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Objective: The surgical workforce needs to at least double by 2030. To increase the workforce, training for non-physician healthcare professionals and community health workers (CHWs) in rural areas is promising to decrease the numbers of untreated surgical patients. Nevertheless, few studies have been conducted on surgical activities of non-physician healthcare professionals and CHWs in rural Cambodia. We sought to measure the level of knowledge of surgical symptoms, and identify factors associated with it. A questionnaire survey was administered to people in rural areas of Kratie Province to determine their knowledge of surgical symptoms, and to strengthen the surgical workforce among medical staff and CHWs.Patient/Materials and Methods: To evaluate the knowledge of surgical symptoms among medical staff and CHWs, a self-reported questionnaire was administered to medical staff, CHWs, and villagers in a rural area of Kratie province, Cambodia. The rating score of the number of correct answers among medical staff, CHWs, and villagers was set as the primary outcome.Results: A total of 91 participants, including 31 medical staff, 24 CHWs, and 36 villagers, completed the survey. The median scores for knowledge of symptoms indicative of surgery were 8 (7–8) [median (interquartile range)] in medical staff, 8 (7–8.5) in CHWs, and 8.5 (8–9) in villagers. There was no significant difference in the scores of surgical symptoms among each of the occupational groups. The group of people who recognized low subjective knowledge of surgical symptom by themselves had significantly higher objective score of knowledge of surgical symptom.Conclusion: Knowledge of surgical symptoms among medical staff and CHWs was inadequate. To at least double the surgical workforce by 2030 successfully, accurate evaluation and improvement of surgical symptomatic knowledge among medical staff in rural areas is crucial.
ABSTRACT
Background Vitrectomy is a primary approach to the treatment of proliferative diabetic retinopathy (PDR).However,postoperative rehaemorrhagia often occur.Ranibizumab is an effective drug of antivascular endothelial growth factor,but whether the combination of intravitreal injection of ranibizumab with vitrectomy can reduce the incidence of postoperative rehaemorrhagia in PDR patients is still unclear.Objective This study was to investigate the preventive effect of the combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy on postoperative rehaemorrhagia.Methods A retrospective cohort study was perfomed.The clinical data of Ⅴ-Ⅵ stage of PDR patients who received 25-gauge vitrectomy in Peking University Interuational Hospital from January 2014 to July 2015 were collected and analyzed.The PDR patients were divided into only surgery group and drug with surgery group.The patients in the only surgery group (34 eyes of 49 patients) received 25-gauge vitrectomy,and the patients in the drug with surgery group (32 eyes of 25 patients) received the intravitreal injection of ranibizumab 0.05 ml (0.5 mg) 7 days before 25-gauge vitrectomy.The distribution of eye number in different grades of visual acuities was observed and compared between the two groups in 1 day,1 week,1 month and 3 months after surgery,and the incidence of rehaemorrhagia was intergrouply compared in 1 day,3-7 days and 1 month after surgery.Results The eye number and percentage of the different visual acuities in the drug with surgery group was not significantly different from the only surgery group in 1 day,1 week,1 month and 3 months after surgery (1 day:Z=0.673,P=0.412;1 week:Z=0.113,P=0.737;1 month:Z=1.755,P=0.185;3 months:Z=2.474.P=0.116).Rehaemorrhagia occurred in postoperative day 1 and day 3-7 was 1 eye and 1 eye respectively in the drug with surgery group,and that in the only surgery group was 9 eyes and 9 eyes respectively,showing significant difference between the two groups (all at P＜0.05).The eye number of rehaemorrhagia in postoperative 1 month was 4 in the only surgery group,and no rehaemorrhagia appeared in the drug with surgery group.Conclusions The combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy can efficiently reduce the incidence of postoperative rehaemorrhagia.
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Objective To observe the effect of computer anorectal therapeutic apparatus in treatmenf of hemorrhoids. Methods 100 cases of hemorrhoids were selected and randomly divided into A group and B group,each group 50 cases. The patients of A group were treated by computer anorectal therapeutic equipment. The patients of B group were administrated with traditional surgical treatment. Then the pain, urine retention, wound edema, the occurrence of postoperative bleeding, wound healing time and the average following - up outcome were observed within 3 days after operation. Results A group had occur pain, urine retention, wound bleeding and wound edema in cases of 3,1,1,8 respectively, and B group had them in cases of 7,3,5,13 respectively,there was no significant difference between the two groups(all P ＜0. 05). The healing time of A group and B group was (13. 5 ±4.6) days and (14.3 ± 4.9) days respectively, there was no significant difference between the two groups (P ＞ 0. 05). 46 cases of A group were cured , 42 cases of B group were cured, there was no significant difference between the two groups (P ＞ 0.05). Conclusion Computer anorectal therapeutic apparatus in treatmenf of hemorrhoids could reduce hemorrhoids bleeding, pain, urine retention ,edema and wound complications, and had good effect.