Is Postextracapsular Tonsillectomy Bleeding More Common on the Side of the Surgeon’s Nondominant Hand?

2021 ◽  
pp. 019459982098263
Author(s):  
Muhamed Masalha ◽  
Are DeRowe ◽  
Roee Landsberg ◽  
Salim Mazzawi ◽  
Lev Shlizerman ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
University Hospital ◽  
Dominant Hand ◽  
Inclusion Criteria ◽  
Medical Record Data ◽  
Risk Of Bleeding ◽  
Nondominant Hand ◽  
Record Data ◽  
The Difference ◽  
Extracapsular Resection

Objectives To determine the difference in bleeding when extracapsular tonsillectomy with electrocautery is performed on the dominant and nondominant side of the surgeon’s hands. Study Design Retrospective cohort study. Setting Academic university hospital. Methods Medical record data of patients who were admitted with posttonsillectomy bleeding from January 1, 2000, to July 31, 2017, were reviewed. Included were age, sex, surgical indication, side of posttonsillectomy bleeding, and time of bleeding. Information on the surgeon’s dominant hand was also collected. All patients underwent total extracapsular resection with electrocautery. Results Of 280 patients, 186 met the inclusion criteria, 116 (62.3%) males and 70 (37.7%) females. Ages ranged from 2 to 74 years (mean ± SD, 17 ± 13 years; median, 13 years). In 136 cases (73.1%), bleeding was on the side of the surgeon’s nondominant hand ( P < .0001). In 50 (26.9%) cases, bleeding was on the side of the surgeon’s dominant hand. The odds ratio of bleeding on the side of the surgeon’s nondominant hand compared to the dominant hand was 8.99. Conclusion The risk of bleeding following extracapsular tonsillectomy with electrocautery on the side of the surgeon’s nondominant hand is significantly higher than on the side of the dominant hand. Thus, additional caution is required when operating on the nondominant side of the oral cavity in extracapsular tonsillectomy using electrocautery. These findings raise questions regarding dexterity as a risk factor for posttonsillectomy bleeding.

scholarly journals A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Syed M. Asim Hussain
Keyword(s):  
Cohort Study ◽  
Standard Deviation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healing Rate ◽  
Leg Ulcer ◽  
University Hospital ◽  
Venous Leg Ulcer ◽  
Number Of Patients ◽  
The Difference

Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers.Study Design. Retrospective cohort study.Location. The leg ulcer clinic at the University Hospital of South Manchester.Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost.Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient.Results. Simple nonadherent dressings had a mean healing rate of 0.353 cm2/week (standard deviation ± 0.319) compared with a mean of 0.415 cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailedpvalue of 0.251 and a two-tailedpvalue of 0.508. Multiple regression analysis gave a significanceFof 0.8134.Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection.

scholarly journals Evaluasi Ketepatan Antibiotik pada Pasien Sepsis

2021 ◽  
Vol 18 (2) ◽  
pp. 194-207
Author(s):  
Ambar Yunita Nugraheni ◽  
Mahyastuty Shintya Putri ◽  
Adi Yusron Saputro
Keyword(s):  
Medical Record ◽  
Observational Data ◽  
Inclusion Criteria ◽  
Medical Record Data ◽  
Exclusion Criteria ◽  
Central Java ◽  
Intravenous Antibiotics ◽  
Record Data ◽  
The Right ◽  
Complete Medical Record

The administration of early intravenous antibiotics was one of the fundamental procedures in sepsis. Inappropriate of antibiotics in septic patients has an impact on mortality and prolongs treatment. The purpose of this study was to evaluate the appropriateness of antibiotics therapy in hospitalized sepsis patients in Central Java based on the parameters right indication, right patient, right drug, and the right dose. This study was observational. Data collected retrospectively and analyzed descriptively. Sampling was done by purposive sampling. The inclusion criteria were inpatients diagnosed with sepsis who received antibiotics therapy with complete medical record data. The exclusion criteria were patients who died of sepsis. Antibiotics analyzed using the DIH 25th edition 2016, IONI 2014, Tata Laksana Sepsis Pada Anak IDAI 2016, Neofax 2014, Kepmenkes PNPK Tata Laksana Sepsis 2017, PPK RS, and SHC Antimicrobial Dosing 2017. Based on data from 108 patients who fulfilled the inclusion criteria obtained results right indication 100%, right patient 97.22%, right drug 90.74%, and the right dose 48.15%. The most used antibiotic was a combination of ampicillin and gentamicin (41.67%), while the single antibiotic was ceftriaxone (12.96%).

