Sonografski prikaz dimenzija bubrega u bolesnika s esencijalnom hipertenzijom u sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi u Nigeriji

Introduction: Hypertension is one of the commonest non-communicable diseases worldwide; it is the second most common cause of end-stage renal disease. Objective: To evaluate the renal dimensions and volume of essential hypertension patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi and to compare the dimensions with that of apparently healthy volunteers. Materials and Methods: A total of two hundred and eleven individuals (comprising 121 females and 90 males) with essential hypertension attending an outpatient clinic in Abubakar Tafawa Balewa University Teaching Hospital Bauchi, and an equal number of healthy volunteers (comprising of 172 females and 49 males) were studied as controls. Both the healthy volunteers and the Hypertensive patients’ renal length, renal width, antero-posterior diameter, and parenchymal thickness were assessed. Statistical Package for Social Sciences (SPSS version 20.0) was used for data analysis. Results: Study show the mean renal length for hypertensive patients to be 9.1 ± 0.79 cm and 9.1 ± 0.73 cm, the mean renal width of 3.5 ± 0.48 cm and 3.8 ± 0.68 cm, and mean renal volume of 87.22 ± 19.58 cm3 and 95.08 ± 22.93 cm3 for the right and left kidneys respectively. Results equally show statistically significant difference in anteroposterior diameter (p<0.05), parenchymal thickness (p<0.05) and renal volume (p<0.05) between the hypertensive group and the volunteer group for both right and left kidneys. Conclusion: This study has established baseline renal dimensions for hypertensive in our population (Bauchi Metropolis). The hypertensive subjects showed a decrease in renal anteroposterior diameter, parenchymal thickness and volume compared to control group.Uvod: Hipertenzija je jedna od najčešćih nezaraznih bolesti u svijetu; drugi je najčešći uzrok završnog stadija bubrežne bolesti. Cilj: Procijeniti dimenzije bubrega i bubrežni volumen kod hipertenzivnih bolesnika u Sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi i usporediti ih s dimenzijama kod naizgled zdravih ispitanika koji su se dobrovoljno javili za sudjelovanje u istraživanju. Materijali i metode: Uzorak se sastojao od dvjesto jedanaest ispitanika (121 žena i 90 muškaraca) koji boluju od esencijalne hipertenzije i na ambulantnom su liječenju u Sveučilišnoj bolnici Abubakar Tafawa Balewa u gradu Bauchi i jednakog broja zdravih ispitanika (172 žene i 49 muškaraca), koji su bili kontrolna skupina. Proučavana je duljina i širina bubrega, anteroposteriorni promjer i debljina parenhima kod ispitanika s hipertenzijom i kod zdravih ispitanika. Za analizu podataka primijenjen je statistički paket za društvene znanosti (SPSS verzija 20.0). Rezultati: Studija pokazuje da je prosječna dužina bubrega kod hipertenzivnih bolesnika 9,1 ± 0,79 cm i 9,1 ± 0,73 cm, prosječna bubrežna širina 3,5 ± 0,48 cm i 3,8 ± 0,68 cm, a prosječni bubrežni volumen 87,22 ± 19,58 cm3 i 95,08 ± 22,93 cm3 za desni i lijevi bubreg pojedinačno. Rezultati također pokazuju statistički značajnu razliku u anteroposteriornom promjeru (p < 0,05), debljini parenhima (p < 0,05) i bubrežnom volumenu (p < 0,05) između hipertenzivne skupine i kontrolne skupine za desni i lijevi bubreg. Zaključak: Ovom su studijom utvrđene osnovne bubrežne dimenzije kod hipertenzivnih bolesnika u populaciji grada Bauchi, glavnog grada Savezne države Bauchi u Nigeriji. Kod ispitanika koji boluju od hipertenzije ustanovljeno je smanjenje anteroposteriornog promjera bubrega, debljine parenhima i bubrežnog volumena u usporedbi s kontrolnom skupinom

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P &lt; 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

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

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: 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

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\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 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\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients