Dammlarkin0822
Conclusion In a well-treated newly diagnosed HF population, repeat assessment at HF programme completion suggests 4.1% of patients have a persisting indication for percutaneous mitral valve repair based on persisting severe symptomatic secondary MR.
Pulmonary embolism (PE) is a cardiovascular emergency caused by occlusion of one or more pulmonary arteries by thrombi that originate from a deep venous thrombosis (subsequently called an embolus), typically in the large veins of the lower limb or pelvis. It is a common cause of preventable hospital death and a cause of mortality in obstetrics setting because it largely remains under diagnosed especially in a resource poor setting.
Mrs OG, a 30-year-old primigravida, had a spontaneous delivery of a baby boy. A few hours after delivery, she had two episodes of syncope and was resuscitated with intra-venous fluids and blood transfusion. Further evaluation, with an abdominopelvic ultrasound scan, showed that she had supra-levator haematoma necessitating emergency exploratory laparotomy. During the induction of anaesthesia for the surgery, she had a cardiac arrest and was again resuscitated with cardiac compression and intravenous adrenaline. She was transferred to ICU on account of cardio-respiratory instabiurgent intervention with embolectomy or thrombolytic therapy. In the absence of these, anticoagulation with vasopressor agents, supplementary oxygen and close monitoring was able to sustain the patient.
Pulmonary embolism is a killer condition with 10% of the patients dying within one hour of onset. Most times, mortality occurs in patients who were never diagnosed. The best prospect for reducing mortality in patients with PE lies in improving diagnosis.
Pulmonary embolism is a killer condition with 10% of the patients dying within one hour of onset. Most times, mortality occurs in patients who were never diagnosed. The best prospect for reducing mortality in patients with PE lies in improving diagnosis.High intensity focused ultrasound (HIFU) is a non-invasive method of treating uterine fibroid that is based on the principle of using extracorporeal ultrasound to cause coagulative necrosis of uterine fibroid. While the technology has been used in other parts of the world, it is new in West Africa. The reported case was the first HIFU treatment of uterine fibroid in Nigeria. A 38-year-old woman was prepared for HIFU treatment of uterine fibroid. Abdomino-pelvic ultrasound scan, Magnetic Resonance Imaging (MRI) and pre-procedural bowel preparation were done. High intensity focused ultrasound (JC200) treatment was done under conscious sedation using average power of 400 Watts with total energy consumption of 278.0 Kilo Joules with total sonication time of 700 seconds. The patient was able to resume her daily activities one week post-HIFU procedure.
Previous studies on breast cancer (BC) in Ghanaian women found the disease to be common in young women who present late with large palpable tumours. The aim of this study was to determine how the size of a primary malignant breast tumour influences the prognosis of BC in Ghanaian women.
A retrospective review of BCs diagnosed in mastectomy and wide local excision biopsy specimens with axillary clearance were conducted. Primary malignant breast tumours were categorised based on the size (cm) into tumour d" 2.0cm (T1), tumour >2.0 d" 5.0 cm (T2) and tumour > 5.0 cm (T3). Data were analysed using SPSS version 23 (Chicago). Associations between tumour variables were determined by Spearman's correlation coefficient and Fisher's exact test (GraphPad prism version 5).
The mean size of primary malignant breast tumours was large (5.8±3.8cm). selleckchem Approximately half were T3 tumours. The mean ages of women diagnosed with T1, T2 and T3 tumours were 51.5 ±2.0, 52.8±12.4 and 51.2 ±12.7 years, respectively. High grade BCs (II and III combined), involvement of 4 or more positive lymph nodes by malignant cells, high TNM stage and increased prevalence of positive malignant tumour margins were all significantly high in T3 tumours (P<0.0001) compared to T1 and T2 tumours. There were significant associations between T2 tumours and the histological subtype (p- = 0.011) and nodal involvement (p = 0.044) by malignant cells. Similarly, T3 tumours showed significant positive association with the histological subtype (p = 0.019) and nodal involvement (p = 0.018).
The study found large primary tumour size (T3) to show significant positive association with the histological subtype and lymph nodes involvement by tumour. T3 tumours also showed increased prevalence of positive tumour margins.
The study found large primary tumour size (T3) to show significant positive association with the histological subtype and lymph nodes involvement by tumour. T3 tumours also showed increased prevalence of positive tumour margins.
Total joint replacement surgeries can produce severe pain in the post-operative period that can prolong the duration of hospital stay. The aim of the study, was to determine the efficacy of Local Infiltration Analgesia in the management of post-operative pain after total joint replacement.
