scholarly journals Impact of COVID-19 on Elective Surgical Lists in Otorhinolaryngology: An Overview

2021 ◽  
Vol 25 (1) ◽  
pp. 6-9
Author(s):  
Memon Afzal ◽  
Tabassum Aziz ◽  
Nausheen Qureshi ◽  
Sundas Masood ◽  
Fatima Shahid ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Descriptive Study ◽  
Microsoft Excel ◽  
Excel Spreadsheet ◽  
Emergency Procedures ◽  
Surgical Services ◽  
Elective Surgical Procedures ◽  
Precautionary Measures ◽  
Spread Of Infection

Objective: To study how the COVID-19 is affecting the treatment and management of other ailments. Try to find a strategy to resume elective OR lists.Introduction: We overviewed the effect of COVID-19 on the elective surgical lists of otorhinolaryngology in the ENT Department of Holy Family Hospital, Rawalpindi.Materials and Methods: The data from Jan 2020 to July 2020 was collected. It is a descriptive study analyzing the data, 3 months before and 3 months after the imposition of lockdown in the whole of Pakistan due to a surge in COVID-19 cases. The data was collected from the operation dating register of OPD and elective operative lists of ENT OT. Data were analyzed by Microsoft excel spreadsheet version 7. Results: There was an overall 92% decrease in the elective surgical procedures done in the ENT dept. of Holy family Hospital during the COVID-19 lockdown period. The procedures done in the COVID lockdown period were mostly emergency procedures and lifesaving procedures.Conclusion: COVID-19 has badly impacted the elective surgical procedures and in turn the health of the patients presenting to ENT OPD with various diseases which were treated surgically before COVID lockdown.Recommendations: To prevent this from happening again during the 2nd wave of COVID-19, we could opt for multiple precautionary measures to avoid the spread of infection and continue the provision of our surgical services to the patients.

scholarly journals Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Royi Barnea ◽  
Adi Niv-Yagoda ◽  
Yossi Weiss
Keyword(s):  
Health Insurance ◽  
Surgical Procedures ◽  
Health Expenditure ◽  
Medical Center ◽  
Waiting Times ◽  
Publicly Funded ◽  
Private Hospitals ◽  
The Public ◽  
For Profit ◽  
Elective Surgical Procedures

Abstract Background The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures. Methods Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics. Results Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%. Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%. Conclusions and policy implications In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals. Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.

A Retrospective Descriptive Study on Death Due to Cyanide Poisoning Over a Period of 20 Years in Government Medical College, Thiruvananthapuram

2021 ◽  
Vol 8 (30) ◽  
pp. 2697-2701
Author(s):  
Sasikala K ◽  
Vitni Fernz ◽  
Abitha Raj B.T ◽  
Ajith V. Asok ◽  
Amritha Mathew ◽  
...  
Keyword(s):  
Social Sciences ◽  
Preliminary Investigation ◽  
Laboratory Data ◽  
Descriptive Study ◽  
Serial Killers ◽  
Age Group ◽  
Cyanide Poisoning ◽  
Microsoft Excel ◽  
Medical College ◽  
Pro Forma

BACKGROUND Cyanide is a rapidly acting poison which has been the suicidal agent of choice since time unknown. Its notoriety also extends to homicide, and it has often been used by serial killers. It is found in nature and is used in various industries, but is difficult to obtain nowadays as a result of strict policy implementation. METHODS All cases of cyanide poisoning over a period of 20 years from 2000 to 2019 were studied. Samples were sent for identification and quantification by GC-MS to the chemical examiner’s laboratory. Data was collected in pro forma and entered into Microsoft Excel and analysed using statistical package for social sciences (SPSS). RESULTS A total of 84 cases were studied over a period of 20 years. The majority of cases were recorded in the first decade of the study period. Most common age group involved was 31 to 40 years. Males comprised 84.9 % of the total. Majority were suicidal in nature, and 22.6 % were suicide pacts. The reason for committing suicide could not be found in 59.3 %. 67.9 % were found dead or brought dead to the hospital. In 24 % cases, the typical smell of bitter almonds was identified. Police were able to make out the presence of poison in 83.3 % during the preliminary investigation. CONCLUSIONS Males were the commonly affected. Ingestion of poison was the method of administration in all cases. Majority were suicides, and occurred in the residence of the victims. In majority of cases, police could identify the cause of death as poisoning. The characteristic smell could be identified only in a few cases. KEYWORDS Cyanide, Corrosion, Poisoning, Suicide

A Guideline for Anticipated Blood Usage during Elective Surgical Procedures

1979 ◽  
Vol 71 (6) ◽  
pp. 680-684 ◽  
Author(s):  
Leonard I. Boral ◽  
Francis J. Dannemiller ◽  
William Stanford ◽  
Sherwood S. Hill ◽  
Terry A. Cornell
Keyword(s):  
Surgical Procedures ◽  
Elective Surgical Procedures ◽  
Blood Usage

