Niger J Clin Pract
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Studies on the application of complex adaptive systems (CAS) framework to describe variations in free healthcare policies during implementation are limited. This study uses a CAS framework to explore interactions among actors and to explain how specific characteristics of CAS framework change in institutional designs of a Free Maternal and Child Healthcare Program (FMCHP) in Nigeria. ⋯ Managing changes in free healthcare policies requires recognizing the power shifts, nonlinearity of outcomes, unpredictable consequences and feedbacks, and addressing the context, adaptive behavior, and network of actors.
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This study aimed to evaluate risk factors that impact 1-year mortality in elderly patients with hip fractures after treatment with primary arthroplasty and proximal femoral nail. ⋯ Delayed surgery and postoperative complications may be the most important risk factors increasing 1-year mortality in elderly patients with hip fractures after treatment with primary arthroplasty and proximal femoral nail. These two risk factors can be prevented with proper precautions, and the rate of 1-year survival for these patients can be increased.
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Analyses of clinical and osteoimmunological parameters on keratinized mucosa around dental implants.
This study investigated the effects of keratinized mucosa width (KMW) on peri-implant tissues by evaluating peri-implant clinical and bone resorption parameters. ⋯ This study demonstrated that adequate KMW and PIPS techniques exhibited positive effects on clinical peri-implant parameters and osteoimmunological mediators.
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Randomized Controlled Trial
Postoperative analgesia after total abdominal hysterectomy: Is the transversus abdominis plane block effective?
Analgesic protocol is needed following gynecologic surgery to ensure early mobilization, decrease the duration in the post-anesthetic care unit and hospitalization, and provide patient comfort. Transversus abdominis plane (TAP) blocks are used in the treatment of acute postoperative pain after lower abdominal surgery. TAP block may be a better choice of postoperative pain control. In the present study, the efficacy of ultrasound-guided TAP block on pain control and postoperative opioid consumption was evaluated in patients undergoing a total abdominal hysterectomy. ⋯ TAP block can effectively treat postoperative pain as part of multimodal analgesia in patients undergoing total abdominal hysterectomy.
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Elevated neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a useful prognosticator of overall survival (OS) in several cancers including castration resistant prostate cancer. However, its utility in black populations known to have benign ethnic neutropenia is unknown. We evaluated the prognostic value of NLR in Nigerian men with CRPC in terms of OS. ⋯ This study demonstrated that NLR is a useful prognostic biomarker in Nigerian men with CRPC and that elevated baseline NLR ≥1.8 is associated with poorer OS.