scholarly journals IMPACT OF COVID 19 PANDEMIC ON ACUTE GENERAL SURGICAL EMERGENCY MANAGEMENT- A TERTIARY CARE HOSPITAL BASED STUDY

2021 ◽  
pp. 41-44
Author(s):  
K. K. Thakuria ◽  
Mon Mohan Boro ◽  
M. Naveen Kumar
Keyword(s):  
Conservative Management ◽  
Emergency Services ◽  
Tertiary Care ◽  
Perioperative Period ◽  
Hospital Staff ◽  
Care Hospital ◽  
Global Challenge ◽  
Surgical Emergency ◽  
Hospital Operations ◽  
Medical Disciplines

BACKGROUND: The COVID-19 pandemic is standing as a never before threat to the healthcare systems and hospital operations worldwide.Transmission of coronavirus (COVID-19) is a considerable risk during the perioperative period of surgery. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services. OBJECTIVES: This study was aimed to evaluate the changes in approach to management and the perioperative outcome of patients with acute surgical emergency during COVID-19 pandemic. STUDY DESIGN AND METHODS:We performed a retrospective observational study in patients presented with acute surgical emergency between April 2020 to June 2021. RESULTS: A total of 298 patients were included, among whom 12 (3.4%) were COVID 19 positive. 274 non-COVID patients and 8 COVID-19 positive patients underwent emergency surgery.While 12 non-COVID (4.1%) and 4 COVID-19 positive patients (40%) underwent conservative management. None of the hospital staff involved in the surgeries of COVID-19 positive patients developed any symptoms related to COVID-19. CONCLUSION: This study showed that the patients with surgical emergency both with or without COVID-19 infection were successfully treated,without influencing each other,through appropriate isolation measures,although managed in the same hospital. Importance can also be given towards conservative management particularly for COVID-19 positive patients presenting with surgical emergency selectively with proper monitoring. So it can be concluded that, although the management of surgical patients during the COVID-19 pandemic is a global challenge,adequate preparedness and strategic plan to adjust the surgical services can reduce the exposures to this highly contagious virus.

scholarly journals Recurrent Emergency Department Users: Two Categories with Different Risk Profiles

2019 ◽  
Vol 8 (3) ◽  
pp. 333 ◽  
Author(s):  
Ksenija Slankamenac ◽  
Meret Zehnder ◽  
Tim Langner ◽  
Kathrin Krähenmann ◽  
Dagmar Keller
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Services ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Co Morbidity ◽  
Ed Visits ◽  
Morbidity Index

Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.

scholarly journals A study on conservative management on paediatric bone forearm fractures in tertiary care hospital in Cuddalore district

2019 ◽  
Vol 5 (6) ◽  
pp. 1186
Author(s):  
Manikandarajan . ◽  
Dinesh Raj
Keyword(s):  
Conservative Management ◽  
Medical Records ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Plaster Cast ◽  
Final Visit ◽  
Care Hospital ◽  
Forearm Fractures ◽  
Before And After

<p class="abstract"><strong>Background:</strong> Diaphyseal fractures of the radius and ulna are common in the pediatric population. The standard management for pediatric forearm fractures remains conservative management with closed reduction and immobilization with an above elbow plaster cast. Though the fracture unites readily, malunion is very common. Stiffness of joints, compartment syndrome is other complications of conservative management with plaster cast Forearm fractures are common in the pediatric population. These fractures are mostly managed conservatively by means of closed manual reduction and casting. The aim of this study was to reiterate the importance of conservative management in both bone forearm fractures in the pediatric population.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study from a tertiary level trauma center on 70 children up to 14 years of age with both bone forearm fractures from June 2018 to June 2019, cases were obtained from medical records. Data were collected and confirmed by plain X-ray films and medical records.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures achieved union at the final visit. More than 90 of diaphyseal forearm fractures achieved exceptional radiological and clinical outcomes and almost no case had a significantly poor outcome. There were significantly reduced angulation deformities before and after treatment (p&lt;0.05).</p><p><strong>Conclusions:</strong> Nonsurgical treatment as a model of management by means of closed reduction and casting is a very well accepted method of treating pediatric diaphyseal forearm fractures. </p>

scholarly journals Cord Care Methods in Neonates

2021 ◽  
Vol 15 (10) ◽  
pp. 3509-3510
Author(s):  
Andleeb Kanwal ◽  
Zahid Anwar ◽  
Mateen Akram ◽  
Shahid Anwar ◽  
Saima Pirzada
Keyword(s):  
Urban Areas ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Newborn Care ◽  
Hospital Staff ◽  
Care Hospital ◽  
Cord Care ◽  
Level 3 ◽  
The Mean ◽  
Nurses And Midwives

