Journal articles on the topic 'District Base Hospital'
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Pulungan, Muhammad Rusli. "NASOPHARYNGEAL CARCINOMA IN PANYABUNGAN DISTRICT HOSPITAL." INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA (IJNPC) 2, no. 02 (June 20, 2020): 38–39. http://dx.doi.org/10.32734/ijnpc.v2i02.3932.
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Abstract Introduction: Nasopharyngeal carcinoma is the most common malignancy found in the head and neck area. Non-specific initial symptoms and hidden locations often make it difficult to diagnose early nasopharyngeal carcinoma. The limitations of tools and human resources in the district are a problem in enforcing and finding patients with nasopharyngeal carcinoma in this situation. Objective: The purpose of this study is to observe the prevalence of nasopharyngeal carcinoma in Departement of Otorhinolaryngology-Head and Neck Surgery Panyabungan District Hospital. Method: This study collecting data from medical record of Nasopharyngeal carcinoma (NPC) at Panyabungan District Hospital. Result: The distribution of NPC patients during January-December 2018 there were 10 patients. NPC base on gender male 50% and female 50%. NPC based on age groups in 46-55 years is 40%, 56-65 years old is 20% and 16-25 years, 26-35 years, 36-45 years, and 66-75 years each of 10%. NPC patients based of clinical appearance is limadenophaty colli is 100%, epistaxis 80%, Nasal congesty 70%.ear fulness 40% and diplopia 30%. NPC based on histophatologycal types is WHO type I 10%, WHO type II 50% and WHO type III 40%. Conclusion: Nasopharyngeal carcinoma is a malignant tumor originating from the nasopharyngeal epithelium. The patient NPC were diagnosed at an advanced stage. All of patients showed enlargement of neck limph nodes and some showed diplopia.
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Stovban, Mykola P., Vasyl M. Mykhalchuk, Alexander K. Tolstanov, and Vira V. Maglona. "INTERACTION LINKS OF HEALTHCARE INSTITUTIONS WITHIN ONE HOSPITAL DISTRICT." Wiadomości Lekarskie 74, no. 3 (2021): 756–60. http://dx.doi.org/10.36740/wlek202103236.
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The aim: Theoretical substantiation and determination of the main characteristics of the interaction links of medical institutions within one hospital district in the conditions of aggravation of the epidemiological situation in Ukraine on the analysis basis of the legislative base and elaboration of literary sources. Materials and methods: In the work is used a range of methods: content analysis, bibliosemantic, systematic approach, analysis of products of activity. Conclusions: The authors propose a doctrinal definition of the term “hospital district”. The key problems of the domestic healthcare sector in the context of a pandemic have also been identified. The author points out that in order to successfully reform the health care system and the effective interaction of hospitals in one hospital district, it is necessary to pay attention to funding sources and proper legal regulation, as without the latter any initiatives will have no legal force and will be ignored. health care may be ineffective.
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ALWI, MUHAMMAD, PUTU KARISMAWAN, I. DEWA KETUT YUDHA S, and IWAN HARSONO. "SARANA PENDIDIKAN, KESEHATAN DAN TINGKAT KEMISKINAN DI KECAMATAN TANJUNG SEBAGAI PUSAT PERTUMBUHAN KABUPATEN LOMBOK UTARA, PASKA GEMPA 2018 DAN MASA PANDEMI COVID-19." GANEC SWARA 16, no. 2 (September 10, 2022): 1616. http://dx.doi.org/10.35327/gara.v16i2.327.
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Earthquake 2018 and than Covid-19 Pandemic as starting point to conduct research about condition of educations, healties and rate of poverty in Tanjung Districts, North Lombok, West Nusa Tenggara Province. Base on analysis data of centre of Statistic Bureau of North Lombok (BPS) and population projection of Tanjung districts untill 2025, the condition are: fasilities of kindergarten has not been enough yet. The distibution of that finfrastructure among the vilages is not equal. The elemnteray or primary school (Sekolah Dasar), junior high school ( Sekolah Menengah Pertama) are more than enough, Midle high school (sekolah Menengah Atas) are not enough yet. The aditional education fasilities in 2022 need to add, such as 20 units of new kindergarten, 1 units of Midle high school. Health fasilities relatively has not been enough yet, compare to district Tanjung population as much 220.412 and the position distric Tanjung as capital of North Lombok regency e.g community helath centre and sub community health centre (Puskesmas dan Puskesmas Pembantu), polyclinic and laboratory, hospital, private doctor services, farmacy are not enough yet realtively to population. It should there 5 unit of Community health centre dan 82 sub cummunity helath centre, 10 private doctor services, 1 unit of laboratory, 3 unit of hospital C or 1 B type. Base on qualitative data that rate of poverty in Tanjung district is relativly high. The lowest education level, skill, Lack of employment opurtunity, and capital are the prime faktor of poverty
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Stovban, M. P., and O. K. Tolstanov. "Medical and Social Justification of the Financial and Economic Status of the Snyatyn Central District Hospital before and after the Introduction of the Hospital District." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 6 (December 28, 2022): 116–23. http://dx.doi.org/10.26693/jmbs07.06.116.
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The article is devoted to the study of the issue of medical and social substantiation of the financial and economic status of the Snyatyn Central District Hospital before and after the introduction of the hospital district. The purpose of the study was to analyze the financial economic status of the Snyatyn Central District Hospital in order to determine the efficiency of the introduction of the hospital district. Materials and methods. The object of the study of this scientific article is the activity of the Snyatyn Central District Hospital, which experts have recognized as one of the most successful not only in the region, but also in Ukraine. It is a unique experience in building an effective financial and economic system, which should be taken into account almost by every hospital district when building an effective system of medical services. Results and discussion. Despite the fact that the financial result of the Snyatyn Central District Hospital during the period being studied is negative, the financial condition is determined by stability, autonomy, independence, liquidity and solvency. These are the indicators that allow the organization to plan their expenses according to the needs, to improve the staff and to expand the material and technical base. With regard to the medical and social aspect of the formation of finances during the formation of hospital districts, it should be noted that the reorganization changes have been negatively reflected in the organization's activities, as 45 employees had to be reduced. However, this fact allowed to increase the salary of the staff and to make minor investments in the upgrade of fixed capital. The financial system of the institution continues to improve, and its main purpose is to form the conditions for providing quality services to the population through the use of modern medical technologies and through consultations of highly qualified workers. Conclusion. Based on the results of the research, it can be concluded that the Snyatyn Central District Hospital is one of the most successful in the country, which is confirmed by the relevant certificate. The medical institution effectively manages its own finances and the funds allocated by the state are almost enough for it. The Snyatyn Central District Hospital really deserves a high rating for effective financial management, particularly important are the indicators of the organization's liquidity, which allows solving all the necessary needs of the institution, including the renewal of the material and technical base. Such financial system allows the organization to develop and create a competitive product
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Matthews, A. E. W. "CHIEF OCCUPATIONAL THERAPIST WARRNAMBOOL & DISTRICT BASE HOSPITAL WARRNAMBOOL VICTORIA." Australian Occupational Therapy Journal 23, no. 2 (August 27, 2010): 79. http://dx.doi.org/10.1111/j.1440-1630.1976.tb01049.x.
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Bykov, V. P. "SURGICAL SERVICE OF KARELIAN FRONT HOSPITAL BASE IN 1941-1945." Ekologiya cheloveka (Human Ecology) 22, no. 2 (February 15, 2015): 57–60. http://dx.doi.org/10.17816/humeco17147.
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To the Karelian front hospital base established in the Arkhangelsk region, there were removed patients that had been primarily operated in hospitals of the military district and needed long-term treatment. Limb bullet and fragment wounds, complicated by osteomyelitis, apostems, phlegmons and fistulas prevailed. Improvement of therapy outcomes was reached due to establishment of specialized surgical wards and training of surgeons in treatment of gunshot injuries, Military Traumatology and surgical infections. The proportion of reconditioned senior officers and soldiers in 1944 was 52.5 %. 16.4 % of the patients were recognized as disabled persons. The main reasons of disabilities were: limb shortening, false joints, amputation stumps, joint contractures. Hospital mortality because of septic complications among the wounded was 0.12 %.
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Natalia Krisnawati, Gita, Sucipto Sucipto, and Rina Firliana. "EVALUASI PENERAPAN SIM-RS MENGGUNAKAN COBIT 5 PADA RSUD LAWANG." Antivirus : Jurnal Ilmiah Teknik Informatika 13, no. 2 (November 30, 2019): 80–89. http://dx.doi.org/10.35457/antivirus.v13i2.858.
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Information technology (IT) has become a crucial part for companies or institutions with enterprise scale. The problem in this research is the service of patients in RSUD Lawang has not been entirely done using the SIM-RS application directly. This study focuses on the implementation of the SIM-RS in Lawang District Hospital in providing health services to the community. This research standard uses COBIT 5 standard with APO 07 domain which discusses the preparation of HR in Lawang District Hospital, BAI 07 discusses readiness in obtaining new information systems (SIM-RS), and DSS 01 discusses procedural development and treatment of all forms operations, infrastructure, and facilities related to the information system used. The conclusions of this study are: (1) The level reached by the APO 07 domain is at level 1. This is due to the application of the SIM-RS in the Lawang District Hospital, which has a base practice but in the design of activities that have not been adequately monitored and evaluated and the work products that have not been applied, controlled, and maintained as appropriate. (2) The level achieved by the BAI 07 domain is at level 2. This is due to the application of the SIM-RS in Lawang District Hospital, which has a planned base of practice, is well monitored and evaluated. Its implementation is following agency needs. But related to the implementation process is still not following established standards. (3) The level achieved by the DSS 01 domain is at level 1. This is due to the application of the SIM-RS in Lawang District Hospital having a base practice. Still, in the design of activities, it has not been adequately monitored and evaluated, and the work products they have not been implemented, controlled, and maintained as should be.
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Gajapati, Charushila Gajapati, Shankargauda H. Patil, and Anupama Desai. "Efficacy of rural camps in achieving vision 2020: Our contribution." Indian Journal of Clinical and Experimental Ophthalmology 7, no. 3 (September 15, 2021): 579–82. http://dx.doi.org/10.18231/j.ijceo.2021.113.
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: To assess the effectiveness of rural camps held under DBCS (District Blindness Control Programme) & compare the results of cataract surgery at base hospital cases. It is a retrospective observational study, medical records of patients operated for cataract in camp & patients operated in base hospital are analyzed.In our hospital outpatient department, we saw 2,08,716 patients from 2010-2019 and 7796 underwent cataract surgery. Under DBCS we conducted 262 camps from 2010-2019 & 4611 underwent cataract surgery.A total of 27,524 patients got screened in 262 rural camps and 4671 underwent small incision cataract surgery at the base hospital after detailed clinical examination and IOL (intraocular lens) power calculation for each patient. Among 2,08,716 outpatients at the base hospital, 7796 underwent cataract surgery. The rate of intraoperative complications in the base hospital was 0.885% whereas in camp cases 1.94%.IOL implantation is done in 100%cases in base hospital surgeries and 0.064%patients left aphakic among rural camps.Screening at outreach camps and surgeries at the base hospital can have excellent results. Mass surgeries in camps following standard protocol can have the least number of complications.
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Tangsawad, Sasithorn, and Surasak Taneepanichskul. "Increasing smear positive-pulmonary tuberculosis cases by strengthening district TB coordinating team in low case-detection provinces, Thailand." Journal of Lung, Pulmonary & Respiratory Research 5, no. 6 (December 20, 2018): 202–10. http://dx.doi.org/10.15406/jlprr.2018.05.00192.
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Background: Tuberculosis (TB) is a communicable infectious diseases and remains a major global health problem as the cause of death from an infectious disease worldwide. This study was increased TB cases notification by strengthening the system of district TB coordinating team. Materials and methods: The research was mixed method, Quasi - Experimental study with two –group control and intervention pre–post analysis. The two low TB-case notification provinces in public health region 7 were purposive selected and two districts from each province was random selected to be the area of the study. Selapoom district, Roiet province and Banpai district, Khonkaen province were the study sites for intervention and control group respectively. The sample size included all of TB suspected cases in both group. Data collected from the suspected TB cases form case record form in each district hospital in 9 month period of base line before and after intervention period in both group. The satisfaction questionnaire collected from participants in district TB coordinating team. The curriculum for TB knowledge applied from the standard of National TB program (NTP ) for teaching in the intervention workshop .Focus group discussion was done about system implementation. Data analysis by descriptive statistic, chi square test, focus group analysis was used in qualitative study. Results: The district TB coordinating team was set up in the intervention hospital included of 14 health personnel from hospital, district health office and health center. The work flow and monitoring system was implemented by the district team in intervention group in 9 months period. There were 838 and 324 suspected TB cases in baseline 9 months before the study and 769 and 379 of suspected TB cases in post 9 months after intervention period among control and intervention hospital respectively. The most age group of TB suspected cases were more than 60 year and the most occupation were agriculturists in both group. In both group found that the factors of gender, chest radiography, sputum microscopy, chest radiography with sputum microscopy, chest radiography with completed microscopic examinations, were associated statistically significant at the 0.05 level. For the relative risk of TB notification cases in control hospital ( RR=0.74 ,95%CI 0.54-1.03, p-value 0.07) and intervention hospital (RR=1.61 ,95%CI 1.04-2.51, p-value 0.03) defined that in the hospital with non-intervention provided had a 25% reduction of TB notification cases and in the hospital with intervention provided had a 61% increase of TB notification cases.. Focus group analysis concluded that district TB coordinating team was benefit in district level and helping team to monitoring of TB control program. The coordinating system especially having TB coordinator was the most satisfaction from the participants. Conclusion: Strengthening district TB coordinating team and the coordinating network in hospital , district health office and health center help to increase TB case notification and percent of suspected tuberculosis cases to complete the investigation in district level.
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Tangsawad, Sasithorn, and Surasak Taneepanichskul. "Efficacy of district tuberculosis co-ordinating team on health service performance for suspected TB patient in district hospital." Journal of Health Research 32, no. 3 (May 14, 2018): 251–56. http://dx.doi.org/10.1108/jhr-05-2018-026.
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Purpose The purpose of this paper is to study the efficacy of a district tuberculosis (TB) co-ordinating team on health service performance for suspected TB patients in a district hospital in northeastern Thailand. Design/methodology/approach A comparison study of pre- and post-evaluations of TB system improvement was conducted in a district hospital in northeastern Thailand between October 2016 and June 2017. Data collection reviewed the record of suspected TB cases reported in the district hospital in the past nine months as a base line for describing the health service performance in term of received investigation for TB diagnosis. Participants from a TB clinic, district health office and health center set up a TB co-ordinating team to explore situations and systematic gaps. The TB co-ordinating team gave recommendations of health service performance for suspected TB patients over a nine-month period. Records of suspected TB cases health service performance were collected nine months after intervention. Data analysis by descriptive statistics and to test the effect of intervention was performed. Findings The records from 324 and 379 suspected TB cases reported in the hospital from the 9 months preceding and 9 months, respectively, after intervention were reviewed. A TB co-ordinating team was set up to improve the system and health service performance in terms of investigation for TB diagnosis. The results revealed that health service performance in terms of complete microscopy and investigation in both chest radiography and microscopy increased after intervention. When comparing between pre- and post-intervention, suspected cases received both chest radiography and microscopy in 176 cases and 283 cases, respectively (p-value=0.001). There were 27 cases diagnosed for smear positive TB in pre-intervention and 51 cases diagnosed in post-intervention (p-value=0.011). There were 21 cases pre- and 36 cases post-intervention that had referral documents from health center with no statistically significant difference. Originality/value The TB co-ordinating team had the role to improve health service performance for suspected TB cases to enroll in investigation process for increase TB diagnosis in district hospital.
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Krama, Agel Vidian, and Nurul Qamilah. "Model Spasial Regionisasi dan Rujukan Fasilitas Kesehatan." KESMARS: Jurnal Kesehatan Masyarakat, Manajemen dan Administrasi Rumah Sakit 1, no. 1 (June 25, 2018): 78–86. http://dx.doi.org/10.31539/kesmars.v1i1.191.
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Location Hospital and Health Center in Bandar Lampung and the District Pesawaran not currently mapped by conventional or digital. And there is no data base that provides information about the location and distribution of hospitals and health centers in Bandar Lampung City, and the uneven number of health facilities to ensure the availability of health services for all citizens, by optimizing existing health care facilities. Contributions utilization of spatial studies in the health field is used for mapping and modeling of health in order to facilitate access, provision of efficiency and planning of health services in order to take policy related to determining the location of health facilities. The research method uses spatial model approach with descriptive research type and analysis through the use of Huff Model. The results of the regionization shows the coverage area of hospital services serving 33 points in the District Pesawaran and 24 point Population in Bandar Lampung with the spread of regionization is divided into 3 regions.
Keywords: Health Service, Regionalization
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Stovban, M. P., and O. K. Tolstanov. "Medical and Social Substantiation of the Financial and Economic State of the Kolomyia District Center of Primary Health Care before and after the Implementation of the Hospital District." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 5 (November 21, 2022): 144–51. http://dx.doi.org/10.26693/jmbs07.05.144.
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The relevance of the study is due to the problems of medical care of the population of Ukraine caused by the 2019 pandemic and the war of 2022, which requires prompt, timely and high-quality management of the health care system. The purpose of the study was to evaluate the indicators of the financial condition of the Kolomyia Regional Medical Center after the introduction of the hospital district. To achieve the goal, the following tasks were performed in the course of the study: the peculiarities of the formation of hospital districts and the reorganization of the health care system at the local level were shown, the financial condition of the Kolomyia Regional Medical Center was investigated, and the changes before and after the introduction of the hospital district in the main indicators were shown. Materials and methods. In the course of the study, methods of economic analysis were used, in particular, the method of horizontal and vertical analysis, R-indicators. The method of observation and strengths, weaknesses, opportunities, and threats analysis were also used. Results and discussion. The results of the study showed that the Kolomyia Regional Medical Center is characterized by an unstable financial condition with worsening indicators after the introduction of the hospital district. Improvement of the material and technical base and increase in staff wages are positive factors of the impact of the reforms. The practical significance of the study is due to the definition of the problems of implementing the reform in the health care system and the possibility of adjusting the strategy of development of medical institutions of territorial communities. Conclusion. The introduction of hospital districts became one of the elements of the medical reform, which allows optimizing state and local financial resources in order to use them effectively without threats or risks to the population. Such a reform was carried out in 2017, as a result of which a medical cluster was created in the Kolomyia United Territorial Community. Such a cluster made it possible to optimize the work of medical institutions. According to the results of the analysis of the financial condition of the Kolomyia Regional Medical Center before and after the introduction of the hospital district, it can be concluded that, taking into account the unchanged budget costs for financing the Kolomyia Hospital, its financial condition has changed significantly. In particular, indicators of financial condition, liquidity, turnover and profitability have deteriorated. At the same time, due to the use of ineffective means of optimization, in particular, the reduction of personnel, there was an increase in wages, as well as the release of additional funds for equipment and technical support of the medical institution. Of course, the formation of a hospital district did not solve the problems of medicine, and to some extent even aggravated them, since in general, medical institutions faced issues of staff reduction and reduced funding. However, at the same time, newly created medical clusters are opening up new forms of financing that allow them to provide services on a competitive basis and gain financial autonomy and even independence
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Fisher, R., V. Hamilton, S. Reader, F. Khatun, and M. Porteous. "Virtual arthroplasty follow-up: five-year data from a district general hospital." Annals of The Royal College of Surgeons of England 102, no. 3 (March 2020): 220–24. http://dx.doi.org/10.1308/rcsann.2019.0139.
