Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Frequency of Depression in Burn Patients at a Tertiary Care Hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 3-7
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Care Hospital ◽  
Burn Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Residential Status ◽  
Duration Of Illness ◽  
Chi Square Test ◽  
Medical University

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.

scholarly journals Trends of caesarean section: an analytical overview of indications

2019 ◽  
Vol 9 (1) ◽  
pp. 288
Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Graphical Representation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
Evidenced Based

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

scholarly journals Instrumental delivery: a comparative study in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1079
Author(s):  
Bhanu B. T. ◽  
Anitha G. S.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Care Hospital ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Maternal And Neonatal Outcomes ◽  
Vertex Presentation

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions.

scholarly journals Incidence and Pattern of Adverse Events in Pentavalent Vaccine Recipients in Pune, India

2017 ◽  
Vol 16 (1) ◽  
pp. 8-13
Author(s):  
Barun Bhai Patel ◽  
Kapil Harish Pandya ◽  
Bikal Shrestha ◽  
Raj Kumar ◽  
Atul Kotwal
Keyword(s):  
Institutional Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Safety Monitoring ◽  
Exposed Group ◽  
Care Hospital ◽  
Chi Square ◽  
Pentavalent Vaccine ◽  
Chi Square Test ◽  
Hep B

Introduction: Safety monitoring of vaccines used in routine programmes on immunization is important in all settings. There is a lot of debate in the country about the relevance of the pentavalent vaccine in general and the Hib component in particular, in view of reports of deaths in children following immunization. This study was conducted to evaluate the incidence and profile of AEFI in children receiving pentavalent vaccine. Methods: A cohort study was conducted between May to Oct 2012, in a tertiary care hospital, Pune. Exposed groups received pentavalent vaccine, while the control received DPT or DPT + Hep B. Both the groups were followed up telephonically after 24 hr, 48 hr, 72 hr and 7 days following vaccination. 175 children in both groups were studied. Convenient sampling was done recruiting consecutive vaccinees till the sample size was achieved. Frequency, percentage, mean difference (T test) and chi square test was used to find associationResults: 100 % children were institutional delivery. In controls, 80 % received DPT and Hep B, rest received only DPT. Fever was present in 76.2 % among exposed and 26.7% among non-exposed. Presence of fever after 1 day following immunization was significantly associated with exposed group (P=0.003). In 19 % exposed group fever continued for 2nd day. Other side effects included swelling (4.8 %) and reduced appetite (4.8 %) among exposed.Conclusion: Pentavalent vaccine does not increase the probability of deaths among the vaccines vis-a-vis nor receivers. The profile of AEFI among both the groups, except fever, is similar as far as frequency and severity is concerned. 

Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

2020 ◽  
pp. 1-8
Author(s):  
Saima Kanwal ◽  
Sara Sajid ◽  
Noreen Nasir ◽  
Syed Ahsan ◽  
Aysha Almas
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Heat Stroke ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Related Factors ◽  
Hospital Perspective ◽  
The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...  

scholarly journals Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad Hanif Khan ◽  
Raheela Hanif ◽  
Rumina Tabassum ◽  
Waris Qidwai ◽  
Kashmira Nanji
Keyword(s):  
Nonverbal Communication ◽  
Tertiary Care ◽  
Eye Contact ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Nonverbal Behaviors ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

scholarly journals A Comparison of Radiation Exposure During Endoscopic Retrograde Cholangiopancreatography (ERCP) by Different Fluoroscope Techniques

2020 ◽  
Author(s):  
Saleh A. Alghsoon ◽  
Khaled S. Shaban ◽  
Altaf H. Khan ◽  
Fares M. Almeshal ◽  
Sulaimon O. Balogun ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Gastrointestinal Endoscopy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Endoscopic Retrograde ◽  
Dose Area Product ◽  
The Mean ◽  
Level I ◽  
American Society

ABSTRACT Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is a relatively new endoscopic procedure combined with fluoroscopy that is performed for multiple diagnostic and therapeutic indications. It carries a known risk of radiation exposure to patients and staff. We aimed to examine radiation administration techniques and to measure the radiation dose delivered by these techniques. Methods This was a retrospective analysis of 437 ERCP procedures performed at a tertiary care hospital between April 2015 and April 2017. Results A total of 437 ERCP procedural charts were reviewed: fluoroscopy administration was endoscopist controlled (EC, n = 187, 42.79%) or technician controlled (TC, n = 250, 57.21%). The mean (and SD) fluoroscopy time (FT) was 2.107 ± 2.0 minutes. The mean (and SD) dose–area product (DAP) was 15,227.371 ± 16,784.738 Gy·cm2. The degree of ERCP difficulty was evaluated as recommended by the American Society for Gastrointestinal Endoscopy, and graded 1–4. Level I TC procedures had a mean FT and DAP of 1.600 minutes and 12,644.72 Gy·cm2, respectively. The FT and DAP values for level I EC procedures were 1.514 minutes and 12,966.71 Gy·cm2, respectively, as compared with level IV TC procedures (mean FT, 2.539 minutes; mean DAP, 19,469.94 Gy·cm2) and level IV EC procedures (mean FT, 4.890 minutes; mean DAP, 37,921.00 Gy·cm2). Conclusion DAP and FT are increased significantly in EC ERCP in American Society for Gastrointestinal Endoscopy 4 procedures. Comparison of the different degrees of difficulty indicated that there is a linear correlation between the degree of difficulty and both FT and DAP.

