ABSTRACT
INTRODUCTION: Maternal mortality and morbidity from eclampsia continues to be seen around the globe. Local Key Performance Index on recurrence of eclamptic fits did not meet targets, thus this raised the issue whether the care provided adhered to the standard management for eclampsia. METHODS: This clinical audit was conducted to assess and improve the quality of the service being offered to patient, particularly in managing eclampsia cases. It was conducted according to the audit cycle. It begins with the development of 12 standardized criteria for eclampsia management. First audit was conducted by retrospectively reviewing eclampsia cases from year 2008 till 2012. Strategies for changes were formulated and implemented following the results of the first audit. Second audit was conducted six months after the changes. RESULTS: The overall incidence rate of eclampsia was 9.17 per 10,000 deliveries. A first seizure occurred during the antepartum period in 52.9% of cases (n=27), intrapartum in 24% (n=11) and postpartum in 21% of cases (n=13). Suboptimal care was mainly on delay of activation of Red Alert system and no treatment for uncontrolled blood pressure. Several strategies were implemented, mainly on improving working knowledge of the staffs and reengineering hospital Red Alert system. Positive achievements observed during the second audit, shown by a reduction in the number of patients with recurrence eclamptic fits and perinatal mortality rate. CONCLUSION: Conducting an audit is essential to evaluate local performance against the standardized criteria. Improvement can be achieved with inexpensive solutions and attainable within a short period of time.
ABSTRACT
The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.
ABSTRACT
The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cell Division/drug effects , Cell Survival/drug effects , Fibroblasts/drug effects , Sea Cucumbers , Tissue Extracts/pharmacology , Animals , Cell Line , Dose-Response Relationship, Drug , Escherichia coli/drug effects , Humans , In Vitro Techniques , Microbial Sensitivity Tests , Prospective Studies , Pseudomonas aeruginosa/drug effects , Staphylococcus aureus/drug effectsABSTRACT
The main objective of the study was to determine the biodegradability, resorption and osteoconductivity potency of coral implant. Coral blocks (CORAGRAF) were prepared from sea coral Porites species. The blocks were implanted in the right mandible of rabbit model. Implants were harvested at 2 and 4 weeks intervals and subjected for light and scanning electron microscopy. Dense hydroxyapatite (DHA) was implanted in the left mandible as a control. The results of this study demonstrated that CORAGRAF is a good implant material that can accelerates bone healing and be resorbed in an acceptable time. The mechanisms of the resorption seemed to be the same (crumbling process), a first step where the edge of the coral become powdery then a second step which could be phagocytosis and dissolution in extracellular fluid.
