Keywords : Literature review
Basrah Journal of Surgery,
2020, Volume 26, Issue 2, Pages 27-31
The increased incidence of caesarean section has got an important issue in the recent researches in obstetrics. The evaluation of the condition and factors that make a decision for an operation still a main challenge to both doctors and patients in evaluating benefits and risk factors both pre and post-operative to the mother and the baby. Continuous studies all over the world are still in run focusing on this problem. World Health Organization reported an incidence lower than 15% to be accepted. Almost all countries still recording higher rates, both in developed and developing countries.
This study has aimed to spotlight the problem in the main teaching obstetrics and gynecology hospital in Basrah, calculating the rate and risk factors associated with caesarean section which, similar to other countries, the rate is growing up.
A retrospective study was conducted to review the statistical data during the last ten years calculating the incidence rate of caesarean operations, reviewing the data of 700 first caesarean operations in year 2019 to assess the main causes for an operation.
It was clear that the rate of caesarean section has increased during the period from 2010 to 2019 from 24.2% to 38.5% with a study increment in both the total number of birth and the operation rate. The main reasons for operation were; repeated caesarean after a previous one in nearly 50%, while for a first caesarean, the causes were; failure to progress in 35%, infertility in 20.4%, breech presentation in 14.4%, meconium in 8.2%, cephalopelvic disproportion in 7%, and elevated blood pressure in 4%.
In conclusion, the decision for an operation is still a challenge to both doctors and patients, the included reasons for an operation are; patient background, fear of labor pain, advances in anesthesia, private sectors and family economic situations, all interacts with the obstetrical, gynecological and medical risk factors for an operation leading to an increasing rate of caesarean operations. Clear criteria are still in need with more expanded studies to reduce the rate, taking in account all the possible post-operative complications.
Key words: Spondylodiscitis, Surgery, Caesarean, Causes, Timing, Risks, Literature review
Basrah Journal of Surgery,
2020, Volume 26, Issue 2, Pages 3-11
Global comparison of The outcome of surgical techniques for spondylodiscitis
Jessica Burton@, Thamer Hamdan*, Bisola Ajayi#, Mohsen Raza$, Angelo Fragkakis&, Cristina Lupu^, Timothy Bishop%, Jason Bernard! & Darren Lui**.
@MB,ChB student. *Professor of Orthopaedic Surgery at Basrah University, Visiting Professor at London Imperial College and Research Fellow as Saint George’s Hospital London. #Orthopaedic and Spine Physician Associate. $Orthopaedic Registrar. &Spine Fellow. ^ Spine CNS. %Orthopaedic Spinal Surgeon. !Orthopaedic Spinal Surgeon. **Orthopaedic Spinal Surgeon. Department of Trauma and Orthopaedics, Saint George’s University Hospital, London, UK.
Spondylodiscitis is an infection of the intervertebral disc and neighbouring bone. It is treated conservatively or surgically using a range of techniques.
The aim of this review is to determine whether the surgical techniques between different countries have an effect on clinical outcome: postoperative complications, relapse rate, treatment failure rate or mortality rate.
Many articles were screened using Ovid and Pubmed databases for studies pertaining to the surgical treatment of spondylodiscitis. Paediatric studies, tubercular/brucellar/fungal/ postoperative infection and case reports were excluded from this review.
The results shows that no differences in the outcome of surgery between countries was found, and reasons for this along with solutions for moving forward with comparing surgical techniques worldwide are noted.
Key words: Spondylodiscitis, Surgery, Outcome, Comparison, Literature review