Medicine and Health Sciences Commons^™

The Reduction Of Pain Perception Through Music Therapy In Surgical Patients, David Collier

MSN Capstone Projects

The control of pain perceptions of surgical patients is an ongoing problem in trying to control the pain with enough narcotics while not giving too much to depress their respiratory status. Using narcotics increases the risks of several side effects which can negatively impact the patient’s recovery (Fu et. al., 2019). Perioperative music is a nonpharmacological method used to decrease the need for pain medication (Fu et. al, 2019; Kahloul et. al., 2016). The patient is in an anxiety state that causes a heightened state of arousal of the sympathetic system, which in turn releases catecholamines to act on the …

A Strategic Plan For The Development Of A Model Of Care For Post Operative Bariatric Patients In Rural Utah, Cris R. Chamberlain

Doctoral Dissertations and Projects

The delivery of health care for postoperative bariatric patients remains a challenge in rural settings, often leading to varied patient outcomes and inefficient resource allocation. This study aims to develop and implement a strategic model of care for postoperative bariatric patients at Castleview Hospital in Rural Utah. Grounded in the Iowa Model of Evidence-Based Practice, this initiative focuses on creating a cohesive and comprehensive postoperative care pathway, tailored to the unique patient demographics and facility constraints of a 39-bed hospital serving 35-45 bariatric patients annually. Methodology includes ethical considerations, secured through CITI training and pending IRB approval, robust data collection …

Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868

for a patient with a recurrent diverticulitis complicated by abscess formation.

Safety And Cost Effectiveness Of Immediate Sequential Bilateral Cataracts Surgery, Miles Bowman, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Rush SW, Gerald AE, Smith JC, Rush AJ, Rush RB. Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States. Journal of Cataract and Refractive Surgery. 2015;41(4):732-739. https://doi.org/10.1016/j.jcrs.2014.07.034

for a patient with bilateral cataracts.

The Long-Term Economic Implications Of Burn Injury For Burn Survivors, Jacob M. Dougherty Bs, Hannan A. Maqsood Mbbs, Zhaohui Fan Md Mph, Stewart C. Wang Md Phd, Mark R. Hemmila Md, Naveen F. Sangji Md Mph

Medical Student Research Symposium

Introduction: The long-term economic implications of burn injury on patients and payors has not been well described. Burn injury can be costly due to prolonged intensive care, wound care, rehabilitation, psychological care, and reconstructive surgery that may be required well after the initial injury. We investigated index and post-acute payor and out-of-pocket (OOP) costs related to burn injury for in-patient care at 30 days, and up to 36 months post-discharge to understand the long-term economic implications for burn survivors.

Methods: An observational cohort study was conducted using a commercial claims database from IBM Watson Health® Marketscan. Patients age ≤ …

Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md

Medical Student Research Symposium

Introduction and Objectives: Female sexual dysfunction (FSD) is commonly associated with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). FSD manifests as abnormalities in sexual desire, arousal, orgasm, pain, distress, and satisfaction. Our primary objective was to assess the impact of micronized amniotic membrane injections (AM) on FSD and lower urinary tract symptoms using comprehensive measures, including the multi-domain Female Sexual Function Index (FSFI), the Pain Visual Analog Scale (VAS), and the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI).

Methods: Study participants included patients diagnosed with IC/BPS and FSD refractory to traditional therapies. Under general anesthesia, these …

Maximizing Value In Total Knee Arthroplasty: Ambulatory Surgical Center Or Hospital Outpatient Department?, Megan Carulla, Meet Patel, Emily Mazier, Alex Lindahl, Trae Hill, Charles S. Day

Medical Student Research Symposium

Introduction:

In the United States, healthcare costs have consistently ranked the highest among developed countries, leading to an urgent push towards decreasing spending. This study compared the cost of robot-assisted total knee arthroplasty (TKA) performed in a hospital outpatient department (HOPD) to an Ambulatory Surgical Center (ASC).

Methods and Materials:

Costs were determined using Time-Driven Activity-Based Costing (TDABC) methodology. All steps of a patient care pathway for robotic TKA performed in ASC and HOPD were organized into one process map. All personnel involved in patient care were included and the average time each allocated to patients was multiplied by their …

Australian Elective Surgery Patients’ Pre-Operative Preparation, Health Literacy, Learning Preferences And Knowledge Resource Needs: A Cross-Sectional Survey, Cory J. Williams, Jed Duff, Chloe Tannagan

Journal of Perioperative Nursing

Aim: To investigate self-reported health literacy levels, learning preferences and knowledge resource needs of Australian elective surgery patients.

