scholarly journals Les Amputations Majeures Des Membres A L’hopital General De Reference Nationale De N’djamena, Tchad

2016 ◽  
Vol 12 (12) ◽  
pp. 270
Author(s):  
Choua Ouchemi ◽  
Touré Abdoul ◽  
Mbainguinam Dionadji ◽  
Mahamat Albichari Ahmat Chaib ◽  
Ahmat Malgnan Okim ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Road Traffic ◽  
Length Of Hospital Stay ◽  
Major Amputation ◽  
Early Presentation ◽  
Average Hospital ◽  
Prosthetic Devices ◽  
Tertiary Teaching ◽  
Limb Injuries ◽  
Study Population

The aim of this study was to describ major limb amputations in a tertiary teaching hospital in N’Djaména, Chad. Patients and Method We realized a both retrospective and prospective study from 01/08/2013 to 31/07/2015 in the General Surgery ward and Orthopedics and Traumatology ward of the National Reference General Hospital of N'Djamena, Chad. Data were collected from patient records, operating theater records and equipment center. Studied parameters: age, sex, indication and level of amputation, length of hospital stay, prosthetic devices and mortality. Results The study population included 155 patients divided into 118 men (70.1%) and 37 women (29.9%), a sex ratio of 2.3. The average age was 43.1 years. Severe limb injuries by road traffic crushes were the first major amputation indication in 74 cases (47.6%), followed by complications of diabetic ulcers in 33 cases (21.4%) and arterial occlusive disease in 21 cases (13.6%). The pelvic and thoracic limbs were affected respectively in 130 cases (84.9%) and 25 cases (16.1%). The levels of amputations were: the leg in 78 cases (50.3%), the thigh in 50 cases (32.3%) and the forearm in 9 cases (5.8%). The average hospital stay was 16 days. We noted wound suppuration in 28.4% of cases and psychiatric events in 4.6%. Mortality was 15.6%. Only 35 patients (22.6%) received a prosthetic device after amputation. Conclusion: road traffic trauma with irreversible vascular damage is the leading indication of major limb amputations in our setting. Complications of diabetic foot are increasing indication. Mostly, traditional bonesetters practiced on the patients before reaching to hospital care. The amputees face great prosthetic difficulties. Major limb amputations are preventable by education, early presentation and management of common indications.

scholarly journals The transpalpebral approach “eyelid incision” for surgical management of intracranial tumors: A 10-years’ experience

2020 ◽  
Vol 11 ◽  
pp. 186
Author(s):  
Mohamed Elnokaly ◽  
Gordon Mao ◽  
Khaled A. Aziz
Keyword(s):  
Hospital Stay ◽  
Skull Base ◽  
Tumor Resection ◽  
Length Of Hospital Stay ◽  
Anterior Skull Base ◽  
Cosmetic Outcome ◽  
Intracranial Tumors ◽  
Average Hospital ◽  
Anatomical Dissection ◽  
Skull Base Lesions

Background: The minimally invasive approaches to the anterior skull base region through fronto-orbital craniotomy remain a highly accepted option that gains countenance and predilection over time. The transpalpebral “eyelid” incision is an under-utilized and more recent technique that offers a safe efficient corridor to manage a wide variety of lesions. Methods: We carried a retrospective study of 44 patients operated on by the fronto-orbital craniotomy through transpalpebral “eyelid” incision for intracranial tumors, in the time period from March 2007 to July 2016. The results from surgeries were analyzed; extent of tumor resection, length of hospital stay, cosmetic outcome, and complications. Results: Out of the 44 intracranial tumor cases, we had 16 male and 28 female patients with median age 54 years. We had 19 anterior skull base lesions, 8 middle skull base lesions and 8 parasellar lesions. We also operated on four frontal intraparenchymal lesions and four other various lesions. Total resection was achieved in 32 cases (72.7%), with excellent cosmetic outcome in 43 cases (97.7%). Average hospital stay was 6 days. No major complications recorded. Three cases (6.8%) had complications that varied between pseudomeningocele, wound infections, and facial pain. Follow-up average period was 23.6 months. Conclusion: The fronto-orbital approach through eyelid incision remains a reliable approach to the skull base. It provides natural anatomical dissection planes through the eyelid incision and a fronto-orbital craniotomy, creating a wide surgical corridor to manage specific lesions with consistent surgical and cosmetic outcome.

scholarly journals A comparative study between vacuum assisted wound closure vs conventional dressing in non-healing ulcers

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2214-2223
Author(s):  
Ajay Rex R ◽  
Balaji D ◽  
Lakshmana R ◽  
Gopi Ramu ◽  
Reka
Keyword(s):  
Hospital Stay ◽  
Wound Closure ◽  
Healing Process ◽  
Control Group ◽  
P Value ◽  
Baseline Characteristic ◽  
Age Group ◽  
Average Hospital ◽  
Study Results ◽  
Study Population

