by Banu Cevik and Yucel Yuce
Original Research
Background: In this prospective study of 859 surgical patients in a tertiary research hospital, we examined the association between ASA physical status classification and Intraoperative Therapeutic Intervention Score (I-TIS). Methodology:All patients were assigned by ASA classification before the operation and received a value of 1-4 points for I-TIS score during surgical procedures. Surgical complexity was also classified and correlation with I-TIS was examined. Results: The correlation coefficient of the ASA with I-TIS was r=0.55 (p<0.01). The correlation between the surgical complexity was r=0.66 (p<0.001). Five patients (ASA IV) with I-TIS score>25 and surgical complexity of major plus were admitted to the intensive care unit. Two of them were followed up six hours and the other three stayed more than 24 hours in the intensive care unit. Conclusions: It’s concluded that I-TIS score may be validated for our surgical patients but this assessment may show variability among institutions. The ASA classification is the most valued and widely used scoring system for evaluation of perioperative risk in surgical patients. It is simple, easy and also a useful tool to assist descriptions of workload and ‘anesthetic risk’ for analysis and research purposes.
American Journal of Clinical Medicine Research. 2018, 6(1), 15-19. DOI: 10.12691/ajcmr-6-1-4
Pub. Date: March 29, 2018
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by Bassam Ahmed ALmutlaq, Mohammad M. Al-Qattan, Bisher Alshanawani, Abdullah Dakheel Alotaibi, Mona alkhotani, Majid Zannon Aturkstani and Hussain Gadelkarim Ahmed
Original Research
Background: The confidently growing outcomes following breast plastic surgery has revealed several advantages to breast reconstructive approach, comprising precise preoperative assessment. The objective of the present study was to assess the influence of women's positioning (standing or sitting) on breast measurements. Methodology: A total of 250 women who were undergoing breast screening or breast cosmetic amendment were included. Breast measurements were performed in two positions (standing and setting). Results: All variables were significantly correlated and only left sternal notch Inframammary Fold (IMF), showed lower significant than others. Conclusion: A proper measurements can give the patients excellent cosmetic and surgery. Accurate measurement can be achieved by calculating the mean of both positioning (standing and sitting).
American Journal of Clinical Medicine Research. 2018, 6(1), 10-14. DOI: 10.12691/ajcmr-6-1-3
Pub. Date: February 05, 2018
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by Faiz Mohammed alruwaili, Abdullah Abdulrahman muharib, Turki seran alharbi, Abdulrhman Alnasser, Areej Abdullatif Madani, Esam Albanyan, Mohammed Alshaalan, Bassam Ahmed Almutlaq and Hussain Gadelkarim Ahmed
Original Research
Background: Invasive Pneumococcal Disease (IPD) is a life-threatening disease, which could be prevented by vaccination using Pneumococcal Conjugated Vaccine (PCV). Therefore, the aim of this study was compare the incidence before and after the introduction of the vaccine among children in King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, and to determine the extent of the disease prevention by the vaccine. Methodology: A retrospective cohort study including all children who are ≤ 14 years of age and microbiologically confirmed as infected (cases) with Streptococcus pneumonia(SP) from a sterile body fluid (blood or cerebrospinal fluid) before the introduction of the pneumococcal conjugated vaccine between the years of 2004-2008 and after the introduction of the pneumococcal conjugated vaccine (2009-2015) in KAMC, Riyadh, Saudi Arabia. Results: Out of 171 retrieved cases, 131/171(76.6%) were not vaccinated and 40/171(23.4%) were vaccinated. Streptococcus Pneumonia was isolated from blood in 163/171(95%) of the cases, and from cerebrospinal fluid in 23/171(13.5%) of the cases. Conclusion: The introduction of PCV7 has significantly decreased the incidence rates of IPD in children. The conjugate vaccines have shown a significant efficacy in reducing IPD among our population.
American Journal of Clinical Medicine Research. 2018, 6(1), 5-9. DOI: 10.12691/ajcmr-6-1-2
Pub. Date: January 23, 2018
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by Banu CEVIK and Yucel YUCE
Original Research
The aim of this study is to evaluate the effectiveness of albumin infusion in critically ill geriatric patients and discuss the prognostic impact on mortality. This study is a retrospective analysis of patients with hypoalbuminemia (≤2.5 g/dl) over 65 years and older followed-up in a 38-bed-mixed medical-surgical tertiary intensive care unit (ICU) of a 650-bed-academic hospital affiliated to University of Health Sciences in İstanbul during 1-year-period. We collected the data including sex, cause of admission, length of stay, duration of mechanical ventilation and APACHE II scores from patients’ medical records. The amount of albumin infused per patient and laboratory evaluation concerning albumin levels was processed by hospital electronic database. Overall 200 patients were included study. Among the patients, 90 (45%) were female, and 110 (53.5%) were male with overall mean age of 78.62±7.63 years. The cause of admission was due to non-surgical reasons in 119(59.5%) patients. Mean length of stay and mechanical ventilation time was significantly higher in non-survivors. The amount of albumin used per patient was similar in both study groups (p=0.276).Pretreatment level of serum album was 2.15±0.28 g/dl and 2.10±0.31 g/dl in both groups respectively (p=0.364) having no significant increase after treatment (p=0.352). In the non-survivors group, APACHE II score was significantly high. Long-term mortality ratio was significantly high which indicated that albumin had no beneficial effect on long-term mortality. The albumin transfusion in critically ill patients over 65 years old has no considerable effect on the treatment of hypoalbuminemia and ICU mortality.
American Journal of Clinical Medicine Research. 2018, 6(1), 1-4. DOI: 10.12691/ajcmr-6-1-1
Pub. Date: January 22, 2018
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