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Introduction Follow-up after hip and knee arthroplasty is advocated to identify asymptomatic loosening and improve patient satisfaction. There are, however, financial and time implications associated with regular clinic appointments. Assessment through virtual means has been suggested as an alternative. Materials and methods At the West Suffolk Hospital, following arthroplasty surgery of the lower limb, patients are followed-up via a questionnaire at one and five years postoperatively, then subsequently at five-yearly intervals. Patients are recalled based on the outcome of these assessments. Using a locally compiled data base we identified all patients reviewed between 2011 and 2015 using this virtual assessment process and examined their outcomes. Results During the five years of follow-up, 5,380 patients were eligible for assessment. Compliance varied from 77% follow up for hips and 83% for knees. Ten patients were recalled following total hip replacement, eight for x-ray changes and one for a poor satisfaction score. Five went on to undergo revision surgery. Some 56 recalls to clinic following knee arthroplasty were seen; 42 due to a poor Oxford Knee Score, 6 with associated x-ray abnormalities and 6 isolated abnormal x-rays. Five subsequently underwent revision surgery; 30 (54%) were discharged after initial review and 18 (32%) were referred to different subspecialties. As a result of the virtual review process, 4,219 clinic appointments were avoided, with no documented admissions as a result of a missed complication from virtual review. Discussion A virtual arthroplasty clinic significantly reduces the number of patients attending regular follow-up clinics, without compromising safe practice.
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Pézier, T., P. Stimpson, RG Kanegaonkar, and DA Bowdler. "Ear, Nose and Throat Day-Case Surgery at a District General Hospital." Annals of The Royal College of Surgeons of England 91, no. 2 (March 2009): 147–51. http://dx.doi.org/10.1308/003588409x359358.
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INTRODUCTION In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. PATIENTS AND METHODS Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. RESULTS Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. DISCUSSION ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.
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Purmonen, Timo T., Päivi K. Auvinen, and Janne A. Martikainen. "Budget impact analysis of trastuzumab in early breast cancer: A hospital district perspective." International Journal of Technology Assessment in Health Care 26, no. 2 (April 2010): 163–69. http://dx.doi.org/10.1017/s0266462310000103.
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Objectives:Adjuvant trastuzumab is widely used in HER2-positive (HER2+) early breast cancer, and despite its cost-effectiveness, it causes substantial costs for health care. The purpose of the study was to develop a tool for estimating the budget impact of new cancer treatments. With this tool, we were able to estimate the budget impact of adjuvant trastuzumab, as well as the probability of staying within a given budget constraint.Methods:The created model-based evaluation tool was used to explore the budget impact of trastuzumab in early breast cancer in a single Finnish hospital district with 250,000 inhabitants. The used model took into account the number of patients, HER2+ prevalence, length and cost of treatment, and the effectiveness of the therapy. Probabilistic sensitivity analysis and alternative case scenarios were performed to ensure the robustness of the results.Results:Introduction of adjuvant trastuzumab caused substantial costs for a relatively small hospital district. In base-case analysis the 4-year net budget impact was €1.3 million. The trastuzumab acquisition costs were partially offset by the reduction in costs associated with the treatment of cancer recurrence and metastatic disease.Conclusions:Budget impact analyses provide important information about the overall economic impact of new treatments, and thus offer complementary information to cost-effectiveness analyses. Inclusion of treatment outcomes and probabilistic sensitivity analysis provides more realistic estimates of the net budget impact. The length of trastuzumab treatment has a strong effect on the budget impact.
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Chaminda, J. L. P. "Assessment of current practice of Medical Equipment at Tangalle Base Hospital in Hambantota District, Sri Lanka." International Journal of Scientific and Research Publications (IJSRP) 11, no. 2 (February 24, 2021): 598–601. http://dx.doi.org/10.29322/ijsrp.11.02.2021.p11076.
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Partanen, Riitta L., Maxine L. O'Brien, and Diann S. Eley. "Necessity breeds innovation: GPs help prevent an emergency department closure." Australian Health Review 33, no. 3 (2009): 467. http://dx.doi.org/10.1071/ah090467.
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In January 2006 the Maryborough Base Hospital in Queensland faced imminent closure of its emergency department (ED) due to a shortage of senior medical staff. At the same time patient confidence in Queensland Health was low. During consultation forums, the community had made it clear that their priority was to maintain emergency services in Maryborough. In search of a solution, the Fraser Coast District Health Service asked Maryborough general practitioners to work in the Maryborough Hospital ED and/or in the internal medicine ward as Visiting Medical Officers. While this represented a solution to the problem, there was much to be considered before such a plan could be put into place.
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A.N., Sabu. "Rhinosporidiosis-Retrospective Analysis of Cases Presenting in a Tertiary Medical College Hospital in Ernakulam." Journal of Evolution of Medical and Dental Sciences 11, no. 1 (January 31, 2022): 253–58. http://dx.doi.org/10.14260/jemds/2022/48.
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BACKGROUND Rhinosporidiosis is a chronic granulomatous disease caused by the eukaryotic organism, Rhinosporidium seeberi affecting humans and animals. This disease is endemic in several parts of South Asia. The principal purpose of this study was to assess the clinical features of rhinosporidiosis and the demographic profile of the disease in the Ernakulam district. The role of predisposing factors like bathing in ponds, nose-picking habits and the postoperative recurrence rate in the patients were also studied. METHODS This retrospective record-based study was conducted in a tertiary care centre in Ernakulam district of Kerala, India, from January 2014 to June 2016. Clinicopathological profile, demographic data of the patients including their area of residence were retrieved from the records. All patients underwent routine haematological investigation and nasal endoscopy. All rhinosporidial masses were excised and their base cauterised under general anaesthesia, with the aid of endoscope. All patients were given dapsone for 6 months. All cases were followed up for a one-year postoperative period. The retrospective data obtained were entered in Microsoft Excel spreadsheet and analysed. RESULTS The patients in the series were between 14 to 60 years of age. There were 12 male and 3 female patients. Most patients came from the urban areas of the Ernakulam district. The main symptoms were nasal obstruction, epistaxis and nasal mass. The nose and nasopharynx were the commonest sites involved. The inferior meatus and floor of the nasal cavity were the common sites of attachment. Most of the nasal masses were pedunculated and multiple. Recurrent cases, which had previously been operated elsewhere formed the majority in the case series. None of the operated cases in the series showed recurrence during one year follow up. Most cases were associated with the O+ blood group. Nasal synechia was the most common sequelae of repeated surgeries. CONCLUSIONS This study revealed the endemic nature of this disease in Ernakulam and surrounding districts. The results showed the disease was associated more with the male gender, the young, bathing in stagnant water and the O+ blood group. Most of the cases came from an urban background. The study showed the complications of recurrent surgeries and the need for careful removal of the rhinosporidial masses under general anaesthesia. It also emphasises the need for educating the general public against bathing in contaminated water bodies. KEY WORDS Rhinosporidiosis, Rhinosporidium, Epidemiology, Recurrence, Retrospective Studies
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Sharova, Elizaveta A. "Evaluation of the children's neurosurgical beds in regions of the Russian Federation." Russian Pediatric Journal 19, no. 4 (April 30, 2019): 232–37. http://dx.doi.org/10.18821/1560-9561-2016-19-4-232-237.
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Organization of rendering neurosurgical care for children refers to the one out of main stages of the reduction ofpreventable health loss from traumatic brain injury (TBI) in children. The most important link in its provision is a material-technical base ofinstitutions. The aim ofthis study was the analysis ofthe activity ofthe children's neurosurgical hospital beds fund neededfor the development of measures for the optimization of the provision of medical care for TBI children. The study was performed according to the data of the statistical reports for 2003-2012 in Russia in total, as well as in federal districts and subjects. There was evaluated the work of the children's neurosurgical beds. Also, there was made the modeling of the necessary number of children's neurosurgical beds for the provision of neurosurgical care for children with brain injury in two ways: with taking into account the level of morbidity rate and with bearing in mind the standards for the requirement.The study showed that in 2003-2012, there was a gain in the prosperity ofthe child population with children's neurosurgical beds in Russia and regions. There most assured were the cities of Moscow and Saint Petersburg, and the least - Urals Federal District and the Far East Federal District. The happening increase of the prosperity index to a greater extent was associated with a reduction in the child population than with an increase in the number of beds themselves. The gain in indices of turnover of beds and rate of hospitalization in reducing the average length ofstay, taking place against the backdrop of increasing the number of beds, testify to the intensification of the use of children's neurosurgical hospital bedfund in Russia and in the regions and its probable failure. According to overall results of the modeling there is revealed the deficiency of Russian children's neurosurgical hospital bed fund and the need to increase it, especially in such federal districts, as the Urals and the Far East.
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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.
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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.
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Simanjuntak, Marta, Destanul Aulia, and Zulfendri. "The Analysis of Differences in Hospital Rill Rates and INA-CBG's Rate on Sectio Caesare Action in RSU. Imelda Pekerja Indonesia Medan 2019." Britain International of Exact Sciences (BIoEx) Journal 3, no. 2 (June 1, 2021): 121–30. http://dx.doi.org/10.33258/bioex.v3i2.442.
