{"title":"Preoperative Anxiety and Associated Factors Among Adult Elective Surgery Patients in North Wollo Zone, Northeast Ethiopia","authors":"Adam Wondmieneh","doi":"10.2147/oas.s285562","DOIUrl":"https://doi.org/10.2147/oas.s285562","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"13 1","pages":"85-94"},"PeriodicalIF":1.0,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46457200","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}
Introduction: World Health Organization (WHO) surgical safety checklist implementation is important for good outcomes of surgical patients. WHO surgical safety checklist has three components (sign in, time out, and sign out) and has to be applied before the surgery and before the transfer of the patient to the recovery room. WHO surgical safety checklist was implemented in 25%−65% among the surgical team in different hospitals. Objective: The objective of this study was to assess the compliance and completeness of the WHO surgical safety checklist at Debre Tabor Comprehensive Specialized Hospital. Methods: We used a three-year retrospective survey from July 2017 to July 2020 based on a chart review of surgical patient charts. We include a total of 3460 surgical patient charts for three years period, and from this, we got a surgical safety checklist from 2842 surgical patient charts. We analyzed the data by using SPSS version 21. And finally, the descriptive statistics presented. Results: From this study, the compliance of the WHO surgical safety checklist was 82.1% (2842/3460). From the parts of the checklist, sign in, time out, and sign out were implemented in 85.1% (2420/2842), 43.9% (1248/2842), and 57.7% (1642/2842), respectively. The overall completeness of the checklist (all boxes ticked off) was 30.4% (864/2842). Conclusion: The compliance of the WHO surgical safety checklist was good but their completeness was still poor so it needs attention and follow-up for better completeness of the WHO surgical safety checklist.
引言:世界卫生组织(WHO)手术安全检查表的实施对手术患者的良好预后非常重要。世卫组织手术安全核对表有三个组成部分(签到、超时和签到)，必须在手术前和患者转至康复室之前应用。在不同医院的外科团队中，实施WHO手术安全检查表的比例为25% ~ 65%。目的:本研究的目的是评估Debre Tabor综合专科医院WHO手术安全检查表的依从性和完整性。方法:我们采用了2017年7月至2020年7月为期三年的回顾性调查，基于对外科患者图表的回顾。我们收集了三年3460例手术患者的病历，从中我们得到了2842例手术患者病历中的手术安全检查表。我们使用SPSS version 21对数据进行分析。最后，进行了描述性统计。结果:本组患者对WHO手术安全检查表的符合率为82.1%(2842/3460)。从检查表的各个部分来看，签到、超时和签出的实现率分别为85.1%(2420/2842)、43.9%(1248/2842)和57.7%(1642/2842)。检查表的总体完成率为30.4%(864/2842)。结论:WHO手术安全检查表的符合性较好，但其完整性仍较差，应引起重视并进行随访，以提高WHO手术安全检查表的完整性。
{"title":"A Three-Year Retrospective Study of the World Health Organisation Safety Checklist Compliance in a Comprehensive Specialized Hospital in Debre Tabor, North Central Ethiopia","authors":"Abebe Tiruneh, Tikuneh Yetneberk","doi":"10.2147/oas.s286969","DOIUrl":"https://doi.org/10.2147/oas.s286969","url":null,"abstract":"Introduction: World Health Organization (WHO) surgical safety checklist implementation is important for good outcomes of surgical patients. WHO surgical safety checklist has three components (sign in, time out, and sign out) and has to be applied before the surgery and before the transfer of the patient to the recovery room. WHO surgical safety checklist was implemented in 25%−65% among the surgical team in different hospitals. Objective: The objective of this study was to assess the compliance and completeness of the WHO surgical safety checklist at Debre Tabor Comprehensive Specialized Hospital. Methods: We used a three-year retrospective survey from July 2017 to July 2020 based on a chart review of surgical patient charts. We include a total of 3460 surgical patient charts for three years period, and from this, we got a surgical safety checklist from 2842 surgical patient charts. We analyzed the data by using SPSS version 21. And finally, the descriptive statistics presented. Results: From this study, the compliance of the WHO surgical safety checklist was 82.1% (2842/3460). From the parts of the checklist, sign in, time out, and sign out were implemented in 85.1% (2420/2842), 43.9% (1248/2842), and 57.7% (1642/2842), respectively. The overall completeness of the checklist (all boxes ticked off) was 30.4% (864/2842). Conclusion: The compliance of the WHO surgical safety checklist was good but their completeness was still poor so it needs attention and follow-up for better completeness of the WHO surgical safety checklist.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44035470","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}
F. Ahmed, Saleh Al-wageeh, E. Al-shami, K. Al-naggar, M. Askarpour, Mohammed Naji
