Клініко-епідеміологічне дослідження дерматозів обличчя у жінок

The face is the most prominent part of the body. Facial blemishes and disorders directly reflect a person's physical appearance, cosmesis and self-image. They may contribute to dysmorphism and even lead to depression in susceptible individuals, especially women. Early identification and management of facial skin disorders are therefore important. The aim: To study the clinical pattern and epidemiological determinants of facial dermatoses among females above 10 years. Methods: This cross-sectional study was conducted among female patients with facial dermatoses, with informed consent, at a rural tertiary hospital for 18 months. Results: A total of 500 patients were enrolled. The majority were in the 4th and 5th decades. Pigmentary dermatoses were highest, melasma predominating. Immunobullous dermatoses formed the smallest group. Occupation-wise, the majority were agricultural labourers. Many dermatoses, especially melasma, were related to occupation and lifestyle with photo-aggravation, cosmetics use and stress. Conclusion: This study assessed the pattern of facial dermatoses among the female clientele of this institution. Hyperpigmentary dermatoses, especially melasma, emerged as the most common dermatosis for which treatment was soughtОбличчя — найбільш помітна частина тіла. Дефекти та недоліки на обличчі безпосередньо впливають на зовнішній вигляд і самооцінку людини. Вони можуть сприяти дисморфізму і навіть призводити до депресії у вразливих людей, особливо жінок. Тому важливу роль відіграє раннє виявлення та лікування розладів шкіри обличчя. Мета: вивчити клінічну картину та епідеміологічні детермінанти дерматозів обличчя у жінок старше 10 років. Методи: перехресне дослідження проводилося серед пацієнтів жіночої статі з дерматозами обличчя за інформованої згоди в сільській лікарні третього рівня протягом 18 місяців. Результати: Всього було досліджено 500 пацієнтів. Більшість з них були віком від 40 до 50 років. Найрозповсюдженішими були пігментні дерматози, переважала мелазма. Найменшу групу захворювань склали імунобуллезні дерматози. За родом занять більшість учасниць дослідження були сільськогосподарськими робітницями. Багато дерматозів, особливо мелазма, були пов'язані з професією та способом життя, включаючи фотозагострення, використання косметики та стрес. Висновок: це дослідження оцінило характер дерматозів обличчя серед жінок-пацієнтів лікарні. Гіперпігментні дерматози, особливо мелазма, виявилися найпоширенішим дерматозом, для якого призначали лікуванн

A clinical-epidemiological study of facial dermatoses in women

The face is the most prominent part of the body. Facial blemishes and disorders directly reflect a person's physical appearance, cosmesis and self-image. They may contribute to dysmorphism and even lead to depression in susceptible individuals, especially women. Early identification and management of facial skin disorders are therefore important. The aim: To study the clinical pattern and epidemiological determinants of facial dermatoses among females above 10 years. Methods: This cross-sectional study was conducted among female patients with facial dermatoses, with informed consent, at a rural tertiary hospital for 18 months. Results: A total of 500 patients were enrolled. The majority were in the 4th and 5th decades. Pigmentary dermatoses were highest, melasma predominating. Immunobullous dermatoses formed the smallest group. Occupation-wise, the majority were agricultural labourers. Many dermatoses, especially melasma, were related to occupation and lifestyle with photo-aggravation, cosmetics use and stress. Conclusion: This study assessed the pattern of facial dermatoses among the female clientele of this institution. Hyperpigmentary dermatoses, especially melasma, emerged as the most common dermatosis for which treatment was sough

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58\ub75%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31\ub72%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10\ub72%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12\ub73%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9\ub74%] of 7339 patients), middle (549 [14\ub70%] of 3918 patients), and low (298 [23\ub72%] of 1282) HDI (p<0\ub7001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17\ub78%] of 574 patients in high-HDI countries; 74 [31\ub74%] of 236 patients in middle-HDI countries; 72 [39\ub78%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1\ub760, 95% credible interval 1\ub705\u20132\ub737; p=0\ub7030). 132 (21\ub76%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16\ub76%) of 295 patients in high-HDI countries, in 37 (19\ub78%) of 187 patients in middle-HDI countries, and in 46 (35\ub79%) of 128 patients in low-HDI countries (p<0\ub7001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding: DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant