scholarly journals Investigating Effective Factors on Estimated Hemorrhage Intraoperative in Brain Meningioma Surgery

2020 ◽  
Vol 11 (5) ◽  
pp. 631-638
Author(s):  
Alireza Tabibkhooei ◽  
◽  
Maziar Azar ◽  
Ahmad Alagha ◽  
Javad Jahandideh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Preoperative Imaging ◽  
Intracranial Meningioma ◽  
Cross Sectional ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
History Of ◽  
Main Determinants ◽  
Magnetic Resonance Imaging Mri ◽  
Meningioma Surgery

Introduction: The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion’s characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery. Methods: This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined Results: A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients. Conclusion: Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery.

scholarly journals The Influencing Factors of Postoperative Delirium in Elderly Hip Fracture Patients: What Should Treatment Focus On

2021 ◽  
Author(s):  
Chunwen Yan ◽  
Min Yang ◽  
Nasha Niu ◽  
Linmei Li ◽  
Li Pan
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Blood Loss ◽  
Elderly Patients ◽  
Influencing Factors ◽  
Postoperative Delirium ◽  
Multivariate Logistic Regression Analysis ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
History Of

Abstract Background: The postoperative delirium is a common yet serious complication in elderly patients with hip fracture, it’s necessary to evaluate the potential risk factors of delirium in patients with hip fracture, to provide reliable evidence to the clinical management of hip fracture.Methods: Elderly patients who underwent hip fracture surgery in our hospital from June 1, 2019 to May 31, 2021 were selected. The characteristics and treatment data of delirium and no delirium patients were collected and compared. Multivariate logistic regression analysis was conducted to analyze the influencing factors affecting postoperative delirium in elderly patients with hip fracture.Results: A total of 245 patients with hip fracture were included, the incidence of postoperative delirium in patients with hip fracture was 13.06%. There were significant differences in the age, BMI, history of delirium, estimated blood loss and duration of surgery (all p<0.05). There were significant differences in the albumin and TSH between delirium and no delirium group(all p<0.05), Logistics analyses indicated that ge≥75y(OR3.112,95%CI1.527~5.742), BMI ≥24 kg/m2(OR2.127,95%CI1.144~3.598), history of delirium(OR1.754,95%CI1.173~2.347), estimated blood loss≥400ml(OR1.698,95%CI1.427~1.946), duration of surgery≥120min(OR2.138,95%CI1.126~3.085), preoperative albumin≤40g/L(OR1.845,95%CI1.102~2.835) and TSH≤2mU/L(OR2.226, 95%CI1.329~4.011) were the independent risk factors of postoperative delirium in patients with hip fracture(all p<0.05).Conclusions: Postoperative delirium is very common in elderly patients with hip fracture, and it was associated with many risk factors, clinical preventions targeted on those risk factors are needed to reduce the postoperative delirium.

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Average Duration ◽  
Uterine Prolapse ◽  
Rational Approach ◽  
Medical College ◽  
Gynecological Disorders ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641

scholarly journals Prevalence of common mental disorder and associated factors among pregnant women in South-East Ethiopia, 2017: a community based cross-sectional study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Ashenafi Mekonnen Woldetsadik ◽  
Abebaw Nigussie Ayele ◽  
Adem Esmael Roba ◽  
Genet Fikadu Haile ◽  
Khan Mubashir
Keyword(s):  
Mental Disorder ◽  
Pregnant Women ◽  
Emotional Abuse ◽  
Common Mental Disorder ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Medical Illness ◽  
Cross Sectional ◽  
History Of ◽  
Main Determinants

Abstract Background Mothers suffering from common mental disorder (CMD), such as anxiety and depression may not be able to function properly, which could adversely affect the mother-infant bond and even result in increased infant morbidity and mortality. The purpose of this study was to assess the prevalence of CMD and its determinants among pregnant women in Southeast Ethiopia. Methods Data was collected from 743 pregnant women via interview-administered, standardised questionnaires during Dec–Jan 2017. The WHO Self-Reported Questionnaire (SRQ) was used to screen CMD. Multivariate logistic regression was conducted and ORs and 95% confidence intervals were calculated. Results The prevalence of CMD during pregnancy was 35.8% (95% CI: 34–38%) and the main determinants of CMD were: illiteracy, presence of health risk, financial instability, physical or emotional abuse, having sexual intercourse without her willingness, family history of psychiatric illness and history of chronic medical illness. Conclusion CMD prevalence during pregnancy was high, indicating a need to regularly screen pregnant women for CMD and its determinants as part of routine obstetric care.

scholarly journals The Effectiveness and Safety of Ultrasonic Bone Scalpel Versus Conventional Method in Cervical Laminectomy: A Retrospective Study of 311 Patients

2019 ◽  
Vol 10 (6) ◽  
pp. 760-766
Author(s):  
Bharat R. Dave ◽  
Ajay Krishnan ◽  
Ravi Ranjan Rai ◽  
Devanand Degulmadi ◽  
Shivanand Mayi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Conventional Method ◽  
Nerve Root ◽  
Surgical Complications ◽  
Nerve Root Injury ◽  
Cervical Laminectomy ◽  
C5 Palsy ◽  
Root Injury ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Study Design: Retrospective cohort study. Objectives: The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM). Method: This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications. Results: GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB. Conclusion: Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.

