scholarly journals EMERGENCY ABDOMINAL SURGERY;

2019 ◽  
Vol 14 (01) ◽  
pp. 10-16
Author(s):  
JUNAID SULTAN ◽  
HARIS BIN BILAL ◽  
HUMAIRA KIRAN ◽  
Badar Bin Bilal ◽  
Azam Yusuf
Keyword(s):  
Mortality Rate ◽  
Abdominal Surgery ◽  
Abdominal Sepsis ◽  
Cross Sectional Study ◽  
Successful Outcome ◽  
Emergency Laparotomy ◽  
Cross Sectional ◽  
Surgical Unit ◽  
Emergency Abdominal Surgery ◽  
Overall Mortality

Intra-abdominal (I.A) sepsis is widely recognized as the leading cause of death in patients following emergency abdominal surgery. Objective To determine the incidence of intra-abdominal sepsis after emergency abdominal surgery. To study the predisposing factors which lead to post-op. I.A sepsis. To determine the micro flora involved in I.A sepsis Study design: A quantitative cross sectional study.. Place of study: Surgical unit-l General Hospital Rawalpindi. Period: March 1999 to August 2000. Material & methods:565 patients) were followed after emergency abdominal surgery and incidence determined. Results: These 565 patients included 400 patients of acute appendicitis, 140 patients of emergency laparotomy and 25 patients of obstructed/strangulated hernias. The incidence of I.A sepsis after emergency abdominal surgery was found to be 10.6% with incidence of generalized I.A sepsis of 6.6%. Different risk factors predispose to the development of post-op. I.A sepsis. Aerobic microflora of the I.Asepsis consists predominantly of E.coli. Overall mortality rate was 7.6% with 4% cases due to post-op. I.A sepsis. Mortality rate in patients with post-op. I.A sepsis was 38.33% with mortality rate of 78% in patients with post-op, generalized I.A sepsis and of 20% in patients with I.A abscesses. Conclusion: IA sepsis continues to be one of the major challenges in general surgery. A successful outcome depends on early diagnosis, rapid and appropriate surgical intervention, prompt administration of broad spectrum antibiotics and aggressive supportive care in ICU remains the therapeutic strategy for these patients. It is important first to determine the risk status of these patients and then to apply proper and sound surgical technique and do timely decision.

SP9.1.7 Emergency Laparotomy for Trauma in the United Kingdom and Ireland: a Prospective Multicentre Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Paul Vulliamy ◽  
Max Marsden ◽  
Richard Carden ◽  
Karim Brohi ◽  
Ross Davenport ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Prehospital Care ◽  
Trauma System ◽  
Emergency Laparotomy ◽  
Trauma Patients ◽  
Transfusion Rate ◽  
Young Males ◽  
Prospective Multicentre Study ◽  
The Uk ◽  
Emergency Abdominal Surgery

Abstract Aims Trauma patients requiring abdominal surgery have significant morbidity and mortality, but are not included in existing national audits of emergency laparotomy. The aim of this study was to examine processes of care and outcomes among trauma patients undergoing emergency abdominal surgery in the UK and Ireland. Methods A prospective trainee-led multicentre audit was conducted over six months from January 2019 across the national trauma system. Patients undergoing laparotomy or laparoscopy within 24 hours of injury were included. Subgroup analysis was conducted in those requiring major haemorrhage protocol (MHP) activation. Results The study included 363 patients from 34 hospitals (22 major trauma centres). The majority were young males with no co-morbidities who required surgery for control of bleeding (51%) or exploration of penetrating injuries (46%). Over 85% received consultant-led care in the emergency department (318/363) and operating theatre (321/363). The MHP subgroup made up 45% of the cohort but accounted for 97% of deaths and 79% of ICU days, with a mortality rate of 19% and a massive transfusion rate of 32%. Compared to non-MHP patients they had shorter times to theatre (122 vs 218 minutes, p < 0.001), higher rates of advanced prehospital care (60% vs 33%, p < 0.001) and higher rates of consultant-led care (95% vs 85%, p < 0.001). Conclusion The majority of trauma patients requiring emergency abdominal surgery receive consultant-delivered perioperative care which is appropriately tailored to patient risk profile. Despite this, mortality and resource utilization among high-risk patients remains substantial, justifying ongoing performance improvement initiatives and research into novel therapeutics.