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The Indonesian government has developed a Health Insurance program National Social Security Administering Bodies (BPJS) Health. One of the ways to pay for health services for hospitals in Era JKN is the Indonesian Case Base Groups (INA-CBG's) payment system, namely the amount of claim payment by BPJS Health to the hospital for the package services based on diagnosis of disease and procedures. This study aims to analyze hospital real rates and INA CBG rates on the action of sectio caesarea and to find out the efforts made hospitals to cover INA-CBG's shortfall in claims costs. Types of research Qualitative descriptive conducted by in-depth interviews. Research sites at the hospital. Imelda Indonesian Worker having his address at Jalan Bilal No. 24 Kelurahan Pulo Brayan Darat I, East Medan District. The research was carried out since months January 2019 until finished. The population in this study is claim data delivery of inpatients who performed sectio casearea at month March and April as many as 143 cases The samples in this study were all population of 143 cases. The results showed that the difference in real rates hospital and INA-CBG rates on Sectio Caesaria at RSU. Imelda Worker Indonesia Medan in 2019 amounted to 73% of the real hospital rates exceeding the tariff INA-CBG's with a total difference in costs reaching IDR 199,661,028. and 39% real hospital fee less than INA-CBG's package rate. Efforts are conducted by the RSU. Imelda Indonesian workers to cover the shortage of costs INA-CBG's claims include using students who come from schools Imelda's own foundation, set the Sectio Caesare service package on general patients and providing supporting facilities. Suggested to RSU. Imelda Indonesian workers evaluate the financial risks received from services Sectio Caesare and evaluating the distribution of INA-CBG's claim costs for services Sectio Caesare is up to standard.
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Gevorkyan, Ashot, Maxim Ishmuratov, Ilya Lumpov, Samvel Petrosyan, and Daniel Sharshunov. "MINIMALLY INVASIVE UROLOGICAL INTERVENTIONS IN OUTPATIENT CLINIC ON THE EXAMPLE OF PROSTATE BIOPSY." EUREKA: Health Sciences 1 (January 31, 2019): 10–15. http://dx.doi.org/10.21303/2504-5679.2019.00848.
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One of the main directions of improving medical care was the introduction of inpatient forms of medical care for patients who do not require round-the-clock supervision. Aim of the research: to prove the effectiveness and economic feasibility of minimally invasive procedures in outpatient conditions. Materials and methods. The study included 3524 patients in the period from 2010 to 2017, who underwent transrectal prostate biopsy on the basis of the Department of urology of polyclinic No. 195 of the Western district of Moscow. For comparison, the patients were taken, who underwent a biopsy of the prostate gland at the base hospital No. 31, No. 51, No. 17. Results. The average number of biopsies performed in hospital No. 31, No. 51 and No. 17 for the year amounted to 344 biopsies, and the average detectability of prostate cancer was 142 (41.3 %). The average number of biopsies per year in the urology department of the branch number 2 GP No. 195 amounted to 440.5, and the average detectability of prostate cancer – 152.8 (34.7 %). Thus, with comparable inpatient detection of prostate cancer in one large outpatient urology center, an average of 28 % more biopsies are performed (440.5 versus 344) than in 3 hospitals over a comparable period of time. Conclusions. Inpatient technologies can reduce the burden on hospitals. The development of hospital-replacing forms is determined by the need of the population and for efficient use of financial and technical resources of health care.
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Mahmood, Fawad, Sumera Kazmi, Hira Wakil, Khalida Kousar, Aamer Ali ,. Khattak, and Zahid Ullah Khan. "Genotype Base Prevalence of Hepatitis C." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 664–67. http://dx.doi.org/10.53350/pjmhs22167664.
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Hepatitis C virus (HCV) has a positive sense single-stranded enveloped RNA virus. HCV is one of the most common blood-borne diseases causing significant morbidity and mortality globally. HCV causes acute and chronic hepatitis which can eventually lead to permanent liver damage, hepatocellular carcinoma and death. World Health Organization reported that 3 % of the world’s population is suffering from HCV infection that is about 170 million people. The prevalence of chronic HCV infections in Pakistan is about 5%, with very common individuals being infected with HCV genotype 3a prevalence is in the range of 4.1 to 36% reported from various parts of Khyber Pakhtunkhwa Province of Pakistan. This study was carried out in District Mardan Khyber Pakhtunkhwa. A total 1500 HCV suspected individuals visited District Headquarter hospital Mardan during September 2014 to April 2015 were enrolled. HCV antibodies were detected in about 230 patient serums during this screening. Out of these 230 patients 217 patient were further confirmed by qualitative Real Time PCR. All 217 samples were further analyzed for HCV genotyping by PCR based molecular technique. Genotyping results showed that HCV genotype 3a was found in 156 (72%) of the HCV positive isolates, 2a genotype in 22 (10%) and 3b genotype 17 (8%) and remaining 10% were mixed genotype. HCV genotype genotype 3a was declared as the most prevalent genotype with same in both genders that is 72 %. Genotypes 2a, 2b and 3b were more prevalent among male patients while mixed genotype was mostly observed in female infected individuals. Moreover majority of the infected population were form the age group 41-50 year. In 21-30 years age group the most prevalent genotype 3a after than following in competition 3b, in 31-40 years age group 2a 5 (7%), in years age group 41-50 2a 8 (9%) more prevalent. Keywords: Hepatitis C, Genotypes, Pakistan
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Dutta, Eliza K., Sampath Kumar, Selvaraju Venkatachalam, Laura E. Downey, and Sandra Albert. "An analysis of government-sponsored health insurance enrolment and claims data from Meghalaya: Insights into the provision of health care in North East India." PLOS ONE 17, no. 6 (June 3, 2022): e0268858. http://dx.doi.org/10.1371/journal.pone.0268858.
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Introduction The Megha Health Insurance Scheme (MHIS) was launched in 2013 in the North-East Indian state of Meghalaya to reduce household out-of-pocket expenditure on health and provide access to high-quality essential healthcare. Despite substantial expansion of the MHIS since the scheme’s inception, there is a lack of comprehensive documentation and evaluation of the scheme’s performance against its Universal Health Care (UHC) objectives. Methods We analysed six years of enrolment and claims data (2013–2018) covering three phases of the scheme to understand the pattern of enrolment, utilisation and care provision under the MHIS during this period. De-identified data files included information on age, sex, district of residence, the district of provider hospital, type of hospital, date of admission, status at discharge, claimed category of care, package codes, and amount claimed. Descriptive statistics were generated to investigate key trends in enrolment, service utilisation, and Government health spending under the MHIS. Results Approximately 55% of the eligible population are currently enrolled in MHIS. Enrolment increased consistently from phase I through III and remained broadly stable across districts, gender, age group and occupation categories, with a small decline in males 19–60 years. Claims were disproportionately skewed towards private provision; 57% of all claims accrued to the 18 empanelled private hospitals and 39% to the 159 public sector facilities. The package ‘General Ward Unspecified’ was responsible for the highest volume of claims and highest financial dispensation across all three phases of the scheme. This likely indicates substantial administrative error and is potentially masking both true burden of disease and accurate financial provision for care under the MHIS. Anti-rabies injections for dog/cat bite contributed to 11% of total claims under MHIS III, and 1.6% of all claims under MHIS II. This warrants investigation to better understand the burden of animal bites on the Meghalayan population and inform the implementation of cost-effective strategies to reduce this burden. Conclusions This paper describes the first analysis of health insurance enrolment and claims data in the state of Meghalaya. The analysis has generated an important evidence base to inform future MHIS enrolment and care provision policies as the scheme expands to provide Universal Health Coverage to the state’s entire population.
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V. R., Krishnamurthy, Ishwaraprasad G. D., Sumana M., and Samudyatha U. C. "Pattern of burn injury admissions at a teaching hospital of Karnataka, India: a three year retrospective study." International Surgery Journal 5, no. 12 (November 28, 2018): 3930. http://dx.doi.org/10.18203/2349-2902.isj20185021.
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Background: The study aims to review current trends in epidemiology, demographics and pattern of burn injury over three year period.Methods: A retrospective study was done using the records of all burn patients admitted from January 2013 to December 2015 at Teaching Hospital, HIMS Hassan. The records were analysed for socio demographic profile, pattern of injuries and outcome.Results: 390 patients were enrolled in the study. Woman patients marginally outnumbered men (52.6% vs. 47.4%). Accidental burns were 92.8%. 84.6% of the patients sustained burns at their home. Flame burn constituted 62.6 % and scald burns 31% of the total burns.Conclusions: Burns is still an issue of concern. Our study highlights the need for a burns data- base to know the reasons and what measures could prevent the occurrence. Number of patients referred is high indicating the need for specialist services at the District level.
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Sozinov, Aleksey S., and Ivan A. Mitrofanov. "History of the kazan psychophysiological laboratory headed by V.M. Bekhterev (1885–1893)." Neurology Bulletin LIII, no. 3 (December 4, 2021): 71–83. http://dx.doi.org/10.17816/nb77936.
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Based on archival data and literary sources, the article presents the history of the Kazan psychophysiological laboratory of V.M. Bekhterev during the years of his work in Kazan (18851893). The circumstances of the creation of the psychophysiological laboratory, its locations (during the years of Bekhterevs work, it changed two rooms) and equipment are described. The main scientific directions of V.M. Bekhterev and his students during the Kazan period of activity, the history of their appointment to the positions of residents and assistants of the Department of Psychiatry are analysed. The reasons and history of creation of a psychophysiological laboratory at the clinical base of the University in the Kazan District Hospital are described.
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Pointer, James E., Michael Osur, Colleen Campbell, Ben H. Mathews, and Chet McCall. "The Impact of Standing Orders on Medication and Skill Selection, Paramedic Assessment, and Hospital Outcome: A Follow-up Report." Prehospital and Disaster Medicine 6, no. 3 (September 1991): 303–8. http://dx.doi.org/10.1017/s1049023x00038735.