Risks of Neoplasia and Malignancy in Surgically Resected Cystic Parotid Lesions

2019 ◽  
Vol 162 (1) ◽  
pp. 79-86
Author(s):  
Brian C. Boursiquot ◽  
Nancy J. Fischbein ◽  
Davud Sirjani ◽  
Uchechukwu C. Megwalu
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Preoperative Imaging ◽  
Cross Sectional ◽  
Risk Of Malignancy ◽  
History Of ◽  
Diagnostic Samples ◽  
Cystic Masses

Objectives To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts. Study Design Retrospective cross-sectional study. Setting Single-institution academic tertiary care center. Subjects and Methods Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA. Results We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy. Conclusion In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.

scholarly journals Assessment of Intraoperative Blood Loss during Oral and Maxillofacial Surgical Procedures in a Nigerian Tertiary Health Care Center

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Babatunde O. Akinbami ◽  
Bisola Onajin-Obembe
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Significant Relationship ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Care Center ◽  
Mean Value ◽  
Health Care Center ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Background. Reports on estimated amount of blood loss in maxillofacial surgical procedures will guide clinicians through units of blood required for each procedure. The aim of the study was to assess the amount of blood loss and duration of surgery. Methods. All cases of maxillofacial surgical procedures done under GA in the MFU theatre, from January 2007 to December 2013, were included in the study. Pre- and postoperative haematocrit values, number of units of whole blood requested and used, amount of blood loss, and duration of surgery were recorded. Results. 139 patients were analyzed, of which 75 (54.0%) were males and 64 (46.0%) were females. Fifty-six (40.3%) cases involved soft tissues. Eighty-three cases involved hard tissues. Age range was 2 months to 78 years; mean ± (SD) was 21.3±(18.5) years. Isolated unilateral cleft lip had the lowest mean value of estimated blood loss of 10.4±10.8 mLs and also the lowest duration of surgery of 58 (76) minutes. There was no significant relationship between both parameters for cleft lip. Fractures of the mandible had mean blood loss of 352 mLs and duration was 175 min. Conclusion. In this study, there was significant relationship between estimated blood loss and duration of surgery for mandibular and zygomatic complex fractures.

scholarly journals The Number of Myomas Is the Most Important Risk Factor for Blood Loss and Total Operation Time in Robotic Myomectomy: Analysis of 242 Cases

2021 ◽  
Vol 10 (13) ◽  
pp. 2930
Author(s):  
Sa Ra Lee ◽  
Ju Hee Kim ◽  
Sehee Kim ◽  
Sung Hoon Kim ◽  
Hee Dong Chae
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Abdominal Surgery ◽  
Operation Time ◽  
Postoperative Fever ◽  
Factors Affecting ◽  
Maximal Diameter ◽  
Estimated Blood Loss ◽  
History Of ◽  
Robotic Myomectomy

To identify factors affecting blood loss and operation time (OT) during robotic myomectomy (RM), we reviewed a total of 448 patients who underwent RM at Seoul Asan Hospital between 1 January 2019, and 28 February 2021, at Seoul Asan Hospital. To avoid variations in surgical proficiency, only 242 patients managed by two surgeons who each performed >80 RM procedures during the study period were included in this study. All cases of RM were performed with a reduced port technique. We obtained the following data from each patient’s medical chart: age, gravidity, parity, body mass index, and history of previous abdominal surgery including cesarean section. We also collected information on the maximal diameter and type of myomas, number and weight of removed myomas, concomitant surgery, total OT from skin incision to closure, estimated blood loss (EBL), and blood transfusion. Data on preoperative use of gonadotropin-releasing hormone agonists (GnRHas) and perioperative use of hemostatic agents (tranexamic acid or vasopressin) were also collected. Data on the length of hospital stay, postoperative fever within 48 h, and any complications related to RM were also obtained. The primary endpoint in this study was the identification of factors affecting EBL and the secondary endpoint was the identification of factors affecting the total OT during multiport RM. Univariate and multivariate analyses were used to identify the factors affecting EBL and OT during multiport RM. The medians of the maximal diameter and weight of the removed myomas were 9.00 (interquartile range [IQR], 7.00 to 10.00) cm and 249.75 (IQR, 142.88 to 401.00) g, respectively. The median number of myomas was two (IQR, one to four), ranging from 1 to 34. Of the cases, 155 had low EBL and 87 had high EBL. Most myomas were of the intramural type (n = 179). The odds of EBL > 320 mL increased by 251% (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.16–5.42) for five to nine myomas and by 647% (OR, 6.47; 95% CI, 1.87–22.33) for ≥10 myomas. The odds of subserosal-type myomas decreased by 67% compared with intramural-type myomas (OR, 0.33; 95% CI, 0.14–0.80). History of abdominal surgery other than cesarean section was positively correlated with EBL. The weight of the removed myomas and a history of previous cesarean section were not correlated with the EBL. Conclusion: The number of myomas (5–9 and ≥10), maximal myoma diameter, and history of abdominal surgery other than cesarean section affect the EBL in RM.