scholarly journals Clinical characteristics and outcome of vasculitides

2016 ◽  
Vol 3 (2) ◽  
pp. 3-9
Author(s):  
Buddhi Prasad Paudyal ◽  
Anjana Education Rajbhandari
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Cross Sectional ◽  
The Mean ◽  
Schonlein Purpura ◽  
Overall Mortality

 Introductions: Vasculitides can cause significant morbidity and mortality if not treated on time. There is lack of data locally. This study aims to define the pattern, clinical characteristics, and outcome of vasculitides.Methods: This was a cross sectional study between January 2011 and December 2015 at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. The medical records of patients diagnosed with vasculitides in adults rheumatology service of the hospital were reviewed.Results: Ninety six patients were diagnosed with vasculitides during the study period. The mean age was 42.2 years. Sixty nine (71.8%) patient had small vessel, 20 (20.8%) large vessel and five (5.2%) had variable vessel vasculitides. Seventy five patients (78.1%) had primary and 21 (21.8%) secondary vasculitides. Cutaneous leucocytoclasticangitis was seen in 27 (28.1%), Takayasu arteritis in 17 (17.7), Henoch-Schonlein purpura in 11 (11.4%) and Rheumatoid arthritis associated vasculitis in nine patients. Purpura was present in all 96 (100%). The overall mortality was 9 (9.3%).Conclusions: Primary vasculitides were more common than secondary forms. Small vessel vasculitis was the most common. Cutaneous symptoms were predominant features. The mortality was attributed to active disease, sepsis, and complications of the primary disease. Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):3-9

scholarly journals Assessment of biochemistry request forms

2017 ◽  
Vol 5 (3) ◽  
pp. 18-24 ◽  
Author(s):  
S Singh ◽  
S Khatiwada
Keyword(s):  
Laboratory Data ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Successful Outcome ◽  
Ethical Review ◽  
Sample Type ◽  
Cross Sectional ◽  
Laboratory Errors ◽  
Specimen Collection ◽  
Drug History

Oversight of information on biochemistry requisition forms may lead to laboratory errors. The aim of this study was to evaluate the level of completion of these forms. The observational cross-sectional study was conducted between December 2014 and March 2015 in the biochemistry department of a tertiary hospital in Kathmandu after approval by the Institutional Ethical Review Committee. Two thousand and thirty nine request forms were randomly assessed for the completeness of information provided by the requesting physician. Microsoft excels software and SPSS-17 was used for analysis. Patient confidentiality was maintained. Out of 2039 request forms examined, the only 100% documented parameter was the pa­tient’s name. Date of specimen collection was recorded in 79.74% of forms and age in 98.53%. The working diagnosis was recorded in 28.44% but no information regarding patient preparation. While the consultants name were stated in 13.29% of cases, drug history in 0.24%. Parameters like gender were recorded in 98.82%, sample type in 0.29%. Whether the patient was present in the ward or in the outpatient department was documented in 15.11% whereas patient number in 38.35%. Doctors were more likely to sign the forms rather than providing their name/designation. This study demonstrates that the custom of completion of request forms was poor. As laboratory data plays a significant role in medical diagnosis and re­search, incomplete data provided to the laboratory could significantly impact on the comments and successful outcome of treatment. Closer interaction between clinicians and laboratory personnel by means of request forms can improve the quality of services to patients.

scholarly journals Treatment Outcomes of Tuberculosis and Associated Factors in an Ethiopian University Hospital

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Minaleshewa Biruk ◽  
Belay Yimam ◽  
Hailay Abrha ◽  
Senafekesh Biruk ◽  
Fisseha Zewdu Amdie
Keyword(s):  
Treatment Outcome ◽  
Cross Sectional Study ◽  
Tuberculosis Treatment ◽  
University Hospital ◽  
Successful Outcome ◽  
Cross Sectional ◽  
Weight Category ◽  
Pulmonary Tb ◽  
Targeted Interventions ◽  
Unsuccessful Treatment

