Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study.

BACKGROUND: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these. METHOD: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality. RESULTS:  1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI 2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality. CONCLUSIONS: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.

Results of a project to calibrate mercury sphygmomanometer blood pressure-measuring devices in Egypt.

Hypertension (HTN) is a common health problem and a major cardiovascular risk factor. Accurate measurement of blood pressure (BP) is mandatory for proper diagnosis and follow-up. The aim of this study was to evaluate the accuracy of mercury sphygmomanometer BP-measuring devices in public hospitals in Cairo, Egypt. Fifty public hospitals were included, and 10% of all mercury sphygmomanometer devices in each hospital were tested. Assessment included physical condition (e.g., mercury status, lid of the device, state of the rubber tubes), leakage rate, and calibration accuracy (as compared with a reference device). Devices were approved as accurate when they could successfully pass all three assessment tests. The total number of sphygmomanometer devices was 465. The overall pass rate was 1.3% (six devices). Twenty-five (5.2%) devices passed all of the physical tests, 50 (10.8%) passed the leakage test, and 50 (16.5%) passed the calibration accuracy test. There were 162 (34.8%) devices that showed a high leakage rate (>80 mmHg) and thus were not tested for calibration accuracy. In conclusion, most of the mercury sphygmomanometer devices in hospitals are neglected and not checked regularly for any errors. A plan should be made to gradually replace those failed devices with new, validated, and well-calibrated devices, preferably devices that do not contain mercury.

Hypertension in Egypt: a systematic review.

BACKGROUND: With 29% of the world's adult population projected to have hypertension by the year 2025, prevention and management of hypertension have become a public health priority. Hypertension also referred to as high blood pressure, in which the arteries have persistent high blood pressure. This results in a condition where the heart has to work harder than normal to flow blood through the vessels. A few years ago, there was no sufficient information about the epidemiology of hypertension, treatment protocols and its consequences in Egypt. Lately, there has been a major change in health system in Egypt, including research development. OBJECTIVES: To evaluate the existing data on prevalence, levels of awareness, treatment and control of hypertension in Egypt with a view of suggestive actions that could enhance control of hypertension and improve quality of life of the patients. METHODS: Six databases (Pub Med, Cochrane, MEDLINE, Sciencedirect, MedEase, Embase) were searched in November 2013, applying the following criteria: published from January 1995 to November 2013 written in English and carried out on human subjects. RESULTS: 21 studies were included in the systematic review of the prevalence, awareness, and control of hypertension in Egypt. The sample size ranged from 27 subjects to 12008 subjects, and the age range from 6-95 years. Every study had both male and female representatives. In most of the studies, the women were more than the men. CONCLUSION: There are declines in the levels of awareness of hypertension and even lower levels of control. Research is required to reveal reasons behind these near to the ground levels of control and treatment, and especially awareness, in order to put in the picture policy for the improvement of quality of life of hypertensive patients in Egypt.