In a surgical ward, acute and continual wounds have an effect on a minimal of 1% of the population. Vacuum-assisted wound closure (VAC) is a technique of Negative pressure in the wound to improve the healing process. To study the advantage of a vacuum assisted closure over conventional dressing in the management of chronic non-healing diabetic ulcers. To study the difference in the rate of amputation, hospital stays in case and control groups. Group1-case group – vacuum associated closure therapy. Group 2-Control group -conventional dressings. Most of the patients in the study population was in the age group of 41 -60 years. 82% of the study population was within the age group of 41-60 years. The two groups are comparable with their baseline characteristic of age, and the P-value is less than 0.05. Wounds were more common in males than females. Out of the 44 patients, 26 were male, i.e. 57% of the study population were males. About 68% of wounds occurred in the foot. About 50% of the culture showed staphylococcus. Nearly 27% of study participants had no growth. The hospital stay is less in VAC dressing when compared to the conventional dressings, who have an average hospital stay of 28 days and the relation is statistically significant (p-value<0.05). Mean hospital stay in Vacuum is 21 compared to stay of 28 in conventional dressings group. Patients in Vacuum had 12 SSG,9 discharge and 1 amputation. There is no statistically significant association in terms of grade of ulcer between the two groups(P =0.23). There is a statistically significant association between VAC and conventional in terms of the results of the Doppler study. (P<0.01). From the study results, it is obvious that VAC dressing has many advantages in terms of Low no of amputation, Earlier discharge, Minimal infection, Lesser complications, Healing in a better way.

scholarly journals Profile of thoracic injury at College of Medical Sciences Teaching Hospital

2014 ◽  
Vol 9 (1) ◽  
pp. 30-39
Author(s):  
D Chapagain ◽  
D Jayapal Reddy ◽  
S Shah ◽  
KG Shrestha
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Flail Chest ◽  
Length Of Hospital Stay ◽  
Thoracic Injury ◽  
Road Traffic Accidents ◽  
Medical Sciences ◽  
Night Time

Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73%) males and 27 (27%) females. The majority of patients (83%) were injured during the evening and night time. The majority of patients 92(92%) sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05) and mortality (P > 0.05).Road traffic accident was the most common cause of injuries affecting 68(68%) of patients followed by fall injury of 19(19%). Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45%) of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04%) had undergone thoracotomy. There were 09(09%) patients of flail chest and treated conservatively. Fourty six patients (46%) were admitted in the ICU. Eleven (11%) patients were treated with ventilator support. Seventeen (17%) patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic injury. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 30-39 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9671

Hyperglycemia treatment is associated with longer length of hospital stay in colorectal cancer surgery patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6133-6133
Author(s):  
J. M. Geraci ◽  
N. Busaidy ◽  
J. Wang ◽  
T. P. Lam ◽  
J. M. Skibber ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Logistic Regression ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Length Of Stay ◽  
Major Surgery ◽  
Cancer Center ◽  
Diabetes Diagnosis ◽  
Colorectal Cancer Surgery ◽  
Study Population

6133 Background: Diabetes mellitus (DM) is associated with longer hospital stays in some medical and surgical inpatient populations. Aggressive control of blood sugar may prevent complications and decrease hospital length of stay (LOS). Methods: We conducted a retrospective study of 519 patients at UT MD Anderson Cancer Center (UTMDACC) who had major surgery for colon or rectal cancer in calendar years 2000–2003. Patient data extracted from the UTMDACC Institutional Database included demographics, admission and discharge dates and diagnoses, surgical procedures, and diabetes medication use during the hospitalization. Known DM was defined as present if the patient had a diabetes diagnosis prior to or at admission; hyperglycemia treatment was defined as receipt of a medication for diabetes (insulin or oral medication) during the index hospitalization. Chi-square and t tests were performed to assess associations between patient characteristics and long LOS, and multiple logistic regression was used to identify independent predictors of hospital LOS at or greater than the 75th percentile for the study population (long LOS). Results: The mean age of the study population was 60.4 years (median 61, range 18–91). Known DM was present in 10.4% of cases; the same percentage received hyperglycemia treatment during their hospital stay, although not all were known diabetics. Mean LOS was 8.9 days; median 7 days and the 75th percentile 9 days. 50% of patients treated for hyperglycemia had long LOS (27 of 54 cases, p< 0.0005). In a logistic regression model controlling for patient demographic and clinical characteristics and the occurrence of post-operative complications, hyperglycemia treatment was an independent predictor of long LOS (odds ratio 4.1, 95% confidence interval 1.6, 10.3). Conclusions: Hyperglycemia treatment is associated with longer LOS in patients undergoing surgery for colon or rectal cancer at UTMDACC. Further studies should determine whether patients at risk for long LOS can be identified prospectively such that they might benefit from an intervention to reduce their LOS. [Table: see text]

scholarly journals Laparoscopic nephrectomy: Moroccan experience of 68 cases

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abdoulazizi Bilgo ◽  
Amine Saouli ◽  
Tarik Karmouni ◽  
Khalid El Khader ◽  
Abdellatif Koutani ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Upper Urinary Tract ◽  
Laparoscopic Nephrectomy ◽  
Reliable Technique ◽  
Average Hospital ◽  
Estimated Blood Loss

Abstract Background The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department. Methods We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software. Results A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients. Conclusion Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.

