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Post Episiotomy Morbidity among Parturient in Alex Ekwueme federal University Teaching hospital Abakaliki, Ebonyi State

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1144-1160页

作者： John Chinedu Obasi Ayodele Adegbite Olaleye Boniface N. Ejikeme John O. Egede Charles Nwambeke Edene Enemma Christian Enemma Victor Onuchukwu Emmanuel Onyekelu Nathan C. Ekpe Wendy Oliobi Emmanuel C. Uwakwe Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital AbakalikiNigeria

Background: Episiotomy is a very common obstetric surgery, and it could be associated with serious complications. However, these complications largely are not noticed due to the shift of attention from mother to baby, after a successful delivery. Objective: To identify the morbidities associated with episiotomies and factors associated with such morbidities. Method: This was a questionnaire based cross sectional descriptive study among women who attended the Obstetric Department of Alex Ekwueme federal University Teaching hospital Abakaliki Ebonyi State, between 1st July and 31st Nov, 2023. The study population consisted of parturients who had episiotomies in their previous confinements, attending either the antenatal clinic or the postnatal clinic at Alex Ekwueme federal University Teaching hospital Abakaliki Ebonyi State. Results: Macrosomia was the most common indication of episiotomy at a rate of 31.6%. The majority of episiotomies were performed on the parturients in their first confinement at a rate of 64.5% and the majority of repairs were performed by the Registrar at a rate of 65.0%. Informed consent was obtained from 45.79% of parturients while 54.21% were not informed before the episiotomy was administered. Only 55.3% of the parturient received analgesia before episiotomy was administered. The majority of the parturients had their episiotomy repaired between 10 - 15 minutes at a rate of 40.3%. Postoperative pain at the rate of 44.5% was the most common complication and dyspareunia as a form of sexual complication was the commonest at a rate of 31.3%. Conclusion: The parturient needs to be properly counselled before administration of episiotomy and adequate analgesia should be given, as episiotomy is a surgical procedure. Proper training of health workers on both the technique of administering and repairing episiotomy is important. Restrictive use of routine episiotomy in primigravidae is advised to reduce the rate of episiotomy.

关键词： Episiotomy Vulva Pains Primigravidae Morbidities Analgesia

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Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention

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Asian Pacific Journal of Tropical Medicine 2024年第3期17卷 95-96页

作者： Abolaji Paul Adekeye Mental Health Department Federal Teaching HospitalIdo-EkitiEkiti StateNigeria Mental Health Department Afe Babalola UniversityAdo-EkitiEkiti StateNigeria

Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the ***,these alterations manifest as c... 详细信息

关键词： rational behaviour emotional

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Metabolic disease and the liver: A review

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World Journal of Hepatology 2024年第1期16卷 33-40页

作者： Márcia Vargas Sheila de Castro Cardoso Toniasso Patricia G Riedel Camila Pereira Baldin Francielle Lopes dos Reis Robson Martins Pereira Maria Carlota Borba Brum Dvora Joveleviths Mario Reis Alvares-da-Silva Program of Graduate Science in Gastroenterology and Hepatology Federal University of Rio Grande do SulPorto Alegre 90040-060Rio Grande do SulBrazil School of Medicine Federal University of Rio Grande do SulPorto Alegre 90040-060Brazil Program of Graduate Science in Gastroenterology and Hepatology Clinicas Hospital of Porto AlegrePorto Alegre 90410000Brazil Medicine Faculty federal University of Rio Grande do Sul Federal University of Rio Grande do SulPorto Alegre 90040-060Brazil Division of Gastroenterology and Hepatology Clinicas Hospital of Porto AlegrePorto Alegre 90035007Brazil

Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most common liver disease worldwide,with an estimated prevalence of 31%in Latin *** presence of metabolic comorbidities coexisting with liver disease varies substantially among *** is acknowledged that obesity is boosting the type 2 diabetes mellitus“epidemic,”and both conditions are significant contributors to the increasing number of patients with *** steatohepatitis represents a condition of chronic liver inflammation and is considered the most severe form of *** diagnosis is based on the presence of steatosis,noninvasive scores and altered liver *** scores of liver fibrosis,such as serum biomarkers,which should be used in primary care to rule out advanced fibrosis,are simple,inexpensive,and widely ***,guidelines from international hepatology societies recommend using noninvasive strategies to simplify case finding and management of high-risk patients with MASLD in clinical ***,there is no definite pharmacological treatment for the *** public health policies to treat patients with risk factors for MASLD prevention is essential.