Background: Surgery contributes significantly to global health care, but surgical waitlists, cancellations and delay remain major challenges for health care systems. Pre-operative preparation and patient education about the surgical journey are essential to reducing these disruptions. Unfortunately, preparation and education are limited by short timeframes and one-size-fitsall approaches. Limited information exists about Australian surgical patients’ health literacy levels, learning preferences and knowledge resource needs.

Design and methods: This cross-sectional waiting room survey investigated patient health literacy, preferred education mode and learning styles …

High-Grade Avm. Educational Vignette And Clinical Cases, Marcos Devanir Silva Da Costa, Marcelo Augusto Acosta Goiri, Daniela Coelho, Juan Alberto Paz Archila, Talita Helena Martins Sarti, Feres Chaddad-Neto

Archives of Neurosurgery

The arteriovenous malformation (AVM) is a vascular malformation characterized by fistulas between arteries and veins forming a nidus, without interposition of capillary vessels and of which early draining vein is identified at the digital angiography. Potential reports of its existence date from the second century AD. Spetzler and Martin (S-M) proposed a classification considering three features and Lawton then added new predictors. A maximum of 10 score can be achieved by applying the modified S-M grade system. This classification guides decision-making and the possible choice of the multimodal treatment (surgery, radiosurgery and embolization). We discuss historical, pathological, clinical and therapeutic …

Modified Inferior Based Reduction Mammoplasty Versus Matrix Rotational Flap In Upper Inner Quadrant Breast Cancer, Abdelaziz Ragab Abdelaziz Sakr, Alaa Abd Elazeem Elsisi, Tarek Mohey Rageh, Mahmoud Ahmed Shahin

Menoufia Medical Journal

Objectives: to compare between inferior pedicle mammaplasty and matrix rotational advancement flap as techniques for upper inner quadrant breast cancers regarding oncoplastic and aesthetic results. Background: Breast conserving therapy (BCT) is the standard of care in early breast cancer; has a value to provide a treatment as effective as mastectomy with benefits of breast preservation. However, traditional conservative surgery in the upper inner quadrant may not have good cosmetic results. Methods: All 30 patients were candidates for breast conservation and with upper inner breast tumors; patients were randomly categorized into two groups. Group A (16 patients) included patients who underwent …

The Therapeutic Use Of Intraoperative Music To Reduce Postoperative Pain In Patients Receiving General Anesthesia, Caroline Ford

Nurse Residency

Background: The recovery from surgery can be very painful for some patients and require opioid management and longer hospital stays for unmanaged pain. Music has been a non-analgesic way of helping patients with chronic pain and recent studies have shown that music intraoperatively can greatly improve the patients' pain after surgery requiring general anesthesia.

Treatment Of Post-Burn Hypopigmentation With Non-Cultured Epidermal Grafting, Islam Ibrahim Abd Elmohsen, Ahmed Tharwat Nassar, Tarek Fouad Kishk, Ahmed Fergany Saber, Hossam Hassan Fawzy

Menoufia Medical Journal

Objectives: To evaluate the applicability of cell therapy using non-cultured epidermal transplantation regarding the aesthetic outcome, , and possible complications in the treatment of post-burn hypopigmentation. Background: new non-cultured autologous epidermal techniques have been developed with similar results to the cultured melanocytes techniques, but are simpler, less expensive, and less time-consuming. Methods: This prospective study was conducted on 35 post-burn hypopigmentation patients presented at the Plastic and Reconstructive Surgery Department in Menoufia University Hospitals between April 2020 to April 2023. Results: We found that the repigmentation ranged between 20-95%, and the color matching ranged between 30-80%. Most cases had good …

Comparative Analysis Of Md And Do Candidates To A Surgical Residency Program, Duyen Quach, Rachel Wright, Vishal Patel, Scott Zimmerle, Brendan Rosamond, Jonathan Lall, Said Maldonado, Zuhair Ali, Rajeev Raghavan, Mike Liang

Gulf Coast Division Research Day 2024

No abstract provided.

