Integrating Casework and Recreation in a Military Hospital

The Family ◽  
1946 ◽  
Vol 27 (8) ◽  
pp. 307-313
Author(s):  
Celia R. Moss
Keyword(s):  
Military Hospital

Device Closure of Ventricular Septal Defect with Amplatzer Muscular Occluder: A Case Report

1970 ◽  
Vol 25 (3) ◽  
pp. 161-163
Author(s):  
Nurun Nahar Fatema ◽  
Mamunur Rahman ◽  
Mujubul Haque
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Failure To Thrive ◽  
Military Hospital ◽  
Device Closure ◽  
Residual Shunt ◽  
Muscular Ventricular Septal Defect ◽  
Cardiac Centre ◽  
History Of ◽  
Observation Period

A four year old girl was diagnosed as a case of mid muscular Ventricular Septal Defect (VSD) since early infancy. She had history of failure to thrive (FTT) and recurrent chest infection or pneumonia. As her pulmonary artery pressure was almost normal she was planned for device closure on elective basis once device and technology would be available in cardiac centre of combined Military Hospital (CMH) Dhaka. Finally it was done on 21st August 2005 and patient was discharged after 72 hours observation period. Echocardiography on next morning showed complete occlusion of defect with no residual shunt. (J Bangladesh Coll Phys Surg 2007; 25 : 161-163)

Pylorus-Preserving Pancreaticoduodenectomy: Evaluation of 50 Cases

2017 ◽  
Vol 13 (1) ◽  
pp. 42-45
Author(s):  
SM Shakhwat Hossain ◽  
Ferdous Rahman
Keyword(s):  
Gastric Emptying ◽  
Mortality Rate ◽  
Wound Infection ◽  
Postoperative Mortality ◽  
Operation Time ◽  
Armed Forces ◽  
Military Hospital ◽  
Morbidity Rate ◽  
Proper Patient Selection ◽  
Periampullary Neoplasms

Introduction: Pancreaticoduodenectomy is the procedure of choice for periampullary neoplasms. It is considered as a major surgical procedure. It is associated with relatively higher postoperative mortality and morbidity rate, however, with development of technology, proper patient selection, meticulous operative technique, appropriate postoperative care, morbidity and mortality rate has decreased subsequently. Up to the 1970s, the operative mortality rate after pancreaticoduodenectomy approached 20% but it has been reduced to less than 5% in recent reports. This study is designed to evaluate the postoperative outcomes of pylorus-preserving pancreaticoduodenectomy procedure in our set up. Objective: To evaluate the outcome of the pylorus-preserving pancreaticoduodenectomy procedure with the intention to measure operation time and per-operative bleeding, observing postoperative anastomotic leakage and gastric emptying time. To find out postoperative wound infection and complications to detect the dumping syndrome. Materials and Methods: A prospective observational study was carried out in the Department of Hepatobiliary Surgery, Combined Military Hospital, Dhaka from July 2013 to January 2017. Fifty patients who underwent pylorus-preserving pancreaticodudenectomy procedure were included in this study. Results: Out of 50 postoperative patients, 12(24%) patients developed complications. Of these patients, 3(6%) developed wound infection, 2(4%) developed bile leakage and 2(4%) developed postoperative haemorrhage. Pancreatic fistula, vomiting, delayed gastric emptying and abdominal collection all were 1(2%) each. Postoperative mortality was 3(6%). Conclusion: The present study demonstrated the development of postoperative complications after pylorus-preserving pancreaticoduodenectomy is as similar as published in different studies. Better outcome can be achieved with meticulous pre-operative evaluation of risk factors and per-operative skill maneuvering. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 42-45

Diving Accident Evacuations by Helicopter and Immersion Pulmonary Edema

2020 ◽  
Vol 91 (10) ◽  
pp. 806-811
Author(s):  
Laëtitia Corgie ◽  
Nicolas Huiban ◽  
Jean-Michel Pontier ◽  
François-Xavier Brocq ◽  
Jean-François Boulard ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Decompression Sickness ◽  
Mediterranean Coast ◽  
Military Hospital ◽  
Emergency Unit ◽  
Diving Accident ◽  
Landing Zone ◽  
Diving Accidents ◽  
Non Invasive Ventilation ◽  
Life Threatening

BACKGROUND: Scuba diving activities expose divers to serious accidents, which can require early hospitalization. Helicopters are used for early evacuation. On the French Mediterranean coast, rescue is made offshore mainly by a French Navy Dauphin or at a landing zone by an emergency unit EC 135 helicopter.METHODS: We retrospectively analyzed diving accidents evacuated by helicopter on the French Mediterranean coast from 1 September 2014 to 31 August 2016. We gathered data at the Center for Hyperbaric Medicine and Diving Expertise (SMHEP) of the Sainte-Anne Military Hospital (Toulon, France), the 35 F squadron at Hyres (France) Naval Air Station, and the SAMU 83 emergency unit (Toulon, France).RESULTS: A total of 23 diving accidents were evacuated offshore by Dauphin helicopter and 23 at a landing zone on the coast by EC 135 helicopter without hoist. Immersion pulmonary edema (IPE) accounted for one-third of the total diving accidents evacuated by helicopter with identified causes. It was responsible for at least half of the deaths at the dive place. A quarter of the rescued IPE victims died because of early cardiac arrest.DISCUSSION: Helicopter evacuation is indicated when vital prognosis (IPE and pulmonary overpressure in particular) or neurological functional prognosis (decompression sickness) is of concern. IPE is the primary etiology in patients with serious dive injuries that are life-threatening and who will benefit from helicopter evacuation. A non-invasive ventilation device with inspiratory support and positive expiratory pressure must be used, in particular for IPE.Corgie L, Huiban N, Pontier J-M, Brocq F-X, Boulard J-F, Monteil M. Diving accident evacuations by helicopter and immersion pulmonary edema. Aerosp Med Hum Perform. 2020; 91(10):806811.

Percutaneous Pulmonary Valve Implantation in a Bangladeshi Center: A Case Series

2020 ◽  
Vol 28 (1) ◽  
pp. 1-6
Author(s):  
Fatema Nurun Nahar ◽  
Jufan Mansur Al ◽  
Shubert Stephan ◽  
Hossain Mir Mahmud
Keyword(s):  
Heart Disease ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Case Series ◽  
Military Hospital ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

INTRODUCTION Incidence of congenital heart disease is 25 per thousand live birth in Bangladesh which is much higher than other countries. Tetralogy of Fallot, the commonest cyanotic heart disease (5%) and some other complex diseases with right ventricular outflow tract abnormality demand surgical correction and revision in many occasions including percutaneous intervention. As a resource constraint country, it was a difficult task to introduce percutaneous pulmonary valve implantation (PPVI) with MelodyTM. However, it was started on 12th December 2012 in Combined Military Hospital Dhaka, Bangladesh and cases performed till October 2019 were included in this series. METHODS Retrospective analysis of six cases who had PPVI with MelodyTM in Combined Military Hospital, Bangladesh. Patient with dysfunctional conduit between right ventricle (RV) and pulmonary artery causing (a) Symptoms of exceptional dyspnoea of various grade (NYHA II,III, IV) (b) RVEVD >150 ml/m2 ±regurgitant fraction >40% (c) RVOT peak instantaneous gradient > 30 mm Hg. (d) RV dysfunction (RVEF<40%) were accepted for the procedure and outcome were analyzed. RESULTS Mean age was 9.56 ± 2.96 years, weight was 28.75 ± 8.61 kg, height was 137.5 ± 17.52 cm. Mean age at surgery was 4.25 ± 2.72 years. Female were 66.66%. Aortic homograft was used in 66.66% cases. Eighteen mm Ensemble was used in four (66.66%) cases and 20 mm and 22 mm in one each. Immediate result was excellent with no residual PS in two cases and negligible residual flow acceleration across pulmonary valve in four cases. No PR seen in all except one. One patient developed Bacterial endocarditis after 3 years and was treated. CONCLUSION Aim of PPVI is to prolong the life expectancy of conduits which were placed surgically from right ventricle to pulmonary artery. In our case series, we found that Melody valve is functioning well without any complications like infective endocarditis or stent fracture. KEYWORDS PPVI, MelodyTM, RVOT, Outcome

The development of health care in Siberia in the 18th — first half of the 19th century

2019 ◽  
Vol 5 (2) ◽  
pp. 121-132
Author(s):  
Ekaterina V. Shulyak
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Political Development ◽  
Medical Personnel ◽  
Military Hospital ◽  
Genetic Method ◽  
Industrial Enterprises ◽  
Medical Institutions ◽  
Russian State ◽  
Folk Remedies

Development of health care of Siberia in the 18<sup>th</sup>&nbsp;— first half of the 19<sup>th</sup> century was closely connected with economic and political development of the Russian state. Before the medical personnel emergence in Siberia its population received medication only in the form of folk remedies. Development of its territory, insanitary conditions of life of Siberians, constant contingent of exiled to the indigenous people, and severe climate contributed to the spread of such diseases as smallpox, syphilis, and others.<br> The first medical institutions of Siberia were military hospital and infirmaries. In the days of reign of the Empress Anna Ioannovna, the city medical care started developing, and thanks to an initiative of the industrial enterprises owners&nbsp;— medical care for miners. After the establishment of the Public Charity Orders in Siberia, hospitals under their jurisdiction began to function in Tobolsk, Irkutsk, and Tomsk. A worthy contribution to the development of local medical institutions was made by donators Tolstopyatov, Bednyagin, Chupalov, and others. However, deficiency of financing, hospitals, and the medical personnel couldn’t adequately satisfy the needs of Siberian inhabitants in medical care.<br> The purpose of the article is to analyse the condition of public health, causes of morbidity and mortality of the population, as well as the process of medical care development in Siberia the turn of the 18<sup>th</sup> century by means of a historical and genetic method.

scholarly journals The Challenging but Imperative Path to Monoclonal Antibody Use Against COVID-19 for a Small Overseas Military Hospital

2021 ◽  
Author(s):  
Spencer Shirk ◽  
Danielle Kerr ◽  
Crystal Saraceni ◽  
Garret Hand ◽  
Michael Terrenzi ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Hospital Admissions ◽  
Adverse Outcomes ◽  
Lessons Learned ◽  
Military Hospital ◽  
Clinical Criteria ◽  
Fda Approval ◽  
Life Saving ◽  
Set Up ◽  
Naval Hospital

ABSTRACT Upon the U.S. FDA approval in early November for a monoclonal antibody proven to potentially mitigate adverse outcomes from coronavirus disease 2019 (COVID-19) infections, our small overseas community hospital U.S. Naval Hospital Rota, Spain (USNH Rota) requested and received a limited number of doses. Concurrently, our host nation, which previously had reported the highest number of daily deaths from COVID-19, was deep within a second wave of infections, increasing hospital admissions, near intensive care unit capacity, and deaths. As USNH Rota was not normally equipped for the complex infusion center required to effectively deliver the monoclonal antibody, we coordinated a multi-directorate and multidisciplinary effort in order to set up an infusion room that could be dedicated to help with our fight against COVID. Identifying a physician team lead, with subject matter experts from nursing, pharmacy, facilities, and enlisted corpsmen, our team carefully ensured that all requisite steps were set up in advance in order to be able to identify the appropriate patients proactively and treat them safely with the infusion that has been clinically proven to decrease hospital admissions and mortality. Additional benefits included the establishment of an additional negative pressure room near our emergency room for both COVID-19 patients and, when needed, the monoclonal antibody infusion. In mid-January, a COVID-19-positive patient meeting the clinical criteria for monoclonal antibody infusion was safely administered this potentially life-saving medication, a first for small overseas hospitals. Here, we describe the preparation, challenges, obstacles, lessons learned, and successful outcomes toward effectively using the monoclonal antibody overseas.

scholarly journals AB0634 BUDGET IMPACT ANALYSIS OF BIOLOGICAL THERAPY COMPARED TO CONVENTIONAL SPONDYLOARTHRITIS TREATMENT, IN A FOURTH LEVEL HOSPITAL IN BOGOTA COLOMBIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1612.2-1613
Author(s):  
J. M. Bello-Gualtero ◽  
O. J. Calixto ◽  
G. Salguedo ◽  
Y. M. Chamorro-Melo ◽  
C. A. Camargo Rodríguez ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Annual Cost ◽  
Impact Analysis ◽  
Budget Impact ◽  
Biological Therapy ◽  
Biologic Therapy ◽  
Disease Diagnosis ◽  
Budget Impact Analysis ◽  
Military Hospital ◽  
Number Of Patients

Background:Spondyloarthritis refers to a family of diseases, of which ankylosing spondylitis and non-radiographic axial spondyloarthritis are responsible for axial impairment. Previously, the only treatment available were NSAIDs, which control activity and stop radiological progression, but at the expense of increased adverse effects, such as cardiovascular risk, dyspepsia and chronic renal failure. For the past 2 decades, biological therapy has been available, which means an increase in care costs.Objectives:The objective of this study is to perform a budget impact analysis of biologic therapy.Methods:To do a budget impact analysis from the perspective of the payer, comparing biological therapy with coventional therapy for the treatment of spondyloarthritis. Demographic characterization of the population attended at the Central Military Hospital. Time horizon from 2012 to 2018, taking the activity count according to the hospital’s billing and the prices of the activities of the state body SISMED. Exchange rates at the end of 2018.Results:The patients attended were 117, mostly men (63, 25%), average age 46, 4 years (SD 13), with disease diagnosis time of 9, 8 years (SD 9, 6). In the budget impact analysis, it is observed that 25% of patients were on DMARDs therapy, 22% with NSAIDs and 96% with biologic therapy. The average year/patient cost with NSAIDs alone would be EUR 381, with DMARDs only EUR 9,318 and, if only biological therapy was used, EUR 423. Within the total number of patients, the average annual cost, including the possibility of combining these drugs, amounted to EUR 5,403Conclusion:Including biological therapy in the care of patients with spondyloarthritis can increase up to 24 times the annual cost per patient. This increase is not only due to higher market value, it also relates to the need for more medical procedures and diagnostic follow-up tests.References:[1]Strömbeck, et al. Cost of Illness from the Public Payers’ Perspective in Patients with Ankylosing Spondylitis in Rheumatological Care. J Rheumatol 2010;37;2348-2355.Disclosure of Interests:None declared

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