ABSTRACT
Objective: To find out the 30-day readmission rate for different surgical procedures and determine the causes for readmissions. Study Design: An audit report. Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, in the calendar year 2014
Methodology: Records were retrospectively reviewed for 30-day readmission rate and their cause in general surgical patients who underwent a general surgical procedure at The Aga Khan University Hospital, Karachi, in the year 2014
Results: Out of 217 [6.4%] readmissions in 3,387 patients, more than 50% unplanned readmissions were avoidable. The highest readmission rate was after placement of feeding tubes [28.5%]
Conclusion: More than half of the readmissions could have been prevented by proper patient/attendant education, good communication and provision of nursing services to these patients beyond the hospital
ABSTRACT
Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital. A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence. Seventy-eight percent were males and the mean age was 45 [range 16-90] years. The mean operative time was 35 [15-78] min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 [0-5] days. Patients were followed-up for 24 [range, 2-48] months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation. Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital
Subject(s)
Humans , Male , Female , Surgical Staplers , Treatment Outcome , Postoperative Complications , Hospitals, UniversityABSTRACT
Acute septic arthritis of the hip joint in the pediatric patient is an emergency in which a satisfactory outcome hinges on an early and accurate diagnosis. The diagnosis is made primarily on clinical grounds and confirmed by finding pus on aspiration of the hip joint. Failure to obtain fluid on aspiration does not rule out the presence of pus in the joint, as in a small child it is difficult to be certain that the needle is indeed within the joint. In recognition of this difficulty, arthrograms were utilized at the Aga Khan University Hospital to obtain confirmatory evidence of the intra-articular position of the aspiration needle. From February 1989 to October 1990, ten children age range from 2 weeks to 10 years, presented to the Aga Khan University Hospital with symptoms suggestive of a septic hip. Five of these had a positive tap and underwent arthrotomy and drainage. In the other five, following a negative tap, an arthrogram was performed with the aspirating needle in situ. In three of these patients the arthrogram confirmed correct position of the needle within the joint and the diagnosis of septic hip was ruled out in these patients. In the remaining two, dye injection revealed the needle tip to be outside the joint cavity. The needle was successfully repositioned in one, pus aspirated and an arthrotomy and drainage performed. In the last patient, the needle was not repositioned and the surgeon proceeded with the arthrotomy. No pus was found in the joint. If arthrography had been pursued according to the protocol this negative arthrotomy could have been avoided. Our experience indicates that arthrography is a simple technique which improves the accuracy of hip aspiration in the diagnosis of septic hip disease in the child