RESUMO
Background Appendicitis is a frequent emergency condition. Surgical site infections (SSI) are a common complication of appendectomy. Despite improvements in infection control, SSIs continue to cause harm, prolonged hospital stays, and even death. Objective The objective of this study is to compare the risk of developing surgical site infections (SSIs) between open laparotomy and laparoscopic appendectomies in Al-Baha, Saudi Arabia. Methods This retrospective cohort study compared laparotomy and laparoscopy for post-operative surgical site infection among patients who underwent an appendectomy at King Fahad Hospital (KFH) in Albaha, Saudi Arabia. Medical record numbers (MRNs) of patients who met the inclusion criteria were collected to build the sampling frame. From the final sampling frame, simple random sampling using a random number generator was used to draw a representative sample. Data were collected from the surgical health records of the patients. The collected data included patients' demographics, comorbidities, presenting symptoms, ordered imaging studies, pre-operative shaving, type and duration of surgery, intraoperative findings, and signs of wound inflammation. Results The total number of patients included in the analysis was 256, who underwent surgery for acute appendicitis. Among those who underwent laparoscopy, 5.7% had to be converted to open laparotomy. Signs of surgical wound inflammation were found in 10.2% of the patients. Patients who underwent open laparotomy had a significantly higher risk of wound infection (RR=3.1, p-value=0.001). Further analysis revealed an effect modification of pre-operative shaving. Open laparotomy has a higher risk of wound infection among patients who have not had pre-operative shaving (RR=4.1 vs. RR=2.6), while both risks were statistically significant (p-value=0.033 and p-value=0.035), respectively. Complicated cases in intra-operative findings were found to have a higher risk of post-appendectomy SSI. Conclusion This study demonstrates that laparoscopic appendectomy carries a lower risk of surgical site infection (SSI) compared to open laparotomy. Additionally, pre-operative shaving of the surgical site was found to increase the incidence of SSI. Healthcare providers can use this information to enhance their practice and reduce the occurrence of surgical site infections. Whenever possible, laparoscopic appendectomy should be preferred over open laparotomy due to its substantially lower SSI risk. We also recommend vigilant monitoring of complicated appendectomy, particularly in cases of ruptured appendicitis, for signs of SSI.
RESUMO
Background Ocular hypertension (OHT), defined by elevated intraocular pressure (IOP) beyond standard levels, is a predominant risk factor for initiating and exacerbating glaucoma, a collection of progressive optic neuropathies responsible for irreversible vision loss. Given the profound implications for vision care, it is imperative to elucidate the interplay between OHT and glaucoma for effective clinical management. Objective The present study aims to measure IOP levels and identify risk factors associated with glaucoma among middle-aged individuals in Al-Baha City, Saudi Arabia. Methods A cross-sectional study was conducted over a six-month span (January-June 2022) in Al-Baha City. The study cohort comprised adults aged 35 and above attending a glaucoma awareness campaign at King Fahad Hospital, Al-Baha. Parameters such as demographics, socioeconomic status, medical and ocular history, and familial history of eye diseases were collated. Initial ophthalmologic assessments and IOP measurements were performed. Statistical analyses utilized Pearson's Chi-square test for nominal variables. Results The study encompassed 111 participants, 84 (75.7%) of whom were male, and 75 (67.6%) were of Saudi nationality. Notably, 102 (91.9%) reported no family history of glaucoma, 91 (81.1%) indicated no past medical history and 81 (73.0%) were not on any chronic medications. The mean IOP for participants' right and left eyes fluctuated between 18.2-21.5 mmHg and 18.9-22.1 mmHg, respectively. Factors such as age, gender, family history of glaucoma, past medical history, use of chronic medications, and history of ophthalmic surgeries demonstrated a statistically significant correlation with IOP (p<0.05). Conclusion This study highlights a higher prevalence of OHT in females, with several risk factors for OHT and glaucoma identified, such as familial history, vascular diseases, diabetes mellitus, and chronic medication use. Notably, our study did not observe a significant association with age or smoking. These findings emphasize the necessity of regular eye examinations and IOP monitoring, especially in high-risk groups.