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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 115 - 115
1 Mar 2012
Sahu A Singh M Bharadwaj R Harshavardana N Hartley R
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Introduction

The aim of this study was to compare the results and length of stay of patients of early (within 12 hours) versus conventional (after 48 hours) ankle fixation our hospital.

Methods of study

It was a retrospective study over 18 month period (July 2004 - Dec 2005) including 200 Patients (aged 16 or more). We looked into age, place of living, Weber classification, mechanism of injury, comorbidities especially diabetes, addictions mainly smoking, etc. Overlying skin condition, the amount of swelling at presentation, associated ankle dislocation or talar shift, acute medical comorbidities, injury types-open or closed were classified accordingly.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 409 - 409
1 Jul 2010
Sahu A Nazary N Harshavardana N Anand S Johnson D
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Purpose: Our aim of this study was to find out the abstract to publication ratio (APR) in peer-reviewed indexed journals of abstracts presented at BASK annual meetings. We also wanted to identify the publishing journals and to look at the amount of time taken for publication.

Methods: We obtained permission from BASK executive committee and retrieved all presentations (podium & poster) over six year period (2000–2005). An extensive PubMed database search was performed to determine whether or not the abstract had been published as a full paper up to the beginning of Nov 2008.

Results: A total of 294 abstracts identified, 114 of them were published as 101 full-text articles in 21 different journals. ‘The Knee’ Journal was the most popular destination with 47 publications (41.2%) followed by JBJS (British) with 28 publications (24.5%). The overall abstract to publication ratio (APR) at BASK annual meetings was 38.77%. The mean duration between presentations to publication was 3.96 yrs (range 0 to 7.2 yrs, median 3.4 yrs).

Conclusion: On bench marking the APR ratio at BASK presentations, it is comparable with those of BOA (33.1%), other BOA affiliated societies (26–50%) and medical specialties (32–66%). Abstract to publication ratio (APR) is considered as a measure of the quality of scientific meetings and our results indicates the higher credentials of BASK meetings. It is very difficult to exactly determine the reason for abstracts failing to indexed publications; it is arguable that some of these projects did not meet the scientific scrutiny of the peer-review process required for full publication. We recommend authors to submit the full manuscript of paper after acceptance of their abstracts for the BASK meeting as done in AAOS meeting in order to encourage them to complete their manuscript before presentation.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 496 - 497
1 Sep 2009
Bharadwaj R Harshavardana N Sahu A Singh M Singla A Hartley R
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Introduction: Spinal pathologies requiring spinal/neurospinal unit’s input/opinion from tertiary centers for their management are initially admitted to DGHs. The referral is usually done by mailing patient’s x-rays/scans with clinical details to the on-call registrar who gets back with a management plan. This arrangement is fraught with delays at various levels having an impact on patient care, mortality & morbidity, financial and medicolegal implications. We discuss these issues between index DGH (Poole Gen Hosp, Dorset) and its tertiary referral centers (Southampton/Reading/Bristol/Oxford/Stanmore).

Objectives: To review the existing management of spinal injury admissions at Poole DGH, analyse critical/ adverse incidents and efforts aimed at minimising them, to identify areas for improving patient care & safety and to draft a regional management protocol/care pathway for spinal admissions.

Methods: A comprehensive retrospective review of all spinal admissions/referrals made to tertiary centers over 6 months (Jan–June 05) was undertaken. 28 of the 64 admissions warranted referrals. A structured proforma was used to document the time of admission, time of formulating clinical diagnosis, time of booking scans, time of performing scans, time of referral to tertiary centre, time of response from tertiary centre and time of transfer were retrieved from case notes and reasons for delay (if any) at each level were critically analysed.

Results: 7 of the 28 referrals had either neurodeficit or spinal instability. Common reasons for delay were delay in obtaining CT/MRI scans (av 2.5 days), delay due to reporting/failing to act on scan results (av 1 day), delays due to missing/‘lost in transit’ scans (av 1.5 day), delay in obtaining opinion from tertiary centre (av 4 days) and non-availability of bed for transfer (av 5.5 days). There was 1 mortality and 5 other complications while awaiting transfer. The financial costs incurred were appx £73,000 & loss of 246 patient-days.

Discussion: Training of junior doctors at induction, implementation of spinal care pathway and diligent documentation/communication coupled with succinct referral to the tertiary centre were strictly enforced following this study. The website www.neurorefer.co.uk was set up by Wessex neurological centre, Southampton to streamline referrals, circumvent lost in transit scans and enhance efficiency which has now grown into a national secure referral portal incorporating other referral centers.