scholarly journals The clinical characteristics of hip fracture: during the novel coronavirus disease (COVID-19) epidemic

2020 ◽  
Author(s):  
Hongjie Zhang ◽  
Zengping Lin ◽  
Jiping Zhong ◽  
Darong Nie ◽  
Hongmei Song ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Medical Treatment ◽  
Exposure Time ◽  
Light Exposure ◽  
The Novel ◽  
Hospitalization Cost ◽  
Epidemic Period ◽  
Group A ◽  
Group B ◽  
Novel Coronavirus

Abstract Background The aim of this study was to assess the characteristics of hip fracture during the novel coronavirus (COVID-19) epidemic.Method Hip-facture patients undergoing surgery from January 26 to March 31, 2020 (group A) and from January 26 to March 31, 2019 (group B) were retrospectively included. The durations from injury onset to hospital discharge, hospitalization cost, comorbidity, and complications of patients in the two groups were collected. The daily activity and light exposure time, and medical treatment interruption of patients in group A before and during their self-quarantine were also collected. In addition, the reasons for those with hospital admission delay were inquired.Results During the COVID-19 epidemic, patients with hip fracture was increased by 9 cases (69.23%). Patients in group A underwent an over 20-hour longer duration from the injury onset to hospital, an over 3-day longer hospitalization stay, and more hospitalization cost of over 4-thousand yuan compared with those for patients in group B (P < 0.05). The self-quarantine led to reduced daily activities (P <0.001), reduced light exposure time (P <0.001) and more medical interruption for hip-fracture patients. There were also slight more comorbidity number and perioperative complications for patients in group A compared with patients in group B. For those with a pre-hospital time more than 24 h, 58.33% feared go out for medical treatment because of the COVID-19 epidemic.Conclusion During the COVID-19 epidemic period, the prevention and management of hip-fracture for the elderly require more attention for the public and medical care personnel.

scholarly journals Innovation of Audio-Visual Triage system in Combating the Spread of COVID-19 Infection and its efficacy: A Novel Strategy

2020 ◽  
Author(s):  
Muhammad Mansoor Hafeez ◽  
Mohammad Azhar ◽  
Hafiz Rizwan Zafar Chudhary ◽  
Muhammad Asim Rana ◽  
Arif Malik
Keyword(s):  
Healthcare Professionals ◽  
The Novel ◽  
Current Analysis ◽  
Triage System ◽  
Group A ◽  
Anxiety Levels ◽  
Novel Strategy ◽  
Group B ◽  
Novel Coronavirus ◽  
Almost All

ABSTRACTDuring the novel coronavirus pandemic, also known as SARS-CoV-2 or COVID-19 pandemic, frontline healthcare professionals suffered psychological as well as pathological trauma due to the lack of preparation to cope with this unforeseen situation. The protocols to prevent the spread of this disease proved to be less effective than anticipated. In these circumstances, improvement of the existing triage system was felt and an AUDIO-VISUAL TRIAGE (AVT) system was introduced to enhance confidence as well as increase the safety of frontline healthcare professionals. The current analysis was performed from March 21, 2020, to April 28, 2020, until the completion of sixty response forms, at Bahria Town International Hospital, Lahore. Thirty participants (Group A) deployed on visual triage and other thirty (Group B) on AVT for screening suspected cases of COVID-19 infection. Anxiety levels were measured by using the GAD-7 scoring system and the participants of both groups were periodically tested for COVID-19 infection by PCR. Independent t-test was used to evaluate the significance of different variables at a confidence level of 95%. The result of the current study revealed the effectiveness of AVT for the screening of COVID-19 patients. There was a statistically significant increase in anxiety levels and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in group A as compared to group B. Almost all participants in group A wanted to shift their place of work or ready to quit the job if they were forced to perform their duties at the same visual triage. AVT system for COVID-19 screening found to be more safe and less stressful than visual triage. It is not only a simple and effective way to prevent the spread of diseases but also boosted the confidence of frontline healthcare professionals to fight against coronavirus spread.

