Introduction: Day care surgery offers cost containment, effective usage of hospital beds, reduced incidence of nosocomial infection and early recovery in home environment. In developing countries like India, there are various factors that influence the success of day care surgery.
Aim: To assess the factors hindering the practice of day care surgery in a tertiary care centre in South India.
Materials And Methods: This observational study was conducted in the Department of General Surgery, JIPMER, Puducherry, India, from January 2013 to March 2014. All male patients with uncomplicated inguinal hernia who were admitted for elective surgery under one particular surgery unit and who were found fit for discharge on Postoperative Day 1 (POD1) based on clinical fitness were included in the study. A questionnaire containing the patient's acceptance decision, VAS (Visual Analogue Scale) pain score and the reason for non acceptance if any was used for assessment.
Results: Among the 89 patients who were fit for discharge on POD1, the decision for discharge was accepted by 57 patients. 32 patients were not satisfied of the decision for discharge on POD1. The common reasons for dissatisfaction with the decision were persistent pain at operated site (13 patients with mean VAS score 8.3), non availability of health care resources in their locality (12 patients) and unwillingness to travel on POD1 (four patients).
Conclusion: A comprehensive and well presented preoperative counselling along with an effective primary health service would help in promoting day care surgery in developing countries.
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http://dx.doi.org/10.7860/JCDR/2017/25445.10076 | DOI Listing |
JBJS Rev
January 2025
Department of Orthopaedic Surgery, University of California Davis, Sacramento, California.
» Patients with diabetes mellitus (DM) undergoing shoulder arthroplasty (SA) have a unique risk profile, which must be considered by clinicians.» The presence of DM as a comorbidity is associated with longer length of stay following SA, greater likelihood of nonhome discharge, and a higher rate of 90-day readmission.» Though the incidence is low, patients with DM are at an increased risk of serious postoperative cardiovascular complications, such as pulmonary embolism, venous thromboembolism, and myocardial infarction.
View Article and Find Full Text PDFHosp Pediatr
January 2025
Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York.
Background/objectives: Limited data exist on the role neighborhood-level social determinants of health (SDOH) play in health care utilization in pediatric patients with common, nonelective surgical conditions. We aimed to test the hypothesis that lower neighborhood-level SDOH are associated with increased health care utilization in pediatric acute uncomplicated appendicitis (AUA) before and during the COVID-19 pandemic.
Methods: This retrospective cohort study included patients aged younger than 19 years, hospitalized through emergency departments, and diagnosed with AUA.
J Trauma Acute Care Surg
November 2024
From the Department of Surgery and Sepsis and Critical Illness Research Center (J.A.M., L.S.K., E.E.P., C.G.A., K.B.K., L.E.B., P.A.E., A.M.M.), University of Florida College of Medicine, Gainesville; and The Gut Biome Lab, Department of Health, Nutrition, and Food Sciences (G.P., R.N.), Florida State University College of Education, Health, and Human Sciences, Tallahassee, Florida.
Background: Traumatic injury leads to gut dysbiosis with changes in microbiome diversity and conversion toward a "pathobiome" signature characterized by a selective overabundance of pathogenic bacteria. The use of non-selective beta antagonism in trauma patients has been established as a useful adjunct to reduce systemic inflammation. We sought to investigate whether beta-adrenergic blockade following trauma would prevent the conversion of microbiome to a "pathobiome" phenotype.
View Article and Find Full Text PDFEur J Prev Cardiol
January 2025
Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland.
Aim: Air pollution remains the single largest environmental health risk factor, while atrial fibrillation (AF) is the most prevalent arrhythmia globally. The study aimed to investigate the relationship between short-term exposure to air pollution and acute AF admissions.
Methods: Individual data on AF hospitalization in the years 2011-2020 were collected from the National Health Fund in Poland (ICD-10: I48.
JAMA Surg
January 2025
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Importance: Surgeon stress can influence technical and nontechnical skills, but the consequences for patient outcomes remain unknown.
Objective: To investigate whether surgeon physiological stress, as assessed by sympathovagal balance, is associated with postoperative complications.
Design, Setting, And Participants: This multicenter prospective cohort study included 14 surgical departments involving 7 specialties within 4 university hospitals in Lyon, France.
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