scholarly journals Comparing patient satisfaction, outcomes and costs between cataract day surgery and inpatient surgery for elderly people

1997 ◽  
Vol 20 (4) ◽  
pp. 27 ◽  
Author(s):  
Yu-Pei Fan ◽  
Duncan Boldy ◽  
Denise Bowen
Keyword(s):  
Cataract Surgery ◽  
Elderly People ◽  
Cost Effective ◽  
Day Surgery ◽  
Insurance Fund ◽  
Number Of Patients ◽  
Study Results ◽  
Inpatient Group ◽  
Hospital Resources ◽  
High Level

The study reported in this paper examined the characteristics of elderly peopleundergoing cataract surgery and compared patient perspectives and satisfaction,outcome, costs, reported health problems and social circumstances of day surgerypatients and hospital inpatients, The study sample was drawn from the client databaseof a health insurance fund and covered 291 people aged 60 years or more who hadrecently undergone cataract surgery.Overall, both day surgery patients and inpatients indicated a high level of satisfactionwith their eye surgery (about 80- per cent for both groups). The majority of patientsfrom both groups reported an improved level of vision, with vision outcome in theday surgery group being as good as in the inpatient group. Overall, inpatienttreatment was more costly and involved higher out of pocket expenses.The study results indicate a potential to increase the number of patients undergoingcataract surgery as a day patient procedure. Pre-operative preparation contributed topatient satisfaction and the availability of family and/or social support was animportant factor influencing day surgery admission. Whilst patients reporting healthproblems were less inclined to have cataract surgery than were day patients, this onlyaccounted for one-fifth of the total inpatient group. Developing systematic andappropriate case selection criteria and effective case management will contribute tomore efficient use of hospital resources, an increased use of day surgery facilities, andhence a more cost-effective overall cataract surgery service for elderly people.

scholarly journals A Study on Raised Serum LDH Level in Acute Intestinal Obstruction – A Marker of Bowel Gangrene

2020 ◽  
Vol 3 (1) ◽  
pp. 120-123
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsan Srikanth
Keyword(s):  
Intestinal Obstruction ◽  
Venous Blood ◽  
Cost Effective ◽  
Abdominal Distension ◽  
Serum Levels ◽  
Acute Intestinal Obstruction ◽  
Number Of Patients ◽  
Study Results ◽  
Bowel Gangrene ◽  
Aseptic Conditions

Background: Bowel gangrene is a major abdominal catastrophe associated with high mortality rate. Intestinal obstruction accounts for 20%   of all surgical emergencies around the world. The present study aims to estimate the LDH levels in patients with acute intestinal obstruction and correlate with bowel viability. Subjects and Methods: In this study, the estimation of serum LDH was conducted in 45 cases of acute intestinal obstruction who were admitted in surgical wards. After fulfilling the inclusion and exclusion criteria the study subjects were recruited. All the cases were thoroughly examined. Time of presentation and onset of symptoms were noted. Under aseptic conditions, 3 ml venous blood samples were collected from the study subjects, centrifuged at 3000 rpm and separated serum sample was used for the estimation of lactate dehydrogenase (LDH) and the estimated value of serum LDH is compared with the viability of the bowel intra operatively. Results: The total number of patients presented with obstruction is 45 out of which 25 were found to have elevated LDH which is about 55.56%. Out of 25 patients presented with elevated LDH, 20 patients found to have gangrenous bowel. 60% presented with abdominal pain and 40% had irreducible swelling. Most commonly associated symptoms are vomiting (84%) followed by abdominal distension (40%), obstipation (36%), pyrexia (24%), blood in stools (8%) and diarrhoea (4%). Per rectal examination showed 76% had normal faecal staining, 12% blood stained faeces and 8% empty. Complications observed were anastomotic leak 8%, wound infection 16%, wound gaping 8%, burst abdomen 8%. Conclusion: The present study results indicate that ischemic changes in any part of the bowel can cause elevation in the serum levels of LDH and a higher value of >1000 IU/L strongly indicates an underlying gangrenous change. It is a less invasive, cost effective and easily available diagnostic tool to diagnose bowel ischemia/gangrene. Hence it is more useful in centres where the diagnostic facilities are limited.

