Search results for: surgery outcome

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

Procedia PDF Downloads 144

Authors: Tomaz Oliveira, Rui Medeiros, André Lacerda

Abstract:

Introduction: Cleft lip and/or palate are the most frequent forms of congenital craniofacial anomalies, affecting mainly the middle third of the face and manifesting by functional and aesthetic changes. Bilateral cleft lip represents a reconstructive surgical challenge, not only for the labial component but also for the associated nasal deformation. Recently, the paradigm of the approach to this pathology has changed, placing the focus on muscle reconstruction and anatomical repositioning of the nasal cartilages in order to obtain the best aesthetic and functional results. The aim of this study is to carry out a systematic review of the surgical approach to bilateral cleft lip, retrospectively analyzing the case series of Plastic Surgery Service at Hospital Santa Maria (Lisbon, Portugal) regarding this pathology, the global assessment of the characteristics of the operated patients and the study of the different surgical approaches and their complications in the last 20 years. Methods: The present work demonstrates a retrospective and descriptive study of patients who underwent at least one reconstructive surgery for cleft lip and/or palate, in the CPRE service of the HSM, in the period between January 1 of 1997 and December 31 of 2017, in which the data relating to 361 individuals were analyzed who, after applying the exclusion criteria, constituted a sample of 212 participants. The variables analyzed were the year of the first surgery, gender, age, type of orofacial cleft, surgical approach, and its complications. Results: There was a higher overall prevalence in males, with cleft lip and cleft palate occurring in greater proportion in males, with the cleft palate being more common in females. The most frequently recorded malformation was cleft lip and palate, which is complete in most cases. Regarding laterality, alterations with a unilateral labial component were the most commonly observed, with the left lip being described as the most affected. It was found that the vast majority of patients underwent primary intervention up to 12 months of age. The surgical techniques used in the approach to this pathology showed an important chronological variation over the years. Discussion: Cleft lip and/or palate is a medical condition associated with high aesthetic and functional morbidity, which requires early treatment in order to optimize the long-term outcome. The existence of a nasolabial component and its respective surgical correction plays a central role in the treatment of this pathology. The high rates of post-surgical complications and unconvincing aesthetic results have motivated an evolution of the surgical technique, increasingly evident in recent years, allowing today to achieve satisfactory aesthetic results, even in bilateral cleft lip with high deformation complexity. The introduction of techniques that favor nasolabial reconstruction based on anatomical principles has been producing increasingly convincing results. The analyzed sample shows that most of the results obtained in this study are, in general, compatible with the results published in the literature. Conclusion: This work showed that the existence of small variations in the surgical technique can bring significant improvements in the functional and aesthetic results in the treatment of bilateral cleft lip.

Keywords: cleft lip, palate lip, congenital abnormalities, cranofacial malformations

Procedia PDF Downloads 82

Authors: Ahmad Jawad Fardin

Abstract:

Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

Procedia PDF Downloads 154

Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

Abstract:

Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

Procedia PDF Downloads 96

Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

Procedia PDF Downloads 225

Authors: Hung Manh Nguyen, Duong Dai Nguyen

Abstract:

Objective: To evaluate the effects of Tai Chi exercise on cognitive performance of community-dwelling elderly in Vinh city, Vietnam. Design: A randomized controlled trial. Participants: One hundred and two subjected were recruited. Intervention: Subjects were divided randomly into two groups. Tai Chi group was assigned 6-months Tai Chi training. Control group was instructed to maintain their routine daily activities. Outcome measures: Trail Making Test (TMT) is primary outcome measure. Results: Participants in Tai Chi group reported significant improvement in TMT (part A) F(1, 71) = 78.37, p < .001, and in TMT (part B) F(1, 71)= 175.00, p < .001 in comparison with Control group. Conclusion: Tai Chi is beneficial to improve cognitive performance of the elderly.

