Predictors And Reasons of Inappropriate Hospitalizations For Surgical Patients in A Tertiary Hospital in Wuhan, China: A Retrospective Study

Background The first step in every quality improvement process is the identification the problem and its extent. We aim to analyze the frequency and its associated factors of inappropriate hospitalization for a tertiary hospital in Wuhan and ascertain the specific reasons for each IHDs to provide evidence for further reduction of inappropriate hospital days.Results A total of 4586 days of hospital stay from 408 cases were evaluated by A cross-sectional and retrospective audit program carried out in a third-level teaching hospital with 5613 beds and 9623 faculty in Wuhan, China. 320 cases (78.43%) were reported to have experience at least one IHD and 1053 hospital days (23.31%) were found to be inappropriate. Predictors of higher levels of inappropriateness with surgery were patients at the age of 60-69(OR=2.328, 95% CI=1.359-3.989) before the surgery, and use of ventilators(OR=2.127, 95%CI=1.116-2.839), admission from outpatient(OR=5.724, 95%CI=1.579-20.744), multiple diagnosis(OR=1.604, 95%CI=1.059-2.432), and higher surgical incision level(OR=2.152, 95%CI=1.391-3.327) after surgery. The main causes of inappropriateness were medical factors that were related to the healthcare services providers, however, the patient factors gave rise to nearly a quarter of IHDs after surgery.Conclusions The prevalence of IHDs was 23.31% in this tertiary hospital in Wuhan. Findings from this study indicate that the characteristics of surgical patients from different phases(preoperative/postoperative) are supposed to be taken into account to develop efficient and feasible interventions for IHD reduction.

Persistent genital arousal disorder: always look beyond the surface - a case report

Persistent genital arousal disorder is a rare condition characterized by unwanted intrusive symptoms of sexual arousal without specific context. Their possible aetiologies and treatments are multiple and mostly based on case reports. We aim to do a comprehensive review of persistent genital arousal disorder and describe a case of a postmenopausal woman who developed this disease and, during the follow-up, was diagnosed with advanced endometrial cancer, reminding physicians to keep in mind the possibility of multiple diagnosis in the same patient, including malignancy. Although there is no description of this association in the literature, the possible aetiologies of persistent genital arousal disorder are diverse, and we sought this rare case should be disclosed.

Kikuchi-Fujimoto Disease in a Filipino Boy: A Case Report

Objective: To report a case of a 12-year-old boy with Necrotizing Lymphadenitis (Kikuchi-Fujimoto disease) presenting as lymphadenitis secondary to multiple diagnosis. Methods: Design : Case Report Setting: Tertiary Private Hospital Patient: One Results: A 12-year-old boy consulted for two-month history of cervical lymphadenopathy with the underlying cause remaining unclear despite multiple consults, diagnosis and medical treatment. Lymphoma was considered and excision biopsy with further investigations confirmed a diagnosis of Kikuchi-Fujimoto disease. Supportive management was given with no recurrence of symptoms noted on 18 months of follow up. Conclusion: Kikuchi-Fujimoto disease in this case was a diagnosis of exclusion. Even with a proper history and physical examination, experts in otolaryngology can be misled to manage this case as malignant. Awareness of the disease and appropriate examinations including immunohistochemistry are important for a timely diagnosis and proper intervention. Keywords: lympadenitis; Kikuchi-Fujimoto disease; lymphoma; cervical lymph nodes

Pranic Healing as a Complimentary Therapy in averting Multiple Organ Failure: A Case Report

The case report has been presented to demonstrate the response to Pranic Healing intervention by a patient with Acute Respiratory Distress Syndrome (ARDS), heading towards multiple organ failure, triggered by secondary haemophagocyticlymphohistiocytosis (HLH)The29 yr old patient had been on ventilator support, immunocompromised and in a critical state with multiple diagnosis and multiple hospitalizations for nearly eight months. He had stopped responding to conventional medicine and acupuncture. Complimentary Therapy in the form of Pranic Healing, a no touch, no drug energy therapy was provided to the patient for three months. Pranic Healing along with standardised medical care helped the patient recover rapidly and he was discharged within six weeks of starting Pranic Healing therapy. The case study provides a promising example of Pranic Healing intervention in averting multiple organ failure and promoting regeneration of vital organs.