scholarly journals Epidemiology of Orthopaedic Admissions at A Teaching Hospital of Eastern Nepal

2017 ◽  
Vol 6 (1) ◽  
pp. 56-62
Author(s):  
Bibhuti Nath Mishra ◽  
Anuja Jha ◽  
Yogendra Gupta
Keyword(s):  
Teaching Hospital ◽  
Inpatient Care ◽  
Open Fracture ◽  
Care Center ◽  
Osteoporotic Fractures ◽  
Tertiary Level ◽  
Health Care Center ◽  
Lower Limb Fractures ◽  
Closed Fractures ◽  
Limb Fractures

Background: There are many other reasons besides fracture for which a patient could potentially be admitted to orthopaedic inpatient care. The goal of this retrospective review was to analyze the spectrum of orthopaedic admissions to a tertiary level teaching hospital of Nepal.Material & Methods: This retrospective descriptive epidemiological study was based on patients admitted for orthopaedic inpatient care at a tertiary level health care center of eastern Nepal. Registry data of 1 year was used to analyze the spectrum of orthopaedic admissions.Results: Male admission outnumbered females with a ratio of 1.82:1. Trauma accounted to majority of Orthopaedic admissions (67.9%) and Infection lied second in order (12.4%). Upper and Lower limb fractures (with right sided dominance) contributed to highest numbers of trauma respectively. Incidence of closed to open fracture was 5.45:1. More than half of trauma and fractures involved the 10 – 39 years age group with predominance in 10-19 years. Fracture incidence was higher among men than women until 59 years of age after which the gender ratio reversed.Conclusions: Leading cause for orthopaedic admission was Trauma accounting more than 2/3 of the total. Biasness in gender admission reflects true picture of male dominated society. Upper limb injury, right side and closed fractures were dominating. Sexual dimorphism was apparent in fractures which may be due to higher rates of Osteoporotic fractures in elderly females.Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017), Page: 56-62

scholarly journals Time to debridement in open high-grade lower limb fractures and its effect on union and infections: A prospective study in a tropical setting

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090755
Author(s):  
Christina Marie Joseph ◽  
Thilak Samuel Jepegnanam ◽  
Boopalan Ramasamy ◽  
Vinoo Mathew Cherian ◽  
Manasseh Nithyananth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Short Form ◽  
Care Center ◽  
Tertiary Care ◽  
High Grade ◽  
Lower Limb Fractures ◽  
Sf 36 ◽  
Limb Fractures

Purpose: To prospectively evaluate whether time to debridement has any correlation with union, infection, and quality of life in high-grade lower limb fractures in a tropical setting. Methods: A prospective cohort study was conducted at a tertiary care center in South India. Two hundred fifty-four adult skeletally mature patients with 301 grade 3 fractures involving the femur, tibia, or fibula were recruited. The cohort was empirically divided into two groups (early and late) based on the time to debridement (less than or more than 12 h from injury). Outcome: The primary outcome was nonunion. Secondary outcomes were deep infection rates and patients’ quality of life. Short form-36 (SF-36) and short musculoskeletal functional assessment (SMFA) questionnaires were also used. Patients were followed up for 9 months. Results: The follow-up rate was 93%. The late group had a significantly higher risk of nonunion (odds ratio(OR): 6.5, 95% confidence interval (CI): 2.82–14.95) and infections (OR: 6.05, 95% CI: 2.85–12.82). There was a 4% increase in the infection risk for each hour of delay for the initial 50 h ( p < 0.0001). SF-36 and SMFA scores were superior in the early group ( p < 0.0001). Conclusion: The study contradicts findings reported in the literature from the West. Our study was in agreement with our hypothesis and proved that debridement within 12 h resulted in significantly lower rates of nonunion and infections and an overall improved quality of life in high-grade open lower limb fractures in a developing country. Level of evidence: Level II Trial registration: German Clinical Trials Register DRKS00015186

scholarly journals Perception of doctors and nurses regarding prevention of COVID-19 infection at a Teaching Hospital, Nepal

2020 ◽  
Vol 7 (3) ◽  
pp. 13-21
Author(s):  
Lucky Sharma ◽  
Abhiskar Thapa ◽  
Hema Chand ◽  
Subash Pant ◽  
Arpana Neopane
Keyword(s):  
Health Care ◽  
Teaching Hospital ◽  
Personal Protective Equipment ◽  
Care Center ◽  
College Teaching ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Health Care Center ◽  
Service Demand

Introduction: The use of personal protective equipment can be burdensome and the risk of COVID-19 infection for this group is high. This study details to evaluate how prepared Health Care Workers consider themselves to be regarding the delivery of infection prevention and control procedures in their place of work. Method: This is a cross-sectional study conducted at Kathmandu Medical College Teaching Hospital in September 2020. A questionnaire was given to participants along with the information about the study. Service demand, skills, beliefs about capabilities, beliefs about consequences, intentions, environmental context and resources, social influences, emotion, WHO Wellbeing (over the last two weeks) were taken as dependent variables. Result: Out of 112 participants, 58(51.7%) were doctors and 54(48.3%) nurses; 65(58.1%) female and 47(41.9%) were male. The mean age was 31.2±4.1 y. Service demand was scored lowest (mean 0.7 out of 7) and beliefs about consequences were scored highest (mean 5.7 out of 7). Conclusion: Healthcare workers agreed that personal protective equipment at work is sufficiently effective to prevent the spread of COVID-19. They were not confident that the health care center at present can manage or can continue to manage the current patient surge related to COVID-19.