Keywords: cognitive, elderly, Vietnam, Tai Chi

Procedia PDF Downloads 499

Authors: Luay Alsalmi

Abstract:

Background: Facial filler is the most common type of cosmetic surgery next to botox. Permanent filler is preferred nowadays due to the low cost brought about by non-recurring injection appointments. However, such fillers pose a higher risk for complications, with even greater adverse effects when the procedure is done using unknown dermal filler injections. AIM: This study aimed to establish an algorithm to categorize and manage patients that receive permanent fillers. Materials and Methods: Twelve participants were presented to the service through emergency or as outpatient from November 2015 to May 2021. Demographics such as age, sex, date of injection, time of onset, and types of complications were collected. After examination, all cases were managed based on an algorithm established. FACE-Q was used to measure overall satisfaction and psychological well-being. Results: The algorithm to diagnose and manage these patients effectively with a high satisfaction rate was established in this study. All participants were non-smoker females with no known medical comorbidities. The algorithm presented determined the treatment plan when faced with complications. Results revealed high appearance-related psychosocial distress was observed prior to surgery, while it significantly dropped after surgery. FACE-Q was able to establish evidence of satisfactory ratings among patients prior to and after surgery. Conclusion: This treatment algorithm can guide the surgeon in formulating a suitable plan with fewer complications and a high satisfaction rate.

Keywords: facial filler, FACE-Q, psycho-social stress, botox, treatment algorithm

Procedia PDF Downloads 59

Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

Abstract:

Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

Procedia PDF Downloads 179

Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 148

Authors: Alison Ryan, Himani Chhabra, Mohammed Dungarwalla, Judith Jones

Abstract:

Background: Impacted and ectopic teeth present in 1-2% of orthodontic patients and often require joint surgical and orthodontic management. The authors present two patients undergoing orthodontic treatment, where the impacted teeth, in a hopeless position, spontaneously erupted during the period of cessation of general anaesthetic lists during the COVID-19 pandemic. Patient information: A healthy 11-year-old boy was referred to the Department of Oral and Maxillofacial Surgery for the management of a mesioangular impacted LR7. The patient was seen by the joint oral surgery/orthodontic team, who planned for the removal of the LR7 under general anaesthetic. A healthy 13-year-old boy was referred to the same Department and team for surgical extraction of unerupted and buccally impacted UL3 and UR3 under general anaesthetic. Management and outcome: The majority of elective dental-alveolar work ceased as a result of the global pandemic. On resumption of activity, the first patient was reviewed in July 2021. The LR7 had spontaneously erupted in a favourable position, and following MDT review, a decision was made to forgo any further surgical intervention. The second patient was reviewed in July 2021. The UL3 had clinically erupted, and there was radiographic evidence of favourable movement of UR3. Due to the nature of the patient’s malocclusion, the decision was made to proceed with the extractions as previously planned. Key Learning Points: Severely impacted teeth do have a prospect of spontaneous eruption or alignment without clinical intervention, and current literature states the initial location, axial inclination, degree of root formation, and relation of the impacted tooth to adjacent teeth roots may influence spontaneous eruption. There is potential to introduce a period of observation to account for this possibility in the developing dentition, with the aim of reducing the unnecessary need for surgical intervention. This could help prevent episodes of general anaesthetic and allocate theatre space more appropriately.

Keywords: spontaneous eruption, impaction, observation, hopeless position, surgical, orthodontic, change in treatment plan

Procedia PDF Downloads 53

Authors: Ratima Damkham, Natasha Dejdumrong, Priyakorn Pusawiro

Abstract:

This paper explored the solution in game design to help game designers in the educational game designing using digital educational game model canvas (DEGMC) and digital educational game form (DEGF) based on Outcome-based Education program. DEGMC and DEGF can help designers develop an overview of the game while designing and planning their own game. The way to clearly assess players’ ability from learning outcomes and support their game learning design is by using the tools. Designers can balance educational content and entertainment in designing a game by using the strategies of the Business Model Canvas and design the gameplay and players’ ability assessment from learning outcomes they need by referring to the Constructive Alignment. Furthermore, they can use their design plan in this research to write their Game Design Document (GDD). The success of the research was evaluated by four experts’ perspectives in the education and computer field. From the experiments, the canvas and form helped the game designers model their game according to the learning outcomes and analysis of their own game elements. This method can be a path to research an educational game design in the future.

