Therapeutic Management and Prognostic Factors of Upper Gastrointestinal Bleeding at Sikasso Regional Hospital | Chapter 2 | Medical Science: Recent Advances and Applications Vol. 8

 

Introduction: Upper digestive haemorrhage (UDH) is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. UDH is defined as any bleeding from the mouth following efforts to vomit (hematemesis) or from the anus (melena) whose lesion is located upstream of the angle of Treitz.

 

Study Aim: The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage.

 

Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent were included. A descriptive analysis of the study sample was carried out. Data were analysed using SPSS version 21 software. The significance level was set at 5%.

 

Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. The hospital frequency of upper digestive haemorrhage was 8.99%. Ruptured oesophagal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of haemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). The study found no statistically significant relationship between prognosis and etiologies (P = 0.11) and length of hospital stay (P = 0.18).

 

Conclusion: This study shows that the hospital frequency of upper digestive haemorrhage and its lethality remain high at the Sikasso regional hospital, despite under-frequentation. Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community aware- awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

 

 

Author(s) Details

Oumar Traoré
Service of Internal Medicine, Regional Hospital, Sikasso, Mali.

 

Abdoul Salam Diarra
National Center for Scientific and Technological Research, Bamako, Mali.

 

Dramane Touré
Department of Pediatric, Health Referral Center of Mopti, Mali.

 

Kadiatou Cissé
Service of Internal Medicine, Regional Hospital, Sikasso, Mali.

 

Mohamed Diarra
Service of Pediatric, Health Referral Center of Kalaban Coro, Koulikoro, Mali.

 

Yacouni Nema Poudiougou
Service of Pediatric, Health Referral Center of Commune VI, Bamako, Mali.

 

Saïdou Touré
Service of Internal Medicine, Regional Hospital, Sikasso, Mali.

 

Mohomedine Touré
Service of Internal Medicine, Regional Hospital, Sikasso, Mali.

 

Aboudou Dolo
Service of Nephrology, Department of Internal Medicine, Regional Hospital, Sikasso, Mali.

 

Youana Koné
Service of Nephrology, Department of Internal Medicine, Regional Hospital, Sikasso, Mali

 

Madou Traoré

Department of Infectious Disease, Regional Hospital, Sikasso, Mali.

 

Leyla B Maïga
Service of Pediatric, University Hospital Center (CHU) Gabriel Toure, Bamako, Mali.

 

Kalba Péliaba

Service of Hepato-Gastroenterology, CHU Gabriel Toure, Bamako, Mali.

 

Hamadoun Sangho
Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v8/5472

Markers and the Materno-Foetal Result of Caesarean Section: A Study at the Secondary Health Facility in Obudu, Cross River State, Nigeria | Chapter 1 | Medical Science: Recent Advances and Applications Vol. 3

Background: Caesarean section (CS) refers to the delivery of a foetus, placenta and membranes after the age of viability through an abdominal and uterine incision. Caesarean section is further divided into two subtypes as far as the urgency of the operation is concerned. Elective caesarean section refers to those occasions where the decision to carry out caesarean section is made and planned more than 24 hours before delivery. Caesarean section (CS) is an important tool in obstetric care for the reduction of maternal and foetal morbidities and mortalities. This study was done to determine the CS rate, the indications and the maternal and foetal outcome of emergency and elective caesarean sections at the Sacred Heart Hospital Obudu, Cross River State.

Methods: A retrospective review of clinical records of all patients delivered by CS from September 2011 to August 2016 at the Sacred Heart Hospital, Obudu, Cross River State, Nigeria was conducted. Data for the study were extracted from theatre records, labour ward records and neonatal ward records using a structured questionnaire. The information obtained included socio-demographic variables, obstetric history and outcome of caesarean section. The data collected was checked for its completeness, entered into a computer and analysed using SPSS version 20.0. Frequencies.

