Hospital Practices and Research

Abstract Background: Minimally invasive hysterectomy is generally preferable to abdominal hysterectomy. The technicity index (TI) is the proportion of hysterectomies performed by minimally invasive surgery. Many centers globally have started to audit local TI as a quality indicator, but only a handful have published their results to help define international standards of care.
Objective: In this study, TI was examined in Winnipeg and Canada to determine consistency between local and national patterns of practice, audit expected changes, and contribute to the growing body of literature defining international standards of care.
Methods: A retrospective cross-sectional database review of hysterectomies performed in the Winnipeg Regional Health Authority (WRHA) from 2008 to 2015 was conducted. Mixed effects linear regression models were generated primarily to analyze TI and account for surgeon and hospital characteristics. The Canadian Institute for Health Information (CIHI) database was accessed to estimate the average national TI from 2009 to 2014. One-sample t tests compared annual WRHA and CIHI TI.
Results: In Winnipeg, 1363±32 hysterectomies were performed annually for all indications with an average TI of 34% independent of time (P=0.09). The CIHI database recorded approximately 27 000 hysterectomies annually with increasing TI (41%-52%, 3.5±1.8%/year, P=0.025). WRHA TI differed from national TI every year (P<2.2x10-16).
Conclusion: Over the study period, WRHA TI was below the Canadian average and static despite national increases. The importance of local audits to identify underperformance and stimulate initiatives for quality improvement is highlighted in this study.

Abstract Background: The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures.
Objectives: The purpose of this study was to determine the frequency of common manifestations of neurological diseases in patients referred to a military hospital’s internal neurology clinic.
Methods: This was a cross-sectional descriptive study of patients referred to the internal neurology clinic of a reference military hospital, Tehran, Iran in 2020. The sampling was done at random using a checklist. Finally data was analyzed by using SPSS software.
Results: Women made up the majority of patients in 336 samples 182 (54.2 %) versus 154 (45.8 %). The patients’ average age was 49.5 ± 16.5 years, with 28.3 % (n = 95) being elderly. The three most common complaints raised by patients were headache, movement disorder, and sensory disorder, accounting for 29.5%, 27.7%, and 27.7% of complaints, respectively. Seventeen patients (5.1%) also mentioned other issues, with anger, anxiety, depression, and nausea being the most common complaints.
Conclusion: Headache, movement disorder, and sensory disorder are the most common neurological disorders referred to a military hospital. Because of the high prevalence of these issues, it is necessary to establish specialized clinics and conduct additional research to determine the most common types of sensory and movement disorders, as well as the most effective methods of prevention and treatment in medical centers.

Abstract Background: Traumatic brain injury (TBI) is the damage to brain tissue and disruption of the brain function caused by an external mechanical force as evidenced by documented medical records.
Objectives: The study aimed to estimate the prevalence of TBI through age-groups, severity, and mechanism of TBI.
Methods: This cross-sectional study contained all TBI patients who were admitted at the main level one trauma center hospital located in southeastern Iran.
Results: The number of reported patients was 445 young and old adults with TBI. In total, the mean age of the patients was 32.35 ranging from 17 to >80 years. Of the studied patients 361 (81.1%) were male and 84 (18.9%) were women. The most common principal severity of TBI among patients aged 20–29 years was moderate. This corresponds with the age groups that are known to be at higher risk for three levels of TBI. Car accident multiple trauma and head trauma show severity of TBI in both genders.
Conclusion: The research findings determined the lack of ignoring the traffic control system in southeastern Iran that was the main cause of the injury; consequently, the focus of all essentials in traffic management should be considered for this problem. It must be noted that the incidence of TBI is necessary as there remains no cure for mild-to-severe TBI. As the evidence for effectiveness and specific treatment is limited, it must be subjected to demanding research.