scholarly journals Risk Factors For Traumatic Open Fracture in Children and Adolescents Presenting With Traumatic Fractures

2021 ◽  
Author(s):  
Hongwei Wang ◽  
Jun Liu ◽  
Deluo Wu ◽  
Lan Ou ◽  
Changqing Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Lower Limb ◽  
Open Fracture ◽  
Fracture Site ◽  
Open Fractures ◽  
Multiple Fractures ◽  
Lower Limb Fractures ◽  
Limb Fractures ◽  
Upper Limb Fractures

Abstract Background: To investigate the risk factors for open fractures in children and adolescents (≤18 years old) presenting with traumatic fractures.Methods: We retrospectively reviewed the records of 2418 children and adolescents who presented with traumatic fractures and were admitted to our university-affiliated hospitals, among which 206 patients (8.5%) presented with open fractures.Results: This study enrolled 1789 males (74.0%) and 629 females (26.0%) with an average age of 11.2±5.0 years. There were 206 patients (8.5%) who presented with open fractures. The five most common fracture sites were the tibia (31.1%, 64/206), fibula (20.9%, 43/206), phalanx (15.5%, 32/206), humerus (11.2%, 23/206) and ulna (9.7%, 20/206). Univariate logistic regression analysis showed that the aetiology (P﹤0.001) and fracture site (P﹤0.001) were risk factors for open fracture. Multivariate logistic regression analysis indicated that mechanical trauma (OR=64.229, P﹤0.001), being hurt/cut by others (OR=26.757, P﹤0.001), and being struck by an object (OR=15.345, P﹤0.001) were stronger risk factors for open fracture than were low falls; additionally, lower limb fractures (OR=5.970, P﹤0.001), upper limb fractures (OR=5.865, P﹤0.001) and multiple fractures (OR=5.414, P﹤0.001) were stronger risk factors than craniofacial fractures for open fractures.Conclusions: Aetiology (especially being injured by a machine or being hurt/cut by others) and the fracture site (including lower limb fractures, upper limb fractures and multiple fractures) were independent risk factors for open fractures.

scholarly journals The impact of a dedicated orthoplastic operating list on time to soft tissue coverage of open lower limb fractures

2015 ◽  
Vol 97 (6) ◽  
pp. 456-459 ◽  
Author(s):  
MA Fernandez ◽  
K Wallis ◽  
M Venus ◽  
J Skillman ◽  
J Young ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Open Fracture ◽  
Soft Tissue Coverage ◽  
National Guidelines ◽  
Management Standards ◽  
Lower Limb Fractures ◽  
Time Period ◽  
Operating List ◽  
Limb Fractures ◽  
The Impact

An observational study was conducted of 105 patients presenting with an open fracture of the tibia or ankle to determine the impact of a dedicated orthoplastic operating list on our management of these injuries over the time period January 2012 to July 2014. There were 51 patients before and 54 after the introduction of the orthoplastic list. Significant improvements were noted in our ability to deliver a service in line with national guidelines across all Gustilo–Anderson grades of injury. Among patients with the most severe grades of injury (Gustilo types IIIB and IIIC), there was a trend towards an improved time to first skeletal stabilisation (29.5 vs 14.2 hours, p=0.068), an improvement in time to soft tissue coverage (173.6 vs 88.1 hours, p=0.009) and a trend towards a reduced length of inpatient stay (32.6 vs 23.2 days, p=0.138). Where the 72-hour target had been breached, there was a significant improvement in the proportion of patients covered within 7 days of injury (48.2% vs 83.3%, p=0.017). Our compliance with national management standards increased significantly to reflect these improvements in care. These results support the implementation of dedicated orthoplastic operating sessions to meet the growing burden of patients presenting with open fractures at specialist centres.

scholarly journals Length of Stay of Orthopaedic Inpatients at a Teaching Hospital in Eastern Part of Nepal

2015 ◽  
Vol 53 (199) ◽  
pp. 180-183 ◽  
Author(s):  
Bibhuti Nath Mishra ◽  
Anuja Jha ◽  
Era Maharjan ◽  
Mahima Limbu ◽  
Sanjaya Sah ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Epidemiological Study ◽  
Average Length ◽  
Care Center ◽  
Third Party ◽  
Tertiary Level ◽  
Health Care Center ◽  
Average Length Of Stay

Introduction: This study aimed to analyze the average length of stay of all inpatients in the department of Orthopaedics and to compare the variations in hospital stay between age, gender, traumatic and non-traumatic co-morbidities and modality of payment. Methods: This hospital based retrospective descriptive epidemiological study was based on patients discharged from a tertiary level health care center of eastern Nepal. Registry data of 1 year was used to calculate length of stay and analyze the variations. Results: Average length of stay was 10.5 days. It was 10.7 days for males and 10.1 days for females. It was 10.12 days for patients paying themselves for their treatment whereas 14.98 days for patients receiving reimbursement (third party payment). Conclusions: Average length of stay was more in elderly and patients of trauma (longest in pelvis injury). It was 1.5 times longer for patients receiving reimbursement for treatment.  Keywords: length of stay; non-traumatic co-morbidities; trauma; third party payment.  

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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