Results: There were 2445 deliveries with 453 caesarean sections during the review period, giving a CS rate of 18.1%. Emergency CS accounted for 338(74.6%), while elective CS accounted for 115(25.6%). The main indications for emergency CS were cephalo-pelvic disproportion (CPD) (16.9%) and obstructed labour (16.0%), followed by breech deliveries. Previous CS was the main indication for elective CS (50.4%). Generally, the maternal and foetal outcomes of elective CS were better than emergency CS. There were 4 deaths, all accounted for by emergency CS, giving a CS mortality of 0.9%. Maternal morbidities like post-partum haemorrhage, sepsis, and prolonged hospital stay were worse among the emergency CS patients. Some conditions, like obstetric fistula and ruptured uterus, were found only amongst the emergency CS patients. For foetal outcome, poor Apgar score, sepsis, death, jaundice and need for referral were worse among emergency CS patients.

Conclusion: The incidence of CS is high in this centre, with a higher rate of emergency than elective CS. Also, the maternal and foetal outcomes of emergency CS were worse than those of elective CS. Caesarean section remains an important tool in obstetrics practice for the reduction of maternal and neonatal morbidity and mortality. In this review, the main indications for emergency CS were CPD, obstructed labour and breech presentation, while previous CS was the main indication for elective CS.

 

Author (s) Details

Maanongun MT
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ornguze AA
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ojabo AO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Eka PO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v3/2630

Consolidate the Diverse Strategies and Advancements for Managing Non-muscle Invasive Bladder Cancer, Focusing on T1 High-grade Cases: A Comprehensive Review | Chapter 13 | Novel Research Aspects in Medicine and Medical Science Vol. 4

 Objective: This inclusive review examines the impact of various scientific approaches employed over ancient times two decades in the treatment of T1 prime bladder tumor. The aim is to assess their influence on dispassionate outcomes through a orderly review.Literature Search Methodology: Through a systematic approach, a composition review spanning 2000 to 2020 was conducted across differing databases including PubMed, Medline, and Embase. This review focuses on randomized reserved trials (RCTs), dispassionate trials, research and review articles, and original offerings that address the diagnosis and administration of non-muscle obtrusive bladder cancer (NMIBC) inside the last two decades. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS tests (Population, Intervention, Comparators, Outcomes, and Study Design), we identified and culled over 573 studies. Ultimately, 85 articles were selected for reasoning, encompassing 19 anticipated trials, 44 RCTs, original and research items, a review article, and clinical tests. Retrospective studies were intentionally expelled to minimize bias.Results: The review delves into the duty of biomarkers in early NMIBC patient identification for predicting frequency and progression. Notably, P-cadherin verbalization and other stones show promise in recurrence and progression forecasting. Risk stratification arises as a pivotal finish to enhance NMIBC patient outcomes, even though refinements are still necessary.Studies underline the positive impact of radiance diagnostic cystoscopy (FDC) and Photodynamic diagnosis (PDD) on repetition-free survival, even though their influence on progression and overall consequences is less evident. Consensus points to intravesical BCG therapy as ultimate transformative situation for altering prime T1 disease trajectories, specifically in terms of progress. Re-TURBT after 2-6 weeks is more endorsed by international peoples. Its potential to enhance continuation is debated, as it offers upgraded sampling for pathologic reading and discovery rates.While numerous items underscore the benefits of early cystectomy for NMIBC cases, contrasting viewpoints plan that cystectomy could conceivably result in overdone treatment. The consensus underlines the necessity for clear selection tests, as postponing cystectomy for NMIBC is associated with a more ominous prognosis distinguished to timely surgical interference.Conclusions: This comprehensive review evaluates the outcomes assign to scientific progresses in managing NMIBC inmates over the past two decades. Variability in outcomes between T1 bladder tumor patients stands from tumor heterogeneity and dispassionate staging. Despite advances in disease, risk stratification, and administration, larger studies are required to better include and tailor treatment for this patient subspace, with the aim of minimizing both over-situation and under-treatment.

