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Register a new userA Ccomparative Study of Oxytocin and Misoprostol in Preventing Postpartum Hemorrhage
المعالجة الجراحية لكسور الرضفة عند البالغين: النتائج الوظيفية
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شمل البحث الأشخاص المصابين بكسور الرضفة الذين تم قبولهم وعلاجهم جراحيا في مشفى الأسد الجامعي في جامعة تشرين في الفترة الواقعة بين عامي (2008 – 2013 ) حيث بلغ عدد الحالات المدروسة 30 حالة تراوحت فيها أعمار المصابين بين 16 – 70 سنة و كان متوسط المتابعة السريرية والشعاعية للحالات ستة أشهر . بلغ أصغر سن للإصابة 16 سنة و أكبر سن لها 70 سنة أي بعمر وسطي (30 – 40) سنة: 37.66 سنة . بلغ عدد الإصابات من الذكور ( 12 ) إصابة ومن الإناث ( 18 ) إصابة. اعتمدنا في تقييم النتائج على سلم ليشولم ذي المائة نقطة وتمت دراسة النتائج الوظيفية بعد مرور ستة أشهر في الثلاثين حالة واعتمادا على التقييم السابق حصلنا على نتائج ممتازة في 27% من الحالات ونتائج جيدة في 47% من الحالات
The study covered 30 cases of patellar fractures in persons who were accepted and treated surgically at Al-Assad University Hospital in Lattakia from 2008 to 2013.Ages of patients ranged between 16-70 years. Average load of clinical and radial continuation was six months. The smaller age of traumatism amounted 16 years and larger age 70 years; average load of age was 37.66 years. The number of traumatism in male was amounted 12 and female 18. In estimating the results, we depend on Lysholm scale scoring. Functional results were studied after 6 months and we had excellent result in 27% of cases and good results in 47% of other cases
References used
Baumgaertner MR, Curtin SL, Lindskog DM, KeggiJM. The value of the tip-apex distance in predicting failure of fixation of patellar fractures. J Bone Joint Surg Am. 1995;77:1058-64
Baumgaertner MR, Solberg BD. Awareness of tipapex distance reduces failure of fixation of patellar fractures. J Bone Joint Surg Br. 1997;79:969-71
Kyle RF, Cabanela ME, Russell TA, SwiontkowskiMF, Winquist RA, Zuckerman JD, Schmidt AH, KovalKJ. Fractures of the patella. InstrCourse Lect. 1995;44:227-53
Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two patellar fractures.J Bone Joint Surg Am. 1979;61:216-21
Knight WM, DeLee JC. Nonunion of patellar fractures : a case study and review [abstract]. Orthop Trans. 1982;6:438
Artificial intelligence review:
Research summary
تناول البحث دراسة النتائج الوظيفية للمعالجة الجراحية لكسور الرضفة عند البالغين. شملت الدراسة 30 حالة تم علاجها في مشفى الأسد الجامعي بجامعة تشرين بين عامي 2008 و2013. تراوحت أعمار المرضى بين 16 و70 سنة، وكان متوسط المتابعة السريرية والشعاعية ستة أشهر. تم تقييم النتائج باستخدام سلم ليشولم ذو المائة نقطة. حصلت 27% من الحالات على نتائج ممتازة و47% على نتائج جيدة. أشارت الدراسة إلى أن طريقة الشد الديناميكي الضاغط كانت الأكثر فعالية في تحقيق نتائج وظيفية جيدة، تليها طريقة استئصال القطب السفلي للرضفة. كما أظهرت الدراسة أن التزام المرضى بالعلاج الفيزيائي وتحسين الحركة بعد الجراحة كان له دور كبير في تحقيق نتائج إيجابية.
Critical review
تعتبر هذه الدراسة مهمة في مجال جراحة العظام، حيث تقدم معلومات قيمة حول طرق علاج كسور الرضفة ونتائجها الوظيفية. ومع ذلك، يمكن الإشارة إلى بعض النقاط التي قد تحتاج إلى تحسين. أولاً، حجم العينة صغير نسبياً (30 حالة فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم تتناول الدراسة بشكل كافٍ العوامل النفسية والاجتماعية التي قد تؤثر على نتائج العلاج. ثالثاً، كان من الأفضل تضمين مقارنة مع طرق علاج غير جراحية لتقديم صورة شاملة عن الخيارات المتاحة. على الرغم من هذه النقاط، فإن الدراسة تقدم مساهمة قيمة في فهم كيفية تحسين النتائج الوظيفية لكسور الرضفة.
Questions related to the research
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ما هي الفئة العمرية الأكثر عرضة لكسور الرضفة وفقاً للدراسة؟
الفئة العمرية الأكثر عرضة لكسور الرضفة هي بين 30 و40 سنة، حيث بلغت نسبة الإصابات في هذه الفئة 60%.
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ما هي الطريقة الجراحية الأكثر فعالية وفقاً للدراسة؟
الطريقة الجراحية الأكثر فعالية وفقاً للدراسة هي طريقة الشد الديناميكي الضاغط، حيث حققت أفضل نسبة من النتائج الوظيفية الجيدة.
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ما هو دور العلاج الفيزيائي في تحسين النتائج الوظيفية لكسور الرضفة؟
العلاج الفيزيائي يلعب دوراً أساسياً وهاماً في تحسين النتائج الوظيفية لكسور الرضفة، حيث يساعد في تحسين حركة الركبة وتقليل الاختلاطات.
