This is a retrospective study of the annual mortality that occurred in the Department of Surgery, Alor Setar Hospital, for the years 1995 to 1997. This study looks at the number of admissions to the surgical wards and categorizes the causes of death. The annual mortality rates were 2.60, 2.89 and 3.25 per hundred admissions for the year 1995, 1996 and 1997 respectively. Head injury was the leading cause of death whilst sepsis and advanced malignancies second and third commonest causes. We hope that with the publication of these figures, we can initiate more studies to analyse similar local data.
Matched MeSH terms: Surgery Department, Hospital/statistics & numerical data*
A prospective survey of antibiotic prescribing patterns in six Ministry of Health general hospitals in Malaysia was undertaken. Information on antibiotic prescriptions including the types of antibiotics used and the purposes for prescription was obtained through the use of questionnaires. A total of 1,918 antibiotic prescriptions were available for analysis. About two-thirds of prescriptions were for therapeutic purposes. The most common infections treated were lower respiratory infection (31%), followed by skin and soft tissue infection (17%), and urinary tract infection (8%). Only 20% of the therapeutic prescriptions were based on microbiological test results. Prophylactic prescriptions were issued for a variety of indications, the most common being toilet and suture of wounds. Only 5% of prophylactic prescriptions were of less than 3 days duration. There was great diversity in antibiotics and antibiotic regimens employed. It was evident that there was a lack of compliance with guidelines on antibiotic use issued by the Ministry of Health.
Matched MeSH terms: Surgery Department, Hospital/organization & administration
Day-case surgery is preferred for adults, allowing post-operative fast recovery in family environment and support. Myringoplasty using the traditional method of underlay temporalis fascia or tragal perichondrium is usually performed as an in-patient. From 2003 to 2004, 22 myringoplasty procedures were performed in a dedicated day surgery unit at the Hospital Melaka. We report the retrospectively review of the outcome results of these procedures. None of the patients need admission overnight. There were no surgical or anesthetic complications noted and this series suggests that day-case surgery is a safe and desirable practice for patients undergoing myringoplasty. However, there should be the facility for admission if required.
Sixty-nine severely head-injured patients treated by general surgeons over a 28 month period with admission Glasgow Coma Scale motor scores of 3 to 8 were reviewed retrospectively. Fifty-one patients were comatose on admission with periods from injury to admission exceeding 4 h in 34 patients who were referred from peripheral hospitals. Forty patients with acute intracranial bleeding underwent emergency decompressive surgery with 13 good recoveries and 18 deaths; good recoveries were observed in 11 of 20 patients with extradural haemorrhages, one out of eight patients with subdural haemorrhages, and one of 12 patients with intracerebral and/or combined haemorrhages. Twenty-nine patients with no evidence of acute mass lesions were treated medically with sedation, mechanical ventilation and mannitol infusion for cerebral decompression with seven good recoveries and 16 deaths. There were 15 good outcomes in 40 patients with admission motor scores of 6, 7 or 8 and five good outcomes in 29 patients with scores of 3, 4 or 5. A good outcome of 29% in the study may be improved by (i) better neurosurgical training of surgical and nursing staff; (ii) provision of technologically advanced diagnostic and treatment modalities; (iii) an efficient referral system; and (iv) provision of effective long-term rehabilitation.
This is a retrospective audit of all patients admitted to the surgical unit for urosepsis from June 2014 to June 2015 at the General Surgery Unit of Hospital Sultan Ismail, Malaysia. Demographics, comorbidities, presenting symptoms, length of stay (LOS), mortality, and associated risk factors were recorded. There were 35 patients treated for urosepsis with a male preponderance of 21/35 patients. Hypertension (n=18) and diabetes (n=10) were the two most common comorbidities. There were five deaths (mortality rate=14.3%) and the main bacterium cultured was Escherichia coli. Age >65, presence of underlying comorbid disease, presence of cancer, urine and blood culture positivity had higher incidence of death but were not statistically significant for urosepsis mortality. However, this result is limited by the small sample size and single centre retrospective data.