Author(s) Details:

Walid F. Alame,
Division of Urology, Sahel General Hospital-FAUMC, Beirut, Lebanon.

Nehme Raad,
Department of Urology, Mouwasat Hospital, Qatif, Kingdom of Saudi Arabia.

Serge Ibrahim,
Urology Resident, Faculty of Medicine, Lebanese University, Beirut, Lebanon.

Please see the link here: https://stm.bookpi.org/NRAMMS-V4/article/view/12107

The Value of ISBAR (Introduction,Background, Assessment and Recommendation) Handover in COVID-19 Pandemic and Non-COVID Clinical Practice in Improving Population Health: A Scoping Review of the Literature | Chapter 1 | Current Innovations in Disease and Health Research Vol. 4

 Having trustworthy handovers during COVID-19 emergencies and well diffusible infectious afflictions helps reduce threats to culture health. In this case, coordination middle from two points teams of various clinical practitioners through a joint handover framework helps diffuse information and data to appreciate COVID-19 and non-COVID multifaceted medical environments in patients and populations. However, individual of the significant subscribers to harmful clinical effects is a communication disintegration, especially when there is an interprofessional handover. The initiation, situation, background, appraisal, and  recommendation (ISBAR or plainly SBAR) communication tool was constructed to improve handover efficiency and is usually believed to improve patient safety and quality of care. Summary of the belongings of SBAR application on patient safety in two together COVID-19 and non-COVID clinical backgrounds are the primary objectives concerning this scoping review. It is also stated that communication bottlenecks happen when health professionals correspond more prevalently with co-laborers from the same instructional or professional background. In this case, information and information about communal patients do not flow consistently inside interprofessional teams. The current chapter is a examine review of articles written on I/SBAR during COVID-19 and non-COVID clinical practice achieved using MEDLINE, PUBMED, EMBASE, CINAHL, Web of Science and Google Scholar. The search also contained the SBAR (Situation, Background, Assessment and Recommendation) derivates such as ISBAR (Introduction + SBAR) and K-SBAR (Kindness + SBAR). All original items fulfilling the eligibility tests were included: (1) SBAR or ISBAR were used in handovers, (2) the studies were determinable, qualitative or assorted methods with strong statistical background and consequence measures, (3) settings were acting as a nurse, pharmacy or medical schools.

Author(s) Details:

Carlo Lazzari,
International Centre for Healthcare and Medical Education, London, United Kingdom.

Marco Rabottini,
International Centre for Healthcare and Medical Education, London, United Kingdom.

Please see the link here: https://stm.bookpi.org/CIDHR-V4/article/view/11443

Adults with Neglected and Recurring Clubfoot: An Approach towards Acute Surgical Correction| Chapter 13 | Current Progress in Medicine and Medical Research Vol. 1

 In this phase, we ought to find out the working outcome of Talipes Equinovarus in men. Neglected clubfoot by definition is untreated equino-cavo-adducto-varus in earlier children, minors or even adults. Untreated severe clubfoot exceptionally exists contemporary in developed countries, except in few migrants from low- and middle-salary countries. The study was conducted at Bashaer University Hospital and Future Hospital in Khartoum, Sudan. All surgeries were accomplished by the alike foot and ankle abscission team in two together hospitals. Data was collected utilizing a questionnaire and the working outcome has been evaluated using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was calculated before surgery and one old age after abscission. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (weak). This score improved to 80.7 ± 13.7 (good to superior), two years after resection. However, this indicates a significant change in the working outcome afterwards the operation (p-value < 0.05). The complicatedness of the multi-planar hoof deformity requires early interference, good surgical planning, and the choice of the appropriate compassionate tissue and or bone processes. Excellent postoperative working outcome was found between patients old 18 - 23 years 18 (50%) p-value: 0.021. The most of patients 36 (90%) were completely satisfied with the movement, 2 (5%) partially quenched and 2 (5%) were unsatisfied.The functional effect of this movement is comparable to other processes like triple Arthrodesis, double osteotomies, and progressive corrections by external fixators.