Perception of spiritual care among palliative care nurses: cross-sectional study in eastern Turkey

2021 ◽  
Vol 27 (5) ◽  
pp. 235-243
Author(s):  
Zeliha Cengiz ◽  
Dilek Olmaz ◽  
Mensure Turan
Keyword(s):  
Palliative Care ◽  
Spiritual Care ◽  
Cross Sectional Study ◽  
Spiritual Support ◽  
Sectional Study ◽  
Cross Sectional ◽  
Daily Care ◽  
Number Of Patients ◽  
Study Results ◽  
High Level

Background: Spiritual care is an integral part of palliative care. A nurse's perception of spiritual care is an effective factor for giving spiritual care. Aim: To determine the perception of spiritual care and the variables that might affect the perception of spiritual care among palliative care nurses. Methods: This cross-sectional study included 51 nurses working in the palliative care units. Perceptions of spiritual care was measured with the Spiritual Support Perception Scale. Findings: The mean score of the perception of the spiritual care of the nurses was found to be 64.22±9.25. A negative correlation was found between the nurses' mean score of the perception of spiritual care and the number of patients to whom those nurses provided daily care. Conclusion: This study has found that palliative care nurses had a high level of perception of spiritual care. Based on the study results, it was determined that the number of patients receiving daily care was a predictor for the perception of spiritual care.

scholarly journals STUDY OF DIFFERENT TYPES OF GRAFT MATERIALS USE IN TYPE - I TYMPANOPLASTY AT ENT DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

2020 ◽  
pp. 18-20
Author(s):  
Mukul Kumar Sinha ◽  
Debarshi Jana
Keyword(s):  
Rural Areas ◽  
Excellent Result ◽  
Cost Effective ◽  
Areolar Tissue ◽  
Type I ◽  
Temporal Fascia ◽  
Long Term Study ◽  
Gap Closure ◽  
Number Of Patients ◽  
Study Results

Background: The present study was undertaken to compare the results of various autogenous tissues as grafting materials for the repair of the tympanic membrane defect. As all the materials used previously were not easily available. So the present study comprised of the materials, which were easily available in adequate amount. These were temporalis fascia, tragalperichnodrium, areolar tissue and Ear lobule fat. Methods: In 100 subjects tympanoplasty operation was performed in 100 ears. The age of subjects ranged from 11 years to 50 years with mean age being 28.9 years. 33 cases were male and 67 cases were female. Majority (62%) of them were residing in rural areas and rest (38%)were from urban population. The period of study was from May 2019 to April 2020 starting from the pre-operative assessment to post– operative follow up all findings were noted in specific proforma. All of them attended ENT outpatient department of Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, with the chief complaints of discharging ear of varying duration. Slight impairment of hearing of varying degree was also complained of. Few of them presented with active stage of the disease and they were treated conservatively so that they attained the criteria as mentioned previously for myringoplasty operation of the present study. Results: Temporal fascia – None of the operated case reached the excellent result of post operative A-B gap closure by 0 – 10 dB. 23 cases showed good A-B gap closure of 11 – 20 dB followed by 9 cases with fair A – B gap closure of 21 – 30 dB and 5 cases showed poor result of >30 dB A-B gap closure. Tragal perichondrium –None of the operated case reached the excellent result of post operative A-B gap closure by 0 -19 dB 5 cases showed good A-B gap closure by 11 -20 dB, followed by 3 cases of fair A-Bgap closure 21 – 30 dB and 1 case of poor result with >30 dB A- B gap closure. Areolar tissue – None of the operated case reached the excellent result of post operative A-B gap closure by 0 -10 dB. 6 cases showed good A-B gap closure by 11 – 20 dB, followed by 2 cases of fair i.e. 21 – 30 dB A- B gap closure. Ear Lobule fat – 8 out of 45 cases showed excellent result with post operative A-B gap closure by 0 – 10 dB followed by 32 cases with good A-B gap closure by 11 – 20 dB, followed by 5 cases of fair i.e. 21 – 30 dB A-B gap closure. Conclusion: Tympanoplasty using Fat from ear lobule has high success rate of 90% for tiny small perforations. It is an office procedure which is cost effective with minimum post operative morbidity. But it is an underused procedure. We should practice it more for the benefit of our patients. Further long term study with more number of patients and verities of graft materials are necessary to achieve detailed and accurate results.

Introducing day case thyroid lobectomy at a tertiary head and neck centre

2021 ◽  
Vol 103 (7) ◽  
pp. 499-503
Author(s):  
Z Sheikh ◽  
V Lingamanaicker ◽  
E Irune ◽  
B Fish ◽  
P Jani
Keyword(s):  
Cost Effective ◽  
Day Surgery ◽  
British Association ◽  
Day Case ◽  
Thyroid Lobectomy ◽  
Number Of Patients ◽  
Same Day Discharge ◽  
Postoperative Haematoma ◽  
The Uk ◽  
Disseminated Disease