scholarly journals A follow-up study on fertility and menstrual pattern in infertile patients after laparoscopy in a tertiary care hospital in Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 125-129
Author(s):  
Naushaba Tarannum Mahtab ◽  
Nusrat Mahmud ◽  
Tanzeem Sabina Chowdhury ◽  
TA Chowdhury ◽  
Tanjima Begum
Keyword(s):  
Diagnostic Laparoscopy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Chi Square ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Chi Square Test ◽  
Menstruating Women ◽  
Lost To Follow Up

Background: Routine use of diagnostic laparoscopy for the evaluation of all cases of female infertility is under debate. Until now, laparoscopy has been widely used as a diagnostic and therapeutic means of treating infertility. This study investigates the fertility outcome for women 2 to 3 years after laparoscopic management. It assessed the benefit and effectiveness of both diagnostic and laparoscopic ovarian drilling regarding reproductive outcome and menstrual regularity. Methods: From May 2013 to November 2014, a total of 303 infertile women undergoing laparoscopy at BIRDEM Hospital, were asked to participate in the study. Sixty subjects were lost to follow up making the study sample size 243. Results: Mean age at the time of laparoscopy was 29.86 ± 4.6 (range 21 - 43) years, 61.7% of women (150 cases) were nulliparous, 38.3% (93 cases) had one child, abortion or ectopic pregnancy. From the time of index surgery to follow-up, 40.3% (98) of women who had tried to conceive had home pregnancy test positive and 25.5% (62) had a live birth following their surgery. Among these 62 subjects, 33 underwent Laparoscopic Ovarian Drilling (LOD) and other 29 had diagnostic laparoscopy along with or without other laparoscopic manipulations. A Chi-square test has revealed that there was significant increase in regularization of menstrual cycle among irregularly menstruating women after laparoscopy indicating regular ovulatory cycles. Conclusion: Laparoscopic procedures can lead to positive results while treating infertility as well as menstrual disturbances, thus establishing a defined position in current fertility practice. Birdem Med J 2020; 10(2): 125-129

scholarly journals Do We Require to Use Antibacterial Prophylaxis in Hand Trauma? Results of a Randomised Prospective Case-Control Trial

2021 ◽  
Vol 75 (2) ◽  
pp. 121-125
Author(s):  
Dzintars Ozols ◽  
Vadims Nefjodovs ◽  
Jānis Zariņš ◽  
Aigars Pētersons
Keyword(s):  
Wound Infection ◽  
Tertiary Care ◽  
Case Control ◽  
Antibacterial Prophylaxis ◽  
Care Hospital ◽  
Hand Trauma ◽  
Chi Square ◽  
Wound Site ◽  
Chi Square Test

Abstract The proper management of traumatic hand injury is crucial for wound infection prevention. Antibiotics in various forms and conditions are prescribed to avoid this complication, but the effectiveness is unclear. Most forms used are intravenous solutions, topical ointments, and oral tablets. This prospective case-control trial was conducted in a tertiary care hospital. Healthy adult patients with simple, non-bite, surgically treated hand wounds were included. During the surgery, a proper debridement and irrigation with simple saline was consistently performed. Patients were randomly assigned to one of the eight groups. Seven groups received different antibacterial prophylaxis and one received none. At the two-week postoperative follow-up the wound site was assessed and any local infection was documented. Patients were excluded from the trial if they did not comply to treatment recommendations (i.e. commence antibiotics, applied solutions or ointments on the wound). Overall, 240 patients (80.2% male, mean age 38.7 years), 30 in each study group were included. 226 patients returned for the follow-up, and seven patients were excluded from the trial. Wound infection was observed in five patients from different groups. Thus, the rate of wound infection was 2.28%. A Chi-square test revealed no difference in infection incidence between the groups (p > 0.05). In this study, antibiotics did not affect incidence of wound infection after hand trauma. Attention should be paid to proper debridement and irrigation of the wound as these interventions reduce the risk for wound infection and avoid unnecessary usage of antibiotics.

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