Author(s) Details:

Sami Nogdallah,
Orthopedic Department, Al Neelain University, Khartoum, Sudan.

Hassan Mohamed Hassan,
Bashaer Teaching Hospital, Khartoum, Sudan.

Alaa Mohamed Mohamed Khairy,
Sudan Medical Specialization Board, Khartoum, Sudan.

Dafaalla Salih,

Alzaiem Alazhari University (AAU), Khartoum, Sudan.

Hozifa Mohammed Ali Abd-Elmaged,

Alzaiem Alazhari University (AAU), Khartoum, Sudan.

Montaser Fatooh,

Orthopedic Department, Al Neelain University, Khartoum, Sudan.

Please see the link here: https://stm.bookpi.org/CPMMR-V1/article/view/11231

COVID - 19: Clinical Profile and Outcome of Patients from Tertiary Care Center in North India| Chapter 7 | Current Overview on Disease and Health Research Vol. 7

 An severe respiratory contamination of unknown origin was first labeled in Wuhan, china and stated to WHO on 31st December 2019 and within a temporal length of event or entity's existence, this outbreak was asserted as a Public Health Emergency of International Concern.  This chapter aims to to assess the range of clinical performances and host related determinants in outcome of COVID-19 all the while the first wave. This single centre study revealed the range of dispassionate manifestations and host-connected characteristics in COVID-19's first wave effects, which can help in decrease the burden of disease, minimize friendly disruption, and decrease the economic impact guide a pandemic. Early acknowledgment, admission, and treatment of earlier and co-morbid inmates might hurry the recovery from the sickness and hence lower mortality.

 Author(s) Details:

S. R. Manjunath,
Department of Community Medicine, AFMS, New Delhi, India.

Ravishekar N. Hiremath,
Department of Community Medicine, AFMS, New Delhi, India.

Kasi Vishwanath,
Department of Community Medicine, AFMS, New Delhi, India.

S. K. Thakur,
Department of Community Medicine, AFMS, New Delhi, India and Department of Orthopedics, AFMS, New Delhi, India.

S. K. Choudhary,
Department of Orthopedics, AFMS, New Delhi, India.

Sandhya Ghodke,
Department of Anaesthesia, Rainbow Children Hospital, Bangalore, India.

Please see the link here: https://stm.bookpi.org/CODHR-V7/article/view/9435

Outcome of Endodontics Treatment | Book Publisher International

Several studies have looked at the outcome of endodontic therapy and the factors that influence it. The success rate and associated boundaries of the tooth being treated are essential for evaluating the expectation and providing strong support for treatment decisions. The concept of evidence-based medicine has gained popularity in the last 10 years.

The patient should be informed about the available information on the cycle, as well as the expected outcomes of nonsurgical root waterway therapy, when treatment planning is taking place. The lack of periapical radiolucency, root restoration without flaws, root filling within 2 mm of the radiographic peak, and excellent coronal reclamation are all factors that affect the outcome of nonsurgical endodontic therapy. The most important of these metrics are the pulpal and periapical analyses. Additionally, the presence or absence of periapical radiolucency before to surgery is a significant predictor of postoperative success or failure.

Author(s) Details:

Shahd Fawaz Alnojaidi

Dar Al Uloom University, Riyadh, Saudi Arabia and Massachusetts Central University, USA.

Ghadeer Fawaz Alnojaidi

Dar Al Uloom University, Riyadh, Saudi Arabia.

Rahaf Fawaz Alnojaidi

Dar Al Uloom University, Riyadh, Saudi Arabia.

Sawsan M. Alyousef

Intensive Care Consultant, King Fahad Medical City, Princess Noura University, Riyadh, Saudi Arabia.