Background Thyroid lobectomy is considered to be a safe day case procedure by the British Association of Day Surgery. However, currently only 5.5% of thyroid surgeries in the UK are undertaken as day cases. We determine if and how thyroid lobectomy with same-day discharge could safely be introduced in our centre. Methods We analysed all thyroid lobectomy surgeries performed between April 2015 and May 2019. Exclusion criteria included completion surgery, revision surgery, additional procedures and disseminated disease. Outcomes were benchmarked against surgeon-reported complications from the British Association of Endocrine and Thyroid Surgery’s 5th National Audit. Additionally, we reviewed the number of patients who met day case criteria currently in use at our hospital to determine accessibility to the service. Results In total, 259 thyroid lobectomy surgeries were undertaken and of these 173 met the inclusion criteria. There was no mortality, return to theatre for evacuation of postoperative haematoma or readmission. There was one postoperative haematoma which was drained at the bedside. Some 47 of the 173 (27.2%) patients met day case criteria currently in use at our centre. Conclusions Day case surgery provides a cost-effective solution to rising bed pressures and a coherent protocol can optimise patient safety and experience.

CRIMINOLOGICAL FEATURES OF CORRUPTION-RELATED CRIMES IN THE FUEL AND ENERGY COMPLEX

2020 ◽  
pp. 23-27
Author(s):  
Сергей Иванович Вележев ◽  
Антон Михайлович Седогин
Keyword(s):  
Legal Protection ◽  
Criminal Activity ◽  
Criminal Cases ◽  
Law Enforcement Agencies ◽  
Energy Complex ◽  
Significant Damage ◽  
Study Results ◽  
Wide Range ◽  
Illegal Activities ◽  
High Level

В представленной статье авторами рассматриваются вопросы уголовно-правовой охраны топливно-энергетического комплекса Российской Федерации от преступных проявлений, в том числе от коррупционной противоправной деятельности должностных лиц. Такие действия причиняют значительный ущерб нормальному функционированию предприятий топливно-энергетического комплекса. Авторами приводятся результаты исследования некоторых криминологических характеристик должностных лиц, совершивших преступления коррупционного характера. Дан анализ причин и условий, способствующих совершению вышеуказанных противоправных действий. Определена типовая модель преступника для данной категории преступлений и его характеристики: в первую очередь, это высокий уровень компетентности, специальное образование и т. д. Авторами отмечается высокий уровень латентной преступности в данной отрасли. Предложены некоторые пути профилактики данной категории правонарушений. Исследование проводилось на основе анализа конкретных уголовных дел, возбужденных следственными органами по результатам оперативно-розыскной деятельности правоохранительных органов. In the article the authors consider the issues of criminal and legal protection of the fuel and energy complex of the Russian Federation from criminal activity including corrupt illegal practices of officials. The authors cite the results of some criminological characteristics study of the fuel and energy complex staff committed corruption crimes. As a result of these illegal actions significant damage is caused to the normal functioning of the fuel and energy enterprises. Such officials` actions determine not only a wide range of other illegal activities, but also lead to public outcry and discredit the industry as a whole. The analysis of the reasons and conditions contributing to the above illegal actions commission is given. A typical model of a criminal for a given crime category and its characteristics are determined. First of all it is a high level competence, special education, etc. A high level of latent crime in this industry is shown. The study results are presented on the example of specific criminal cases initiated by the investigating authorities based on the results of the operation detection activities of law enforcement agencies. Some ways of preventing this category of offenses are proposed.

Cost Avoidance and Clinical Benefits Derived from a Pharmacy-Managed Anemia Program

2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Cost Avoidance ◽  
Number Of Patients ◽  
Epoetin Alpha ◽  
Clinical Benefits ◽  
Unit Dose ◽  
One Year ◽  
Alpha Therapy

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.

scholarly journals Health status and regularity of preventive activities among working population in Bulgaria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Georgieva ◽  
M Kamburova ◽  
P Stefanova ◽  
D Tsanova
Keyword(s):  
Age Groups ◽  
Blood Cholesterol ◽  
Health Improvement ◽  
Insurance Fund ◽  
Working Population ◽  
Active Population ◽  
Study Results ◽  
Working People ◽  
Population Potential ◽  
Knowledge And Attitude

