Factors Associated With Prolonged Length of Stay for Elective Hepatobiliary and Neurosurgery Patients: A Retrospective Medical Record Review

Background: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice. Methods: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18　years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student\u27s t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS. Results: Factors associated with prolonged LOS for the HPB sample were age and admission after 5　pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections. Conclusion: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices

Engineering properties of old alluvium for Changi extension line project in Singapore

Old Alluvium is one of the main geological formations in Singapore. Three types of soils strata: Fill, Kallang Formation and Old Alluvium were encountered along the Changi Extension Line (CEL) project in Singapore. The Old Alluvium Formation comprises a sequence of very weak to weak quartzo-feldspathic sandstones with conglometric and mudstone horizons in which the upper parts have been weathered to form a silty clay and geavelly sand. A site investigation programme was carried to characterize the geotechnical properties of the three types of soil strata, in particular the Old Alluvium. The laboratory and in-situ test results are presented in this project. The in-situ tests include the Standard Penetration Tests (SPT), Field Vane Shear Tests (FVT), Piezocone Penetration Tests (CPTU), Pressuremeter Tests (PMT) and Cone Pressuremeter (CPM) tests. The index properties, soil classification, compressibility, consolidation parameter and shear strength parameters for each type of strata are analyzed and presented in this report. Correlations between laboratory and in-situ data were made. The suitability of the some of existing interpretation methods and correlation relationships are examined.Master of Science (Geotechnical Engineering

A proposal for an administrative set up of river basin management in the Sittaung River Basin

The purpose of this report is to present a proposal for how an administrative approach based on River Basin Management can be implemented in Myanmar. The Sittaung River Basin has been used as an example area to investigate how the basin can be administered according to the IWRM principles of cooperation between the different sectors and the administrative units, including stakeholder involvement.Ministry of Natural Resource and Environmental Conservation, Myanmar Norwegian Ministry of Foreign Affairs, Norwa

A study of the impact of Haemophilia on educati on, employment and joint health among pati ents treated at the Yangon General Hospital

A hospital-based cross-secti onal analyti cal study was carried out on 53 patients&nbsp;with haemophilia A at the Department of Clinical Haematology, Yangon General Hospital&nbsp;during the period of October 2014 to September 2016. Haemophilia Joint Health Score (HJHS) and Functi onal Independence Score in Haemophilia (FISH) were used to assess&nbsp;the pati ents&rsquo; physical well-being. All pati ents were males with a mean age of 23.18 &plusmn;&nbsp;10.2 years (r = 12-55). Twenty-four pati ents (45.3%) disconti nued their educati on and among them 66.7% disconti nued due to pain with recurrent bleeding in the joints and&nbsp;33.3% disconti nued due to other reasons. Seventeen pati ents (32.08%) in this study were&nbsp;students, while another 17 pati ents (32.08%) were workers/employed and 19 pati ents&nbsp;(35.85%) disconti nued working. Out of 19 pati ents who disconti nued working, 84.21%&nbsp;disconti nued due to severity of the disease and 15.79% disconti nued due to personal&nbsp;and religious reasons.</p

Preclinical animal models of multiple myeloma

Multiple myeloma is an incurable plasma-cell malignancy characterized by osteolytic bone disease and immunosuppression. Murine models of multiple myeloma and myeloma bone disease are critical tools for an improved understanding of the pathogenesis of the disease and the development of novel therapeutic strategies. This review will cover commonly used immunocompetent and xenograft models of myeloma, describing the advantages and disadvantages of each model system. In addition, this review provides detailed protocols for establishing systemic and local models of myeloma using both murine and human myeloma cell lines