Appropriate use of colonoscopy in Nigeria: a retrospective study using the American Society of Gastrointestinal Endoscopy (ASGE) 2012 guidelines

INTRODUCTION: Epidural analgesia has been used in many major surgeries like upper abdominal surgery, cardio-thoracic surgery, orthopedic surgery etc. Epidural analgesia is one of the commonly used methods of postoperative pain control despite its associated complications. So, this study was conducted to find out its effectiveness in major orthopedic surgeries done in Universal College of Medical Sciences. MATERIAL AND METHODS: A retrospective study was done at Universal College of Medical Sciences & Teaching Hospital, Bhairahawa, Nepal from July 2012 to June 2014. Data of 57 patients, aged between 17 to 91 years having American Society of Anesthesiologists (ASA) physical status 1 and 2 who had undergone major orthopedic surgeries under spinal anesthesia and lumber epidural catheterization were collected and important information regarding anesthesia and surgery, epidural catheter and postoperative epidural analgesia, any complications if occurred throughout the study period were recorded. Departmental Protocol for epidural analgesia was followed in these patients. Patients who received intraoperative epidural anesthesia or analgesia and any other anesthetic or analgesic agents were excluded in this study. RESULTS: This study found epidural analgesia, a very effective way to relieve pain in patients undergoing major orthopedic surgeries, when given according to the Departmental Protocol. There were no any complications related to epidural analgesia till 4th postoperative day. Out of 57, only 2 patients received injection Ketorolac intravenously as a rescue analgesic at the same day of operation before epidural top up. Average time to demand for analgesic after the last dose of epidural top up was 21.933 hours. All patients were mobilized around their beds on 2nd postoperative day. The average postoperative days of hospital stay was only 6.5 days. CONCLUSION: Epidural mixture of Bupivacaine-morphine in lower dose and concentration given as an intermittent bolus dosing via lumber epidural catheter is safe and very effective in relieving postoperative pain after major orthopedic surgeries without any significant complications.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10

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Incidence of hypoxemia in a post-anaesthesia care unit and relevant risk factors: a retrospective study of 14604 patients with general anaesthesia

10.21203/rs.2.12878/v1 ◽

2019 ◽

Author(s):

Shuai Tang ◽

Liangyan Zhang ◽

Wei Han ◽

Yang Xue ◽

Yi Tian ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Regression Analysis ◽

Retrospective Study ◽

Retrospective Cohort ◽

Post Anaesthesia Care Unit ◽

Postoperative Hypoxemia ◽

Total Incidence ◽

American Society ◽

Anaesthesia Care

Abstract Background This article is aim to investigate the incidence and risk factors for postoperative hypoxemia in a post-anaesthesia care unit (PACU). Methods The retrospective cohort assessed 14604 postoperative patients who were admitted to PACU between January 2015 and December 2015. A pulse oximeter was used to monitor and record pulse oxygen saturation (SpO2) every 5 minutes. Clinical data were collected for all these patients, and the incidence of and risk factors for postoperative hypoxemia were analysed. Results The total incidence of hypoxemia was 21.83% (SpO2 ≤ 95%) and 2.79% (SpO2 ≤ 90%). Multiple regression analysis indicated that the risk factors were age ≥50-year old, body mass index (BMI) ≥25kg/m2, American Society of Anaesthesiologists (ASA) II and III, limb surgery, and thoracic surgery. Conclusions Therefore, hypoxemia was common in postoperative patients in the PACU. Age, BMI, ASA classification, and surgical site are associated with postoperative hypoxemia. More attention should be paid to these patients to prevent hypoxemia in the PACU.

