02 Dec 2022
30 Nov 2022
Advantages of laparoscopic appendectomy (LA) have been well documented. Yet, its use in secondary health care facilities has not been well discussed. Our work aimed to evaluate the feasibility, outcome and role of LA in managing both complicated and non-complicated appendicitis in a secondary health care setting. Patients who are clinically suspected to have acute appendicitis were included in this three-year retrospective study that took place in the period from March 2016 to March 2019 with a follow up period of 18 months. Two hundred and thirty-three patients underwent LA during the study period. They were 128 males and 105 females with the male to female ratio of 1.3: 1. They were classified into three groups; Group l (n=142, 61%) included those who clinically and sonographicaly proved to have uncomplicated acute appendicitis. On the other hand, Group II (n= 61, 26%) were those patients with suspicion of having complicated appendicitis. Group III (n=30, 13%) were those with equivocal diagnosis of acute appendicitis. Patients in the three groups underwent LA with eighteen cases that were converted to open appendectomy (OA) due to various causes. Overall success rate of the technique was above 85%. LA besides being the usually adopted feasible and minimally invasive tool within the tertiary health care facilities may also be safely implemented within the secondary health care settings.
The origins of the right to health care are analyzed. The purpose is to establish the state of observance of the right of convicts and staff to health protection, to determine the main directions for improving legal regulation and organization of medical services in the criminal Executive practice of Ukraine. The methodological basis of the study is a dialectical method of scientific knowledge, which allows us to consider the observance of the right to health of prisoners and staff in prison in their development, relationship, and mutual influence. On this methodological basis, separate scientific methods of cognition are used. In particular, system-functional, structural-logical, as well as statistical and sociological research methods. The problems with the right to health protection in conditions of deprivation of liberty are outlined, namely, when serving sentences of imprisonment for a certain period and life imprisonment. It provides an overview of the problems in respect of the right to health protection, related to personnel who carry out sentences against convicted persons. Attention is drawn to the practical level and today's extremely low assessment of the work of medical institutions in places of detention: unsatisfactory pricing policy for medicines, outdated equipment, and lack of professional medical personnel. Proposals are made to ensure the rights of convicts to health care in places of detention in Ukraine.
Surgical site infection (SSI) is the most frequently studied and the most common healthcare-associated infection. Improvements in prevention methods, infection control and risk reduction may prove beneficial. A retrospective review study of the Orthopedic surgeries from 2015 to 2020 at Orthopedic & Traumatology Hospital, after SSI prevention measures and risk factor assessments formulated by the hospital have been applied. 2539 patients' records were included in this study and we were able to reduce the infection rate to 0.43% equivalent to 11 patients. System-wide effort to reduce SSI should be highly considered.
The Health Office of Pontianak City, West Kalimantan Province reported that there were 387 confirmed cases of COVID-19 per July 2020 and 4 of them died. Unfortunately, the use of Geographic Information System (GIS) for planning, monitoring, and decision-making to support surveillance program by local- health managers has not been well documented, particularly in the distribution of COVID-19. The utilization of GIS is required as a method for public health surveillance and monitoring. This study aimed to analyze the distribution of COVID-19 cases with a spatial approach to support the epidemiological surveillance program in Pontianak City between March 2020 to July 2020. This research was a cross- sectional study. The dependent variable was cases COVID-19 (suspect and confirmation) and the independent variables included ages, sex, and patient’s status. A total of 332 cases of COVID-19 in Pontianak City were collected from six districts. The results showed that males were more likely to suffer from COVID-19 than females, the age group of 31-40 years was more vulnerable, and some patients were cured. The study also revealed the spread of one district with a Clustered type of COVID-19. The presence of spatial autocorrelation was explored using global and local Moran's I statistics. The global Moran's I revealed a negative but statistically significant spatial autocorrelation COVID-19 incident rate (I = 0,000). The mapping of COVID-19 cases using GIS can facilitate the epidemiology programmer in Pontianak City Health Office and Public Health Centre in intervening the social determinant of health to identify the spread of COVID-19 disease.