scholarly journals Surgical Needs at the End of the Battle of Mosul: Results from Mosul General Hospital

2019 ◽  
Vol 44 (3) ◽  
pp. 673-679
Author(s):  
Fredrik Bäckström ◽  
Denise Bäckström ◽  
Lin Sadi ◽  
Peter Andersson ◽  
Andreas Wladis
Keyword(s):  
General Hospital ◽  
Red Cross ◽  
Final Phase ◽  
Hospital Data ◽  
Related Condition ◽  
Northern Iraq ◽  
Number Of Children ◽  
Body Regions ◽  
Life Threatening ◽  
Official Declaration

Abstract Purpose The aim of the study was to analyze the surgical needs of patients seeking emergency care at the Mosul General Hospital in the final phase of the battle of Mosul in northern Iraq between an international military coalition and rebel forces. During the conflict, the International Red Committee of the Red Cross (ICRC) supported the hospital with staff and resources. Ceasefire in the conflict was declared at the end of July 2017. Methods Routinely collected hospital data from the ICRC-supported Mosul General Hospital from June 6, 2017, to October 1, 2017 were collected and analyzed retrospectively. All patients with weapon-related injuries as well as all patients with other types of injuries or acute surgical illness were included. Results Some 265 patients were admitted during the study period. Non-weapon-related conditions were more common than weapon-related (55.1%). The most common non-weapon-related condition was appendicitis followed by hernia and soft tissue wounds. Blast/fragment was the most frequent weapon-related injury mechanism followed by gunshot. The most commonly injured body regions were chest and abdomen. Children accounted for 35.3% of all weapon-related injuries. Patients presented at the hospital with weapon-related injuries more than 2 months after the official declaration of ceasefire. A majority of the non-weapon-related, as well as the weapon-related conditions, needed surgery (88.1% and 87.6%, respectively). Few postoperative complications were reported. Conclusions The number of children affected by the fighting seems to be higher in this cohort compared to previous reports. Even several months after the fighting officially ceased, patients with weapon-related injuries were presenting. Everyday illnesses or non-weapon-related injuries dominated. This finding underlines the importance of providing victims of conflicts with surgery for life-threatening conditions, whether weapon related or not.

Description of multimorbidity clusters of admitted patients in medical departments of a general hospital

2021 ◽  
pp. postgradmedj-2020-139361
Author(s):  
María Matesanz-Fernández ◽  
Teresa Seoane-Pillado ◽  
Iria Iñiguez-Vázquez ◽  
Roi Suárez-Gil ◽  
Sonia Pértega-Díaz ◽  
...  
Keyword(s):  
General Hospital ◽  
Multiple Correspondence Analysis ◽  
Hypertensive Heart Disease ◽  
Chronic Kidney Failure ◽  
Hospital Environment ◽  
Heart Valve Disease ◽  
Malignant Neoplasms ◽  
Hospital Data ◽  
Data Set ◽  
And Gender

ObjectiveWe aim to identify patterns of disease clusters among inpatients of a general hospital and to describe the characteristics and evolution of each group.MethodsWe used two data sets from the CMBD (Conjunto mínimo básico de datos - Minimum Basic Hospital Data Set (MBDS)) of the Lucus Augusti Hospital (Spain), hospitalisations and patients, realising a retrospective cohort study among the 74 220 patients discharged from the Medic Area between 01 January 2000 and 31 December 2015. We created multimorbidity clusters using multiple correspondence analysis.ResultsWe identified five clusters for both gender and age. Cluster 1: alcoholic liver disease, alcoholic dependency syndrome, lung and digestive tract malignant neoplasms (age under 50 years). Cluster 2: large intestine, prostate, breast and other malignant neoplasms, lymphoma and myeloma (age over 70, mostly males). Cluster 3: malnutrition, Parkinson disease and other mobility disorders, dementia and other mental health conditions (age over 80 years and mostly women). Cluster 4: atrial fibrillation/flutter, cardiac failure, chronic kidney failure and heart valve disease (age between 70–80 and mostly women). Cluster 5: hypertension/hypertensive heart disease, type 2 diabetes mellitus, ischaemic cardiomyopathy, dyslipidaemia, obesity and sleep apnea, including mostly men (age range 60–80). We assessed significant differences among the clusters when gender, age, number of chronic pathologies, number of rehospitalisations and mortality during the hospitalisation were assessed (p<0001 in all cases).ConclusionsWe identify for the first time in a hospital environment five clusters of disease combinations among the inpatients. These clusters contain several high-incidence diseases related to both age and gender that express their own evolution and clinical characteristics over time.

scholarly journals General Paediatric Surgical Provision of Percutaneous Endoscopic Gastrostomy in a District General Hospital – A 12-Year Experience

