scholarly journals Surgery Department during Coronavirus Disease 2019 Virus Universitas Sebelas Maret to Sebelas Maret University

2021 ◽  
Vol 9 (E) ◽  
pp. 437-442
Author(s):  
Muhammad David Perdana Putra ◽  
Kristanto Yuli Yarso ◽  
Ikhdin Saadi ◽  
Yohanes Adinugroho
Keyword(s):  
Health Care Services ◽  
Health Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Standard Operating Procedure ◽  
Surgical Patient ◽  
Care Services ◽  
Number Of Patients ◽  
Surgery Department ◽  
The Impact

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has severely affected the provision of health-care services in hospitals around the world, including bringing challenges to those who perform surgical procedures. Multidepartment data analysis will reflect the pandemic’s impact and challenges in managing surgical cases in various surgery departments. AIM: This study aims to assess the impact of COVID-19 lockdowns on surgical cases carried out in eight tertiary care center surgery departments. METHODS: Retrospective data from all patients in the eight surgery departments of Dr. Moewardi General Hospital, Surakarta, during the lockdown period due to COVID-19 were collected and compared to the period before the lockdown. Then, the data were analyzed regarding the effects of following the standard operating procedure for surgical services in the hospital during the lockdown period. RESULTS: All the surgery departments involved in the study showed a significant reduction in the number of patients treated during the lockdown period than before the lockdown, with a total number of cases across all departments of 2432, a decrease from 4503 before the lockdown. In surgical patient care, several special measures during the COVID-19 pandemic were carried out in outpatient, intraoperative, and inpatient services to reduce the virus spread to patients and health workers. CONCLUSION: The COVID-19 pandemic has severely affected the provision of health services in hospitals with a reduction in the number and types of patients in each surgery department, and the obligation to follow hospital protocols against COVID-19 has resulted in various treatments and services being delayed in all surgery departments.

scholarly journals Impact of COVID-19 on Management of Laryngeal/Oropharyngeal Neoplasms

2020 ◽  
pp. 194338752096382
Author(s):  
Mohamed Abd Elmottaleb Sabaa ◽  
T. M. Algarf
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Services ◽  
Tertiary Care ◽  
Care Hospital ◽  
Oropharyngeal Neoplasms ◽  
Care Services ◽  
Number Of Patients ◽  
The Impact

Study Design: A retrospective cohort study. Objective: The world was unprecedentedly struck by the new coronavirus in December 2019. Consequently, lockdown measures were imposed by many governments. Health-care services were reserved for emergencies and malignancies. Nevertheless, many patients who urgently needed these services did not present. This study estimates the impact of COVID-19 and lockdown measures on the patients’ flow in the outpatient clinic (OPC) and the operations for laryngeal and/or oropharyngeal neoplasms. Methods: This study is a retrospective cohort study performed in otolaryngology department of a tertiary care hospital which is a major referral center. All patients who attended the OPC and all operations performed for laryngeal and/or oropharyngeal neoplasms were counted from February 1, 2020 to May 31, 2020 and compared with the previous year as a reference. Results: In 2020, the number of patients attending the otolaryngology OPC and the laryngeal and/or oropharyngeal surgeries showed a major drop, especially after imposing the lockdown measures. The total number of these operations in April and May 2019 dropped by 79% for the same period in 2020. Conclusion: An estimate of 79% of patients, who had been presenting for laryngeal and/or oropharyngeal neoplasms, did not show up due to indirect COVID-19 effect.

scholarly journals Paradigm Shift in Clinical Practice of Sexual Health in Men During COVID-19 Pandemic

2021 ◽  
pp. 263183182110323
Author(s):  
Aditya Prakash Sharma ◽  
Japleen Kaur ◽  
Ravimohan S. Mavuduru ◽  
Shrawan K. Singh
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Seeking ◽  
Number Of Patients ◽  
The Impact

