Surgical outcome of brain contusions treated by decompressive craniotomy with or without lobectomy at high volume tertiary care trauma centre

2014 ◽  
Vol 11 (1) ◽  
pp. 5-9
Author(s):  
Sumit Sinha ◽  
Yashpal S. Rathore ◽  
Ashok K. Mahapatra ◽  
Bhawani S. Sharma
Keyword(s):  
Surgical Outcome ◽  
Tertiary Care ◽  
High Volume ◽  
Trauma Centre ◽  
Decompressive Craniotomy

scholarly journals Vascular anomalies in pancreatic head resection do not impact surgical outcome in high volume center

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S299
Author(s):  
I. Frigerio ◽  
S. Mancini ◽  
V. Allegrini ◽  
A. Giardino ◽  
P. Regi ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Pancreatic Head ◽  
High Volume ◽  
Vascular Anomalies ◽  
Pancreatic Head Resection ◽  
High Volume Center

scholarly journals Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

2021 ◽  
Vol 10 (10) ◽  
pp. 2056
Author(s):  
Frank Herbstreit ◽  
Marvin Overbeck ◽  
Marc Moritz Berger ◽  
Annabell Skarabis ◽  
Thorsten Brenner ◽  
...  
Keyword(s):  
Influenza A ◽  
Health Care Systems ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
High Volume ◽  
Single Center Experience ◽  
Severe Influenza ◽  
Tertiary Care Facility ◽  
Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

scholarly journals Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

2015 ◽  
Vol 16 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Cuneyt Eftal Taner ◽  
Atalay Ekin ◽  
Ulas Solmaz ◽  
Cenk Gezer ◽  
Birgul Cetin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
High Volume ◽  
Tertiary Care Center

Prevalence and Risk Factors of work Related Musculo Skeletal Disorders (wrmsd’s) Among Doctors - A Cross Sectional Study

2021 ◽  
pp. 1-4
Author(s):  
Biju Azariah ◽  
◽  
Geethu Babu ◽  
Keyword(s):  
Risk Factors ◽  
Service Sector ◽  
Care Delivery ◽  
Tertiary Care ◽  
Health Sector ◽  
High Volume ◽  
Cross Sectional Study ◽  
Working Environment ◽  
Cross Sectional ◽  
Work Related

Work related musculoskeletal disorders (WRMSDs) have not only shown to impact the physical and pschycological comfort of the employee but also deteriorate the prospects of any production or service sector. The prevalence of WRMSDs, though studied extensively in various sectors, has been understudied in health sector, especially among doctors. This study which evaluated the prevalence and risk factors of these disorders among fifty cancer treating Radiation Oncologist at a Tertiary Care Cancer Centre in India had exposed out an alarming 68% prevalence of these disorders in the study population, with neck pain being the commonest site of these Muscloskeletal Disorders (MSDs). Several factors which could impact the development of MSDs were analysed. This higher incidence of MSDs is presumed to be because of extreme physical and mental stress of working in a high volume cancer care centre, persistent unhealthy postures during work, inadequate micropauses between works and uncomfortable working atmosphere. Adequate physician patient ratio, restricting the patient load, providing good physician friendly working environment and adequate mandatory breaks might significantly reduce the incidence of these disorders and can prevent the sagging of health care delivery.

scholarly journals Pancreatic Fistula Following Pancreaticoduodenectomy: Clinical Predictors and Patient Outcomes

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
C. Max Schmidt ◽  
Jennifer Choi ◽  
Emilie S. Powell ◽  
Constantin T. Yiannoutsos ◽  
Nicholas J. Zyromski ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Tertiary Care ◽  
High Volume ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Endoscopic Stenting ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Pancreatic Anastomosis ◽  
Septic Complications

Pancreatic fistula continues to be a common complication following PD. This study seeks to identify clinical factors which may predict pancreatic fistula (PF) and evaluate the effect of PF on outcomes following pancreaticoduodenectomy (PD). We performed a retrospective analysis of a clinical database at an academic tertiary care hospital with a high volume of pancreatic surgery. Five hundred ten consecutive patients underwent PD, and PF occurred in 46 patients (9%). Perioperative mortality of patients with PF was 0%. Forty-five of 46 PF (98%) closed without reoperation with a mean time to closure of 34 days. Patients who developed PF showed a higher incidence of wound infection, intra-abdominal abscess, need for reoperation, and hospital length of stay. Multivariate analysis demonstrated an invaginated pancreatic anastomosis and closed suction intraperitoneal drainage were associated with PF whereas a diagnosis of chronic pancreatitis and endoscopic stenting conferred protection. Development of PF following PD in this series was predicted by gender, preoperative stenting, pancreatic anastomotic technique, and pancreas pathology. Outcomes in patients with PF are remarkable for a higher rate of septic complications, longer hospital stays, but in this study, no increased mortality.

