Clinical and radiological aspects of mandibular fractures: A review of 128 cases

The objective was to study the epidemiological, clinical and radiological aspects of patients with mandibular fractures in the odontostomatology department at the General hospital Idrissa Pouye in Senegal. This was a retrospective study of the records of patients who came for a mandibular fracture during the period from February 2007 to June 2019 to the odontostomatology department of the General hospital Idrissa Pouye in Dakar. The inclusion criterion was any patient file containing complete information and presenting a mandibular fracture received in the odontostomatology department. We used sociodemographic, clinical and radiographic variables. Of 128 patients who came for consultation with a mandibular fracture, 115 were male and 13 were female. The age group most affected was between 21 and 30 years. Workers (25.2%), pupils and students (25.2%) were the most represented. The most frequent cause of mandibular fractures was road traffic accidents (36.71%). In 41% of the road accidents, Jakarta mopeds were involved. The diagnosis was confirmed by radiological examination, which consisted of an orthopantomogram in 83.5% of cases. The mandibular symphysis was the most frequent location with 40.3% of fracture sites. Total continuity of the lines was observed in 21.9% of cases.

Frailty as a growing challenge for anesthesiologists – results of a Dutch national survey

Background Frailty is a multidimensional condition characterized by loss of functional reserve, which results in increased vulnerability to adverse outcomes following surgery. Anesthesiologists can reduce adverse outcomes when risk factors are recognized early and dedicated care pathways are operational. As the frail elderly population is growing, we investigated the perspective on the aging population, familiarity with the frailty syndrome and current organization of perioperative care for elderly patients among Dutch anesthesiologists. Methods A fifteen-item survey was distributed among anesthesiologists and residents during the annual meeting of the Dutch Society of Anesthesiology. The first section included questions on self-reported competence on identification of frailty, acquaintance with local protocols and attitude towards the increasing amounts of elderly patients presenting for surgery. The second part included questions on demographic features of the participant such as job position, experience and type of hospital. Answers are presented as percentages, using the total number of replies for the question per group as a denominator. Results A sample of 132 surveys was obtained. The increasing number of elderly patients was primarily perceived as challenging by 76% of respondents. Ninety-nine percent agreed that frailty should influence anesthetic management, while 85% of respondents claimed to feel competent to recognize frailty. Thirty-four percent of respondents reported the use of a dedicated pathway in the preoperative approach of frail elderly patients. However, only 30% of respondents reported to know where to find the frailty screening in the patient file and appointed that frailty is not consistently documented. Interestingly, only 43% of respondents reported adequate collaboration with geriatricians. This could include for example a standardized preoperative multidisciplinary approach or dedicated pathway for the elderly patient. Conclusions This survey demonstrated that the increasing number of frail elderly patients is perceived as important and relevant for anesthetic management. Opportunities lie in improving the organization and effectuation of perioperative care by more consistent involvement of anesthesiologists.

A survey of cybersecurity vulnerabilities in healthcare systems

The security of healthcare servers and their applications from unauthorized access and hacking effect of patient file safety as a result of missing or modified data. Therefore, it is necessary to protect those servers and health systems and to know the cyber weaknesses in them and other related services to prevent them before they occur and treat them if they occur as soon as possible to reach the highest level of security and confidentiality of patient data and their privacy in addition to the safety of systems from malfunctions as a result of the attack. This research revolves around the concept of penetration and the motives of the attackers, in addition to the methods of penetration and vulnerability with mentioning some common attacks and clarifying their method of operation, and determining their effects on the victim. The research also deals with the most important basics and requirements to achieve privacy and security for health systems at different levels, including systems, users, and devices, with some intrusion protection techniques mentioned, and some challenges and solutions will be discussed in addition to some security issues in general, the research aims to gain the best level of security and privacy in the infrastructure of health systems.

Musculoskeletal Physiotherapy in the Emergency Department – Evaluation of a New Physiotherapy Service in a Swiss University Hospital

Background Many countries report a significant increase in emergency department (ED) visits. Patients with musculoskeletal disorders account for a large proportion of non-urgent cases. Objective Characterization and evaluation of a new service that provides immediate access to physiotherapy for patients in the ED. Method To characterize a new service at the Department of Emergency Medicine, Bern University Hospital, and to evaluate first experiences with it, a mixed methods approach was chosen. Data was collected from the electronic patient file and from a logbook kept by the physiotherapists. In addition, guideline-based interviews with involved health care staff were conducted. Results During the 63 days of the pilot study 79 patients were treated by physiotherapists. The most frequently reported patient complaint was back pain (47 %). Interventions included taking the medical history, performing manual tests and multimodal treatment and developing recommendations for further treatment. In 59 % of patients no medical imaging and in 58 % no additional physiotherapy was prescribed. Patients rated the physiotherapeutic service as very good or excellent (88 %). Physiotherapy was experienced as positive and appreciated by the other professions, and all interviewees emphasized the added value for patients. Conclusion The pilot study indicates that the physiotherapeutic consultation service has the potential to improve quality of care. The findings of this study are therefore valuable when considering the introduction of such a service in an ED.

