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Enhanced Recovery after Cesarean section (Cs) versus Conventional Care in a Lower Middle-Income Country: A Randomized Controlled Trial

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Open Journal of Nursing 2022年第12期12卷 831-841页

作者： Atef Darwish Manal Mustafa Entrsar Youness Bushra al-harazi Department of Obstetrics and Gynecology Faculty of Medicine Assiut University Assiut Egypt Department of Obstetrics and Gynecological Nursing Faculty of Nursing Assiut University Assiut Egypt Department of Obstetrics and Gynecological Nursing Faculty of Medicine and Health Sciences-Nursing Department Sana’a University Sanaa Yemen

Background: Enhanced recovery after surgery (ERAs) has been tested in a wide variety of surgeries with promising outcomes. However, there is a need for a standardized, evidence-informed approach to both the development of new ERAs society guidelines, and the adaptation and revision of existing guidelines. Developing countries have limited resources and deserve every effort to improve economic status. Aim of the study: to evaluate perinatal maternal outcomes of ERAssup>?sup> versus routine care protocols in women undergoing elective cesarean section (Cs) in a lower middle-income country with limited resources ranked as a third most country performing Cs worldwide using a multidisciplinary team (MDT) management. Design: A prospective randomized Controlled Trial. setting: Outpatient department (OPD) and labor ward at the Woman’s Health hospital, Assiut University, Egypt. Participants: Healthy pregnant women planned for elective Cs (300 women) were randomly divided into a study group offered ERAs protocol and a control group offered regular care. Results: Repeat Cs was the main indication of elective Cs in both groups without significant difference (89 cases (59.3%) and 75 cases (50%) in both groups respectively). Other indications included cephalopelvic disproportion in 17 cases (11%) and 19 cases (12.6%), placenta previa in 28 (18.6%) and 34 (22.6%) cases, DM in 11 (7%) and 19 (12.6%) cases, and others in 5 (0.3%) and 3 (2%) cases in both groups respectively. The study group took much less time to eat and walk. It had significantly lower pain levels and postoperative problems, as well as much greater women’s satisfaction and a shorter hospital stay (p = 0.001). Conclusions: Collaboration of nursing, obstetricians and anesthesiologists is the cornerstone for a successful ERAs for Cs. significant better perinatal maternal outcomes encourage expansion of ERAs in lower middle-income countries with limited resources.

关键词： Nursing Cesarean section Enhanced Recovery

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Retention of skills with and without Debriefing Three-Months after Cardiopulmonary Resuscitation Training in Makkah, saudi Arabia: A Randomized Controlled Trial

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Open Journal of Preventive Medicine 2019年第11期9卷 141-154页

作者： Rehab Mohammed Gaafar soha aly Elmorsy Abdulmajeed soliman Khan Mohammad kamel al-harazi s.aimaa kamel al-harazi Nouf kamel al-harazi saudi Heart Association Riyadh KSA Research Center King Abdullah Medical City Makkah KSA Internal Medicine Department Hera General Hospital Makkah Ministry of Health (MoH) Makkah KSA Community Medicine Department MoH Hera General Hospital Makkah KSA King saud University for Health sciences Riyadh KSA Umm al-Qura University Makkah KSA

Background: Evidence of cardiopulmonary resuscitation (CPR) performance has driven interest in procedures, e.g., debriefing to improve CPR quality. Aim: To investigate retention of skills with and without debriefing 3-months after CPR training on high-fidelity manikins (HFM) among participants involved in the “Heart safe City Initiative” event (HsCI) in Makkah, saudi Arabia. Methodology: A randomized controlled design was used during October 2017-January 2018. Participants were divided into two groups: an intervention group to receive debriefing after CPR (debriefing group or “subjects”), and a non-intervention group (“controls”). Participants were tested repeatedly: before training (pre-training test), immediately after and 3-months after training (retention or late test);and scores for each test were recorded. Results: The study’s subjects and controls did not vary by age, sex, nationality, and profession’s criteria (p > 0.05, all analyses). The mean retention posttests scores significantly varied between subjects and controls [t>(df = 200) = 27.7, p p = 0.18). Further, the immediate posttest scores were significantly higher than the pretests’ within the study population as a whole group [mean difference 38.05% ± 27.59%, t>(df = 201) = 13.5, p t>(105) = 14.31, p t>(df = 95) = 13.50, p t>(df = 201) = 20.85, p t>(df = 105) = 21.46, p t>(df = 95) = 22.12, p t>(df = 200),4.76, p t(df = 97) = -2.95, p Conclusions: Debriefing using HFM training achieves the target of improving the public’s skills of CPR. Considering the urgent need to recruit every society member to be a heartsaver;debriefing after CPR training helps improve the quality and retention of basic CPR skills.

