Unlocking of the Orthopedic Department in the Largest Tertiary Referral Hospital of Iran: Our Experience during Coronavirus Disease 2019 Pandemic

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the largest global healthcare crisis of the last century since its emergence in December 2019. As more of the condition’s chronicity became evident and the government policies changed, the unlocking of the orthopedic wards seemed necessary. In this study, we decided to share our experience regarding the unlocking of our orthopedic ward in the largest tertiary referral hospital of Iran and to explain its negative and positive consequences. Methods: This observational study was done in Imam Khomeini Hospital Complex, Tehran, Iran, from April to August 2020. We extracted the data regarding the number of elective/trauma operations, emergency patients, and morning report sessions attendance from our registry database. The data were analyzed and plotted using Microsoft Excel 365. Results: The mean weekly number of orthopedic operations decreased from 50 for elective and 30 for trauma operations in January 2020 to almost zero for both in late March and early April 2020 [the first coronavirus disease 2019 (COVID-19) peak]. Following the department unlocking, the mean weekly elective and trauma operations returned to 50 and 20 by mid-June, respectively. The mean weekly orthopedic emergency visits followed the same order with decrease from 50 to almost zero in late March and increase to 70 in mid-June. However, by the beginning of the second wave, it decreased to almost 38 in early July and further to 28 in late July by the end of the second wave. Conclusion: The unlocking of the orthopedic department in a tertiary referral hospital during the COVID-19 pandemic is possible, provided that there is a set of protocols for patient care in the ward, emergency room (ER), operating room (OR), and clinic during the pandemic.

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Staphylococcus aureus Carriage Status in Patients with Hidradenitis Suppurativa: An Observational Cohort Study in a Tertiary Referral Hospital in Athens, Greece

Dermatology ◽

10.1159/000504537 ◽

2019 ◽

Vol 236 (1) ◽

pp. 31-36 ◽

Cited By ~ 4

Author(s):

Alexander Katoulis ◽

Vasiliki Koumaki ◽

Ourania Efthymiou ◽

Dimitra Koumaki ◽

Evangelia Dimitroulia ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Cohort Study ◽

Hidradenitis Suppurativa ◽

Observational Cohort Study ◽

Referral Hospital ◽

Stage Iii ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Observational Cohort ◽

The Mean

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent, auto-inflammatory disease that affects the pilosebaceous unit in apocrine gland-bearing areas. Bacteria are thought to play a role in the development and progression of disease. In addition, antibiotics are frequently used as first-line management for HS. We sought to determine the carriage status of Staphylococcus aureus and its resistance to antibiotics among patients with HS in a tertiary referral hospital in Athens, Greece. Methods: In this observational cohort study, 68 consecutive patients attending the HS clinic of “Attikon” General University Hospital in Athens, Greece, during a 9-month period were enrolled. All patients had not received any antibiotic therapy for any reason during the previous 3 months before enrollment. Nasal and oropharyngeal samplingwere obtained, and specimens were tested for the presence of S. aureus.Antibiotic susceptibility testing was performed using the VITEK 2 system. Standard statistical tests, descriptive statistics tests, and χ2 and Pearson correlation tests were performed, using IBM SPSS Statistics 25.The level of significance was set at a pvalue <0.05. Results: Sixty-eight patients with HS were studied. There were 44 females (64.7%) and 24 males (35.3%). The mean age was 36.63 ± 13.0 (IQR = 21), and the mean age at onset of disease was 23.90 ± 11.53 (IQR = 14). The mean duration of disease was 12.74 ± 10.20 years (IQR = 15). Fifteen (22.1%) of the patients were Hurley stage I, 22 (32.4%) were Hurley stage II, and 31 (45.6%) were Hurley stage III. S. aureus carriage was detected in 17 patients (25%). Six of them (35.3%) had MRSA strains. There was an increased prevalence of S. aureus colonization (p = 0.058) and MRSA (p = 0.101) in Hurley stage III patients, but this result was not statistically significant. Conclusions: We found a 25% prevalence of S. aureus colonization (17/68 patients) and a 35.3% prevalence of MRSA (6/17) among our HS patients. There was an increased prevalence of S. aureusand MRSA positivity in HS patients with Hurley stage III. Further studies are needed to clarify the possible clinical significance of S. aureus carriage in the disease development and progression as well as in the treatment outcome.

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Maternal Health Beneficiary Scheme: Impact on Emergency Referred Cases at Tertiary Referral Hospital

International Journal of Scientific Research ◽

10.15373/22778179/feb2013/106 ◽

2012 ◽

Vol 2 (2) ◽

pp. 315-318

Author(s):

Dr. Arti J Patel ◽

◽

Dr. Hardik P Chauhan

Keyword(s):

Maternal Health ◽

Referral Hospital ◽

Tertiary Referral ◽

Tertiary Referral Hospital

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EFFICACY OF A NOVEL DEVICE TO DETECT, ALERT AND RESOLVE NEONATAL APNEA - PILOT STUDY

Innovative Journal of Medical and Health Science ◽

10.15520/ijmhs.v9i9.2644 ◽

2019 ◽

Vol 9 (9) ◽

pp. 608-613

Author(s):

Dr. Swapna Lingaldinna,Dr. Himabindu Singh,Mona Sharma*

Keyword(s):

Newborn Care ◽

Standard Of Care ◽

The Novel ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Care Community ◽

Novel Device ◽

Sick Newborn ◽

Central Apneas ◽

Neonatal Apnea

Objective: To measure the accuracy of a novel device in detecting Bradycardia andDesaturation (B&D) events and to determine its efficacy in resolving apneas innewborns with comparison to standard monitor (which only detects B&D eventsand alerts).Design: This was a prospective observational study.Setting: Sick Newborn Care Unit of a large tertiary referral hospital in Hyderabad,India.Methods: 31 newborns were provided with a novel device, which monitored oxygensaturation and pulse rate and alarmed when values dropped below a set thresholdwhich is referred as an event, henceforth. The novel device also provided footstimulation in response to above-mentioned events. When the monitor alarmed, anurse attended to the baby to confirm whether the baby was breathing and whetherthe event had been resolved by the device. If the event had not resolved, appropriateaction as per the standard-of-care was performed.Results: The novel device “ApneBootTM” positively detected B&D events 94.03% oftimes as compared to the standard reference monitor. 56 of 67 observed B&D eventswere visually confirmed to be apneas, indicating that 83.6% of B&D eventscoincided with apneas. Of the 56 apneic events, 50 were central apneas, of which 35were resolved by the novel device, making the device’s efficacy of apnea resolution70%.Conclusion: The results of the study indicate that this novel device “ApneBootTM”is very effective in detecting and alarming B&D events, which coincides with theapnea, and resolving it by providing foot stimulation.Keywords: Novel Device, Neonatal Apnea, Low Birth Weight, Body Temperature,Kangaroo Mother Care, Community Health,

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