Keywords: constructive alignment, constructivist theory, educational game, outcome-based education

Procedia PDF Downloads 321

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

Procedia PDF Downloads 81

Authors: Agada N. Ihuoma, Nagata Yasunori

Abstract:

Artificial intelligence (AI) techniques play a crucial role in predicting the expected energy outcome and its performance, analysis, modeling, and control of renewable energy. Renewable energy is becoming more popular for economic and environmental reasons. In the face of global energy consumption and increased depletion of most fossil fuels, the world is faced with the challenges of meeting the ever-increasing energy demands. Therefore, incorporating artificial intelligence to predict solar radiation outcomes from the intermittent sunlight is crucial to enable a balance between supply and demand of energy on loads, predict the performance and outcome of solar energy, enhance production planning and energy management, and ensure proper sizing of parameters when generating clean energy. However, one of the major problems of forecasting is the algorithms used to control, model, and predict performances of the energy systems, which are complicated and involves large computer power, differential equations, and time series. Also, having unreliable data (poor quality) for solar radiation over a geographical location as well as insufficient long series can be a bottleneck to actualization. To overcome these problems, this study employs the anaconda Navigator (Jupyter Notebook) for machine learning which can combine larger amounts of data with fast, iterative processing and intelligent algorithms allowing the software to learn automatically from patterns or features to predict the performance and outcome of Solar Energy which in turns enables the balance of supply and demand on loads as well as enhance production planning and energy management.

Keywords: artificial Intelligence, backward elimination, linear regression, solar energy

Procedia PDF Downloads 137

Authors: Emil Iskandarov, Nazrin Agayeva

Abstract:

Background: The effectiveness of hormone suppressive therapy (HST) in patients with nodular goiter (NG) is controversial. The aim of this study was to identify the impact of long-time HST on the Quality of Life (QoL) of patients with NG. Material and Methods: A retrospective analysis of 146 patients with NG showed treated with HST showed that in 38,4% of cases, HST was not effective. Nodules were increased in size and moreover, and new nodules were developed. Statistical procedure identified the predictors of resistant nodules: only one nodule in the left lobe; nodule size >17mm; calcinate within the nodule. 174 patients with NG, by whom predictors of resistant nodules were established, were informed about the results of previous research and surgery was suggested. Eighty-eight patients (the basic group) agreed with surgery and thyroidectomy was led. 86 patients (control group) ignored the suggestion and wished to receive HST. 3, 6 and 12 months after starting HST; control group patients were examined. HST was non-effective and patients, due to developing symptoms, were operated on. Patients in both groups were followed up 3, 6 and 12 months after thyroidectomy. Quality of Life was checked with the SF-36 survey form and compared between groups. The statistical analysis was performed with the non-parametric Mann–Whitney U test and with the Student t-test. P values ＜0.05 were considered statistically significant. Results and Discussions: QoL of patients in the basic and control groups 3 months after surgery was almost the same. However, Emotional problems severely interfered with patients in a control group with normal social activities with family, friends, and neighbors. The causes were related to the non-effective HST treatment before surgery: stress for forgetting to take drugs timely every day for a long time; blood tests for thyroid hormone level; needle biopsies of nodules for cancer screening and regular ultrasound investigations, which showed that nodules not diminished in size. Changing the treatment method after 1-year non-effective HST and delayed surgery negatively impacted patient's QoL. Social role functioning and mental health in the control group were also impaired and the difference between the results in the basic group was statistically significant (p <0.05). Conclusion: Predictors, such as only one nodule, the width of nodules more than 17mm, and the existence of calcinate within the nodule, are able to forecast the resistant nodules. HST in patients with resistant nodules is non-effective and surgery is suggested in patients with resistant nodules in the thyroid gland. Long time HST has a negative impact on the QoL patient after surgery.