scholarly journals Gambaran Pasien Tuli Mendadak di Bagian THT-KL RSUP Dr. M. Djamil Padang

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Hedo Hidayat ◽  
Yan Edward ◽  
Noza Hilbertina
Keyword(s):  
General Hospital ◽  
Clinical Symptoms ◽  
Sudden Deafness ◽  
Inclusion Criteria ◽  
Hearing Improvement ◽  
Medical Record Data ◽  
Early Management ◽  
Descriptive Research ◽  
Record Data ◽  
Diabetes Melitus

AbstrakTuli mendadak adalah penurunan pendengaran sensorineural yang berlangsung dalam waktu kurang dari 72 jam. Penyakit ini merupakan salah satu kegawatdaruratan neurotologi dan memerlukan penatalaksanaan dini untuk menghindari kecacatan yang dapat ditimbulkan. Tujuan penelitian ini adalah melihat gambaran kejadian tuli mendadak di Bagian THT-KL RSUP Dr. M.Djamil. Ini merupakan penelititan deskriptif retrospektif dengan menggunakan data rekam medik di RSUP Dr. M. Djamil Padang selama tahun 2010 sampai tahun 2013. Didapatkan hasil sebanyak 26 kasus yang masuk kriteria inklusi pada periode tersebut. Sebaran umur penderita dari 8 sampai 79 tahun, dengan distribusi terbanyak pada usia 40 – 60 tahun. Faktor resiko yang ditemukan berupa hipertensi dan diabetes melitus sama besar yaitu 11,54%. Gejala klinis terdiri atas tinitus (76,92%), diikuti vertigo (38,46%), dan rasa penuh di telinga (15,38%). Pasien terbanyak pada derajat ketulian sangat berat (38,46%), kemudian derajat sedang berat dan berat (23,08%), diikuti derajat ringan (11,54%) dan sedang (3,85%). Distribusi onset terapi terbanyak pada 0 – 7 hari (50,00%), kemudian onset > 14 hari (30,77%) dan onset 8 – 14 hari (19,23%). Perbaikan pendengaran ditemukan sama banyak pada kategori sangat baik dan baik sebanyak 6 kasus dan diikuti kategori sembuh satu kasus. Dari penelitian ini dapat dikatakan tidak hanya satu faktor yang menentukan perbaikan tuli mendadak.Kata kunci: tuli mendadak, retrospektif, gejala klinis1Mahasiswa FK Unand, 2Bagian Pulmonologi FK Unand, 3Bagian Patologi Anatomi FK UnandAbstractSudden deafness is a sensorineural hearing loss  in less than 72 hours. Sudden deafness is a neurotological emergency and requiring an early management to avoid the defects that can be caused. The objective of  this study was to see cases of sudden deafness in Dr. M. Djamil General Hospital. This was a descriptive research with retrospective design using medical record data in Dr. M. Djamil General Hospital in Padang during 2010 to 2013. From the research, 26 cases were obtained that can meet the inclusion criteria in the period. The age ranged from 8 to 79 years old, with most distributions at age 40-60 years old. Risk factors, hypertension and diabetes mellitus, were found equally 11,54%. Clinical symptoms consisted of tinnitus (76,92%), followed by vertigo (38,46%), and ear fullness (15,38%). Using grades of hearing impairment, most of patients were classified profound impairment (38,46%), then moderate and moderate severe impaitment (23,08%), followed by slight (11,54%) and moderate impairment (3,85%). Most therapeutic onset distribution is 0-7 days (50,00%), > 14 days onset (30,77%) and onset 8-14 days (19,23%). Hearing improvement was found equally in very good and good category (6 cases) and followed by recover category (1 case). It can be conclude that there were many factors can affect hearing improvement in sudden deafness case.Keywords: sudden deafness, retrospective, clinical symptoms

Effect of Diazepam on Visuomotor Reaction Time

1985 ◽  
Vol 60 (1) ◽  
pp. 107-110 ◽  
Author(s):  
James G. Barbee ◽  
Iryna Lawriw Black
Keyword(s):  
Single Dose ◽  
Reaction Time ◽  
Reaction Times ◽  
Double Blind Study ◽  
Dominant Hand ◽  
Time Intervals ◽  
Female Adult ◽  
Double Blind ◽  
Nondominant Hand ◽  
The Difference

20 male and 10 female adult, normal, healthy subjects, whose mean age was 26.34 yr., participated in a double-blind study of the effect of a single dose (0.2 mg./kg. of body weight) of diazepam on visuomotor reaction time. Reaction time was measured before drug administration, and 60 min., and 120 min. after administration. Separate reaction times for the dominant and nondominant hand were recorded. There were no significant differences between the diazepam and placebo group at each of the three time intervals. Diazepam in the single dose employed does not appear to affect adversely visuomotor reaction time of relatively young, normal, healthy adults. For both groups the difference in visuomotor reaction time between the dominant hand and the nondominant hand was statistically significant as expected.

Influential Factors in The Law Enforcement Process of Sexual Violence Cases in Children in The City of Semarang

SOEPRA ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. 4
Author(s):  
Liya Suwarni
Keyword(s):  
Law Enforcement ◽  
Sexual Violence ◽  
Medical Record ◽  
Child Protection ◽  
Influential Factors ◽  
Medical Record Data ◽  
Violence Against Children ◽  
Record Data ◽  
The Law ◽  
The City

Background. Cases of sexual violence increase every year, victims ranging from adolescents, children to toddlers. Based on data from the Indonesian Child Protection Commission, abuse and violence against children in Indonesia in 2013 were 23 cases, in 2014 there were 53 cases, in 2015 there were 133 cases, 2017 reached 1,337 cases, and as of July 2018 there were 424 cases. Purpose. Knowing the factors that influence the law enforcement process of sexy violence cases in Semarang City. Method This study uses descriptive analytical methods for cases of violence against children, based on medical record data in hospitals, documents in Mapolrestabes, the District Attorney's Office and the Semarang City Court for the period of January 2015 to December 2018. Results. Based on research results obtained 213 experimental cases section from medical record data in hospitals in the city of Semarang. Most cases of child abuse occurred in 2018 with 72 cases. Most victims are 12-14 years old age group, female. Most types of cases are cases of intercourse. The majority of violations are persons known as victims, perpetrators not working, and most of the places of occurrence are in the defendant's house. At the time of prosecution and trial, the number of cases was significantly reduced to only 8 cases. Factors related to this include lack of evidence, difficulty in obtaining information from victims, convoluted statements of coverage, lack of election, and obtaining diversion rates. Conclusion Cases of sexual violence have increased from year to year. The process of law enforcement on this problem still has many difficulties in each manufacturing process which is still difficult to overcome.

Hepatitis A Seroprevalence Among Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study in Iran During 2016-2017

2020 ◽  
Vol 20 (5) ◽  
pp. 748-751
Author(s):  
Seyed Ali Dehghan Manshadi ◽  
Neda Alijani ◽  
Mohammadreza Salehi ◽  
Omid Dadras ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis A ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Reasonable Approach ◽  
The Difference ◽  
Prevention Method

Introduction: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting. Methods: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19. Results: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001). Conclusion: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.

Screwdriver torque strength and physiological cost of muscles dependent on hand preference and direction of rotation

1998 ◽  
Vol 1 (1) ◽  
pp. 13-22
Author(s):  
Helmut Strasser ◽  
Baoquiu Wang
Keyword(s):  
Hand Preference ◽  
Dominant Hand ◽  
Muscle Forces ◽  
Maximum Torque ◽  
Physiological Cost ◽  
Nondominant Hand ◽  
Physiological Differences ◽  
Torque Values ◽  
The Right

