Fistula Campaigns-Are They of Any Benefit?

Objective Evaluation of the problems encountered during a voluntarily fistula campaign in a regional hospital of Niger (Africa) Materials and Methods Women underwent basic gynecological examination, methylene blue testing, and/or direct cystoscopy as necessary According to their clinical condition, women were informed and surgical options offered as appropriate Operations were performed under spinal or epidural anesthesia Immediate postoperative outcomes were followed during the stay of the surgical team in the country Results A total of 62 women were examined and 11 had causes of incontinence other than obstetric fistula In 9 8% of the women, severe local infection precluding any surgical intervention was evident In 58 8% of patients, the trigonal region and/or urethra were irreversibly damaged A proportion of patients (9 8%) with large lesions and intact urethra that were offered vaginal layered closure refused the intervention Of the women that were operated on (21 6%), six underwent vaginal layered closure with Martius fat flap and five women underwent a combined abdomino vaginal approach Conclusion It is extremely difficult to meet the needs of this global problem with short term programs and volunteers Directing these efforts to specialist fistula centers and creating reliable scientific evidence should be the main goal [Taiwan J Obstet Gynecol 2010,49(3) 291-296

Responsiveness of urogynecologic quality of life measurements to change after radical gynecologic surgery

In order to assess the responsiveness of short forms of the Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) in a subset of women undergoing radical operations for gynecologic cancer. Women with cervical cancer without any abnormal urodynamic abnormalities who had undergone Class III hysterectomy were included in the study. All women underwent urodynamic investigation and completed the IIQ-7 and UDI-6 questionnaires pre-operatively and post-operatively in the sixth month. Twenty-eight patients were enrolled and general and subscale scores of the questionnaire were calculated in the study between February 2008 and September 2008. Class III hysterectomy was performed in 28 women with stage Ib cervical carcinoma. Scores of IIQ-7 and the irritative and obstructive subscales of UDI-6 in the sixth post-operative month were significantly higher than the pre-operative scores. The Cronbach's alpha was 0.84. Cystometric parameters were in concordance with these changes in the questionnaire scores. The IIQ-7 and UDI-6 questionnaires are sensitive to changes in patients who have undergone radical oncologic operations because their life impact of incontinence may be affected. Validated questionnaires are reasonable measures to detect these changes, which are confirmed by urodynamic findings

Postpartum sexual function of women and the effects of early pelvic floor muscle exercises

Objective. To evaluate the effects of early pelvic floor muscle training after vaginal delivery on sexual function. Design. Prospective randomized study. Settings. Urogynecology clinic of a tertiary medical center in Istanbul, Turkey. Population. Total of 75 primiparous women. Methods. Pelvic floor-muscle strength was assessed during rest and straining in primiparous women in their 4th postpartum month, after which the women were randomized into training (n = 37) and control (n = 38) groups. Patients were re-evaluated in the 7th postpartum month. Main outcome measures. Female sexual function and pelvic muscle strength scores. Results. Desire, pain and total female sexual index scores were significantly higher in the 7th month compared to 4th month in both groups (p 0.05). All domains except satisfaction were significantly higher in the training group compared with the controls. Pelvic floor-muscle strength was found to be increased in the 7th month in the training group (Wilcoxon rank test, Z = 4.123, p 0.05). Conclusion. Pelvic floor-muscle training improves pelvic floor-muscle function, and starting after the puerperal period, exercise appears to have positive effects on female sexual function

Radical trachelectomy in late pregnancy: is it an option?

[No Abstract Available

Mediating role of loneliness and organizational conflict between work overload and turnover intention

20th Congress of the International Ergonomics Association, IEA 2018 -- 26 August 2018 through 30 August 2018 -- 216789The fact that organizations offer employees a positive organizational climate not only increases employees’ happiness levels but also raises the level of creativity of employees. When it is thought that the only way for organizations to survive in a competitive environment is innovative and creative applications, the positive dynamics within the organization once again emerges. This research focuses on negative behaviors such as work overload, loneliness, organizational conflict and turnover intention which affect employees’ creativity and it aims to discover the mediating role of loneliness and organizational conflict between work overload and turnover intention. In the present research, a survey was conducted including 145 service sector employees. To analyze the demographic characteristics of the participants, internal consistency and correlations of scales, SPSS 22.0; and to test the mediating role, SmartPLS 2.0 were used. According to the analysis results; it is determined that between work overload and turnover intention, loneliness and organizational conflict have a mediating role. When all the results are evaluated together, work overload in the organization forces employees to extreme behavior and it is found that employees feel loneliness or conflict, and as a result, their turnover intention increases. Related to this, it is possible to say that the overloaded employees get further away from creativity. © Springer Nature Switzerland AG 2019.2-s2.0-8505181227

Magnetic Energy Conversion

In this study, magnetic and electromagnetic energy conversion of magnetocaloric materials (MCMs) and magnetic refrigeration, which is based on magnetocaloric effect (MCE), is presented in detail and made apprehensible. The MCE is defined as cooling or warming occurring in the magnetic material under adiabatic conditions when the external magnetic field is applied or removed from the magnetic material and vice versa. This result has been known as "adiabatic demagnetization" for years, though this phenomenon is a practical use of the MCE in magnetic materials. The magnetic materials demonstrate the MCE in the vicinity of their critical temperature. The magnetocaloric system is environmentally friendly and more efficient than conventional refrigeration cycle system based on vapor compression. Magnetic refrigeration is a cooling technology based on the MCE. This technique can be used to attain low temperatures, as well as the ranges used in common refrigerators. In magnetic and electromagnetic energy conversion, the coefficient of the performance (COP) for the system reaches 30-60% theoretical efficiency of the Carnot cycle. Magnetic refrigeration is being pursued using low magnetic fields near room temperature in hopes of enabling commercial devices using permanent magnets as the field source.In a magnetic refrigerator, a magnetocaloric heat pump is used as a cooling device based on MCMs, which are an ideal alternative to traditional compressor-based refrigeration technology. Theoretical studies demonstrate that refrigeration systems based on the MCE can be up to 35% more energy-efficient than vapor compression systems. Furthermore, cooling systems based on MCMs will operate with less noise due to the absence of a compressor. This technology makes use of water-based coolants instead of gaseous refrigerants. © 2018 Elsevier Inc. All rights reserved

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients