scholarly journals Outcomes of management of intestinal obstruction at an urban tertiary hospital in sub Saharan Africa: a cross-sectional study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arlene Muzira Nakanwagi ◽  
Stephen C. Kijjambu ◽  
Peter Ongom ◽  
Tonny Stone Luggya
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Abdominal Distension ◽  
Sub Saharan Africa ◽  
Prolonged Hospital Stay ◽  
Wound Sepsis ◽  
Bowel Sounds ◽  
Colicky Abdominal Pain ◽  
Prolonged Hospital

Abstract Background Intestinal obstruction (IO) is a common cause of acute abdomen globally, it remains challenging as it increases surgical financial expenditure while also causing major morbidity. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis, especially in resource limited settings, can be clinical but is usually confirmed radiologically. We studied the current diagnosis, management and outcomes of IO in Mulago Hospital. Materials and methods This was a prospective study done at all the surgical units of Mulago from January to May 2014 to assess general diagnosis and management of IO. Ethical approval was got in line with Helsinki declaration, we used pretested and validated questionnaires to collect data. Informed consent was got with eligible and consenting/assenting patients that fitted the inclusion criteria of age and presenting with suspected intestinal obstruction. Uni-variate and bi-variate variables analysis was done plus measures of association. Results We enrolled 135 patients, excluded 25 and recruited 110 patient. We had more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were commonest symptoms, then abdominal distension, increased bowel sounds and abdominal tenderness were the commonest signs. Most patients’ (51%) were diagnosed radiologically with a lesser number clinically diagnosed. “Dilated bowel loops” was the commonest radiological sign. Surgery was the main stay of management at 72.7% while 27.3% were conservatively managed. Postoperatively the bowels opened averagely on the 3rd post-operative day (POD) with return of bowel sounds occurring on 5th POD. Most discharges (73%) occurred by the 7th POD. Unfavourable outcomes were prolonged hospital stay followed by wound sepsis (surgical site infection) and then Mortality. Conclusion This study noted that In Mulago we mostly diagnosed patients radiologically with most surgically managed and which is similar to regional practices. Postoperatively bowel opening happening on third POD with return of bowel sounds on fifth POD. Prolonged hospital stay followed by wound sepsis and then mortality were commonest unfavorable management outcomes.

scholarly journals Diagnosis, Management and Outcomes of Intestinal Obstruction at an Urban Tertiary Hospital in Sub Saharan Africa: a Cross-Sectional Study.

2021 ◽  
Author(s):  
Arlene Muzira Nakanwagi ◽  
Stephen C Kijjambu ◽  
Tonny Stone Luggya
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Abdominal Distension ◽  
Sub Saharan Africa ◽  
Prolonged Hospital Stay ◽  
Bowel Sounds ◽  
Colicky Abdominal Pain ◽  
Validated Questionnaire ◽  
Prolonged Hospital

Abstract BACKGROUND: Intestinal Obstruction (IO) is among the commonest causes of acute abdomen worldwide and globally it remains a challenge because it is a major cause of morbidity and surgical financial expenditure. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis can be clinical but is confirmed usually by radiologic imaging. We studied the current diagnosis, management and outcomes of IO in Mulago HospitalMATERIALS AND METHODS: This was a Prospective Descriptive Study in all the surgical units of Mulago from January to May 2014. Ethical approval was got in line with Helsinki declaration and then a pretested and validated questionnaire was used to collect data. Informed consent was got with eligible and consenting/assenting patients recruited among those patients of all ages and sex presenting with suspected Intestinal Obstruction. Uni-variate and bi-variate of the variables plus measurements of associations were done.RESULTS: We enrolled 135 patients, excluded 25 and recruited 110 patient with more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were the 3 commonest symptoms with abdominal distension, increased bowel sounds and abdominal tenderness as commonest signs. Majority of the patients were diagnosed radiologically (51%) and the rest (48.2%) clinically diagnosed accounting. “Dilated bowel loops” was the most frequent radiological sign. Return of bowel sounds occurred within 5 days of the POD, while opening of bowels on average, occurred on the 3rd POD. The mean day of discharge was the 5th POD and 73% of the patients were discharged by the 7th Post-Operative Day. The commonest unfavourable management outcome noted was prolonged hospital stay followed by wound sepsis (Surgical Site Infection) and MortalityCONCLUSION: Majority of the patients were diagnosed radiologically (51%). surgical management was done for 72.7% of the cases and 27.3% conservatively managed. Prolonged hospital stay was the commonest unfavorable outcome of management