Abstract Background Prevention is an important instrument for public health improvement and maintaining workability of active age people. National Health Insurance Fund of Bulgaria (NHIF) finances an annual regular check-up for people over 18 years of age. In addition, working people have access to preventive activities at their workplace. The aim of the study is to explore an actual regularity of preventive activities at active population in Bulgaria. Materials and Methods Data were collected by documents review and direct individual self-administered questionnaire, within a larger research project on health of active population in Bulgaria. It includes 326 employees in a study representing different branches, companies and professions. The questionnaire consists of questions about: a) distribution of risk factors, b) knowledge and attitude to prevention as a tool for better health c) types and regularity of preventive activities. Data processing was performed by SPSS v.24. Results Three of four respondents have been diagnosed with chronic disease, 49.4% of them suffer from more than one disease. One third of observed people take more than one medicine. Despite NHIF offers free of charge and obligatory annual check-ups, only 46% of study subjects have undergone a preventive examination within the last year, 49.7% - between 2 and 5 years and 4.3% have done so more than 5 years ago or never, which decrease the effectiveness of preventive measures. Visiting regular check-ups is significantly lower for younger age groups (below 44 years; p < 0.05). Relatively large part of people measured blood pressure (88.5%), blood glucose (67%) and blood cholesterol (51.5%) during the last year in relation to any symptoms, but not within the regular check-up. Conclusions Study results confirm the current tendency for low coverage of annual check-ups of working population in Bulgaria. Potential of preventive activities is not rationally used because recommended regularity is not observed. Key messages Phenomena as polymorbidity and polypragmasia are widely distributed in Bulgarian active population. Potential of preventive activities is not fully used because recommended regularity is not observed. Despite Bulgarian NHIF finances obligatory annual check-up for people aged over 18 years, most people become subjects of medical examination in case of disease symptoms, rather than regular check-ups.

scholarly journals Nanogel-Facilitated In-Situ Delivery of a Cataract Inhibitor

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1150
Author(s):  
Dixa Gautam ◽  
Michelle G. Pedler ◽  
Devatha P. Nair ◽  
Jonathan Mark Petrash
Keyword(s):  
Cataract Surgery ◽  
Vision Loss ◽  
Effective Means ◽  
Lens Capsule ◽  
Posterior Capsular Opacification ◽  
Surgical Removal ◽  
Visual Disability ◽  
Visual Axis ◽  
Number Of Patients ◽  
Subsequent Degradation

Cataracts are a leading cause of blindness worldwide. Surgical removal of cataracts is a safe and effective procedure to restore vision. However, a large number of patients later develop vision loss due to regrowth of lens cells and subsequent degradation of the visual axis leading to visual disability. This postsurgical complication, known as posterior capsular opacification (PCO), occurs in up to 30% of cataract patients and has no clinically proven pharmacological means of prevention. Despite the availability of many compounds capable of preventing early steps in PCO development, there is currently no effective means to deliver such therapies into the eye for a suitable duration. To model a solution to this unmet medical need, we fabricated acrylic substrates as intraocular lens (IOL) mimics scaled to place into the capsular bag of the mouse lens following a mock-cataract surgery. Substrates were coated with a hydrophilic crosslinked acrylate nanogel designed to elute Sorbinil, an aldose reductase inhibitor previously shown to suppress PCO. Insertion of the Sorbinil-eluting device into the lens capsule at the time of cataract surgery resulted in substantial prevention of cellular changes associated with PCO development. This model demonstrates that a cataract inhibitor can be delivered into the postsurgical lens capsule at therapeutic levels.

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

scholarly journals Assessment of Lacrimal Duct Patency in Patients Undergoing Endoscopic Medial Maxillectomy

2021 ◽  
Vol 10 (2) ◽  
pp. 245
Author(s):  
Andrzej Sieśkiewicz ◽  
Tomasz Łysoń ◽  
Marek Rogowski ◽  
Marek Bielecki ◽  
Ewa Gindzienska-Sieskiewicz ◽  
...  
Keyword(s):  
Assessment Method ◽  
Test Results ◽  
Functional Disorders ◽  
Lacrimal Duct ◽  
Assessment Tests ◽  
Number Of Patients ◽  
Study Results ◽  
Assessment Techniques ◽  
Medial Maxillectomy ◽  
Comparison Of The Results

Purpose: The risk of epiphora after medial maxillectomy with lacrimal duct transection is difficult to assess. The data available in the literature are inconclusive due to various operating techniques used by the authors of medical publications, different additional procedures aimed at improving tear drainage after maxillectomy, and a variety of lacrimal duct patency assessment techniques. The aim of our work was to assess the anatomical and functional patency of lacrimal ducts after medial maxillectomy without performing additional procedures to improve tear drainage as well as comparison of the results obtained with different assessment tests. Materials and methods: 21 patients who underwent medial maxillectomy in the years 2016–2019 were assessed for discomfort and epiphora based on patients’ own reports and basic clinical examination, lacrimal duct rinse test, the Munk score, and a modified endoscopic Jones I test. Results: Gradually increasing the sensitivity of the assessment method resulted in an increase in the number of patients with potential tear drainage disorders, starting from 0% in the rinsing test, 4.8% self-reported tearing complaints, 14.3% Munk score, and 19% modified endoscopic Jones I test. Conclusions: The study results revealed that a small fraction of patients tend to report epiphora as a consequence of medial maxillectomy themselves. Subtle functional disorders, which are not particularly bothersome to patients, are more common. More sensitive lacrimal duct patency tests reveal more cases of tear drainage disorders. The results of studies assessing the incidence of epiphora after medial maxillectomy appear to depend on the type of test used.

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