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Fulltext Poor bowel preparation in patients undergoing colonoscopy

Qureshi A, Ismail S, Azmi A, Murugan P, Husin M

Med J Malaysia, 2000 Jun;55(2):246-8.
PMID: 19839154

A prospective analysis of 500 consecutive patients undergoing colonoscopy at the endoscopy unit of Hospital UKM under the care of the surgical unit was analysed. All colonoscopies were supervised by one of two consultant surgeons. The bowel preparation was graded from grade 1 to 4 according to established criteria. All patients had 3 litres of colonic lavage solution as bowel preparation. One hundred and two patients (20.4%) were considered to have poor bowel preparation, while 398 patients (79.6%) had good bowel preparation. Statistically significant factors that resulted in poor bowel preparation included age <20 years and >60 years (p<0.0001), and inpatients (p<0.0193). There was no significant difference in respect to sex, ethnic groups and the indication for colonoscopy. We conclude that young adults and the elderly as well as inpatients are more likely to have a poor bowel preparation using the standard regime.

Matched MeSH terms: Preoperative Care/standards*
Fulltext Pre-operative investigations: yield and conformity to national guidelines

Juliana H, Lim TA, Inbasegaran K

Med J Malaysia, 2003 Mar;58(1):5-16.
PMID: 14556321

Routine ordering of pre-operative investigations yields a low true positive rate and is not cost effective. In this study, case notes of 251 adults who underwent elective surgery were reviewed. Pre-operative investigations were classified as 'indicated' or 'not indicated', based on the national guidelines. Only 56% of all tests done were indicated. The overall rates of expected and unexpected abnormal values from pre-operative blood investigations were 51.1% and 34.4% respectively. This study found that selective testing based on guidelines was beneficial. However, the results also suggest that the local guidelines need to be reviewed.

Matched MeSH terms: Preoperative Care/standards*
Transcatheter aortic valve implantation during the COVID-19 pandemic: Clinical expert opinion and consensus statement for Asia

Tay EL, Hayashida K, Chen M, Yin WH, Park DW, Seth A, et al.

J Card Surg, 2020 Sep;35(9):2142-2146.
PMID: 32720374 DOI: 10.1111/jocs.14722

OBJECTIVES: The impact of the COVID-19 pandemic on the treatment of patient with aortic valve stenosis is unknown and there is uncertainty on the optimal strategies in managing these patients.
METHODS: This study is supported and endorsed by the Asia Pacific Society of Interventional Cardiology. Due to the inability to have face to face discussions during the pandemic, an online survey was performed by inviting key opinion leaders (cardiac surgeon/interventional cardiologist/echocardiologist) in the field of transcatheter aortic valve implantation (TAVI) in Asia to participate. The answers to a series of questions pertaining to the impact of COVID-19 on TAVI were collected and analyzed. These led subsequently to an expert consensus recommendation on the conduct of TAVI during the pandemic.
RESULTS: The COVID-19 pandemic had resulted in a 25% (10-80) reduction of case volume and 53% of operators required triaging to manage their patients with severe aortic stenosis. The two most important parameters used to triage were symptoms and valve area. Periprocedural changes included the introduction of teleconsultation, preprocedure COVID-19 testing, optimization of protests, and catheterization laboratory set up. In addition, length of stay was reduced from a mean of 4.4 to 4 days.
CONCLUSION: The COVID-19 pandemic has impacted on the delivery of TAVI services to patients in Asia. This expert recommendation on best practices may be a useful guide to help TAVI teams during this period until a COVID-19 vaccine becomes widely available.

Matched MeSH terms: Preoperative Care/standards*

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