Evaluation of Status and Income Effects of Admission and Referral of Patients in Need of Vascular Surgery Service in Hospitals of Iran University of Medical Sciences

Background: Admission and dispatch of patients is considered as part of the patient treatment process. The aim of this study was to investigate the status and income effects of admission and dispatch of patients in need of vascular surgery in hospitals of Iran University of Medical Sciences in 2018-2019. Methods: The present study is a descriptive cross-sectional study in which a checklist was compiled and the required information about admission and dispatch of patients in Iran University of Medical Sciences was extracted from the MCMC (Medical Care Monitoring Center) system. In order to extract the income of services related to vascular surgery service from the average income of each patient file in need of this service, university hospitals were used. The sampling method was census and 14,481 patients admitted and dispatched were examined. The data were analyzed by descriptive statistics using Excel software. Results: The total number of registrations for dispatch of vascular surgery service was 605, 378 of which were successful. Of these, 145 were from hospitals affiliated to private hospitals and other hospitals affiliated to other medical universities, 233 were related to vascular surgery admissions, and 227 patients were related to failure to dispatch and death. The lost income due to dispatching patients is equal to 4,875,100,680 Rials. Also, the hospitals affiliated to the university have gained income equal to 7,833,782,472 Rials by admitting and not dispatching these patients. Conclusion: The findings showed that the lost income due to dispatching patients requiring vascular surgery is 4,875,100,680 Rials. Also, the earned income resulting from the existence of medical facilities in the field of the patients’ admission to the hospitals affiliated to the university is 7,833,782,472 Rials.

Towards an Internet of Things for Health Centers in the Southern Saudi Arabia Region

The health centers in the village are well equipped in terms of infrastructure. It also has a large group of patients and staff who usually run services such as opening the file and adding data of patients or doctors using the papers and searching between the patient files. This manual job is challenging to do and wastes time. The developed system in the research aims to transform the center into a technology-based center by leaving paperwork in their daily work. The proposed system is considered as the first part of a global and integrated solution based on Internet of Things (IoT) technology. It seeks the enhancement of the Saudi Arabia health system, especially in the current pandemic period. The whole analysis diagrams are realized through the Visual Paradigm tool suite. The patient file management system has three types of modules, including the administrator, doctor, and receptionist. The proposed system provides a computerized patient file management in the health center. It will benefit the small health center and the receptionists who currently depend on the manual system. The proposed system is automated patient file management by integrating hospital information and details and healthcare information of the patients to a central system database. It also provides receptionists an easy way for booking an appointment according to patients’ preference, and they can search and access patients’ information conveniently.

Diabetic Macular Edema in Diabetological Practices

Using mobile OCT equipment and remote ophthalmological diagnosis of n = 1538 diabetics in 17 diabetes practices in Germany, we found diabetic macular edema in 10.1% of the patients and retinal bleedings or microaneurysms in 15.6%. In 1.62% of the diabetics examined, the size of the edema was > 0.4 mm², in 7% the retinal thickness was > 300 µm and thus in need of treatment. An intravitreal anti-VEGF injection was administered prior to the examination in only 10% of the patients with diabetic macular edema. By means of mobile tele-eye consultation and remote ophthalmological diagnosis using the cloud-based patient file certified as medical device IIa, patients with diabetic macular edema were identified and informed on site quickly and definitively. The data and images were made available to all attending physicians and ophthalmic surgeons.

Concordance of triage performed with emergency severity index in the emergency departments of Rasoul Akram and Haft Tir hospitals

Introduction: Triage is prioritizing patients by disease severity in the shortest possible time. Proper triage increases the quality of patient care services, increases patient’s satisfaction, decreases patient waiting time, decreases mortality, and enhances emergency department efficiency. Objectives: The aim of this study was to evaluate the concordance of triage performed by nurses with ESI standard, at Rasoul Akram and Haft Tir hospitals, which are the most important educational centers of Iran University of Medical Sciences. Patients and Methods: This is a cross-sectional design study done in 2019. The study population is patients referred to Rasoul Akram and Haft Tir hospitals. A sample of 800 patients was selected. In this study, we determined how triage level were determined and compared with triaging by emergency medicine assistant. Data were analyzed by SPSS 23. Results: Out of 800 samples, the highest triage level was related to level three (79.1%) and levels two, four and one were in the next levels. 13.5% of the cases were not properly triaged according to the ESI standard and the adaptation coefficient (kappa) between the triage level specified in the patient file with the emergency severity index (ESI) triage level between physician and nurse was 58%, which was a significant difference (P<0.001). The relationship between correct triage leveling and patients’ complaints was significant (P<0.001). Conclusion: Nurses triage education about appropriate triage and ESI tool should be one of the most urgent topics and priorities of the studied hospitals. Over triage causes resources wasted and under triage may harm the patient’s health.

The Development of the Vital Signs Tele-monitoring System for the Elderly by Using ‘UML’ Language and the Interoperability Standard ‘Continua’

Aims: We aim to develope a system allowing the telemonitoring of the elderly health status. Medical telemonitoring can make life easy and safe for elderly. The goal of this project is the development of a medical telemonitoring application. Background: Medical telemonitoring can make life easy and safe for elderly. Objective: The goal of this project is the development of a medical telemonitoring application. Methods: In this paper we exposed the different steps of the developing of a medical telemonitoring system designed for the elderly. We studied the medical needs and the system specifications. We used the UML language. Then we detailed the designed system with a total respect to the standard for the interoperability of connected medical equipment, Continua. We presented printed screens of the realized interfaces. Results: We realized an application based on web development, more specifically development of a management application for medical telemonitoring. Conclusion: In terms of perspectives, we aim to integrate security protocols in the developed system, integrate the data sent from the sensors into an E, H & R (HER) and send the patient file to a H, I & S (HIS).