer (NSCLC) and Vascular endothelial growth factor (VEGF) is used to play the major role in regulation of angiogenesis in malignancies. Aim: The aim of this study was to compare chemotherapy alone in comparison with addition of anti -vegf (bevacizumab) to chemotherapy and assessment of response rate , progression free survival, overall survival in patients diagnosed with nonsquamous non small cell lung cancer in Saudi German hospitals in the period between March 2013 and February 2016. Patients and methods: This study was held between March 2013 and February 2016 in Saudi German hospitals when we performed a randomized study in which 40 patients with recurrent or advanced nonsmall-cell lung cancer (stage IIIB or IV) received paclitaxel and carboplatin (paclitaxel-carboplatin arm) (20 patients) paclitaxel and carboplatin in addition to bevacizumab (paclitaxel-carboplatin-bevacizumab arm) (20 patients). Results: The median overall survival was 15.5 months in the paclitaxel-carboplatin-bevacizumab arm as compared with 10.5 months in the paclitaxelcarboplatin arm ( P=0.002) and the median progression-free survival was also significantly improved in the paclitaxel-carboplatin-bevacizumab arm reaching (8.4 months versus 5.9 in the paclitaxel-carboplatin arm) for a hazard ratio for disease progression of 0.67 (95% CI, 0.57 to 0.77; P<0.001) and the addition of bevacizumab to paclitaxel and carboplatin improved the response rate as (25 %) in the paclitaxel-carboplatin arm had a response versus (65%) in the paclitaxel-carboplatin-bevacizumab arm (P<0.001) and the rates of hypertension, bleeding, thrombocytopenia, neutropenia, febrile neutropenia, proteinuria were significantly higher in the paclitaxel-carboplatin-bevacizumab arm than in the paclitaxel-carboplatin arm. (P<0.05). Conclusion: The addition of bevacizumab to the chemotherapy added a significant value to the patients with non squamous NSCLC in terms of response rate, progression free survival and overall survival however with significant side effects.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123774560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We tried to determine the safest triglyceride value in the plasma. Methods: Check up cases with a triglyceride value lower than 60 mg/dL were collected into the first, lower than 100 mg/dL into the second, lower than 150 mg/dL into the third, lower than 200 mg/dL into the fourth, and equal to or greater than 200 mg/dL into the fifth groups, respectively. Results: Study included 478 cases (288 females and 190 males), totally. Mean values of age, body weight, body mass index, triglyceride, and low density lipoprotein cholesterol and prevalences of smoking, white coat hypertension (WCH), hypertension, type 2 diabetes mellitus (DM), and coronary artery disease (CAD) increased nearly in all steps from the first towards the fifth groups, gradually and significantly (p<0.05). Conclusions: Probably metabolic syndrome is a chronic inflammatory process mainly affecting the vascular endothelium all over the body and terminating with early aging and premature death. The syndrome has reversible parameters including sedentary life style, animal-rich diet, overweight, smoking, alcohol, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, WCH, chronic inflammations and infections and irreversible end points including obesity, hypertension, DM, cirrhosis, peripheric artery disease, chronic obstructive pulmonary disease, chronic renal disease, CAD, mesenteric ischemia, osteoporosis, and stroke. Hypertriglyceridemia may be one of the most significant reversible parameters of the syndrome, and it is better to have the lowest plasma triglyceride value as much as possible to live longer.
{"title":"Lower the Triglyceride, Longer the Survival","authors":"M. Helvaci, O. Ayyıldız, Orhan Ekrem Muftuoglu","doi":"10.5742/MEIM.2017.93045","DOIUrl":"https://doi.org/10.5742/MEIM.2017.93045","url":null,"abstract":"Background: We tried to determine the safest triglyceride value in the plasma. Methods: Check up cases with a triglyceride value lower than 60 mg/dL were collected into the first, lower than 100 mg/dL into the second, lower than 150 mg/dL into the third, lower than 200 mg/dL into the fourth, and equal to or greater than 200 mg/dL into the fifth groups, respectively. Results: Study included 478 cases (288 females and 190 males), totally. Mean values of age, body weight, body mass index, triglyceride, and low density lipoprotein cholesterol and prevalences of smoking, white coat hypertension (WCH), hypertension, type 2 diabetes mellitus (DM), and coronary artery disease (CAD) increased nearly in all steps from the first towards the fifth groups, gradually and significantly (p<0.05). Conclusions: Probably metabolic syndrome is a chronic inflammatory process mainly affecting the vascular endothelium all over the body and terminating with early aging and premature death. The syndrome has reversible parameters including sedentary life style, animal-rich diet, overweight, smoking, alcohol, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, WCH, chronic inflammations and infections and irreversible end points including obesity, hypertension, DM, cirrhosis, peripheric artery disease, chronic obstructive pulmonary disease, chronic renal disease, CAD, mesenteric ischemia, osteoporosis, and stroke. Hypertriglyceridemia may be one of the most significant reversible parameters of the syndrome, and it is better to have the lowest plasma triglyceride value as much as possible to live longer.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121085710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Results: One hundred and forty-four cases either with cholelithiasis or cholecystectomy for cholelithiasis were detected among 3,437 cases, totally (4.1%). One hundred and sixteen (80.1%) of them were females with a mean age of 53.6 years. Obesity (54.8% versus 43.7%, p<0.01), body mass index (BMI) (31.0 versus 28.9 kg/m2, p<0.01), and hypertension (26.3% versus 13.1%, p<0.001) were significantly higher in the cholelithiasis or cholecystectomy group. Although the prevalence of hyperbetalipoproteinemia was significantly lower in the cholelithiasis or cholecystectomy group (9.7% versus 18.0%, p<0.05), hypertriglyceridemia (25.0% versus 18.0%, p<0.05) was significantly higher in them.
