Hamdan Medical Journal最新文献_第8页

Knowledge and attitude of resident doctors towards prehabilitation: An audit in a tertiary care centre 住院医生对康复的知识和态度：一家三级护理中心的审计

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_67_22

R. Kumari, A. Bhalotra, Rahil Singh

{"title":"Knowledge and attitude of resident doctors towards prehabilitation: An audit in a tertiary care centre","authors":"R. Kumari, A. Bhalotra, Rahil Singh","doi":"10.4103/hmj.hmj_67_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_67_22","url":null,"abstract":"Background: Major surgery is associated with a significant decline in the functional capacity of patients. Prehabilitation is the practice of enhancing a patient's functional capacity prior to surgery and thus improving postoperative outcomes. It is a multimodal approach, encompassing medical optimization, preoperative physical exercise, nutritional support, and stress/anxiety reduction. In this audit, we tried to find out how many resident doctors know about prehabilitation and, how they implement it in their patients in routine practice. Aims and Objectives: To study the knowledge amongst resident doctors regarding the role of prehabilitation in surgical patients; and to create awareness and implement quality practices for better post-operative outcomes. Materials and Methods: A questionnaire was prepared on Google docs with multiple choice questions and circulated electronically through emails with the participants. The submitted data were updated on Google docs and analyzed subsequently. Results: One hundred and ninety resident doctors participated in the audit. One hundred seventy residents (89.7%) were aware of holistic multimodal interventions. Three- fourths of residents (150 residents; 78.95%) accurately understood the rationale behind prehabilitation. Most of the residents (183 residents; 96.84%) were aware of preoperative medical optimization. A majority (188 residents; 98.95%) were familiar with the techniques of psychological support to patients. However, the knowledge with regard to the rationale behind prehabilitation and the category of patients requiring it, baseline functional capacity assessment, techniques for exercise intensity optimization, and questions pertaining to nutrition was unsatisfactory. Conclusion: Our audit focuses on the need to enhance the knowledge of resident doctors regarding the prehabilitation program to improve post-operative outcomes in patients.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"214 - 219"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48268516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A huge mesenteric cyst: A case report and literature review 巨大肠系膜囊肿1例报告并文献复习

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_39_22

Maryam Makki, Rufaida Osman, B. Hussein, Wessam Issa, Omar Al-Marzouqi

引用次数: 0

Partograph adherence and its barriers in a tertiary care hospital: A mixed-method study 三级护理医院的分娩图依从性及其障碍：一项混合方法研究

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_50_22

Nirmalya Manna, P. Bhattacharya, R. Mukherjee, Adwitiya Das

{"title":"Partograph adherence and its barriers in a tertiary care hospital: A mixed-method study","authors":"Nirmalya Manna, P. Bhattacharya, R. Mukherjee, Adwitiya Das","doi":"10.4103/hmj.hmj_50_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_50_22","url":null,"abstract":"Background: Partograph is a low cost, effective and mandatory tool for intrapartum monitoring. However, the partograph has been grossly underutilised. Aims and Objectives: The present study aims to find out the extent of the use of a partograph and the barriers to effectively using the same in a tertiary care facility. Materials and Methods: This cross-sectional study comprises quantitative and qualitative methods. The quantitative component consisted of a retrospective review of case sheets of patients undergoing uncomplicated vaginal delivery between 1 January 2020 and 15 February 2020. The percentage of cases where a partograph was initiated and completed was assessed. For the qualitative part, staff nurses on duty in the labour room during the study period and responsible for recording the partograph were invited to participate in a focused group discussion (FGD). Sister-in-charges, supposed to supervise the staff nurses were invited to participate an In-depth interview (IDI). Results: Out of 131 case sheets, a partograph was initiated in 64 (48.85%) cases and completed in 4 out of 64 partographs (6.25%). The 'Cervical dilatation' parameter was plotted in all 64 cases, while the 'amniotic fluid condition' was the least plotted parameter (12 [18.75%]). Data regarding the 'time of rupture of membranes' (15.63%) and 'condition at birth' (4.69%) were also neglected parameters. The FGD and IDI revealed 'shortage of staff and heavy workload', 'presentation in advanced labour', 'poor training and supervision', 'incomplete documentation of clinical information by doctors' and 'policy level lacunae' as the potential barriers to partograph adherence and completeness. Conclusion: Partograph adherence and completeness appeared inadequate in this tertiary care centre.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"195 - 200"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41357694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

DUBAI triangle and Amin's Triangle, a new invention during TransOral Endoscopy Thyroidectomy Vestibular Approach (TOETVA) for critical view of safety for preservation of vital structures 迪拜三角和阿明三角，经口内窥镜甲状腺切除术前庭入路(TOETVA)的新发明，对重要结构保存的安全性至关重要

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_101_22

Yasir A.Latif, Aliya Ishaq, M. Khalid, E. Ghazi, R. Hartung

引用次数: 0

Idiopathic proximal small bowel intussusception in an adult 成人特发性近端小肠肠套叠1例

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_59_22

A. Ashraf, C. Singh, Mohd Bilal

引用次数: 0

Recovery from anaesthesia in post-COVID-19 mucormycosis debridement surgery: An observational study COVID-19后毛霉菌病清创手术麻醉后的恢复：一项观察性研究

Hamdan Medical Journal Pub Date : 2022-10-01 DOI: 10.4103/hmj.hmj_54_22

Roopa Sachidananda, Dharmesh A. Ladhad, Vikas Joshi, Madhuri S. Kurdi, V. Bhat, Athira Sarasamma

{"title":"Recovery from anaesthesia in post-COVID-19 mucormycosis debridement surgery: An observational study","authors":"Roopa Sachidananda, Dharmesh A. Ladhad, Vikas Joshi, Madhuri S. Kurdi, V. Bhat, Athira Sarasamma","doi":"10.4103/hmj.hmj_54_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_54_22","url":null,"abstract":"Background: Mucormycosis has emerged as the most common lethal post-COVID-19 infection. Since the onset of the COVID-19 pandemic, anaesthesiologists have faced the challenge of anaesthetising post-COVID mucormycosis patients, which requires extensive surgical debridement. Various perioperative factors can have an impact on the recovery from the neuromuscular blockade of these patients. Aims and Objectives: This study was undertaken to observe the recovery pattern from the neuromuscular blockade and the impact of various factors on extubation time. Materials and Methods: The retrospective study included all post-COVID-19 mucormycosis patients who underwent debridement surgery under general anaesthesia in a tertiary referral hospital. All the pre-anaesthetic evaluation charts, treatment charts and anaesthetic management charts were reviewed. The following outcome variables at recovery from anaesthesia were noted: duration of surgery, duration of anaesthesia and extubation time. Results: A total of 72 patients underwent post-COVID-19 debridement surgery in the study period, of which 26 patients were excluded from the study and 46 patients were included in the analysis. The median extubation time was 32 min and interquartile range was 7–37 min. Seventeen (37%) patients were extubated in <15 min and 29 (63%) patients were extubated after 15 min. The shortest extubation time was 2 min, whereas the longest was 1440 min. Conclusion: Extubation time was prolonged when post-COVID patients underwent debridement surgery for rhino-orbito-cerebral mucormycosis. Although pre-operative and intraoperative factors can impact recovery from neuromuscular blockade, our study did not demonstrate such findings. Delayed extubation time may be related to the COVID illness rather than pre-operative risk factors.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"201 - 205"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45859411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Study of surgical and functional outcome in the management of proximal tibial fracture with circular wire-based external fixation 圆形金属丝外固定治疗胫骨近端骨折的手术和功能效果研究

