Immediate Dialysis After Simultaneous Laparoscopic Peritoneal Dialysis Catheter Placement and Laparoscopic Inguinal Hernia Repair.

Background and Objectives: Peritoneal dialysis (PD) is an accepted renal replacement therapy for end-stage renal disease (ESRD). Managing inguinal hernia in patients with PD is not standardized. Thus, this study reported the outcomes of simultaneous laparoscopic peritoneal dialysis catheter (PDC) placement and transabdominal preperitoneal (TAPP) repair of inguinal hernia. Methods: Thirteen patients with chronic renal disease and inguinal hernia attending a tertiary hospital between May 1, 2016 and June 30, 2021 were evaluated for laparoscopic PDC placement. Concurrent laparoscopic inguinal herniorrhaphy and laparoscopic PDC placement were performed. Dialysate fluid was measured intraoperatively to the level below the incised peritoneum by 1 inch. The inflow and outflow was smooth without leakage. The amount was increased gradually in the two weeks after regular PD was obtained. Results: Laparoscopic PDC was inserted for 13 patients. Ten patients had unilateral hernia and two had bilateral inguinal hernia. Associated paraumbilical hernia was discovered in two patients. The median follow-up was 30 months. The measured safe amount of dialysate fluid intraoperatively was 400 - 600 mL. There was no death, intraoperative complication, or dialysate leakage. Three PDCs were removed owing to noncompliance. No hernia recurrence was observed. Conclusion: Simultaneous laparoscopic PDC placement and laparoscopic repair of inguinal hernia with immediate dialysis is a safe and feasible surgical technique. Utilizing minimally invasive surgery affords PDC placement and inguinal hernia repair simultaneously.

Association of Online Health Information-Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia.

BACKGROUND: Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information-seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. OBJECTIVE: The aim of this study was to determine the online health-related information-seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information-seeking behavior on their self-care activities. METHODS: A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. RESULTS: Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease, unemployment, and not seeking diabetes education were the most common barriers for online health-related information-seeking behavior. Younger age, female, marital status, higher education, higher income, and longer duration of Internet usage were associated with more online health-related information-seeking behaviors. Most (89/96, 93%) online health-related information seekers reported positive change in their behaviors after seeking online health information. Overall odds ratio (OR 1.56, 95% CI 0.63-3.28) for all self-care responses demonstrated that there was no statistically significant difference between those seeking health-related information online and non-health-related information seekers. However, health-related information seekers were better in testing their blood glucose regularly, taking proper action for hyperglycemia, and adopting nonpharmacological management. CONCLUSIONS: Physicians and television are still the primary sources of health-related information for adult diabetic patients in Saudi Arabia whether they seek health-related information online or not. This study demonstrates that participants seeking online health-related information are more conscious about their diabetes self-care compared to non-health-related information seekers in some aspects more than the others.