Australasian Medical Journal
Not a member yet
1482 research outputs found
Sort by
Patient-specific three-dimensional printing in cardiovascular disease
Get PDFThree-dimensional (3D) printing has become a widely used technique showing great promise in medical applications. In recent years, patient-specific 3D printed models are shown to play an important role in the domain of cardiovascular disease, ranging from medical education to presurgical planning and simulation of complex cardiovascular procedures, as well as development of optimal computed tomography (CT) imaging protocols. This review article provides a summary of the current applications of using 3D printed cardiovascular models with future research directions highlighted
Starting a movement: An epidemiological audit into the distribution and determinants of Clostridium Difficele infection at an Australian tertiary hospital site
Get PDFBackgroundThe emergence of hypervirulent strains of Clostridioides (Clostridium) difficile over the past few decades has cemented C. difficile infection (CDI) as the most common cause of nosocomial infectious diarrhoea within Australia. This report was initiated to better understand the burden of disease at the Bankstown-Lidcombe Hospital through analysis of CDI incidence, risk factors, and treatment.AimsThe specific objectives of this study were two-fold; 1) to determine the prevalence of hospitalised patients affected with CDI and 2) to identify risk factors for CDI in hospitalised patients.Methods A retrospective review of all consecutive CDI cases at the Bankstown-Lidcombe Hospital between 1 July 2014 and 31 December 2018 was performed. CDI incidence was calculated based on the number of CDI cases observed per 10,000 patient days. Annual incidence and predisposing antibiotics to CDI were compared via univariate analysis and Student t-tests. Treatment for CDI was compared using contingency analysis via Pearson’s chi-squared analysis. Results The CDI diagnoses ranged from 3.2–4.6 (as a proportion of 10,000 occupied bed days) throughout 2014 and 2018. There was a significant decrease in CDI associated with Macrolides between 2017 and 2018 (p=0.03). There was a significant rise in CDI associated with Beta lactamase inhibitors and Penicillins (e.g., Tazobactam/Piperacillin). The majority of CDI patients were treated with single therapy metronidazole during their hospital stays.ConclusionCDI risk minimisation presents a significant challenge to all hospital departments. This audit highlights the importance of antibiotic usage influencing in-patient CDI cases and the vital role of multidisciplinary teams (microbiologists, pathologists, physicians, surgeons and pharmacists) in managing and monitoring these patients
Which level of preoperative glycated haemoglobin (HbA1c) affect early morbidity and mortality after cardiac surgery?
Get PDFBackgroundDiabetics account for 34 per cent of all patients undergoing coronary artery bypass graft (CABG) surgery, and have higher rates of postoperative mortality. Furthermore, they are at risk for ICU admission postoperatively due to complications of hyperglycaemia, which in turn increases hospital mortality.AimsThe purpose of this study was to evaluate the level of glycated haemoglobin (HbA1c) in patients undergoing cardiac surgery, and to establish it is an independent predictor for postoperative mortality and morbidity.Methods This retrospective study was conducted at King Fahd University Hospital. Files of 146 diabetic patients who underwent cardiac surgery in the period between September 2015 to June 2018 were included. One hundred and five patients met the inclusion criteria. Depending on the results of HbA1c preoperatively, patients were divided into 2 groups: Group A, with a HbA1c > =8.5 per cent, accounting for 33 patients, and Group B with a HbA1c < =8.4 per cent accounting for 71 patients.Results This study included 79 males and 25 females, with ages ranging in between 17 to 87 years old, with no significant difference between both groups in age and sex. A significant difference was found between Group A and Group B in postoperative mortality (p-value < 0.002). No significant difference was found when comparing length of hospital stay, wound infection postoperatively, reoperation, or readmission.ConclusionThere was a significant difference in mortality postoperativly between the two groups, with patients who had higher HbA1c levels experiencing higher mortality. Since our sample size was small, we recommend that further studies be done in multiple centres
The social, psychological, educational opportunities and economical impact on spina bifida families in King Fahd University Hospital, Saudi Arabia
Get PDFBackgroundIn Saudi Arabia, there is insufficient data about the incidence and prevalence of neural tube defects (NTDs). Based on single hospital studies on limited geographical areas here, the incidence ranges approximately from 0.97 per 1,000 births to 1.09 per 1,000 births. During the past six decades, medical care for NTDs has improved significantly, resulting in better life expectancy.AimsIn this study, we are aiming to identify the impact of SB on educational opportunities for the affected individuals, and the psychological, social and financial burden on the families.MethodsA cross-sectional study conducted at the Mylomengiyocele clinic at King Fahad University Hospital in Khobar, Saudi Arabia. 50 caregivers of patients with SB (between 2018–2019) were included. Data were obtained by answering a structured questionnaire through a telephonic interview.ResultsFinancially, 14.6 per cent pay for medications needed but not provided by the hospital. 52.4 per cent need to use a wheelchair, with 66.7 per cent provided by the family only. 46.5 per cent of the total patients needed to use urinary catheters, 52.4 per cent of them provided by the family. 71 per cent of the families receiving financial aid complained that it was not enough to cover the main needs of their child. Socially, 13.6 per cent reported some issues between the child and child’s siblings. Psychologically, there was significant association between caregiver feeling loss of interest and sadness with spina bifida (SB) child interaction with his/her brothers or sisters. Regarding the schooling of SB Child, 33.3 per cent of our sample discontinued their education for a period. Also, 13.6 per cent of our sample reported lack of wheelchair ramp, and 59.1 per cent of the school faculty were not trained enough to provide the needed help to the child in cases of emergencies.ConclusionWith the results yielded, we recommend funding the social medias more in order to increase the awareness of this condition, more campaigns to advocate for SB rights. Also, providing public and school special needs preparations
