The Problem of the Hospital Surgery Department Debottlenecking

2020 ◽  
pp. 289-302
Author(s):  
Alexander A. Lazarev ◽  
Darya V. Lemtyuzhnikova ◽  
Alexander S. Mandel ◽  
Nikolay A. Pravdivets
Keyword(s):  
Surgery Department

TO DETERMINE THE ROLE OF CA125 IN THE DIAGNOSIS OF ACUTE APPENDICITIS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Ca 125 ◽  
Care Hospital ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Surgery Department

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.

Childhood Intussusception: Timely Management Leads to Decreased Surgical Risk

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Dr. Sunil Kumar Mehra, Dr. Dinesh Kumar Barolia, Dr. Arun Kumar Gupta, Dr. Vinita Chaturv
Keyword(s):  
Operative Procedure ◽  
Delayed Diagnosis ◽  
Diagnostic Methods ◽  
Treatment Modalities ◽  
Surgical Morbidity ◽  
Surgical Risk ◽  
Medical College ◽  
Pneumatic Reduction ◽  
Surgery Department ◽  
Resection And Anastomosis

Intussusception is the most common cause of intestinal obstruction in infants and children in < 1yr of age (1). Intussusception cases usually reported late therefore operative procedure was inevitable and results in significant morbidity and mortality. By this study we emphasized on timely transfer of intussusception case to a pediatric surgical center so as to decrease surgical risk. The surgical morbidity was low in those who were admitted early or directly to our center.  Methods - We retrospectively reviewed cases of intussusception in children <15 years. Children were treated from October 2015 to December 2107 at pediatric surgery department of SMS medical college Jaipur Rajasthan. Age, sex, month of admission, symptom with duration, diagnostic methods, and treatment modalities were recorded and analyzed.  Results - We studied 300 patients with intussusception.272 (90%) were treated surgically. We recently started ultrasonography guided pneumatic reduction and 24(85.7%) out of 28 treated successfully by it. Out of the patients requiring surgery 202 (67.34%) patients were reduced by per-operative manual reduction and in 60(22%) patients resection and anastomosis with 10(3.6%) treated with resection and ileostomy. 25.34% cases have delayed diagnosis and lately  transferred from peripheral hospitals requiring resection and diversion. Conclusion - In conclusion, Intussusception cases usually reported late therefore high likelihood of surgical management. The patients who underwent resection have longer duration of hospital stay.

Retrospective study on parotid gland tumors

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 22-23
Author(s):  
Ibric Cioranu ◽  
Vlad Petrescu Seceleanu ◽  
Viorel Ibric Cioranu ◽  
Andreea Smarandache ◽  
Sorin Vasilescu ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Maxillofacial Surgery ◽  
Squamous Carcinoma ◽  
Benign Tumors ◽  
Warthin Tumor ◽  
Parotid Tumors ◽  
Non Hodgkin Lymphoma ◽  
Adenoid Cystic ◽  
Modal Treatment ◽  
Surgery Department

During 2011-2012, 56 patients diagnosed with parotid tumors were admitted to the Maxillofacial Surgery Department of “Lucian Blaga” University and in Euroclinic Hospital. 72% were benign tumors and 28% malignant. All patients received surgical treatment (total or partial parotidectomy). For the malignant tumors, radiotherapy was added to the modal treatment (94% of the cases). Pleomorphic adenoma was encountered in 70% of the benign cases, followed by Warthin tumor in 15%. Adenoid cystic carcinoma was noticed in 31% of the malignant cases, mucoepidermoid carcinoma in 25% of the cases, and squamous carcinoma and non-Hodgkin lymphoma on 12.5% of the malignant cases.  

