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Factors associated with short term outcomes of hypospadias repair at the University Teaching Hospital, Lusaka, Zambia
Get PDFThesisHypospadias is a common congenital penile abnormality with an incidence of 1 in 250 per live
male births. It occurs as a birth defect resulting in the urethral opening being located anywhere
from the glans along the ventral aspect of the shaft of the penis up to the scrotum or perineum in
extreme cases. In its moderate to severe forms surgery is always advocated because affected
individuals fail to pass urine while standing, the penis is cosmetically different from others and
importantly causes subfertility in adulthood. However surgery is not without complications. An
audit done locally at UTH, Lusaka in the year 2017 showed high complication rates of 10 percent
for distal hypospadias and 67% for proximal hypospadias. The objective of this study was to
determine the short-term complications and factors that are associated with this outcome at UTH
Lusaka. In this study we hypothesized that small glans size, narrow urethral plate, PDS suture for
urethroplasty, age more than 18months at operation and Haemoglobin level are not associated with
increased complication rate.
This was a consecutive (total enumerative) observational cohort study done at D-block and Clinic
7 at UTH Lusaka over a period of nine months. A total of 41 patients were enrolled and their
demographic data, hemoglobin, maximum glans width size and urethral plate size before creating
glans wing or midline plate incision were noted and measured. Logistic regression assessed
urethroplasty complications (urethrocutaneous fistula, glans dehiscence, infection, penile torsion,
persistent chordee) on urethral plate size, glans size, hemoglobin, suture material and catheter
problems.
The average age of participants was 34months. Distal hypospadias was the most common type at
61%, while middle hypospadias was 27% and proximal hypospadias 12%.The complication rate
was 34%. The most common complication seen was urethrocutaneous fistula 9(53%). The other
complications seen included 2(11.8%) glanular dehiscence, 2(11.8%) infection 1(6%) persistent
chordee and 1(6%) penile torsion. The risk factors for post-operative complications included, the
location of the urethral opening. The more proximal the site of the hypospadias the higher the
complication rate. Complications were strongly associated with hemoglobin levels of less than
11.5g/dl (p=0.001) and catheter blockage or dislodgment (p=0.008). There was no association of
complications with Social economic status, Age at time of repair, glans width size or suture
material. Contrary to the finding of many authors wider urethral plate in this study was associated
with higher complication rate.
The conclusion was that short term complication rate at the UTH Lusaka Zambia is at 34%. The
most common complication is urethrocutaneous fistula while the main factors associated with
increased complications are hemoglobin less than 11.5g/dl, blocked and dislodgment urethral
catheters, proximal hypospadias type. The recommendation from this study is hypospadias repair
to be done with a hemoglobin of 12g/dl or more and post operatively a close catheter care is
imperative.
Keywords : Hypospadias, short term outcomes, complications, complication rate,
Urethrocutaneous fistula, glanular dehiscence, persistent chordee, penile torsion
Factors associated with short term outcomes of hypospadias repair at the University Teaching Hospital, Lusaka, Zambia
No full textThesisHypospadias is a common congenital penile abnormality with an incidence of 1 in 250 per live
male births. It occurs as a birth defect resulting in the urethral opening being located anywhere
from the glans along the ventral aspect of the shaft of the penis up to the scrotum or perineum in
extreme cases. In its moderate to severe forms surgery is always advocated because affected
individuals fail to pass urine while standing, the penis is cosmetically different from others and
importantly causes subfertility in adulthood. However surgery is not without complications. An
audit done locally at UTH, Lusaka in the year 2017 showed high complication rates of 10 percent
for distal hypospadias and 67% for proximal hypospadias. The objective of this study was to
determine the short-term complications and factors that are associated with this outcome at UTH
Lusaka. In this study we hypothesized that small glans size, narrow urethral plate, PDS suture for
urethroplasty, age more than 18months at operation and Haemoglobin level are not associated with
increased complication rate.
This was a consecutive (total enumerative) observational cohort study done at D-block and Clinic
7 at UTH Lusaka over a period of nine months. A total of 41 patients were enrolled and their
demographic data, hemoglobin, maximum glans width size and urethral plate size before creating
glans wing or midline plate incision were noted and measured. Logistic regression assessed
urethroplasty complications (urethrocutaneous fistula, glans dehiscence, infection, penile torsion,
persistent chordee) on urethral plate size, glans size, hemoglobin, suture material and catheter
problems.
The average age of participants was 34months. Distal hypospadias was the most common type at
61%, while middle hypospadias was 27% and proximal hypospadias 12%.The complication rate
was 34%. The most common complication seen was urethrocutaneous fistula 9(53%). The other
complications seen included 2(11.8%) glanular dehiscence, 2(11.8%) infection 1(6%) persistent
chordee and 1(6%) penile torsion. The risk factors for post-operative complications included, the
location of the urethral opening. The more proximal the site of the hypospadias the higher the
complication rate. Complications were strongly associated with hemoglobin levels of less than
11.5g/dl (p=0.001) and catheter blockage or dislodgment (p=0.008). There was no association of
complications with Social economic status, Age at time of repair, glans width size or suture
material. Contrary to the finding of many authors wider urethral plate in this study was associated
with higher complication rate.
The conclusion was that short term complication rate at the UTH Lusaka Zambia is at 34%. The
most common complication is urethrocutaneous fistula while the main factors associated with
increased complications are hemoglobin less than 11.5g/dl, blocked and dislodgment urethral
catheters, proximal hypospadias type. The recommendation from this study is hypospadias repair
to be done with a hemoglobin of 12g/dl or more and post operatively a close catheter care is
imperative.
Keywords : Hypospadias, short term outcomes, complications, complication rate,
Urethrocutaneous fistula, glanular dehiscence, persistent chordee, penile torsion
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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