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PERCEPTION OF HOARDING BEHAVIOR AMONG GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD CITIES OF PAKISTAN: AN EXPLORATORY QUALITATIVE INQUIRY 巴基斯坦拉瓦尔品第和伊斯兰堡城市普通人群对囤积行为的感知:一项探索性质的调查
IF 0.5 Q3 Health Professions Pub Date : 2020-01-01 DOI: 10.46903/GJMS/18.03.833
F. Malik, A. Kamal
Background: Hoarding is a complex phenomenon that has received extensive attention in recent years. Most studies have been conducted in Western culture with few from other regions of world, which advocates need to explore the phenomenon in different cultural contexts. Objective of this study was to ascertain the perception of hoarding behavior among general population of Rawalpindi and Islamabad cities of Pakistan. Materials & Methods: This exploratory qualitative study with grounded theory design was conducted in National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan from September 2015-May 2016. Sample of 46 subjects from different socio-cultural backgrounds was selected from otherwise healthy adult (20-60 years) population of Rawalpindi & Islamabad cities of Pakistan by purposive sampling. A qualitative research methodology was employed to develop theoretical understanding of phenomenon. Focus group discussions with six groups were conducted to assess existence and phenomenology of hoarding behavior in present cultural framework. Data was analyzed using grounded theory method. Results: Findings of this study support current literature concerning the role of emotional attachments, associated positive and negative affect, certain personality characteristics and early experiences in development and maintenance of hoarding behavior. This study also confirms that material possessions are source of security by providing sense of identity to owner, and are considered symbols of status in society. Finally, it involves the account of socio-cultural aspects like status transformation, with resulting sense of competition, gender role, impact of material deprivation, and religious construction of phenomenon that emerged as more of culture specific elements in indigenous settings of Pakistan. Conclusion: This study addresses factors that underpin major themes in relation to form and prevalence of hoarding behavior in cultural context of Pakistan and discusses the findings in reference to the similarities and differences with extant literature.
背景:囤积是近年来受到广泛关注的一种复杂现象。大多数研究都是在西方文化中进行的,很少有来自世界其他地区的研究,这就需要在不同的文化背景下探索这一现象。本研究的目的是了解巴基斯坦拉瓦尔品第和伊斯兰堡城市普通人群对囤积行为的认知。材料与方法:本探索性定性研究采用扎根理论设计,于2015年9月- 2016年5月在巴基斯坦伊斯兰堡Quaid-i-Azam大学国家心理研究所进行。采用目的抽样的方法,从巴基斯坦拉瓦尔品第和伊斯兰堡市健康成人(20-60岁)人群中选取不同社会文化背景的46名受试者。采用定性研究方法对现象进行理论理解。通过六个小组的焦点小组讨论来评估当前文化框架下囤积行为的存在性和现象学。数据分析采用扎根理论方法。结果:本研究的发现支持了目前关于情感依恋、相关的积极和消极影响、某些人格特征和早期经历在囤积行为发展和维持中的作用的文献。该研究还证实,物质财富是安全感的来源,为所有者提供认同感,被认为是社会地位的象征。最后,它涉及社会文化方面的解释,如地位转变,由此产生的竞争意识,性别角色,物质剥夺的影响,以及在巴基斯坦土著环境中作为更多文化特定元素出现的现象的宗教建构。结论:本研究探讨了与巴基斯坦文化背景下囤积行为的形式和流行有关的主要主题的基础因素,并讨论了与现有文献的异同。
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引用次数: 1
PALMAR CREASE PIGMENTATION 手掌皱纹色素沉着
IF 0.5 Q3 Health Professions Pub Date : 2019-12-31 DOI: 10.46903/gjms/17.04.2099
H. Khan
A young lady presented with history of giddiness, blackouts, and darkness of her skin colour especially the face. On examination the colour of her skin was quite dark but not much darker than her spouse. She had buccal pigmentations and her palmar creases were obviously pigmented. Facility for short Synacthen test was not available. Her serum cortisol was on the lower normal side and ACTH was sky high; 1024 pg/ml (ref. range adults: 6-76 pg/ml). She was screened for ectopic ACTH production which could not reveal any pathology. Also plain abdominal x-ray didn’t show any adrenal calcification. She was labeled as Addison’s disease and improved drastically after replacement therapy (Cortisone + Fludrocortisone). Giddiness aloof, she was delighted with the fairness of her colour.
