Efeect of Kegel's Exercises on First Degree Pelvic Organ Prolapse Among Women

Background: Kegel's exercises are recommended to increase the strength and elasticity of the pelvic floor muscles and decrease the incidence of prolapse and stress urinary incontince. Aim: was to assess the effect of kegel's exercises on first degree pelvic organ prolapse among women. Design: quasi-experimental, non equivalent pre-post test research design was adopted. Setting: this research was carried out at gynecological clinic at El Galaa Obstetrics and Gynecology Teaching Hospital. Sample: Convenience sample, of 110 women were recruited for this study as one group to be measured before and after according to certain criteria. Tools: three tools were used for data collection: structured interview tool; assessment & follow up tool for clinical picture of prolapse and Prinometry to measure the strength of pelvic floor muscles. Result: revealed that, a statistically significantly differences were founded between before and after following of kegel's exercises in relation to sexual clinical picture P value was ≥ 0.05, urinary clinical picture was (χ2 = 145.4 and p value ≤ 0.001 and types of urinary problems. χ2 = 167.4 and p value≤ 0.001 ) . And bowel clinical picture was (χ2 =128.8 & P.value ≤ 0.001). Regarding to perinometry reading, the results revealed that, highly statistically significant differences was found between the three reading of prinometry (F=68.047, p≤0.001). In Conclusion: practicing kegel's exercises lead to decrease in the clinical picture of prolapse and improve strength of pelvic floor muscles. Recommendation: based on the study findings, its recommended kegel's exercises should be followed during each development phases of women's life span, so it should form an essential part of sex education and the nurse should work as educator and counselor to teach women benefits and technique of kegel's exercises. Keywords:  kegel's exercises, prolapse, prinometry

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially