scholarly journals Utilization of clinical autopsy services in a Nigerian teaching hospital

2020 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Samuel Robsam Ohayi ◽  
Anthony Jude Edeh ◽  
Nnaemeka Thaddeus Onyishi

Objectives: The aim of this study was to ascertain the rate of uptake of clinical autopsy services in our hospital and also determine the associated factors. Autopsy is an important part of clinical practice. It serves as an audit and quality control for diagnosis and treatment of diseases. It also provides families with “informed grieving” by giving clearer understanding of the nature of illness and cause of death and may reveal inheritable or communicable diseases among other benefits. Despite these benefits, the rate of autopsy is low and declining globally. Material and Methods: A retrospective study of hospital autopsies performed from January 2013 to December 2017 was carried out. The mortuary and autopsy records of our hospital over the period were retrieved and reviewed. Deaths reported to the police, namely, coroner deaths and deaths before arriving at the hospital (brought in dead, BID) were excluded from the study. Results: A total of 1976 bodies was studied, 1078 males and 898 females (M:F = 1:1.2). Consent for autopsy was sought in 22 (1.1%) cases: 13 (0.66%) from pediatrics, 5 (0.25%) from internal medicine, and the rest from surgery and obstetrics and gynecology. Consent was granted and autopsy performed in 6 (0.3%) cases giving an average of 1.2 autopsies/year. Average hospital stay was 12.6 days and 36.3 days for those consenting to and those declining autopsy, respectively. Consenting persons belong to diverse socioeconomic strata. Conclusion: Autopsy rate is very low in our center. Attending clinicians and relatives of the deceased contribute to this trend. Vigorous education for all stakeholders about the benefits of hospital autopsy is recommended.

2021 ◽  
Vol 17 (1) ◽  
pp. 14-19
Author(s):  
Irina Drăgan ◽  
Ioan Adrian Petrache ◽  
Valerian Cristian Păvăloiu ◽  
Petruț Giuliano ◽  
Ion Mîndrilă ◽  
...  

We performed a retrospective study focusing on examining all rib fracture cases discharged from 4 thoracic surgery clinics in Romania. Over a period of 3 years, we analyzed data regarding the patients, diagnosis and number of days spent in the hospital. 2.417 patients were included in this study and all patient evolutions were taken into account. The most patients suffered from multiple rib fractures, involving four or more ribs. In total average hospital stay was 5.46 days. The pneumothorax was the most common encountered complication followed by hemo-pneumothorax, hemothorax and lung contusion. Men seem to be at a higher risk to develop a rib fracture than women. Fracture incidence increased with age in both sexes. The main goal when treating thoracic traumatic pathology is attaining less impairment of pulmonary functions and fast social reintegration. Management of rib fractures must be tailored to each individual case.


2016 ◽  
Vol 12 (33) ◽  
pp. 177
Author(s):  
Ossibi Ibara Bienvenu Rolland ◽  
, Obengui ◽  
Damba Banzouzi Bébene ◽  
Ossou-Nguiet Paul Macaire ◽  
Paka Herdan ◽  
...  

Goal . Neuromeningeal determine the prevalence of disease in PLHIV and identify factors associated with death. Methodology. Retrospective study on descriptive and analytical referred cases hospitalized in the Infectious Diseases department during the period 1 January 2013 to 31 May 2015. Results. One hundred and fifty patients included (10.5% of admissions) with mean age of 41.1 ± 11.8 years (range 19 to 69) women (n = 86, 57.3%), sex ratio of 1,3. were without jobs (n = 68; 45.3%), single (n = 96; 64%), heterosexually infected by HIV-1 (100%). The average time of consultation was 19.2 ± 1.3 days. Fever (n = 99; 66.0%), disorders of consciousness (n = 66; 44.0%) were the main reasons for consultations. Meningeal stiffness (40%), focal signs (n =62; 41,4%) were the main signs consideration. CSF was clear (n = 94; 62.7%), hyperproteinorachique (59.8%), hypoglycorrachique (43.8%). Examining the ink was positive in 39 cases (34.8%) The Gerh was positive in 35 patients .the CT abnormalities were dominated abscess (n = 12; 15.4%).. Thirty four patients were on TDF + FTC + EFV regimen. The average hospital stay was 14.4 ± 9.5 days. Overall mortality was 83.2% mainly due to cerebral herniation (n = 28; 33.3%). Conclusion. The prevalence and lethality of diseases neuromeningeal of HIV are high. The diagnosis delay and TNM influence the prognosis of patients; Hence the importance of early detection of HIV infection for its management to prevent immunosuppression.


2016 ◽  
Vol 12 (27) ◽  
pp. 117
Author(s):  
Vignon Kc ◽  
Mehinto Dk ◽  
Vignon Kr ◽  
Mbele Rii ◽  
Natta N’tcha Nh ◽  
...  

Introduction: Duodenal or gastric ulcer perforations constitute a medical and surgical emergency. Purpose: Expose its epidemiological, diagnostic and therapeutic aspects. Method: About a retrospective study from January 1st 2006 to March 31st, 2012 in visceral surgery at CNHU of Cotonou, records of 86 cases of duodenal or gastric ulcer perforation were analyzed. Results: On average 13.8 cases / year, perforation of peptic ulcer was the most etiological cause of acute generalized peritonitis (25.7%). The average age was 34.2 years, the sex ratio of 16.2. Average admission stay was 6 days and it was observed: undocumented epigastralgia (42cas; 48.8%), no pathological medical history (32 cases; 37.2%). Peritoneal syndrome was in 81 cases (94.2%). Abdomen radiography without preparation (71 patients / 86; 82.6%) showed a pneumoperitoneum (52 cases / 71; 77.6%). The treatment was nonoperative (2 cases / 86; 2.3%) with a favorable outcome. Surgical patients had duodenal perforation (49 cases / 84; 57%), gastric perforation (35 cases / 84; 43%). Suturing with or without other technical devices was achieved in all cases. Postoperative complications were present in 28.5% of cases and parietal abscesses were documented as a priority (14 cases / 84; 16.7%). Mortality rate was 4.7% (4/86) and the average hospital stay was 11.6 days. Conclusion: The perforations of peptic ulcer were common in young men. Clinical examination was especially helpful in the diagnosis by abdomen radiography without preparation. The treatment was medical and surgical and the outcome was mostly favorable.


2016 ◽  
Vol 2 (3) ◽  
Author(s):  
Marco Antônio Guimarães Da Silva

Por circunstâncias relacionadas à minha titulação, acabei designado pela Universidade Castelo Branco do Rio de Janeiro (UCB) para avaliar uma parceria proposta pela Escola de Osteopatia de Madri (EOM). À época, em 1997, a EOM propunha que a UCB passasse a organizar academicamente os cursos de osteopatia que a referida Escola já vinha ministrando no Brasil, com vistas a, no futuro, torná-lo um curso de pós-graduação. Algumas viagens à Madri para observar a estrutura acadêmica e pedagógica da sede da EOM, condição imposta pela UCB para concretizar a parceria, me levaram a conhecer esta modalidade terapêutica, com resultados efetivamente comprovados através de trabalhos científicos.Realizadas as adaptações que se faziam necessárias, a UCB aprovou, em 2000, o curso de osteopatia, com uma carga horária de 1050 horas para a titulação de especialização acadêmica, nível Lato Sensu. A resolução do COFITO, que estabelece a osteopatia como uma especialidade da fisioterapia, levou-nos a propor ao CEPE da UCB uma complementação de 450 horas, alcançando, assim, as 1.500 horas, distribuídas ao longo de cinco anos, exigidas pela referida resolução do COFITO. A introdução desta técnica terapêutica no Brasil pela corrente Européia e a pronta intervenção do COFITO foram fatores decisivos para nos brindar com mais uma especialidade. Houvera sido a Osteopatia implantada no Brasil por influência da escola americana, talvez os rumos tomados fossem outros. Senão, vejamos. Nos EUA, a osteopatia é normalmente exercida pelo médico, que deve obter sua permissão através do National Board of Osteopatic Medical Examiners, e está dividida em Sociedades Osteopáticas que se distribuem por todas as modalidades médicas; a saber: Allergy and Immunology, Anesthesiology, Dermatology ,Emergency Medicine, Internal Medicine, Neurologists and Psychiatrists, Obstetrics and Gynecology, Occupational and Preventive Medicine, Ophthalmology and Otolaryngology, Orthopedics Pathology, Pediatrics Proctology, Radiology, Physical Medicine and Rehabilitation, Rheumatology Sports Surgery Medicine.Com o objetivo de incentivar as linhas de pesquisas na área da osteopatia, estará sendo criado, durante as III Jornadas Hispano-Lusas de Fisioterapia em Terapia Manual (Sevilha-Espanha, 5 de outubro de 2001), o Centro Internacional de Pesquisas em Osteopatia. O referido Centro, dirigido por um fisioterapeuta brasileiro com Doutorado, terá sua sede na Espanha e manterá núcleos, vinculados a Universidades, na Argentina, no Brasil, na Itália, em Portugal e na Venezuela. Esperamos, desta forma, ao lado do reconhecimento profissional já oferecido pela resolução COFITO, dar mais um passo na consolidação acadêmica da nossa mais nova modalidade terapêutica.


