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Establishment of trauma registry at queen elizabeth Central hospital(QECH), Blantyre, Malawi and mapping of high risk geographic areas for trauma

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World Journal of Emergency Medicine 2019年第1期10卷 33-41页

作者： Linda C.Chokotho Wakisa Mulwafu Mulinda Nyirenda Foster J.Mbomuwa Hemant G.Pandit Grace Le Christopher Lavy Beit Cure International hospital Department of Surgery College of Medicine University of Malawi Adult Emergency and Trauma Center Queen Elizabeth Central Hospital Ministry of Health Chapel Allerton hospital University of Leeds Nuff ield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford

BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre(AETC) at queen elizabeth Central hospital(QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS(16) software ***: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault(38.2%), and road traffi c injuries(31.6%). The majority had soft tissue injury(53.1%), while 23.8% had no diagnosis indicated. Fractures(OR 19.94 [15.34–25.93]), head injury and internal organ injury(OR 29.5 [16.29–53.4]), and use of ambulance(OR 1.57 [1.06–2.33]) were found to be predictive of increased odds of being admitted to hospital while assault(OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Signifi cant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings.

关键词： Trauma Registry Adult injuries Hot spot analysis Low and middle income countries

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Associative Factors for Birth Asphyxia at queen elizabeth Central hospital—Malawi

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Journal of Biosciences and Medicines 2017年第5期5卷 22-31页

作者： Edith Tewesa Ellen Chirwa Maureen Daisy Majamanda Alfred Maluwa Angela Chimwaza queen elizabeth Central hospital Blantyre Malawi University of Malawi—Kamuzu College of Nursing Malawi

Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. queen elizabeth Central hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia. This study was conducted to explore associative factors for birth asphyxia at QECH. Methodology: The study design was descriptive cross sectional that employed quantitative methods of data collection and analysis. Data sources were case notes of neonates and their mothers.? Sample size was 87 neonates with birth asphyxia and 87 neonates admitted with conditions other than birth asphyxia as controls. Data were collected from November to December 2013. Statistical Package for Social Science (SPSS) version16.0 was used to analyze data. Results: Findings revealed that there were no maternal associative factors for birth asphyxia, however, foetal distress, prolonged first and second stage of labour were significant associative factors for birth asphyxia. Conclusion: Associative factors for birth asphyxia at QECH are Foetal distress, prolonged first and second stage of labour. These factors can be prevented if quality care is provided to women in labour through close monitoring of foetal heart, appropriate use of the partograph, prompt decision making and early interventions.

关键词： Neonates Birth Asphyxia Risk Factors

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Improved survival at the cost of more chronic lung disease?Current management and outcomes in extremely preterm infants born in New South Wales and the Australian Capital Territory:2010-2020

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World Journal of Pediatrics 2024年第3期20卷 230-238页

作者： Nele Legge Himanshu Popat Dominic Fitzgerald Liverpool hospital Corner Elizabeth and Goulburn StreetsLiverpoolNSWAustralia University of Sydney CamperdownAustralia Children's hospital Westmead WestmeadAustralia

Background Since 2010,most tertiary care hospitals in Australia have changed how they care for extremely premature ***,in-hospital and longer-term outcome data have suggested unchanged or even worse health outcomes in later epochs,especially respiratory *** study examined the trend in outcomes since these changes were introduced,particularly the prevalence of chronic neonatal lung disease(CLD).Methods This is a retrospective cross-sectional analysis of data from the Neonatal Intensive Care Units'(NICUS)database of all perinatal intensive care units in New South Wales and the Australian Capital Territory,including infants born at≥24 and≤28 weeks of gestational age in tertiary perinatal units between January 1,2010,and December 31,*** trends and changes in primary outcome were examined by linear and adjusted multivariable logistic regression *** This study included 3258 *** saw significant changes in antenatal magnesium sulfate(75% increase),delayed cord clamping(66% increase),delivery room intubations(30% decrease),any time(20% decrease),duration on mechanical ventilation(100-hour decrease),and hours on noninvasive ventilation(200-hour increase).Mortality decreased from 17% to 6%.The incidence of CLD increased significantly even when adjusted for confounders(15% increase).Any time and mean hours spent on mechanical ventilation significantly increased the odds of *** study could not find a significant association of any of the protective antenatal treatments on *** The last decade saw a significant improvement in survival and survival to discharge without major *** was increased use of magnesium sulfate,delayed cord clamping,and less invasive respiratory management of extremely preterm *** avoidance of mechanical ventilation may impact the incidence of CLD.

