38 research outputs found
sj-pdf-1-aic-10.1177_0310057X221092455 - Supplemental material for Perioperative provider safety in the pandemic: Development, implementation and evaluation of an adjunct COVID-19 Surgical Patient Checklist
No full textSupplemental material, sj-pdf-1-aic-10.1177_0310057X221092455 for Perioperative provider safety in the pandemic: Development, implementation and evaluation of an adjunct COVID-19 Surgical Patient Checklist by Nichole E Starr Conceptualization Formal analysis Investigation Methodology Project administration Validation Writing – original draft Writing – review & editing Jolene N Moore Conceptualization Formal analysis Investigation Methodology Writing – review & editing Constance S Harrell Shreckengost Investigation Validation Writing – review & editing Katie Fernandez Formal analysis Investigation Project administration Writing – review & editing Reshma P Ambulkar Investigation Writing – review & editing Nina Capo-Chichi Conceptualization Investigation Methodology Validation Writing – review & editing John E Varallo Formal analysis Writing – review & editing Adesoji O Ademuyiwa Conceptualization Methodology Writing – review & editing Sophallyda Krouch Conceptualization Investigation Validation Writing – review & editing Pankaj Singh Rana Writing – review & editing JC Allen Ingabire Investigation Writing – review & editing Thomas G Weiser Conceptualization Formal analysis Investigation Methodology Writing – review & editing Tihitena Negussie Mammo Investigation Methodology Writing – review & editing Faye M Evans Conceptualization Formal analysis Investigation Methodology Writing – review & editing in Anaesthesia and Intensive Care</p
Повторні хірургічні втручання в лікуванні гострого апендициту в дітей
No full textСучасна діагностика та раціональна лікувальна тактика при післяопераційних ускладненнях у дітей, яким виконали апендектомію з приводу різних форм гострого апендициту (ГА), залишається одним з актуальних і складних завдань дитячої хірургії. Повторні оперативні втручання (ПВ) (релапаратомія, релапароскопія, дренування тощо) – основні методи лікування післяопераційних абдомінальних ускладнень у пацієнтів з ускладненим перебігом патології. Інколи це єдина можливість врятувати життя дитині. Так, за даними В. А. Авакимяна і співавт., ПВ потребували 37,4 % пацієнтів із поширеним гнійним перитонітом; за даними Tihitena Negussie еt al., таких пацієнтів 17,2 % [6]. Частота виникнення
релапаротомій після виконання ургентних апендектомій більша, ніж після планових у співвідношенні 4:1. Агзамова М. Н. і співавт. наголошують, що найчастіше релапаротомії виконують у хворих, які прооперовані з приводу гангренозного і гангренозно-перфоративного апендициту (33,7 % випадків), а основними причинами повторних оперативних утручань були абсцеси черевної порожнини, гостра спайкова кишкова непрохідність, неспроможність швів анастомозу та післяопераційний перитоніт. За даними А. М. Унгуряна (2015), кількість хворих із періапендикулярними абсцесами зросла з 11,42 % у 2003 р. до 29,23 % у 2012 р., а під час лікування почали застосовувати мініінвазивні технології. Гриценко Є. М., крім названих причин релапаротомій, відзначає також перфорацію гострих виразок (у 10,2 % випадків), кровотечі (3,6 %) та закриту травму живота з пошкодженням тонкої кишки (17 % випадків). Малик С. В. і співавт., крім наведених причин повторних лапаротомій, визначають евентрації в 7,1 % випадків та діагностичні релапаротомії, що здійснені у 1,6 % хворих. За даними Tihitena Nagussie et al., повне розходження рани було причиною повторних хірургічних утручань у 13,2 % пацієнтів, а стомальні ускладнення – у 7,5 %. До розвитку післяопераційних ускладнень запального і спайкового характеру призводить також деструктивно змінений сальник
Author response to: Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study
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Hypospadias Repair in Ethiopia: A Five Year Review
No full textBACKGROUND: Hypospadias repair is one of the problematic issues in pediatric surgery. As a result of the multiple complications following the procedure, a variety of techniques have been used and newer methods continue to emerge. There is still controversy regarding the best method of repair. We aimed to determine the outcome of surgery and factors contributing to unfavorable outcomes in children with hypospadias.MATERIALS AND METHODS: This is a retrospective review undertaken from September 2009 to August 2014. The research was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. All children who underwent hypospadias repair and had regular follow-up were included in the study.RESULTS: A total of 202 boys aged less than 13 years were assessed. Most surgeries (80.3%) were performed in children older than 18 months. Transverse incised plate urethroplasty (TIP) was frequently performed for distal hypospadias (71.2 %), while transverse ventral preputal flap (TVPF) was the most common procedure done for proximal hypospadias (62.8 %). Overall success rate for first surgery was 55.9 %. There was a high rate of major post-operative complications (44.1%) of which urethrocutaneous fistula (UCF) was the most common (31.2%) followed by meatal stenosis and glans breakdown (7.4 % each). These complications were found to be higher in those who were operated at a later age and those with proximal hypospadias (p=0.03 and p=0.01 respectively). There was also a significant difference among the type of procedures with TIP and TVPF having the least complications (p<0.01).CONCLUSION: From our experience, we found TIP a relatively safe and reliable method of repair for distal hypospadias while TVPF single stage repair was superior in the proximal ones. The high rate of complications in our institution was associated with higher burden of severe hypospadias and older age at surgery.