Quality of time spent without symptoms of disease or toxicity of treatment for transmetatarsal amputation versus digital amputation in diabetic patients with digital gangrene

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 142-150 ◽  
Author(s):  
Mohamed Elsherif ◽  
Wael Tawfick ◽  
Patrick Canning ◽  
Niamh Hynes ◽  
Sherif Sultan
Keyword(s):  
Hospital Stay ◽  
Statistical Significance ◽  
Length Of Hospital Stay ◽  
Major Amputation ◽  
Diabetic Patients ◽  
Tertiary Referral Center ◽  
Hospital Stays ◽  
Transmetatarsal Amputation ◽  
Digital Amputation

Aim We aim to compare the outcome of diabetic patients with gangrenous toes who were managed initially either by digital amputation or by transmetatarsal amputation. The null hypothesis is that transmetatarsal amputation had less theatre trips and better healing. Materials and Methods A parallel observational comparative study of all diabetic patients who underwent either digital or transmetatarsal amputation in a tertiary referral center from 2002 through 2015. Comorbid conditions, subsequent amputations, hospital stay, and readmission were noted. Results A total of 223 patients underwent minor amputation during the study period, of which 147 patients were diabetic and 76 patients were non-diabetic. Seventy-seven patients had digital amputation and 70 transmetatarsal amputation in diabetic patients. Demographics were similar in both groups. The median time to major amputation was (400 ± IQR 1205 days) in the digital amputation group, compared to 690 ± IQR 891 days in the transmetatarsal amputation group ( P = 0.974). 29.9% of digital amputations and 15.7% of transmetatarsal amputations in diabetic patients, required minor amputations or revision procedures ( P = 0.04). Median length of hospital stay was (20 days, IQR 27) in the digital group and (17 days, IQR17) in the transmetatarsal amputation group ( P = 0.17). Need for re-admission was 48.1% in digital patients compared to 50% in transmetatarsal amputation patients ( P = 0.81). Quality of time spent without symptoms of disease or toxicity of treatment (Q-TWiST) was (315 days, IQR 45) in digital group and (346 days, IQR 48) in the transmetatarsal amputation patients ( P = 0.099). Conclusion Despite the lack of statistical significance, transmetatarsal amputation offered better outcome in the diabetic patients, with less re-intervention rate, shorter hospital stays, less theatre trips, and longer time without toxicity (TWiST).

scholarly journals Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

2013 ◽  
Vol 2 (1) ◽  
pp. 179 ◽  
Author(s):  
Marco Giammanco ◽  
Silvana Bavetta ◽  
Rossella Greco ◽  
Danila Di Majo ◽  
Maurizio La Guardia
Keyword(s):  
Hospital Stay ◽  
Liver Diseases ◽  
Linear Regression Analysis ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Mean Value ◽  
Study Population ◽  
Student’S T ◽  
Liver Transplant Waiting List ◽  
End Stage

It is important to prevent protein/calorie malnutrition in children with end stage liver diseases prior to transplantation. This study involved 34 patients between the ages of 10 and 156 months (mean value 25.69 months ± 32.2) (13 females and 21 males) on the liver transplant waiting list. Data collected as of three months before transplant and up to ten months after the procedure concerned gender, age, weight, height, Pediatric End Stage Liver Disease Score, baseline pathology, type of nutrition, type of transplant, immunosuppression, pulse steroid therapy, length of stay, and post transplant complications. Linear regression analysis showed that the length of hospital stay was 24.5 days more for females than for males, but also that intensive nutrition therapy shortens this stay for both female patients (P = 0.085) and younger patients (P = 0.023). The study population was divided into two groups according to the different nutritional therapies adopted. The Student’s t-test and Mann-Whitney test evidenced that the group receiving intensive nutrition therapy grew taller compared with the group following an oral diet (<em>mean</em> -1.37 and Prob<em> </em>= 0.043); that females grew taller compared to males (<em>mean</em> -1.65 +/- 0.56); and that there was an increase in height among the children in the group receiving intensive nutrition therapy despite the presence (-1.37 +/- 0.56) or absence (-14.8 +/- 5.44 and Prob = 0.035) of complications, and despite the administration (-1.03 +/- 0.33) or non administration (-1.48 +/- 0.55 and Prob = 0.019) of steroids. Intensive nutrition therapy enhances the velocity of growth in height and shortens the length of hospital stay, thus optimizing the final prognosis of the baseline pathology.