Hamdan Medical Journal Pub Date : 2022-07-01 DOI: 10.4103/hmj.hmj_20_22

T. Mondal, S. Ghosh, Soma Ghosh

{"title":"Study of surgical and functional outcome in the management of proximal tibial fracture with circular wire-based external fixation","authors":"T. Mondal, S. Ghosh, Soma Ghosh","doi":"10.4103/hmj.hmj_20_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_20_22","url":null,"abstract":"Background: The principle of treatment in proximal tibial fracture includes soft tissue care, restoring articular surface congruity and reduction of anatomical alignment enabling early joint mobility. Aim: Assessing surgical, and functional outcomes by evaluating pain, range of motion (ROM) and muscle power in circular wire-based external fixation procedure in proximal tibial fractures with complications. Objectives: Documenting clinical observations, preoperative, and postoperative symptoms in the study population with time for bony union and complications. Materials and Methods: Thirty patients aged 18–70 years with proximal tibial fractures excluding polytrauma and pathological fracture cases were included in the prospective observational study. Surgery and post-operative follow-up were done at 6, 12, 24 weeks and 6 months. Functional assessment is done by the knee society score system. Removal of fixator followed evidence of clinical and radiological union with advice for full weight bearing. Results: Road traffic accident was a major injury, right laterality more than left. The type of tibial fractures was 41A2, A3 and C3. Eighty per cent of patients had no persistent residual pain after fracture union; 80% showed normal relative to age walking capacity, and 95% showed normal to <10° lack of extension. Fourteen patients had ROM of 125° and 120° in ten. Twenty-six patients showed normal stability in extension and 20° flexion. Twenty-five patients showed excellent knee scores, 24 showed excellent functional scores; four showed good knee scores and five showed good functional scores. Post-operative complications included pin-tract infection in four patients followed by delayed and non-union in one patient each. Conclusion: Circular wire-based external fixation in the proximal tibial fracture is an effective method of treatment even with moderate soft-tissue injury showing excellent to good functional outcome.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"145 - 150"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45486965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An observational study of risk association of diabetes mellitus and hypertension in the first-degree relatives of patients with diabetes mellitus 糖尿病患者一级亲属中糖尿病与高血压危险关系的观察研究

Hamdan Medical Journal Pub Date : 2022-07-01 DOI: 10.4103/hmj.hmj_16_22

D. Rani, Pradyumna Singh

{"title":"An observational study of risk association of diabetes mellitus and hypertension in the first-degree relatives of patients with diabetes mellitus","authors":"D. Rani, Pradyumna Singh","doi":"10.4103/hmj.hmj_16_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_16_22","url":null,"abstract":"Background: Occurence of diabetes and hypertension is affected by the genetic modulation and environmental factors. Thus it becomes important to determine associated factors governing them among the relatives. Aims and Objectives: The objectives of this study were to determine the prevalence of diabetes mellitus (DM) and hypertension (HTN) and associated risk factors in the first-degree relatives (FDRs) of the patients with type 2 DM (T2DM). Materials and Methods: The study design was cross-sectional for a period of 18 months from September 2017 to March 2019 wherein 200 people who were FDRs of T2DM patients, visiting Holy Family Hospital, New Delhi, were enrolled. The demographic details, anthropometric measurements, blood pressure and HbA1c levels were assessed, based on which the FDRs were classified into pre-diabetes, diabetes and hypertensive. The odds ratio was calculated for risk association to predict the occurrence of DM and HTN. Results: The age of the study population ranged from 30 to 50.25 years, with a median age of 38 years. There were 116 (58%) males and 84 (42%) females. The median body mass index (BMI) was 24.5, with 49.5% having normal BMI, 43% being pre-obese and 7.5% obese. As per the glycaemic parameters, 80 (40%) had normal glucose tolerance, 50 (25%) were pre-diabetic and 70 (35%) had diabetes. Amongst the 200 FDRs, HTN was prevalent in 95 (47.5%) cases. Higher age was found to be a significant risk factor for DM, with a higher odds of 1.056 (P = 0.021), while higher age and female gender carried a significantly higher odds of occurrence of HTN in FDRs, with an odds ratio of 1.049 and 2.178. Conclusion: DM and HTN are prevalent in FDRs of T2DM patients. Higher age is a significant risk factor for both DM and HTN, necessitating a regular screening of FDRs for an early interception to prevent these diseases.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"139 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47405081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bigels: A newer system – An opportunity for topical application Bigels：一个更新的系统——一个专题应用的机会