{"title":"Hypertriglyceridemia May Actually Be an Acute Phase Reactant in the Plasma","authors":"M. Helvaci, M. Davarci, O. Ozkan","doi":"10.5742/MEIM.2017.93043","DOIUrl":"https://doi.org/10.5742/MEIM.2017.93043","url":null,"abstract":"Results: One hundred and forty-four cases either with cholelithiasis or cholecystectomy for cholelithiasis were detected among 3,437 cases, totally (4.1%). One hundred and sixteen (80.1%) of them were females with a mean age of 53.6 years. Obesity (54.8% versus 43.7%, p<0.01), body mass index (BMI) (31.0 versus 28.9 kg/m2, p<0.01), and hypertension (26.3% versus 13.1%, p<0.001) were significantly higher in the cholelithiasis or cholecystectomy group. Although the prevalence of hyperbetalipoproteinemia was significantly lower in the cholelithiasis or cholecystectomy group (9.7% versus 18.0%, p<0.05), hypertriglyceridemia (25.0% versus 18.0%, p<0.05) was significantly higher in them.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133988564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This is a retrospective study of descriptive patterns of findings seen in hysterectomy specimens based on records from a Modern histopathology laboratory in Aden. A total of 2,544 specimens were analyzed during the 6 years period from January 2006 to December 2012, to study the histopathological findings of these specimens. The age of the patients at hysterectomy ranged from 16-80 years with a mean of 44.6, with the maximum patients (56.3 %) in the age group 41-50 years and less patients in less than 30 years. Most common pathology findings are; Endometrial hyperplasia 1481 (58.3%), Non neoplastic cystic lesion 1386 (54.5%), Chronic cervicitis 1363 (53.6%), Adenomyosis 793 (31.2% ) follow by Leiomyoma 697 (27.4%). Other less frequent pathologies identified included atrophic endometrium, Inadequate secretory endometrial transformation, Gestational Trophoblastic disease, Endometroid adenocarcinoma, cervical prolapse. This study confirms that benign pathologies are more common in hysterectomy specimens than their malignant counterparts.
{"title":"Histopathological Findings in Hysterectomy Specimens : A Retrospective Study","authors":"O. Mohamed, Mazen Abood Ben Thabet","doi":"10.5742/MEIM.2017.93046","DOIUrl":"https://doi.org/10.5742/MEIM.2017.93046","url":null,"abstract":"This is a retrospective study of descriptive patterns of findings seen in hysterectomy specimens based on records from a Modern histopathology laboratory in Aden. A total of 2,544 specimens were analyzed during the 6 years period from January 2006 to December 2012, to study the histopathological findings of these specimens. The age of the patients at hysterectomy ranged from 16-80 years with a mean of 44.6, with the maximum patients (56.3 %) in the age group 41-50 years and less patients in less than 30 years. Most common pathology findings are; Endometrial hyperplasia 1481 (58.3%), Non neoplastic cystic lesion 1386 (54.5%), Chronic cervicitis 1363 (53.6%), Adenomyosis 793 (31.2% ) follow by Leiomyoma 697 (27.4%). Other less frequent pathologies identified included atrophic endometrium, Inadequate secretory endometrial transformation, Gestational Trophoblastic disease, Endometroid adenocarcinoma, cervical prolapse. This study confirms that benign pathologies are more common in hysterectomy specimens than their malignant counterparts.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"1 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120857518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Body mass index (BMI), weight, and height may be due to various hereditary and environmental factors. Material and methods: Age and sex-matched cases with a hematocrit value of less than 30% were collected into the first, less than 36% into the second, less than 40% into the third, and 40% or greater into the fourth groups of patients. Results: The study included 108 anemia patients (101 females) with a mean age of 34.7 years (range 15-68). The anemia cases were mainly iron deficiency anemia and/or thalassemia minors. When we compared the first group with the second, the BMI and weight were significantly retarded in the first group (23.6 versus 26.9 kg/m2, p= 0.005 and 61.3 versus 69.9 kg, p= 0.008), whereas there were nonsignificant differences between the second, third, and fourth groups for both (p>0.05 for all). Although there was significantly retarded BMI and weight in the first group, body heights were similar in the four groups (p>0.05 for all). Conclusion: Although the BMI and weight can be affected by moderate anemia, the height may strongly be determined by heredity. Since the excess weight may be a significant underlying cause of the metabolic syndrome, and the metabolic syndrome shortens human lifespan significantly, and there is no case with shortened survival due to iron deficiency anemia and/or thalassemia minors, an iatrogenic and moderate iron deficiency anemia with frequent blood donation may prolong human survival by decreasing the BMI and weight in the overweight and obese individuals.
