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Artigo em Inglês | MEDLINE | ID: mdl-33689020


INTRODUCTION: One-stop neck lump clinics (OSNLC) are gaining popularity worldwide especially in the UK hospitals following NICE recommendation. The main aim of this speciality clinic is a quick diagnosis and early management while simultaneously improving patient experience. OBJECTIVES: To analyse and compare the efficacy of OSNLC and general ENT/Head and neck clinic with specifics to a number of appointments required for formulating management plan and a number of 'one stop' visits. DESIGN: Retrospective observational study SETTING: Regional Head and Neck Cancer Center (Secondary care hospital) PARTICIPANTS: Patients referred by General practitioner with symptoms of a neck lump MAIN OUTCOME MEASURES: Patients seen in general ENT/Head and neck and OSNLC in 2 phases to understand the difference in a number of appointments, one-stop visits, the requirement of Ultrasound and efficiency of Fine needle aspiration. RESULTS AND CONCLUSIONS: Improved efficacy of OSNLC was noted as patients seen in the clinic required a lesser number of appointments, reached a faster diagnosis and management plan when compared to patients seen in general ENT clinic.

Med J Armed Forces India ; 72(3): 236-41, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27546962


BACKGROUND: Acute renal failure (ARF) is a common entity in the intensive care unit (ICU) setting. There is scanty data regarding acute kidney injury (AKI) in ICUs from our country and no data from the service setting. METHODS: All patients admitted to the ICU of a tertiary care teaching hospital for six months were included in the study. They were divided into two groups: surg gr (admitted in surgical ICU) and med gr (admitted in medical ICU). During the stay in ICU, patients were observed for the development of AKI depending on the creatinine values and hourly urine output. Staging was done based upon the Risk Injury Failure Loss and End stage kidney (RIFLE) criteria. Relevant data associated with development of AKI was collected for correlation. RESULTS: 17.15% patients developed AKI after admission to the ICU 40% patients admitted with sepsis developed AKI. An increased susceptibility to develop AKI was found on day 4 of admission in both the groups. Of the patients who developed AKI, the surg gr of patients had a higher sequential organ failure assessment (SOFA) score both on day of admission (7.85 vs 5.65) and on the day of development of AKI (9.47 vs 6.18) as compared to the medical group. CONCLUSION: The incidence of ARF in our study was 17.2% with the patients of polytrauma/MODS being of major concern. The initial 3-4 days are the most critical and susceptible patients must be intensive monitored during this time for prevention of ARF. Medical ICU patients develop ARF at a low SOFA score in comparison to surgical ICU patients and thus need greater attention.