Peripartum Hysterectomy

Peripartum hysterectomy is a lifesaving surgical procedure that is performed during or immediately after childbirth. Although it is a rare event, it is associated with significant maternal morbidity and mortality. This chapter provides a comprehensive overview of the indications, techniques, and outcomes of peripartum hysterectomy. It also discusses the risk factors, prevention strategies, and management of complications associated with this procedure. The chapter is a valuable resource for obstetricians, gynecologists, and other healthcare professionals involved in the care of pregnant women. It provides evidence-based recommendations and practical guidance to help improve the outcomes of peripartum hysterectomy and ultimately save lives

Meckel’s Diverticulum Perforation Due to Strangulated Inguinal Hernia (Littre’s Hernia): A Rare Case

Meckel's diverticulum is remnant of omphalomesenteric ductus and it is the most frequent congenital malformation of the gastrointestinal tract. Rarely, any hernia sac contains it and named as a Littre hernia. A 59-year-old male patient with Meckel's diverticulum perforation due to strangulated inguinal hernia, was successfully treated with diverticullectomy using linear GIA stapler and performing graft-free hernia repair. Littre’s hernia may also be present in abdominal wall hernias requiring urgent surgical intervention due to incarceration. For this reason, it is important to have information about treatment management of this clinical entity

Prevalence and Risk Factors of CoronaVac Side Effects: An Independent Cross-Sectional Study among Healthcare Workers in Turkey

Background: COVID-19 vaccine hesitancy is a serious threat to mass vaccination strategies that need to be accelerated currently in order to achieve a substantial level of community immunity. Independent (non-sponsored) studies have a great potential to enhance public confidence in vaccines and accelerate their uptake process. Methods: A nationwide cross-sectional study for the side effects (SE) of CoronaVac was carried out in February 2021 among Turkish healthcare workers who were recently vaccinated. The questionnaire inquired about local and systemic SEs that occurred in the short-term, within four weeks, following vaccination. Results: A total of 780 healthcare workers were included in this study; 62.5% of them experienced at least one SE. Injection site pain (41.5%) was the most common local SE, while fatigue (23.6%), headache (18.7%), muscle pain (11.2%) and joint pain (5.9%) were the common systemic SEs. Female healthcare workers (67.9%) were significantly more affected by local and systemic SEs than male colleagues (51.4%). Younger age, previous infection, and compromised health status (chronic illnesses and regular medicines uptake) can be associated with an increased risk of CoronaVac SEs; Conclusions: The independent research shows a higher prevalence of CoronaVac SEs than what is reported by phase I-III clinical trials. In general, the results of this study confirm the overall safety of CoronaVac and suggest potential risk factors for its SEs. Gender-based differences and SEs distribution among age groups are worth further investigation.Masaryk University [MUNI/IGA/1543/2020, MUNI/A/1608/2020]; INTER-EXCELLENCE grant Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic [LTC20031]This study was funded by Masaryk University, grant numbers MUNI/IGA/1543/2020 and MUNI/A/1608/2020. The work of A.R., A.P., J.K. and M.K. was supported by the INTER-EXCELLENCE grant number LTC20031-Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician's vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection