729 Effect Of COVID-19 On Orthopaedic Trauma Admissions in A London District General Hospital

Introduction

The coronavirus pandemic (COVID-19) has presented orthopaedic services with new challenges across all aspects of healthcare delivery. This study explores the effect of the COVID-19 lockdown on trauma admissions at a London District General Hospital.

Method

Data was collected retrospectively from electronic patient records during the lockdown period (16th March -30thApril 2020) and compared to the same dates in 2019. Patient age, date and time of admission, operation and anaesthesia timings and length of stay (LOS) were analysed.

Results

Fewer trauma patients were admitted in 2020 (108 vs. 65). Additionally, there was a patient demographics shift, with mean age increasing from 55.6 years to 64.1 years (p = 0.038). Falls remained the leading cause of injury, although the proportion dropped from 75% to 62%. Anaesthesia duration was longer in 2020 (136 vs 83 minutes, p < 0.00001). Similarly, there was a 13.6% increase in median operation length. Finally, although LOS was similar, admission-operation was greatly reduced in 2020 (1.22 days vs 4.74, p < 0.0000001).

Conclusions

Orthopaedic trauma care remains a vital service, particularly in high-volume hospitals. By understanding the effects of the lockdown on trauma admissions, healthcare managers can more effectively plan for future changes in non-emergent trauma service delivery as we move towards easing lockdown restrictions.

Factors affecting the time lag to the second eye cataract surgery in a hospital-based population

INTRODUCTION

Cataract can be treated successfully, yet patients delay surgery. Surgery in one eye may not promote surgery in the second.

OBJECTIVES

To determine the time lag to the second eye cataract surgery and identify the factors that affect it.

MATERIALS AND METHODS

This study was conducted at an ophthalmology out-patient department of a teaching hospital and was an observational, cross-sectional study. Consecutive patients of over 45 years who had had cataract surgery in one eye and had visually significant senile cataract in the other were categorized into those that requested sequential surgery (Group 1) and those that refused (Group 2). The relevant history and vision were recorded. A questionnaire was used to seek possible responsible factors that determined the refusal for the second surgery.

STATISTICAL ANALYSIS

Categorical variables were compared between groups using the chi-square test and continuous variables using the Student t-test. Factors significantly affecting the time lag were subjected to the analysis of covariance. Rresults: Of the 250 patients of the study, only 104 (41.6 %) requested the second eye surgery, less than one-fifth within one year. Thirteen patients from Group 2 presented with complications of hypermaturity in the second eye. The average time lag was 2.39 ± 2.19 years. It was significantly more in Group 2 patients (p = 0.024) who also reported more barriers (2.75 ± 1.23 versus 1.58 ± 1.10; p = 0.005). The factors that increased the time lag were older age (p = 0.028), extra-capsular surgery (p less than 0.001), and being able to manage after the first surgery (p = 0.011) in Group1, and eye-camp (p = 0.021) or extra-capsular surgery (p less than 0.001) in Group 2 patients.

CONCLUSIONS

One-fifth of the patients reported back for sequential surgery within one year. Patients who refused surgery had more barriers; most were related to the first surgery and should be anticipated by compassionate ophthalmic professionals after surgery in the first eye.

Effects of haloperidol on cell proliferation in the early postnatal rat brain

Haloperidol, a widely used neuroleptic, produced a significant depression of the rate of [3H]thymidine incorporation into the DNA of 11-day-old rat brain. The reduction of in-vivo DNA synthesis rate was detectable by 4 h after subcutaneous injection of a single dose of haloperidol (20 mg/kg) and through the period 10-24 h after drug treatment the rate was less than 50% of that of controls in the forebrain. [3H]Thymidine incorporation returned to control values by 32 h. The effect on the cerebellum was similar but less pronounced. The depression was dose-dependent and a half-maximal effect was produced with haloperidol doses of 5-10 mg/kg. Parallel histological studies on treated rats suggested prolongation of the DNA synthesis phase of the cell cycle in the forebrain subependymal layer, associated with an increase in turnover time of about 15%.