View Book: https://stm.bookpi.org/OET/article/view/7415

Anti-Retroviral Regimen Change & Subsequent Patient–Related Outcomes in South Africa | Chapter 6 | Current Practice in Medical Science Vol. 2

The purpose of the study was to discover variables that impact antiretroviral treatment (ART) regimen modification and to evaluate patient outcomes post regimen change. At a Provincial Hospital ARV Clinic in KwaZulu-Natal, from January 2008 to December 2012, a retrospective chart analysis of 269 HIV-infected non-pregnant patients (age >18 years) who underwent an antiretroviral (ARV) regimen change and were followed up for roughly one year since initiation was conducted. Findings showed that 200 of the 269 cases involved women (75 percent). Most of the patients were in the 30 to 44 age range (57.6 percent). Only five of the people were infected with TB (2 percent). Stavudine (D4T)/ lamivudine (3TC)/ efavirenz (EFV) was the first-line ART regimen that was altered the most frequently (n = 111). (41 percent ). Tenofovir (TDF)/3TC/EFV was the most often changed medication for patients (n = 89). (33 percent ). The most often used medication alternative was stavudine (35.5 percent ). ADRs with lipodystrophy were more prevalent (56.8 percent ). ADR was the reason for changing the ART regimen in 175 patients (65%), whereas treatment failure (TF) was the reason in 94 individuals (35 percent ). After changing the regimen, immunological success (CD4 counts) was seen (374.21 243.16 vs. 456.09 250.07, CI: 0.95, p 0.001). After the regimen was changed, undetectable viral levels were discovered in 172/205 (83.9%) patients. According to the findings of this study, adverse drug reactions (ADRs) were the primary reason why antiretroviral regimens were changed. Lipodystrophy was the most frequent adverse effect of stavudine, the medicine that was most frequently replaced. After changing the regimen, progress was seen in the areas of immunology and virology.

Author(s) Details:

Vereesha Soorju,

Madadeni Hospital, School of Health Sciences, University of KwaZulu - Natal, South Africa.

Panjasaram Naidoo,

Madadeni Hospital, School of Health Sciences, University of KwaZulu - Natal, South Africa.

Please see the link here: https://stm.bookpi.org/CPMS-V2/article/view/7345

Impact of Maternal Age on Pregnancy | Chapter 20 | New Horizons in Medicine and Medical Research Vol. 4

 The goal of this study was to see how maternal age affected obstetric and newborn outcomes in the Al-Madinah region.

Methods: After receiving ethical approval from MMCH, this retrospective cohort analysis was based on a database of medical records from Madinah Maternal and Children Hospital (MMCH) from January to December 2017.

The target maternal age group was separated into three categories: women under the age of 20, women between the ages of 20 and 35, and women over the age of 35.

The total number of pregnancy cases collected was 849. Women aged 35 years old were responsible for 47 percent of abortions, 66.3 percent of gestational diabetes mellitus (GDM), 59 percent of Caesarian section (LSCS), 71.5 percent of stillbirths, and 55.8% of NICU admissions.

Conclusions: Maternal age influences obstetric and neonatal outcomes.

Miscarriage, GDM, CS, stillbirth, and NICU hospitalisation are all linked to maternal age. Other issues are more common among adolescent mothers. Because maternal age is a critical factor that can influence obstetric and neonatal outcomes, women must be educated about the best age to start planning a pregnancy and the need of antenatal care.

Author(S) Details

Mohammad Othman
Department of Obstetrics and Gynaecology, Fakeeh College of Medical Sciences, Jeddah, Saudi Arabia.

Basil M. Othman
Al-Rayan Medical College, Madinah, Saudi Arabia.