scholarly journals EP.WE.105Hand trauma during COVID pandemic: a tertiary trauma centre experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Amir Ghareib ◽  
Sylwia Oniska ◽  
Laura Karran ◽  
Jamil Moledina
Keyword(s):  
High Volume ◽  
Trauma Centre ◽  
Active Movement ◽  
Trauma Patients ◽  
University Hospitals ◽  
Hand Fractures ◽  
Good Movement ◽  
Hand Fracture ◽  
June July

Abstract Introduction St. George’s University Hospitals NHS Foundation Trust is a tertiary trauma centre. We receive a high volume of hand referrals from all over the south West London region. Closed hand fractures represent a significant number of our referrals. COVID-19 has put more burden in all health service endangering poor management of these trauma patients. Aim To assess management of close hand trauma patients during COVID pandemic. Methods Retrospective evaluation of closed hand fracture referrals during June, July, and August 2020. Clinical documentations, operative details and follow up visit notes have been reviewed. Results 106 patients have been included. 47 patients treated surgically with 81% of them were in need for metalwork insertion. Most of operations were done within 8 days. Number of hospital visits was variable with a mean of six days for adult and two days for children. Patient who was in need for hand therapy have been seen within the first 8 days of their surgery. At three months follow up, only three cases had infection. Only one case had osteomyelitis and the other two case had infected metalwork. Most of the patents reported good movement in ASSH Total Active Movement of Hand score (TAM) at the end of the three months. Conclusion Despite COVID 19 pandemic our service managed to achieve acceptable results in dealing with these cases. Yet, securing a reasonable number of operating sessions and clinic appointments remains a challenge.

scholarly journals SURGICAL OUTCOME OF CHILDHOOD TRAUMATIC CATARACT IN A TERTIARY CARE HOSPITAL

2015 ◽  
Vol 2 (34) ◽  
pp. 5220-5225
Author(s):  
Ravindra Kumar Chowdhury ◽  
Jayashree Dora ◽  
Promod Kumar Sharma ◽  
Jagadish Prasad Rout
Keyword(s):  
Surgical Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Traumatic Cataract

Perioperative outcomes in human immunodeficiency virus-infected patients – the PRO HIV study

2018 ◽  
Vol 29 (10) ◽  
pp. 968-973 ◽  
Author(s):  
Divyashree Shanthamurthy ◽  
Abi Manesh ◽  
Naveena GP Zacchaeus ◽  
Lisa R Roy ◽  
Priscilla Rupali
Keyword(s):  
Surgical Procedures ◽  
Median Duration ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Tertiary Care ◽  
Perioperative Outcomes ◽  
Care Hospital ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell

It is estimated that a quarter of patients with HIV/AIDS undergo at least one surgical procedure in their life time. Surgical outcomes in these patients from developing countries are poorly characterized and surgeons are often concerned about poor surgical outcomes, especially when their CD4 cell counts are less than 200 cells/µl. This study evaluated the surgical outcomes of HIV-infected patients undergoing various surgical procedures over a six-year period in a large tertiary care hospital from South India. Two hundred and ninety-three patients underwent 374 surgical procedures during the study period. The median duration of HIV prior to surgery was 1.9 years (range 0–18.8 years). Two-thirds (58%) were on highly active antiretroviral therapy (HAART) at the time of surgery with the median duration of this treatment being 38 months (n = 194). About one-third (35%) of surgical procedures were performed as an emergency. Abdomino-pelvic surgeries were the most common (225, 60%). Adverse surgical outcome defined as death or post-operative infection was seen in 25 (6.6%). The post-operative infection rate was 5% (20/374). The most common of these was surgical site infection observed in nine (60%) followed by pneumonia in five patients (33%) and urinary tract infection in one patient. Day 30 mortality was 2% (n = 8) and a quarter of these were reported to be related to post-operative infectious complications. On multivariate analysis, only preoperative haemoglobin of less than 10 g/dl was significantly associated with a poor surgical outcome. HIV-related parameters such as CD4 cell counts, duration of HIV infection and HAART regimen did not seem to contribute towards an adverse surgical outcome.

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