Sumerianz Journal of Medical and Healthcare
Online ISSN: 2663-421X
Print ISSN: 2706-8404
Journal Website: https://www.sumerianz.com/?ic=journal-home&journal=31
Volume 3 Issue 10 (2020)
Current Real-World Outcomes of Recurrent Kawasaki Disease
Authors : Toshimasa Nakada
Studies have shown that recurrent Kawasaki disease (KD) is a risk factor for resistance to initial intravenous immunoglobulin (IVIG) therapy and development of coronary artery lesions (CALs). However, current real-world outcomes of recurrent KD patients remain unclear. The objective of this retrospective study was to elucidate the outcomes of recurrent KD patients in the era of 2 g/kg IVIG therapy. Data were included from 201 KD patients who underwent acute-phase treatment from January 2009 to September 2020, with 184 (91.5%) receiving 2 g/kg IVIG therapy. The patients were divided into 7 with (recurrent group) and 194 without (nonrecurrent group) recurrent KD. At the first onset, the rates of initial IVIG therapy resistance (28.6% vs. 21.5%, P = 1.000), rescue therapy (14.3% vs. 14.4%, P = 1.000), and CALs (0.0% vs. 2.6%, P = 1.000) were similar between the recurrent and nonrecurrent groups. The rates of initial IVIG therapy resistance (14.3% vs. 21.5%, P = 1.000), rescue therapy (14.3% vs. 14.4%, P = 1.000), and CALs (0.0% vs. 2.6%, P = 1.000) were also similar between the recurrent group at the second onset and the nonrecurrent group at the first onset. KD recurrence may no longer be a risk factor for developing CALs in the era of 2 g/kg IVIG therapy, unless CALs appear at the initial episode.
Effect of Enhanced Recovery Pathway on Hysterectomy Complications in Suez Canal University Hospital and General Hospital at Ismailia City
Authors : Heba Ahmed Galal Atia ; Eman Ahmed Keshk ; Inas Mohamed Abd-Allah
Background: The enhanced recovery pathway concept emerged as a multimodal approach directed at optimizing the patient experience, standardizing perioperative care, and improving surgical outcomes. Aim: to evaluate the effect of enhanced recovery pathway on hysterectomy complications for women in Suez Canal University Hospital and General Hospital in Ismailia City. Design: - A quasi-experimental study design was used in this study. Sample: - convenient sample consist of 132 women undergoing hysterectomy operation. Tool: - Structured interviewing questionnaire included questions personal and socio-demographic characteristics and -Obstetric, gynecological, surgical history and follow up assessment checklist. Results: - the majority of women in two groups were complained from bleeding (65.2% in control group and 60.6% in study group). 54.5 % of control group and 42.4% of study group had fibroid as a medical diagnosis. The highest frequency women (60.6% in control group and 43.9% in study group) had 1-6 month as time of current complained. The women in the study group were less likely to suffer from complications as fever, vaginal prolapse and pneumothorax compared to those in control group. Differences observed are statistically significant P= (0.023, 0.049, 0.004). Conclusion: The result of the study concluded that women undergoing hysterectomy operation who received enhanced recovery pathway protocol were more likely to decrease the incidence of post-operative complications than women who didn’t. Recommendation: - Health care settings should emphasize the importance of coordination between health care members relating to the application of the evidenced key elements of enhanced recovery pathway management regarding hysterectomy.