Day surgery: Are we transferring the burden of care?

Context: Day procedures are preferred by many surgeons for minor and intermediate procedures in fit patients. It is however considered to transfer the burden of care to care.givers and other healthcare providers.Aim: The aim of the following study is to assess the tendency of day care patients seeking attention from health care providers and their ability to ambulate in the first week.Settings and Design: Prospective study in a tertiary health facility in South.South Nigeria.Materials and Methods: Patients in American Society of Anesthesiologists class I and II undergoing day.care procedures in a surgery unit were assessed at one week for the effects of the procedure on ambulation and their likelihood to seek medical attention. Data on the sex, type of  procedure, pain, bleeding and ambulation was analyzed. A visual analogpain score of 0. 3 (mild); 4.6 (moderate) and 7.10 (severe) was used. Bleeding was defined as complete soaking of the two.layered gauze dressing with blood.Statistical Analysis: Analysis was performed with SPSS 17 for Windows (SPSS Inc. Chicago, Illinois) and presented as percentages, mean and tables.Results: A total of 99 patients comprised of 47 males and 52 females registered in the study; with a mean age of 38 years (range 16.70); 76 patients (77%) complained of pain at the operation site while 23 (23%) had no complaints. Pain was mild in 59 (78%) and moderate 17 (22%). None had severe pain or bleeding from the operation site; 85 patients (86%) could ambulate easily, 14 (14%) partially and none completely unable to ambulate.Conclusion: Day procedures in selected patients has minimal affects on their ambulation and no increased risk of seeking medical attention in the first week and would appear not to transfer the burden of care to the community.Key words: Ambulation, burden of care, community, day surger

Stay@Work: Participatory Ergonomics to prevent low back and neck pain among workers: design of a randomised controlled trial to evaluate the (cost-)effectiveness

<p>Abstract</p> <p>Background</p> <p>Low back pain (LBP) and neck pain (NP) are a major public health problem with considerable costs for individuals, companies and society. Therefore, prevention is imperative. The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics (PE) to prevent LBP and NP among workers.</p> <p>Methods</p> <p>In a randomised controlled trial (RCT), a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline. The departments consisting of about 150 workers are pre-stratified and randomised. The control departments receive usual practice and the intervention departments receive PE. Within each intervention department a working group is formed including eight workers, a representative of the management, and an occupational health and safety coordinator. During a one day meeting, the working group follows the steps of PE in which the most important risk factors for LBP and NP, and the most adequate ergonomic measures are identified on the basis of group consensus. The implementation of ergonomic measures at the department is performed by the working group. To improve the implementation process, so-called 'ergocoaches' are trained.</p> <p>The primary outcome measure is an episode of LBP and NP. Secondary outcome measures are actual use of ergonomic measures, physical workload, psychosocial workload, intensity of pain, general health status, sick leave, and work productivity. The cost-effectiveness analysis is performed from the societal and company perspective. Outcome measures are assessed using questionnaires at baseline and after 6 and 12 months. Data on the primary outcome as well as on intensity of pain, sick leave, work productivity, and health care costs are collected every 3 months.</p> <p>Discussion</p> <p>Prevention of LBP and NP is beneficial for workers, employers, and society. If the intervention is proven (cost-)effective, the intervention can have a major impact on LBP and NP prevention and, thereby, on work disability prevention. Results are expected in 2010.</p> <p>Trial registration</p> <p>ISRCTN27472278</p

Bilateral psoas abscess: case report and review of literature

Background: Psoas abscess is rare, the presentation confounding and varied thusmaking the diagnosis and definitive management delayed with resultant severe morbidity and high mortality. The paucity of literature on this disease would appear to account for the low index of suspicion among primary carephysicians who often have first contact with these patients. Methods: We present a case of bilateral psoas abscess in an adultmale who presented with acute abdomen and the diagnosis of psoas abscess was made at laparotomy.Conclusion: We highlight the salien features of the disease, which may assist practitioners in reaching early diagnosis and improve outcome of the disease.Niger Med J. Vol. 48, No. 3, Oct. – Dec., 2007: 103 – 104.Keywords: Psoas abscess,Confoundingdiagnosis,Laparotom

Impalement Injury to the Abdomen: Report of a Case

Impalement presents a combination of injuries severe enough to cause the homeostatic mechanisms to malfunction or fail. It challenges the abilities of the managing team as well as the available medical resources. Its management is even more demanding in environments where health‑care personnel, facilities for emergency care, and communications infrastructure are absent or poorly funded and equipped. The primary objective of managing impalement injuries is to prevent further injuries and preserve or restore homeostasis. Leaving the impaling object in situ until in the operating room is a time proven approach as it allows for managing life‑threatening hemorrhage in the operating room. Adequate volume replacement, good visualization, debridement of injuries, and anti‑infective measures are complementary. We present a case of type I abdominal impalement in a young man who sustained minimal visceral or neurovascular injuries and underwent exploratory laparotomy for his injuries; he developed a traumatic incisional hernia. He defaulted on the scheduled hernia repair.Keywords: Anti‑infective measures, debridement, impalement injury, lavag

Performance of five swamp rice (Oryza Sativa L) varieties at different sodium chloride levels

No Abstract.Global Journal of Agricultural Sciences Vol. 5 (2) 2006: pp. 117-12

Pathogenicity of Meloidogyne incognito race 1 on Nigerian pepper ( Capsicum spp) lines

No abstractKeywords: pepper lines; Capsicum; Meloidogyne incognito; resistance; toleranceGlobal Journal of Agricultural Sciences Vol. 4(1) 2005: 23-2