What Is The Ideal Free Flap For Microvascular Lower Limb Soft Tissue Reconstruction?, Mohamed Abdallah Elnahas, Abdallah Ahmad Amin, Fouad Mohamed Ghareeb, Hassam Hassan Fawzy

Menoufia Medical Journal

Objectives: is to detail four reliable free flaps including the anterolateral thigh, radial forearm, thoracodorsal and latissimus dorsi for use in lower extremity microvascular reconstruction and to establish factors to consider when developing an algorithm for reconstructing lower extremity injuries. Background: to achieve restoration of normal functions and good aesthetic outcomes ; microvascular free flaps are the preferred method for complex injuries repair in lower limbs. Methods: A total of 30 patients with complex soft tissue lower limb defects and deformities required surgical reconstruction were enrolled in this study. They underwent four types of free flap reconstruction. All patients were …

Outcome Of Combined Or Single Flexor Digitorum Superficialis And Flexor Digitorum Profundus Repair In Zone Ii, Mayadah Adel Nossir, Dalia Mofreh Elsakka, Hady Saleh Abou-Ashour, Mohamed Abdallah Elnahas

Menoufia Medical Journal

Objectives: To evaluate the outcomes of the repair of flexor digitorum Profundus (FDP) alone versus its repair combined with flexor digitorum superficialis (FDS) repair in Zone II flexor tendon injury. Background: Flexor tendon injuries in zone II of the hand present a challenging problem for hand surgeons. Injuries involving the FDP and FDS tendons require careful assessment and planning. The primary goals of repair are to achieve optimal tendon healing, maximize range of motion, and restore functional strength. Methods: A total of 24 patients presenting with FDP and FDP injury at zone II were surgically treated from 2020 to 2022. …

Patients’ Expectations Before Coronary Artery Bypass Graft Surgery: A Cross- Sectional Study, Mohammad Abdallah, Shymaa Mamdouh Mohamed Abdu Sh.M, Abdel-Hady El-Gilany Ah.G, Wael Abdel-Aziz, Noha Eladawy, Olfat Farag

Menoufia Medical Journal

Background

Exploring patient’ s expectations before coronary artery bypass graft (CABG) surgery provides clinicians with important insights into their service population.

Objectives

The objective of this study is to describe the expectations of patients before CABG surgery and its associated factors.

Patients and methods

A cross-sectional study was conducted in the Outpatient Clinic of an Egyptian Cardiac Surgery Unit during the period from May 2017 to April 2018. A total of 446 patients who underwent CABG surgery were included. The socio-demographic and clinical data were collected from patients and their medical records. The Cardiac Surgery Patient Expectations questionnaire was used …

Treatment Of Acute Lower Extremity Deep Venous Thrombosis With Rivaroxiban Versus Warfarin, Mahmoud S. Eldesouky, Walid Salah-Eldin Gaber Elsayed, Abdelmoniem Farid Mohammed

Menoufia Medical Journal

Objectives: to assess extent of thrombus resolution and rate of complications in patients with lower extremity acute Deep Venous Thrombosis (DVT) treated with rivaroxaban compared to warfarin therapy. Background: For years, the standard treatment for acute lower extremity DVT has been the use of warfarin with bridge therapy by enoxaparin. New oral anticoagulant drugs such as rivaroxaban have been developed and used as an alternative to warfarin in the treatment of acute lower extremity DVT. Methods: This is a prospective study that was conducted on 130 patients to assess extent of thrombus resolution and rate of complications in patients with …

Study Of The Different Modalities For Scrotal Skin Reconstruction, Mohamed Ahmed Megahed, Ahmed Tharwat Nassar, Khaled Mohamed Albassam, Qutaibah Alkandari, Ahmed Fergany Saber, Mina Safwat Zaki

Menoufia Medical Journal

Objectives: to study different modalities of reconstruction of defects in the scrotum and to verify indications and efficacy of each technique. Background: Techniques of genital reconstruction continue to evolve. However, mainstays of therapy include split-thickness skin graft, primary closure, and musculocutaneous flap. The best cosmetic and functional outcomes appear to occur in patients being treated for local cutaneous and lymphatic conditions. Methods: A prospective cross-sectional study was conducted on thirty male patients with a defect of scrotal skin with age range between 20 and 70 years old. They attended the plastic surgery and burn department of Menoufia University during the …