Sexual health-care seeking behavior and practices have been affected during COVID-19 pandemic. The impact of COVID-19 on this subspecialty is far reaching. This study aimed to assess the impact of COVID-19 on health-care seeking practice pertaining to sexual health in men in our tertiary care center and review the relevant literature regarding impact of COVID-19 on sexual health seeking practice and challenges faced. Outpatient data was analyzed from January 2019 to April 2021. Patients awaiting surgical procedures due to COVID were documented. A narrative synthesis of literature based on systematic search using the keywords sexual health, sexual health seeking, sexual health practice, andrology, and COVID with operators “AND” and “OR” was carried out in three search engines PubMed, Scopus, and Embase. The study outcomes were obtained by comparing data of outpatient attendance and compiling the reviewed literature. The mean attendance fell significantly from 95.11±11.17 to 17.25±13.70 persons (P <.0001) per outpatient clinic, March 2020 being the reference point. Teleconsultation has taken over physical consultation. In 98/949 cases, teleconsult could not be provided despite registration. Over 25 patients were waiting for surgical procedures pertaining to andrology due to shut down of elective services. Similar trends have been reported from other countries. Number of patients seeking consultation for sexual health problems has dramatically decreased during COVID-19 era. Establishment of data safe teleconsultation facility and its widespread advertisement is needed to encourage patients to seek consult.

Abstract 14747: Dwindling Trends of Cardiology Admissions Amidst Covid-19 Pandemic in a Tertiary Care Center of Pakistan

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamshed Ali ◽  
Osman Faheem ◽  
Pirbhat Shams ◽  
ghufran adnan ◽  
Maria Khan
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Electronic Record ◽  
Medical Attention ◽  
Care Hospital ◽  
Record System ◽  
Admission Rates ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
The Impact

Introduction: Social containment measures have been adopted globally to control COVID-19 outbreak. Reduction in hospital visits and inpatient admission rates have become cause for concern. Through this study we aimed to analyze the impact of SARS-CoV-2 virus Outbreak on cardiology inpatient admissions at a tertiary care hospital in Pakistan. Hypothesis: COVID-19 pandemic has resulted in significant decline in cardiology admissions. Methods: We conducted a retrospective study at our center. Admission log was accessed via electronic record system. Comparison was made for same months of 2019 and 2020 with regard to cardiology inpatient admissions. Results: A total of 239 patients were admitted to cardiology services in 2019 period and 106 in 2020 period with resultant reduction of 55.6%. Number of patients admitted to the coronary care unit were 179 and 78 respectively where as the numbers declined to 28 from 60 for cardiac step down. Reduction for admission numbered to 52.4% for males and 38.89% for females. 9.3% patients left against medical advice in 2019 and 3.4% in 2020. Conclusions: Our study concludes that numbers of cardiology admissions have dwindled. Possible explanation for this can be implementation of social containment and fear of acquiring infection. This has raised a question of whether a significant number of cardiovascular morbidity and mortality has occurred without seeking medical attention and has went unrecorded during the pandemic. This calls for stringent diagnostic measures in future to diagnose previously unrecorded burden.

Evaluation of Health Care Services Provided in Political Public Meetings in Turkey: A Forgotten Detail in Politics

2018 ◽  
Vol 33 (6) ◽  
pp. 607-613
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir ◽  
Gamze Babur Güler
Keyword(s):  
Health Care ◽  
Political Parties ◽  
Health Care Services ◽  
Heat Index ◽  
Election Campaign ◽  
Medical Conditions ◽  
Public Meetings ◽  
Care Services ◽  
Number Of Patients ◽  
The Impact

