Background The healthcare industry of today is defined by patient centricity, perishability, intangibility and heterogenicity. Healthcare managers are faced with a challenge to maximize results by utilizing minimum resources. Forecasting is one of the techniques that help them in planning services. However, the accuracy of the forecast depends on multiple factors such as time horizon, the technique that is applied and certain irregular variations, which may be beyond the control of managers. Methods A retrospective record analysis was done to analyze trends in the monthly footfall in the emergency. Forecasting techniques were applied to predict the number of fever cases that were expected during a particular time period, based on which, the quantum of supplies needed was calculated using linear programming model. The actual and predicted number of patients that visited the emergency for 4 years was tabulated. Results It was observed that the demand for different consumables increased by 33–200% during the peak season. The Mean Absolute Deviation (MAD) was calculated to be 3981.22, Mean Absolute Percentage Error (MAPE) was 30.17% and the Tracking Signal varied between − 1.78 and + 0.86 which indicates that the forecast method was fairly accurate. Conclusion The same method may be applied to forecast the number of patients and accordingly the quantum of resources required for their management.
Background Various surgical techniques are practised to provide best possible outcome for ventral hernia patients. This study was conducted to understand the patient's perspective regarding the choice and outcome of treatment. Aim To determine the level of satisfaction 1 month after ventral hernia repair. To analysed various factors which affects the patient's decision regarding the choice of surgery. To compare post operative outcomes between laparoscopic and open ventral hernia repair. Material & Methods An observational study was conducted between January 2020 and December 2021. Total 70 patients with ventral hernia were included. Relevant data was collected and analysed using SPSS version 28. Results 39 patients underwent open repair and 31 patients underwent laparoscopic repair. 40% patients thought that their choice is better than the other option. 18.5% patients who preferred laparoscopic surgery were scared of big incision and 5% patients opted for open surgery because of unaffordability of mesh. 11.4% patient's decision was affected by the advice from other doctors whom they may have consulted before, 2.8% patients took advise from friends and family. Almost 20% patients left the decision on the treating team. The incidence of complications was significantly less in laparoscopic repair. However, there was no significant difference in the postoperative pain, duration of hospital stay, return to activity and satisfaction at discharge. level of satisfaction at 1 month was significantly higher in the laparoscopic group compared to open group. Conclusion laparoscopic ventral hernia repairs should be preferred in view of fewer complications and higher satisfaction.
Background Lichtenstein inguinal hernia repair (LIHR) is the most commonly performed operation for inguinal hernia, even in developed nations. The European Hernia Society (EHS) guidelines recommend that local anesthesia (LA) should be considered an option in all patients undergoing LIHR. However, most patients still undergo this repair under general anesthesia (GA) or spinal anesthesia (SA). Even in a low resource area like North Ghana, only 37% patients had LIHR under LA. Specialty hernia clinics perform a majority of inguinal hernia repairs under LA. They have standardized their technique of administration of LA and the technique described by Amid et al. is simple, easily learnt, and works well in the hands of an average surgeon as well as a surgical trainee. However, not all surgeons are comfortable in performing this operation under LA. One possible reason for this is that the surgeon prefers a relaxed operating feld and he has heard stories of bad experiences with LA because of non-optimal technique of LA with unacceptable intensity of pain during LA. Aim To present a short video demonstrating the technique of infiltration of lignocaine for Lichtenstein repair under LA. Materials and methods Video. Results In our series of 30 patients, median intra-operative pain VAS was 2.5(0,5). 30% patients reported a VAS>3 during operation. All patients successfully underwent operation using LA. Conclusion LA should be strongly considered for all patients with unilateral inguinal hernia undergoing open repair.
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