Clinical Results Of Single-Vessel Versus Multiple-Vessel Infrapopliteal Intervention In Critical Limb Ischemia, Mostafa Kamel

Menoufia Medical Journal

Objectives: to compare the clinical outcomes of single-vessel versus multiple-vessel infrapopliteal interventions in patients diagnosed with critical limb ischemia (CLI) undergoing infrapopliteal revascularization. Background: Critical limb ischemia is a severe condition requiring revascularization procedures to restore blood flow. The choice between single-vessel and multiple-vessel interventions remains debatable. Understanding the clinical outcomes associated with each approach can guide treatment decisions and optimize patient care. Methods: A prospective study was conducted on 60 adult patients diagnosed with CLI who underwent infrapopliteal revascularization between January 2021 and January 2023. Single-vessel interventions were performed on 30 patients, while multiple-vessel interventions were performed on the …

Primary Resection Of Duodenal Neuroendocrine Tumor With Suspected Lymph Node Metastasis: A Case Report, Raleigh Payton, David Bassa, Furrukh Jabbar, Hassan Ahmed

North Texas Research Forum 2024

Introduction: Duodenal neuroendocrine carcinomas are an uncommon variant of Neuroendocrine tumors (NETs) that are typically non-functional with locoregional spread at the time of diagnosis. Management of these tumors is dependent on size, grade, stage, functional status and location. Summary: A 66-year-old male presented with an incidental finding of low grade 3 centimeter duodenal NET on esophagogastroduodenoscopy (EGD) located in the second segment of the duodenum with evidence of lymphadenopathy on staging scans. In patients with suspected lymph node metastases, the first choice for curative intent is a pancreaticoduodenectomy (PD), also known as Whipple Procedure. We achieved surgical resection with free …

Konsep Diagnosis Dan Penatalaksanaan Fraktur Osteoporosis Terkini, I Gusti Ngurah Wien Aryana, Febyan Febyan

Jurnal Penyakit Dalam Indonesia

Osteoporosis is a metabolic bone disease that is caused by a decreased amount of bone mass, and microarchitectural damage to bone tissue that affects the bone to break easily. Osteoporosis can be divided into primary and secondary etiologies. Vertebral, hip, distal radius, and proximal humerus are the most common predilection of fracture complication due to osteoporosis. The diagnosis of osteoporotic fractures is established based on the identification of risk factors, general clinical manifestations, specific manifestation from each fracture predilection, and advanced examinations, including radiology imaging and dual-energy x-ray absorptiometry. The purpose of osteoporotic fractures management in elderly is a stable …

Short Term Results Of Coiling Embolization Of Peripheral Arteriovenous Malformations, Abd El-Moniem Farid, Yehia Elkhatib, Fawzi Abobakr, Mahmoud Said

Menoufia Medical Journal

Objectives: To assess the short-term outcomes and procedure-related complications in AVM patients treated with endovascular coiling. Background: Peripheral arteriovenous malformations (AVMs) one of the most challenging among the various congenital vascular malformations to be treated. The Schobinger staging system is currently used to classify AVMs based on their clinical presentation. The best way to treat each AVM on a case-by-case basis, depending on AVM location and classification, on top of that, there is no consolidated agreement on the methods of treatment of AVMs. Methods: Fifty patients were involved in this clinical prospective study, diagnosed as peripheral AVM by several diagnostic …

Relationship Between Surgical Rhinoplasty And Demodex Infestation: A Case-Control Study, Abdullah Demi̇rbaş, Di̇lek Bayramgürler, Emrah Kağan Yaşar, Muhammed Adak, Can İlker Demi̇r

Turkish Journal of Medical Sciences

Background/aim: Human Demodex mites are parasites that live in the pilosebaceous unit and can cause demodicosis. While demodicosis may occur as a primary skin disease, it may also result from immunosuppression and topical or systemic immunosuppressive therapies. Surgical rhinoplasty is one of the most commonly performed cosmetic procedures, and it is the cause of a variety of cutaneous complications, particularly acne, as it affects the skin's adnexal structures. Thus, this study aimed to investigate whether the cutaneous changes in surgical rhinoplasty patients render them vulnerable to Demodex infestation. Materials and methods: Individuals who had undergone rhinoplasty (patients) and age- and …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Large Right Lower Quadrant Abdominal Mass, Isheeta Madeka, Cannon Greco-Hiranaka, Ozlem Kulak, Wilbur Bowne

Jefferson Hospital Staff Papers and Presentations

No abstract provided.

