Injury Characteristics and Request for Discharge against Medical Advice among Road Trauma Patients | Chapter 10 |Medical Science: Updates and Prospects Vol. 3

 

Background: Discharge Against Medical Advice (DAMA) occurs when a patient leaves the hospital contrary to the managing physician's recommendation. DAMA, with its attendant effects of increased healthcare cost and mortality, is common globally. Therefore, DAMA must be continuously brought into public discourse, and strategies to address it should be explored.

 

Aim: The aim of this study was to highlight the Patterns of injuries by Road Traffic Accident victims, the implications of discharge against Medical Advice on certain critical injuries, and the importance of follow-up.

 

Methods: A retrospective study was carried out at the Federal Medical Centre Makurdi, a tertiary health facility in North Central Nigeria, from January 2021 to March 2022. Medical records (case notes) of 121 patients who were involved in Road Traffic Accidents (RTAs), and were admitted either into the ward through the Accident and Emergency Unit, or at the Accident and Emergency Unit of the hospital, were retrieved and analyzed against such variables as age, sex, occupation, resident, types of injury, and length of hospital stay.  Descriptive Statistics were deployed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) to analyse the data.

 

Results: DAMA rate was 12.4% (n=15), of which 8 (6.6%) were females, and 7 (5.7%) were males. Head injury was the commonest injury, 8 (53.3%), seen, while musculoskeletal injuries were 7 (46.7%). The majority of the victims, 6, were in the age group, 30-39 years, with an average age of 37.2. Farmers and housewives were the dominant occupational groups involved. The average hospital stay was 6 days. There was no form of health insurance coverage or follow-up protocol.

 

Conclusion: DAMA for critically injured patients is common in our environment, and there is no known established follow-up system. There is no health insurance coverage. Physicians must strive to track and follow up on these patients to improve outcomes.

 

 

Author(s) Details

Suega P. Inunduh
Department of Human Anatomy/Surgery, Veritas University Abuja, Nigeria.

 

Anthony A. Amuta
Department of Surgery, Federal Centre Makurdi, Nigeria.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6808

Primary High-Grade Serous Carcinoma of the Fallopian Tube Initially Misdiagnosed as Ovarian Carcinoma: A Case Report |Chapter 9| Medical Science: Recent Advances and Applications Vol. 11

 

Background: Historically, primary fallopian tube carcinoma has been reported to constitute only about 0.3% of all female genital tract malignancies. However, literature suggests that its actual incidence may be higher, as many cases are often classified as ovarian cancer. Preoperative diagnosis is difficult and challenging due to the absence of specific symptoms. Clinically, fallopian tube carcinoma resembles epithelial ovarian cancer, and histologically, it is also similar; hence, its evaluation and treatment are essentially the same.

 

Objective: As primary fallopian tube carcinoma (PFTC) is a rare gynecologic malignancy that poses a diagnostic dilemma and is often misdiagnosed as ovarian carcinoma, we report a case of primary high-grade serous adenocarcinoma of the fallopian tube. This case highlights its role in the differential diagnosis of adnexal masses and emphasizing the diagnostic challenges and the importance of intraoperative evaluation, appropriate treatment and follow-up.

 

Case Summary: A 48-year-old woman presented with watery vaginal discharge, and on bimanual examination, a firm, non-tender mass in the left fornix measuring 6 × 6 cm separately from the uterus. Radiological imaging suggested an ovarian tumour, and serum CA-125 was markedly elevated at 2586 U/ml. The patient underwent staging laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and pelvic as well as para-aortic lymphadenectomy. Intraoperatively, a solid, polypoidal growth measuring 5 × 5 × 7 cm was identified arising from the fimbrial end of the left fallopian tube. Approximately 100 ml of hemorrhagic peritoneal fluid was noted in the pelvis,  and two para-aortic lymph nodes were enlarged, measuring up to 1.5 × 1 cm. Histopathological examination confirmed a poorly differentiated serous adenocarcinoma of the left fallopian tube, classified as histologic grade III and nuclear grade II, and staged as pathological stage IC2.

 

Outcome: Postoperatively, the patient received adjuvant chemotherapy with paclitaxel and carboplatin. She was monitored regularly over five years with physical examinations, CA-125 testing, and imaging studies, during which no symptoms or signs of recurrence were observed.

 

 

Author(s) Details

Gayam S.
Department of Obstetrics and Gynaecology, Vijay Marie Hospital, Hyderabad, India.