Background. Tuberculosis remains a major global health problem. It causes ill-health among millions of people each year and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of death worldwide.Purpose. To assess the outcome of tuberculosis treatment and to identify factors associated with tuberculosis treatment outcome.Methods. A five-year retrospective cross-sectional study was employed and data were collected through medical record review. Data were analyzed using SPSS version 16 and binary and multiple logistic regression methods were used. Apvalue of less than 0.05 was considered as statistically significant in the final model.Results. Out of the 1584 pulmonary TB patients (882 males and 702 females) including all age group, 60.1% had successful outcome and 39.9% had unsuccessful outcome. In the final multivariate logistic model, the odds of unsuccessful treatment outcome was higher among patients of weight category 30–39.9 kg (AOR = 1.51, 95% CI: 1.102–2.065) and smear negative pulmonary TB (AOR = 3.204, 95% CI: 2.277–4.509) and extrapulmonary TB (AOR = 3.175, 95% CI: 2.201–4.581) and retreatment (AOR = 6.733, 95% CI: 3.235–14.013) and HIV positive TB patients (AOR = 1.988, 95% CI: 1.393–2.838) and unknown HIV status TB patients (AOR = 1.506, 95% CI: 1.166–1.945) as compared to their respective comparison groups.Conclusion. In this study, high proportion of unsuccessful treatment outcome was documented. Therefore emphasis has to be given for patients with high risk of unsuccessful TB treatment outcome and targeted interventions should be carried out.

scholarly journals Ventilator-Associated Pneumonia in Dr. Soetomo General Hospital Surabaya

2021 ◽  
Vol 12 (2) ◽  
pp. 57
Author(s):  
Ismi Masyithah ◽  
Usman Hadi ◽  
Eko Budi Koendhori
Keyword(s):  
Mortality Rate ◽  
General Hospital ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Ventilator Associated Pneumonia ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
The Mean ◽  
X 24

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the intensive care unit (ICU). Mechanically, ventilated patients have a higher risk of VAP. VAP can increase morbidity, mortality, and treatment costs. However, Indonesia lacks data about VAP. The objective of this study was to find out the characteristics of VAP in Dr. Soetomo General Hospital, Surabaya, in the period of August 2017 until August 2018.Methods: This was a cross-sectional study by assessing medical records of the patients in ICU. The variables observed in this study were age, gender, outcome, length of stay in the ICU (LOSICU), and primary diagnosis. The inclusion criteria were the patients who have been using mechanical ventilation at least 2 x 24 hours in the ICU and confirmed VAP. The data were analyzed descriptively by using Microsoft Excel 2016.Results: A total of 18 VAP patients were diagnosed. VAP patients were dominated male (55.6%). The mean of LOSICU was 22.83 ± 11.24 days, and the mortality rate of VAP patients was high (55.6%). 30% of VAP patients had Guillain-Barre Syndrome (GBS) as the primary diagnosis, and 16.65% had Congenital Heart Disease (CHD).Conclusion: Most VAP patients were male and had prolonged stays. The mortality rate of VAP patients was still high. GBS was the most frequent of primary diagnoses in patients with VAP and also CHD.

scholarly journals The Effect of Scheduling on Operating Room Utilization at an Affiliated Hospital of Shahid Sadoughi University of Medical Sciences in Yazd

2019 ◽  
Author(s):  
Seyed Jamaledin Tabibi ◽  
Bahram Delgoshaei ◽  
Maryam Nikfard
Keyword(s):  
Operating Room ◽  
General Surgery ◽  
Cross Sectional Study ◽  
Utilization Rate ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Research Findings ◽  
Turn Over ◽  
Surgical Unit ◽  
Nose And Throat

