African Journal of Medicine and Surgery

African Journal of Medicine and Surgery Vol. 1 (2), pp. 009-012, September, 2013. © International Scholars Journals

Full Length Research paper

Surgical stress differences between total hip arthroplasty and total knee arthroplasty

Motoki Sonohata*, Kenji Tsunoda, Hajime Kugisaki, Shinsuke Someya, Hidefumi Honke, Mitsunori Komine, Masaru Kitajima, Masaaki Mawatari and Takao Hotokebuchi

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan.

*Corresponding author. E-mail: [email protected]. Tel.: +81-952-34-2343. Fax: +81-952-34-2059

Accepted 2 September, 2013

Abstract

This study aims to clarify the difference between surgical stress of total hip arthroplasty (THA) and total knee arthroplasty (TKA) under the same conditions through blood transfusion and ischemic extremity. Body temperature, white blood cell (WBC) count, the level of C- reactive protein (CRP), and interleukin-6 (IL-6) were measured for eleven patients undergoing THA and eight patients undergoing TKA. All the patients who underwent THA and TKA received a transfusion of 2 units of autologous blood but no transfusion with homologous blood, and the TKA surgery was performed without an air tourniquet. The first day after the surgery, there was no significant difference between the THA and TKA with respect to body temperature and CRP. However, there was a significant difference between the THA and TKA in WBC count (p < 0.05) and IL- 6 (p < 0.01) on the first day after the surgery. In addition, there was a significant difference between the THA and TKA in IL-6 (p < 0.05) and CRP level (p < 0.05) on the seventh day after the surgery. The surgical stress of TKA was significantly larger than the surgical stress of THA. There may be more potential complications in the patients who underwent TKA than those who underwent THA.

Key words: Cytokine, surgical stress, total hip arthroplasty, total knee arthroplasty.

African Journal of Medicine and Surgery Vol. 1 (3), pp. 015-019, October, 2013. © International Scholars Journals

Full Length Research Paper

Evaluation of patient safety culture: Single-center, non-randomized, cross-sectional study, Department of General Surgery, Faculty of Medicine, Trakya University, Turkey experience

Tamer Sagiroglu¹*, Serhat Oğuz¹, Mehmet Ali Yağcı¹, Hilmi Tozkır² and Tülin Yalta³

¹General Surgery Department, Medical Faculty, Trakya University, Edirne/Turkey.

²Medical Biology Department, Medical Faculty, Trakya University, İstanbul/Turkey.

³Pathology Department, Medical Faculty, Trakya University, Edirne/Turkey.

*Corresponding author. E-mail: [email protected]. Tel: 00905322848934. Fax: 00902842352730.

Accepted 27 February, 2013

Abstract

This study aims to measure and analyze the patient safety culture in General Surgery Department, Faculty of Medicine, Trakya University, Edirne-Turkey. A cross-sectional study, utilizing the Turkish version of the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality and a demographic questionnaire was distributed to 125 health professionals including nurses, technicians, managers and medical staff. 125 healthcare staff, including physicians, nurses, and health officers participated in this research. The main outcome measure(s) comprise the patient safety culture score including subscores on 12 dimensions and 42 items; patient safety grade and number of events reported. Results of this study reveals overall patient safety grade was rated as excellent or very good by 40% of respondents, acceptable by 46% and failing or poor by 14%. The percentage of positive responses was highest for ‘staffing’ (52%), ‘management support for patient safety (41%), ‘non-punitive response to error” (40%), lowest for ‘teamwork within units (11%), feedback and communication about error (12%), organizational learning and continuous improvement (15%). Thus, improving patient safety culture, setting national and organizational based patient safety system without fear of punitive action should be a priority among hospital and national administrators.

Medical Subject Headings (MeSH) Terms: Healthcare surveys, safety management/methods, medical errors/prevention and control, attitude of health personnel, organizational culture.

African Journal of Medicine and Surgery Vol. 1 (1), pp. 001-005, August, 2013. © International Scholars Journals

Full Length Research Paper

Incarcerated external anterior abdominal wall hernias: a 5 year experience in Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State of Nigeria

Dr.  B. G. Fente BMBCH, FWACS, FMCS, FICS¹, and Dr. H. S. Ukoima, MBBS, FMCS².

^1,2Department of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria. 

*Corresponding author. Email: [email protected]. Tel. +2348033132866

Accepted 1 June, 2013

Abstract

The aim of this study is to document our first experiences in the surgical management and outcome of incarcerated external anterior wall hernias (EAAWH) in our local environment, outlining the clinical profile, treatment outcome and identify predictors of outcome among these patients. The study design used was a retrospective analysis of data. The study was conducted at the Department of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria from January 2008 to December 2012. Records of 29 patients who underwent emergency surgery for incarcerated external anterior abdominal wall hernia in a teaching hospital were analyzed for age, sex, type of hernia, characteristics of clinical presentation, duration of symptoms, past medical history, and significant concomitant diseases, ASA class, type of anesthesia, contents of the hernia sac, surgical procedures, complications, duration of hospital stay and mortality. Twenty-four (82.76%) patients were males and 5 (17.24%) were females. The age of patients ranged from 1 month to 75 years. There were 28 (96.5%) Inguinal hernias, 1 (3.5%) Para-umbilical hernias and none of Incisional and femoral hernias. Gut resection was done in 4 (13.8%) patients. The mortality rate was 3.5%. The mortality was related to septicemia from gangrenous bowel in a one month old child and late presentation. Mortality associated with emergency surgery of incarcerated external anterior abdominal hernias is related to late presentation with subsequent bowel gangrene, very young age, and associated medical illnesses.

Key words: Incarcerated hernia, treatment outcome, predictors, mortality, abdominal wall hernia.