一位年轻的女士有头晕、昏厥和肤色暗沉的病史,尤其是脸部。经检查,她的肤色很黑,但不比她丈夫黑多少。她的颊部有色素沉着,手掌的皱纹也有明显的色素沉着。没有短Synacthen测试设备。她的血清皮质醇处于较低的正常水平,ACTH异常高;1024 pg/ml(成人参考范围:6-76 pg/ml)。她被筛查为异位ACTH产生,不能显示任何病理。腹部x线平片也没有显示肾上腺钙化。她被标记为Addison病,并在替代治疗(可的松+氟化可的松)后显著改善。她高高在上,为自己白皙的肤色而高兴。
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引用次数: 0
LADY HEALTH WORKERS PROGRAM IN PAKISTAN 巴基斯坦妇女保健工作者项目
IF 0.5 Q3 Health Professions Pub Date : 2019-12-31 DOI: 10.46903/gjms/17.04.2094
I. Ahmad
Being signatory to Alma Ata declaration, the Government of Pakistan started the ‘National Program for Family Planning and Primary Health Care’ (NPFP & PHC), also called ‘Lady Health Workers (LHWs) program’ in 1994. Being one of the largest and successful, community-based program in the world, it is providing door-step PHC services to about one billion people, especially home-bound, rural, poor women, children and elderly. The program has been improving many health indicators including infant and maternal mortality rates in the last two & a half decades.1
作为《阿拉木图宣言》的签署国,巴基斯坦政府于1994年启动了“国家计划生育和初级卫生保健计划”,也称为“女性卫生工作者计划”。作为世界上最大、最成功的社区项目之一,它正在为大约10亿人提供入门级初级保健服务,特别是在家、农村、贫困妇女、儿童和老年人。在过去的25年里,该计划一直在改善许多健康指标,包括婴儿和产妇死亡率。1
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引用次数: 3
PREDICTORS OF IN-HOSPITAL MORTALITY IN PATIENTS WITH SNAKE BITE IN POPULATION OF KARACHI, PAKISTAN 巴基斯坦卡拉奇地区蛇咬伤患者住院死亡率的预测因素
IF 0.5 Q3 Health Professions Pub Date : 2019-12-31 DOI: 10.46903/gjms/17.04.1861
H. Kumar, A. Bashir, K. Abid, N. Baig
Background: Snake bite remains major public health problems worldwide. The objective of this study was to determine predictors of in-hospital mortality in patients presenting with snake bite in population of Karachi, Pakistan.Materials & Methods: It was cross-sectional study conducted at Department of General Medicine, Postgraduate Medical Center, Karachi, Pakistan from 11th June 2016 to 10th August 2017. 300 patients with snake bite were selected. Age, gender, acute kidney injury, vomiting and in-hospital mortality were variables. Except age, all variables were nominal and were analyzed by frequency and percentage. Cox-proportional-hazard regression model was applied and hazard ratios were calculated along with 95% confidence intervals (CI) to assess the strength of association between predictors i.e. age, gender, AKI and vomiting and outcome (in-hospital mortality). Kaplan-Meier and time to event plot were used to investigate all patients who were on follow-up for 7 days from admission. Log-rank test was used to identify the predictors of in-hospital mortality for significant independent influence on prognosis at alpha .05.Results: The mean age of the sample was 27.7±14.58 years. Out of a sample of 300 patients, 221 (73.7%) were males and 79 (26.3%) females. The frequency (%) of AKI was 102 (66%), vomiting 122 (40.7%) and of in-hospital mortality 31 (10.3%). The probability of survival at day 7 was 81.8%. Vomiting [hazard ratio 6.86 (95% CI: 2.78-16.93), p=<0.001] and acute kidney injury [hazard ratio 3.85 (95% CI: 1.75-8.45), p=<0.001] were associated with higher risk of death in adjusted analysis.Conclusion: Acute kidney injury and vomiting are strong predictors of mortality among patients with snake bite. These predictors can be helpful for clinicians in assessing prognosis of their patients more accurately and by early management of these factors, mortality & morbidity can be reduced.
