A Prospective Study of Common Surgical Problems in Geriatric Patient with Special Reference to Gastrointestinal Tract Diseases in Vindhya Region

Background: Aging is a continuous process which begins with conception and ends with death. It is said that nobody grows oldmerely by living a certain number of years, while aging merely stands for growing. The health problems to be considered shouldinclude – physical, mental, emotional, and socioeconomical. Old age is not a disease but the aged people are often vulnerableto long-term diseases such as cardiovascular, cerebrovascular, respiratory, gastrointestinal, cancers, mental derangement,hearing and visual loss, and conditions affecting the locomotor system. Aim of this study is to analyze the common surgicalproblems in geriatric patient with special reference to gastrointestinal tract (GIT) diseases in Vindhya region.Materials and Methods: A total of 1585 cases were studied with common surgical geriatrics problems admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the periodfrom 1 June 2018 to 31 May 2019. The proposed study includes patients with age 60 years and above who will be admittedthrough surgical outpatient department, casualty and/or will be transferred from other departments. After admission of patients,particular will be recorded and they will be also inquired for chief complaints with duration, history, drug history, personal history,and family history. Their findings will be recorded in a pro forma.Results: Of 10,887 patients admitted in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, during the period of 1 June 2018–31 May 2019, in which common surgical problems were diagnosed in 1585 patients(14.55%), among which most of the patients were males (1137) and rest were females (448). Most of the patients belonged to 60–64years of age group. From this study, intestinal obstruction among GIT diseases was found to be the most common surgical problem.Conclusion: Majority of elderly patients admitted with GIT disorders were having intestinal obstruction (22.17%), followedby PUD (21.47%), peritonitis (17.09%), malignant lesions and hemorrhoids (9.23%), and colitis (6.92%). Of sex-wise totaladmission. The incidence of intestinal obstruction (26.11% vs. 20.40%) and colitis (14.92% vs. 3.34%) was more common infemale than male. Whereas PUD (23.41% vs. 17.16%) and perforation peritonitis (19.06% vs.12.68%), hemorrhoids were morecommon in male than female.

CT tube purchasing patternexplore / 中国医学装备

Objective:To reduce the purchase cost as far as possible, avoid the risk, ensure the continuity of hospital’s work and minimize economic losses in the legal premise. Methods:Take Philips heat capacity 8M MRC tube for example, According to the reasonable and objective actual exposure seconds every month, hospital assumes no responsibility for the ending of life cycle in the process of tube use at any time , and the supplier must offer new tube unconditionally within 3 days. Results:Explore a new mode to use the second exposure time paid for the first time to purchase the ball tube, to achieve the collaboration, and mutual, benefit both sides for the supplier and the demander. Conclusions:Pay rate according to the reasonable and objective actual exposure seconds every month, Can avoid risk and pressure for demander, Meanwhile adjust the price dynamically in due time, is beneficial to both sides long-term good faith friendly cooperation, mutual benefit and win-win.

Investigation of the optimal surrogate for forced vital capacity in the diagnosis for chronic obstructive pulmonary disease / 中国综合临床

Objective To evaluate whether the forced expiratory volume in sixth scend(FEV6) was the optimal surrogate for forced vital capacity (FVC) in the diagnosis for chronic obstructive pulmonary disease (COPD).Methods Retrospectively analyzed the spirometric data of 142 COPD patients (7 cases with mild COPD,60 cases with moderate COPD,48 cases with severe COPD,27 cases with extremely severe COPD) admitted to Hebei Chest Hospital from October 2011 to October 2012 who had FEV6 data.FEV6,FEV5,FEV4 and FEV3 were measured on volume-time curves and the diagnostic value was analyzed.Results FEV6,FEV5,FEV4 and FEV3 were highly correlated to FVC (r =0.994,0.939,0.935 and 0.923 respectively,P ＜0.001).Assuming =70％ as the diagnostic standard for obstruction,FEV1/FEV6 had a diagnostic rate of 92.96％ with a false negative rate of 7.04％.FEV1/FEV5,FEV1/FEV4 and FEV1/FEV3 had higher false negative rates (9.86％,13.38％ and 27.46％ respectively) than FEV6.The value of FEV1/FEV6-FEV1/FVC had no statistical significance between the mild-moderate and the severe-extremely severe COPD groups(t =1.376,P =0.171).Conclusion There is a strong correlation between FEV6 and FVC.FEV6 may be the best surrogate for FVC in the diagnosis of chronic obstructive pulmonary disease.Elevating diagnostic critical value can reduce the false negative rate.

Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over

The present cross-sectional, population-based study was designed to evaluate the performance of the FEV1/FEV6 ratio for the detection of airway-obstructed subjects compared to the FEV1/FVC <0.70 fixed ratio test, as well as the lower limit of normality (LLN) for 1000 subjects ³40 years of age in the metropolitan area of São Paulo, SP, Brazil. After the exclusion of 37 (3.7 percent) spirometries, a total of 963 pre-bronchodilator (BD) and 918 post-BD curves were constructed. The majority of the post-BD curves (93.1 percent) were of very good quality and achieved grade A (762 curves) or B (93 curves). The FEV1/FEV6 and FEV1/FVC ratios were highly correlated (r² = 0.92, P < 0.000). Two receiver operator characteristic curves were constructed in order to express the imbalance between the sensitivity and specificity of the FEV1/FEV6 ratio compared to two FEV1/FVC cut-off points for airway obstruction: equal to 70 (area under the curve = 0.98, P < 0.0001) and the LLN (area under the curve = 0.97, P < 0.0001), in the post-BD curves. According to an FEV1/FVC <0.70, the cut-off point for the FEV1/FEV6 ratio with the highest sum for sensitivity and specificity was 0.75. The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for the diagnosis of airway obstruction, both using a fixed cut-off point or below the LLN as reference. The FEV1/FEV6 ratio has the additional advantage of being an easier maneuver for the subjects and for the lung function technicians, providing a higher reproducibility than traditional spirometry maneuvers.

FEV_6 as a surrogate for FVC in the diagnostic screening for chronic obstructive pulmonary disease / 中国实用内科杂志

Objective The purpose of this study was to determine the efficacy of forced expiratory volume in six seconds(FEV6) as an alternative for forced vital capacity(FVC)and the fixed eat-off points for FEV1/FEV6 in the diagnostic screening for chronic obstructive pulmonary disease (COPD).Methods From August 2007 to December 2008,a total of 1210 spirometric examinations in were analyzed,FEV6 was measured on volume-time curves.The correlation between FEV1/FVC and FEV1/FEV6 was evaluated by the Kendall correlation test.Considering FEV1/FVC