2009 ◽  
Vol 91 (5) ◽  
pp. 404-409 ◽  
Author(s):  
T Sathesh-Kumar ◽  
Hazel Rollins ◽  
Sarah Cheslyn-Curtis
Keyword(s):  
General Hospital ◽  
Percutaneous Endoscopic Gastrostomy ◽  
District General Hospital ◽  
Late Complications ◽  
General Anaesthetic ◽  
Paediatric Surgery ◽  
Number Of Children ◽  
Endoscopic Gastrostomy ◽  
Local Access ◽  
The Uk

INTRODUCTION A small, but significant, number of children require long-term nutritional support. The aim of this study was to demonstrate the safety and efficacy of providing a percutaneous endoscopic gastrostomy (PEG) service for children in a district general hospital and to raise awareness of the suitability of the procedure to be performed on paediatric surgery lists in similar hospitals across the UK. PATIENTS AND METHODS A multidisciplinary paediatric nutrition team was established and all children accepted for PEG insertion between 1995 and 2007 were entered onto a database prospectively and are included in this study. PEG tubes were inserted by the standard pull-through technique under general anaesthetic. RESULTS A total of 172 procedures were performed in 76 children. The median age at first tube insertion was 3 years (range, 0.5–18 years). Length of follow-up ranged from 1 month to 12.6 years. Fifty-eight children (76%) had a neurological abnormality, the commonest being cerebral palsy. All but one procedure were performed successfully, of which 63 (37%) were new insertions, 99 change of tube, 4 changed from surgical gastrostomy and 6 from PEG to button gastrostomy. The median hospital stay was 2 days (range, 2–7 days) for new insertions and 1 day for tube changes. There were 10 (6%) early complications within 30 days, the commonest being peritubal infection (6). The 39 late complications included 16 peritubal infection/granulomata, 9 ‘buried bumpers’, 4 worsening of gastro-oesophageal reflux disease, 2 gastrocolic fistulae, 3 gastrocutaneous fistulae and 4 tubal migration. There was no mortality. CONCLUSIONS We have demonstrated that paediatric PEG procedures and continuing management by a supporting team can be successfully and efficiently provided in the district general hospital. It should be possible for the majority of similar hospitals to provide local access and increase the availability of PEG feeding for children.

scholarly journals Epidemiology of Equestrian Accidents: a Literature Review

2019 ◽  
Author(s):  
Lauren Meredith ◽  
Robert Ekman ◽  
Karin Brolin
Keyword(s):  
Literature Review ◽  
Soft Tissue Injuries ◽  
Weather Conditions ◽  
Review Of The Literature ◽  
Hospital Data ◽  
Young Females ◽  
Body Regions ◽  
Horse Riding ◽  
Warm Weather ◽  
The Usa

Purpose: This manuscript aimed to present a review of the literature pertaining to horse riding and other horse-related injuries. Method: A review of the literature was performed, searching for appropriate terms with regards to horse accidents, horse riding injuries and protective clothing for the horse riding context. The literature review search returned 151 relevant full-text articles, with 71 of these detailing the overall injury epidemiology of horse-related accidents. Most of these studies were conducted in the USA and used a retrospective review of hospital data methodology. Results: Of the 71 articles investigated, 60 suggested that those most frequently involved in horse-related accidents are young females and 97% of papers investigating injury mechanisms found the most commonly involved was a fall from horseback. It was suggested in multiple studies that these injury events mostly occurred in warm weather conditions, when the horse behaved in an unexpected manner. Injury type and location varied by the primary mechanism of injury; but frequently involved body regions were the head and upper extremities, and the most common injuries observed were fractures and soft tissue injuries. Neurological trauma was reported by all relevant studies to be the most frequent cause of fatality. Conclusion: Some improvements in horse-related accident numbers and outcomes have been observed with the development and introduction of protective devices such as helmets and vests. Yet despite the benefits of helmet and vest usage, there is evidence to suggest helmets do not perform as well as they could. Further work could investigate improvements in safety measures and risk factors associated with fatalities.

scholarly journals PENGALAMAN CAREGIVER DALAM MERAWAT PASIEN PALIATIF DI PANTI WERDHA TULUS KASIH

2021 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Putri Raissa Hamidah ◽  
Nurhayati Siagian
Keyword(s):  
Elderly Patients ◽  
Old Age ◽  
Sampling Technique ◽  
Development Stage ◽  
Daily Activities ◽  
Final Phase ◽  
Interview Methods ◽  
Life Threatening ◽  
Caregiver Experiences ◽  
Palliative Patients