背景:蛇咬伤仍然是世界范围内主要的公共卫生问题。本研究的目的是确定巴基斯坦卡拉奇人群中蛇咬伤患者住院死亡率的预测因素。材料与方法:横断面研究于2016年6月11日至2017年8月10日在巴基斯坦卡拉奇研究生医学中心普通医学部进行。选择300例蛇咬伤患者。年龄、性别、急性肾损伤、呕吐和住院死亡率是可变因素。除年龄外,所有变量均为名义变量,并通过频率和百分比进行分析。采用Cox-proportional-hazard regression模型,并计算风险比和95%置信区间(CI),以评估预测因素(如年龄、性别、AKI和呕吐)与结局(院内死亡率)之间的关联强度。采用Kaplan-Meier和事件时间图对入院后随访7天的所有患者进行调查。采用Log-rank检验确定住院死亡率对预后有显著独立影响的预测因素,alpha为0.05。结果:患者平均年龄27.7±14.58岁。在300例患者中,221例(73.7%)为男性,79例(26.3%)为女性。AKI发生率为102例(66%),呕吐发生率为122例(40.7%),住院死亡率为31例(10.3%)。第7天生存率为81.8%。在校正分析中,呕吐[危险比6.86 (95% CI: 2.78 ~ 16.93), p=<0.001]和急性肾损伤[危险比3.85 (95% CI: 1.75 ~ 8.45), p=<0.001]与较高的死亡风险相关。结论:急性肾损伤和呕吐是蛇咬伤患者死亡的重要预测因素。这些预测因素可以帮助临床医生更准确地评估患者的预后,通过对这些因素的早期管理,可以降低死亡率和发病率。
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引用次数: 0
GJMS Vol 17, No.4, Oct-Dec 2019 GJMS第17卷第4期,2019年10月- 12月
IF 0.5 Q3 Health Professions Pub Date : 2019-12-31 DOI: 10.46903/gjms/17.04
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引用次数: 0
BLOOD PRODUCTS TRANSFUSION DURING 2012-13 IN PESHAWAR, PAKISTAN 2012-13年巴基斯坦白沙瓦的血液制品输血
IF 0.5 Q3 Health Professions Pub Date : 2019-09-12 DOI: 10.46903/gjms/16.04.1915
Rashid Azeem, Nadia Altaf, S. Shah, Naeem Khattack, M. T. Khan, M. Tahir
Background: Blood products transfusion has been a major treatment modality especially in critical care settings. The objectives of this study were to determine frequency and distribution of blood products transfusion in public and private health care facilities during 2012-2013 in Peshawar, Pakistan. Materials & Methods: This cross-sectional, study was conducted in the Department of Pathology, Northwest School of Medicine, Peshawar, Pakistan from 1st January 2012 to 31st December 2013. Sample size was 2,04,942 blood products transfusion, selected through consecutive non probability technique. All allogeneic cases of transfusions in inpatient and emergency were included. A total of six public, one private and two stand-alone blood banks were enrolled into the study. Demographic variable were name of the health care facility, sex and age groups of donors. Research variables were type of blood products transfusion (whole blood, packed red blood cell, fresh frozen plasma, platelets). All variables being categorical were described as count and percentages. Data was analyzed using software SPSS version 23. Results: Out of 2,04,942 units, 1,33,212 (65%) were men and 71,730 (35%) women. Packed red blood cells were the most commonly used component with 80227 units (39.1%), whole blood 77655 units (37.8%), Fresh frozen plasma 35932 units (17.5%) and platelets 11128 units (5.6%). Blood products transfusion was 46927 units (22.89%) in 65 years. Conclusion: Modal group was men. Packed red blood cells were the most frequently transfused blood component in hospitals of Peshawar especially Lady reading hospital. Most common age group was 18-40 years. Whole blood still comprises a significant fraction of transfusions which is alarming.
