Effectiveness Of Structured Exercise Protocol On Functional Performance In Subjects With Covid-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1244-1249
Author(s):  
Rakesh Kumar Sinha ◽  
Saumi Sinha ◽  
Varadharajulu G
Keyword(s):  
Hospital Stay ◽  
Musculoskeletal System ◽  
Functional Performance ◽  
Psychosocial Problems ◽  
P Value ◽  
Exercise Protocol ◽  
Established Fact ◽  
Physical Functional Performance ◽  
Prolonged Hospital

It is a well-established fact that patients of Covid 19 have musculoskeletal dysfunctions in addition to cardiorespiratory and psychosocial problems. Musculoskeletal system is amongst the most common systems found to be affected in patients admitted in ICU for prolonged periods and some patients of Covid 19 do have to spend a reasonably long period in ICU’s. Prolonged hospital stay may be needed in Covid 19 patients having ARDS or pneumonia and symptoms of fever, cold and cough to monitor their recovery. This may result in musculoskeletal dysfunctions as demonstrated in some studies. Thus, treating the musculoskeletal system becomes a vital part of the regimen to be followed during the patients stay in the ICU which needs to be followed up even after the patient is shifted from the ICU by keeping a track of Physical Functional performance of the subjects after discharge. This experimental study was done on 150 Covid-19 positive subjects to see the long term effectiveness of a structured exercise protocol on the Physical Functional performance of Covid 19 patients. The results of the study were analysed statistically and both the outcome measures FIMS and POMA showed significant changes with p value <0.05 and <0.05 respectively. The study thus shows that the structured exercise protocol helped in maintaining the Physical Functional performance of the subjects through-out the hospital stay and also after discharge during follow up.

scholarly journals Factors Associated with Prolonged Hospital Stay: a Retrospective Study for Imported Malaria Cases

2021 ◽  
Author(s):  
Liang Huang ◽  
Hong Jin ◽  
Hong Zhang ◽  
Yang Liu ◽  
Xinxing Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infection ◽  
Hospital Stay ◽  
Predictive Factors ◽  
Imported Malaria ◽  
Health Concern ◽  
P Value ◽  
Prolonged Hospital Stay ◽  
Imported Cases ◽  
Prolonged Hospital

Abstract Background China had entered post-elimination era for malaria, however, the imported cases are continuously are a public health concern as the increasing number of cases. In this study we studied the potential predictive factors for prolonged hospital stay for imported malaria patients. Material and Methods We retrospectively collected patients of imported malaria cases data from 2017–2020 in our hospital. we analyzed the data from clinical, epidemiological, geographical, and seasonal points of view, and used cox proportional hazard model to find the predictive factors for prolonged hospital stay. Results We found most of imported cases were from Democratic Republic of the Congo(23%, 34/150) and most cases 74%(26/34) were infected by P. falciparum. Through Edwards Test, no significant seasonality of imported cases were found(χ2 = 2.51 p-value = 0.28). We found bacterial infection(HR = 0.58, p-value = 0.01) and thrombocytopenia(HR = 0.66, p-value = 0.02) were protective factors for discharge, that were, the risk factors for prolonged hospital stay. Conclusions The imported cases are the major risk of malaria in post-elimination era of China. The bacterial infection and thrombocytopenia were the risk factors for prolonged hospital stay.

scholarly journals Postoperative recovery; Stapled Hemorrhoidopexy versus Conventional haemorrhoidectomy.

2020 ◽  
Vol 27 (01) ◽  
pp. 166-171
Author(s):  
Ashar Ahmad Khan ◽  
Tania Mahar ◽  
Muhammad Kashif Adnan ◽  
Abdul Rasheed Surahio ◽  
Abdul Manan ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Postoperative Recovery ◽  
Stapled Hemorrhoidopexy ◽  
Anal Stenosis ◽  
P Value ◽  
Group A ◽  
Conventional Haemorrhoidectomy ◽  
Group B

Conventional haemorrhoidectomy, a usual procedure for hemorrhoids in our set up have many short and long term complications. Some patients complained pain many weeks after surgery and are unable to do their routine work. Anal stenosis and recurrence are long term issues. There is need for some other procedure which can decrease postoperative pain and hospital stay. Objectives: To compare the postoperative recovery between stapled hemorrhoidopexy and conventional hemorrhoidectomy. Study Design: Randomized Clinical trial. Setting: Surgery Department of Nishtar Medical University Multan. Period: from 01-01-2018 to 31-12-2018. Material & Methods: Randomly 02 equal groups of the patients, A and B were made. Stapled hemorrhoidopexy (SH) and conventional haemorrhoidectomy was done in group A and B respectively. SPSS version 20 used for data analysis. Mean and standard deviation were used for quantitative variables including postoperative pain, age and hospital stay. Independent Student t test used for comparison of hospital stay and postoperative pain. Effect modifier including gender, age, duration and grade of hemorrhoids were controlled by stratification and Chi square test was applied. P value less than 0.05 was taken as significant. Results: Out of 60 patients, 32 were males and 28 females. In Group A (Stapled Hemorrhoidopexy), mean age was 37.37 + 6.36 years and 39.17 + 5.53 years in Group-B. Postoperative pain in Group A was 3.60 + 1.27 and 6.03 + 1.73 in Group B. Postoperative pain was significantly high in Group B (CH) and P value =0.000. Mean hospital stay was 0.90 + 0.48 days in Group A and 1.87 + 0.57 days in Group B with P value= 0.000. Conclusion: Stapled hemorrhoidopexy is associated with shorter hospital stay and decrease postoperative pain irrespective of age, sex and grade of the hemorrhoids.

scholarly journals Evaluation of mesh fixation versus non-fixation in laparoscopic mesh hernioplasty in inguinal hernias

2020 ◽  
Vol 7 (10) ◽  
pp. 3354
Author(s):  
Shubra Kochar ◽  
Dipanshu Kakkar ◽  
Devendra Pal Singh
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Mesh Fixation ◽  
Preperitoneal Space ◽  
P Value ◽  
Chi Square ◽  
Analgesic Requirement ◽  
Inguinal Hernias ◽  
Group A

 Background: Laparoscopic inguinal hernia repair (LIHR) is usually done by two methods, which vary in approach to the preperitoneal space; transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP). This study aimed at comparing the effect of mesh fixation and non-fixation in terms of operative time, hospital stay, analgesic requirement, complications and cost analysis with respect to fixation device in LIHR.Methods: This prospective randomized comparative study included 60 patients of inguinal hernias admitted to the Department of Surgery at Rajendra Hospital, G.M.C, Patiala from July 2016 to September 2017 (duration of study was 15 months). Cases were divided into two groups by draw of lots with group A as mesh fixation (n=30) and group B as non-fixation (n=30).Results: The results were calculated with chi square test (p value). Results were found to be not significant in two groups in the terms of postoperative analgesia, complications i.e. (intraoperative, postoperative and long term) postoperative hospital stay and time to return for work. The cost of procedure was found to be very high in Group A and results were highly significant (p<0.001).Conclusion: LIHR repair without mesh fixation shows advantages over mesh fixation, which includes significant less cost of surgery, with comparable intraoperative, postoperative and long-term complications (with no increase in hernia recurrence), hospital stay and mean operative time. Hence, our study favours LIHR without mesh fixation a valuable alterative option.

scholarly journals Puzzle Out the Reason behind Prolonged Hospital Stay among Children

2021 ◽  
pp. 217-222
Author(s):  
Bela Shaikh ◽  
Samina Ghoto ◽  
Abdullah Khilji ◽  
Muhammad Khan ◽  
Faizah Mughal ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Hospital Stay ◽  
Demographic Data ◽  
Total Duration ◽  
Significant Risk ◽  
P Value ◽  
Age Group ◽  
Prolonged Hospital Stay ◽  
Duration Of Stay ◽  
Prolonged Hospital

Aim: To find out the reasons behind prolonged hospital stay among children. Study Design: Descriptive cross-sectional Place and Duration of Study: Study was conducted at the People university of medical and health sciences hospital during the period of November 2020 to April 2021. Methodology: All the children between the age group of 1 year to 12 years, who were admitted in pediatric ward of the hospital for any reason, were included in the study. Prolonged hospital stay was labelled when it exceeded above 7 days. A self-designed proforma was made which consisted of demographic data, total duration of stay and the most probable cause of stay. Data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. p-value less than 0.05 was considered as significant Results: The mean age of the study participants with standard deviation was 6.8 ± 2.3 years. Half of the participants (50.9%) admitted in hospital for prolonged duration were from the age group of ≤ 5 years. About 55.7% of the participants were female and majority were from the lower socioeconomic class (53.8%) Mean and standard deviation of duration of hospital stay was 11.85 ± 2.29. In majority of cases (n=80) there was delay in consulting a physician which was followed by resistant to the therapy and acquiring nosocomial infection while very few of the cases were having some invasive procedure done so increased duration of stay. Conclusion: It can be concluded that the younger age group that is less than 5 years is the most significant risk factor while the most common reason is the delayed consultation to the physician.

scholarly journals Factors Associated With Prolonged Hospital Stay: a Retrospective Study for Imported Malaria Cases

2021 ◽  
Author(s):  
Liang Huang ◽  
Hong Jin ◽  
Hong Zhang ◽  
Yang Liu ◽  
Xinxing Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infection ◽  
Hospital Stay ◽  
Predictive Factors ◽  
Imported Malaria ◽  
Health Concern ◽  
P Value ◽  
Prolonged Hospital Stay ◽  
Imported Cases ◽  
Prolonged Hospital