Hamdan Medical Journal Pub Date : 2022-07-01 DOI: 10.4103/hmj.hmj_33_22

Nensi Raytthatha, Jigar Vyas, Isha Shah, U. Upadhyay

{"title":"Bigels: A newer system – An opportunity for topical application","authors":"Nensi Raytthatha, Jigar Vyas, Isha Shah, U. Upadhyay","doi":"10.4103/hmj.hmj_33_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_33_22","url":null,"abstract":"Introduction: A gel is a solid or semisolid system composed of at least two parts, namely a condensed mass containing and interpenetrating a liquid. Hydrogel, emulgel and organogel are novel gel systems that are widely known but have some drawbacks. For example, hydrogel delivers hydrophilic but not poorly water-soluble drugs and has a lower ability to penetrate the stratum corneum, organogel has a greasy nature that causes stickiness and difficulty in removal and emulgel has different mechanical phases that cause instability. This impediment can be solved by using a unique and innovative formulation termed bigels. Method: The aqueous phase is typically made by a hydrophilic polymer, while the organic phase is comprised of gelled vegetable oil due to the presence of an organogelator. For the bigel manufacturing process, the percentage of the respective gelling agent in each phase, the organogel/hydrogel ratio, as well as the mixing temperature and speed, should be considered. The presence of desirable characteristics in both hydrogels and organogels increases patient compliance as well as the loading capacity of both lipophilic and hydrophilic drugs. Result: The substantial focus of this descriptive review is to look at the possible correlations (i.e. cross-linked polymer structures) among various parts of hybrid systems (i.e. bigels or multi-component organogels). Bigels are systems formed by combining a hydrogel with an organogel. Discussion: So far, researchers have mostly investigated bigel systems for regulated drug administration in topical applications. These bigels are investigated in research, yet to find popularity in the market.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"113 - 121"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42749723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Experience of implementation of enhanced recovery after surgery in colorectal surgeries in rashid hospital 拉希德医院大肠癌术后加强康复的实施体会

Hamdan Medical Journal Pub Date : 2022-07-01 DOI: 10.4103/hmj.hmj_21_22

A. AlBaroudi, N. AlZarooni, Labib AlOzabi, Nourhan Hejazi

{"title":"Experience of implementation of enhanced recovery after surgery in colorectal surgeries in rashid hospital","authors":"A. AlBaroudi, N. AlZarooni, Labib AlOzabi, Nourhan Hejazi","doi":"10.4103/hmj.hmj_21_22","DOIUrl":"https://doi.org/10.4103/hmj.hmj_21_22","url":null,"abstract":"Background: Enhanced Recovery After Surgery guidelines in colorectal surgery state that there is improvement in general post-operative outcomes including reduction in operative complications and 30 days readmission rates. These recommendations were originating from high flow, excellence and academic centers. Aim and objectives: Demonstrating the feasibility of ERAS protocols application in low-flow centres as our hospital is the aim of this study. Materials and Method: A retrospective cohort study was performed at a tertiary hospital. A total of 99 patients were included over a period of 6 years from January 2014 till January 2020 for all elective colorectal cases after being filtered through inclusion and exclusion criteria. They were divided into two groups Pre-ERAS (n=29) and ERAS group (n=70) starting from August 2016 the date of beginning implementation of the local protocol. Results: It was observed that there was statistical significance in reducing the length of hospital stay from an average of 13 days in Pre-ERAS to average of 8 days in the ERAS group and a decrease in day 1 post-operative pain score were achieved without adverse impact in surgery related morbidities or readmission rate. Conclusion: ERAS protocol can be applied to improve surgical outcomes in colorectal surgery without increased risk of complications.","PeriodicalId":34280,"journal":{"name":"Hamdan Medical Journal","volume":"15 1","pages":"151 - 154"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48667583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0