: Penile torsion is a congenital anomaly rarely detected in isolation and mostly accompanied by hypospadias and chordee. It could also happen iatrogenically after penile circumcision. In previous literature, the incidence rate of isolated penile torsion has been reported between 1.7 and 27%. The diagnosis and treatment of penile torsion have been illustrated in the previous published articles. However, there are few published studies on the familial predominance of penile torsion. Additionally, the clinical characteristics and potential hereditary components of penile torsion are not well known. Therefore, we studied a 12-year-old boy with a severe 180-degree penile torsion, which surgically corrected and his one-year-old brother, who had mild penile torsion and surgically corrected during circumcision. Additionally, the clinical characteristics and potential hereditary components are not well known. We present a severe penile torsion 180 degrees in a 12 years old boy, which surgically corrected and mild penile torsion in one-year old his brother. The surgical procedure includes degloving the penis, Bucks fascia resection, some incision in the base of the penis, plication of tunica, and dorsal dartos flap. Three months after the operation, the pateint had a successful correction of penile rotation with no residual rotation.
{"title":"Congenital Isolated Penile Torsion: A Case Report in 2 Brothers","authors":"F. Ahmed, Saleh Al-wageeh, E. Al-shami, K. Al-naggar, M. Askarpour, Mohammed Naji","doi":"10.2147/oas.s275810","DOIUrl":"https://doi.org/10.2147/oas.s275810","url":null,"abstract":": Penile torsion is a congenital anomaly rarely detected in isolation and mostly accompanied by hypospadias and chordee. It could also happen iatrogenically after penile circumcision. In previous literature, the incidence rate of isolated penile torsion has been reported between 1.7 and 27%. The diagnosis and treatment of penile torsion have been illustrated in the previous published articles. However, there are few published studies on the familial predominance of penile torsion. Additionally, the clinical characteristics and potential hereditary components of penile torsion are not well known. Therefore, we studied a 12-year-old boy with a severe 180-degree penile torsion, which surgically corrected and his one-year-old brother, who had mild penile torsion and surgically corrected during circumcision. Additionally, the clinical characteristics and potential hereditary components are not well known. We present a severe penile torsion 180 degrees in a 12 years old boy, which surgically corrected and mild penile torsion in one-year old his brother. The surgical procedure includes degloving the penis, Bucks fascia resection, some incision in the base of the penis, plication of tunica, and dorsal dartos flap. Three months after the operation, the pateint had a successful correction of penile rotation with no residual rotation.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47474314","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}
M. Peyvasteh, S. Askarpour, Mahmood Khoshkhabar, H. Javaherizadeh
Background: The main therapeutic option for hypertrophic pyloric stenosis (HPS) is pyloromyotomy surgical technique which can be performed via different methods, including right upper quadrant (RUQ) transverse incision and supraumbilical curved skin incision; thus, the aim of this study was to evaluate and compare clinical efficacy of supraumbilical curved skin incision and standard (RUQ) skin incision. Materials and Methods: In this retrospective case-control study, 35 patients with HPS were initially evaluated. After evaluating hospital records, 31 patients with completed hospital records were included: 9 from case group and 22 from control group. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents. Results: Results showed that the surgery parameters such as surgery duration (P=0.211), postoperative fasting duration (P=0.831), and hospitalization duration (P=0.521) in both groups were similar. Moreover, surgery complications such as duodenal or gastric perforation and surgical site infection did not differ between the groups (P>0.05). While we found that Vancouver Scar Scale was significantly lower in supraumbilical curved skin incision as compared to control group (1.8 ± 0.5 vs 5.1 ± 0.7, P<0.001, respectively). Conclusion: The results of this study showed the beneficial effects of supraumbilical curved skin incision technique on surgery scar outcomes and gives best cosmetic results with minimal complications, which could be replaced to RUQ operative technique and significantly lead to better control of surgery scar.
