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Introduction: Post-trauma patients are at risk of developing symptoms of post-traumatic stress disorder (PTSD) and major depression. The primary goal of this study is to estimate the prevalence of PTSD and depression symptoms in patients who have been hospitalised for the treatment of physical trauma. Additionally, we wanted to compare the prevalence of PTSD or depression symptoms alone versus PTSD associated with depression symptoms, in orthopaedic post-trauma patients. Materials and Methods: This study had involved orthopaedic post-trauma patients in the orthopaedic ward and clinic of Hospital Tuanku Jaafar (HTJ), Seremban, Malaysia, using an online questionnaire, which consist of English and Malay language. We then determined the prevalence of depression and PTSD symptoms in orthopaedic post-trauma patients and compared this prevalence to the severity of the injuries sustained and any association between PTSD and depression symptoms. Results: Only 12.9% of the participants are likely to have post-traumatic stress disorder (PTSD) symptoms and 43.3% of participants have depression symptoms. There is no significant association between patient demographics and severity of the injuries with the prevalence of post-traumatic stress disorder (PTSD) and depression symptoms. However, of those deemed likely to have PTSD, 93.5% of them had both post-traumatic stress disorder (PTSD) symptoms as well as depressive symptoms. Conclusion: Only a few of the participants are likely to develop post-traumatic stress disorder (PTSD) while almost half of the participants are likely to have developed depression. Physicians caring for trauma patients should screen them for early symptoms of PTSD and depression and treat them accordingly.
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Medicine and healthcare can rightly be considered as High Reliability Organization (HRO) when it strives to promote and maintain reproducible and safe outcomes for all patients. Situational awareness (SA) as a concept meant to augment patient safety has often been discussed in the literature, but our own local contribution to this important discussion is decidedly deficient. Being initially implemented in the aviation industry, this concept has been extended to be a crucial element in high-demand activities, including healthcare. As such, extensive exposure is given early on during the training of medical personnel in many countries. We believe that our own medical students and other healthcare candidates in training should be similarly exposed to this concept as it can have a tremendous impact on patient well-being and safety. This paper attempts to provide a short overview of the SA in healthcare and how we can similarly promote its inclusion in our training programmes.
Asunto(s)
Concienciación , Seguridad del Paciente , Humanos , Reproducibilidad de los Resultados , Personal de Salud , Atención a la SaludRESUMEN
Infection following total knee arthroplasty can be devastating. Even with established treatment protocols, eradication of the infection may not be feasible. We report 2 patients who required above-knee amputation to eradicate recalcitrant infection.
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Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla/efectos adversos , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Adulto , Amputación Quirúrgica , Femenino , Humanos , Articulación de la Rodilla/microbiología , Pierna/cirugía , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/microbiología , Infecciones Relacionadas con Prótesis/cirugía , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/cirugía , Insuficiencia del TratamientoRESUMEN
PURPOSE: To survey Malaysian orthopaedic surgeons' attitudes to and use of venous thromboembolic disease prophylaxis. METHODS: A total of 144 orthopaedic surgeons from various governmental and private institutions responded to a questionnaire. RESULTS: Only slightly more than half of these surgeons considered venous thromboembolic disease as common a problem in Malaysia as in western countries. The majority of surgeons (91.0%) reported using prophylaxis selectively for patients based on various indicators such as risk grading of surgery, obesity, and malignancy etc. Bleeding tendencies were cited as the greatest fear against the use of pharmacological prophylaxis. Low-molecular-weight heparin appeared to be the most commonly used pharmacological prophylaxis, used either singly or in combination with other forms of prophylaxis. The majority of surgeons employed prophylaxis until their patients were mobile. CONCLUSION: There should be greater awareness among surgeons in Malaysia of the need for protection against venous thromboembolic disease. Current practice needs to be reviewed and further recommendations made for existing protocols.
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Anticoagulantes/administración & dosificación , Actitud del Personal de Salud/etnología , Ortopedia , Inhibidores de Agregación Plaquetaria/administración & dosificación , Tromboembolia/prevención & control , Vendajes , Encuestas de Atención de la Salud , Humanos , MalasiaRESUMEN
We attempted to compare the accuracy of our clinical examination and the usage of magnetic resonance imaging (MRI) in evaluating patients suspected of having internal derangement of the knee who were seen in our Orthopaedic clinic. This was done using the findings of arthroscopy as the 'gold standard'. The accuracy of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to 48-65% for clinical examination. We thus propose that MRI examination is an effective first-line investigation for patients with suspected internal knee derangement, especially menisci injuries; allowing arthroscopy to be reserved for patients in whom surgery is truly indicated.