关键词： Chronic lung disease Extreme prematurity Health outcomes Survival

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Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy

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World Journal of Clinical Cases 2024年第3期12卷 488-494页

作者： Shamir O Cawich Joseph Martin Plummer Sahle Griffith Vijay Naraynsingh Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Department of General Surgery and Consultant General and Colorectal Surgeon Department of SurgeryUniversity of the West IndiesKingstonKIN7Jamaica Department of Surgery Queen Elizabeth HospitalBridgetownBarbados Department of Surgery Port of Spain General HospitalPort of SpainTrinidad and Tobago

BACKGROUND Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer,but we have experienced resistance to the introduction of the FreeHandffrobotic camera holder to augment laparoscopic colorectal *** To compare the initial results between conventional and FreeHandffrobot-assisted laparoscopic colectomy in Trinidad and *** This was a prospective study of outcomes from all laparoscopic colectomies per-formed for colorectal carcinoma from November 29,2021 to May 30,*** following data were recorded:Operating time,conversions,estimated blood loss,hospitalization,morbidity,surgical resection margins and number of nodes *** data were entered into an excel database and the data were analyzed using SPSS ver *** There were 23 patients undergoing colectomies for malignant disease:8(35%)FreeHandff-assisted and 15(65%)conventional laparoscopic *** were no *** time was significantly lower in patients under-going robot-assisted laparoscopic colectomy(95.13±9.22 vs 105.67±11.48 min;P=0.045).Otherwise,there was no difference in estimated blood loss,nodal harvest,hospitalization,morbidity or *** The FreeHandffrobot for colectomies is safe,provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

关键词： Laparoscopic Colectomy Robot Surgery Minimally invasive

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Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-Lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-Yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-Chung Lam Division of Urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of Urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(queen Mary hospital and Princess Margaret hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

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SIMAP500: A novel risk score to identify recipients at higher risk of hepatocellular carcinoma recurrence following liver transplantation

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World Journal of Transplantation 2024年第3期14卷 132-143页

作者： Amr Alnagar Nekisa Zakeri Konstantinos Koilias Rosemary E Faulkes Rachel Brown Owen Cain M Thamara P R Perera Keith J Roberts Rebeca Sanabria-Mateos David C Bartlett Yuk Ting Ma Shivan Sivakumar Shishir Shetty Tahir Shah Bobby V M Dasari Department of HBP and Liver Transplantation Surgery Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom Centre for Liver Research Institute of Biomedical ResearchBirmingham B152TTUnited Kingdom Department of Hepatology Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom Department of Pathology University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Department of Oncology Queen Elizabeth HospitalUniversity Hospitals of BirminghamBirmingham B152GWUnited Kingdom

BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely *** stratification is vital with a long LT waiting time,as that could influence the recurrence despite strict listing *** This study aims to identify predictors of recurrence and develop a novel risk pre-diction score to forecast HCC recurrence following *** A retrospective review of LT for HCC recipients at University hospitals Bir-mingham between July 2011 and February *** and multivariate analyses were performed to identify recurrence predictors,based on which the novel SIMAP500(satellite nodules,increase in size,microvascular invasion,AFP>500,poor differentiation)risk score was *** 234 LTs for HCC were performed with a median follow-up of 5.3 *** developed in 25 patients(10.7%).On univariate analyses,RETREAT score>3,α-fetoprotein(AFP)at listing 100-500 and>500,bridging,increased tumour size between imaging at the listing time and explant histology,increase in the size of viable tumour between listing and explant,presence of satellite nodules,micro-and macrovascular invasion on explant and poor differentiation of tumours were significantly associated with recurrence,based on which,the SIMAP500 risk score is *** SIMAP500 demonstrated an excellent predictive ability(c-index=0.803)and outper-formed the RETREAT score(c-index=0.73).SIMAP500 is indicative of the time to disease *** SIMAP500 risk score identifies the LT recipients at risk of HCC *** stratification allows patient-centric post-transplant surveillance *** validation of the score is recommended.

关键词： Liver transplantation Hepatocellular carcinoma Recurrence Survival

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Change in mean postoperative pain in patients undergoing tonsillectomy with cold water versus usual practice:A pragmatic trial

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 24-28页

作者： Haissan Iftikhar Nida Zahid Adan Zubair Mohammad Wasif Nabeel N.Baig Khadijah Abid Muhammad Ozair Awan Muhammad Sohail Awan Department of Otolaryngology Queen Elizabeth HospitalBirminghamUK Department of Surgery Aga Khan University HospitalKarachiPakistan College of Physicians and Surgeons Higher Education CommissionKarachiPakistan Department of UGME Aga Khan UniversityKarachiPakistan