{"title":"Pyloromyotomy in Hypertrophic Pyloric Stenosis: A Comparative Study Between Supraumbilical Curved Skin Incision and Standard (Right Upper Quadrant) Skin Incision: Study in a Resource Limited Setting","authors":"M. Peyvasteh, S. Askarpour, Mahmood Khoshkhabar, H. Javaherizadeh","doi":"10.2147/oas.s262825","DOIUrl":"https://doi.org/10.2147/oas.s262825","url":null,"abstract":"Background: The main therapeutic option for hypertrophic pyloric stenosis (HPS) is pyloromyotomy surgical technique which can be performed via different methods, including right upper quadrant (RUQ) transverse incision and supraumbilical curved skin incision; thus, the aim of this study was to evaluate and compare clinical efficacy of supraumbilical curved skin incision and standard (RUQ) skin incision. Materials and Methods: In this retrospective case-control study, 35 patients with HPS were initially evaluated. After evaluating hospital records, 31 patients with completed hospital records were included: 9 from case group and 22 from control group. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents. Results: Results showed that the surgery parameters such as surgery duration (P=0.211), postoperative fasting duration (P=0.831), and hospitalization duration (P=0.521) in both groups were similar. Moreover, surgery complications such as duodenal or gastric perforation and surgical site infection did not differ between the groups (P>0.05). While we found that Vancouver Scar Scale was significantly lower in supraumbilical curved skin incision as compared to control group (1.8 ± 0.5 vs 5.1 ± 0.7, P<0.001, respectively). Conclusion: The results of this study showed the beneficial effects of supraumbilical curved skin incision technique on surgery scar outcomes and gives best cosmetic results with minimal complications, which could be replaced to RUQ operative technique and significantly lead to better control of surgery scar.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42309321","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}
A. Mekonen, Miesso Negesso, Hailemariam Mulugeta Kasim, Zemedu Awoke Ferede
Background: Thyroidectomy is the most common endocrine surgical procedure being performed throughout the world. Thyroidectomy in a non-controlled or poorly controlled toxic state may lead to thyroid storm. But, if surgery is the only option all precautions with detail risk-benefit analysis involving a multi-disciplinary team is mandatory. Case Presentation: A 24-year-old female patient who had anterior neck swelling of 4 years duration was taking antithyroid medication of a varying dose for the past 2 years. However, there was no improvement in the clinical feature and deranged biochemical tests. Subtotal thyroidectomy was performed. Conclusion: Even though there are challenges of performing surgery in non-euthyroid patients in a resource-limited area, poor adherence, failure of antithyroid therapy due to long duration of therapy with side effects and complications with persistent toxic state necessitate surgical intervention. The thyroidectomy procedure was performed uneventfully with the available resources after careful risk-benefit analysis. There was no apparent perioperative complication.
{"title":"Perioperative Management of Thyroidectomy After a Failed Antithyroid Therapy in a Resource Limited Setting: A Clinical Case Report","authors":"A. Mekonen, Miesso Negesso, Hailemariam Mulugeta Kasim, Zemedu Awoke Ferede","doi":"10.2147/oas.s264575","DOIUrl":"https://doi.org/10.2147/oas.s264575","url":null,"abstract":"Background: Thyroidectomy is the most common endocrine surgical procedure being performed throughout the world. Thyroidectomy in a non-controlled or poorly controlled toxic state may lead to thyroid storm. But, if surgery is the only option all precautions with detail risk-benefit analysis involving a multi-disciplinary team is mandatory. Case Presentation: A 24-year-old female patient who had anterior neck swelling of 4 years duration was taking antithyroid medication of a varying dose for the past 2 years. However, there was no improvement in the clinical feature and deranged biochemical tests. Subtotal thyroidectomy was performed. Conclusion: Even though there are challenges of performing surgery in non-euthyroid patients in a resource-limited area, poor adherence, failure of antithyroid therapy due to long duration of therapy with side effects and complications with persistent toxic state necessitate surgical intervention. The thyroidectomy procedure was performed uneventfully with the available resources after careful risk-benefit analysis. There was no apparent perioperative complication.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s264575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42059672","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}
Befekadu Lemmu, Abebe Megersa, E. Abebe, Kirubel Abebe