AbstractBackgroundPolitical parties in Turkey execute political public meetings (PPMs) during their election campaign for members of the parliament (MoP). A great number of people attend these meetings. No guidelines exist regarding preparation and organization of health care services provided during these meetings. Furthermore, there is no study evaluating health care problems encountered in previous PPMs.ObjectivePolitical parties arranged PPMs in 2015 during the election campaign for general election of MoP. The present study aimed to investigate the context of health care services, the distribution of assigned health staff, as well as the number and the symptoms of patients admitted in health care tents in these PPMs.MethodsTwo general elections for MoP were done in Turkey on June 7, 2015 and November 1, 2015. Health care services were provided by the City Emergency Medical Services Department (CEMSD) in the cities. Demographic characteristics, symptoms, comorbid conditions, treatment, discharge, and hospital transfer of the patients were obtained from patient medical registration records. Information about the distribution and the number of the assigned staff was received from local CEMSDs. The impact of variables such as the number of attendees, heat index, humidity, and the day of the week on the number of patients and the patient presentation rate (PPR) were analyzed.ResultsA total of 97 PPMs were analyzed. The number of total attendees was 5,265,450 people. The number of patients seeking medical help was 1,991. The PPR was 0.5 (0.23-0.91) patients per 1,000 attendees. Mean age of the patients was 40 (SD=19) years old while 1,174 (58.9%) of the patients were female. A total of 1,579 patients were treated in the tents and returned to the PPM following treatment. Two-hundred and three patients were transferred to a hospital by ambulance. Transfer-to-hospital ratio (TTHR) was 0.05 (0.0-0.13) patients per 1,000 attendees. None of the patients suffered sudden cardiac death (SCD) or cardiac arrest. Medical conditions were the main cause for admission. The most common symptoms were dizziness, low blood pressure, fatigue, and hypertension, respectively. The most commonly used medical agents included pain killers and myorelaxants. The number of attendees, heat index, and weekend days were positively correlated with the number of the patients.Conclusion: The majority of medical conditions encountered in PPMs are easily treatable in health care tents settled in the meeting area. The number of attendees, heat index, and weekend days are factors associated with the number of patients.CeyhanMA, DemirGG, GülerGB. Evaluation of health care services provided in political public meetings in Turkey: a forgotten detail in politics. Prehosp Disaster Med. 2018;33(6):607–613.

scholarly journals P.109 Causes of albuminocytologic dissociation and the impact of an age-adjusted reference limit on review of 2,627 CSF samples

2018 ◽  
Vol 45 (s2) ◽  
pp. S45-S45
Author(s):  
JA Brooks ◽  
C McCudden ◽  
A Breiner ◽  
P Bourque
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Care Center ◽  
Tertiary Care ◽  
Common Finding ◽  
Blood Cell Count ◽  
Reference Limit ◽  
Number Of Patients ◽  
Upper Reference Limit ◽  
The Impact

Background: We set out to test the discriminative power of an age-adjusted upper reference limit (URL) for CSF total protein (CSF-TP) in identifying pathological causes of albuminocytologic dissociation (ACD). Methods: We reviewed the charts of 2,627 adult patients who underwent a lumbar puncture at a tertiary care center over a 20-year period. Samples with CSF-TP above 45 mg/dL (0.45 g/L) were included. Samples with white blood cell count > 5×109/L, red blood cell count > 50×109/L, and glucose < 2.5 mmol/L (45 mg/dL) were excluded. Patients with CSF-TP elevated above 45 mg/dL were considered to have ‘pseudo’ albuminocytologic dissociation (ACD) or ‘true’ ACD if their CSF-TP was in excess of age-adjusted norms. Results: Among all patients with ACD, a pathological source of CSF-TP elevation was identified in 57% (1490/2627) of cases, 51% of those with ‘pseudo’ ACD, and 75% with ‘true’ ACD (p< 0.001). Use of an age-adjusted upper reference limit favored the detection of polyneuropathy patients (13.5% proportionate increase) and excluded a larger number of patients with isolated headache (10.7% proportionate decrease; p < 0.0001). Conclusions: Elevated CSF-TP is a relatively common finding. Use of age-adjusted upper reference limits for CSF-TP values improve diagnostic specificity and help to avoid over-diagnosis of ACD.

Importance of community engagement in primary health care: the case of Afghan refugees

2015 ◽  
Vol 21 (3) ◽  
pp. 262 ◽  
Author(s):  
I-Hao Cheng ◽  
Sayed Wahidi ◽  
Shiva Vasi ◽  
Sophia Samuel
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Engagement ◽  
Health Care Services ◽  
Local Community ◽  
Health Workers ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
The Impact