Late adulthood or known as old age, is the final phase of the life development stage. Old age is often identified with a period of decline in various bodily functions and an impact on helplessness. Because of this, many elderly suffer from incurable and life-threatening diseases known as palliative diseases. Many families of elderly patients who have palliative diseases feel unable to care for their patients at home, and finally, choose to leave elderly palliative patients at the Wredha Home because patients depend on the help of others for care to fulfill their needs and to carry out their daily activities accompanied by a caregiver at the Wredha Home. This reasearch was to ascertain an expertises felt by caregivers in caring for palliative patients at the Tulus Kasih Home. This research uses qualitative methods, data collection using interview methods with structured guides, and a purposive sampling technique that includes four participants. The result of this study covered six themes: the caregiver's understanding of palliative patients, what the palliative patients needs, what difficulties the caregiver experiences when giving action to elderly palliative patients, the caregiver's response when having difficulty caring for palliative patients, what efforts are made by the caregiver when having difficulty caring for palliative patients, and the efforts made by the caregiver in increasing the action for palliative patients.

scholarly journals Dental Caries and Associated Risk Indicators among Married Saudi Women

2021 ◽  
Author(s):  
Syed Akhtar Hussain Bokhari ◽  
Kawthar Almumtin ◽  
Wala Mohammed Alhashiem ◽  
Duaa youssef Albandar ◽  
Zainab Nouh Alyahya ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Dental Caries ◽  
General Hospital ◽  
Dairy Products ◽  
Family Income ◽  
Dietary Habits ◽  
Risk Indicators ◽  
Dental Visits ◽  
Saudi Women ◽  
Number Of Children

Abstract Objective The aim of this study was to evaluate decayed, missing, and filled teeth (DMFT) experience among married females in Saudi Arabia and provide an exploratory data for subsequent primary prevention. Materials and Methods A cross-sectional quantitative study was conducted at a general hospital in Hofuf, Saudi Arabia. All married women attending the general hospital from March 1st to April 15th, 2021 were requested to participate. Data was collected on a validated self-reported questionnaire consisting of sociodemographic factors, medical history, dietary pattern, and DMFT. Descriptive and regression analyses were performed using p ≤0.050. Results Four hundred forty-eight married females with the mean age of 30.81 ± 6.11 years, mean duration of marriage of 9.55 ± 6.58 years, and having average number of children 2.32 ± 1.69 participated in the study. 61.7% mothers had ≥10 years of education. 63.6% were non-working and 56.5% were found with low family income. 66% participants reported of doing exercise less or more often yet 51.7% were ≥overweight. Consumption of energy drinks and dairy products was found significantly associated with increasing number of DMFT. Use of fluoridated toothpaste and dental visits was also found associated with increasing number of dental caries. Increasing age (p = 0.040), increasing number of children, and middle family income were also significantly associated with higher DMFT, respectively (p = 0.002, p = 0.022). In multi-logistic adjusted analysis, only consumption of dairy products, dental visits, and the unsure status of the use of fluoridated toothpaste were significantly associated with DMFT ≥1. Conclusion DMFT status in married Saudi women was associated with participants' dietary habits, oral health-related practices, family income, married years, and number of children.

scholarly journals Achieving beneficial outcomes for children with life-limiting and life-threatening conditions receiving palliative care and their families: A realist review

2019 ◽  
Vol 34 (3) ◽  
pp. 387-402 ◽  
Author(s):  
Sarah Mitchell ◽  
Karina Bennett ◽  
Andrew Morris ◽  
Anne-Marie Slowther ◽  
Jane Coad ◽  
...  
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Realist Review ◽  
Health Concern ◽  
Service Development ◽  
Children And Families ◽  
Family Outcomes ◽  
Number Of Children ◽  
Palliative Care Services ◽  
Life Threatening

Background: Palliative care for children and young people is a growing global health concern with significant resource implications. Improved understanding of how palliative care provides benefits is necessary as the number of children with life-limiting and life-threatening conditions rises. Aim: The aim is to investigate beneficial outcomes in palliative care from the perspective of children and families and the contexts and hidden mechanisms through which these outcomes can be achieved. Design: This is a systematic realist review following the RAMESES standards. A protocol has been published in PROSPERO (registration no: CRD42018090646). Data sources: An iterative literature search was conducted over 2 years (2015–2017). Empirical research and systematic reviews about the experiences of children and families in relation to palliative care were included. Results: Sixty papers were included. Narrative synthesis and realist analysis led to the proposal of context–mechanism–outcome configurations in four conceptual areas: (1) family adaptation, (2) the child’s situation, (3) relationships with healthcare professionals and (4) access to palliative care services. The presence of two interdependent contexts, the ‘expert’ child and family and established relationships with healthcare professionals, triggers mechanisms, including advocacy and affirmation in decision-making, which lead to important outcomes including an ability to place the emphasis of care on lessening suffering. Important child and family outcomes underpin the delivery of palliative care. Conclusion: Palliative care is a complex, multifactorial intervention. This review provides in-depth understanding into important contexts in which child and family outcomes can be achieved so that they benefit from palliative care and should inform future service development and practice.