Background: Proper cord care methods in neonates have been known to reduce infections, sepsis, and death. This study intends to document the frequency of cord care methods. Methods: A questionnaire-based study was done in 6 months in a tertiary care hospital with a level 3 nursery and NICU (Fatima Memorial Hospital, Lahore). We interviewed mothers and female companions of neonates in wards and outpatient clinics. Answers were added to SPSS in socio-demographic categories and cord care methods. Result: A total of 778 females were interviewed. The mean age is 28 + 8.1 years, mostly educated (90%) and resided in urban areas (83%). 39.4% of the participants had personal experience of newborn care. Most were housewives (74.4%). 36.8% would not apply anything to the cord, but the other majority would apply some agent to the newborn cord, methylated spirit being the favourite (48.5%), remaining being mostly antibiotics and antimicrobial agents. Chlorhexidine was used only by one participant. Doctors and nurses had counselled 70% of the participants, but 10% listened to the advice of relatives and grandmothers. 18.5% declined any knowledge of safe practices. Conclusions: Our study emphasizes the need to educate our hospital staff (doctors, nurses and midwives) as well as family members of neonates with standardised cord care methods. Keywords: Neonates, Cord care, Umbilical cord,Methylated spirit.

scholarly journals Radiological Parameters for Conservative Management of Solid Organ Injuries in a Tertiary Care Hospital

2020 ◽  
Vol 5 (8) ◽  
pp. 672-676
Author(s):  
Hridhay. K.Prit ◽  
Dr. Perumal Boney
Keyword(s):  
Retrospective Analysis ◽  
Conservative Management ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Solid Organ ◽  
Care Hospital ◽  
The Past ◽  
Radiological Parameters ◽  
Hepatic Injuries

The management of solid organ injuries has changed drastically over the past couple of decades, with there being a shift from operative to conservative mode of management. The main purpose of this study is to establish radiological parameters for conservative management in order to make conservative mode of management more efficient. Retrospective analysis of solid organ injuries was done for 50 patients between January 2020 and March 2020 in a tertiary care hospital. It is found that conservative mode of management can be considered for patients belonging to grade I, II and III according to AAST classification of Splenic and Hepatic injuries whereas in Renal injuries it is considered for patients belonging to grade I and II

scholarly journals A study on waiting time and out-patient satisfaction at Gujarat medical education research society hospital, Valsad, Gujarat, India

2017 ◽  
Vol 4 (3) ◽  
pp. 857
Author(s):  
Ravikant Patel ◽  
Hinaben R. Patel
Keyword(s):  
Medical Education ◽  
Patient Satisfaction ◽  
Waiting Time ◽  
Treatment Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Research Society ◽  
Care Hospital ◽  
The Mean

Background: Gujarat Medical Education Research society started GMERS medical college and tertiary care Hospital in Valsad since last 4 years. As civil Hospital is converted in to tertiary care hospital and many of the departments running in different buildings so, searching the concern OPDs is difficult for patients, waiting time and patients satisfaction is important to avail the services. Patient satisfaction is one of the important goals of any health system, but it is difficult to measure the satisfaction. Aims & objectives were (1) to study the waiting time at various Out Patient Department (OPDs). and various investigation; (2) To study the accessibility of various department of hospital;  (3) To study the patient satisfaction on hospital process, behavior of hospital staff and treatment cost.Methods: This was a cross sectional observational study conducted in G.M.E.R.S. Hospital-Valsad for the period of 2 months and total 135 patients were interviewed availing the OPD Services.Results: The mean age of patient attending the OPD was 30.31±15.65 years and majority of them are female patient (54.07%). Hospital staff (48.89%) was main source of guidance for searching the OPDs for consulting the doctor. 54.07% patient registered 20 min after standing in queue. The mean waiting time was 12.16±2.35 min. 94.07% and 98.52% patients were satisfied with treatment cost and behavior of staff respectively.Conclusions: Many patients face the difficulties in finding the various departments. On an average 12 minutes of waiting time outside the various O.P.Ds. They were also satisfied with the treatment cost and behaviour of hospital staff.