Introduction: Resource management and efficiency analysis assist the hospitals in controlling the expenses and optimum utilization. Operating room (OR) is one of the most critical and expensive resources in a hospital. Operating room utilization is a measure calculated as a ratio between the available time and the used actual minutes. In the current study, we aimed to measure OR utilization in Yazd Shahid Sadoughi Hospital. Methods: This is a descriptive cross-sectional study in which all the surgeries performed in ORs of Shahid Sadoughi Hospital were investigated during a 15-day period. Data were collected from four randomly-selected rooms in the surgical unit in January 2013 using some pre-designed checklists. Results: A total of 151 surgeries were conducted during a 53-day period in four ORs. We found that OR utilization was 68% for the Orthopedics, 61% for the Ophthalmology, 89% for the General Surgery, and 86% for the ear, nose and throat (ENT) ORs. Total adjusted utilization was 77% and raw utilization rate was 70%. Of the 19080 minutes dedicated for surgeries, 13400 minutes were spent on surgeries and 1215 minutes were used for the turn-over-time or the delay between two surgeries. Of 53 days, the ORs were used efficiently for 7 days, under-utilized for 27 days, and over-utilizedfor 19 days. Conclusion: Data analysis showed that the Orthopedics and Ophthalmology ORs were under-utilized; whereas, the General Surgery room was over-utilized. The ENT utilization was in an appropriate range. The lowest utilization rate in a day was recorded for the Orthopedics OR (17%), while the highest rate was 158% for ENT. Further studies are recommended to measure OR utilization in a longer period of time and use the research findings to have accurate  scheduling for the ORs leading to their efficiency improvement.

scholarly journals Lack of lockdown, open borders, and no vaccination in sight: is Bosnia and Herzegovina a control group?

2021 ◽  
Author(s):  
Adnan Fojnica ◽  
Ahmed Osmanovic ◽  
Nermin Đuzic ◽  
Armin Fejzic ◽  
Ensar Mekic ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Bosnia And Herzegovina ◽  
Health Care Professionals ◽  
Herd Immunity ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Control Group ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Open Borders

AbstractBosnia and Herzegovina is among ten countries in the world with the highest mortality rate due to COVID-19 infection. Lack of lockdown, open borders, high mortality rate, no herd immunity, no vaccination plan, and strong domestic anti-vaccination movement present serious COVID-19 concerns in Bosnia and Herzegovina. In such circumstances, we set out to study if the population is willing to receive the vaccine.A cross-sectional study was conducted among 10,471 adults in Bosnia and Herzegovina to assess the attitude of participants toward COVID-19 vaccination. Using a logistic regression model, we assessed the associations of sociodemographic characteristics with vaccine rejection, reasons for vaccine hesitancy, preferred vaccine manufacturer, and information sources.Surprisingly, only 25.7% of respondents indicated they would like to get a COVID-19 vaccine, while 74.3% of respondents were either hesitant or completely rejected vaccination. The vaccine acceptance increased with increasing age, education, and income level. Major motivation of pro-vaccination behaviour was intention to achieve collective immunity (30.1%), while the leading incentive for vaccine refusal was deficiency of clinical data (30.2%). The Pfizer-BioNTech vaccine is shown to be eightfold more preferred vaccine compared to the other manufacturers. For the first time, vaccine acceptance among health care professionals has been reported, where only 39.4% of healthcare professionals expressed willingness to get vaccinated.With the high share of the population unwilling to vaccinate, governmental impotence in securing the vaccines supplies, combined with the lack of any lockdown measures suggests that Bosnia and Herzegovina is unlikely to put COVID-19 pandemic under control in near future.

scholarly journals Compliance of anti-rabies vaccine among dog bite victims in an urban slum of Chennai: a cross sectional study

2018 ◽  
Vol 5 (4) ◽  
pp. 1487
Author(s):  
Shivasakthimani R. ◽  
Vinoth Gnana Chellaiyan D. ◽  
Ravivarman G. ◽  
Murali R.
Keyword(s):  
Mortality Rate ◽  
Compliance Rate ◽  
Health Centre ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Rabies Vaccine ◽  
Sectional Study ◽  
Dog Bite ◽  
Cross Sectional ◽  
Dog Bites