Background: Surgical informed consent (SIC) is an established ethical and legal requirement for surgical treatment. Patient understanding of the process is essential for efficient surgical care. This study aimed to assess the knowledge and perception of operated patients towards surgical informed consent. Methods: An institution-based cross-sectional study of all adult surgical patients who signed informed consent and underwent surgery at St. Paul’s Hospital Millennium Medical College (SPHHMC) from February 1st to March 30th, 2018, was performed. Data were collected postoperatively before discharge using a pretested structured questionnaire. Results: Of 420 patients identified, 385 (91.7%, M:F=2:1) agreed and interviewed. The mean age was 40.3 years (SD± 15.1), and many of the respondents (285, 74.0%) had some level of formal education. Even if most (336, 87.3%) knew the reason why they had surgery, less knowledge and awareness was reported regarding the options of alternative treatments (153, 39.7%), identifying the operating surgeon (129, 33.5%), the type of surgery (160, 41.6%), anesthesia-related risks (96, 24.9%), complications of surgery (69, 17.9%) and postoperative care (4, 1.0%). The legal requirement of surgical informed consent was reported by 267 (69.4%) subjects; however, more than half had no information on the right to change their mind after signed surgical informed consent (223, 57.9%) and whom it protects (224, 58.2%). Only 40 (10.5%) respondents had a good level of knowledge, and it was significant in those with some level of formal education (OR=4.8; 95% CI 1.45–16.01; P=0.010) and in patients who live in an urban area (OR=4.7; 95% CI 1.81–12.35; p=0.002) than their respective groups. Conclusion: Our patients had limited knowledge and perception regarding surgical informed consent. Hence, the current consent process seems inadequate and needs a revisit.
{"title":"Knowledge and Perception of Ethiopian Surgical Patients to Informed Consent Practice for Surgical Procedures","authors":"Befekadu Lemmu, Abebe Megersa, E. Abebe, Kirubel Abebe","doi":"10.2147/oas.s268009","DOIUrl":"https://doi.org/10.2147/oas.s268009","url":null,"abstract":"Background: Surgical informed consent (SIC) is an established ethical and legal requirement for surgical treatment. Patient understanding of the process is essential for efficient surgical care. This study aimed to assess the knowledge and perception of operated patients towards surgical informed consent. Methods: An institution-based cross-sectional study of all adult surgical patients who signed informed consent and underwent surgery at St. Paul’s Hospital Millennium Medical College (SPHHMC) from February 1st to March 30th, 2018, was performed. Data were collected postoperatively before discharge using a pretested structured questionnaire. Results: Of 420 patients identified, 385 (91.7%, M:F=2:1) agreed and interviewed. The mean age was 40.3 years (SD± 15.1), and many of the respondents (285, 74.0%) had some level of formal education. Even if most (336, 87.3%) knew the reason why they had surgery, less knowledge and awareness was reported regarding the options of alternative treatments (153, 39.7%), identifying the operating surgeon (129, 33.5%), the type of surgery (160, 41.6%), anesthesia-related risks (96, 24.9%), complications of surgery (69, 17.9%) and postoperative care (4, 1.0%). The legal requirement of surgical informed consent was reported by 267 (69.4%) subjects; however, more than half had no information on the right to change their mind after signed surgical informed consent (223, 57.9%) and whom it protects (224, 58.2%). Only 40 (10.5%) respondents had a good level of knowledge, and it was significant in those with some level of formal education (OR=4.8; 95% CI 1.45–16.01; P=0.010) and in patients who live in an urban area (OR=4.7; 95% CI 1.81–12.35; p=0.002) than their respective groups. Conclusion: Our patients had limited knowledge and perception regarding surgical informed consent. Hence, the current consent process seems inadequate and needs a revisit.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44536709","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}
Z. Abraham, A. Kahinga, K. B. Mapondella, E. Massawe, D. Ntunaguzi
Aim: We aimed to determine the prevalence of and characterize accessory maxillary sinus ostium (AMO) in patients with chronic rhinosinusitis at a private health facility which serves the largest number of patients seeking treatment under private practice in Tanzania’s largest city. Methods: Fifty adult patients with symptoms of chronic rhinosinusitis attending the ENT clinic on an outpatient basis were selected and then computerized tomography scan of the nose and paranasal sinuses (CT scan PNS) was performed. Nasal endoscopy was done to all patients to determine the presence and location of AMO. Results: Of all the 50 studied patients, CT scan PNS depicted positive signs of rhinosinusitis in 35 patients (70%). Upon nasal endoscopy of the 35 patients, AMO was found in 25 patients (71.4%). Of the 15 patients with no depicted CRS upon CT scan, AMO was found in 4 (26.7%) patients. Conclusion: Nasal endoscopy provides additional evidence of obstruction of natural sinus ostia thus leading to chronic maxillary rhinosinusitis apart from CT PNS. Such observation is of importance to clinicians who are to execute management of these patients. an international, peer-reviewed, open access journal that focuses on all aspects of surgical procedures and interventions. Patient care around the peri-operative period and patient outcomes post-surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.