The Clinical Neuromuscular Pharmacology of 51W89 in Patients Receiving Nitrous Oxide/Opioid/Barbiturate Anesthesia 

1995 ◽  
Vol 82 (5) ◽  
pp. 1139-1145 ◽  
Author(s):  
Matthew R. Belmont ◽  
Cynthia A. Lien ◽  
Steve Quessy ◽  
Martha M. Abou-Donia ◽  
Amy Abalos ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Surgical Procedures ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agent ◽  
Blocking Effect ◽  
Preclinical Studies ◽  
Physical Status ◽  
Elective Surgical Procedures ◽  
Recovery Index

Background Atracurium is a mixture of ten stereoisomers. 51W89, one of these isomers, is a potent nondepolarizing intermediate-duration neuromuscular blocking agent. Preclinical studies have shown 51W89 to be significantly more potent than atracurium but with a similar neuromuscular blocking profile. This study was undertaken to establish the neuromuscular blocking potency and pharmacodynamics of 51W89 in patients undergoing elective surgical procedures. Methods Ninety-nine ASA physical status 1 or 2 patients undergoing elective surgical procedures under nitrous oxide/opioid/barbiturate anesthesia were studied. The neuromuscular blocking effect of 51W89 was assessed after administration of bolus doses from 0.015 to 0.4 mg/kg, as well as during and after continuous infusions from 11 to 249 min in length. Results The calculated ED95 for inhibition of adductor pollicis twitch evoked at 0.15 Hz was 0.048 mg/kg. At 0.10 mg/kg, maximum block developed within 5.2 +/- 0.3 min, and recovery to 95% twitch height occurred 64.4 +/- 3.9 min after injection. At 0.4 mg/kg, onset was 1.9 +/- 0.1 min, and 95% recovery developed within 121.0 +/- 5.9 min. Comparative recovery indexes from 5% to 95% or from 25% to 75% twitch heights did not differ significantly among all dosage groups from 0.1 to 0.4 mg/kg (means ranged from 29.6 to 32.3 min and from 12.6 to 14.3 min, respectively). The average infusion rate necessary to maintain approximately 95% twitch suppression was 1.35 micrograms/kg/min. Recovery indexes from infusions were 5-95% 33.2 +/- 1.8 min and 25-75% 15.0 +/- 0.6 min, not differing significantly from recovery indexes from single bolus doses. Twenty-five patients received neostigmine (0.06 mg/kg) with atropine (0.03 mg/kg) at twitch height recovery of between 6% and 21%. Antagonism to 95% control twitch height developed within 6.8 +/- 0.3 min, and the neostigmine-accelerated 25-75% recovery index was 2.8 +/- 0.2 min. Conclusions 51W89 is a potent nondepolarizing neuromuscular blocking agent that shows noncumulative intermediate-duration neuromuscular blocking pharmacodynamics.

Simulating Fraunhofer diffraction of waves using microsoft excel spreadsheet

2018 ◽  
Vol 53 (5) ◽  
pp. 055010
Author(s):  
I Singh ◽  
K Khun Khun ◽  
B Kaur
Keyword(s):  
Fraunhofer Diffraction ◽  
Microsoft Excel ◽  
Excel Spreadsheet

Allergy skin testing: Science or quackery?

PEDIATRICS ◽  
1977 ◽  
Vol 59 (4) ◽  
pp. 495-498
Author(s):  
Gail G. Shapiro ◽  
C. Warren Bierman ◽  
Clifton T. Furukawa ◽  
William E. Pierson
Keyword(s):  
Physical Examination ◽  
American Academy ◽  
Surgical Procedures ◽  
Skin Testing ◽  
Skin Tests ◽  
Elective Surgical Procedures ◽  
American Academy Of Pediatrics ◽  
Telephone Calls ◽  
Allergy Skin Testing

A commentary in Pediatrics in September 19751 condemned procedure-oriented fee schedules because they encouraged and rewarded the abuse of laboratory and elective surgical procedures. Allergy skin testing was included in this list. Letters to the American Academy of Pediatrics and telephone calls to the Chairman of the Section on Allergy of the Academy took issue with this inclusion. The commentary, however, was directed toward physicians and allergy laboratories who abuse skin testing rather than toward the procedure itself. It was directed to those who perform innumerable and casually selected skin tests as a substitute for an appropriate history, physical examination, and carefully selected tests based on that evaluation.

Major trauma

2019 ◽  
pp. 875-884
Author(s):  
David Nott
Keyword(s):  
Trauma Patient ◽  
Surgical Procedures ◽  
Medical Management ◽  
Major Trauma ◽  
Initial Assessment ◽  
Medical Providers ◽  
Low Resource ◽  
Surgical Services ◽  
Management Guidance

This chapter provides essential management guidance for medical providers in low-resource environments when surgical services are not readily available. ‘Major trauma’ reviews management of a trauma patient, from initial assessment and medical management, to basic, yet lifesaving, surgical procedures.

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