Abstract BackgroundChina had entered post-elimination era for malaria, however, the imported cases are continuously are a public health concern as the increasing number of cases. In this study we studied the potential predictive factors for prolonged hospital stay for imported malaria patients. Material and MethodsWe retrospectively collected patients of imported malaria cases data from 2017-2020 in our hospital. we analyzed the data from clinical, epidemiological, geographical, and seasonal points of view, and used cox proportional hazard model to find the predictive factors for prolonged hospital stay.ResultsWe found most of imported cases were from Democratic Republic of the Congo(23%, 34/150) and most cases 74%(26/34) were infected by P. falciparum. Through Edwards Test, no significant seasonality of imported cases were found(χ2 =2.51 p-value= 0.28). We found bacterial infection(HR=0.58, p-value=0.01) and thrombocytopenia(HR=0.66, p-value=0.02) were protective factors for discharge, that were, the risk factors for prolonged hospital stay.ConclusionsThe imported cases are the major risk of malaria in post-elimination era of China. The bacterial infection and thrombocytopenia were the risk factors for prolonged hospital stay.

Stopping Warfarin Therapy is Unnecessary for Hand Surgery

2004 ◽  
Vol 29 (3) ◽  
pp. 201-203 ◽  
Author(s):  
D. L. WALLACE ◽  
M. D. LATIMER ◽  
H. J. C. R. BELCHER
Keyword(s):  
Hospital Stay ◽  
Warfarin Therapy ◽  
Hand Surgery ◽  
Morbidity And Mortality ◽  
Minor Bleeding ◽  
Prolonged Hospital Stay ◽  
Coagulation Monitoring ◽  
Prolonged Hospital ◽  
Anticoagulated Patients

Interruption of appropriate therapeutic warfarin therapy imposes a risk of morbidity and mortality on the patient. Strategies to reduce the risks of interruption impose relatively large costs in terms of prolonged hospital stay, medication and coagulation monitoring. We report a series of 47 consecutive surgical episodes on the hands of 39 patients without interruption of therapeutic warfarin anticoagulation and with an INR of between 1.3 and 2.9. There was no difficulty with intraoperative haemostasis. Two patients had minor bleeding-related complications with no long-term sequelae. The authors conclude that interruption to warfarin therapy is unnecessary if the INR is less than 3.0 and therefore inappropriate for therapeutically anticoagulated patients undergoing hand surgery.

scholarly journals Evaluation of the Effect of Combination Therapy on Treatment of COVID-19: A Cohort Study

2021 ◽  
Keyword(s):  
Cohort Study ◽  
Combination Therapy ◽  
Oxygen Saturation ◽  
Hospital Stay ◽  
Definitive Treatment ◽  
P Value ◽  
Epidemic Disease ◽  
Treatment Regimens ◽  
Reactive Protein ◽  
Prolonged Hospital

COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease. Materials and Methods: This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively. Results: The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients. Conclusion: The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens.

Custom Presurgical Planning for Midfacial Reconstruction

2020 ◽  
Vol 36 (06) ◽  
pp. 696-702
Author(s):  
Nolan B. Seim ◽  
Enver Ozer ◽  
Sasha Valentin ◽  
Amit Agrawal ◽  
Mead VanPutten ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Functional Performance ◽  
Three Dimensional ◽  
Free Tissue Transfer ◽  
Long Term Effects ◽  
Presurgical Planning ◽  
Dental Rehabilitation ◽  
Midface Reconstruction ◽  
Reconstructive Algorithm

AbstractResection and reconstruction of midface involve complex ablative and reconstructive tools in head and oncology and maxillofacial prosthodontics. This region is extraordinarily important for long-term aesthetic and functional performance. From a reconstructive standpoint, this region has always been known to present challenges to a reconstructive surgeon due to the complex three-dimensional anatomy, the variable defects created, combination of the medical and dental functionalities, and the distance from reliable donor vessels for free tissue transfer. Another challenge one faces is the unique features of each individual resection defect as well as individual patient factors making each preoperative planning session and reconstruction unique. Understanding the long-term effects on speech, swallowing, and vision, one should routinely utilize a multidisciplinary approach to resection and reconstruction, including head and neck reconstructive surgeons, prosthodontists, speech language pathologists, oculoplastic surgeons, dentists, and/or craniofacial teams as indicated and with each practice pattern. With this in mind, we present our planning and reconstructive algorithm in midface reconstruction, including a dedicated focus on dental rehabilitation via custom presurgical planning.

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

2020 ◽  
Author(s):  
Jason D. Tegethoff ◽  
Rafael Walker-Santiago ◽  
William M. Ralston ◽  
James A. Keeney
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Surgical Morbidity ◽  
Exact Test ◽  
Total Knee ◽  
Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

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