Evaluation of the Role of Water-Soluble Contrast Administration in Management of Patients with Adhesive Intestinal Obstruction

2021 ◽  
Author(s):  
Hamdy Shaban ◽  
Sameh T Abu-Elela ◽  
mohammed faisal ◽  
Ahmed Abo Bakr
Keyword(s):  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Nasogastric Tube ◽  
Length Of Hospital Stay ◽  
Water Soluble ◽  
Time Interval ◽  
Traditional Group ◽  
Number Of Patients ◽  
Water Soluble Contrast ◽  
Adhesive Intestinal Obstruction

Abstract Background: Adhesive intestinal obstruction is a common post-operative cause of hospitalization. This study aims to evaluate the oral administration of water-soluble contrast on the outcome of patients with adhesive intestinal obstruction in regard to recovery, operative rate and hospital stay.Methods: In this prospective randomized trial, patients were randomized into two groups: gastrografin (GG) and traditional treatment group (TT). in the gastrografin group (GG)after stomach was emptied through a nasogastric tube, the water soluble contrast follow-through was performed within 24 h of hospital admission using 100 mL of 76% gastrografin injected through the nasogastric tube and erect ,supine abdominal x-ray was taken(at 8,12,24h)later. The endpoints of the study were to evaluate the time interval between admission and relief of obstruction, the length of hospital stay and the need for surgery. Results: Fifty-four patients with a mean age 45 ±2.4years, 25(46.3%) males and 29(53.7%) females. The number of patients who were successfully conservatively treated in the gastrografin group was 22(81.5%), which was significantly higher than 13(48.1%) in the traditional group. among these patients, mean hospital stay in gastrograffin group was 31.3±4.5 hours, which was significant shorter than 48.9±8.2hours in traditional group(p=0.004). Conclusions: Administration of an oral water-soluble contrast agent in postoperative adhesive bowel obstruction helps in the earlier resolution of the obstruction, decreases the length of hospital stay and the need for surgery.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals A retrospective study on the effect of Vitamin C in the management of dengue fever in three different states of India

2019 ◽  
Vol 10 (4) ◽  
pp. 2670-2673 ◽  
Author(s):  
Kothai Ramalingam ◽  
Christina S Varghese ◽  
Chinchu Elias ◽  
Gigi M Mathew ◽  
Arul Balasubramanian
Keyword(s):  
Retrospective Study ◽  
Vitamin C ◽  
Hospital Stay ◽  
Dengue Fever ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Madhya Pradesh ◽  
Percentage Increase ◽  
Number Of Patients

The objective of the study was to analyze the effect of vitamin C in the management of Dengue fever in the tertiary care hospitals of selected three states of India (Tamil Nadu, Kerala, and Madhya Pradesh). This retrospective study was carried out for a period of 6 months from November 2017 to April 2018, in which 200 patients were selected by considering the inclusion and exclusion criteria. It included 100 patients who were administered with Vitamin C and another 100 patients who were not given Vitamin C. All data were entered into the prepared PROFORMA. Mainly the increase in platelet counts and the duration of the hospital stay for both categories of patients were studied. Majority of dengue cases were in Tamil Nadu, followed by Kerala and then Madhya Pradesh depending upon the seasonal variations. Occurrence in male patients (58.5%) were more than female patients (41.5%). The most commonly affected age group ranges from 0-15 years (35.5%). Among the various types of dengue fever, a large number of patients had common dengue fever (87.5%). The 100 patients who were treated with vitamin C were mostly administered by oral routes. It was seen that the patients who were administered with Vitamin C had a greater percentage increase in their platelet count and a shorter duration of hospital stay. Study indicates that there exists an association between Vitamin C intake and length of hospital stay.

The Economic Impact of Early Enteral Feeding in Gastrointestinal Surgery: A Prospective Survey of 51 Consecutive Patients

2005 ◽  
Vol 71 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Paul A. Lucha ◽  
Ralph Butler ◽  
Jessica Plichta ◽  
Michael Francis
Keyword(s):  
Hospital Stay ◽  
Nasogastric Tube ◽  
Postoperative Morbidity ◽  
Hospital Costs ◽  
Gastrointestinal Surgery ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Nursing Workload ◽  
Feeding Group ◽  
Postoperative Feeding

Early postoperative oral feeding has been demonstrated to be safe and not increase postoperative morbidity. There are conflicting reports about its effect on postoperative length of stay. Some patients will fail attempts at early postoperative feeding and may be relegated to a longer postoperative course. Few studies to date have attempted to identify cost savings associated with early oral support, and those identified address nasoenteric support only. Fifty-one consecutive patients were randomized into either a traditional postoperative feeding group or an early postoperative feeding group after their gastrointestinal surgery. Length of hospital stay, hospital costs (excluding operating room costs), morbidity, and time to tolerance of a diet were compared. There was a tendency toward increased nasogastric tube use in the early feeding arm, but the morbidity rates were similar. Length of hospital stay and costs were similar in both arms. Early postoperative enteral support does not reduce hospital stay, nursing workload, or costs. It may come at a cost of higher nasogastric tube use, however, without an increase in postoperative morbidity.