 

Babu C.
Department of Surgical Oncology, Apollo Hospital, Hyderabad, India.

 

V.V.S. L.
Department of Obstetrics and Gynaecology, Vijay Marie Hospital, Hyderabad, India.

 

Maddali S.
Histopathology & Cytology Laboratory, Hyderabad, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msraa/v11/6258

Impact of COVID-19 Fear on Cancer Patient Follow-up | Chapter 6 | Advanced Concepts in Medicine and Medical Research Vol. 8

 The COVID-19 ailment, caused by the novel SARSCoV-2 (harsh acute respiratory disease coronavirus-2), was declared as a community health emergency of international concern for one World Health Arranging in February 2020. The novelty of the virus in addition to no known cure available for contamination & serious sickness resulting because of it, surpassed to immense fear in the public all along the pandemic while compliance of many family with social outrunning, masking and sanitising protocols was depressed, more so in populations place infectious disease burden is extreme. The lockdown situation was questioning for both health-care conveniences and cancer patients alike. Victims due for post treatment effect visits were not able to physically accompany clinics due to lack of transport, limits on movement and limited chance of services. The lockdown had allure psychological affect the population with extreme stress levels particularly among cases of chronic diseases the one were more prone to succumb to harsh infection. The aim of this study search out assess level of fear and worry among cancer survivors the one were due for post-treatment follow-up utilizing a validated questionnaire. Accordingly, strategies were implemented to evaluate the type and severity of worry or fear among patients utilizing a validated Fear of Corona Bug 19 (FCV 19S) scale by doing telephonic follow-up. The results mirrored that fear of dying from severe contamination due to raised susceptibility to SARSCoV2 was significant as was the fear of frequency. The method of telephonic follow-up was establish to be useful for health management providers and reassuring for most patients and can convince to be a good modality influential delivery inappropriate settings.

Author(s) Details:

Priyanka Singh,
Department of Gynaecological Oncology, Kalyan Singh Super Specialty Cancer Institute & Hospital, Lucknow, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V8/article/view/12788

Impact of Health Education Intervention on Uptake of Random Screening for Cervical & Breast Cancers among Rural Women in Villages of Gurgaon Cluster, Haryana, India: A Cross-Sectional Study | Chapter 14 | Recent Developments in Medicine and Medical Research Vol. 12

 Disease awareness and socio-cultural practises influence rural women's treatment seeking behaviour and uptake of preventative screening for breast and cervical cancers. In Gurgaon villages chosen at random by our financial partner, DLF Foundation, Gurgaon, this study was performed to evaluate rural women's awareness and understanding of cervical and breast cancers, as well as their attitudes and uptake for primary screening for these diseases. A cross-sectional study was conducted on 603 women between the ages of 21 and 65 who attended women's cancer awareness and screening camps, where they were randomly screened for breast and cervical cancers. Out of 603 women who participated in various camps organised in several villages within Gurgaon between 2014 and 2016, 235 women (39%) were checked for cervical and breast cancers. Furthermore, 365 women (61%) were taught how to conduct a self-breast examination. 88 (37.44 percent) of the 235 persons assessed were found to have genital infections, for which they were given free drugs. Out of 235 women tested, 99 (42%) were suspected of having cervical or breast abnormalities and were recommended for additional testing (Pap smear, USG Abdomen, and Mammography in 20 cases) to confirm the condition and offer treatment recommendations. Only 38 of the instances, on the other hand, followed the protocol for follow-up. All participating women received specially created, easy-to-understand pamphlets (in Hindi) on the four women's cancers (endometrial cancer, breast cancer, ovarian cancer, and cervical cancer). The most significant conclusion was that rural women had little understanding of cervical and breast cancer screening, as well as the symptoms, risk factors, and preventative screening for these cancers. Effective education and large-scale primary screening are required in India to lower the burden of cervical and breast cancers. Low family finances and a lack of mobility have been reported to make it difficult for women to access to health centres while enduring the severe symptoms of these diseases. Because the majority of rural women never have their cervical and breast cancers examined, the study indicated that cancer awareness programmes, as well as on-site primary screening for cervical and breast cancers using simple, cost-effective procedures, can considerably benefit them.

Author(S) Details

P. Cheena Chawla
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

Anil Kumar Chawla
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

Seema Chaudhary
World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310, India.

View Book:- https://stm.bookpi.org/RDMMR-V12/article/view/4680