scholarly journals INNOVATION OF AUDIO-VISUAL TRIAGE SYSTEM IN COMBATING THE SPREAD OF COVID-19 INFECTION AND ITS EFFICACY: A NOVEL STRATEGY

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
MM Hafeez ◽  
M Azhar ◽  
HRZ Chudhary ◽  
W Nazar ◽  
MA Rana
Keyword(s):  
Healthcare Professionals ◽  
The Novel ◽  
Current Analysis ◽  
Triage System ◽  
Group A ◽  
Anxiety Levels ◽  
Novel Strategy ◽  
Group B ◽  
Novel Coronavirus ◽  
Almost All

During the novel coronavirus pandemic, also known as SARS-CoV-2 or COVID-19 pandemic, frontline healthcare professionals suffered psychological as well as pathological trauma due to the lack of preparation to cope with this unforeseen situation. The protocols to prevent the spread of this disease proved to be less effective than anticipated. In these circumstances, improvement of the existing triage system was felt and an AUDIO-VISUAL TRIAGE (AVT) system was introduced to enhance confidence as well as increase the safety of frontline healthcare professionals. The current analysis was performed from March 21, 2020, to April 28, 2020, until the completion of sixty response forms, at Bahria Town International Hospital, Lahore. Thirty participants (Group A) deployed on visual triage and other thirty (Group B) on AVT for screening suspected cases of COVID-19 infection. Anxiety levels were measured by using the GAD-7 scoring system and the participants of both groups were periodically tested for COVID-19 infection by PCR. Independent t-test was used to evaluate the significance of different variables at a confidence level of 95%. The result of the current study revealed the effectiveness of AVT for the screening of COVID-19 patients. There was a statistically significant increase in anxiety levels and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in group A as compared to group B. Almost all participants in group A wanted to shift their place of work or ready to quit the job if they were forced to perform their duties at the same visual triage. AVT system for COVID-19 screening found to be more safe and less stressful than visual triage. It is not only a simple and effective way to prevent the spread of diseases but also boosted the confidence of frontline healthcare professionals to fight against coronavirus spread.

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Medical Group ◽  
Consensus Definition ◽  
Transcutaneous Oxygen ◽  
European Consensus ◽  
Group A ◽  
One Year ◽  
Group B

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).

scholarly journals Antibiotic use and other risk factors at hospital level for outbreaks with Clostridium difficile PCR ribotype 027

2008 ◽  
Vol 57 (6) ◽  
pp. 709-716 ◽  
Author(s):  
T. I. I. van der Kooi ◽  
M. Koningstein ◽  
A. Lindemans ◽  
D. W. Notermans ◽  
E. Kuijper ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Antibiotic Use ◽  
Study Groups ◽  
Ribotype 027 ◽  
Defined Daily Doses ◽  
Hygiene Measures ◽  
Epidemic Period ◽  
Group A ◽  
Group B ◽  
The Relationship

The first Dutch outbreak due to Clostridium difficile ribotype 027 was observed in mid-2005; by the end of that year, eight hospitals were affected. To study the relationship between hospital-wide antibiotic use and the incidence of 027-linked C. difficile-associated disease (CDAD) three study groups were made: group A, all eight hospitals with an 027-associated epidemic; group B, five of a total of six hospitals with occasional 027 cases, without an increase in CDAD; and group C, ten randomly selected hospitals with no reported 027 epidemics or isolated 027 cases. Quarterly data on CDAD incidences, hygiene measures and the use of fluoroquinolones, second- and third-generation cephalosporins, extended-spectrum penicillins, penicillins with beta-lactamase inhibitors, carbapenems, lincomycins and macrolides were collected for 2004 and 2005, and divided into pre-epidemic and epidemic periods. Using a multilevel Poisson regression analysis, CDAD incidence was linked to antibiotic use in the previous quarter and to certain hygiene measures. In the pre-epidemic period, the total use of the studied antibiotics was comparable between affected and unaffected hospitals. Higher use of second-generation cephalosporins, macrolides and all of the studied antibiotics were independently associated with a small increase in CDAD incidence [relative risk (95 % confidence interval): 1.14 per increase of 100 defined daily doses per 10 000 bed days (1.06–1.23), 1.10 (1.01–1.19) and 1.02 (1.01–1.03), respectively]. However the effect was too small to predict which hospitals might be more prone to 027-associated outbreaks.