Use of Synthetic Protetic Materials in Surgical Abdominal Defects. Analysis of the Advantages and Lack of the Liechtenstein Method

2018 ◽  
Vol 69 (7) ◽  
pp. 1740-1743
Author(s):  
Vlad Dumitru Baleanu ◽  
Denis Vlad Constantin ◽  
Anca Pascal ◽  
Dragos Ovidiu Alexandru ◽  
Simona Bobic ◽  
...  
Keyword(s):  
Relative Risk ◽  
Recurrence Rate ◽  
General Surgery ◽  
Prosthetic Material ◽  
Emergency Hospital ◽  
Rural And Urban ◽  
Abdominal Interventions ◽  
Defects Analysis ◽  
Surgery Department

Liechtenstein procedure represents the most frequent technique used for surgical abdominal interventions. Although, it is a modern and inovative procedure, it still has a relative risk for complications. A number of 93 subjects were included in our research. We develop our study in General Surgery Department of County Emergency Hospital of Craiova, Romania between 1st July 2017-31th March 2018. From the total of 93 patients, 88% were men. Most of subjects had ages between 70 and 79 years old, were operated by Liechtenstein technique and they were coming from quite equal percent from rural and urban areas.The incidence for complications(seroma, hematoma, infection, abscess) was generally lower for the patients diagnosticated with Liechtenstein procedure comparing with the subjects operated by other technique. Liechtenstein procedureis recommended especially for its simplicity and efficiency, reproducibility and safety. It is very important to choose the perfect synthetic prosthetic material to have a good evolution of the disorder and a small recurrence rate.

The Causative Organisms of Bacterial Meningitis and their Antimicrobial Resistance Profiles in Iranian Children in 2011-2016

2020 ◽  
Vol 20 (2) ◽  
pp. 229-236
Author(s):  
Sepideh Keshavarz Valian ◽  
Shima Mahmoudi ◽  
Babak Pourakbari ◽  
Maryam Banar ◽  
Mohammad Taghi Haghi Ashtiani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Meningitis ◽  
Medical Center ◽  
Blood Cultures ◽  
Gram Positive ◽  
Gram Negative ◽  
Number Of Patients ◽  
Resistance Patterns ◽  
Iranian Children ◽  
Surgery Department

Objective: The study aimed to describe the identity and antimicrobial resistance patterns of the causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital, Tehran, Iran. Methods: This retrospective study was performed at CMC Hospital during a six-year period from 2011 to 2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and blood cultures, and antibiotic susceptibility profiles of isolated organisms. Results: A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent (n=73) of the patients were male. The median age of the patients was ten months (interquartile range [IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae (n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28% (n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam, vancomycin, and linezolid were the best choices. Imipenem was the most active drug against Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive bacteria isolated from blood cultures. Conclusion: Results of this study provide valuable information about the antibiotic resistance profiles of the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical therapies.

scholarly journals Patients’ Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department

2021 ◽  
pp. 155335062110080
Author(s):  
Lara Blanco Terés ◽  
Carlos Cerdán Santacruz ◽  
Javier García Septiem ◽  
Rocío Maqueda González ◽  
José María Lopesino González ◽  
...  
Keyword(s):  
Categorical Variables ◽  
Average Score ◽  
Job Status ◽  
Perceived Satisfaction ◽  
The Future ◽  
Chi Squared ◽  
Single Centre Study ◽  
Set Up ◽  
Almost All ◽  
Surgery Department

Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest ( P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.

scholarly journals The volume of general surgery emergency cases in a government hospital during the COVID-19 pandemic and two other periods: a comparative, retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ibrahim Abu Shakra ◽  
Maxim Bez ◽  
Samer Ganam ◽  
Rola Francis ◽  
Amir Muati ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Control Period ◽  
Medical Laboratory ◽  
Government Hospital ◽  
Analog Scale ◽  
Surgical Interventions ◽  
Medical Emergencies ◽  
The Mean ◽  
Surgery Department ◽  
Second Lebanon War

Abstract Background During March and April 2020, reductions in non-COVID-19 hospital admissions were observed around the world. Elective surgeries, visits with general practitioners, and diagnoses of medical emergencies were consequently delayed. Objective To compare the characteristics of patients admitted to a northern Israeli hospital with common surgical complaints during three periods: the lockdown due to the COVID-19 outbreak, the Second Lebanon War in 2006, and a regular period. Methods Demographic, medical, laboratory, imaging, intraoperative, and pathological data were collected from electronic medical files of patients who received emergency treatment at the surgery department of a single hospital in northern Israel. We retrospectively compared the characteristics of patients who were admitted with various conditions during three periods. Results Patients’ mean age and most of the clinical parameters assessed were similar between the periods. However, pain was reportedly higher during the COVID-19 than the control period (8.7 vs. 6.4 on a 10-point visual analog scale, P < 0.0001). During the COVID-19 outbreak, the Second Lebanon War, and the regular period, the mean numbers of patients admitted daily were 1.4, 4.4, and 3.0, respectively. The respective mean times from the onset of symptoms until admission were 3, 1, and 1.5 days, P < 0.001. The respective proportions of surgical interventions for appendiceal disease were 95%, 96%, and 69%; P = 0.03. Conclusions Compared to a routine period, patients during the COVID-19 outbreak waited longer before turning to hospitalization, and reported more pain at arrival. Patients during both emergency periods were more often treated surgically than non-operatively.