scholarly journals Determinants of Persistent Post COVID-19 symptoms: Value of a Novel COVID-19 symptoms score

2020 ◽  
Author(s):  
Islam Galal ◽  
Aliae AR Mohamed Hussein ◽  
Mariam T Amin ◽  
Mahmoud M Saad ◽  
Hossam Eldeen E Zayan ◽  
...  
Keyword(s):  
Symptom Score ◽  
Acute Phase ◽  
Acute Attack ◽  
Cross Sectional Study ◽  
Acute Stage ◽  
Cross Sectional ◽  
Before And After ◽  
History Of ◽  
The Mean ◽  
Main Determinants

AbstractBackgroundBeing a newly emerging disease little is known about its long-lasting post COVID-19 consequences. Aim of this work is to assess the frequency, patterns and determinants of persistent post COVID-19 symptoms and to evaluate the value of a proposed Novel COVID-19 symptoms score. Patients with confirmed COVID-19 in the registry were included in a cross sectional study. The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and treatment taken during acute state, as well as symptoms score before and after convalescence were recorded.ResultsThe most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%) and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post COVID 19 symptoms score was 13.1±12.6 (P<0.001). The main determinants of the persistent post COVID-19 symptoms were the need for oxygen therapy (P<0.001), pre-existing hypertension (P=0.039), chronic pulmonary disorders (P=0.012), and any chronic comorbidity (P=0.004). There was a correlation between the symptom score during the acute attack and post COVID-19 stage (P<0.001, r=0.67). The acute phase score had 83.5% sensitivity and 73.3% specificity for the cutoff point > 18 to predict occurrence of Post-COVID-19 symptoms.ConclusionsCOVID-19 can present with a diverse spectrum of long-term post COVID-19 symptoms. Increased acute phase symptom severity and COVID-19 symptom score > 18 together with the presence of any comorbid diseases increase the risk for persistent post COVID-19 manifestations and severity.

The validity of Visual Blood Loss Estimation in Postpartum Hemorrhage in Shanghai Hospitals: A Web-based Survey (Preprint)

2019 ◽  
Author(s):  
Ying Liu ◽  
Weiwei Cheng ◽  
Ying Shen ◽  
Lin Rao ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Descriptive Analysis ◽  
Mainland China ◽  
Visual Estimation ◽  
Chi Square ◽  
Cross Sectional ◽  
Estimated Blood Loss ◽  
Tertiary Hospitals ◽  
Chi Square Test

BACKGROUND Postpartum Hemorrhage has been recognized as the most fatal factor in maternal death. Yet midwives can barely distinguish whether the blood loss has reached a life-threatening amount without precise measurement, particularly during a slow hemorrhage. Also, understaffed midwives in mainland China adds to the difficulty of timely accurate measurement of blood loss. OBJECTIVE To evaluate the accuracy of visual estimated blood loss in postpartum hemorrhage by clinical midwives, as well as the reproducibility of the visual estimation and influencing factors on accuracy. METHODS With a modified on-line visual estimation questionnaire of blood loss, a cross-sectional multicenter study was conducted among voluntary midwives or obstetrical nurses engaged in clinical practice in secondary and tertiary hospitals in Shanghai. A descriptive analysis was performed with demographic features and the rate of accurate responses. The Kappa coefficient was employed to determine the reproducibility of the agreement of visual estimation. The correlations between demographics and items of the questionnaire were conducted with Chi-square test and Spearman correlation analysis. RESULTS A total of 281 midwives and nurses participated in the survey. The finding showed relatively low accuracy and reproducibility of visual estimation, with 25.6% and 17.8% subjects in Shanghai hospitals distinguishing the postpartum hemorrhage (500ml) and the severe postpartum hemorrhage (1000ml), respectively. The Kappa coefficients were slight to moderate (0.062~0.450). The institutional routine for blood loss calculation turned out to be relevant to the accuracy of visual estimation. CONCLUSIONS Visual estimation cannot provide sound validity for blood loss evaluation in postpartum hemorrhage in China, especially when the amount exceeds 500ml. Institutions should make routines on how blood loss can be reckoned with the sterile drapes and gauzes they use, and provide regular training for midwives and nurses.

Sign in / Sign up

Export Citation Format

Share Document