Palliative nasogastric tube placement for patients with advanced esophageal cancer with nearly total obstruction: Consider the feasibility and acceptability considerations

2019 ◽  
Author(s):  
CHIH WEI YANG ◽  
I-Hsuan Huang ◽  
Wei-Kuo Chang
Keyword(s):  
Esophageal Cancer ◽  
Hospital Stay ◽  
Survival Time ◽  
Nasogastric Tube ◽  
Tertiary Care ◽  
Caloric Intake ◽  
Length Of Hospital Stay ◽  
Tube Placement ◽  
Advanced Esophageal Cancer ◽  
Observation Study

Abstract Background: Nasogastric tube (NGT) feeding was reasonable choice for patients with advanced esophageal cancer with a short-life expectancy. Bedside blind NGT placement beyond the nearly total obstruction lesion usually fail and is challenging. Each individual patient might have different cancer stage, tumor location and size, natural course of the disease, technique feasibility, and tolerability of NGT placement. This study evaluates the benefits and limitations of palliative NGT placements for advanced esophageal cancer during their last months of life. Method: Retrospective observation study was performed. We implemented three techniques of palliative NGT placement, compared the advantages and limitations, and evaluated the clinical outcomes in patients advanced esophageal cancer with nearly total obstruction. The present study was performed in at a tertiary care teaching hospital, Taiwan. Patients (n =32) received palliative care, failure of bedside blind NGT placement, and/or NPO (Nil per os) treatment were included. Patients were divided into different palliative NGT placements: guidewire method (n = 6), the drag method (n = 6), push method (n = 10). Results: Success rate of palliative NGT placement was observed in the guidewire method (75%), drag method, (100%), and push method (93%). Compared the palliative NGT groups to NPO group, NGT groups had significantly increased in enteral caloric intake (p < 0.05), serum albumin level (p < 0.01), decreased the length of hospital stay (p = 0.01), but increased the survival time (p = 0.01). Conclusion: Patients who tolerated the NGT placement will able to receive desired caloric intake, decrease length of hospital stay, and increase the overall survival time.

POST OPERATIVE LESS COMPLICATIONS IN ROBOTIC DONOR NEPHRECTOMY WITH MINIMAL HOSPITAL STAY

2021 ◽  
pp. 74-76
Author(s):  
Vinay Mahendra ◽  
Palash Saha ◽  
J.B. Roy ◽  
Tridibesh Mandal ◽  
Debarshi Jana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Donor Nephrectomy ◽  
Postoperative Blood Loss ◽  
Minimally Invasive Surgical ◽  
Number Of Patients ◽  
Widespread Acceptance ◽  
Pain Duration ◽  
Group 2

Introduction: Minimally invasive surgical procedures have gained widespread acceptance in the eld of living kidney donation over the last decade. Ratner et al. were the rst to describe laparoscopic donor nephrectomy (LDN). Since then, compared to open donor nephrectomy, LDN has demonstrated several improvements in terms of decreased postoperative pain, decreased length of hospital stay (LOS), rapid patient rehabilitation, reduced postoperative blood loss, and superior cosmetic results. Aims And Objective: The aim of this study is to study less complication in robotic Donor nephrectomy with Respect to clinical outcome which include pordoprade pain, time and minimal stay in hospital. Materials And Methods: This study had been conducted on patients admitted for Robotic Donor Nephrectomy. This study done at Apollo Gleneagles Hospital, Kolkata. Prospective study was carried out in cases performed between which includes number of patients. All patients were older then 20years for this study. Result And Analysis: It was found that 49 (96.1%) patients had under vein group1, and 2(3.9%) patient had under vein group 2. 43 (84.3%) patients had under artery group1, and 8(15.7%) patient had under artery group 2. 1(2.0%) patient had acute graft rejection. 41 (80.4%) patients had Left site, and 10(19.6%) patient had Right site. Conclusion:Robotic donor Nephrotomy performed by the vinei Robot the use 7 Robot allows Minimum blood loss, Minimum OT time in their better result our study proven the ruperiority 7 then method and add then there were less complication. Pastopade pain Duration of hospital stay was less and return to regular life earlier so therefore Robot arrited Donor Nephrotomy is the method I choice for Renal tramplant Surgery.