scholarly journals First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala

2021 ◽  
Vol 16 (01) ◽  
pp. e46-e50
Author(s):  
Carmen Joanna González Lemus ◽  
Fernando Xavier Romero Prieto
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Main Mode ◽  
Cross Sectional ◽  
Speed Up ◽  
Male Patients ◽  
Mode Of Transportation ◽  
Surgery Department

Abstract Objective This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. Materials and Methods In this cross-sectional descriptive study, 2,923 medical records of patients aged 1 to 64 years who presented at outpatient peripheral nerve unit of the Orthopedic Surgery Department of Hospital Roosevelt, Guatemala, from January 2017 to December 2017, were prospectively analyzed to identify the prevalence and factors associated with brachial plexus injuries. Results The prevalence rate of brachial plexus injuries in patients was 5.74%. This injury is more common in men (90.5%) aged 24 to 64 years. Brachial plexus injuries occurred secondary to motorcycle accident in 72% of the cases, with the majority affecting the dominant upper extremity. In addition, 64.28% of the patients took 1 to 6 months to seek consultation, whereas only 16.07% requested medical assistance <1 month from the onset of symptoms, and this result was associated with early diagnosis and adequate recovery during follow-up. Furthermore, 66.67% presented upper brachial plexus injury with no associated fractures or vascular injury, manifesting distress while performing daily activities that required hand, arm, and elbow movements. Conclusion The risk of suffering BPIs in Guatemala increases in economically active male patients that use motorcycles as main mode of transportation. Patients should consult immediately after injury onset to optimize management results. For this reason, hospitals must develop specialized clinical guidelines to speed up the identification and treatment of BPI injuries.

scholarly journals Physiological Biomarkers Assessed by Low-Tech Exercise Tests Predict Complications and Overall Survival in Patients Undergoing Pneumonectomy Due to Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 735
Author(s):  
Tomasz Marjanski ◽  
Damian Wnuk ◽  
Robert Dziedzic ◽  
Marcin Ostrowski ◽  
Wioletta Sawicka ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Odds Ratio ◽  
Cardiac Complications ◽  
First Year ◽  
Exercise Tests ◽  
Walking Test ◽  
Increased Risk ◽  
Surgery Department

Due to its debilitating character pneumonectomy this is last-resort procedure. Preoperative results of the 6-min walking test (6MWT) help to identify high risk of postoperative complications and increased mortality in patients undergoing lobectomy for lung cancer. The aim of the study was to validate the value of 500 m in 6MWT as an indicator, which differentiates risk of complications in patients undergoing pneumonectomy. 125 patients who underwent pneumonectomy at Thoracic Surgery Department between 2009 and 2018. On the day preceding the surgery, patients underwent 6MWT. The patients were in median age of 63 years. The cut-off value of 500 m identified patients with increased 90-day mortality [17.9% vs. 3.5%, odds ratio (OR) 6.271, 95% confidence interval (CI) 1.528–25.739], first-year mortality (30.7% vs. 11.6%, OR 3.378, 95% CI 1.310–8.709), and overall survival (p = 0.02). Patients who covered a distance ≤ 500 m had an increased risk of atrial fibrillation (35.9% vs. 16.3%, OR 2.880, 95% CI 1.207–6.870) and cardiac complications (38.4% vs. 19.8%, OR 2.537, 95% CI 1.100–5.849). Patients unable to reach 500 m in 6MWT are in a high risk of postoperative death after pneumonectomy, what may be a result of increased frequency of postoperative cardiac complications. Poor result of 6MWT is a predictor of worse overall survival.

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