A study on the design of a wardrobe, for patients bed-ridden with cancer, applying the knowledge of anonymous design

Impact ◽  
2020 ◽  
Vol 2020 (7) ◽  
pp. 45-47
Author(s):  
Naoko Fujii
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Healthcare Professionals ◽  
The Other ◽  
Human Beings ◽  
Prolonged Hospital Stay ◽  
Hospital Patients ◽  
Hospital Gowns ◽  
Hospital Stays ◽  
Prolonged Hospital

The majority of human beings will be admitted to hospital at some point over the course of their lives. For the more fortunate among us, these hospital stays will be brief and will barely register as a significant experience. However, for others, being admitted for weeks or months at a time will be necessary in order to combat and recover from whatever it was that made admittance to hospital necessary. While it is easy to think of many reasons why a prolonged hospital stay might be undesirable, one that may escape our attention is the clothes that are worn by patients during their stay. Once a patient has been assigned a bed, they are often given a gown which they put on without thought and then lie down. The gowns that are given to patients are generally designed with healthcare professionals in mind. For example, in Japan pyjamas and yukata (bathrobes) are used as hospital gowns because they have a front opening that is easy to use during treatment and nursing care. In addition, the other gowns can be opened from the ankle to the crotch using the zip. Dr Naoko Fujii has focused her career on designing clothes for hospital patients and believes that there is a way to satisfy the practical needs of a hospital and the care it gives at the same time as satisfying the requirements of patients. She is now focusing her attention on this challenge.

scholarly journals COPD in patients after heart transplantation is associated with a prolonged hospital stay, early posttransplant atrial fibrillation, and impaired posttransplant survival

2018 ◽  
Vol Volume 10 ◽  
pp. 1359-1369 ◽  
Author(s):  
Rasmus Rivinius ◽  
Matthias Helmschrott ◽  
Arjang Ruhparwar ◽  
Bastian Schmack ◽  
Fabrice F. Darche ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Transplantation ◽  
Hospital Stay ◽  
Prolonged Hospital Stay ◽  
Prolonged Hospital

scholarly journals Factors Associated with Prolonged Hospital Stay: a Retrospective Study for Imported Malaria Cases

2021 ◽  
Author(s):  
Liang Huang ◽  
Hong Jin ◽  
Hong Zhang ◽  
Yang Liu ◽  
Xinxing Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infection ◽  
Hospital Stay ◽  
Predictive Factors ◽  
Imported Malaria ◽  
Health Concern ◽  
P Value ◽  
Prolonged Hospital Stay ◽  
Imported Cases ◽  
Prolonged Hospital

Abstract Background China had entered post-elimination era for malaria, however, the imported cases are continuously are a public health concern as the increasing number of cases. In this study we studied the potential predictive factors for prolonged hospital stay for imported malaria patients. Material and Methods We retrospectively collected patients of imported malaria cases data from 2017–2020 in our hospital. we analyzed the data from clinical, epidemiological, geographical, and seasonal points of view, and used cox proportional hazard model to find the predictive factors for prolonged hospital stay. Results We found most of imported cases were from Democratic Republic of the Congo(23%, 34/150) and most cases 74%(26/34) were infected by P. falciparum. Through Edwards Test, no significant seasonality of imported cases were found(χ2 = 2.51 p-value = 0.28). We found bacterial infection(HR = 0.58, p-value = 0.01) and thrombocytopenia(HR = 0.66, p-value = 0.02) were protective factors for discharge, that were, the risk factors for prolonged hospital stay. Conclusions The imported cases are the major risk of malaria in post-elimination era of China. The bacterial infection and thrombocytopenia were the risk factors for prolonged hospital stay.

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