关键词： Cardiopulmonary Resuscitation Debriefing Retention skills saudi Arabia

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Integrated Genomic and Network-Based Analyses of Complex Diseases and Human Disease Network

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Journal of Genetics and Genomics 2016年第6期43卷 349-367页

作者： Olfat al-harazi sadiq al Insaif Monirah A.al-Ajlan Namik Kaya Nduna Dzimiri Dilek Colak Department of Biostatistics Epidemiology and Scientific ComputingKing Faisal Specialist Hospital and Research Centre College of Computer and Information sciences King Saud University Department of Genetics King Faisal Specialist Hospital and Research Centre

A disease phenotype generally reflects various pathobiological processes that interact in a complex network. The highly interconnected nature of the human protein interaction network（interactome） indicates that, at the molecular level, it is difficult to consider diseases as being independent of one another. Recently, genome-wide molecular measurements, data mining and bioinformatics approaches have provided the means to explore human diseases from a molecular basis. The exploration of diseases and a system of disease relationships based on the integration of genome-wide molecular data with the human interactome could offer a powerful perspective for understanding the molecular architecture of diseases. Recently, subnetwork markers have proven to be more robust and reliable than individual biomarker genes selected based on gene expression profiles alone, and achieve higher accuracy in disease classification. We have applied one of these methodologies to idiopathic dilated cardiomyopathy（IDCM） data that we have generated using a microarray and identified significant subnetworks associated with the disease. In this paper, we review the recent endeavours in this direction, and summarize the existing methodologies and computational tools for network-based analysis of complex diseases and molecular relationships among apparently different disorders and human disease network. We also discuss the future research trends and topics of this promising field.

关键词： Proteineprotein interaction subnetwork marker Diseasome Network medicine systems biology Genomics

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Association between the cytotoxic T-lymphocyte antigen-4 polymorphisms and breast cancer risk and prognosis

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Journal of Cancer Metastasis and Treatment 2015年第1期1卷 16-20页

作者： Meraj Farbod seyed Mostafa shiryazdi Hamid harazi Tahereh Nazari Mohammad Hasan sheikhha Department of General surgery Shahid Rahnemon HospitalShahid Sadoughi University of Medical SciencesYazd ***Iran Department of General surgery Shahid Sadoughi HospitalShahid Sadoughi University of Medical SciencesYazd ***Iran Department of General surgery Shohada-Kargar HospitalSocial Security OrganizationYazd ***Iran Department of Human Genetics International CampusShahid Sadoughi University of Medical SciencesYazd ***Iran Department of Medical Genetics Research and Clinical Center for InfertilityShahid Sadoughi University of Medical SciencesYazd ***Iran

Aim:The aim was to evaluate the potential infl uences of cytotoxic T-lymphocyte antigen-4(CTLA-4)gene polymorphisms on breast cancer risk,the distribution of CTLA-4 single nucleotide polymorphisms(1661AG)in breast cancer patients and control subjects was ***:In this case-control study,100 patients with breast cancer as case group and 100 healthy participants as a control group were *** were determined by the polymerase chain reaction-restriction fragment length polymorphism *** characteristics of the study population,as well as tumor size,tumor grade and stage were collected in a questionnaire designed for this *** collected data were statistically analyzed by sPss-16.0(sPss Inc.,Chicago,UsA)predictive analytic software using the Chi-square ***:The mean age of women was 43.42±13.1 *** AA genotype was frequent in case group(43%)whereas the AG genotype was found more in the control group(69%).There was no signifi cant relationship between the studied polymorphisms and the grade,stage and size of the tumor,nor between the studied polymorphisms and estrogen receptor,progesterone receptor and lymph node involvement(P>0.05).signifi cant association between the studied polymorphisms and breast cancer metastases was found(P=0.02).Conclusion:According to the results of the study,the AA genotype is associated with breast cancer,but none of the studied gene polymorphisms is associated with prognostic factors such as tumor stage,grade or size.

关键词： Breast cancer cytotoxic T-lymphocyte antigen-4 polymorphism prognosis

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