View Book:- https://stm.bookpi.org/NHMMR-V4/article/view/6382

Gender Differences in COVID-19 Patients with Arterial Hypertension and Diabetes Mellitus | Chapter 17 | Issues and Developments in Medicine and Medical Research Vol. 3

 Background: The coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2) has infected over 160 million people worldwide. Susceptibility to SARS-CoV-2 infection is increased by hypertension (HT), chronic heart disease (CHD), and diabetes mellitus (DM). Aims. The goal of this retrospective investigation was to see if there were any gender differences in SARS-CoV-2 patients who were hypertensive diabetics. We presented data on inflammatory status, hospital stays, ICU admission, Rx and CT report, and therapy, with gender differences indicated.

Methods: From March 26 to June 30, 2020, we enrolled 1014 patients with confirmed COVID-19 who were admitted to several Campania hospitals. The diabetic-hypertensive group (DM-HT group), which comprises 556 patients with diabetes mellitus and arterial hypertension, and the non-diabeticnon-hypertensive group (non-DM, non-HT group), which contains 458 individuals, were divided into two groups. Up until June 30, 2020, clinical outcomes (such as discharges, death, length of stay, therapy, and admission to critical care) were tracked.

Results: We found that females in the DM-HT group had a greater proportion of ischemic cardiopathy (CHD) (47.5 percent vs. 14.8 percent, respectively; p 0.0001) and lung illnesses (34.8 percent vs. 18.5 percent, respectively; p 0.0001). We found that male subjects had a higher proportion of kidney diseases (CKD) (11 percent vs. 0.01 percent, respectively; p 0.0001), a longer hospital stay (22 days vs. 17 days, respectively, p 0.0001), a higher ICU admission (66.9% vs. 12.8 percent, respectively, p 0.0001), and a higher death rate (17.3 percent vs. 10.7%, respectively, p 0.0001).

Conclusion: These findings show that male participants have a longer hospital stay, more ICU admissions, and a greater death rate than female ones. To resolve all of the problems that have been raised, large studies with full analyses of all risk factors and longer follow-up are required.

Author(S) Details

Tiziana Ciarambino
Internal Medicine Department, Hospital of Marcianise, 81037 Caserta, Italy.

Filippina Ciaburri
Hypertension Unit, Cardarelli Hospital, 80110 Naples, Italy.

Venere Delli Paoli
Internal Medicine Department, Cardarelli Hospital, 80110 Naples, Italy.

Giuseppe Caruso
Hypertension Unit, Cardarelli Hospital, 80110 Naples, Italy.

Maria D’Avino
Hypertension Unit, Cardarelli Hospital, 80110 Naples, Italy.

View Book:- https://stm.bookpi.org/IDMMR-V3/article/view/5478

A Comparative Overview of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy | Chapter 9 | New Frontiers in Medicine and Medical Research Vol. 2