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AbstractIntroduction:A prior report demonstrated a five-minute decrement in scene and total prehospital times in the standing order and limited standing order intervals as compared to control.Methods:The Alameda County Emergency Medical Service (EMS) District studied the impact of standing orders on field times, comparison of paramedic assessments with emergency department diagnoses, field drug use and procedures, and hospital outcome. These variables were studied over three discrete, six-week, time-study intervals, which represented three different levels of base-hospital medical control (control, standing order, and limited standing order).Results:There were no statistically significant differences between the three time-study intervals for the following variables: 1) incidence of prehospital administration of three cardiac arrest drugs; 2) incidence of prehospital administration of no drugs; 3) incidence of performance of endotracheal intubation; 4) incidence of performance of defibrillation; 5) assessment comparison; and 6) hospital outcome. There were statistically significant differences between intervals for incidence of: 1) administration of naloxone; 2) administration of 50% dextrose; 3) intravenous (IV) starts; and 4) paramedic performance of no procedures.Conclusion:Although there are several potential flaws in method, the data suggest that standing orders result in decreased incidence of drug administration and IV starts in non-critical situations without a negative impact on paramedic assessments or hospital outcome.
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Абельская, И. С., Ю. В. Слободин, and Т. В. Каминская. "Endovideosurgery to the Regions": Initial Experience of Implementation of Educational Program in the Regions of the Republic of Belarus." Хирургия. Восточная Европа, no. 3 (November 16, 2021): 403–10. http://dx.doi.org/10.34883/pi.2021.10.3.011.
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Введение. Хирургические методы и технологии не стоят на месте и имеют динамичное развитие. Уже сегодня эндовидеохирургия при выполнении таких частых оперативных вмешательств, как холецистэктомия, герниопластика паховых грыж, аппендэктомия, является «золотым стандартом». Но пока еще многие из рутинных операций эндовидеохирургическим методом доступны только в клиниках г. Минска и крупных больницах областных центров. Цель. Показать образовательные программы и возможность внедрения современных оперативных эндовидеохирургических вмешательств в районных больницах. Материалы и методы. На базе симуляционного центра внедрены в практику образовательные программы по ряду направлений, одним из которых является эндовидеохирургия. В центре разработана и с 2021 г. начала внедряться в работу образовательная программа «Эндовидеохирургия в регионы». Цель этой программы - развитие и внедрение эндовидеохирургических вмешательств в районных и областных больницах Республики Беларусь. Результаты. По программе «Эндовидеохирургия в регионы» с целью освоения и внедрения в своей практике операций по малоинвазивной хирургии паховых грыж прошли обучение врачи-хирурги УЗ «Лунинецкая центральная районная больница» г. Лунинца Брестской области. На сегодняшний день отделением хирургии данной больницы полноценно внедрено в практику эндовидеохирургическое лечение паховых грыж. Выводы. 1. Современные методы выполнения рутинных общехирургических операций должны быть максимально доступны пациентам независимо от их места жительства в Республике Беларусь. 2. Профессионализм и возможности хирургов районных больниц позволяют им внедрять в свою практику эндовидеохирургические операции. 3. Внедрение полноценной и эффективной практико-ориентированной образовательной программы на постдипломном этапе позволит расширить доступность данного вида хирургии в регионах. Introduction. Surgical methods and technologies do not stand still and have a dynamic development. Today, endovideosurgery is the "gold standard" for performing such frequent surgical interventions as cholecystectomy, hernioplasty of inguinal hernias, appendectomy. However, until today, many of the routine endovideosurgical operations are available only in clinics of Minsk and large hospitals of regional centers. Purpose. To show educational programs and the possibility of introducing modern surgical endovideosurgical interventions in district hospitals. Materials and methods. On the base of the simulation center, educational programs in a number of areas have been put into practice, one of which is endovideosurgery. The educational program "Endovideosurgery in the regions" has been developed at the Center and has been implemented since 2021. The purpose of this program is the development and implementation of endovideosurgical interventions in district and regional hospitals of the Republic of Belarus. Results. According to the program "Endovideosurgery in the regions", in order to master and implement the minimally invasive surgeries of inguinal hernias, the surgeons of the Luninetsky Central District Hospital were trained in Luninets, Brest region. Today, the Department of Surgery of this hospital has fully implemented the endovideosurgical treatment of inguinal hernias. Conclusions. 1. Modern methods of surgery for routine general surgical operations should be maximally accessible to patients, regardless of their place of residence in the Republic of Belarus. 2.The professionalism and capabilities of surgeons of district hospitals allow them to introduce endovideosurgical operations into their practice. 3. Introduction of a full-fledged and effective practice-oriented educational program at the postgraduate stage will expand the availability of this type of surgery in the regions.
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Kasimov, R. R., A. A. Zavrazhnov, I. V. Blinda, and K. S. Puchin. "Application of new approaches in the organization and conduct of classes on combat and special training of military medical personnel." Bulletin of the Russian Military Medical Academy 22, no. 3 (December 15, 2020): 217–20. http://dx.doi.org/10.17816/brmma50563.
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Abstract. Considers an example of organizing and conducting practice-oriented classes on providing emergency medical care for injuries with medical personnel of the military level, garrison and base military hospitals in the Western military district. In large garrisons of the military district in 2019, we conducted four rounds of field training on the organization of emergency medical care for major life-threatening conditions. The format of classes included master classes and blitz lectures on various topics: cardiopulmonary resuscitation, stopping ongoing external bleeding, eliminating asphyxia and pneumothorax, transport immobilization, and features of the use of modern means of emergency medical care. An important practical part of the training was training with surgeons of military and hospital units on living biological objects. At the beginning and end of the course, primary and control tests of the level of knowledge were conducted. During the initial testing, the percentage of correct answers in the groups averaged: surgeons (n=20) 53,9%, doctors of other specialties (n=25) 56,5%, average medical staff (n=34) 52,8%, health instructors (n=52) 52,6%. During the control testing, the following results were obtained: 71,5; 83,5; 84,3 and 83,9% respectively. The format of classes reliably (p˂0,05) showed their high efficiency in all groups. Thus, the need to actively introduce a practice-oriented form of training in the form of demonstration classes, including the use of biological models and simulators, into the combat and special training of military medical personnel is obvious and beyond doubt.
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D.H, Liyanage. "A survey on the Patient Waiting Time at the Out Patient Department of a Type A Base Hospital in Galle District." International Journal of Scientific and Research Publications (IJSRP) 11, no. 6 (April 18, 2021): 665–68. http://dx.doi.org/10.29322/ijsrp.11.06.2021.p11486.
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Ralapanawa, Udaya, Kushalee Poornima Jayawickreme, Madhushanka Ekanayake, Deementha Basnayake, Thilak Jayalath, Thilak Abeysekera, and Roshan Munas. "Analysis of clinical and demographic characteristics of patients presenting with features of urolithiasis to a district base hospital in Sri Lanka." Sri Lanka Journal of Medicine 27, no. 1 (June 30, 2018): 20. http://dx.doi.org/10.4038/sljm.v27i1.74.
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Farmer, Isabel, Samah Babiker, Jumoke Stella Okikiolu, Matthew Steel, Chandima Wanniarachchi, Shona Littlewood, Yishi Tan, et al. "A Large London District General Hospital Highlights CLL and Bame As Risk Factors for Severe Disease Amongst Haematology-Oncology Patients." Blood 136, Supplement 1 (November 5, 2020): 5. http://dx.doi.org/10.1182/blood-2020-134341.
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Introduction The earliest documented transmission of the coronavirus SARS-CoV-2, causing the disease Covid-19 occurred in the United Kingdom in February 2020. With data from Wuhan and Italy indicating a significant mortality rate in the region of 1-3% and identification of the risks of co-morbidities, hemato-oncology patients were quickly identified as being at a heightened risk from the virus due to baseline and chemotherapy induced immunosuppression. Data has shown that patients with cancer have a significantly higher incidence of severe events following infection with SARS-CoV-19 than those without cancer. Unlike many reported case series, our institution sees an unselected take of all hemato-oncology diagnoses within a large, ethnically-diverse locality and therefore provides an unfiltered snapshot of the impact of SARS-CoV-2 at an all-inclusive, population level. Methods Prospective data collection was carried out on all hemato-oncology patients admitted with a confirmed diagnosis of Covid-19 during March and April 2020 by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay on a nasopharyngeal aspirate across two sites in one of London's largest District General Hospital Trusts. Our institution has a catchment area of 810 000 heads of population of which 38-46.5% are of black, Asian and minority ethnic (BAME) ethnicity depending on locality. Results We identified a total of 30 hemato-oncology patients admitted with PCR proven SARS-CoV-19. Their baseline characteristics are shown in figure 1. When compared with our cancer registry data (Fig 2A) this highlights a disproportionate representation of BAME patients (57% of cases vs 26% of base population). Lymphoid malignancies and plasma cell dyscrasias (PCD) accounted for 90% of the admissions. CLL and PCD accounted for 30% and 23% respectively (Fig 2C). Co-morbidities were less prevalent than those seen in patient cohorts without hematological malignancy. 70% of patients had </=1 co-morbidity and only 29% had >/= 2 comorbidities (Fig 2B) highlighting that, unlike other non-oncology series, hematological malignancy alone acts as a major risk factor for serious illness. Hypertension and Diabetes were the most common risk factors, seen in 50% and 43% of patients respectively. The most common presenting features were cough (84%), fever (72%) and shortness of breath (80%). 16% had Gastrointestinal symptoms, but only seen in the context of concurrent respiratory symptoms. The vast majority (84%) had radiological changes consistent with a diagnosis of COVID-19. Our cohort had a mortality rate of 47%. Of those that died, 57% were from BAME groups and 43% were White. 71% of those that died had either CLL (6/14 cases) or multiple myeloma (MM) (4/14 cases). CLL appears to be an independent risk factor from age, as two of the patients with CLL that died were amongst the youngest in our cohort (47 years and 59 years). Two patients that died had Myelodysplastic syndrome, one had Diffuse large B cell lymphoma and one had Hodgkin's lymphoma. We found that age and number of co-morbidities were positively associated with death. Of the patients that died, 79% were 70 years of age or over and the majority of survivors were 60 years old or younger (56%). Lymphopenia was a consistent finding at diagnosis (median lymphocyte count 0.8 x 109/l), neutropenia was rare (median neutrophil count 5.9 x 109/l) and C-reactive protein was elevated in all cases (median value 169, range 42-473 mg/l). Of our 4 patients with plasma cell dyscrasias who died, 2 had end stage myeloma (4th line+ of therapy), 1 had primary refractory MM and 1 had plasma cell leukaemia, thus identifying these patients as extremely high risk from the outset. Conclusion It is of great importance to identify patient and disease specific risk factors conferring poor risk amongst our hemato-oncology patients. With shielding, invariably comes the increased risk of morbidity from social isolation and delayed presentation of non-COVID illness. Our data shows that CLL and BAME patients appear to be at particular risk of severe illness and poor outcomes. In a local ethnically diverse population, our patients are at heightened risk of morbidity and mortality and must be offered all strategies for interventions that may reduce likelihood of becoming infected with COVID 19 and should be considered early for vaccination, convalescent plasma and monoclonal antibodies. Disclosures No relevant conflicts of interest to declare.