Minidose Bupivacaine–Fentanyl Spinal Anesthesia for Surgical Repair of Hip Fracture in the Aged

2000 ◽  
Vol 92 (1) ◽  
pp. 6-6 ◽  
Author(s):  
Bruce Ben-David ◽  
Roman Frankel ◽  
Tatianna Arzumonov ◽  
Yuri Marchevsky ◽  
Gershon Volpin
Keyword(s):  
Blood Pressure ◽  
Hip Fracture ◽  
Spinal Anesthesia ◽  
Surgical Repair ◽  
Systolic Pressure ◽  
The Elderly ◽  
Vasopressor Support ◽  
Group A ◽  
Blood Pressures ◽  
Group B

Background Spinal anesthesia for surgical repair of hip fracture in the elderly is associated with a high incidence of hypotension. The synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. Methods Twenty patients aged &gt; or = 70 yr undergoing surgical repair of hip fracture were randomized into two groups of 10 patients each. Group A received a spinal anesthetic of bupivacaine 4 mg plus fentanyl 20 microg, and group B received 10 mg bupivacaine. Hypotension was defined as a systolic pressure of &lt; 90 mmHg or a 25% decrease in mean arterial pressure from baseline. Hypotension was treated with intravenous ephedrine boluses 5-10 mg up to a maximum 50 mg, and thereafter by phenylephrine boluses of 100-200 microg. Results All patients had satisfactory anesthesia. One of 10 patients in group A required ephedrine, a single dose of 5 mg. Nine of 10 patients in group B required vasopressor support of blood pressure. Group B patients required an average of 35 mg ephedrine, and two patients required phenylephrine. The lowest recorded systolic, diastolic, and mean blood pressures as fractions of the baseline pressures were, respectively, 81%, 84%, and 85% versus 64%, 69%, and 64% for group A versus group B. Conclusions A "minidose" of 4 mg bupivacaine in combination with 20 microg fentanyl provides spinal anesthesia for surgical repair of hip fracture in the elderly. The minidose combination caused dramatically less hypotension than 10 mg bupivacaine and nearly eliminated the need for vasopressor support of blood pressure.

scholarly journals Consideration of the Management of Pediatric Fever Clinics During the Novel Coronavirus Pneumonia Outbreak

2020 ◽  
pp. 1-7
Author(s):  
Hui Ding ◽  
Zhaoling Shi ◽  
Zhen Ruan ◽  
Xiaoning Cheng ◽  
Ruying Li ◽  
...  
Keyword(s):  
Medical Staff ◽  
Prevention And Control ◽  
Cross Infection ◽  
The Novel ◽  
Wuhan City ◽  
Control Programs ◽  
Treatment And Prevention ◽  
Epidemic Period ◽  
Novel Coronavirus ◽  
And Control

ABSTRACT Since the outbreak of 2019 novel coronavirus (2019-nCoV) infection in Wuhan City, China, pediatric cases have gradually increased. It is very important to prevent cross-infection in pediatric fever clinics, to identify children with fever in pediatric fever clinics, and to strengthen the management of pediatric fever clinics. According to prevention and control programs, we propose the guidance on the management of pediatric fever clinics during the nCoV pneumonia epidemic period, which outlines in detail how to optimize processes, prevent cross-infection, provide health protection, and prevent disinfection of medical staff. The present consideration statement summarizes current strategies on the pre-diagnosis, triage, diagnosis, treatment, and prevention of 2019-nCoV infection, which provides practical suggestions on strengthening the management of pediatric fever clinics during the nCoV pneumonia epidemic period.