Transfusions and long-term functional outcomes in traumatic brain injury

2010 ◽  
Vol 113 (3) ◽  
pp. 539-546 ◽  
Author(s):  
Matthew A. Warner ◽  
Terence O'Keeffe ◽  
Premal Bhavsar ◽  
Rashmi Shringer ◽  
Carol Moore ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Glucose Level ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Number Of Patients ◽  
Transfusion Volume ◽  
Gcs Score

Object In this paper, the authors' goal was to examine the relationship between transfusion and long-term functional outcomes in moderately anemic patients (lowest hematocrit [HCT] level 21–30%) with traumatic brain injury (TBI). While evidence suggests that transfusions are associated with poor hospital outcomes, no study has examined transfusions and long-term functional outcomes in this population. The preferred transfusion threshold remains controversial. Methods The authors performed a retrospective review of patients who were admitted with TBI between September 2005 and November 2007, extracting data such as HCT level, status of red blood cell transfusion, admission Glasgow Coma Scale (GCS) score, serum glucose, and length of hospital stay. Outcome measures assessed at 6 months were Glasgow Outcome Scale-Extended score, Functional Status Examination score, and patient death. A multivariate generalized linear model controlling for confounding variables was used to assess the association between transfusion and outcome. Results During the study period, 292 patients were identified, and 139 (47.6%) met the criteria for moderate anemia. Roughly half (54.7%) underwent transfusions. Univariate analyses showed significant correlations between outcome score and patient age, admission GCS score, head Abbreviated Injury Scale score, number of days with an HCT level < 30%, highest glucose level, number of days with a glucose level > 200 mg/dl, length of hospital stay, number of patients receiving a transfusion, and transfusion volume. In multivariate analysis, admission GCS score, receiving a transfusion, and transfusion volume were the only variables associated with outcome (F = 2.458, p = 0.007; F = 11.694, p = 0.001; and F = 1.991, p = 0.020, respectively). There was no association between transfusion and death. Conclusions Transfusions may contribute to poor long-term functional outcomes in anemic patients with TBI. Transfusion strategies should be aimed at patients with symptomatic anemia or physiological compromise, and transfusion volume should be minimized.

scholarly journals Study comparing the stroke unit outcome and conventional ward treatment: a randomized study in Joinville, Brazil

2003 ◽  
Vol 61 (2A) ◽  
pp. 188-193 ◽  
Author(s):  
Norberto L. Cabral ◽  
Carla Moro ◽  
Giana R. Silva ◽  
Rosana Herminia Scola ◽  
Lineu César Werneck
Keyword(s):  
Hospital Stay ◽  
Stroke Unit ◽  
Survival Curve ◽  
Clinical Status ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
General Ward ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

BACKGROUND AND PURPOSE: To assess the impact of a stroke unit (SU) on acute phase treatment when compared to a conventional general ward treatment (GW). METHOD: Seventy-four patients with acute stroke were randomized between a SU and conventional general ward (GW). We compared both groups regarding the length of hospital stay, lethality and functional and clinical status within 6 months, using the Scandinavian scale and Barthel index. RESULTS: Thirty-five and thirty-nine patients were allocated at SU and GW, respectively. Lethality on the 10th day at SU and GW achieved 8.5% and 12.8% respectively (p= 0.41), whereas 30-days mortality rates achieved 14.2% and 28.2% (p= 0.24), 17.4% and 28.7% on the 3rd month (p= 0.39), and 25.7% and 30.7% on the 6th month (p= 0.41). Thirty-day survival curve achieved 1.8 log rank (p= 0.17), with a trend for lower lethality in the SU. In order to save one death in 6 months in SU, NNT (the number need to treat) was 20; to get one more home independent patient NNT was 15. No significant difference was found between the length of hospital stay and morbidity. CONCLUSION: No significant benefit was found in SU patients compared to GW group. However,an evident benefit in absolute numbers was observed in lethality, survival curve and NNT in thirty days period after stroke. Further collaborative studies or incresead number of patients are required to define the role of SU.

scholarly journals Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

2016 ◽  
Vol 42 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Eleci Vaz Ferreira ◽  
Marcelo Basso Gazzana ◽  
Muriel Bossle Sarmento ◽  
Pedro Arends Guazzelli ◽  
Mariana Costa Hoffmeister ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Ct Angiography ◽  
Pulmonary Thromboembolism ◽  
Length Of Hospital Stay ◽  
X Rays ◽  
Cross Sectional ◽  
Median Hospital Stay ◽  
Alternative Diagnosis ◽  
Number Of Patients

Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients.

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