A general practitioner primer on groin hernias

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

Download Full-text

Evaluation of an Electronic General-Practitioner-Based Syndromic Surveillance System - Auckland, New Zealand, 2000-2001

PsycEXTRA Dataset ◽

10.1037/e307182005-030 ◽

2004 ◽

Author(s):

Nicholas F. Jones ◽

R. Marshall

Keyword(s):

New Zealand ◽

General Practitioner ◽

Surveillance System ◽

Syndromic Surveillance ◽

Syndromic Surveillance System

Download Full-text

The role of the general practitioner in dementia care

PsycEXTRA Dataset ◽

10.1037/e537132013-009 ◽

1999 ◽

Author(s):

Murna Downs

Keyword(s):

General Practitioner ◽

Dementia Care

Download Full-text

Primary prevention in the general practitioner office - a mixed-method study

Das Gesundheitswesen ◽

10.1055/s-0032-1322032 ◽

2012 ◽

Vol 74 (08/09) ◽

Author(s):

C Holmberg ◽

G Sarganas ◽

N Mittring ◽

V Braun ◽

L Dini ◽

...

Keyword(s):

General Practitioner ◽

Primary Prevention ◽

Mixed Method ◽

Mixed Method Study

Download Full-text

Postmarketing Surveillance Based on Electronic Patient Records: The IPCI Project

Methods of Information in Medicine ◽

10.1055/s-0038-1634402 ◽

1999 ◽

Vol 38 (04/05) ◽

pp. 339-344 ◽

Cited By ~ 88

Author(s):

J. van der Lei ◽

B. M. Th. Mosseveld ◽

M. A. M. van Wijk ◽

P. D. van der Linden ◽

M. C. J. M. Sturkenboom ◽

...

Keyword(s):

General Practitioner ◽

General Practitioners ◽

Validation Studies ◽

Resource Planning ◽

Routine Practice ◽

Patient Records ◽

Postmarketing Surveillance ◽

Electronic Patient Records ◽

Use Of Data ◽

Data Requirements

AbstractResearchers claim that data in electronic patient records can be used for a variety of purposes including individual patient care, management, and resource planning for scientific research. Our objective in the project Integrated Primary Care Information (IPCI) was to assess whether the electronic patient records of Dutch general practitioners contain sufficient data to perform studies in the area of postmarketing surveillance studies. We determined the data requirements for postmarketing surveil-lance studies, implemented additional software in the electronic patient records of the general practitioner, developed an organization to monitor the use of data, and performed validation studies to test the quality of the data. Analysis of the data requirements showed that additional software had to be installed to collect data that is not recorded in routine practice. To avoid having to obtain informed consent from each enrolled patient, we developed IPCI as a semianonymous system: both patients and participating general practitioners are anonymous for the researchers. Under specific circumstances, the researcher can contact indirectly (through a trusted third party) the physician that made the data available. Only the treating general practitioner is able to decode the identity of his patients. A Board of Supervisors predominantly consisting of participating general practitioners monitors the use of data. Validation studies show the data can be used for postmarketing surveillance. With additional software to collect data not normally recorded in routine practice, data from electronic patient record of general practitioners can be used for postmarketing surveillance.

Download Full-text

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

Journal of Surgical Sciences ◽

10.3329/jss.v23i2.46111 ◽

2020 ◽

Vol 23 (2) ◽

pp. 54-58

Author(s):

ABM Mahbubur Rahman ◽

Tamjeed Alam ◽

AHM Shamsul Alam ◽

Fahim Ferdaus ◽

Gazi Gias Uddin

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Groin Hernia ◽

Tertiary Care ◽

Groin Hernia Repair ◽

Groin Hernias ◽

Laparoscopic Groin Hernia Repair ◽

Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

Download Full-text

A Clinical Study and Management of Inguino-scrotal Swellings In Children

Journal of Medical Research and Innovation ◽

10.15419/jmri.125 ◽

2018 ◽

Vol 2 (S1) ◽

pp. e000125

Author(s):

Khyati Vaja ◽

Mukesh Suvera

Keyword(s):

Inguinal Hernia ◽

Pediatric Surgery ◽

Pediatric Patients ◽

Undescended Testis ◽

Length Of Hospital Stay ◽

Indirect Inguinal Hernia ◽

Short Term ◽

One Year ◽

Groin Hernias ◽

Inguinal Hernia In Children

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.

Download Full-text