The site of insulin storage inside domestic refrigerators is associated with ketoacidosis and hypoglycemic episodes among patient with diabetes mellitus
Get PDFBackgroundInsulin storage is vital for use in type 1 diabetes and most patients with type 2 diabetes mellitus. No researchers have investigated the site of insulin storage inside the fridge, the proper rotation of insulin injection sites, and the worsening glucose profile in Tabuk, Saudi Arabia.AimsThe study aimed to assess the association between storing insulin in different sites of the fridge, rotating insulin injection sites, hypoglycemia, and ketoacidosis.Methods This is a cross-sectional study conducted in King Fahd Specialist Hospital, Tabuk, Saudi Arabia during the period from May 2019 to November 2019, 394 participants were approached to collect demographic data, site of insulin storage in domestic refrigerators, number of ketoacidosis and hypoglycaemic attack during the last year, number of insulin injection sites and rotation of injections, and if the patients were regularly checking their glycated haemoglobin.Results Of the 349 patients (98 per cent had type 2 diabetes), 98.3 per cent had a hypoglycaemic episode during the last year, and 11.2 per cent were admitted for ketoacidosis, this is mirrored by not properly storing insulin inside the fridge (39.2 per cent), and inappropriately rotating insulin injection sites (87.4 per cent). Patients who were storing their insulin inappropriately had higher rates of both ketoacidosis and hypoglycaemia than their comparators (0.26±0.65 vs. 0.11±0.39, and 19.51±19.46 vs. 7.07±9.54 respectively, P < 0.05.ConclusionHypoglycaemia and ketoacidosis were common among patients who inappropriately store insulin inside the fridge and wrongly rotate insulin injection sites. Further larger multi-center studies investigating the patient's behaviour to high and low blood sugar and the rates of lipohypertrophy are recommended
A safe model for implementing live streaming of surgery to improve surgical education
Get PDFBackgroundLive surgery broadcasting has had increasing use in medical education, especially in distributed education models. However, there have been several concerns raised regarding its safety and ethics with many surgical colleges banning its use.AimsOur study aimed to implement a model of live surgery broadcasting of Orthopaedic surgery that utilised its educational benefits whilst addressing the current concerns.Methods A telemedicine system using a one-way transmission microphone was installed in a tertiary public hospital to securely transmit live Orthopaedic surgery broadcasting from an operating theatre to a lecture theatre holding either medical students, surgical nurses or musculoskeletal physiotherapists. We performed common Orthopaedic operations on patients that were known to the surgeon within their routine time limits. An evaluation survey was administered at the end of each live surgery session using a 5-point Likert scale and open answers. Questions addressed the quality and usefulness of this education model for each discipline.Results Five live surgery broadcasting sessions were conducted and 179 survey responses received. 38% of medical students had never attended theatre with 71% having never seen a common Orthopaedic operation. Most surgical nurses and musculoskeletal physiotherapists had also never seen common orthopaedic procedures. There was a statistically significant benefit in the improvement of educational experience gained by live surgery broadcasting for all five sessions (p < 0.01). Over 80% of all cohorts would like to expand this model to include other surgical specialties.ConclusionLive surgery broadcasting can successfully provide educational benefit to medical students, surgical nurses and musculoskeletal physiotherapists without infringing upon patient safety
Assessment of sleep quality, post-traumatic stress disorder, and locus of control in motor vehicle accident survivors
Get PDFBackgroundHigh incidence of Motor Vehicle Accidents (MVAs) in Saudi Arabia and the established link between MVA and related psychological factors necessitate a survey of the prevalence of MVA and associative factors. AimsTo investigate the relationship between sleep patterns, locus of control, and post-traumatic stress disorder (PTSD) among MVA survivors at King Abdulaziz Medical City (KAMC), Riyadh.MethodsA cross-sectional survey was conducted on 334 patients with MVA admitted cases, and patients who visited outpatient clinics. In addition to basic demographic information and driving history, PTSD severity, sleep quality, and locus of control were assessed using a validated PTSD Checklist – Civilian Version (PCL-C), Rotter’s Locus of Control Scale (LCS), and items taken from the Pittsburg Sleep Quality Index. Association between the variables was analysed using the Chi-Square test.ResultsPrevalence of moderate to severe PTSD was 39.2 per cent. No association between PTSD severity and involvement in an MVA was found. Women had significantly higher scores PTSD lower internal locus of control scores. The majority of the respondents reported fairly good to very good sleep quality, although 18 per cent admitted to having a driving impairment or hindrance in completing other daily activities due to inadequate sleep in the past month. Regarding trouble staying awake while driving, a significant correlation was found with powerful others (p=0.026) and chance (0.019).ConclusionNo correlation was found between PTSD severity, poor sleep, locus of control and MVA in this study, although high rates of PTSD necessitate valid identification and treatment of patients at risk
Vitamin D supplementation as a fall prevention method: A systematic review
Get PDFBackgroundFalls are common occurrences events leading to remarkable morbidity and mortality. Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials conclude contradictory results.AimsThis review aimed to summarize the available RCTs that studied the effect of vitamin D administered on falls in older adults.Methods Pub Med, Google Scholar, and EBSCO databases were systematically search for relevant articles. The terms vitamin D, falls, ergocalciferols, 25-hydroxy vitamin D, and 1, 25-dihydroxy vitamin D were used. out of Three hundred and four, only eleven fulfilled the inclusion criteria.Results In the majority of the randomized control trial, vitamin D supplementation provides protection against falls among the elderly population.ConclusionThe majority of the studies concluded that vitamin D alone or in combination with calcium was a successful fall reduction method among the elderly
