10 research outputs found

    Study of Demographic and Clinical Profile of Injuries Related to “Kite Flying” Celebration in Urban India

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    Introduction: Kites were first introduced by the Chinese more than three thousand years ago, but in places like India, Pakistan and Afghanistan, Kite flying is celebrated in unique way. People enjoy cutting down others kites and there is an instinct to catch the threads of the “Cut-Kite” and rejoice the gain. In this study conducted at a tertiary care emergency medicine department to understand demographic profile and injuries related in such a festive celebration, occurring in one urban area, to spread awareness and reduce such incidence. Methodology: This cross-sectional descriptive study was conducted using preformatted form in consecutive two year. Results: Among 83 cases we studied, 81% were male. 65% were in the age group of 11-40. 70% incidences took place in noon and evening hours. 68.67 % presented in 108 ambulance services, 43% presented with fall from height (terraces), 34 % had road traffic accidents because of strings and festival related excitement. Maximum had fall from 1 storey buildings. 56% received Out Patient based treatment. Among the admitted patients 15% had head injury, 2 cut throat, 9.7% had fractures and 1 had to undergo laparotomy, 2 died eventually during the hospital stay because of grievous injuries. Conclusion: This study re-emphasizes the importance of spreading awareness and increasing the care, particularly of children during such an enjoyable festival

    Self-assembly modulation in star block copolymers by amphiphilic diol: A scattering insight

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    The present study offers a better insight into the alteration in the aggregation characteristics of ethylene oxide-propylene oxide (EO-PO)-based star block copolymers Tetronics® T1304 and T1307 induced by an amphiphilic diol Surfynol® 104 (hereafter C14_{14} diol) using scattering (dynamic light scattering and small angle neutron scattering) with complementary physical property measurement viz. solution viscosity and cloud point (CP). It is the hydrophobic interaction that drives C14_{14} diol molecules to penetrate inside copolymer micelles resulting in dehydration that lowered the CP and markedly increase in solution viscosity. Quite interestingly, initial lowering in CP is followed by sudden increase at higher level of solubilization. A significant increase in the apparent hydrodynamic diameter (Dh_h) divulges the growth of micelles which is equally supported by SANS measurements. The micellar parameters obtained from SANS analysis for T1304 and T1307 in the presence of C14_{14} diol are described. The preferential partitioning of C14_{14} diol into the copolymer micelles is the driving force for morphological changes from spherical to unilamellar vesicles. Also, the effect of temperature and NaCl was examined with the aim to observe various micellar transitions. The observed changes are clarified in terms of the hydrophobic interaction of C14_{14} diol with Tetronic® micelles and HLB value of copolymers. The perception of C14_{14} diol stabilised Tetronic® micelles is anticipated and correlated with optimal parameters obtained from computational simulation approach, providing a clear understanding of the correlation between the molecular orbital energy levels of Tetronic® and C14_{14} diol. The present manuscript thus sheds light on C14_{14} diol induced dehydration causing the micelle growth for both Tetronics® with varied hydrophobicity. Such hydrophobic diol-induced spherical to vesicular transition is observed for the first time in Tetronic®-diol mixed system

    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

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    Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

    Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

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    This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

    The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

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    © 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine
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