 Hysterectomy is a gynaecological procedure used to treat benign conditions like uterine leiomyoma, dysfunctional uterine bleeding, endometrial hyperplasia, dysmenorrhea, dyspareunia, and severe endometriosis that have failed to respond to medical or conservative surgical treatment, as well as malignant conditions like cervical, endometrial, and ovarian cancer. Abdominal, vaginal, and laparoscopic hysterectomy are all options. The most common procedure is abdominal hysterectomy, but it is more intrusive and is associated with more blood loss, a longer recovery time, and a longer hospital stay. Laparoscopic hysterectomy has become a generally accepted treatment around the world since Reich's introduction in 1989. When compared to laparotomy, laparoscopic hysterectomy was found to have lower postoperative morbidity, greater quality of life, shorter hospital stay, and less blood loss. The study's goal was to assess the surgical outcomes, as well as intra- and post-operative complications, of Total Laparoscopic Hysterectomy (TLH) versus Total Abdominal Hysterectomy (TAH) (TAH). Between October 2016 and September 2018, a retrospective study was undertaken at SMGS hospital, GMC Jammu, with a total of 252 patients participating. Patients were separated into two groups, each with 126 patients: Group A included patients who had TLH and Group B included patients who had TAH. We found no significant differences between the two groups in terms of patient age (45.164.58 against 45.236.44), parity (4.322.08 versus 4.773.18), or surgical indication. The operation time in TLH (116.0216.38) was observed to be longer than in TAH (83.1821.40). The time spent in the hospital was much shorter in TLH than in TAH ( p value 0.0001). The TAH group had a higher Hb decline than the TLH group (1.460.64 versus 1.830.68). TAH patients received 25 (19.8%) post-operative blood transfusions, whereas TLH patients received only 9 (7.14%) post-operative blood transfusions, a statistically significant difference (p value0.0001). The time to ambulation in TLH patients was significantly less than in TAH patients (9.944.29 versus 23.031.28). In TAH, wound infection was more common than in TLH; 5 patients had wound infection, and 4 had wound dehiscence that required suturing. Due to adhesions, vascular injury, and bowel injury in one case, laparoscopy was switched to laparotomy in eight patients. An skilled surgeon can safely perform TLH as an alternative to abdominal hysterectomy, according to this study. It provides a number of benefits over TAH, including a smaller incision, earlier ambulation, a shorter hospital stay, and a quicker recovery time, as well as the lack of more serious problems.

Author (S) Details

Anju Dogra
Department of Obstetrics and Gynaecology, SMGS Hospital, Government Medical College, Jammu, J&K, India.

Vinay Kumar
Department of Obstetrics and Gynaecology, SMGS Hospital, Government Medical College, Jammu, J&K, India.

View Book :- https://stm.bookpi.org/NFMMR-V2/article/view/2682

Study on Management of Comminuted Fractures of the Shaft of Femur by Interlocking Nailing at a Tertiary Level Hospital in India | Chapter 18 | Highlights on Medicine and Medical Science Vol. 15

 A femoral shaft fracture is one of the most common fractures observed in orthopaedic practise. In patients who have been exposed to high energy trauma, the fracture shaft of the femur is a leading cause of morbidity and mortality. This study looks at the epidemiology of patients who report with femur fractures at a tertiary level hospital in Navi Mumbai.

The goal of this study was to see how long it took for comminuted femur fractures to heal. 2) To determine the length of stay in the hospital, and 3) to investigate the issues that may arise. 4) It's time to go for a walk.

This prospective study was undertaken in a tertiary level hospital in Navi Mumbai from January 1, 2014 to July 31, 2015. All patients with a comminuted femur fracture who were treated with interlocking nailing were included in the study. Various clinical and radiological indicators were gathered during the course of treatment.

The study included 50 patients, with 84 percent of them being men. 88 percent were under the age of 50. A car accident was the most common cause of injury, and 54 percent of patients had a fracture in the middle one-third of their femur. After 12 to 14 weeks, 52 percent of patients had clinical union, whereas radiological union was evident in the majority of patients after 16 to 18 weeks. In 10 weeks, 36% of patients started partial weight bearing, and in 16 weeks, 42% started complete weight bearing. The majority of patients were admitted for 10 to 14 days, and 66 percent of them had excellent functional outcomes as judged by Klemm and Borner criteria. Only six patients developed issues as a result of the procedure.

Conclusions: In our experience, interlocking nailing resulted in a low complication rate and a good functional outcome in two-thirds of comminuted femur fracture patients.

Author (s) Details

Aashay Kekatpure
Department of Orthopaedics, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Navi Mumbai, India.

Shikhar D. Singh
Department of Orthopaedics, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Navi Mumbai, India.

Sachin Kale
Department of Orthopaedics, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Navi Mumbai, India.

Prasad Chaudhari
Department of Orthopaedics, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Navi Mumbai, India.

Sanjay Dhar
Department of Orthopaedics, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Navi Mumbai, India.

View Book :- https://stm.bookpi.org/HMMS-V15/article/view/2479