scholarly journals Surgical versus Conservative Management of Granular Myringitis: A single-centre Randomized Control Trial

2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Granulation Tissue ◽  
Randomized Control Trial ◽  
Simple Random Sampling ◽  
Secondary Outcome ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68

scholarly journals 13 Amending Admission Protocol to Reduce Proton Pump Inhibitor-Induced Hyponatraemia on A Specialist Hip Fracture Unit

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
R Darnell ◽  
B Clements ◽  
E Reeve ◽  
N Singh
Keyword(s):  
Hip Fracture ◽  
Proton Pump Inhibitor ◽  
Elderly Patients ◽  
Proton Pump ◽  
Side Effect ◽  
Sodium Concentration ◽  
Improvement Project ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Abstract Introduction Hyponatraemia is a common electrolyte disturbance amongst elderly patients. Defined as a sodium concentration below 135 mmol/L, the BNF cites hyponatraemia as a ‘rare’ side effect of Omeprazole, a common proton pump inhibitor (PPI). In elderly patients, hyponatraemia can have significant morbidity. On our Hip Fracture Unit (HFU) at St Helier Hospital, all patients are commenced on Omeprazole on admission. We conducted a quality improvement project to reduce the incidence of PPI-induced hyponatraemia by altering standard protocol from Omeprazole to Ranitidine. Methods Phase 1: Retrospective analysis identifying incidence of PPI-induced hyponatraemia, defined as sodium concentration below 133mmol/L on two consecutive readings and resolving on switching to Ranitidine (Group A: n=86). Phase 2: Identifying incidence of hyponatraemia following administration of Ranitidine from admission (Group B: n=62). Exclusion criteria: Patients already on gastric protection or hyponatraemic on presentation. Chi squared analysis to establish statistical significance for risk of hyponatraemia associated with omeprazole. Results Total number of patients was 148. Age range 60-101 years (median 82 years). Incidence of PPI-induced hyponatraemia in Group A was 10.5% (9 cases). All resolved on switching to ranitidine. Following change in admission protocol to Ranitidine (Group B), incidence of hyponatraemia was 1.6% (1 case). The chance of developing hyponatraemia with Omeprazole was significantly higher than with ranitidine (P=0.0454). Conclusions 10.5% of admissions to the HFU experienced PPI-induced hyponatraemia. The European Medicines Agency defines side effects occurring at greater than 10% as very common. Whilst 45% of patients were on medication associated with hyponatraemia on admission, the absence of hyponatraemia at presentation and biochemical response when switching to ranitidine, demonstrates this is a significant side effect of PPIs. Given the increased morbidity associated with hyponatraemia, particularly in frail, elderly patients, amending protocol to ranitidine for gastric protection has the potential to reduce harm and improve patient outcomes.

scholarly journals A comparative study for the effectiveness of Tamsulosin alone versus Tamsulosin plus Tadalafil combination as an expulsive medical treatment in the management of lower ureteric calculous in Al-Diwaniyah teaching hospital

2019 ◽  
Vol 10 (2) ◽  
pp. 1551-1555
Author(s):  
Ahmed Abdulameer Alwan ◽  
Hussain T. Ajeel ◽  
Ahmed Hamza Abd
Keyword(s):  
Medical Treatment ◽  
Equal Treatment ◽  
Expulsion Rate ◽  
Treatment Groups ◽  
Ureteric Calculi ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
Urology Clinic