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ما هي نسبة الإصابات بين الذكور والإناث في الدراسة؟
بلغت نسبة الإصابات بين الإناث 60%، بينما كانت نسبة الإصابات بين الذكور 40%.
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This search included 150 pregnant women who had gestational age of 36 weeks or more, and had been admitted to the Department of Obstetrics and Gynecology at Al – Assad University Hospital in Lattakia for the spontaneous vaginal delivery during the st
udy period
( 1\1\2012 to 1\7\ 2013). Exclusion criteria were patients undergoing cesarean section, patients with placenta previa, or abruptio placenta, patients with hemoglobin<9 gm%, pregnancy-induced hypertension or pre eclampsia–eclampsia, grand multiparty, coagulation abnormalities, positive history of PPH, expensive hemorrhage or other medical disorders.
Patients were randomly divided into three groups: ( 1: uterine massage group, 2: 10 units oxytocin in 500 cc glucose 5% intravenously with delivery of the anterior sholder\ control group, 3: three 200µg rectal misoprostol tablets\study group).
No significant differences were observed between the groups regarding baseline characteristics. There was blood loss of ≥500 ml occurred in 18% in the first group, 6% in the second group, 8% in the third group. Routine use of 600 µg of rectal misoprostol was effective in reducing blood loss after delivery ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g (RR 0.44 ; CI 0.32 – 1.53), but not as effective as intravenous oxytocin (RR 1.33 ; CI 0.4 – 3.39).
Although these were differences, they were not significant (No significant differences were observed between the control and study groups for the length of the third stage of labor, the estimated blood loss, the changes in Hb and Hct concentrations, need for additional uterotonics, manual removal of placenta, blood transfusion…..).
This dose of misoprostol and route of administration were well tolerated, and usual side effects such as shivering and fever were transient, resolved on their own, and were not threatening. Because PPH is the most significant direct cause of maternal mortality and because most of these maternal mortality occurs in low resource countries, misoprostol offers several advantages over oxytocin in such settings. It is formulated as a tablet, widely available and affordable, and it does not need require special storage conditions (i.e. it is stable at ambient room temperature and does not require specific conditions for transfer and has a shelf-life of several years). It also does not require any special skills, equipment, or facilities for its use. So misoprostol can fill a service delivery gap in settings where women and providers are unable to access oxytocin.ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g
Fractures of the mandibular condyles are frequent in facial traumas and their treatment represents a highly controversial issue in maxillofacial traumatology, functional and surgical treatments being the two principal management modalities for such f
ractures.
The aim of this study is to evaluate the results of functional treatment of mandibular condylar fractures in patients which received this type of treatment.
Eighty-six patients between 6 and 66 years old who were previously treated fuctionally for a fracture of the mandible condyle were recalled for follow up examination with a mean postoperative observation time of 10.4 years. Mandibular function was assessed using the mandibular function impairment questionnaire and patient's complaints were assessed during physical examination. The results showed a significant increase of dysfunction index values with increasing age at the time of trauma. Radiologic abnormalities such as reduced ramus height, deviation of the mandibular midline, and irregular shape of the condyle were observed and seen frequently, but they were not correlated with the severity of dysfunction. Predictors of mandibular function impairment after closed treatment of fractures of the mandibular condyle were: great deviation, reduced mouth opening, women gender, and increased age. The results of this study support the opinion that functional treatment is sufficient in pediatric patients, whereas in older age groups the results of conservative treatment are less sufficient
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The fixation of the humeral,s supracondylare fractures in children by percutaneous pinning is considered a new and good principle in without the disadvantages that appear by treating it by open reduction and internal fixation . A prespective and pers
pective study was done for 48 kids whose old was between 2 – 14 year, those kids were admitted and treated surgically by these two methods ( pinning and ORIF ) In AL-ASSAD hospital in LATTAKIA in TISHREEN-UNIVERSITY in 2014 The ages of patients were between 2 – 14 , female ratio was ( 62.5% ) and male ( 37.5% ) the common reasons for these fractures were sportive and home accidents and the dominant upper limb was left . Fractures were isolate in 90% of cases and we noted 4 cases with accompanied and nondisplaced fractures in forearm and wrist that were treated conservatively . Pins and cast were removed in the four weeks . The more common complications were the secondary displacement , movement limitation and cubitus varus. The percutaneous pinning stills an easy way in understanding and application and gives good results for long period functionally and cosmetically , and this way has no important complications which can be avoided .
This research was conducted to study all the causes leading to postpartum hemorrhage in order to implement all the appropriate treatments, according to all reason and thus avoiding the complications of postpartum hemorrhage and death, and study of th
e risk of bleeding factors in order to reach the best method of prevention of bleeding . This research included on 77 patient acceptable in Al Assad University Hospital in Lattakia, with primary postpartum hemorrhage occurred after vaginal delivery, including (12) patient after vaginal birth outside the hospital, during the extended study period: from 1/1/2014 until 1/1 / 2016, and excluded all patients who were born cesarean delivery. We determine the percentage of postpartum hemorrhage occurring between vaginal deliveries in the hospital, and the ratio was (3.52%), and we could not determine this percentage outside the hospital.
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