{"title":"An Endoscopic Study on the Prevalence of Accessory Maxillary Sinus Ostium in Patients with Chronic Rhinosinusitis in Dar es Salaam, Tanzania","authors":"Z. Abraham, A. Kahinga, K. B. Mapondella, E. Massawe, D. Ntunaguzi","doi":"10.2147/oas.s264176","DOIUrl":"https://doi.org/10.2147/oas.s264176","url":null,"abstract":"Aim: We aimed to determine the prevalence of and characterize accessory maxillary sinus ostium (AMO) in patients with chronic rhinosinusitis at a private health facility which serves the largest number of patients seeking treatment under private practice in Tanzania’s largest city. Methods: Fifty adult patients with symptoms of chronic rhinosinusitis attending the ENT clinic on an outpatient basis were selected and then computerized tomography scan of the nose and paranasal sinuses (CT scan PNS) was performed. Nasal endoscopy was done to all patients to determine the presence and location of AMO. Results: Of all the 50 studied patients, CT scan PNS depicted positive signs of rhinosinusitis in 35 patients (70%). Upon nasal endoscopy of the 35 patients, AMO was found in 25 patients (71.4%). Of the 15 patients with no depicted CRS upon CT scan, AMO was found in 4 (26.7%) patients. Conclusion: Nasal endoscopy provides additional evidence of obstruction of natural sinus ostia thus leading to chronic maxillary rhinosinusitis apart from CT PNS. Such observation is of importance to clinicians who are to execute management of these patients. an international, peer-reviewed, open access journal that focuses on all aspects of surgical procedures and interventions. Patient care around the peri-operative period and patient outcomes post-surgery are key topics for the journal. All grades of surgery from minor cosmetic interventions to major surgical procedures are covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute major areas of interest. The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48820402","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: Cesarean section (CS) is a lifesaving medical intervention. It plays a vital role in decreasing maternal mortality and morbidity rates. It is also an indicator of maternal health services quality of a country. CS practice has been rising regardless of the medical condition, age, race, or gestational age. However, it is associated with many complications compared with vaginal deliveries, particularly in developing countries. Therefore, the aim of this study was to assess the magnitude and determinants of primary cesarean section among women who gave birth in Suhul General Hospital, Shire town, Northern Ethiopia. Methods: Institutional cross-sectional study was conducted from September 19 to October 20, 2017, among women who gave birth between September and August 2016 in Suhul General Public Hospital. Data were entered into EPI Info version 7 and exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regressions were examined to assess the association between outcome and independent variables. Finally, variables with p-value less than 0.05 on multivariate logistic regression analysis were considered as significantly associated. Results: The magnitude of primary CS was 20.2%. The main indication for CS was non-reassuring fetal heartbeat pattern (NRFHRP) (32.2%). Women who had been augmented were 3.14 times more likely to undergo primary CS than those who had not (adjusted odds ratio (AOR)= 3.14; 95% CI: 1.49, 6.57). Women who had pregnancy-induced hypertension were 3.1 times more likely to undergo primary CS than those who had not (AOR= 3.10; 95% CI: 1.23, 7.83). Additionally, women who gave birth of ≥4000 gm newborns were 11 times (AOR= 11; 95% CI: 2.30, 57.51) more likely to undergo primary CS than those who gave birth 2500–3999 gm of newborns. Moreover, women with unknown gestational age were 5.83 times (AOR= 5.83; 95% CI: 2.37, 14.31) more likely to undergo primary CS than women whose gestational age was 37–42 weeks. Conclusion: The magnitude of the primary cesarean section in this study was high. Gestational age, augmentations, PIH, and birth weight were significant determinants of primary CS. Objective decisions should be practiced to reduce the magnitude of the primary caesarean section.
