scholarly journals A preliminary study of the hospital-admitted older patients in a Sri Lankan tertiary care hospital

2010 ◽  
Vol 50 (1) ◽  
pp. 18 ◽  
Author(s):  
N Weerasuriya ◽  
S Jayasinghe
Keyword(s):  
Older Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sri Lankan ◽  
Care Hospital ◽  
Preliminary Study

scholarly journals Neurological diagnoses in the emergency room: differences between younger and older patients

2011 ◽  
Vol 69 (2a) ◽  
pp. 212-216 ◽  
Author(s):  
Marcos C. Lange ◽  
Vera L. Braatz ◽  
Carolina Tomiyoshi ◽  
Felipe M. Nóvak ◽  
Artur F. Fernandes ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Emergency Room ◽  
Older Patients ◽  
Tertiary Care Hospital ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Primary Headache ◽  
Care Hospital ◽  
National Guidelines ◽  
And Training

Neurological diseases are prevalent in the emergency room (ER). The aim of this study was to compare the neurological diagnoses between younger and older patients evaluated in the ER of a tertiary care hospital. METHOD: Patients admitted to the ER who required neurological evaluation in the first 24 hours were separated into two groups based on age, <;50 years old and >50 years old. RESULTS: Cerebrovascular disease (59.6% vs. 21.8%, p<0.01) was most frequent in the >50 years old group. Seizures (8.1% vs. 18.6%, p<0.01) and primary headache (3.7% vs. 11.4%, p<0.01) were most frequent in the <;50 years old group. CONCLUSION: The current study demonstrated that these three neurological diagnoses represented the majority of the neurological evaluations in the ER. National guidelines for ER teams that treat these prevalent disorders must be included in clinical practice and training.

scholarly journals Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025299
Author(s):  
Udagedara Mudiyanselage Jayami Esha Samaranayake ◽  
Yasith Mathangasinghe ◽  
Anura Sarath Kumara Banagala
Keyword(s):  
Informed Consent ◽  
Qualitative Study ◽  
Tertiary Care Hospital ◽  
Comparative Method ◽  
Tertiary Care ◽  
Lifestyle Changes ◽  
Cultural Norms ◽  
Sri Lankan ◽  
Care Hospital ◽  
Asking Questions

ObjectiveTo identify the different perceptions on informed surgical consent in a group of Sri Lankan patients.MethodsA qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations.ResultsThirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood.ConclusionThe informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society.

scholarly journals A secondary analysis of atypical presentations of older patients with infection in the emergency department of a tertiary care hospital in Thailand

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Panita Limpawattana ◽  
Thapanawong Mitsungnern ◽  
Pariwat Phungoen ◽  
Natthida Tansangworn ◽  
Wannisa Laosuangkoon
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Infectious Diseases ◽  
Older Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Analysis ◽  
Care Hospital ◽  
Associated Risk Factors ◽  
Atypical Presentations

AbstractBackgroundClassic symptoms of illness are often absent in older adults, delaying diagnosis and management, and resulting in unfavorable outcomes.ObjectivesTo determine the prevalence of atypical presentations by older Thai adults with infections in the emergency department (ED) of a tertiary care hospital, and to identify factors associated with atypical presentations in such patients.MethodsWe performed a secondary analysis of a retrospective cohort observational study of atypical presentations of patients aged ≥65 years in the ED using a subset of data first reported in the Archives of Gerontology and Geriatrics in 2015; 62:97-102.ResultsThe prevalence of atypical presentations was 35% of those with infectious diseases (64 of 183 cases). Pneumonia was the most common (30%). We identified 4 associated risk factors: complicated urinary tract infection (UTI) (odds ratio (OR) 4.54; 95% confidence interval (CI) 1.75,11. 78; P = 0.002), cancer (OR 2.64; 95% CI 1.07, 6.53; P = 0.04), dementia (OR 6.66; 95% CI 1.47, 30.11; P = 0.01), and pulse rate >90 beats/min (OR 2.06; 95% CI 1.01, 4.22; P = 0.04). Infective diarrhea was protective (OR 0.27; 95% CI 0.09, 0.8; P = 0.02).ConclusionsAtypical presentations of infectious diseases by older Thai patients in the ED accounted for about one third of those with infectious disease. Associated risk factors were complicated UTI, cancer, dementia, and increased pulse rate. Older patients with these factors who have uncertain diagnoses should be considered for hospitalization because the absence of classic symptoms does not exclude life-threatening infections.

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