ABSTRACT
OBJECTIVE: Objective of this study is to determine the outcome of Burr-hole craniostomy for chronic subdural hematoma [CSDH]
STUDY DESIGN: A descriptive study
SETTING: Department of Neurosurgery, Liaquat University Hospital, Jamshoro study period 15th September 2010 to 16th March 2012
METHODS: All patients of either gender presented with clinical and radiological evidence of CSDH and undergoing burr-hole craniostomy. The outcome evaluated by postoperative improvement of patients using Glasgow Coma Scale and Markwalder scale
RESULTS: Among 33 subjects, the mean age of the patients was 65.94 years with age ranges between 30 - 88 years with majority males [63.6%]. 57.6% had history of trauma and 66.7% presented with complain of headache. A significant improvement in the Post-Operative Markwalder grade and Glasgow coma scale [p<0.01] noticed as compare to pre-operative Markwalder grade and Glasgow coma scale
CONCLUSION: Burr hole Craniostomy with closed drainage system under local anesthesia is a good choice of treatment. In CSDH, Burr hole Craniostomy is safe and results are comparable to those of the major series of the literature as the surgical procedure is standardized
ABSTRACT
The purpose of this study was to assess the patient's awareness of informed consent and to evaluate the current practice of obtaining informed consent from patients proposed for elective surgery in tertiary care hospital. Cross sectional survey. This study was conducted in Isra University Hospital, Hyderabad, Sindh from 2[nd] April 2012 to 3[rd] March 2013. This study was designed as an observational investigation and no interference was made regarding the informed consent process to the patient. The selection criteria for the patients who were interviewed were convenience sampling. All adult patients of >18 years, who were undergoing various surgical procedures were interviewed after taking verbal informed consent on the second postoperative day, when they were comfortable to answer the questions. While all those patients who were uncomfortable due to pain or other reason and were unwilling to answer the questions were excluded from the study. All the patients were asked predesigned questions related to the information they were provided before the surgery as part of standard informed consent practice. Questions were asked in local language which includes the demographic data, operative details, risk, benefit, complications of surgery, type of anesthesia and alternative treatment options etc. The data was entered on SPSS version 16. Frequency and percentages were calculated to show the results. Mean age of the patients was 34.95 +/- SD 14.236 years. 220 patients were included in the study. 183[83.18%] patients were told about the indications of surgery while 136 [61.81%] patients were not told about any complication of Surgery. Type of anesthesia was discussed in only 25[11.36%] of patients while complications of anesthesia were discussed in only 18[8.18%] of patients. 165[75%] patients were not given time to ask the questions regarding their disease or surgery. Consent by the consultants was taken in only 63[28.63%] patients. The majority of the patients knew the indication of surgery but very few were informed about the possible complications and risk of the surgery and anesthesia