Outpatient pre-operative assessment in joint replacement surgery.

An anaesthetist-led outpatient pre-operative assessment (OPA) clinic was introduced in our unit in an effort to improve patient care and cost-effectiveness. To assess the efficiency of the clinic, 112 patients who attended the OPA clinic (attendance rate 98%) during the first year were assessed prospectively and compared with 118 patients who did not undergo OPA the year before. There were fewer cancellations among those who attended the OPA clinic (13.6% compared to 3.6%), and the hospital stay was shortened from an average of 10.7 days to 7.0 days. This has resulted in more efficient utilization of operating theatre, reduced hospital costs and improved patient satisfaction. More extensive use of the pre-admission clinic is recommended and should be explored in other clinical settings.

Recurrent Chromobacterium violaceum infection in a patient with chronic granulomatous disease.

We report a rare case of recurrent infection of Chromobacterium violaceum in an immunocompromised patient. Despite the high mortality rate associated with this infection as reported in the literature, this patient survived three episodes of recurrent infection. We believe that with high clinical suspicion, prompt treatment and appropriate antimicrobial agents, it is possible for clinicians to treat this infection effectively and reduce the mortality rate.

Objective triceps muscle strength measurement using computerized adaptation.

In our centre the non-availability computerized exercise machines limits the objective monitoring of strength rehabilitation. We undertook this research programme to objectively measure triceps muscle strength by interfacing NORSK-Gym machine with accelerometer and positional transducers to a computer. This data was tabulated and processed using Microsoft Excel. The positional transducer was first calibrated and it showed an excellent Pearson Correlation Coefficients against a standard metric reading (r = 0.9999). Peak Force was used as a test parameter for isotonic triceps muscle strength measurements. The criterion-referenced validity was established as the peak forces measured using the accelerometer and positional transducer demonstrated identical Peak Forces (r = 0.94). Analysis of our mean Peak Force measurements using non-biological force as well as the intra-individual reproducibility demonstrated excellent Pearson Correlation Coefficients (r) = 0.982-0.998 and 0.929-0.972 respectively. This computerized adaptation of the NORSK-Gym machine produced an objective, valid and reproducible triceps muscle strength measurement.