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Mukasahaha, D., F. Uwinkindi, L. Grant, J. Downing, J. Turyahikayo, M. Leng, and M. A. Muhimpundu. "Assessment of Palliative Care Needs in Hospital Settings in Rwanda." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 111s. http://dx.doi.org/10.1200/jgo.18.78900.
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Background: Rwanda is among the first African countries with a palliative care (PC) policy and implementation plan. A partnership with the Ministry of Health (MoH) through the Rwanda Biomedical Centre (RBC) and the University of Edinburgh has supported an integrated approach including expanding the evidence base. Aim: To assessing the need for (PC) to inform policy, service delivery and training. Methods: A point prevalence PC needs assessment was conducted in nine public hospitals (referral, provincial and district). A records census identified those with life-limiting illness (LLI) who were then invited to participate by interview. The assessment tool included the APCA African POS, POS S, WHO performance status and demographic information. Results: 608 case notes were reviewed, 152 eligible and 124 completed assessment. 25% of all patients admitted had LLI, of which 99.2% had evidence of unmet need determined by at least one score on the APCA POS ≥ 3. Diagnoses 29% cancer, 29% cardiovascular disease, 16.9% end-stage organ failure and 13.7% HIV. Symptoms with greatest impact; nausea and vomiting (34.7%) and pain (32.3%). 63.7% with WHO performance status 4 or 5. 8.1% seen by existing PC services. Conclusion: Although the MoH and RBC are making bold steps toward developing PC in Rwanda, there remains a significant amount of unmet PC needs. Meeting this need requires recognition of the scope of PC needs beyond cancer, feedback to the hospitals and health care workers, thinking strategically how to further strengthen the health system and further capacity building and training.
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Banerjee, Tanya Sreeta, and Naomi Chambers. "Does price labelling result in sustained cost awareness?" BMJ Leader 1, no. 3 (August 9, 2017): 29–31. http://dx.doi.org/10.1136/leader-2017-000014.
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IntroductionPressures on the National Health Service require improvement in quality of care on a reducing budget. Acute trusts spend £6 billion on procurement, an area highlighted in the Carter Report with the potential for up to £2 billion in efficiency savings. Meanwhile, cost awareness of products among clinicians is poor.Case studyA survey of 20 ENT (ear, nose and throat) theatre doctors and nurses was carried out in a North West district general hospital to gauge the level of cost awareness in 2011. This was followed by a 2-month period of price labelling of selected products. A follow-up survey in 2017 looked at any sustained effect of awareness.ResultsWhile individual product prices were not recalled, awareness of price differences and specific expensive items was sustained in 75% of respondents, with influence on product choice also dependent on evidence base and clinical outcome. The remaining 25% included new staff employed post initial survey in 2011.ConclusionA combination of price labelling with education and a clinical evidence base has potential for efficiency savings. Clinicians willingly participate in product selection when shown that change will lower cost and leave patient outcome unaffected or improved.
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Hosamani, Sushma, K. Vallabha, and Vijaykumar Warad. "Post-operative complications and visual outcome in eye camp patients undergoing sutureless cataract surgery at a Base Hospital in Vijayapura District, South India." Nigerian Journal of Ophthalmology 23, no. 1 (2015): 16. http://dx.doi.org/10.4103/0189-9171.164500.
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Seram, S. N. V., and P. M. G. Punchihewa. "Knowledge on complementary feeding among parents of children aged 4-12 months attending a base hospital in a rural district in Sri Lanka." Sri Lanka Journal of Child Health 46, no. 2 (June 5, 2017): 139. http://dx.doi.org/10.4038/sljch.v46i2.8270.
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Girardi, Fabio, Paola Paiusco, Paolo Manente, Michela Bortolin, Maria Grazia Ruggeri, Antonella Biancon, Giovanni Vicario, et al. "Simultaneous care in Italy’s Veneto Region Health District 8: Integrated assistance to provide better outcomes in end-of-life care." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e19595-e19595. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e19595.
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e19595 Background: The number of cancer patients requiring active treatment and palliation for symptoms relief is progressively increasing, due to the possibility to significantly prolong survival even in persons affected by metastatic disease. Italian Board of Health, within the National Oncological Plan 2010-2012, gave “simultaneous care” the recognition as the most qualified model to ensure the best result regarding life expectation, quality of life, adherence to therapies. Methods: In Italy’s veneto region health district 8 a unit dedicated to palliative care works in cooperation with oncology clinic, medical wards, general practitioner, social services; periodical meetings are scheduled to review all the requests; each patient is given a multidimensional evaluation, to assess the care needs. The Unit is able to provide a daily home-care, with total parenteral nutrition if needed, management of infusional devices, invasive procedures such as paracentesis, in order to minimize the number of intervening hospital admissions. We considered the percentage of patients who received a simultaneous care approach between 2008 and 2010, the number of patients who died at home or in a hospice, the average time-period of care, the number of elapsing hospital admissions. Results: In 2008 268 new patients received assistance by the Palliative Care Unit, 273 new patients in 2009 and 434 new patients in 2010; 82 (31,3%), 70 (25,6%) and 111 (25,6%) were affected by advanced cancer, respectively; in 2008 208 patients out of 262 (79,4%) died at home or in a hospice, in 2009 224 patients out of 273 (82,1%), in 2010 376 patients out of 434 (86,7%); in 2008 the average time-period of care was 93 days (calculated as the ratio between the total number of days of assistance to patients as a whole and the number of patients), 88 days in 2009; in 2008 the average number of intervening hospital admissions was 0,26 (calculated as the ratio between the number of admissions and the number of patients), 0,28 in 2009. Conclusions: Our data show that the earlier the patient affected by advanced cancer is evaluated by Palliative care Unit, the higher is the likelihood to develop an adequate home- or hospice-base care plan.
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Grigoryev, E. G., and T. V. Olenkina. "Vsevolod I. Astafyev – the Man ahead of Time." Acta Biomedica Scientifica 6, no. 2 (June 24, 2021): 218–23. http://dx.doi.org/10.29413/abs.2021-6.2.25.
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The authors describe the life and activity of a famous scientist and qualified Russian surgeon, a great man with distinguished leadership ability in medicine and higher medical education, Professor Vsevolod Ivanovich Astafyev.As a student, Vsevolod I. Astafyev was keen about emergency surgery, and worked a lot in experimental laboratory. He graduated from the Kursk medical institute with honors, completing by the time his PhD thesis. However, he gave up postgraduate study and began working as a surgeon in a district hospital. After returning to the Kursk medical institute, Vsevolod I. Astafyev worked as an assistant at the hospital surgery department and successfully defended his PhD thesis. At the age of 35, he defended his doctorate thesis and competed for a post of the head of hospital surgery department at the Irkutsk medical institute. He had continued to be actively engaged in science, pedagogy and practical surgery, and organized the Siberian branch of the All-Soviet Union Scientific Center of Surgery of the USSR Academy of Medical Sciences. The branch had a clinical base with 220 beds at the Irkutsk regional hospital. Vsevolod I. Astafyev created a school of polyvalent surgeons, lecturers, and scholars.In 1987, Vsevolod Astafyev accepted an offer to become the deputy head doctor of the Republican hospital of Yakutia. Shortly after coming to Yakutsk city, he was elected a deputy of the supreme council of the Yakut Republic. On his initiative, supported by the Republic’s governance, a modern equipped medical center was built and put into operation within a short time. The so-called “sanctuary of science” still successfully works as one of the leading clinics of Russia and abroad.
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Fernandez, Ana, James A. Gillespie, Jennifer Smith-Merry, Xiaoqi Feng, Thomas Astell-Burt, Cailin Maas, and Luis Salvador-Carulla. "Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations." Australian Health Review 41, no. 1 (2017): 38. http://dx.doi.org/10.1071/ah15154.
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Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.
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Ribeiro, Julival, Ricardo Boaventura, Rilson F. Moitinho, Neila F. Moitinho, Kleber N. Campos, Ruiter R. Silva, and Geni N. N. L. Câmara. "Prevalence of HIV-1, HBV, and HCV Among Patients Admitted to the Emergency Department of the Hospital de Base of the Federal District, Brazil." Infection Control & Hospital Epidemiology 21, no. 9 (September 2000): 558. http://dx.doi.org/10.1086/503236.
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Matoušek, Vojtěch, Ivan Herold, Lenka Holanová, and Martin Balík. "A Rare Case of Severe Metabolic Alkalosis with Unusual Hyperproteinemia Treated with Continuous Renal Replacement Therapy and Regional Citrate Anticoagulation." Case Reports in Nephrology and Dialysis 8, no. 2 (August 3, 2018): 138–46. http://dx.doi.org/10.1159/000491628.