Introduction:Tonsillectomy is one of the most common procedures performed in *** are various methods to perform tonsillectomies(cold and hot).Thermal damage and inflammation of the surrounding tissue using monopolar cautery is said to point to increased pain whereas immediate cooling of the burnt area is thought to reduce pain owing to heat *** objective was to determine the difference in mean post‐tonsillectomy pain scores among patients irrigated with cold water(4℃)and in patients not irrigated with cold *** and Methods:A quasi‐experimental trial was conducted from January 2016 to December 2017 at a tertiary care *** tonsillectomies were carried out with monopolar cautery at a power of 20 *** either received cold water irrigation post tonsillectomy of the tonsillar bed(intervention arm)or no irrigation(control arm).The pain score was measured on Days 0,1,3,5,and *** scores were charted on a visual analog scale on the respective ***:Seventy‐eight patients were included in the *** mean age of our patients was 10.26(4.24)years old in the intervention arm,and 11.95(4.19)years old in the control *** was observed that the pain was significantly lower in patients with cold water irrigation of the tonsillar fossa on Days 1,3,5,and 7(p=0.001).There were no readmissions postprocedure and none of our patients developed any complications ***:In this trial,we report a reduced pain score at all days of observation in the intervention *** of the tonsillar fossa is a safe,cost-effective,and less technically demanding technique that could be employed to reduce postoperative *** studies with randomization,blinding and a larger sample size could further improve on our results.

关键词： cold water tonsillectomy monopoalr tonsillectomy postoperative pain tonsillectomy

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Overview on signal transduction cascades regulation roles of garlic and its bioactive constituents

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Food Science and Human Wellness 2024年第5期13卷 2353-2362页

作者： Ammad Ahmad Farooqi Iqra Mobeen Rukset Attar Khalida I.Noel Baojun Xu William C.Cho Institute of Biomedical and Genetic Engineering(IBGE) Islamabad 44000Pakistan Khursheed Rasheed hospital Lahore Lahore 53720Pakistan Department of Obstetrics and Gynecology Yeditepe UniversityAtaşehir 34755Turkey Human Anatomy Department College of MedicineAl-Mustansiriyah UniversityBaghdad 10036Iraq Food Science and Technology Program Department of Life SciencesBNU-HKBU United International CollegeZhuhai 519087China Department of Clinical Oncology Queen Elizabeth HospitalHong Kong G514TFChina

High-throughput technologies in combination with modern exciting advancements in mass spectrometry-based proteomics and data analysis pipelines have empowered comprehensive characterization of disease phenotypes and their mechanistic regulation by dietary agents and bioactive molecules at unprecedented dimensionality and ***-ordinary breakthroughs in the field of nutrigenomics have leveraged our understanding altogether to a new level of *** researchers have extensively analyzed health promoting and pharmacologically significant properties of garlic(Allium sativum).Importantly,garlic and its biologically active chemicals targeted oncogenic signaling *** this mini-review we have attempted to summarize how garlic and its bioactive constituents regulated signal transduction cascades in cell culture studies and tumor-bearing mice.

关键词： Cancer Nutrigenomics Signaling Apoptosis Allium sativum

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Surgical cystogastrostomy: Is it still worthwhile?

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World Journal of Gastroenterology 2024年第17期30卷 2298-2301页

作者： Kin Pan Au Kenneth Siu Ho Chok Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong 999077China Department of Surgery The Chinese University of Hong KongHong Kong 999077China

The article by Ker et al explores the treatment of peripancreatic fluid collection(PFC).The use of percutaneous drainage,endoscopy,and surgery for managing PFC are *** drainage is noted for its low risk profile,while endoscopic cystogastrostomy is more effective due to the wider orifice of the metallic *** cystogastrostomy is a definitive treatment with a reduced need for reintervention,especially for cases with extensive collections and significant *** choice of treatment modality should be tailored to individual patient characteristics and disease factors,considering the expertise available.

关键词： Endoscopic cystgastrostomy Surgical cystgastrostomy Pancreatitis Pancreatic necrosis Peripancreatic collection

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Post-fontan circulation hepatocellular carcinoma:Open and laparoscopic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 90-93页

作者： Karin KY Ho Wong Hoi She Simon HY Tsang Kevin S Lo Tan To Cheung Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Anaesthesiology Queen Mary Hospital102 Pok Fu Lam RoadHong KongChina

To the Editor:Fontan-associated liver disease shows increasing incidence as advances in pediatric cardiology have prolonged life expectancy in patients with single ventricle congenital heart defects[1].Their unique physiology and procedure-related sequelae present an increasingly relevant challenge in hepatic *** hereby reported a series of patients suffering from hepatocellular carcinoma(HCC)who successfully underwent open and laparoscopic hepatectomy.

关键词： hepatocellular hepatectomy surgery

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