The focus of this research was to investigate how maximum torque and muscle forces were affected by pronation and supination, i.e., inward and outward rotation of the forearm in a series of screwdriver tests with 6 varied handles. Consecutively, maximum torque for pronation and supination was determined, submaximum isometric levels of torque were demanded, and, finally, an equal dynamic screwing work for all subjects was simulated. Physiological cost of performance was simultaneously measured by registrations of electromyographic activities (EA) from 4 muscles, which were expected to be involved intensively in screwing tasks. Significant and essential differences between maximum torque values produced by pronation and supination of the right and the left arm of the mainly right-handed subjects were found. For clockwise work, as it is necessary e.g., for driving in screws, inward rotations (pronations) of the nondominant hand are at least as strong as outward rotations of the dominant hand. Differences of about 8% favour of pronations were found. Yet, for counter clockwise work involved e.g., in removing a tightened screw, inward rotations of the dominant hand yielded a much more stronger torque strength than outward rotations of the nondominant hand. Differences of more than 50% right-handed subjects were measured. Also, EA values of the 4 muscles monitored on the right arm differed significantly. Systematically operational and physiological differences due to the varied screwdriver grips, as results of investigations which were not the main objective of the study, corresponded well with the findings of prior studies.

scholarly journals Gap between real-world data and clinical research within hospitals in China: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038375
Author(s):  
Feifei Jin ◽  
Chen Yao ◽  
Xiaoyan Yan ◽  
Chongya Dong ◽  
Junkai Lai ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Clinical Research ◽  
Real World ◽  
Data Standards ◽  
Medical Record Data ◽  
Real World Data ◽  
World Data ◽  
Electronic Medical Record Data ◽  
Research Platform ◽  
Record Data

ObjectiveTo investigate the gap between real-world data and clinical research initiated by doctors in China, explore the potential reasons for this gap and collect different stakeholders’ suggestions.DesignThis qualitative study involved three types of hospital personnel based on three interview outlines. The data analysis was performed using the constructivist grounded theory analysis process.SettingSix tertiary hospitals (three general hospitals and three specialised hospitals) in Beijing, China, were included.ParticipantsIn total, 42 doctors from 12 departments, 5 information technology managers and 4 clinical managers were interviewed through stratified purposive sampling.ResultsElectronic medical record data cannot be directly downloaded into clinical research files, which is a major problem in China. The lack of data interoperability, unstructured electronic medical record data and concerns regarding data security create a gap between real-world data and research data. Updating hospital information systems, promoting data standards and establishing an independent clinical research platform may be feasible suggestions for solving the current problems.ConclusionsDetermining the causes of gaps and targeted solutions could contribute to the development of clinical research in China. This research suggests that updating the hospital information system, promoting data standards and establishing a clinical research platform could promote the use of real-world data in the future.

Supine Traction Versus Prone Bending Radiographs for Assessing the Curve Flexibility in Spinal Deformity

2021 ◽  
pp. 219256822097913
Author(s):  
Niek te Hennepe ◽  
Maarten Spruit ◽  
Martin H. Pouw ◽  
Marco Hinderks ◽  
Petra Heesterbeek
Keyword(s):  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Retrospective Cohort ◽  
De Novo ◽  
Traction Force ◽  
Degenerative Lumbar Scoliosis ◽  
Curve Correction ◽  
Subgroup Analyses ◽  
The Difference ◽  
Side Bending

Study Design: Retrospective cohort study. Objectives: No consensus exists among surgeons on which radiologic method to prefer for the assessment of curve flexibility in spinal deformity. The objective of this study was to evaluate the difference in curve correction on supine traction radiographs versus prone side bending radiographs. Methods: A retrospective analysis of idiopathic scoliosis (IS), degenerative idiopathic scoliosis (DIS) and de novo degenerative lumbar scoliosis (DNDLS) patients was performed on supine traction as well as prone bending films (when available). Age, weight, traction force, diagnosis and Cobb angles of the primary and secondary curves were extracted. Differences in curve correction (percentages) on traction versus prone bending radiographs were analyzed for the primary and secondary curve. Subgroup analyses were performed for the 3 different diagnoses. Results: In total, 170 patients were eligible for inclusion. 43 were diagnosed with IS, 58 with DIS and 69 with DNDLS. For the primary curve, greater curve correction was obtained with bending in the DNDLS group ( P < 0.001). In the DIS group, there was a trend toward more correction on bending ( P = 0.054). In de IS group no difference was found. For the secondary curve, bending showed more curve correction in the IS and DIS group ( P = 0.002 and P <0.001). No difference was found in the DNDLS group. Conclusion: Compared to traction radiographs, bending radiographs better serve the purpose of curve flexibility assessment of IS, DIS and DNDLS spinal deformity, despite the fact that patients are exposed to more radiation.

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