Impact Of Climate Change On Surgery: A Scoping Review To Define Existing Knowledge And Identify Gaps, Tina Bharani, Rebecca Achey, Harris Jamal, Alexis Cherry, Malcolm K. Robinson, Guy J. Maddern, Deirdre K. Tobias, Divyansh Agarwal

Department of Surgery Faculty Papers

With climate change accelerated at a worrisome rate, global warming also will have implications for surgery and surgical practice. The goal of this current study was to systematically survey the literature and better understand how climate change has affected surgical disease burden, surgical care delivery, and surgical outcomes. We performed a comprehensive scoping review, screening 3334 unique citations from three databases – 1766 from Embase, 1329 from Pubmed and 239 from Scopus – to identify studies that had associated climate change with surgery. After systematic searching, quality appraisal, and data extraction, we synthesized findings from qualitative and quantitative studies. Twenty-six …

Cavernous Malformations Of The Central Nervous System: An International Consensus Statement, Anastasia Tasiou, Alexandros G. Brotis, Adamantios Kalogeras, Christos Tzerefos, Cargill H. Alleyne, Alexandros Andreou, Andreas K. Demetriades, Nikolaos Foroglou, Robert M. Friedlander, Bengt Karlsson, Neil Kitchen, Torstein R. Meling, Aristotelis Mitsos, Vasilios Panagiotopoulos, Themistoklis Papasilekas, Giacomo Pavesi, Lukas Rasulic, Alejandro N. Santos, Robert F. Spetxler, Ulrich Sure, Stavropoula Tjoumakaris, Christos M. Tolias, Peter Vajkoczy, Kostas N. Fountas

Department of Neurosurgery Faculty Papers

Introduction: Cavernous malformations (CM) of the central nervous system constitute rare vascular lesions. They are usually asymptomatic, which has allowed their management to become quite debatable. Even when they become symptomatic their optimal mode and timing of treatment remains controversial.

Research question: A consensus may navigate neurosurgeons through the decision-making process of selecting the optimal treatment for asymptomatic and symptomatic CMs.

Material and methods: A 17-item questionnaire was developed to address controversial issues in relation to aspects of the treatment, surgical planning, optimal surgical strategy for specific age groups, the role of stereotactic radiosurgery, as well as a follow-up pattern. …

The Efficacy Of Free Latissimus Dorsi Flap In Patients With Lower Limb Distal Extensive Injuries., Mohamed Abdullah Mohamed El-Nahas, Tarek Fouad Keshk, Sherif Mohamed El Kashty, Ahmed Abdelaziz Talaab

Menoufia Medical Journal

Objectives: to elucidate our experience in the use of latissmus dorsi free flap for the surgical reconstruction of distal lower limb complex injuries, regarding the surgical techniques and the patients' outcome. Background: from the variable types of free flaps, the free transfer Latissimus dorsi (LD) musculocutaneous flap is considered a workhorse in lower limb reconstruction. Methods: A total of 16 patients with complex lower limb defects and deformities required surgical reconstruction were enrolled in this study. They underwent free LD flap reconstruction and followed up for 6 months. Results: The total number of patient was 16 patients; they had a …

Evaluation Of Implant Based Immediate Breast Reconstruction, Mohamed Hamed Elmeligy, Mohamed Sabry Ammar, Ahmed Fawzy Ahmed Dewidar, Mohamed Abdullah Elnahas

Menoufia Medical Journal

Objectives: To evaluate immediate breast reconstruction using silicone implant regarding: advantage, disadvantage, complications and aesthetic outcomes, Background: Reconstruction after mastectomy allows women to mitigate some of the emotional and aesthetic effects of this devastating disease. Although there are a variety of alloplastic and autologous techniques, they all aim to achieve the same objective: the successful reconstruction of a breast mound that appears as natural as possible, Methods: This study will be conducted on 19 patients at General Surgery Department, Menoufia University and Patients will be randomly selected, Results: Among our studied patients 31.6% developed post-operative complications after reconstruction. Among our …

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …