scholarly journals Colorectal stenting in England: a cross-sectional study of practice

2020 ◽  
Vol 102 (6) ◽  
pp. 451-456
Author(s):  
J Lam ◽  
V Chauhan ◽  
I Lam ◽  
L Kannappa ◽  
Y Salama

Introduction UK and European guidelines recommend consideration of a self-expandable metallic stent (SEMS) as an alternative to emergency surgery in left-sided colonic obstruction. However, there is no clear consensus on stenting owing to concern for complications and long-term outcomes. Our study is the first to explore SEMS provision across England. Methods All colorectal surgery department leads in England were contacted in 2018 and invited to complete an objective multiple choice questionnaire pertaining to service provision of colorectal stenting (including referrals, time, location and specialty). Results Of 182 hospitals contacted, 79 responded (24 teaching hospitals, 55 district general hospitals). All hospitals considered stenting, with 92% performing stenting and the remainder referring. The majority (93%) performed fewer than four stenting procedures per month. Most (96%) stented during normal weekday hours, with only 25% stenting out of hours and 23% at weekends. Compared with district general hospitals, a higher proportion of teaching hospitals stented out of hours and at weekends. Stenting was performed in the radiology department (64%), the endoscopy department (44%) and operating theatres (15%), by surgeons (63%), radiologists (60%) and gastroenterologists (48%). A radiologist was present in 66% of cases. Of 14 hospitals that received referrals, 3 had a protocol, 3 returned patients the same day and 4 returned patients for management in the event of failure. Conclusions All responding hospitals in England consider the use of SEMS in colonic obstruction. Nevertheless, there is great variation in stenting practices, and challenges in terms of access and expertise. Centralisation and regional referral networks may help maximise availability and expertise but more work is needed to support this.

2021 ◽  
pp. sextrans-2020-054525
Author(s):  
Myrte Tielemans ◽  
Mireille van Westreenen ◽  
Corné Klaassen ◽  
Hannelore M Götz

ObjectivesEuropean guidelines advise the use of dual nucleic acid amplification tests (NAAT) in order to minimise the inappropriate diagnosis of Neisseria gonorrhoeae (Ng) in urogenital samples from low prevalence areas and in extragenital specimens. In this cross-sectional study, we investigated the effect of confirmatory testing and confirmation policy on the Ng-positivity in a population visiting the sexual health clinic in Rotterdam, the Netherlands.MethodsApart from urogenital testing, extragenital (oropharyngeal/anorectal) testing was performed for men who have sex with men (MSM) and according to sexual exposure for women and heterosexual men. Ng detection using NAAT was performed using BD Viper and for confirmatory testing BD MAX. Sexual transmitted infection consultation data were merged with diagnostic data from August 2015 through May 2016.ResultsIn women (n=4175), oral testing was performed in 84% and 22% were tested anally. In MSM (n=1828), these percentages were 97% and 96%, respectively. Heterosexual men (n=3089) were tested urogenitally. After confirmatory testing, oropharyngeal positivity rates decreased from 7.3% (95% CI 6.5 to 8.2) to 1.5% (95% CI 1.1 to 1.8) in women and from 13.9% (95% CI 12.3 to 15.5) to 5.4% (95% CI 4.3 to 6.4) in MSM. Anorectal positivity rates decreased from 2.6% (95% CI 1.6 to 3.7) to 1.8% (95% CI 0.9 to 2.6) in women and from 9.3% (95% CI 7.9 to 10.7) to 7.2% (95% CI 6.0 to 8.5) in MSM. Urogenital Ng-positivity rate ranged between 3.0% and 4.4% and after confirmation between 2.3% and 3.9%. When confirming oropharyngeal samples, Ng-positivity was 3.8% in women, 3.0% in heterosexual men and 12.5% in MSM. Additional confirmation of urogenital and anorectal samples led to 3.0% Ng positivity in women, 2.7% in heterosexual men and 11.4% in MSM.ConclusionsConfirmation of urogenital and anorectal samples reduced the Ng-positivity rates, especially for women. However, as there is no gold standard for the confirmation of Ng infection, the dilemma within public health settings is to choose between two evils: missing diagnoses or overtreatment. In view of the large decrease in oropharyngeal positivity, confirmation Ng-positivity in oropharyngeal samples remains essential to avoid unnecessary treatment.


2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19


2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Nana Xiong ◽  
Jing Wei ◽  
Kurt Fritzsche ◽  
Rainer Leonhart ◽  
Xia Hong ◽  
...  

BMJ ◽  
1999 ◽  
Vol 318 (7183) ◽  
pp. 566-567 ◽  
Author(s):  
C. A O'Donnell ◽  
A. McConnachie ◽  
K. Moffat ◽  
N. Drummond ◽  
P. Wilson ◽  
...  

