Perceptions and expectations among pregnant women receiving second-trimester ultrasound scans at Jordan University Hospita

To evaluate women's information about the purpose of the second-trimester ultrasound scan, their expectations before the scan, the extent to which these expectations are fulfilled after the scan, and their perceptions of the foetus. A sample of pregnant women [540] attending a second-trimester ultrasound scan at Jordan University Hospital were asked to complete two parts of a questionnaire during a 3-month period in 2011. The first part included patients' characteristics, the purpose of the scan, and expectations before the scan. The second part included patients' perceptions of the foetus and how the expectations of the scan were fulfilled. Both parts of the questionnaires were completed by 503 [93%] of the women. Three fourths of the participants were accompanied by their husband or a family member. Sixty [12%] women were referred specifically to rule out congenital anomalies. Comparison between patients' expectations before and after the scan using the chi-square test showed significant improvement in all expectations variables [P-value< 0.001]. A routine second-trimester ultrasound scan is an important event for most participating women. Improvements are required in the provision of pre-ultrasound information

Risk factors for hematoma development post reduction mammaplasty: novel associations and implications

The aim of this retrospective study was to analyze various preoperative and intraoperative factors that may contribute to the development of wound hematoma after reduction mammaplasty. This will help us to estimate a prospective patient's individualized risk based on selected identifiable factors, facilitating patient selection and preoperative counseling. Sixty six patients, who underwent Wise-pattern, Inferior pedicle reduction mammaplasty over a 10- year period [1999-2008] performed by a single surgeon were studied. The following factors were addressed: age, medical history, medications, smoking habits, Body Mass Index [BMI], phase of menstrual cycle, mass of resection, prophylactic heparin, operation time, intraoperative blood loss, preoperative and postoperative Hemoglobin [Hb] and Hematocrit [Hct] levels, various blood pressure measurements and hematoma formation. The operative time was divided into two periods and in our experience, hemostasis was achieved in the second period. In our series, six patients developed a postoperative wound hematoma; only two patients required operative evacuation [3%]. Body Mass Index [BMI], mass of resection and subcutaneous prophylactic heparin significantly affected the likelihood of wound hematoma [P values: 0.018, 0.002 and 0.031, respectively]. Smoking, age, medical illnesses and phase of menstrual cycle had no statistical significance on the development of wound hematoma. Logistic regression analysis showed that the peak systolic blood pressure during the period of hemostasis was significantly lower in patients who developed hematoma [P=0.019]. Our data indicate that there was a significant correlation between post-operative hematoma and Body Mass Index [BMI], mass of resection, prophylactic heparin and intraoperative hypotention during the period of hemostasis

Effects of sevoflurane on postoperative liver functions in morbidly obese as compared to the non-obese patients

To assess the effect of sevoflurane anesthesia on hepatic function in morbidly obese versus non-obese patients undergoing abdominal surgeries. We prospectively evaluated the levels of the serum concentration of liver enzymes aspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH], gamma glutamyl transferase [GGT], alkaline phosphatase [ALP], and total bilirubin [TBil], in 42 morbidly obese and 40 non obese patients who were scheduled for elective abdominal surgery under sevoflurane anesthesia at the Jordan University Hospital, Amman, Jordan. Measurement of liver enzymes was done in the recovery room, and on the first, 3 and 7 days after sevoflurane anesthesia, and the results were compared between the morbidly obese and non obese patients. ALT, AST, GGT and LDH increased significantly in the morbidly obese than they did in non obese patients. In morbidly obese patients TBil increased gradually peaking 7 days after anesthesia, LDH increased in the recovery room, AST and ALT increased in the recovery room and first day, while GGT increased 7th day after anesthesia. In non obese patients, AST, LDH increased in the recovery. ALP did not change in both groups. Sevoflurane induces elevation of the serum liver enzymes in morbidly obese patients with variable onsets