Objective: This study aims at assessing the incidence of haematoma formation in abdominoplasty cases who had previous bariatric surgery and in those who did not have bariatric surgery before. Patients and Methods: This is a 4 years retrospective study involving patients who underwent abdominoplasty surgery between the period of July 2015 and June 2019. The incidence of haematoma formation was assessed in relation to history of previous bariatric surgery in these patients. Results: 164 patients met the inclusion criteria of the study;46 of them were males and 118 were females. The mean age of the patients included in the study was 38.6 (21 - 60 years). The mean BMI was 27 kg/m2 (21.4 - 34.7 Kg/m2). The mean hospital stay was 6.6 days (4 - 19 days). 107 patients had history of previous bariatric surgery performed and 57 had not. 21 patients developed haematoma (12.8%). 16 of the patients who had haematoma had previous bariatric surgery done (15% of post bariatric surgery cases) while 5 patients developed haematoma with no history of previous bariatric surgery (8.8%). Sixteen male patients out of the 46 male patients in the study developed postoperative haematoma (34.8% of the male patients) while only 5 of the 118 female patients developed postoperative haematoma (4.2% of the female patients) which shows a significant difference in haematoma formation when comparing males to females in general (p Conclusion: Our study shows that the incidence of post abdominoplasty haematoma formation is significantly higher in male patients who had bariatric surgery before when compared to those who had not (p < 0.05). The incidence was higher in males when compared to females (p < 0.001) indicating that males with previous history of bariatric surgery have the highest chance of developing haematoma formation. Combining liposuction of the lower flanks, plication of the recti muscles or both to the abdominoplasty procedure did not result significantly in an increased risk of haematoma formation.
Anoud Al QaydiDalal Al MansooriMedhat EmilShamsa AlameriAysha Al NaqbiIbrahim Al MarzooqiAbdulla Tareq Al HassaniMuhammad Tariq AyubDalia Medhat HabibOmar Alameri
Objective: This study aims at assessing the relation between smoking and the incidence of haematoma formation in abdominoplasty surgery cases. Patients and Methods: This is a 4 years retrospective study involving the patients who underwent abdominoplasty surgery between the period of May 2015 and April 2019 in Zayed Military Hospital, Abu Dhabi, United Arab of Emirates. The incidence of haematoma formation was assessed in relation to tobacco use in these patients. Results: 164 patients met the inclusion criteria of the study. 35 patients were smokers (21.3%) and 129 patients were non-smokers (78.7%). The mean age was 38.4 (21 - 59 years). The mean BMI was 27 kg/m2 (21.4 - 34.7 kg/m2) and the mean hospital stay was 6.5 days (4 - 19). 23 patients in the study developed haematoma (14%). 11 of them had surgical evacuation of the haematoma (6.7%) while the rest were aspirated in the out-patient clinic. Out of the 23 patients who developed haematoma, 17 patients were smokers and 6 were non-smokers. The incidence of haematoma among smokers was 48.6% (17 out of 35 cases) while its incidence among nonsmokers was 4.7% (6 out of 129 cases) showing a clear relationship between smoking and hematoma formation (p Conclusion: Our study shows a direct relationship between smoking and haematoma formation in abdominoplasty cases. Cessation of smoking during the perioperative period is required before embarking on such a procedure.
Dalal Al MansooriAnood AlqaydiShamsa AlameriMedhat EmilIbrahim Al MarzooqiAysha Al NaqbiMuhammad Tariq AyubDalia Medhat HabibOmar Alameri
Objective:Using data mining technology to explore the rules of traditional Chinese medicine(TCM)in the treatment of threatened abortion in the early stage of pregnancy with sub-chorionic haematoma(SCH).Methods:Literature of TCM in the treatment of threatened abortion in the early stage of pregnancy with SCH were retrieved from CNKI,VIP,WANFANG and Pubmed,EMBASE.The literature information database was established to be used for descriptive analysis,association rule analysis and cluster analysis of relevant data.Results:A total of 100 literatures were included,involving 114 Chinese herbs.The efficacy of Chinese herbs were mainly tonic drugs,hemostatic drugs,heat-clearing drugs,dissolving blood stasis and hemostatic drugs.The medicinal properties were mostly mild and warm,and the taste of the drug was mainly sweet,bitter and pungent.The liver meridian,spleen meridian and kidney meridian were frequently used.The commonly used drug pair combination was"Xu duan(Radix dipsaci,续断)-Tusizi(Semen Cuscutae,菟丝子)",and the core combination was"Tusizi-Xu duan-Ejiao(Donkeyhide gelatin,阿胶)-Baizhu(Atractylodes macrocephala,白术)-Dangshen(Codonopsis pilosula,党参)".Commonly used drugs for removing blood stasis and hemostasis were with Sanqi(Panax notoginseng,三七),Puhuang(cattail pollen,蒲黄),and Qiancao(Radix Rubiae,茜草).Conclusion:Data mining traditional Chinese medicine for the treatment of threatened abortion in the early stage of pregnancy with SCH clinically commonly used drug efficacy,taste,meridian,commonly used drug pairs,core combination and commonly used blood stasis hemostatic drugs,has important reference significance for the treatment of threatened abortion in the early stage of pregnancy combined with SCH.
