Current practice of pre-operative assessment at a public sector hospital in Pakistan – a clinical audit
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Abstract:
Objective: To assess the practice of ordering unnecessary laboratory investigations by primary surgical teams. Method: The clinical audit was conducted from December 17, 2022, to January 15, 2023, at the Civil Hospital, Karachi, and comprised primary surgeons working in different surgical units who ordered laboratory investigations for patients as a part of preoperative assessment. Data was collected using a self-administered questionnaire. Data was analysed using SPSS 20. Results: Of the 280 surgeons approached, 249(89%) responded. The units covered were General surgery 96(38.5%), Gynaecology 74(29.7%), Neurosurgery 5(2.0%), Ear, Nose and Throat 19(7.6%), Plastic surgery 15(6.02%), Paediatric surgery 13(5.2%), Vascular surgery 8(3.21%), Oromaxilofacial 9(3.61%), Opthalmology 6(2.4%), and Orthopaedics 4(1.60%).As part of baseline investigations, 244(98%) surgeons ordered complete blood count, 173(69.5%) ordered urea and creatinine, 229(92%) ordered viral markers, 197(78.7%) ordered fasting and random blood glucose, and 178(71.5%) focussed on cardiac fitness. Conclusion: There was a found a need for standard protocols for pre-surgery evaluation so that unnecessary investigations may be avoided. Key Words: Preoperative, Investigation, Guidelines, Assessment, Audit.Purpose: The aim of this study was to evaluate the common interventions performed by neurosurgery and otolaryngology in dural invasion in frontal sinus related pathologies.
Materials and Methods: A comprehensive study involving 45 patients who underwent surgical interventions for frontal sinus-associated pathologies between January 2018 and July 2023 was conducted collaboratively by otorhinolaryngology and neurosurgery departments. Patient data, including demographics, pathology types, and surgical approaches, were collected from medical records, surgical reports, imaging studies, and videos. Interdisciplinary surgical teams executed tailored interventions with documented techniques.
Results: Among 45 patients, 31 were female (68.8%) with a mean age of 44. Posterior wall defects were detected in 13 (28.8%) patients, and intervention was necessary for only 8 of them. Among the 8 (17.7%) patients with identified dural invasion, pathological dural tissue was excised, and duraplasty was performed in 5 (11.1%) cases. There were no neurological complications observed in patients during the postoperative period.
Conclusion: Despite limitations, the findings contribute to evolving knowledge and highlight the need for prospective studies to optimize patient care strategies.
Frontal sinus
Demographics
Sinus (botany)
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG
Pediatric neurosurgery
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY PRACTICE CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY PRACTICE CNS.ORG
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Evidence - based medicine is medicine based on evidence. The application of evidence - based medicine to otorhinolaryngology is evidence - based otorhinolaryngology. The major enforcement strategies of evidence - based otorhinolaryngology include discovering problems and bringing them forward, seeking valuable evidence from the otorhinolaryngology relevant literature, making experimental or methodological assessments, applying in the practice of clinical otorhinolaryngology, and evaluating the results of the practice. Evidence- based medicine and evidence- based otorhinolaryngology are of great significance to the advancement of clinical otorhinolaryngology.
Evidence-Based Medicine
Clinical Practice
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG
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