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A 23-year-old woman was referred to the tertiary centre with acute kidney injury and severe metabolic alkalosis following an accidental ethylene glycol poisoning. The patient had been treated with continuous haemodiafiltration and regional citrate anticoagulation, and a tracheostomy was performed due to pneumonia. Besides severe metabolic alkalosis and hypernatremia, the laboratory tests revealed total protein of 108 g/L on admission to the tertiary centre. The haemodiafiltration with regional citrate anticoagulation continued with parallel correction of the alkalosis and normalisation of the total plasma protein. The tracheostomy was decannulated and the patient was discharged to the district hospital. The case demonstrates the usefulness of regional citrate anticoagulation even in severe metabolic alkalosis which was likely related to the method setting prior to admission and to an overcompensation of the initial severe metabolic acidosis. The unusual hyperproteinaemia might be interpreted with the aid of the Stewart-Fencl model of the acid-base regulation.
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Iordanishvili, A. K., F. I. Komarov, and V. V. Voskresensky. "RECENT BACKWARD OF NATIONAL MILITARY NAVAL MEDICINE." Marine Medicine 5, no. 4 (November 29, 2019): 109–15. http://dx.doi.org/10.22328/2413-5747-2019-5-4-109-115.
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Here is the contribution of K. N. Kostur in the development of national military naval medicine based on documentary data. K. N. Kostur was born on May 6, 1921 in the village of Kuzmin, Gorodok district of the Khmelnitsky region of the Ukrainian SSR. After graduating secondary school with ten years of study, he entered the Naval Medical School (NMS). He passed the first practice in August 1940 on the cruiser «Aurora», which was in Kronstadt. In late October 1941, after an early release from NMS, he was sent to the «Road of Life». The convoy of the Red Banner Baltic Fleet (RBBF), where he served, took the wounded, women and children out of besieged Leningrad. Konstantin Nikolaevich Kostur, being a senior medical assistant, was part of the Railway Artillery Battery of the 263rd Division of Railway Artillery of the 1st Guards Brigade of the Red Banner Baltic Fleet. He participated in combat operations to break the blockade of Leningrad, liberate the islands in the Vyborg gulf, and also liberate the Baltic states and East Prussia. Several post-war years participated in the combat demining of the Finland gulf. Then — 5 years of study at the Naval Medical Academy (NMS), service on the cruiser «Maxim Gorky» as the head of the medical service, and also — 22 years of hard work in the 1st order of Lenin Naval Hospital of the Leningrad Naval Base. Here K. N. Kostur went from the young attending doctor to the head of the gastroenterological department and the lead therapist of the hospital. After the release to the reserve, Konstantin Nikolayevich until the last day was actively working as a therapist at the 285th Polyclinic of 1st order of Lenin Naval Hospital of the Leningrad Naval Base, assisting military personnel, members of their families, military retirees and civilians. Despite high positions and great administrative and medical work, K. N. Kostur conducted deep research studies on topical issues of naval therapy and gastroenterology, was actively engaged in inventive and rationalization activities.
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Muma, Mulenga I. K., Grace Chipalo-Mutati, Judith Munthali, Teddy Chibwe, Evans Ngalande, Kenneth Siputuma, Exhildah Phiri, et al. "Vision Screening of Learners (School Children) by Teachers in Kafue District in Zambia as a Strategy to Address the Challenges of Childhood Blindness." Medical Journal of Zambia 48, no. 1 (April 6, 2021): 4–14. http://dx.doi.org/10.55320/mjz.48.1.788.
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Background: Early detection and treatment of eye diseases in children is critical in combating childhood blindness. Innovative community-based strategies such as training of teachers in vision screening need to be developed for effective utilisation of the available human resources as well as to counter the challenges of inequitable distribution of trained eye health human resources as well as the limited access of quality eye health care services to the majority of our population.
Aim: To evaluate the effectiveness of using teachers as the first level of vision screeners.
Materials and Methods: Teacher training programmes were conducted for schoolteachers to educate them about childhood eye diseases and the significance of their early detection. The teachers trained for the school vision screening were from all government, private and community schools located in Kafue District. The teachers then conducted vision screening of learners in their schools. Subsequently, the mobile eye health teams visited the schools for the re-evaluation of learners identified with poor vision. All learners identified with refractive errors had refraction performed on them and spectacles prescribed. The mobile eye health teams referred learners requiring a further ophthalmic evaluation to the University Teaching Hospitals – Eye Hospital which was the base hospital for the programme. The assessment included calculation of true positives, false positives, true negatives and false negatives.
Results: One hundred and fifty-four (154) teachers from 73 primary and secondary schools underwent training in vision screening. The teachers screened 18,713 learners and reported eye diseases in 2,818 (15.1%) children. However, the mobile eye health teams examined 5,958 learners who included 2,818 referrals from teachers and 3,140 rescreened learners. The mobile eye health teams confirmed eye problems in 2,818 learners screened by the teachers and further diagnosed more eye problems in 999 learners giving a total of 3,817 learners with eye problems. Thus, the teachers were able to correctly identify eye problems (true positives) in 100.0% (2,818/2,818) of learners. The teachers could not identify eye problems in 999 learners giving false negatives were 26.2% (999/3,817).
Conclusion: Considering the high true positive value and the comprehensive coverage provided by the survey, vision screening in schools by teachers is an effective method of identifying learners with eye problems and poor vision early. This strategy could be valuable in reducing the workload of the eye health care staff.
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Pathania, Anjali, and Gowhar Rasool. "Investigating power styles and behavioural compliance for effective hospital administration." International Journal of Health Care Quality Assurance 32, no. 6 (July 8, 2019): 958–77. http://dx.doi.org/10.1108/ijhcqa-02-2018-0059.
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Purpose The purpose of this paper is to examine the use of power tactics by hospital administrators in order to gain employee compliance. It attempts to understand the influence of power bases of hospital administrators on the employee compliance using an analytic hierarchy process (AHP) technique. Design/methodology/approach The study adopted a mixed method technique and was conducted in two phases. In the first phase, qualitative analysis was carried out through content analysis of the anecdotes collected from the employees working in tertiary hospitals. Content analysis of responses aided in obtaining a list of criteria and sub-criteria affecting employee behavioural compliance. In the second phase, quantitative analysis was carried out using the AHP technique. While applying AHP, the issue pertaining to employee behavioural compliance with hospital’s policies, procedures and related instructions was formulated in form of a hierarchy of one objective, two criteria, six sub-criteria and five alternatives established through literature review and content analysis. Furthermore, the subject matter experts were asked to conduct pairwise comparison wherein priority rankings were achieved. Findings The results indicated that reward power (25 per cent) is the most significant power style exercised by effective hospital administrators in achieving employee behavioural compliance followed by expert (24 per cent), referent (22 per cent) and legitimate powers (17 per cent). As coercive (12 per cent) came out to be the least preferred power style, it should be cautiously exercised by hospital administrators in the present day scenario. Research limitations/implications The major limitation of this study is that the sample was drawn only from three tertiary hospitals in Jammu district that limits the generalizability of the findings in all the hospital settings across different regions. No attempt is made in this study to understand the variations with regard to demographics of the respondents that can be taken as a future research study. This study is cross-sectional in nature and provides the perspective of specific time. A longitudinal study could further provide insights into different time variations and the comparison and henceforth can be more comprehensive, thus supporting the generalizability of this study. Practical implications The study empirically identifies the relative importance of exercising power styles in order to gain employee behavioural compliance. The study helps in understanding the complex problem of behavioural compliance in hospital setting by examining the intensity of each factor affecting employee behavioural compliance. This knowledge is very critical in effective hospital management and getting the work done. The priority rankings obtained for power styles can be used for developing selection batteries and performance records of hospital administrators. As the behaviour of the employees is not static, there may exist the inherent limitations of adopted cross-sectional design for the present study. Furthermore, longitudinal study can be conducted at different time periods, to understand the variations in the patterns of employee’s compliance behaviour and associated practiced power styles by hospital administrators. Originality/value This is perhaps the first study that has scientifically attempted to integrate the power styles and analyzed their effective use in hospital administration. This research study has attempted to develop an elementary base for academicians, scholars as well as management practitioners on the effective use of power styles for achieving employee behavioural compliance in hospitals.
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Ahmed, Sayem, Guibehi B. Koudou, Maïwenn Bagot, François Drabo, Windtaré R. Bougma, Caisey Pulford, Moses Bockarie, and Robert A. Harrison. "Health and economic burden estimates of snakebite management upon health facilities in three regions of southern Burkina Faso." PLOS Neglected Tropical Diseases 15, no. 6 (June 21, 2021): e0009464. http://dx.doi.org/10.1371/journal.pntd.0009464.
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Background Snakebite has become better recognized as a significant cause of death and disability in Sub-Saharan Africa, but the health economic consequences to victims and health infrastructures serving them remain poorly understood. This information gap is important as it provides an evidence-base guiding national and international health policy decision making on the most cost-effective interventions to better manage snakebite. Here, we assessed hospital-based data to estimate the health economic burden of snakebite in three regions of Burkina Faso (Centre-Ouest, Hauts Bassins and Sud-Ouest). Methodology Primary data of snakebite victims admitted to regional and district health facilities (eg, number of admissions, mortality, hospital bed days occupied) was collected in three regions over 17 months in 2013/14. The health burden of snakebite was assessed using Disability-Adjusted Life Years (DALYs) calculations based upon hospitalisation, mortality and disability data from admitted patients amongst other inputs from secondary sources (eg, populations, life-expectancy and age-weighting constants). An activity-based costing approach to determine the direct cost of snake envenoming included unit costs of clinical staff wages, antivenom, supportive care and equipment extracted from context-relevant literature. Findings The 10,165 snakebite victims admitted to hospital occupied 28,164 hospital bed days over 17 months. The annual rate of hospitalisation and mortality of admitted snakebite victims was 173 and 1.39/100,000 population, respectively. The estimated annual (i) DALYs lost was 2,153 (0.52/1,000) and (ii) cost to hospitals was USD 506,413 (USD 49/hospitalisation) in these three regions of Burkina Faso. These costs appeared to be influenced by the number of patients receiving antivenom (10.90% in total) in each area (highest in Sud-Ouest) and the type of health facility. Conclusion The economic burden of snake envenoming is primarily shouldered by the rural health centres closest to snakebite victims–facilities that are typically least well equipped or resourced to manage this burden. Our study highlights the need for more research in other regions/countries to demonstrate the burden of snakebite and the socioeconomic benefits of its management. This evidence can guide the most cost-effective intervention from government and development partners to meet the snakebite-management needs of rural communities and their health centres.