Background: Among infectious disease, rabies has the highest case fatality rate. The major problem of rabies is attributable to its dog-mediated transmission which is an impending threat to more than 3.3 billion people. Poor compliance of vaccine increases the mortality rate due to rabies. The present study attempts to ascertain pattern of dog bite and compliance to post exposure prophylaxis.Methods: This cross sectional study was carried out in Primary Health Centre in an urban slum of Chennai in Tamil Nadu. The study included 301 dog bite victims residing in urban slum with wound categories II & III (as per WHO). A pretested, semi-structured questionnaire was used for data collection. Data was analysed with SPSS-IBM (version 21.0). Chi-square test was applied.Results: Mean (SD) age of study participants was 28 (±16.3) years. Males were 176 (58.5%) and females were 125 (41.5%). Among the bites, pet dog bites were 140 (46.5%), and stray dog bites were 161 (53.5%). Majority of the bites 161 (53.5%) were unprovoked, category II bites were 216 (28.2%).Compliance up to 3 dose was found in 213(70.8%). Association was found between site of the dog bite and compliance of anti- rabies vaccine (p=0.021).Conclusions: Despite the availability of costless vaccines in public health care system, the compliance rate is only moderate. Health education about the vaccination after dog bite needs to be imparted among the community to reduce the rabies related mortality rate.

scholarly journals Biological risk in the activity of the nurse auditor.

2018 ◽  
Vol 18 (70) ◽  
Author(s):  
Lucieno De Moura Santos ◽  
James Anthony Falk
Keyword(s):  
Emergency Services ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Biological Risk ◽  
Hospital Work ◽  
Terapia Intensiva ◽  
The City ◽  
Surgical Unit

ABSTRACTThe hospital work environment is considered unhealthy for grouping patients with different infectious diseases and providing many procedures which may lead to accident risks and diseases for health workers. Employees who are potentially exposed to risks have to be informed and trained to avoid health problems. This study aimed to identify if the nurse auditor is exposed to biological risks in the development of their activities. It is a descriptive, exploratory, cross-sectional study with quantitative analysis. It was held in a private, medium-sized hospital in the city of Recife, Brazil, which has clinical and cardiological emergency services; hospitalization; diagnostic aid; surgical unit and intensive care unit. The sample consisted of 31 internal and external nurses, in relation to the characterization of the sample or study revealed that the interviewees are mostly women aged 27 to 38 years, with 4 to 6 years of professional experience and who sporadically attend courses of improvement. 94% of the interviewees answered that there was presence of blood or secretion in the audited medical records, and 84% of them reported that this happened sporadically. 65% are in contact with the patient (on-site) and 85% do not receive the additional unhealthy. The evaluation for the payment of hazard pay is qualitative, what can help to ensure that each employer adopt the way you believe to be the most convenient for the implementation or not of this payment. Key words: biological risk, nursing, auditory. RESUMOO ambiente de trabalho hospitalar é considerado insalubre por agrupar pacientes portadores de diversas enfermidades infectocontagiosas e viabilizar muitos procedimentos que oferecem riscos de acidentes e doenças para os trabalhadores da saúde. Os funcionários potencialmente expostos aos riscos precisam estar informados e treinados para evitar problemas de saúde. Este estudo teve por objetivo identificar se o enfermeiro auditor está exposto a riscos biológicos no desenvolvimento de suas atividades. Trata-se de um estudo descritivo, exploratório, transversal com análise quantitativa. Foi realizado em um hospital privado, de médio porte, na cidade de Recife-PE, Brasil, que possui os serviços de emergência clínica e cardiológica; internação; auxílio ao diagnóstico; bloco cirúrgico e unidade de terapia intensiva. A amostra foi composta por 31 enfermeiros auditores internos e externos, em relação a caracterização da amostra o estudo revelou que os entrevistados em sua maioria são mulheres com idade de 27 a 38 anos, com 4 a 6 anos de experiência profissional e que esporadicamente frequentam cursos de aperfeiçoamento, 94% dos entrevistados responderam que havia presença de sangue ou secreção nos prontuários auditados sendo que 84% destes, relataram que este fato ocorria de maneira esporádica, 65% atuam em contato com o paciente (in loco) e 85% não recebem o adicional de insalubridade. A avaliação para o pagamento da insalubridade é qualitativa, o que pode contribuir para que cada empregador adote a maneira que acredita ser a mais conveniente para a efetivação ou não desse pagamento. Palavras-chave: risco biológico, enfermagem, auditoria.

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