Author(s):  
Risma Maharani ◽  
Syahrul Rauf ◽  
Rina Masadah

Objective: To determine the expression of Phosphatase Regenerating Liver-3 (PRL-3) and E-Cadherin in the epithelial ovarian cancer on various stages and differentiation grades. Method: This was a cross-sectional study design conducted at Obstetrics and Gynecology Department of several teaching hospitals, Faculty of Medicine Universitas Hasanuddin from January to June 2015. The expression of PRL-3 and E-cadherin was assessed immunohistochemically in 40 patients with epithelial ovarian cancer including 15 patients in early stage and 25 patients in advanced stage. We used the Fisher’s exact test with the significance of p0.05). The significant difference was found in the expression of E-cadherin whereas the high expression was shown at early stage than advanced stage (p0.05). This study also pointed out no correlation between the expression of PRL-3 and E-cadherin in epithelial ovarian cancer (p>0.05). Conclusion: PRL-3 overexpression does not decrease E-cadherin expression in epithelial ovarian cancer. Keywords: E-cadherin, epithelial ovarian cancer, PRL-3


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mohammed Abacha ◽  
Isah Mustapha Nma ◽  
Sadiq Abubakar Audu ◽  
Abubakar Umar ◽  
Mohammed Dahiru ◽  
...  

Background: Cleanliness and dirt are a dichotomy to categorize a particular environment especially hospital settings in which cleanliness pave a great linkage to patient satisfaction on quality of care and reduction of infection. Dirt creates negative thought on the quality of services being rendered to patients in the hospital environment. Objectives: To assess the perception of patients and their relatives on the level of cleanliness in radiology department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto and to determine which amongst the diagnostic rooms is the cleanest (Computed Tomography (CT) room, Routine X-rays room or contrast exams room (fluoroscopy)). Materials and Method: A descriptive cross-sectional study was conducted, 100 questionnaires were distributed to the respondents of which 66 in Routine xray room, 23 in CT suit and 11 in contrast examination room. Out of the 100 questionnaires nine were not returned and the remaining 91 were analysed. The questionnaire contains fifteen statements in total apart from the socio-demographic component. The count of responses was considered and for each type of response (SA, A, N, D, and SD) the percentage were calculated using statistical package for social sciences (SPSS) version 23.0. Results: Sixty percent of the respondents were patients while 40% were relatives of patients that were critically ill. The modal age range of the respondents was 25-34years, 58% were married, while 48.4% were civil servants. The result of our study shows that the respondents have adequate knowledge on cleanliness with a mean score of 4.3, they perceived radiology department as a clean environment for diagnosis and visitation but need further improvement. According to the findings, CT room was the cleanest (87.0%) followed by contrast examination room 64.0% and routine X-rays room was the least 47.0%. It also revealed that lack of manpower is the cause of inadequate sanitation. Conclusion: Radiology Department in Usmanu Danfodiyo University Teaching Hospital is clean and the CT suit is the cleanest.


2017 ◽  
Vol 11 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Farahnaz Joukar ◽  
Fariborz Mansour-Ghanaei ◽  
Mohammad Reza Naghipour ◽  
Tolou Hasandokht

Background: Health care workers (HCWs) represent high risk population for viral hepatitis infection. Objectives: This study sought to assess the knowledge of HCWs regarding hepatitis B (HBV) and hepatitis C (HCV) infection. Methods: In a multi-center cross sectional study, all HCWs from eight teaching hospitals were invited to participate in the study and to fill in a self-administered questionnaire. Results: A total of 1008 eligible HCWs have responded to the study. A high proportion of the study participants (55.4% and 52.9%) had unsatisfactory knowledge about HBV and HCV. Mean knowledge score toward HBV was significantly higher among more educated staff, p <0.001 and vaccinated personnel, P=0.02. Majority of responders answered correctly to transmission questions toward HBV and HCV (90% and 80%, respectively). There was statistically significant difference in only transmission domain score between various hospitals (p<0.05). The highest scores were related to surgical hospital. Conclusion: Although more than ninety percent of our participants were educated about HBV and HCV, knowledge about nature of disease, prevention, treatment and vaccine availability was unsatisfactory. Continuous training program toward viral infection is a matter of necessity.


2018 ◽  
Vol 8 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Waris Qidwai ◽  
Imdad Ali Khushk ◽  
Fizzah Farooq ◽  
Muhammad Yusuf Hafiz ◽  
Kashmira Nanji

Background: Worldwide, some one million people pass the sixty year old threshold every month (Ageing, WHO). Between 2010 and 2050, the number of older people in less developed countries is projected to increase. Methods: Cross-sectional study conducted in Outpatient clinics (OPD) of two hospitals in Karachi from April to May 2013. Elderly (> 60 years of age) visiting the clinics were consecutively recruited. 477 elderly were approached and a pretested, structured questionnaire was used to obtain information. Data was analyzed using SPSS version 19 and Pearson chi-square test was used to identify the factors related to choosing of "Old Age Homes". Results: A total of 400 participants were selected. Fifty-five percent of the elderly were in between 60 to 65 years of age and majority was males 54.8 percent. Elderly were aware of the presence of "Old Age Homes" in Pakistan, however only 7 percent choose to live in there. The main reason was found to be that the elderly did not want to go away from their families and loved ones. Conclusion: In conclusion, majority of the participants felt insecure to live in a home with strangers. However, "Old Age Homes" were preferred choice for those with chronic diseases or those living alone. Media should initiate public education programs to reduce social stigmas in seeking alternate long-term care services outside of the family.


Sign in / Sign up

Export Citation Format

Share Document