Peripartum hysterectomy for cesarean section with morbidly adherent placenta: case series of 25 patients

Background: The current paper reports the outcome of case series of patients presented with placenta accreta confirmed histopathologicaly after management by peripartum hysterectomy.Methods: The study was set in Women’s Health Hospital, Assiut University, Egypt. This was a case series of 25 women presented with placenta accreta between May 2017 and April 2018. We included all pregnant women with placenta previa as diagnosed by ultrasound with suspicion of abnormal placentation by Doppler, confirmed intra-operatively undergoing either emergent or elective CS. All cases were performed by an expert team of obstetricians and anesthetists. Cesarean delivery was done under general anesthesia through pfannensteil incision. The primary outcome was the estimated intra-operative blood loss through assessment of amount of blood in the suction by ml, difference between the weight of surgical drapes and towels before and after operation.Results: Pre-operative Hb was 10.64±1.01 gm/dL and there was significant decline in the postoperative Hb reaching 8.36±1.21 gm/dL (p<0.001). The mean drop in Hb was 2.28±1.43gm/dL. Estimated intra-operative blood loss was 974.4±398.05 ml in the towels and 847.6±362.56 ml in the suction apparatus. The total blood loss was 1822±653.73 ml. The mean number of units of whole blood transfused was 2160.0±825.6 ml and fresh frozen plasma was 1010.0±349.7 ml. Regarding intra-operative complications, bladder injury was the most common one in 14 cases (56%), followed by ureteric injury in two cases (8%). Postoperative ICU admission was in 6 cases (24%) and the mean duration of hospital stay 12.44 ± 4.07 days. No cases of maternal mortality.Conclusions: In conclusion, peripartum hysterectomy is considered life-saving surgery in patients with placenta accreta

Synthesis and Biological activity of 1,3-Thiazolylidenehydrazinylidene ethylpyridiniumbromide monohydrate, 1,3-Thiazolylidenehydraziniumbromide and 1,3-Thiazolylidenehydrazine derivatives

1,3-Thiazolylidenehydrazinylidene ethylpyridinium bromide monohydrate, 1,3-thiazolylidenehydrazinium bromide and 1,3-thiazolylidenehydrazine derivatives were synthesized by heterocyclization of 2-(1-substituted ethylidene) hydrazinecarbothioamides, characterized and screened for their anti-bacterial activities. The structures of synthesized compounds were established by spectroscopic (IR, 1H, 13C-NMR, Mass) and X-ray analyses

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Impact of perceived social media marketing activities on brand and value consciousness: Roles of usage, materialism and conspicuous consumption

Copyright © 2018 Inderscience Enterprises Ltd. This research investigates the impact of perceived social media marketing activities on brand- and value consciousness. It further examines the effect of social media usage on materialism, brand consciousness and conspicuous consumption, as examining materialism-centric behaviour is becoming important in a consumption-based economy. A self-administered questionnaire was developed and administered to a sample of 346 undergraduate students. Two different research models are tested and confirmed. The findings of this research indicated that perceived social media marketing activities have a significant effect on brand loyalty; brand consciousness and value consciousness mediate the relationship between perceived social media marketing activities and brand loyalty. Moreover, evidence supports the idea that the greater the use of social media, the greater the tendency towards materialism and conspicuous consumption. This study confirms the growing importance of perceived social media marketing activities in envisioning brand loyalty and provides insights on impact of social media on materialism and conspicuous consumption

Using Netnography Research Method to Reveal the Underlying Dimensions of the Customer/Tourist Experience

Purpose – The interest in customer experience has increased at a phenomenal rate. However,research to capture the true meaning of the concept is limited. Therefore, this study aims to address thequestion of what are the underlying dimensions that constitute the construct of customer experience.Design/methodology/approach – The netnography method is utilized to validate a priori conceptsthat have been identified in the literature within the tourist industry in Egypt.Findings – The results identified eight dimensions; comfort, educational, hedonic, novelty,recognition, relational, safety and beauty, which are consistent with major studies on experience.Research limitations/implications – The focus of the study was on customer reviews thatwere written in English and posted online. Therefore, care should be taken when interpreting thesefindings.Practical implications – This study attempted to gain a meaningful degree of understanding ofcustomer experience construct. The results suggest a number of implications for service, marketingand brand managers. The knowledge of customer experience and the challenge of creating greatcustomer experience are of utmost importance. Many marketers acknowledge the importance ofcustomer experience, but they have very little knowledge of what the components are of customerexperience.Originality/value – Netnography has not been widely used as a marketing research technique