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Title : The study of enterocutaneous fistula management, in AlSader teaching hospital, Al Najaf, Iraq
Abstract :Enterocutaneous fistula management is challenging because of massive fluid loss that leads to severe dehydration and malnutrition, that consider being the major cause of morbidity and mortality. To describe the outcome of our experience in the management of enterocutaneous fistula (ECF) in Al Sader teaching hospital, Najaf, Iraq. Prospective descriptive study comprised 93 patients presenting with enterocutaneous fistula (ECF). We try to treat all patients conservatively primarily for 6-8 weeks, and surgical intervention that involves one-stage repair was only adopted when the fistula does not heal after this period. Enteral nutrition is used in the management. Patients in the high output fistula group received doses of octreotide 100 µg every 8 hours for a maximum of 7 days. There were 32(34.41%) female, and 61(65.599%) male patients. Only one patient presented with a spontaneous fistula the remaining fistula resulted as consequences of post-operative complications for different causes. The most common anatomical type was colonic fistula 46patients. There were 35(37.63%) patients who had high output fistula and 58(62.37%) with a low output. In 69(74.19%) patients their fistula closed spontaneously with conservative treatment with a mean duration of 10.32 weeks ranging from 2-20 weeks. In the remaining 24(25.81%) patients, the fistula was successfully closed with surgical intervention. Normal or low serum albumin does not affect the outcome. Haemoglobin <10gm/dl have a higher mortality rate and less spontaneous closure rate. Postoperative iatrogenic complication consider to be the main cause of ECF in almost all patients. The conservative treatment using enteral nutrition was effective in spontaneous closure. Octreotide did not affect the closure rate or mortality rate. Higher mortality rate found in patients with high output fistula.
Title : A prospective comparative study between IPACK and 50 mg Tramadol plus adductor canal block respectively after knee surgery
Abstract :Total knee arthroplasty is a painful procedure that requires a multimodal analgesia for pain relief. Adductor canal block (ACB) combined with ultrasound-guided local anesthetic infiltration of the interspaces between popliteal artery and the capsule of posterior knee (IPACK) providing significant knee joint analgesia without hamper motor function. This prospective comparative study aimed to evaluate the efficiency and safety of adductor canal block (ACB) combined with local anesthetic infiltration between popliteal artery and posterior knee capsule (IPACK block) versus adductor canal block (ACB) combined with Tramadol in pain control after total knee arthroplasty (TKA). This prospective study was carried out in the orthopedic theatre of Al Basra Teaching Hospital. Sixty patients were divided into two groups with 30 patients in each one, group A (ACB + IPACK block) patients with odd number while group B (ACB + Tramadol) patients with even number. All patients were evaluated with VAS and satisfaction scale recorded at the first 8 h at rest and movement after the surgery. The patient outcome parameter was assessed by presences of nausea, vomiting, hemodynamic parameters& needs of I.V opioid consumption during the first 8h postoperatively. ACB + ipack block could significantly lowered VAS, improved patient satisfaction scale, decrease the incidence of nausea and vomiting and significantly reduced I. V opioid consumption during the 1st 8h postoperative TKA compared to ACB + Tramadol. The ACB + IPACK block provide excellent analgesia of the knee joint with preservation of quadriceps muscle function beside reduces opioid consumption after total knee arthroplasty compared to ACB + Tramadol allowing for early rehabilitation and discharge.
Title : Effect of Home Quarantine Due to COVID19 Pandemic on Psychological Status and Behaviour of Under 5 years Old Children
Abstract :Children are largely spared from the direct health effects of COVID-19, nevertheless, they are among the biggest victims because of the profound effect on their mental well-being, social development, safety, privacy, and their economic security. Studying the effect of home quarantine on the mental and psychological wellbeing of the under five years' children compared with their own status prior to the quarantine. A comparative retrospective cross sectional survey study was carried out online. A sample of 200 under-five age children was taken and their primary care giver had answered the questions. The study was done in 2020. A statistically significant difference between the mean score of the children before and after quarantine (t= -6.8, p=.0001), most of the changes were increase screen time, increase stubbornness, clinging to parents, anger and sleeping problems. Home quarantine had a significant effect on the psychological status and behaviour of under-five age children.
Title : Barriers to research among staff members, Faculty of Medicine, University of Tabuk, Saudi Arabia.
Abstract :The Saudi vision 2030 is aiming to foster research and development through its development and innovation programs. The University of Tabuk recognizes the significance of scientific research and its integral role in the development of the Community and improvement of patients' care. Therefore, this research aimed to assess the barriers to and perception of research among staff members, Faculty of Medicine, University of Tabuk. A cross-sectional study was conducted among 94 faculty members, Faculty of Medicine, University of Tabuk, Saudi Arabia (response rate 40%). The study was conducted in September and October 2021. A web-based questionnaire consists of two parts. The first collected demographic data, and the second inquiries about the type of research published. The reasons behind conducting research, and challenges or barriers to research (support, knowledge were reported. In addition, other barriers include time constraints, social factors, and lack of access to statistical software like SPSS. The Statistical Package for Social Sciences was used for data analysis. There were 42 staff members from different Departments. In the present study, the deficit in skill set for collection of data, inadequate knowledge of research methodology, and Difficulty in performing statistics were the main barriers to research. Personal barriers are more prevalent than regulatory and administrative barriers. More research to include all the staff members in the College and the whole University is needed.
Title : Relationship between interleukin 6 and 10 with seminal fluid characteristics in patients with varicocele
Abstract :Infertile males were tested for the presence of interleukin 6 and 10, as well as for the presence of lipid peroxidation in their sperm. A total of 75 men with varicoceles and 25 fertile men served as controls, with sperm samples collected via masturbation. Malondialdehyde (MDA) production in the sperm membrane was used to assess the degree of lipid peroxidation in the membrane. Statistics were used to examine the association between the quantities of interleukin-6 (IL-6) and interleukin-10 (IL-10) in plasma of seminal and lipid peroxidation levels of sperm membranes. There existed a statistically significant difference in the concentration of IL-6 in the seminal plasma of unfertile males and fertile men (p < 0.05) between the two groups. On the other hand, the concentration of interleukin-10 (IL-10) in the seminal plasma of infertile men was considerably greater than that of fertile men (p < 0.05), and the degree of lipid peroxidation in the semen of infertile men was significantly higher than that of fertile men (p < 0.05). in seminal plasma the levels of IL-6 and membrane lipid peroxidation procces in the spermatozoa were found to be positively related to each other (p < 0.05), while IL-10 levels in seminal plasma and lipid peroxidation membrane in sperm were found to be positively correlated with each other (p < 0.05). It seems that there is a potential link between plasma interleukin-10 and 6 and ranks of spermatozoa and peroxidation of fat in the sperm membrane based on these findings. It may explain the encouragement species reactive formed by sperm of males and leukocytes, which is stimulated by great ranks of IL-6. Moreover, IL-10 is categorised by chemoattractant action of both T cells and basophils, as well as by the use of a proangiogenic effect on vascular smooth muscle cells. IL-10 is a cytokine that shows a key character in a variety of inflammatory disorders.
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