BACKGROUND Acute spinal subdural haematoma(ASSH)is a rare and potentially devastating condition with a variable prognosis.Previously described subdural haematomas were thought to have occurred spontaneously or be related to major or minor iatrogenic or traumatic injuries caused by surgery,spinal puncture or epidural anaesthesia.Other contributing pathologies have been described,such as intradural tumours or spinal arteriovenous malformations.ASSH has also been associated with anticoagulation therapy,haemostatic abnormalities and risk factors such as pregnancy.To the best of our knowledge,this case study described the first reported occurrence of an ASSH during spinal surgery in a paediatric patient.The patient was not known to have any coagulopathies,and no obvious vascular lesions were documented.The surgical procedure did not directly involve the dura mater,and no evident intraoperative dural tears were found.CASE SUMMARY We reported and discussed a case of ASSH complicating a posterior spinal instrumented fusion during surgery for paediatric congenital scoliosis.This condition has not been previously described.We made recommendations for facing such an occurrence,explored its aetiology in the context of malformation and discussed the benefits of neuromonitoring during scoliosis correction and the management protocol.We conducted a PubMed literature review for cases of paediatric ASSH and other closely related disorders.We reviewed recommendations regarding neuromonitoring and treatment management in such cases.CONCLUSION ASSH is a rare complication of posterior spinal instrumented fusion.Published cases are more often associated with anticoagulation therapy or coagulopathy.Neuromonitoring is strongly recommended to detect and assess neurological status,thus enabling rapid diagnosis and treatment and facilitating early spinal decompression and a return to a normal neurological status.
Godefroy Michon du MaraisAnne Tabard-FougèreRomain Dayer
Background Prestroke physical activity(PA)has been linked to improved outcomes after intracerebral haemorrhage(ICH),but its association with ICH volume is unknown.We aimed to investigate associations of prestroke PA with location-specific haematoma volume and the clinical outcome of ICH.Methods All patients with primary ICH,admitted to three hospitals between 2014 and 2019,were included.Patients performing light PA≥4 hour/week the year before stroke were considered physically active.Haematoma volumes were assessed from admission brain imaging.Adjusted associations were estimated using multivariate linear and logistic regression models.Haematoma volume was explored as mediator to the relationship between prestroke PA and mild stroke severity(0-4 points on the National Institutes of Health Stroke Scale),a good 1-week functional status(0-3 points on the modified Rankin Scale)and 90-day survival.Average direct effects(ADE)and average causal mediation effects(ACME)were computed.Results Of 686 primary ICH cases,349 were deep,240 lobar and 97 infratentorial.Prestroke PA predicted smaller haematoma volumes in deep ICH(β=−0.36,SE=0.09,p<0.001)and lobar ICH(β=−0.23,SE=0.09,p=0.016).Prestroke PA was also associated with mild stroke severity(OR 2.53,95%CI 1.59 to 4.01),a good 1-week functional status(OR 2.12,95%CI 1.37 to 3.30)and 90-day survival(OR 3.48,95%CI 2.06 to 5.91).Haematoma volume partly mediated the relationships between PA and stroke severity(ADE 0.08,p=0.004;ACME 0.10,p<0.001),1-week functional status(ADE 0.07,p=0.03;ACME 0.10,p<0.001)and 90-day survival(ADE 0.14,p<0.001;ACME 0.05,p<0.001).Conclusions Light PA≥4 hour/week prior to ICH was associated with smaller haematoma volumes in deep and lobar locations.Physically active patients with ICH had a higher likelihood of mild stroke,a good 1-week functional status and 90-day survival,in part mediated by smaller haematoma volumes on admission.
Adam ViktorissonDongni BuvarpAnna DanielssonThomas SkoglundKatharina S Sunnerhagen