背景:剖宫产术(CS)是一种挽救生命的医学干预措施。它在降低产妇死亡率和发病率方面发挥着至关重要的作用。它也是一个国家产妇保健服务质量的指标。无论医疗状况、年龄、种族或胎龄如何，CS的做法一直在增加。然而，与阴道分娩相比，它与许多并发症有关，特别是在发展中国家。因此，本研究的目的是评估在埃塞俄比亚北部夏尔镇Suhul总医院分娩的妇女初次剖宫产的程度和决定因素。方法:于2017年9月19日至10月20日对2016年9月至8月在苏湖尔综合公立医院分娩的妇女进行机构横断面研究。数据输入EPI Info version 7，导出到SPSS version 25进行分析。检验双变量和多变量逻辑回归来评估结果和自变量之间的关联。最后，多变量逻辑回归分析中p值小于0.05的变量被认为是显著相关的。结果:原发性CS发生率为20.2%。CS的主要指征为非安心胎儿心跳模式(NRFHRP)(32.2%)。接受强化治疗的女性发生原发性CS的可能性是未接受强化治疗的女性的3.14倍(调整优势比(AOR)= 3.14;95% ci: 1.49, 6.57)。有妊娠高血压的妇女发生原发性CS的可能性是无妊娠高血压妇女的3.1倍(AOR= 3.10;95% ci: 1.23, 7.83)。此外，生育≥4000克新生儿的妇女为11倍(AOR= 11;95% CI: 2.30, 57.51)比出生2500-3999克新生儿的孕妇更容易发生原发性CS。孕周未知妇女为5.83次(AOR= 5.83;95% CI: 2.37, 14.31)比孕龄为37-42周的妇女更容易发生原发性CS。结论:本研究中原发性剖宫产的发生率较高。胎龄、增体、PIH和出生体重是原发性CS的重要决定因素。应采取客观决策，减少初次剖宫产的规模。
{"title":"Magnitude and Determinants of Primary Cesarean Section Among Women Who Gave Birth in Shire, Northern Ethiopia","authors":"A. Alemu, Liknaw Bewket Zeleke","doi":"10.2147/oas.s254758","DOIUrl":"https://doi.org/10.2147/oas.s254758","url":null,"abstract":"Background: Cesarean section (CS) is a lifesaving medical intervention. It plays a vital role in decreasing maternal mortality and morbidity rates. It is also an indicator of maternal health services quality of a country. CS practice has been rising regardless of the medical condition, age, race, or gestational age. However, it is associated with many complications compared with vaginal deliveries, particularly in developing countries. Therefore, the aim of this study was to assess the magnitude and determinants of primary cesarean section among women who gave birth in Suhul General Hospital, Shire town, Northern Ethiopia. Methods: Institutional cross-sectional study was conducted from September 19 to October 20, 2017, among women who gave birth between September and August 2016 in Suhul General Public Hospital. Data were entered into EPI Info version 7 and exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regressions were examined to assess the association between outcome and independent variables. Finally, variables with p-value less than 0.05 on multivariate logistic regression analysis were considered as significantly associated. Results: The magnitude of primary CS was 20.2%. The main indication for CS was non-reassuring fetal heartbeat pattern (NRFHRP) (32.2%). Women who had been augmented were 3.14 times more likely to undergo primary CS than those who had not (adjusted odds ratio (AOR)= 3.14; 95% CI: 1.49, 6.57). Women who had pregnancy-induced hypertension were 3.1 times more likely to undergo primary CS than those who had not (AOR= 3.10; 95% CI: 1.23, 7.83). Additionally, women who gave birth of ≥4000 gm newborns were 11 times (AOR= 11; 95% CI: 2.30, 57.51) more likely to undergo primary CS than those who gave birth 2500–3999 gm of newborns. Moreover, women with unknown gestational age were 5.83 times (AOR= 5.83; 95% CI: 2.37, 14.31) more likely to undergo primary CS than women whose gestational age was 37–42 weeks. Conclusion: The magnitude of the primary cesarean section in this study was high. Gestational age, augmentations, PIH, and birth weight were significant determinants of primary CS. Objective decisions should be practiced to reduce the magnitude of the primary caesarean section.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s254758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48292100","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}
Saleh Al-wajih, F. Ahmed, Hossein-Ali Nikbakht, E. Al-shami, M. Askarpour, Umayir Chowdhury
