ABSTRACT
Aim: In 2019, the British Society of Gastroenterology (BSG) published the first United Kingdom national guidelines for acute lower gastrointestinal bleeding (LGIB),(1) following inadequacies in LGIB emergency service provision.(1,2) Method: We performed a retrospective cohort study (January 2019 to September 2020), using paper and electronic notes through coded data, for all LGIB emergency surgical admissions for LGIB. Paper and electronic notes were used, in retrieving data. Primary outcome end-points: evaluate our standards as per BSG guidelines. Result(s): 48 patients were identified as matching the inclusion criteria, with a median age of 64.75 and diverticular diseases accounting for the majority of cases. None of the patients were categorised in the group of being stable/unstable or had their Oakland scores calculated. 62.5% of patients were offered outpatient investigations versus 6.25% for inpatient investigations. 0% of unstable patients were offered a CT angiogram (as no patients were stratified as unstable). 75% of patients achieved haemoglobin target levels post-transfusion. 100% of patients taking warfarin and dual antiplatelets followed guidelines versus 50% on clopidogrel, 80% on dual antiplatelet therapy and 63.6% on aspirin alone. Conclusion(s): This study found that our department did not adhere to the BSG guidelines. This can be improved through the routine calculation of the Oakland score and shock index, which will stratify clinical risk. Additionally creating an agreed trust management pathway and assigning a gastrointestinal bleed lead will allow for earlier detection and encourage better clinical practice. Whilst there were limitations due to restricted data collection, as a result of the coronavirus, further research will identify how these implementations can be amended and if the changes are effective in local practice.
ABSTRACT
Coronavirus (COVID-19) has become a pandemic worldwide. The number of deaths is increasing without a vaccine to stop its spread and has threatened Malaysia’s national security. With the increased number of human fatalities due to COVID-19, cremation may be the final solution to prevent the spread from dead bodies as the virus remains on the body after death. However, religion has different perspectives in dealing with the cremation of the dead body. Malaysia is a Muslim majority country but its citizens also consisted of Christians, Hindus, Buddhists, and others. This study will look at the acceptance of Malaysians on the issue of cremating dead bodies during disasters. A qualitative approach was used with respondents answering questionnaires. Analysis of legislation related to disaster management of human corpses was also conducted. Results show that the majority of the respondents disagreed with the cremation of the dead body because of their religion and they believe that there must be a better alternative to deal with the dead body infected by COVID-19. © Penerbit UMT