Keywords: thyroid gland, nodule, hormone suppressive therapy, quality of life

Procedia PDF Downloads 102

Authors: Haleh Dadgostar, Sara Kaviani, Hanieh Adib, Ali Mazaherinezhad, Masoud Solaymani-Dodaran, Fahimeh Soheilipour, Abdolreza Pazouki

Abstract:

Background and Objectives: Effectiveness of various exercise protocols in weight reduction after bariatric surgery has not been sufficiently explored in the literature. We compared the effect of minimally supervised home-based and closely supervised Gym based exercise programs on weight reduction and insulin resistance after bariatric surgery. Methods: Women undergoing gastric bypass surgery were invited to participate in an exercise program and were randomly allocated into two groups. They were either offered a minimally supervised home-based (MSHB) or closely supervised Gym-based (CSGB) exercise program. The CSGB protocol constitute two sessions per week of training under ACSM guidelines. In the MSHB protocol participants received a notebook containing a list of recommended aerobic and resistance exercises, a log to record their activity and a schedule of follow up phone calls and clinic visits. Both groups received a pedometer. We measured their weight, BMI, lipid profile, FBS, and insulin level at the baseline and after 20 weeks of exercise and were compared at the end of the study. Results: A total of 80 patients completed our study (MSHB=38 and CSGB=42). The baseline comparison showed that the two groups are similar. Using the ANCOVA method of analysis the mean change in BMI (covariate: BMI at the beginning of the study) was slightly better in CSGB compared with the MSHB (between-group mean difference: 3.33 (95%CI 4.718 to 1.943, F: 22.844 p < 0.001)). Conclusion: Our results showed that both MSHB and CSGB exercise methods are somewhat equally effective in improvement of studied factors in the two groups. With considerably lower costs of Minimally Supervised Home Based exercise programs, these methods should be considered when adequate funding are not available.

Keywords: postoperative exercise, insulin resistance, bariatric surgery, morbid obesity

Procedia PDF Downloads 257

Authors: Rafael Ricieri, Rogerio Barros, Francisco Clovis

Abstract:

Objective– The Objective of this is study is to report a rare case of dermoid cyst, with a sublingual location and cutaneous fistula in a 4 year-old child.Methods: This study is a case report. The main study instrument was the medical record and the radiological and intraoperative image bank. Results: Infants with congenital cervical lesions eventually need tomography for diagnostic elucidation, and health services should be structured to perform sedation and thin tomographic sections in order to reduce morbidity.

Keywords: congenital, sublingual dermoid cyst, fistula, pediatric surgery, head and kneck surgery

Procedia PDF Downloads 62

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

Procedia PDF Downloads 228

Authors: Selvia Arokiya Mary

Abstract:

Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of twin therapeutic approaches on certain bio-physiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai. Objectives: This study is to 1. assess the level of certain biophysiological parameters in women after mastectomy. 2. assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy. 3. correlate the practice of twin therapeutic approaches with certain biophysiological parameters. 4. associate the selected demographic variables with certain biophysiological parameters in women after mastectomy Research Design and Method: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai. Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance. There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of < 0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study. Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama had effect in terms of reduction of pain, arm exercise programme had effect in prevention of arm stiffness among post operative women following breast surgery. Thus the stated hypothesis was accepted. Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of pranayama and arm exercise program.

Keywords: biophysiological parameters breast surgery, lumpectomy , mastectomy, radical mastectomy, twin therapeutic approach, pranayama, arm exercise

Procedia PDF Downloads 221

Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

Abstract:

Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

Procedia PDF Downloads 106

Authors: Dusanee Suwankhong, Pranee Liamputtong

Abstract:

Breast surgery leaves undesirable scars to all women who experienced mastectomy, despite the fact that this could be a principle approach to save one life. This paper explores how Thai women living with breast cancer perceived and experienced a scarred body after breast surgery. In-depth interviews and drawing methods were employed among 20 women diagnosed with breast cancer. The interviewed data were analysed using thematic analysis method. The results showed that all women with breast cancer who underwent breast surgery perceived and experienced scar as a persisting and visible side-effect. This disfigurement appearance presented a negative image of feminine identity and led to emotional burdens among women. They responded to being scarred in different ways relating to their perceptions of body and changes. The older group had less embarrassed feelings towards being scarred comparing to the younger one. All women tried to seek means to cope with such physical impairment and keep balance life related to their condition. For example, they relied on Buddhism practice and tried to heal the keloid using natural products. Scars appeared to be an unpleasant effect for women who underwent breast mastectomy. Nurses and health care professionals in the local health service sectors need to pay close attention to how the women see the scarred body and their experiences of living with the distorted feminine appearance, and to provide sensitive support that meets the needs of these vulnerable women. The suitable supports can reduce the sense of embarrassment and increase their sense of self-confidence about their social femininity.