scholarly journals Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Isaac O. Akerele ◽  
Adaeze C. Oreh ◽  
Mohammed B. Kawu ◽  
Abubakar Ahmadu ◽  
Josephine N. Okechukwu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Alcohol Intake ◽  
Health Workers ◽  
Tertiary Education ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Symptom Presentation ◽  
Early Presentation ◽  
Daily Alcohol Intake ◽  
Treatment Centre

Background: Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes.Aim: This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja.Setting: The study was conducted in Abuja, the Federal Capital Territory, Nigeria.Methods: This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation.Results: Patients’ median age was 39.3 years (interquartile range [IQR]: 26–52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5–19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%.Conclusion: Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.

scholarly journals Phase I Clinical Research of Jejunal Interposition in Adenocarcinoma of the Esophagogastric Junction II/III Proximal Gastrectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kai Tao ◽  
Jian-Hong Dong
Keyword(s):  
Hospital Stay ◽  
Esophagogastric Junction ◽  
Average Length ◽  
Proximal Gastrectomy ◽  
Length Of Hospital Stay ◽  
Remnant Stomach ◽  
Jejunal Interposition ◽  
Average Hospital ◽  
Inflammatory Granuloma ◽  
Reconstruction Time

Objective.To investigate the feasibility and specific methods of single-tract jejunal interposition between esophagus and remnant stomach (ers-STJI) in adenocarcinoma of the esophagogastric junction (AEG) II/III proximal gastrectomy.Methods.15 AEG II/III gastric cancer (GC) patients in phase T1-3N0M0 with tumor size <5 cm were selected and they underwent proximal gastrectomy with ers-STJI from August 2013 to August 2014.Results.All of the 15 patients successfully completed GC R0 proximal gastrectomy with ers-STJI and no operative death or no significant complication occurred; one patient had anastomotic inflammatory granuloma. The digestive tract reconstruction time was 29.5 ± 5.7 min; the intraoperative blood loss was 96.7 ± 20.2 mL, and the number of lymph node dissections was 21.3 ± 3.0; the postoperative flatus time was 48.2 ± 11.9 h; the average length of hospital stay was 10.7 ± 2.3 d, and the average hospital stay cost was 60 ± 3 thousands. All of the patients were followed up for 12 months, and their postoperative single food intake, body weight, hemoglobin, and albumin were all recovered to the preoperative levels.Conclusions.The applications of ers-STJI in proximal gastrectomy were safe and feasible, and the length of jejunal interposition could be 15–25 cm.

scholarly journals (P2-100) Prognosis of Unknown and Unattended Patients in the Neurosurgical Department

2011 ◽  
Vol 26 (S1) ◽  
pp. s169-s169
Author(s):  
A.S. Mathew
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Road Traffic ◽  
Road Traffic Crash ◽  
Neurosurgical Department ◽  
Unique Problem ◽  
Average Hospital ◽  
Number Of Patients ◽  
The Mean ◽  
Gcs Score

BackgroundIn 2009 in Delhi, 7,516 road traffic crash victims were admitted to hospitals as unknown or unattended.ObjectiveThe aim of this study was to assess the morbidity and mortality of unknown or unattended patients and problems they faced relative to the provision of nursing care.MethodsThis is a retrospective analysis from February 2010 to August 2010 wherein all unknown or unattended patients with head injuries (Glasgow Coma Scale (GCS) score = 1–15) admitted to the neurosurgery department were included. The duration of hospital stay, admission GCS, and outcome were assessed and an attempt also was made to analyze the problems faced by nursing personnel.ObservationsThe total number of patients enrolled was 38. Of these, 22 were unknown, and 16 were unattended. The average hospital stay of unknown and unattended victims was 35 (1–151), and 21 (7–120) days, respectively. The mean GCS score of unknown patients upon admission was 9 (3–15), and during discharge, 8 (3–15). The mean GCS scores of unattended patients during admission and discharge was 12 (13–15) and 14 (3–15). respectively. Of the 22 unknown patients, 24% were identified during their stay, 33% were transferred to rehabilitation homes, and 43% died without being identified. Of the 16 unattended patients, 25% went home, 63% were transferred to rehabilitation homes, and 12% expired. The most common problems faced during nursing care were contractures (8%) and pressure sores (11%), due mainly to their long hospital stays.ConclusionsPatients remaining unknown/unattended is a unique problem as far as developing countries are concerned. Managing these patients is difficult, as they occupy hospital beds for a longer duration, and require more nursing care, and have higher mortality and morbidity. It remains surprising that in spite of advancements in the field of mass communication, almost 76% of the unknown patients remain unidentified.

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