关键词： Nonalcoholic fatty liver disease Primary care Metabolic risk Liver Metabolism

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Determinants and Outcomes of Pregnancies among Booked versus Unbooked Patients in a Tertiary hospital South East, Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 144-161页

作者： Chijioke S. Anyigor-Ogah John O. Egede Chijioke O. Ogeh Chika C. Agunanne Alphosus I. Ozioko Chinyere C. Duru Department of Family Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Paediatrics Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria

Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme federal University Teaching hospital Abakaliki, Nigeria. Chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% CI = 1.24 - 32.59), educational status (OR = 36.40, 95% CI = 5.26-152.83), place of residence (OR = 0.15, 95% CI = 0.06 - 0.41), partner’s support (OR = 0.05, 95% CI = 0.01 - 0.37), family support (OR = 0.03, 95% CI = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% CI = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% CI = 2.45 - 14.83) and NBICU admission (OR = 3.75, 95% CI = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. Conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.

关键词： Socio-Demographic Characteristics Booking Status Antenatal Delivery

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Adjuvant Rectal Diclofenac for Post Operative Analgesia after Caesarean Section—A Randomized Controlled Study

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 591-609页

作者： Eziaha Eric S. Ede Ayodele A. Olaleye John C. Irechukwu Uchenna Nelson Nwaedu Borniface N. Ejikeme Vincent Chidiebere Ali Bartholomew I. Olinya Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can be used for postoperative analgesia. It is available and affordable. OBJECTIVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P CONCLUSION: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.

关键词： Pain Caesarean Section Diclofenac Placebo Suppository

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Fecal calprotectin and endoscopic scores: The cornerstones in clinical practice for evaluating mucosal healing in inflammatory bowel disease

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World Journal of Gastroenterology 2024年第24期30卷 3022-3035页

作者： Marcia Henriques de Magalhães Costa Ligia Yukie Sassaki Júlio Maria Fonseca Chebli Department of Clinical Medicine Fluminense Federal UniversityRio de Janeiro 24210-200Brazil Department of Internal Medicine Medical SchoolSão Paulo State University(Unesp)Botucatu 18618-686São PauloBrazil Division of Gastroenterology Department of MedicineUniversity Hospital of The Federal University of Juiz de ForaUniversity of Juiz de Fora School of MedicineJuiz de Fora 36036-247Minas GeraisBrazil

Managing inflammatory bowel disease(IBD)is becoming increasingly complex and personalized,considering the advent of new advanced therapies with distinct mechanisms of *** mucosal healing(MH)is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares,hospitalization,surgery,intestinal damage,and colorectal *** proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation,even if subclinical,to alter the natural course of *** monitoring of fecal calprotectin(FC)levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD,assessing MH,and detecting subclinical ***,we comment on the article by Ishida et al Moreover,this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with ***,we intend to present some evidence on the role of these markers in future targets,such as histological and transmural *** prospective multicenter studies with a stricter MH criterion,standardized endoscopic and histopathological analyses,and virtual chromoscopy,potentially including artificial intelligence and other biomarkers,are desired.

关键词： Fecal calprotectin Endoscopic scores Mucosal healing Histological healing Ulcerative colitis Inflammatory bowel diseases

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Insights into complications after unicompartmental knee arthroplasty

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World Journal of Clinical Cases 2024年第25期12卷 5662-5664页

作者： Tomas Nicolino Ignacio Garcia-Mansilla Knee Division Hospital Italiano de Buenos AiresCapital Federal 1109Argentina

Zhao's study,offers a comprehensive analysis of unicompartmental knee arthroplasty(UKA)revision *** study provides a detailed,case-by-case analysis of the factors leading to knee revision surgery in 13 *** only elucidates the complexities of UKA revisions but also underscores the importance of continuous improvement in surgical techniques and the adoption of innovative technologies.

关键词： Unicompartmental knee arthroplasty UKA Complications Revision Total knee arthroplasty

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Noninvasive Ventilation Interfaces in the Treatment of Acute Respiratory Insufficiency: A Critical Review

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Open Journal of Emergency Medicine 2024年第3期12卷 95-103页

作者： Andréa Nóbrega Cirino Nogueira Chakira Torres Lima Renata dos Santos Vasconcelos Suzy Maria Montenegro Pontes Arnaldo Aires Peixoto Junior Renan Magalhães Montenegro Junior Clinical Research Unit Walter Cantdio University Hospital Federal University of Cear/EBSERH Fortaleza Brazil