背景:血液制品输血一直是一种主要的治疗方式,尤其是在重症监护环境中。本研究的目的是确定2012-2013年巴基斯坦白沙瓦公共和私人医疗机构输血的频率和分布。材料与方法:这项横断面研究于2012年1月1日至2013年12月31日在巴基斯坦白沙瓦西北医学院病理学系进行。样本量为2,04942血液制品输注,通过连续非概率技术选择。包括住院和急诊中的所有同种异体输血病例。共有六家公共血库、一家私人血库和两家独立血库参与了这项研究。人口统计学变量包括医疗机构的名称、捐赠者的性别和年龄组。研究变量为输血的血液制品类型(全血、浓缩红细胞、新鲜冷冻血浆、血小板)。分类的所有变量都被描述为计数和百分比。使用SPSS 23版软件对数据进行分析。结果:在2,04942个单元中,1,32312(65%)为男性,71730(35%)为女性。包装红细胞是最常用的成分,有80227单位(39.1%),全血77655单位(37.8%),新鲜冷冻血浆35932单位(17.5%)和血小板11128单位(5.6%)。结论:模态组为男性。在白沙瓦的医院,尤其是雷丁夫人医院,填充的红细胞是最常见的输血成分。最常见的年龄组是18-40岁。全血仍然占输血的很大一部分,这令人担忧。
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引用次数: 0
OVARIAN VOLUME BETWEEN FERTILE AND INFERTILE MARRIED WOMEN WITH TRANSVAGINAL SONOGRAPHY 经阴道超声检查已婚育龄妇女和不孕妇女的卵巢容积
IF 0.5 Q3 Health Professions Pub Date : 2019-09-12 DOI: 10.46903/gjms/16.04.1892
Sarah Yunus, Sadaf Rasheed, Amir A. Amanullah, Shehla Aman, Usman Ullah, Fidaullah Wazir
Background: Infertility is a social problem and a big stigma. The objectives of the study were to determine the age wise distribution of ovarian volume and the difference in ovarian volume between married fertile and infertile women with transvaginal sonography. Materials & Methods: This comparative, cross-sectional study was conducted in the Department of Anatomy, Gomal Medical College, D.I.Khan, Pakistan from March 2013 to December 2013. Sample Size was 100 women selected by consecutive non probability sampling technique. Sample size was calculated using online calculator Raosoft. Inclusion criteria were women aged 18-50 years, married, fertile and infertile. Color Doppler sonoscape with multi frequency transvaginal probes were used in measurements on any day in the start of menstrual cycle by the same observer. The volume was calculated by applying formula for ellipsoid called Prolate ellipsoid formula. The total volume was represented by sum of volume of two ovaries. Data collection site was out patient department of Radiology DHQ Teaching Hospital, D.I.Khan. Demographic variable were age groups and presence of fertility. Research variable was ovarian volume. Mean and standard deviation were calculated for ovarian volume whereas frequency and percentages were calculated for age groups and presence of fertility. Descriptive statistics along with estimation of parameter was done at 95% confidence interval for proportion and mean. Student- t test was used for significance of difference in ovarian volume between fertile and infertile women with p value
背景:不孕不育是一个社会问题,也是一大耻辱。本研究的目的是通过阴道超声确定已婚育龄妇女和不孕妇女卵巢体积的年龄分布以及卵巢体积的差异。材料与方法:这项比较横断面研究于2013年3月至2013年12月在巴基斯坦D.I.Khan Gomal医学院解剖系进行。样本量为通过连续非概率抽样技术选择的100名女性。使用在线计算器Raosoft计算样本量。纳入标准为18-50岁、已婚、有生育能力和不育的女性。同一观察者在月经周期开始的任何一天都使用带有多频率经阴道探头的彩色多普勒声景进行测量。体积的计算是通过应用椭球体的公式称为Prolate椭球体公式。总体积用两个卵巢的体积之和表示。数据收集点位于D.I.Khan DHQ教学医院放射科门诊部。人口统计学变量为年龄组和生育率。研究变量为卵巢体积。计算卵巢体积的平均值和标准差,而计算年龄组和生育率的频率和百分比。在95%置信区间下,对比例和平均值进行描述性统计和参数估计。Student-t检验用于评估具有p值的育龄妇女和不孕妇女卵巢体积差异的显著性
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引用次数: 0
CAUSES OF HYDROCEPHALUS AND COMPLICATIONS OF VP SHUNT IN PEDIATRIC POPULATION 小儿副静脉分流术脑积水及并发症的原因分析
IF 0.5 Q3 Health Professions Pub Date : 2019-09-12 DOI: 10.46903/gjms/16.04.1694
S. Nawaz, Fakhar Hayat, S. Khan, Sarah Rehman, N. Sardar, Shehla Aman