Refugees can experience problems accessing and utilising Australian primary health care services, resulting in suboptimal health outcomes. Little is known about the impact of their pre-migration health care experiences. This paper demonstrates how the Afghan pre-migration experiences of primary health care can affect engagement with Australian primary care services. It considers the implications for Australian primary health care policy, planning and delivery. This paper is based on the international experiences, insights and expert opinions of the authors, and is underpinned by literature on Afghan health-seeking behaviour. Importantly, Afghanistan and Australia have different primary health care strategies. In Afghanistan, health care is predominantly provided through a community-based outreach approach, namely through community health workers residing in the local community. In contrast, the Australian health care system requires client attendance at formal health service facilities. This difference contributes to service access and utilisation problems. Community engagement is essential to bridge the gap between the Afghan community and Australian primary health care services. This can be achieved through the health sector working to strengthen partnerships between Afghan individuals, communities and health services. Enhanced community engagement has the potential to improve the delivery of primary health care to the Afghan community in Australia.

The Impact of the COVID-19 Pandemic on an Israeli Acute Care Surgery Unit: Fewer Patients, More Disease

2021 ◽  
pp. 000313482110111
Author(s):  
Yossi Maman ◽  
Adam Lee Goldstein ◽  
Uri Neeman ◽  
Yonatan Lessing ◽  
Lior Orbach ◽  
...  
Keyword(s):  
Health Care ◽  
Care Center ◽  
Tertiary Care ◽  
Acute Care Surgery ◽  
Charlson Comorbidity Index Score ◽  
Apache Ii Score ◽  
Number Of Patients ◽  
Significant Difference ◽  
Care Surgery ◽  
The Impact

Background The COVID-19 pandemic has transformed and affected every aspect of health care. Like any catastrophic event, the stress on hospitals to maintain a certain level of function is immense. Acute surgical pathologies cannot be prevented or curtailed; therefore, it is important to understand patterns and outcomes during catastrophes in order to optimize care and organize the health care system. Methods In a single urban tertiary care center, a retrospective study examined the first complete lockdown period of Israel during the COVID-19 pandemic. This was compared to the same time period the previous year. Results During the pandemic, time to hospitalization was significantly decreased. There was also an overall reduction in surgical admissions yet with a higher percentage being hospitalized for further treatment (69.2% vs 23.5%). The patients admitted during this time had a higher APACHE-II score and Charlson comorbidity index score. During the pandemic, time to surgery was decreased, there were less laparoscopic procedures, and more RBC units were used per patient. There were no differences in overall complications, except when sub-analyzed for major complications (9.7% vs 6.3%). There was no significant difference in overall in-house mortality or morbidity. Length of hospitalization was significantly decreased in the elderly population during the pandemic. Conclusion During the COVID-19 pandemic, despite a significantly less number of patients presenting to the hospital, there was a higher percentage of those admitted needing surgical intervention, and they were overall sicker than the previous year.

scholarly journals Retrospective Analysis of Early Impact of COVID-19 on Systemic Cancer Treatment—A Pilot Study

2021 ◽  
Vol 42 (01) ◽  
pp. 015-020
Author(s):  
Anakha Pattiyeil ◽  
Febin Antony ◽  
Sunu L Cyriac ◽  
Anilkumar Jose ◽  
Jini M. P.
Keyword(s):  
Cancer Care ◽  
Medical Oncology ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Drop ◽  
Relaxation Phase ◽  
Number Of Patients ◽  
Increased Risk ◽  
The Impact

Abstract Introduction Cancer care during the coronavirus disease 2019 (COVID-19) pandemic is challenging as the patients are at an increased risk of developing complications compared with the general population. Objectives This study was conducted to assess the impact of COVID-19 pandemic and nationwide lockdown on systemic cancer care. Materials and Methods This comparative descriptive study was conducted in the Department of Medical Oncology and Haematology in a tertiary care center in India. The study compared and analyzed the consecutive patient data of two different units in the Department of Medical Oncology in the pre-COVID phase (PCP) and post lockdown relaxation phase (PLRP). We represented the categorical data in frequency and percentage, and chi-squared test was used to analyze the variables. Results Patients were categorized based on demographic, disease-related, and hospital visit-related parameters and a significant drop noted in patients who utilized a prebooking facility (p = 0.0001), in the number of patients aged >50 years (p = 0.004), number of patients who presented with hematological malignancies (p = 0.006), and who came for follow-up (p = 0.0001). The other parameters remained statistically insignificant. Conclusions During PLRP, active systemic cancer care seems to have been less affected, whereas follow-up of patients and visits of elderly patients were significantly reduced. If the pandemic remains under control, cancer care may not get compromised. This shows the importance of flattening the curve for quality management of other diseases during a pandemic.