To evaluate the efficacy & safety of tamsulosin alone versus tamsulosin plus tadalafil combination as expulsive medical treatment of distal ureteric calculus. From March 2015 utile March 2017, two hundred patients (one hundred thirty males and seventy females), who attended the outpatient urology clinic and presented with stones size 5 to 10 mm in distal ureteric part, have been randomly allocated into two equal treatment groups. Group A treated with tamsulosin alone, and group B treated with tamsulosin plus tadalafil. Both treatments were given for a maximum of six weeks’ duration. The rate and time to the calculous passage, type of analgesic use, adverse effects of the drugs, number of outpatient urology clinic visits for pain, and follow-up were noted. Both treatment groups have higher expulsion rate with a lower time to expulsion with no statistically significant differences between them (p=0.350, p=0.074, respectively). Group B showed a significantly lower rate in admission to the hospital for pain and need for analgesia than in group A. no dangerous adverse events had been observing in both groups. Additional benefit seen in group B was the improvement in erectile function regarding male patients. Using tamsulosin and tadalafil as an expulsive medical treatment for distal ureteric calculous is safe and efficacious. Such combination therapy may provide additional advantages in cases of erectile dysfunction co-exist with distal ureteric calculi.

scholarly journals PENGARUH PEMBERIAN AIR PERASAN JERUK NIPIS (Citrus aurantifolia) TERHADAP JUMLAH PIGMEN MELANIN KULIT MENCIT (Mus musculus) YANG DIPAPARKAN SINAR MATAHARI

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Anggun R.P. Layuck ◽  
Poppy M. Lintong ◽  
Lily L. Loho
Keyword(s):  
Treatment Group ◽  
Experimental Research ◽  
Light Exposure ◽  
Skin Pigmentation ◽  
Melanin Pigment ◽  
Control Group ◽  
Group A ◽  
The Subject ◽  
Group B ◽  
Group D

Abstract: Over exposure of light can increase skin pigmentation. The aim of this study is to know the effect of lime and light exposure to the amount of melanin in mice’s skin. This is an experimental research and used mices as the subject research, which was randomly divided into 5 mice of control group and 15 mices of treatment group. Group A (K-) were given pellets for 20 days, Group B (K+) were given pellets and light exposure for 1 hour in 20 days, Group C were given pellets, smeared by lime on the back, then exposed to the light for 1 hour in 20 days, Group D were given pellets and exposed to light for 1 hour in 20 days then smeared by lime the next 10 days. The results showed that light exposure increases melanin pigment in group B compared to group A. For group C and group D, the amount of melanin pigment is less than group B. Conclusions: Lime can reduce the amount of melanin pigment in mice’s skin that had been exposed to the light.Keywords: melanin pigment, sunlight, limeAbstrak: Paparan berlebihan terhadap sinar matahari dapat meningkatkan pigmentasi kulit. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian jeruk nipis dan pemaparan sinar matahari terhadap jumlah pigmen melanin kulit mencit. Metode penelitian yang digunakan adalah metode eksperimental dengan subjek penelitian menggunakan mencit yang dibagi atas 5 ekor kontrol dan 15 ekor perlakuan. Kelompok A (K-) diberikan pelet selama 20 hari, Kelompok B (K+) diberikan pelet dan sinar matahari selama 1 jam dalam waktu 20 hari, kelompok C diberikan pelet, diolesi jeruk nipis di bagian punggung, lalu dipaparkan sinar matahari selama 1 jam dalam waktu 20 hari, kelompok D diberikan pelet, dipaparkan sinar matahari selama 1 jam dalam waktu 20 hari lalu diolesi jeruk nipis 10 hari berikutnya. Hasilnya : paparan sinar matahari menunjukkan peningkatan pigmen melanin pada kelompok B (K+) dibandingkan dengan kelompok A (K-). Sedangkan pada kelompok C dan kelompok D menunjukkan jumlah pigmen melanin yang lebih berkurang dibandingkan kelompok B. Simpulan: Pemberian jeruk nipis menurunkan jumlah pigmen melanin kulit mencit yang dipaparkan sinar matahari.Kata kunci : pigmen melanin, sinar matahari, air perasan jeruk nipis

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