This was a prospective study with patients recruited for the study divided into group A and B. Group A received intra-operative analgesic cocktail while those in group B (control group) received an equal volume of normal saline. Both groups received the same post-operative pain management protocol. Pain assessment in the post-operative period was done using the visual analogue scale, at 4 hours, 8 hours, 24 hours and 48 hours post surgery. Time to achieving assisted ambulation, occurrence of adverse events, and the number of times analgesic was administered for breakthrough pain were assessed.
A total number of 50 patients who had either total joint arthroplasty (25 in each group) were recruited for the study. The Normal saline group had significantly higher VAS scores in the first 8 hours after surgery (p values 0.016 at 4 hours and 0.037 at 8 hours post-operation) while both groups had similar pain scores thereafter. Mobilization times were not significantly different between both groups and adverse events occurred with almost equal frequency in both groups.
Periarticular local infiltration analgesia as part of multimodal pain control protocol is effective in the control of early post-operative pain after total joint replacement.
Periarticular local infiltration analgesia as part of multimodal pain control protocol is effective in the control of early post-operative pain after total joint replacement.In their study of manifestations of policy support organizations (PSOs), Al Sabahi et al found that PSOs are united in their goal to support evidence-informed policy-making (EIPM), albeit with differing approaches. Their article is an important contribution to the body of research on evidence utilization and implementation. The unprecedented evidence climate presented by coronavirus disease 2019 (COVID-19) provides a unique window to motivate EIPM implementation. Research such as Al Sabahi and colleagues must prompt a dialogue regarding how best to address some of the current shortcomings in the field of EIPM. Monitoring and evaluation of best practices in EIPM is scarce. EIPM uptake is unsatisfactory, and the scientific community needs to ask itself why that is and what can be done. And, we should strive to develop a gradient that discerns between the convenient and the essential so countries can evaluate and pursue the policies to best address their greatest pain points through evidence.
The health policy and systems research literature increasingly observes that knowledge translation (KT) practices are difficult to sustain. An important issue is that it remains unclear what sustainability of KT practices means and how it can be improved. The aim of this study was thus to identify and explain those processes, activities, and efforts in the literature that facilitate the sustaining of KT practices in health policy-making processes.
We used a critical interpretive synthesis (CIS) to review the health policy and systems research and Science and Technology Studies (STS) literature. The STS literature was included as to enrich the review with constructivist social scientific perspectives on sustainability and KT. The CIS methodology allowed for creating new theory by critically combining both literatures. We searched the literature by using PubMed, Google Scholar, Web of Science, and qualitative sampling. Searches were guided by pre-set eligibility criteria and all entries were iteratively anaing work' perspective of our CIS emphasises KT actors' ongoing work directed at sustaining KT practices. We suggest that this perspective can guide empirical study of sustaining work and that these empirical insights, combined with this CIS, can inform training programmes for KT actors, and thereby improve the sustainability of KT practices.Waitzberg and colleagues identified strategies that managers and physicians in hospitals apply to reconcile dilemmas between clinical and economic considerations. Contributions that actually acknowledge the institutional complexity of hospitals and describe how to deal with it are rare. This comment explains the reason behind the institutional complexity in healthcare organizations and argues that institutional complexity is a good foundation for a well-functioning and sustainable healthcare, as long as we are able to deal with this complexity. This point underscores the importance of their contribution. However, even if the identified strategies on how to reconcile and balance different, competing demands are important, they are not easy to apply in practice. First, the strategies require frequent and high-quality interaction between different actors adhering to different institutional logics. Second, even when the strategies are applied successfully, it is difficult to make them sustainable since they rest on a fragile balance between competing logics. However, these are important avenues for future research for researchers who want to follow the route of Waitzberg and colleagues.
Regional cooperation on health in Africa is not new. The institutional landscape of regional cooperation for health and health research, however, has seen important changes. Recent health emergencies have focussed regional bodies' attention on supporting aspects of national health preparedness and response. The state of national health research systems is a key element of capacity to plan and respond to health needs - raising questions about the roles African regional bodies can or should play in strengthening health research systems.
We mapped regional organisations involved in health research across Africa and conducted 18 interviews with informants from 15 regional organisations. We investigated the roles, challenges, and opportunities of these bodies in strengthening health research. We deductively coded interview data using themes from established pillars of health research systems - governance, creating resources, research production and use, and financing. We analysed organisations' relevant activian continent requires strategic thinking about the roles, comparative advantages, and capability of regional organisations to facilitate capacity and growth of health research systems.
Continued strengthening of health research on the African continent requires strategic thinking about the roles, comparative advantages, and capability of regional organisations to facilitate capacity and growth of health research systems.