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Indicadores de calidad de colangiopancreatografía retrógada endoscópica en un hospital nivel III asociados al desarrollo de pancreatitis aguda post-cpre

Revista del Cuerpo Médico del HNAAA ◽

10.35434/rcmhnaaa.2021.142.1028 ◽

2021 ◽

Vol 14 (2) ◽

pp. 132-138

Author(s):

Katherine Alexandra Pérez Acuña-Medina ◽

Cristian Díaz-Vélez

Keyword(s):

Gastrointestinal Endoscopy ◽

American Society

Objetivo: Evaluar la asociación entre los indicadores de calidad de colangiopancreatografía retrógada endoscópica (CPRE) y desarrollo de pancreatitis aguda post-CPRE en el Hospital Regional Lambayeque durante el período 2016–junio 2017. Material y métodos: estudio observacional, transversal analítico, retrospectivo. Población censal 539 y muestra 358. Se evaluaron historias clínicas usando un checklist de indicadores de calidad de “The American Society for Gastrointestinal Endoscopy (ASGE)”. Se usó media y desviación estándar para la edad y frecuencias absolutas y porcentajes para las demás variables. Se evaluó el porcentaje de cumplimiento de cada indicador. Se encontró la asociación entre indicadores de calidad y el desarrollo de pancreatitis usando razones de prevalencia (IC95%) y X2(p<0,05). Resultados: La edad promedio es 52,24+20,168, el 66,5% son mujeres. 98,3% de las CPREs tiene indicación apropiada; 0,3% no tiene consentimiento informado completo; 15,38% tuvo administración de antibiótico adecuada; 92,2% fueron realizadas por un endoscopista capacitado; en 96,9% se logró la canulación profunda, ninguno tuvo medición del tiempo de fluoroscopio, 65,1% logró extracción de cálculos <1cm, 95,5% logró la colocación de stent; ninguna tuvo reporte completo y en el 98,5% los efectos adversos fueron documentados. La tasa de pancreatitis fue 7%, de perforación 0,6% y de hemorragia 2,5%. Solo el 3,9% tuvo control en >14 días. Conclusiones: No existe asociación entre los indicadores de calidad de CPRE y el desarrollo de pancreatitis. No se cumplen todos los criterios de calidad. La pancreatitis post-CPRE tiene más posibilidad de presentarse en mujeres, pero menos en mayores de 65 años.

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Cervical Cytology–Histology Correlation Based on the American Society of Cytopathology Guideline (2017) at the Russian National Medical Research Center for Obstetrics, Gynecology, and Perinatology

Diagnostics ◽

10.3390/diagnostics12010210 ◽

2022 ◽

Vol 12 (1) ◽

pp. 210

Author(s):

Aleksandra Asaturova ◽

Darya Dobrovolskaya ◽

Alina Magnaeva ◽

Anna Tregubova ◽

Guldana Bayramova ◽

...

Keyword(s):

Retrospective Study ◽

Medical Research ◽

Sampling Error ◽

Pap Test ◽

Research Center ◽

National Medical ◽

American Society ◽

Screening Errors ◽

Discrepancy Detection ◽

Self Learning

Recent evidence suggests that a cytology–histology correlation (CHC) with discrepancy detection can both evaluate errors and improve the sensitivity and specificity of the cytologic method. We aimed to analyze the errors in cytologic–histologic discrepancies according to the CHC protocol guideline of the American Society of Cytopathology (2017). This retrospective study included 273 patients seen at the National Medical Research Center of Obstetrics, Gynecology and Perinatology (Moscow, Russia) between January 2019 and September 2021. The patients’ mean age was 34 ± 8.1 years. The cytology–histology agreement was noted in 158 cases (57.9%). Major discrepancies were found in 21 cases (7.6%), while minor discrepancies were noted in 93 cases (34.1%). The reason for 13 (4.8%) discrepancies was a colposcopy sampling error and, in 46 (16.8%) cases, the reason was a Papanicolaou (PAP) test sampling error. The discrepancy between primary and reviewed cytology was due interpretive errors in 13 (4.8%) cases and screening errors in 42 (15.4%) cases. We demonstrated that the ASC guidelines facilitate cervical CHC. A uniform application of these guidelines would standardize cervical CHCs internationally, provide a scope for the inter-laboratory comparison of data, and enhance self-learning and peer learning.

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