1982 ◽  
Vol 91 (5) ◽  
pp. 469-473 ◽  
Author(s):  
Richard R. Gacek

The results of a poll revealed that 96 singular neurectomies have been performed by ten surgeons in this country. Eighty-eight of these (91.7%) resulted in complete relief of benign paroxysmal positional vertigo (BPPV). In seven patients (7.3%) there was a sensorineural hearing loss as a result of this procedure. The average hospital stay for patients having this procedure ranged from 2–6 days, and the return to work time ranged from 1 to 3 weeks. These results indicate that singular neurectomy is an effective selective vestibular ablation procedure for BPPV and that the risks and disability are comparable to other routine middle ear procedures. The causes for failure of this procedure to relieve positional vertigo are a) misdiagnosis of BPPV and b) failure to recognize the singular nerve in the middle ear. Knowledge of the pathophysiology of the disorder and of the anatomical variation in the location of the singular canal will reduce these causes of failure.


2007 ◽  
Vol 2 (2) ◽  
pp. 88-94 ◽  
Author(s):  
D. Arioli ◽  
M. Pipino ◽  
E. Boldrini ◽  
E. Amateis ◽  
A. Cristani ◽  
...  

2016 ◽  
Vol 89 (1) ◽  
pp. 110-116
Author(s):  
Mihai Mleșnițe ◽  
Ioan Stelian Bocșan

Background and aim: Multi-hospital health systems have become the most popular administrative structure in healthcare, leading to both opportunities and challenges for hospital administrators. In government-funded healthcare systems, there is a balance between costs and the provision of health services.The aim of the present study is to assess the efficiency in terms of costs of a multi-pavilion hospital from Cluj County, Romania.Methods: The institution analyzed in this article is the Adults’ Clinical Hospital in Cluj-Napoca. A descriptive retrospective study collected data from January 2004 to December 2010. A set of indicators were compiled, divided into three main categories: personnel, statistics, and financial.Results: Twenty-one financial indicators were investigated. Heterogeneity between different years was observed for the continuous hospitalization indicator and the wage budget indicator. The highest variability was observed between the budget and expenses indicators, while a smaller variability was observed at the average costs per patient. The costs per patient have increased at all pavilions in the studied time frame, the higher costs being at the Internal Medicine and Surgery pavilions: 10,203 RON in 2010 (1 euro ~ 4.4 RON)Conclusion: The pavilions included in the Adults’ Clinical Hospital Cluj-Napoca have different expenses patterns, as each pavilion is focused on different specialties. Each pavilion serves different target groups, requiring different procedures. This in turn results in different expense patterns across each pavilion.


Author(s):  
NOVIANA JOENPUTRI ◽  
KETUT SURYANA

Objective: Infections contributed to higher morbidity and mortality in people living with HIV/AIDS (PLWHA) in both developed and developing countries. This study aimed to describe the spectrum of opportunistic infections (OIs) and associated factors among PLWHA on highly active antiretroviral therapy (HAART) at Merpati Clinic, Wangaya Regional General Hospital in Denpasar, Bali. Methods: This was a retrospective study. All of PLWHA, who still receiving HAART at Merpati Clinic from January 2018 to January 2020, who met inclusion and exclusion criteria, were included as subjects in this study. All data were collected through a review of the complete medical record of patients. Results: The prevalence of OIs in this study was 43.4%. Most PLWHA who experienced OIs were male (68.8%), age ≤40 y old with a median of age 36 y old, educational status senior high school (57.7%), married (62.1%), employed (89.7%), CD4 cell count ≥ 200 cells/µl (67.6%) and transmission route of HIV non-Intravenous (IV) drug user (99.2%). Sex, age, marital status, and CD4 cell count were significantly associated with OIs, p=0.000, p=0.005, p=0.005, and p=0.000, respectively. Conclusion: The commonest OI in this study was pulmonary tuberculosis. The presence of OIs was associated with sex, age of HIV diagnosis, marital status, and CD4 cell count. With the knowledge of OIs spectrum, clinicians are expected to be able to prevent, diagnose and treat OIs promptly to decrease the morbidity and mortality caused by OIs efficiently.


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