{"title":"Moderate Iron Deficiency Anemia in the Treatment of Metabolic Syndrome","authors":"M. Helvaci, M. Albayrak, O. Balçik","doi":"10.5742/meim.2017.93044","DOIUrl":"https://doi.org/10.5742/meim.2017.93044","url":null,"abstract":"Background: Body mass index (BMI), weight, and height may be due to various hereditary and environmental factors. Material and methods: Age and sex-matched cases with a hematocrit value of less than 30% were collected into the first, less than 36% into the second, less than 40% into the third, and 40% or greater into the fourth groups of patients. Results: The study included 108 anemia patients (101 females) with a mean age of 34.7 years (range 15-68). The anemia cases were mainly iron deficiency anemia and/or thalassemia minors. When we compared the first group with the second, the BMI and weight were significantly retarded in the first group (23.6 versus 26.9 kg/m2, p= 0.005 and 61.3 versus 69.9 kg, p= 0.008), whereas there were nonsignificant differences between the second, third, and fourth groups for both (p>0.05 for all). Although there was significantly retarded BMI and weight in the first group, body heights were similar in the four groups (p>0.05 for all). Conclusion: Although the BMI and weight can be affected by moderate anemia, the height may strongly be determined by heredity. Since the excess weight may be a significant underlying cause of the metabolic syndrome, and the metabolic syndrome shortens human lifespan significantly, and there is no case with shortened survival due to iron deficiency anemia and/or thalassemia minors, an iatrogenic and moderate iron deficiency anemia with frequent blood donation may prolong human survival by decreasing the BMI and weight in the overweight and obese individuals.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116567680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To determine the rate, indications and complications of instrumental deliveries at Prince Hashim Ben Abdullah The Second Hospital (former name Princess Haya Bent Al-Hussein), Aqaba, Jordan. Methods: This retrospective observational study has been carried out over a four-year period between 1st January 2012 and 31st December 2015. The medical records of all patients who underwent instrumental deliveries were reviewed and analyzed. Results: During this four-year period 238 successful instrumental deliveries were performed out of 9,767 deliveries with a rate of 2.56%. The commonest instrument used was vacuum (202/240) and 36 patients were delivered by forceps. The indications were; presumed fetal distress (132), prolonged 2nd stage of labor (85) and maternal exhaustion (21). Maternal complications reported were postpartum hemorrhage (18) and different degrees of genital tract tears (28). Fetal complications registered consisted of 34 cases of which (11) were cases of Erbs palsy, (12) were cases admitted to NICU for observation and one case was diagnosed with cerebral palsy. Conclusion: Our study showed a lower rate of operative vaginal delivery in comparison to the international figures. This may be attributed to the lack of epidural anesthesia which increases the incidence of instrumental deliveries, in addition to the simple experience of the attending residents who fear possible complications of applying these instruments and the potential subsequent litigation. The complications reported in our study were expected in assisted vaginal deliveries (AVD) and mimic those mentioned in the literature.
{"title":"Assisted Vaginal Deliveries in Far South of Jordan","authors":"Mitri Rashed, Areej Bisharat, B. Nusair","doi":"10.5742/MEIM.2017.92939","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92939","url":null,"abstract":"Objective: To determine the rate, indications and complications of instrumental deliveries at Prince Hashim Ben Abdullah The Second Hospital (former name Princess Haya Bent Al-Hussein), Aqaba, Jordan. Methods: This retrospective observational study has been carried out over a four-year period between 1st January 2012 and 31st December 2015. The medical records of all patients who underwent instrumental deliveries were reviewed and analyzed. Results: During this four-year period 238 successful instrumental deliveries were performed out of 9,767 deliveries with a rate of 2.56%. The commonest instrument used was vacuum (202/240) and 36 patients were delivered by forceps. The indications were; presumed fetal distress (132), prolonged 2nd stage of labor (85) and maternal exhaustion (21). Maternal complications reported were postpartum hemorrhage (18) and different degrees of genital tract tears (28). Fetal complications registered consisted of 34 cases of which (11) were cases of Erbs palsy, (12) were cases admitted to NICU for observation and one case was diagnosed with cerebral palsy. Conclusion: Our study showed a lower rate of operative vaginal delivery in comparison to the international figures. This may be attributed to the lack of epidural anesthesia which increases the incidence of instrumental deliveries, in addition to the simple experience of the attending residents who fear possible complications of applying these instruments and the potential subsequent litigation. The complications reported in our study were expected in assisted vaginal deliveries (AVD) and mimic those mentioned in the literature.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126641013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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