scholarly journals Drug Utilization, Dosing, and Costs After Implementation of Intravenous Acetaminophen Guidelines for Pediatric Patients

2014 ◽  
Vol 19 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Nicholas M. Fusco ◽  
Kristine Parbuoni ◽  
Jill A. Morgan
Keyword(s):  
Pediatric Patients ◽  
Tertiary Care ◽  
Cost Effective ◽  
Perioperative Period ◽  
Care Hospital ◽  
Eligibility Criteria ◽  
Intravenous Acetaminophen ◽  
Age Appropriate ◽  
Acquisition Costs ◽  
Effective Use

OBJECTIVES The objectives of this evaluation of medication use were to characterize the use of intravenous acetaminophen at our institution and to determine if acetaminophen was prescribed at age-appropriate dosages per institutional guidelines, as well as to evaluate compliance with restrictions for use. Total acquisition costs associated with intravenous acetaminophen usage is described as well. METHODS This retrospective study evaluated the use of acetaminophen in pediatric patients younger than 18 years of age, admitted to a tertiary care hospital, who received at least 1 dose of intravenous acet-aminophen between August 1, 2011, and January 31, 2012. RESULTS A total of 52 doses of intravenous acetaminophen were administered to 31 patients during the 6-month study period. Most patients were admitted to the otorhinolaryngology service (55%), and the majority of doses were administered either in the operating room (46%) or in the intensive care unit (46%). Nineteen doses (37%) of intravenous acetaminophen were administered to patients who did not meet institutional guidelines' eligibility criteria. Three patients received single doses of intravenous acetaminophen that were greater than the dose recommended for their age. One patient during the study period received more than the recommended 24-hour maximum cumulative dose for acetaminophen. Total acquisition cost of intravenous acetaminophen therapy over the 6-month study period was $530.40. CONCLUSIONS Intravenous acetaminophen was used most frequently among pediatric patients admitted to the otorhinolaryngology service during the perioperative period. Nineteen doses (37%) were administered to patients who did not meet the institutional guidelines' eligibility criteria. Our data support reinforcing the availability of institutional guidelines to promote cost-effective use of intravenous acetaminophen while minimizing the prescription of inappropriate doses.

scholarly journals Post-operative hypocalcemia in patients undergoing thyroid surgeries in tertiary care hospital: an observational study

2021 ◽  
Vol 7 (8) ◽  
pp. 1293
Author(s):  
Tabish Maqbool ◽  
Showkat Ahmad Showkat ◽  
Kulvinder Singh Mehta
Keyword(s):  
Thyroid Surgery ◽  
Tertiary Care Hospital ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Perioperative Period ◽  
Female Gender ◽  
Care Hospital ◽  
Thyroid Resection ◽  
Strong Risk Factor ◽  
Permanent Hypocalcemia

<p><strong>Background: </strong>Post-operative hypocalcaemia is one of the most common complications of thyroid and parathyroid surgery. Temporary hypocalcaemia has been reported to occur in 1.6-50% of the patients undergoing bilateral thyroid resection. Permanent hypoparathyroidism results in 0-13% of patients after bilateral thyroid surgery.</p><p><strong>Method: </strong>We have analyzed the data of 34 patients undergoing total thyroid surgery (with or without neck dissection) and completion thyroidectomy at the department of ENT and HNS, SMHS hospital over a period of 1.5 years between May 2019 to November 2020.</p><p><strong>Results:</strong> Hypocalcemia was found in a total of 15 patients out of 34 patients in the post-op period. Among the total patients who developed hypocalcemia 5 (14.7%) were males and 10 (29.4%) were females. Among the patients who developed post-op hypocalcemia 14 patients developed transient hypocalcemia (p&gt;0.01) which is not statistically significant and 1 patient developed permanent hypocalcemia (p&gt;0.01) which also has no statistical significance.</p><p><strong>Conclusions: </strong>The study suggests that female gender is a strong risk factor for developing post-operative hypocalcemia, other factors that play a role include difference in serum calcium levels in the perioperative period and type of surgery.</p>

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