Keywords: breast surgery, emotional response, qualitative study, scars, Thai women

Procedia PDF Downloads 138

Authors: Mohammad Pervez Mughal, Huma Shazadi

Abstract:

Pakistan became a full signatory to the Washington Accord in June 2017, with the expectation that undergraduate engineering programs will be recognized by other signatory countries. Pakistan's accrediting body, the Pakistan Engineering Council (PEC), has distributed 12 Program Learning Outcomes (PLOs) under Outcome Based Education (OBE) criteria for engineering institutions in Pakistan to follow. However, no research has been conducted to rank graduates' employability skills in relation to these PLOs from the perspective of potential employers. The current work makes a concerted effort to rank the skills required by employers, which include both technical and non-technical skill sets. A survey was conducted throughout Pakistan to validate the relative importance of employability skills. 198 HR personnel, 1554 graduating students, 1540 alumni, and 267 faculty members provided valid responses, which were analyzed. According to the findings, ethics, communication, and lifelong learning are the most important attributes of engineering graduates' employability in the eyes of employers. Graduating students, alumni, and faculty's differential prospects are also presented and compared to employers' perspectives.

Keywords: employability skills, employers' perspective, outcome-based education, engineering graduates, Pakistan

Procedia PDF Downloads 86

Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

Abstract:

Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

Procedia PDF Downloads 102

Authors: M. H. Korayem, N. Sangsefidi

Abstract:

Magnetically guided soft robots have emerged as a promising technology in minimally invasive surgery due to their ability to adapt to complex environments. However, one of the main challenges in this field is damage to the vascular structure caused by unwanted stress on the vessel wall and deformation of the vessel due to improper control of the shape of the robot body during surgery. Therefore, this article proposes an approach for controlling the form of a magnetic, soft, continuous robot body using a PID controller. The magnetic soft continuous robot is modelled using Cosserat theory in static mode and solved numerically. The designed controller adjusts the position of each part of the robot to match the desired shape. The PID controller is considered to minimize the robot's contact with the vessel wall and prevent unwanted vessel deformation. The simulation results confirmed the accuracy of the numerical solution of the static Cosserat model. Also, they showed the effectiveness of the proposed contouring method in achieving the desired shape with a maximum error of about 0.3 millimetres.

Keywords: PID, magnetic soft continuous robot, soft robot shape control, Cosserat theory, minimally invasive surgery

Procedia PDF Downloads 51

Authors: Jeong-Moh John Yahng, Angelika Na

Abstract:

Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

Procedia PDF Downloads 113

Authors: Jake Tempo, Georgina Williams, Iain Robertson, Claire Pascoe, Darren Rama, Richard Cetti

Abstract:

Introduction: The twelfth rib is commonly used as a landmark for surgery; however, its variability in length has not been formally studied. The highly variable rib length provides a challenge for urologists seeking a consistent landmark for percutaneous nephrolithotomy and retroperitoneoscopic surgery. Methods and materials: We analysed CT scans of 100 adults who had imaging between 23rd March and twelfth April 2020 at an Australian Hospital. We measured the distance from the mid-sagittal line to the twelfth rib tip in the axial plane as a surrogate for true rib length. We also measured the distance from the twelfth rib tip to the kidney, spleen, and liver. Results: Length from the mid-sagittal line to the right twelfth rib tip varied from 46 (percentile 95%CI 40 to 57) to 136mm (percentile 95%CI 133 to 138). On the left, the distances varied from 55 (percentile 95%CI 50 to 64) to 134mm (percentile 95%CI 131 to 135). Twenty-three percent of people had an organ lying between the tip of the twelfth rib and the kidney on the right, and 11% of people had the same finding on the left. Conclusion: The twelfth rib is highly variable in its length. Similar variability was recorded in the distance from the tip to intra-abdominal organs. Due to the frequency of organs lying between the tip of the rib and the kidney, it should not be used as a landmark for accessing the kidney without prior knowledge of an individual patient’s anatomy, as seen on imaging.