Protocol-Based Intravenous Fluid Hydration for Newly Created Ileostomies Decreases Readmissions Secondary to Dehydration

2020 ◽  
pp. 000313482097157
Author(s):  
Daniel J. Borsuk ◽  
Adam Studniarek ◽  
Slawomir J. Marecik ◽  
John J. Park ◽  
Kunal Kochar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Emergency Department Visits ◽  
Sporadic Group ◽  
Nursing Support ◽  
Protocol Implementation ◽  
Number Of Patients ◽  
Intravenous Hydration ◽  
The Impact

Background Newly created ileostomies often result in patient readmission due to dehydration secondary to high ostomy output. Implementation of a mandatory home intravenous hydration protocol can avoid this. We aim to evaluate the impact of mandatory home intravenous hydration for patients with newly created ileostomies. Materials and Methods All patients at a single, tertiary care center who underwent ileostomy creation during a period of sporadic home intravenous hydration (February 2011-December 2013) and mandatory protocol hydration (March 2016-December 2018) were reviewed for incidence of dehydration, readmissions, and emergency department visits. Results 241 patients were evaluated. 119 were in the “sporadic” group and 122 were in the “protocol” group. Operative approach differed among both groups, with hydration protocol patients undergoing 15% less open procedures and 4.9% more hand-assisted laparoscopic procedures ( P = .0017). Prior to protocol implementation, 23.5% of patients were sent home with intravenous hydration. Length of hospital stay after index ileostomy creation was shorter for “protocol” patients by 3.3 days ( P < .0001). 15.1% of “sporadic” patients experienced dehydration as compared to 7.4% of “protocol” patients ( P = .0283). Following protocol implementation, the number of patients readmitted due to dehydration increased from 13 to 14 ( P = .01). Discussion Standardized, mandatory at-home intravenous hydration following ileostomy creation leads to a significant reduction in postoperative incidence of dehydration and dehydration-associated readmissions. This protocol should be followed for all patients with newly created ileostomies, so long as adequate home health nursing support and active surveillance are available.

scholarly journals The impact of COVID-19 in the attendance of patients to the otolaryngology clinic: a retrospective review

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kanachai Boonpiraks ◽  
Yanin Nawachartkosit ◽  
Dhave Setabutr
Keyword(s):  
Head And Neck ◽  
Retrospective Review ◽  
Care Center ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Patient Specific ◽  
One Year ◽  
Surgery Department ◽  
The Impact

Abstract Background To evaluate the impact of the COVID-19 outbreak on patient management at an Otolaryngology Head and Neck Surgery Department at a tertiary care center in Southeast Asia. This is a retrospective review. Patient load and diagnosis at the Outpatient Division of the Otolaryngology Head and Neck Surgery Department were reviewed at the height of the initial wave of the COVID-19 pandemic. Patient-specific data was then compared during the same timeframe one year prior. Patients were then grouped into an additional subspecialty subgroup based upon their diagnosis. Descriptive statistics were analyzed. Results A total of 819 cases were identified in 2019 during the study period. At the peak of the first wave, cases fell to 483, constituting a 41% decrease between the years (p value = 0.083). The largest decrease was in Otology cases with a drop by 53% (p value = 0.047), with the smallest decrease noted in General cases. Laryngology visits overall showed an increase in cases by 41.7%. Moreover, new visits decreased by 35.5%, with the largest decrease in new Laryngology visits and new Head and Neck Oncology cases. New visits for general issues had the smallest drop in patients, decreasing by only 21% (p value = 0.006) Conclusions The COVID-19 pandemic caused a significant decrease in overall cases in the Otolaryngology Head and Neck Surgery outpatient department. Thus, in anticipation of future outbreaks, interventions may be tailored according to these trends.

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