Background: Noninvasive ventilation (NIV) is an important therapeutic modality for the treatment of acute respiratory failure (ARF). In this review, we critically analyze randomized controlled trials on the most used NIV interfaces in the treatments of ARF. Methods: The searches were conducted in the Medline, Lilacs, PubMed, Cochrane, and Pedro databases from June to November 2021. The inclusion criteria were Randomized clinical trials (RCTs) published from 2016 to 2021 in Portuguese, Spanish, or English and involving adults (aged ≥ 18 years). The eligibility criteria for article selection were based on the PICO strategy: Population—Adults with ARF;Intervention—NIV Therapy;Comparison—Conventional oxygen therapy, high-flow nasal cannula (HFNC) oxygen therapy, or NIV;Outcome—improvement in ARF. The search for articles and the implementation of the inclusion criteria were independently conducted by two researchers. Results: Seven scientific articles involving 574 adults with ARF due to various causes, such as chest trauma, decompensated heart failure, coronavirus disease 2019 (COVID-19), and postoperative period, among others, were included. The interfaces cited in the studies included an oronasal mask, nasal mask, full-face mask, and helmet. In addition, some favorable outcomes related to NIV were reported in the studies, such as a reduction in the rate of orotracheal intubation and shorter length of stay in the ICU. Conclusions: The most cited interfaces in the treatment of ARF were the oronasal mask and the helmet.

关键词： Noninvasive Ventilation Respiratory Insufficiency Respiration Artificial Continuous Positive Airway Pressure

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Peritoneal interposition flap reduces symptomatic lymphocele following transperitoneal robot-assisted radical prostatectomy and pelvic lymph node dissection:An updated meta-analysis

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Current Urology 2024年第3期18卷 167-176页

作者： João Henrique Sendrete de Pinho Lorrane Vieira Siqueira Riscado João Padua Manzano Faculty of Medicine of the federal University of Juiz de Fora Minas GeraisBrazil Faculty of Medicine of the federal University of São Paulo São PauloBrazil

Background Robot-assisted radical prostatectomy with intraoperative pelvic lymph node dissection is the criterion standard for surgical treatment of nonmetastatic intermediate-and high-risk prostate ***,this method is associated with symptomatic lymphocele(SLC),which is an important morbidity *** overcome this complication,several modifications of the technique have been developed,including the peritoneal interposition flap(PIF).We performed an updated systematic review and meta-analysis to investigate the efficacy and safety of this technique for preventing SLC and lymphocele(LC)*** and methods Searches were performed using databases and references from included studies and previous systematic *** randomized controlled trials and nonrandomized cohorts were *** outcomes were the incidence of SLC and LC formation,and safety outcomes were defined as operation time,estimated blood loss,length of hospital stay,and urinary *** assessment was performed using the Newcastle-Ottawa Scale and Cochrane Collaboration's *** treatment effects were estimated using odds ratios with 95%confidence intervals(CIs)for binary *** was examined using Cochran's Q test and I2 statistics;p values25%were considered significant for *** used Mantel-Haenszel fixed-effect models in the analyses with low ***,the DerSimonian and Laird random-effects model was *** The initial search yielded 510 *** the removal of duplicate records and application of the exclusion criterion,9 studies were fully reviewed for *** randomized controlled trials and 5 retrospective cohorts met all the inclusion criteria,comprising 2261 patients,of whom 1073(47.4%)underwent *** studies reported a significant reduction in SLC in the PIF group,and 3 of the 4 studies reported LC formation yielded significant results in preventing this complication.

关键词： Robot-assisted radical prostatectomy Lymphocele Peritoneal reapproximation Peritoneal interpolated flap Meta-analysis

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Patellar reconstruction in primary total knee arthroplasty using bone chips from routine cuts:A case report and review of literature

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World Journal of Methodology 2024年第2期14卷 158-166页

作者： Juan Ignacio Perez-Abdala Franco L De Cicco Tomas Nicolino Juan Astoul Institute of Orthopaedics“Carlos E.Ottolenghi” Italian Hospital of Buenos AiresCapital Federal 1198Argentina

BACKGROUND Total patellectomy is currently reserved for exceptional cases,such as recalcitrant patellofemoral instability and comminuted fractures,due to its demonstrated negative impact on knee ***,managing patellectomy is crucial to mitigate its inherent deleterious *** techniques have been described,including autologous or allogeneic bone grafts for reconstruction and soft tissue realignment to enhance the extensor *** SUMMARY A 73-year-old male underwent a patellectomy due to a comminuted fracture,subsequently developing osteoarthritis and experiencing a decline in functional *** with total knee replacement,we conducted a patellar reconstruction,incorporating routine bone cuts and utilizing bone chips to fashion a new *** intervention resulted in the restoration of full extension and improvement of knee *** Patellar reconstruction demonstrates benefits on knee mechanics and stabilization,contributing to enhanced outcomes and satisfaction following knee *** present an affordable technique for managing patellectomized patients undergoing total knee replacement.

关键词： Patellectomy Patella Reconstruction Knee arthroplasty Autologous bone Knee osteoarthritis Case report

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