Background: Thyroid diseases are major health problems in our society, which are manifested by alteration in hormone secretion, enlargement of the thyroid gland, or both. This study was designed to determine thyroid histopathological patterns in patients who underwent thyroid operation. Materials and Methods: This retrospective study was carried out at Sana ’ a University Hospital over two years, from January 1, 2014, to December 30, 2015. All 260 patients who underwent thyroid surgery were included in this study. Factors such as age, sex, residency, fi ne needle aspiration biopsy (FNAB) result, and post-operative histopathological patterns were recorded. Patients who only underwent FNA were excluded. Results: The mean age of participants was 40.06±13.18 years. Females were most com-monly affected by thyroid diseases (90%) in comparison to males (10%). Histopathologic patterns were nodular colloid goiter (63.1%), adenoma (4.6%), papillary thyroid neoplasms (20.4%), follicular thyroid carcinoma (3.8%), medullary thyroid carcinoma (1.9%), thyroiditis (5.4%) and anaplastic thyroid carcinoma (0.8%). Papillary thyroid cancer was the most common thyroid cancer, with a prevalence of 53 (20.4%). The accuracy of FNAB and fi nal histopathology in combine was 88.07%. However, FNAB was not precise enough in the pre-operative diagnosis of follicular carcinoma (40%). FNAB sensitivity ranged from 70.8% to 88.8%, while FNAB speci fi city ranged from 97.1% to 99.9%. Conclusion: Nodular colloid goiter is the most prevalent thyroid disease, while papillary thyroid carcinoma is the most frequent cancer seen in this study. We recommend further studies with a larger population to validate our study.
{"title":"An Investigation of the Histopathological Pattern of Thyroid in Patients Undergoing Thyroid Operations: A Cross-Sectional Study","authors":"Saleh Al-wajih, F. Ahmed, Hossein-Ali Nikbakht, E. Al-shami, M. Askarpour, Umayir Chowdhury","doi":"10.2147/oas.s253109","DOIUrl":"https://doi.org/10.2147/oas.s253109","url":null,"abstract":"Background: Thyroid diseases are major health problems in our society, which are manifested by alteration in hormone secretion, enlargement of the thyroid gland, or both. This study was designed to determine thyroid histopathological patterns in patients who underwent thyroid operation. Materials and Methods: This retrospective study was carried out at Sana ’ a University Hospital over two years, from January 1, 2014, to December 30, 2015. All 260 patients who underwent thyroid surgery were included in this study. Factors such as age, sex, residency, fi ne needle aspiration biopsy (FNAB) result, and post-operative histopathological patterns were recorded. Patients who only underwent FNA were excluded. Results: The mean age of participants was 40.06±13.18 years. Females were most com-monly affected by thyroid diseases (90%) in comparison to males (10%). Histopathologic patterns were nodular colloid goiter (63.1%), adenoma (4.6%), papillary thyroid neoplasms (20.4%), follicular thyroid carcinoma (3.8%), medullary thyroid carcinoma (1.9%), thyroiditis (5.4%) and anaplastic thyroid carcinoma (0.8%). Papillary thyroid cancer was the most common thyroid cancer, with a prevalence of 53 (20.4%). The accuracy of FNAB and fi nal histopathology in combine was 88.07%. However, FNAB was not precise enough in the pre-operative diagnosis of follicular carcinoma (40%). FNAB sensitivity ranged from 70.8% to 88.8%, while FNAB speci fi city ranged from 97.1% to 99.9%. Conclusion: Nodular colloid goiter is the most prevalent thyroid disease, while papillary thyroid carcinoma is the most frequent cancer seen in this study. We recommend further studies with a larger population to validate our study.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/oas.s253109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43464471","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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