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Budnik, Ya I., A. L. Lopatina, I. A. Cheshik, and T. M. Sharshakova. "EXPERT ASSESSMENT OF MEDICAL OBSERVATION OF ABLE-BODIED PATIENTS SUFFERING FROM BLOOD CIRCULATION DISEASES IN PRIMARY HEALTH CARE." Health and Ecology Issues, no. 4 (December 28, 2013): 118–23. http://dx.doi.org/10.51523/2708-6011.2013-10-4-23.
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Objective: to give an expert assessment of the medical observation of able-bodied patients with arterial hypertension and ischemic heart disease in one district covered by therapeutic care. Material and methods. The medical observation of the patients with arterial hypertension and ischemic heart disease was assessed by a card-scheme developed by authors in accordance with Instruction on the organization of medical observation of adult population of the Republic of Belarus approved by Resolution of the Ministry of Health of the Republic of Belarus of 12.10.2007 No. 92 (version of 01.06.2011 No.51). The necessary data were copied from Form N 025/у-07 «Medical card of an out-patient» into the expert card-scheme and transcribed into the electronic data base. A total of 300 medical records of patients with arterial hypertension and ischemic heart disease having undergone the out-patient observation at one of the branches of the Gomel Central Municipal Polyclinic (200 patients) and at the polyclinic ward of Petrikov Central District Hospital (100 patients). The statistical interpretation of the study was carried out on a personal computer using «Microsoft Excel», 2011. Results. In the present system of primary medical care, the able-bodied out-patients with blood circulation diseases are paid special attention. Out-patient clinic specialists diagnose the blood circulation diseases, detect the risk factors, conduct regular medical observation and rehabilitation of the patients. The article presents the results of the expert assessment of the observation of the able-bodied patients suffering from arterial hypertension and ischemic heart disease in the district covered by therapeutic care. Conclusion. The results of the expert assessment of the patients with blood circulation diseases are indicative of insufficient work with this group of the patients.
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Butterworth, D. M., S. S. Rose, P. Clark, P. Rowland, S. Knight, and N. Y. Haboubi. "Light Microscopy, Immunohistochemistry and Electron Microscopy of the Valves of the Lower Limb Veins and Jugular Veins." Phlebology: The Journal of Venous Disease 7, no. 1 (March 1992): 27–30. http://dx.doi.org/10.1177/026835559200700107.
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Objectives: To demonstrate the light, electron microscopy and immunohistochemistry appearances of the valves of lower limb veins and jugular veins of subject with evidence of venous disease. Design: A prospective study of saphenous veins obtained at post mortem examination and jugular vein obtained at time of surgery. Setting: Health Service district general hospital. Patients: Patients with no evidence of venous disease being treated in the hospital for unrelated conditions, or examined at autopsy in the Department of Pathology. Interventions: Sections of saphenous vein from the lower limb and jugular vein were examined using conventional histology, immunohistochemical staining and electron microscopy. Main outcome measures: Microscopic and electron microscopic appearances of histological sections of venous valves. Results: The valve agger contains an increased amount of fibrous tissue compared with the vein wall and saphenous and jugular veins. However, in saphenous veins the muscle layer of the wall could be traced across the base of the agger, but this was deficient in jugular valves. Electron microscopic examination showed that most of the valve cusp was composed of collagen fibrils, aggregated in irregularly arranged bundles. Elastic fibre material was present in the subendothelial zones. Nerve and muscle fibres were not present in the cusp. Conclusions: Valve cusps in both high and low pressure systems are similar, and the authors suggest that cusp/agger/vein wall complex is important for valve function.
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Pokhrel, Babu Ram, Sushila Acharya, and Namu Koirala. "Utilization of Maternal Health Care Services and Home or Hospital Delivery of Child Birth Among Women of Deupurkot VDC of Parbat District in Nepal." Medical Journal of Eastern Nepal 1, no. 02 (December 31, 2022): 10–13. http://dx.doi.org/10.3126/mjen.v1i02.51154.
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Background Nepal has made significant improvement in meeting the maternal and child health care services also progress newborn, infant and under mortality over the past two decades. The stark disparities on utilization of health services due to women with lower education, low wealth quintile household, disadvantage cast/ethnic groups and women in remote areas. The utilization of available maternal health care services from public and private service is remarkable to reduce maternal morbidity and mortality in Nepal. Methods The community base descriptive cross sectional study was conducted in 509 households through door to door home visit in Deupurkot VDC covering all first to nine wards. The information was obtained using pretested questionnaire of Pokhara University by Bachelor level students of Public Health. The data was entered into Microsoft excel and analyzed. The data was collected from 19th November to 18th December 2014. Results The nuclear family size was (74.3%). Majority (80%) of the household have their pakka house, (95.7%) household used sanitary latrine and (86.7%) household heads were literate. The major occupation was agriculture (52.55%). The age of marriage before 18 yrs was (25.30%). Majority of women (81%) women used Injection Depo-Provera and less used device was Norplant/Implant user was (3.7%) World Health Organization (WHO) recommended almost (41%) had antenatal care (ANC) visit. Majority (96.70%) had gone for ANC visit and (67%) of them give birth their children at health institution. More than half (51.60%) women had knowledge of postnatal care (PNC) but (32.60%) used this service either in Health post, primary health care center (PHCC) or Hospital. Conclusion The antenatal care (ANC) visit were high in conclusion is high even up to WHO recommendation mark. There is a gap between knowledge of postnatal care (PNC) and its utilization, we need to improve this NPC visit gap utilizing available health services.
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Thapa, SS, I. Paudyal, S. Khanal, and G. Van Rens. "Results of the Bhaktapur Glaucoma Study, Nepal." Nepalese Journal of Ophthalmology 5, no. 1 (March 26, 2013): 81–93. http://dx.doi.org/10.3126/nepjoph.v5i1.7832.
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Introduction: The Bhaktapur Glaucoma Study is a population-based, cross-sectional and longitudinal study undertaken in one of the districts of Nepal. Objectives: To determine the prevalence of glaucoma in Bhaktapur district, Nepal. Materials and methods: Thirty clusters were randomly selected and a door-to-door census was conducted to identify citizens 40 years of age and older. Four thousand eight hundred individuals fulfilling the eligibility criteria were referred to the base hospital in Kathmandu for a detailed clinical examination. The diagnosis of glaucoma was based upon criteria described by the International Society for Geographic and Epidemiological Ophthalmology (ISGEO). Results: Complete data was available on 3991 subjects (response rate 83.15 %). The mean IOP was 13.3 mm Hg (97.5th and 99.5th percentiles, 18 and 20 mm Hg, respectively) and mean VCDR 0.26 (97.5th and 99.5th percentiles, 0.6 and 0.8 mm Hg, respectively). Seventy-five subjects had glaucoma, an age-sex-standardized prevalence of 1.80 (95 % confidence interval (CI), 1.68 - 1.92). The age-and sex-standardized prevalence of POAG was 1.24 % (CI, 1.14 - 1.34), PACG 0.39 % (CI, 0.34 - 0.45) and secondary glaucoma 0.15 % (CI, 0.07-0.36). The prevalence of glaucoma increased with increase in age and there was no significant difference in gender. Nine eyes were blind and two subjects bilaterally blind from glaucoma. Conclusion: The overall prevalence of glaucoma was 1.9 %. POAG was the most common form of glaucoma. Visual morbidity from PACG, however, was higher. A large majority of the subjects with POAG had not been previously diagnosed and had intraocular pressure within the normal range. Nepal J Ophthalmol 2013; 5(9):81-93 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7832
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Skogberg, Natalia, Päivikki Koponen, Paula Tiittala, Katri-Leena Mustonen, Eero Lilja, Olli Snellman, and Anu Castaneda. "Asylum seekers health and wellbeing (TERTTU) survey: study protocol for a prospective total population health examination survey on the health and service needs of newly arrived asylum seekers in Finland." BMJ Open 9, no. 4 (April 2019): e027917. http://dx.doi.org/10.1136/bmjopen-2018-027917.
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IntroductionHealth, well-being and health service needs of asylum seekers have emerged as urgent topics following the arrival of 2.5 million asylum seekers to the European Union (EU) between 2015 and 2016. However, representative information on the health, well-being and service needs of asylum seekers is scarce. The Asylum Seekers Health and Wellbeing (TERTTU) Survey aims to: (1) gather population-based representative information; (2) identify key indicators for systematic monitoring; (3) produce the evidence base for development of systematic screening of asylum seekers’ health, well-being and health service needs.Methods and analysisTERTTU Survey is a population-based prospective study with a total population sample of newly arrived asylum seekers to Finland, including adults and children. Baseline data collection is carried out in reception centres in 2018 and consists of a face-to-face interview, self-administered questionnaire and a health examination following a standardised protocol. Altogether 1000 asylum seekers will be included into the study. Baseline data will be followed up with national electronic health record data encompassing the entire asylum process and later with national register data among persons who receive residency permits.Ethics and disseminationEthical approval has been granted by the Coordinating Ethics Committee of the Helsinki and Uusimaa Hospital District. Participation is voluntary and based on written informed consent. Results will be widely disseminated on a national and international level to inform health and welfare policy as well as development of services for asylum seekers. Results of the study will constitute the evidence base for development and implementation of the initial health assessment for asylum seekers on a national level.