CheckList Expansion for Antisepsis and iNfection Control in Cesarean Section (CLEAN–CS): a stepped-wedge, cluster-randomized controlled interventional trial to reduce surgical site infections in Ethiopia
No full textBackground:
Clean Cut is a quality improvement program developed in Ethiopia that aims to strengthen compliance with six standards of perioperative infection prevention: 1. hand and skin antisepsis, 2. instrument sterility, 3. sterile field preparation, 4. prophylactic antibiotics, 5. gauze counting and, 6. the use of the WHO Surgical Safety Checklist. Pilot work improved compliance with these six standards and reduced surgical site infections (SSI) by 35%, but a more rigorous assessment is needed.
Intervention:
Each cluster underwent baseline assessment followed by Clean Cut implementation, which included process-mapping the six standards, using baseline data to create site-specific systems-level improvements, and delivery of four training workshops on the use of a surgical safety checklist, infection prevention and control practices, instrument reprocessing, and non-technical skills training on operating room teamwork and communication
CheckList Expansion for Antisepsis and iNfection Control in Cesarean Section (CLEAN–CS): a stepped-wedge, cluster-randomized controlled interventional trial to reduce surgical site infections in Ethiopia
No full textBackground:
Clean Cut is a quality improvement program developed in Ethiopia that aims to strengthen compliance with six standards of perioperative infection prevention: 1. hand and skin antisepsis, 2. instrument sterility, 3. sterile field preparation, 4. prophylactic antibiotics, 5. gauze counting and, 6. the use of the WHO Surgical Safety Checklist. Pilot work improved compliance with these six standards and reduced surgical site infections (SSI) by 35%, but a more rigorous assessment is needed.
Intervention:
Each cluster underwent baseline assessment followed by Clean Cut implementation, which included process-mapping the six standards, using baseline data to create site-specific systems-level improvements, and delivery of four training workshops on the use of a surgical safety checklist, infection prevention and control practices, instrument reprocessing, and non-technical skills training on operating room teamwork and communication
Men's Attitude towards Contraceptive Use in Ethiopia: A Multilevel Analysis of 2000 Ethiopian Demographic and Health Survey
No full textIn Ethiopia, family planning program is women slanting. Men '.r exclusion fromfamily planning strongly affects their preferred family size and attitude towardscOnlraceptive use. Some researchers also concluded toot women's attitude towardscontraception is strongly affected by their husband's attitudes. This article isdesigned to examine the influence of husband's attitude towards couple's currentcontraceptive use in Ethiopia. The 2000 Ethiopian Demographic Health Su",ey datais used as main data source. The qualitative data is also collected rhrough in·depthinte",iew from thirty·six currently married men in four regions (Tigray, Amhara,Oromiya and SNNPR). BOlh bivariate and multivariate analyses are applied in thestudy. Multilevel modeling was also further developed to identify the possiblecommunity level variation on couple 's current contraceptive use. Both bivariate andmultivariate analysis results showed that husband's approval of contraceptive /Lieand couple communicarion are statistically signijicanJ (at p<O.OI level ofsignificance) in contraceptive use, indicating that husbands who approve and discussfamily planning with partners oove positive altitude towards contraceptive use.Moreover, significant community level variations have beet! found in the multilevelmodel, demonstraring rhe existence of variation in husbands' attitude towardscontraceptive use across communities. The author suggests thaI the policy effortshould be made to enable men for realizing the positive consequence of theirapproval and discussion regarding family planning. Furthermore, the exisringfamilyplanning program in Ethiopia should focus on changing men's altitude towardsfamily planning
Synchronous esophageal and jejunal duplication in an infant: A case report
No full textIntroduction: Alimentary tract duplications are rare congenital anomalies that usually occur at a single site; however, multisite duplications may arise and present with diverse clinical manifestations. Case presentation: A one-month-old male neonate, previously healthy, developed tachypnea and grunting during the first week of life. Antenatal follow-up had revealed a fluid-filled structure in the abdomen. He was admitted to a local hospital and treated with antibiotics for two weeks without improvement. On presentation, he exhibited severe respiratory distress. Physical examination revealed a palpable abdominal mass in the left upper quadrant extending to the pelvis. Chest radiographs suggested bilateral lung opacities. Abdominal ultrasonography identified an 11 × 5.6 cm intra-abdominal cyst and a 7 × 5.5 cm right intrapleural cyst. Thoracoabdominal computed tomography confirmed a 5.5 × 5 cm right thoracic cyst and two intra-abdominal cysts measuring 7.5 × 6.5 cm and 5.5 × 5.3 cm.The patient underwent right posterolateral thoracotomy and laparotomy with excision of the esophageal cyst and enucleation of small bowel duplication cysts. The postoperative course was uneventful. Histopathology confirmed esophageal and small bowel duplication cysts. On follow-up, he remained asymptomatic. Conclusion: Although alimentary tract duplications typically involve a single site, multisite involvement can occur and should be considered, particularly in patients with varied clinical presentations
Heteropagus (parasitic) twins
No full textHeteropagus (parasitic) twin is a type of conjoined twinning in which a partially formed defective twin is attached to an otherwise normal twin. It is an extremely rare anomaly. In this paper, we describe five cases we encountered over the past 9 years. Except one, all presented early within a few days of birth. None of them shared an organ but two had bony/visceral connections. All surgeries were successful, and we only encountered wound complications. To the best of our knowledge this is the largest compilation of original cases in a parasitic twin report. Keywords: Conjoined twin, Parasitic twin, Heteropagus twin, Ethiopi