ABSTARCT Background: Ventriculoperitoneal (VP) shunt is a common procedure for treatment of hydrocephalus. The objectives of the study were to determine the causes of hydrocephalus and complications of VP shunt in our pediatric population. Materials & Methods: This descriptive, cross-sectional study was conducted in the Department of Neurosurgery, Gomal Medical College, D.I.Khan, Pakistan from January 2018 to January 2019. The sample size was 97 selected through consecutive, non-probability sampling technique using online sample size calculator, the Raosoft. The inclusion criteria were all pediatric patients with hydrocephalus. All those post-operative patient operated for other pathologies of brain and spine without VP shunt were excluded from the study. CT or MRI of brain with and without contrast were done. Post operatively all the patients were followed up till 6 months and any complication which occurred were documented. Demographic variable were sex and age in years. Research variables were causes of hydrocephalus and post-operative complications of VP shunt. All variables except age in years being categorical were analyzed through frequency and percentages. Age was calculated by mean and SD using SPSS version 20. Results: Out of 97 patients, boys were 59(60.82%) and girls were 38(39.17%). The mean age of the sample was 4.5 ±5 ranging from 5 months to 13 years. The most common cause was aqueductal stenosis having 58(59.7 %), myelo-meningocele were 17(17.7%), post meningitis were 12(12.3%) and remaining 10(10.3%) were associated with brain tumors. Out of 21 patients 12(57.2%) developed shunt obstruction, 5(23.8%) shunt infection, 2(9.5%) developed post-operative seizures, 2(9.5%) had exteriorization of lower end of shunt through abdominal incision. Conclusion: The most common cause of hydrocephalus is acqueductal stenosis. The most common complication of VP shunt is shunt obstruction in pediatric population, having pre-school boys as modal group.
背景:脑室-腹膜(VP)分流术是治疗脑积水的常用手术。该研究的目的是确定脑积水的原因和并发症的副静脉曲张分流在我们的儿科人群。材料与方法:本描述性横断面研究于2018年1月至2019年1月在巴基斯坦dii khan的Gomal医学院神经外科进行。使用在线样本量计算器Raosoft,通过连续非概率抽样技术选取97个样本量。纳入标准均为小儿脑积水患者。所有术后因脑及脊柱其他病变而行VP分流术的患者均排除在本研究之外。分别对脑进行CT或MRI检查。术后随访6个月,记录术后并发症发生情况。人口统计学变量为性别和年龄(以年为单位)。研究变量为脑积水的原因及VP分流术的术后并发症。除年龄外,所有变量均通过频率和百分比进行分类分析。年龄采用SPSS version 20均值和标准差计算。结果:97例患者中,男孩59例(60.82%),女孩38例(39.17%)。样本平均年龄为4.5±5岁,年龄范围为5个月至13岁。最常见的原因是输水管狭窄58例(59.7%),髓膜膨出17例(17.7%),脑膜炎后12例(12.3%),其余10例(10.3%)伴有脑肿瘤。21例患者中有12例(57.2%)发生分流管梗阻,5例(23.8%)发生分流管感染,2例(9.5%)发生术后癫痫发作,2例(9.5%)发生分流管下端经腹部切口外翻。结论:脑积水最常见的病因是后水管狭窄。副静脉分流术最常见的并发症是分流梗阻在儿童人群中,以学龄前男孩为模态组。
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引用次数: 0
ADVANCED STAGE OF FACIAL BASAL CELL CARCINOMA 晚期面部基底细胞癌
IF 0.5 Q3 Health Professions Pub Date : 2019-09-12 DOI: 10.46903/gjms/16.04.1989
Muhammad Sharjeel
An eighty years old man presented with a slowly progressing, ulcerative mass near the left eye diagnosed as the advanced stage of facial basal cell carcinoma (rodent ulcer) which has involved his left eye and orbit, left nostril and left cheek area. According to the patient, it was a very slow growing tumor and has reached this stage over a span of more than ten years. He has been advised removal of his left eye and adjacent structure along with plastic reconstruction of the damaged half of the nose and face. It will be important to excise the tumor along with healthy margins to prevent recurrences. Take home message is that basal cell carcinoma should be excised early to prevent damage to the eye and nearby structures.