Keywords: PCNL, rib, anatomy, nephrolithotomy

Procedia PDF Downloads 84

Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

Abstract:

There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

Procedia PDF Downloads 345

Authors: L. Roseiro, C. Veiga, V. Maranha, A. Neto, N. Laraqi, A. Baïri, N. Alilat

Abstract:

In orthopedic surgery there are various situations in which the surgeon needs to implement methods of cutting and drilling the bone. With this type of procedure the generated friction leads to a localized increase in temperature, which may lead to the bone necrosis. Recognizing the importance of studying this phenomenon, an experimental evaluation of the temperatures developed during the procedure of drilling bone has been done. Additionally the influence of the use of the procedure with / without additional lubrication during drilling of bone has also been done. The obtained results are presented and discussed and suggests an advantage in using additional lubrication as a way to minimize the appearance of bone tissue necrosis during bone drilling procedures.

Keywords: bone necrosis, bone drilling, thermography, surgery

Procedia PDF Downloads 559

Authors: Alldila Hendy, Agi Satria

Abstract:

Background: A colostomy procedure is an important part in the management of surgical procedures in some diseases involving the gastrointestinal tract. So it is necessary to find the factors that influence the occurrence of complications. Methods: This is a retrospective cross-sectional analytic study in Cipto Mangunkusumo Hospital noting medical records of patients after the colostomy from January 2012 to December 2014 at the Division of Digestive Surgery. Results: In 136 cases of post-colostomy, 66 cases have complications, 14 is early-onset, and 52 is late-onset. 70 is without complications. Most complications are dermatitis, which is 31 (22.8%), cases of infection/abscess/fistula and intestinal obstruction are 13 (9.6%) and 5 patients (4.4%). A rare complication is colostomy retraction by 2 patients (1.5%), colostomy prolapse and necrosis/gangrene, which is only 3 patients (2.2%). A colostomy procedure in emergency surgery is riskier than elective surgery for complications after colostomy (p < 0.007, OR 2.85), Based on the operator who performs a colostomy procedure, the consultant had a lower risk of complications than fellow or resident (p < 0.0001). Based on the age factor, where the age of about 50 years has a risk of complications after colostomy (p < 0.018). Conclusion: The timing of operation (emergency or elective), age, and operator who perform a colostomy procedure have a significant relationship with an increased prevalence of complications after colostomy in RSCM.

Keywords: colostomy, complications, factors, procedure

Procedia PDF Downloads 247

Authors: Todd Jackson

Abstract:

In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

Procedia PDF Downloads 37

Authors: Abdelmaguid Ramzy, Mohamed Bahaa

Abstract:

Introduction: The effects of ovarian endometrioma on fertility outcomes with IVF have been always related to poor outcomes. Objective: To evaluate the effect of unilateral unoperated ovarian endometrioma < 2cm on the number of developing follicles and compare them with the contralateral ovary as a control. Design: Retrospective case control study. Setting: KasrEl-Aini IVF center. Patient(s): We studied 32 women with unilateral endometrioma who underwent their first IVF cycle. Methods: 32 Patients aged between 20-35 years selected for IVF who were diagnosed with one unilateral endometrioma (diameter <2 cm) and who did not undergo previous ovarian surgery were retrospectively identified. The number of follicles > 17 mm during folliculometry on the day of HCG trigger in the ovary that contained endometrioma were compared with those from the contralateral ovary. They were all hyperstimulated using long protocol with (225-300 IU) gonadotrophins. Primary outcome: The number of follicles > 17 mm during folliculometry on the day of HCG trigger. Result(s): The mean ± SD age, Day 3 serum FSH and LH were 27± 3.7 years, 5.8 ± 1.6 IU/ml and 4.5 ± 1.7 IU/ml respectively. There was no significant difference in the number of follicles > 17 mm on the day of HCG trigger in the ovary that contained endometrioma (4.4 ±2.5) and in the opposite ovary (4.5 ± 2.8) (P= 0.48). Conclusion: The presence of ovarian endometrioma in a controlled ovarian hyperstimulation cycle for IVF treatment is not associated with a reduced number of follicles > 17 mm during folliculometry on the day of HCG trigger.

Keywords: endometrioma, folliculometry, hyperstimulation, fertility

Procedia PDF Downloads 186