Medication prescribing pattern and potential teratogenicity risk among pregnant women at Hidar 11 General Hospital, south Wollo, northeast Ethiopia

2020 ◽  
Vol 35 (1) ◽  
pp. 67-72
Author(s):  
Oumer Sada Muhammed ◽  
Kemal Ahmed Seid ◽  
Beshir Bedru Nasir
Keyword(s):  
Pregnant Women ◽  
General Hospital ◽  
Treatment Guidelines ◽  
Risk Category ◽  
Hospital Data ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Fetal Risk ◽  
Medication Prescribing ◽  
Us Fda

Drugs given to pregnant mothers for therapeutic purposes may cause serious structural and functional adverse effects in the developing child. However, the fact that drugs are needed to mitigate complications during pregnancy cannot be totally avoided. Hence, the current study is aimed to evaluate the pattern of medication prescribing practice during pregnancy at Hidar 11 General Hospital, Ethiopia. Institution based cross sectional study was conducted on 310 pregnant women whose medical charts were selected using systematic random sampling from antenatal care (ANC) attendants at Hidar 11 General Hospital. Data was collected through medical chart review by using data abstraction tool and analyzed by statistical package for social sciences (SPSS) Version 24 software. Among the study participants, 263 (84.8%) had a prescription at least for one drug during their pregnancy. Majority of the drugs prescribed for the pregnant women were vitamins and minerals (60.6%), antibacterial agents (30.6%) and central nervous system drugs (28.4%). A high proportion of drugs were prescribed from US Food and Drug Administration (US FDA) category C (57.7%) followed by category B (50.6%) and category A (22.9%). Only 6.8% of the prescribed drugs were with positive evidence of risk (US FDA category D) during all trimesters and no drugs were prescribed from proven fetal risk category (US FDA X category). Even though, drugs from category X were not prescribed, a significant number of pregnant women consumed drugs with potential fetal risk that should be addressed by informing the prescribers to stick to the treatment guidelines and seek safer options.  

Development of a model emergency oncology response system (EORS): The California oncology emergency master plan (COEMP)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6142-6142
Author(s):  
R. Moss ◽  
P. Yu ◽  
C. Presant ◽  
J. Gonzalez ◽  
M. Lamb ◽  
...  
Keyword(s):  
Hurricane Katrina ◽  
Homeland Security ◽  
Support Network ◽  
Red Cross ◽  
Data Repository ◽  
Active Components ◽  
Educational Materials ◽  
Contact Data ◽  
Life Threatening ◽  
Pilot Implementation

6142 Background: Hurricane Katrina displaced patients (PT) and physicians (MD). Time & resources were needed to match displaced PT with oncology (ONC) practices (PRC) for ongoing care. Disruption of care can be life-threatening to ONC PT who need to adhere to schedules & monitoring. California (CA) is particular risk for natural disaster. In order to better support PT in a future emergency (E) MOASC & ANCO created a model EORS with pilot implementation of select elements. Methods: MOASC & ANCO prepared a multi-component COEMP. Joint calls & meetings yielded a draft EORS approved by both society boards. Initial & long-term funding is expected via granting mechanisms. Pilot implementation of specific elements began in 11/2005. Results: Goals of the COEMP are: Establish dedicated E ONC MD network; Create a voluntary ONC-specific PT medical record (MR) template & secure data repository; Create & test a functional E MD responder system for CA ONC MD; Develop liaison with relief providers (Homeland Security, FEMA, Red Cross); Strengthen existing role with Bio-Pharma (BP) for delivery of medicine (Rx) to displaced PT and PRC; Develop specific educational materials for the EORS (PT, MDs, Insurers, BP); Create & distribute an EORS “PT Wallet Card” with PT national digital record (NDR) and E responder contacts. To prioritize components of the COEMP, a needs assessment, reviewing past E experience, response, and current capacity, has been initiated. The specific active components of the EORS include: 1-E ONC MD support network: ONC MDs have been invited to volunteer via email and at regional meetings. 2-Secure PT MR repository: MDs and PT will coordinate relevant MR, insurance, and E contact data, in locations (home of PT, w/relatives, NDR). 3-E coordinator MDs & staff will respond to E calls from PT/MD via phone & email. 4-Open dialogue with BP for E access to Rx for displaced PT. 5-Educational & training for PRC and PT in printed & electronic form. Conclusions: COEMP provides an initial E model for ONC. It may be applicable for state societies or national ONC groups. At ASCO 2006, MDs will be invited to participate and expand COEMP capabilities. Although we hope COEMP/EORS need never be used, its development will enable ONC practices to be more prepared for loco-regional E. No significant financial relationships to disclose.

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