一位八十岁男性,左眼附近出现进展缓慢的溃疡性肿块,诊断为晚期面部基底细胞癌(啮齿动物溃疡),已累及左眼、眼眶、左鼻孔和左脸颊区域。据病人说,这是一个生长非常缓慢的肿瘤,在十多年的时间里已经达到了这个阶段。医生建议他切除左眼和附近的结构,同时对受损的一半鼻子和脸进行塑料重建。重要的是切除肿瘤与健康边缘,以防止复发。结论是基底细胞癌应该及早切除,以防止对眼睛和附近结构造成损害。
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引用次数: 0
TYPE, TIME-TREND AND INDICATIONS OF HYSTERECTOMY 子宫切除术的类型、时间趋势及适应证
IF 0.5 Q3 Health Professions Pub Date : 2019-09-12 DOI: 10.46903/gjms/16.04.1958
Fauzia Anbreen, S. Qadir, Hira Naeem, Najma Farhat, Mariam Ghafoor, S. Hassan
ABSTRACT Background: The frequency of hysterectomy varies in same geographical area. The objectives of this study were to determine the type, time trend and indications of hysterectomy in our population. Materials & Methods: This cross-sectional, study was conducted in the Department of Gynecology and Obstetrics, Gomal Medical College, D.I.Khan, Pakistan, from 1st January 2013 to 31st December 2016. A sample size of 571 was selected through consecutive technique. Inclusion criteria were all hysterectomies done for gynecological indications. Demographic variable was age groups. Research variables were type, time trend and indications for hysterectomy. All variables being categorical were expressed as frequency and percentages. 95% confidence interval for proportion were calculated. SPSS version 19 was used for statistical analysis. Results: Out of 571 hysterectomies, 333(58.31 %) were abdominal and 238(41.68 %) were vaginal. Age-wise distribution of hysterectomies shows >61 is the modal age group. The hysterectomy frequency increased from 7% of total gynecological admission during 2013 to 17% of total gynecological admission in 2016. The indication for hysterectomy by type from 2013-2016 was menstrual disorders and uterine prolapse. Conclusion: Trans abdominal hysterectomies were more common than vaginal hysterectomies. Most common age group for hysterectomy was older than 60 years. The indication for abdominal hysterectomy was menstrual disorders whereas the only indication for vaginal hysterectomy was uterine prolapse. Line diagram was showing an increase in hysterectomy frequency over time from 2013-16.
摘要背景:在同一地理区域,子宫切除术的频率各不相同。本研究的目的是确定我们人群中子宫切除术的类型、时间趋势和适应症。材料与方法:这项横断面研究于2013年1月1日至2016年12月31日在巴基斯坦D.I.Khan Gomal医学院妇产科进行。通过连续技术选择了571个样本。纳入标准为所有妇科指征子宫切除术。人口统计学变量是年龄组。研究变量包括子宫切除术的类型、时间趋势和适应症。所有分类变量都用频率和百分比表示。计算出比例的95%置信区间。采用SPSS 19进行统计分析。结果:571例子宫切除术中,腹部切除333例(58.31%),阴道切除238例(41.68%)。子宫切除术的年龄分布显示>61岁是典型的年龄组。子宫切除术的频率从2013年占妇科住院总人数的7%增加到2016年占妇科入院总人数的17%。2013-2016年子宫切除术的适应症为月经紊乱和子宫脱垂。结论:经腹子宫切除术比阴道子宫切除术更常见。子宫切除术最常见的年龄组是60岁以上。腹式子宫切除术的适应症是月经失调,而阴道子宫切除术唯一的适应症则是子宫脱垂。折线图显示,从2013-16年开始,子宫切除术的频率随时间增加。
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引用次数: 4
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Gomal Journal of Medical Sciences
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