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Background Ralstonia pickettii is an opportunistic waterborne microbe which can survive in many kinds of solutions. Contamination of these solutions may result as outbreaks, which can be mortal for immuncompromised patients. Herein we report an outbreak of R. pickettii related to contaminated saline infusion in our center. Methods This study was conducted in Ankara Pediatric City Hospital. An outbreak occured in Pediatric Hematology and Oncology Unit between August 28, 2019 and September 13, 2019. When the outbreak occured, infection control team began an investigation. Environmental samples were collected in order to find the source of the outbreak. Results A total of 11 patients with catheter related blood stream infection caused by R. pickettii who were diagnosed with leukemia were affected. None of the patients infected with R. pickettii died during the outbreak. A total of seventy environmental samples were cultured with the purpose of finding the source of outbreak. R. pickettii grew in normal saline solution culture and all isolates had the same clone of R. pickettii. The outbreak lasted two weeks and was controlled by stopping the usage and sending back the saline solutions belonging to the same manufacturing batch. Conclusions We reported an outbreak of R. pickettii BSIs in highly immunocompromised patients due to contaminated intravascular solution, which was rapidly controlled by infection control measures. Vigilant surveillance by hospital infection control teams and prompt investigation to identify the source of nosocomial infections are crucial to stop an outbreak.

Background . Nowadays, due to the development of different methods of osteosynthesis, sometimes the same types of fractures could be treated using several possible options of the osteosynthesis. This fact was reflected in the Clinical Recommendations for the Bone Fractures Treatment, adopted by the Plenum of the Ukrainian Association of Orthopaedists and Traumatologists 15.05.2013. Taking into consideration the possibility of such choice, investigation of the place of the every method of osteosynthesis, and external transosseous osteosynthesis as one of the examples, in the practice of traumatological department of the city hospital may be useful and important. The purpose of the study was to determine the frequency of the external transosseous osteosynthesis for the treatment of bone fractures and their consequences in the practice of traumatological department of the city hospital and its comparison with the frequency of the internal osteosynthesis. Materials and methods. Retrospective study based on the materials of the traumatological department of the City Hospital N 3, Kramatorsk (February, 2015 — January, 2017) was carried out. A total selection of all cases of external osteosynthesis (72 cases) during this period and its correlation with the number of internal osteosynthesis was performed. Results. External transosseous osteosynthesis was used as a main method for bone fractures treatment in 53 cases (73.6 %), in the treatment of bone fractures consequences in 11 (15.3 %) cases, as a way of temporary fixation in 8 (11.1 %) cases. During the studied period the number of operations of the external transosseous osteosynthesis amounted to 31.9 % of the total number of operations on similar segments (72 operations from 226; 1 : 2.14). External fixation prevailed in the treatment of diaphyseal fractures of the tibia (26 of 47 cases; 1.24 : 1), fractures of the distal radius epimetaphysis (2 : 1) and the calcaneal bone (2.5 : 1). The ratio of the external and internal osteosynthesis in the treatment of the ankle injuries amounted 1 : 2.93 (14 vs 41). Conclusions. External osteosynthesis amounts to 31.9 % of the total number of the osteosynthesis. It was used as the main type of treatment in 88.9 % cases, in 11.1 % as a way of temporary fixation. The most frequent indications for its using were diaphyseal fractures of the tibia, ankle injuries, fractures of the distal radius.

OBJECTIVE To determine the PNI's prognostic effect of prognostic nutritional index (PNI) on operated papilla vateri tumor (PVT) survival. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey, from April 2003 to December 2020. METHODOLOGY One hundred and eighty-two patients diagnosed with PVT were retrospectively screened. One hundred and twenty-six non-metastatic patients, who met the inclusion criteria and underwent curative surgery. PNIs were calculated using preoperative albumin and lymphocyte values and the cut-off value was taken and the two groups were compared in terms of overall survival. RESULTS The median age of the patients included in the study was 61 (36-88) years; 59.5% were males. The cut-off value was obtained using ROC-curves for the preoperative PNI values of 126 patients who underwent curative surgery. Patients were divided into two groups as PNI ≥38 and PNI

Despite the evolution in modern surgery and in pharmaceutical industry, purulent pathology of the hand is occupying a leading position for many years among all diseases with which patients are admitted to hospitals. Over the years, medical care for such patients has been improving. A high social and economic significance of this problem makes surgeons to continue searches of new directions not only in surgical techniques, but also in postoperative wound management to improve outcomes in patients with purulent diseases of the hand.The purpose of this work is to assess results of care of patients with purulent finger and hand diseases treated with laser light necrectomy and photodynamic therapy. A comparative analysis of wound process dynamics and treatment outcomes in 198 patients with hand purulent diseases who had been admitted to Moscow City Hospital No. 4 was made by the authors. All patients were divided into four groups depending on the curative modality. In Group 1 (n = 53), a wound was sutured after surgery, and a drainage-lavage system (DLS) was installed; in Group 2 (n = 50), a wound was not sutured because of contraindications to suturing; in Group 3 (n = 46), patients had laser necrectomy after which a wound was sutured and DLS was installed; in Group 4 (n = 49), a wound was not sutured because of contraindications like in Group 2, but it was treated with antiseptic dressings and photodynamic therapy at an early postoperative period. Various aspects of the effectiveness of laser techniques have been analyzed: dynamics of wound healing, changes in wound defect size, level of pain syndrome assessed by VAS, changes in clinical blood tests, changes in wound exudate cytological picture as well as changes in wound microflora. Acceleration of wound healing was noted in all patients who were treated with laser light what, consequently, shortened their inpatient stay. Laser light also changed cytological and microbiological patterns of wound exudate, as evidenced by the decrease of wound detritus and by the decrease of microbial content in the wound. In patients, who were treated with laser light, less pain syndrome was registered immediately after laser technique application.The obtained findings demonstrate a positive effect of laser necrectomy with DLS at wound process as well. Photodynamic therapy significantly improved results in patients with open wound management on the hand and fingers. Laser techniques have good perspectives in purulent surgery of the hand.

Professor Gavriil Abramovich Ilizarov was born on June 15, 1921 in the town of Bialowiez in the Bialystok Voivodeship of the Polish Republic. Gavriil was able to go to school only at the age of 11, but his level of education allowed him to pass the exams for the elementary grades, and he was enrolled immediately in the fourth grade. He graduated from the eight-year school with excellent marks and in 1938 continued his studies at the medical faculty in the city of Buinaksk, Dagestan ASSR. In 1939, Gavriil Abramovich entered the Crimean State Medical Institute, after graduating from which in 1944 he worked as a doctor in Polovinskaya and then Kosulinskaya district hospitals of the Kurgan region. At this time, Ilizarov came up with a brilliant idea for the treatment of complex fractures of long tubular bones with the fixation of their fragments with a special metal controlled device instead of blind and static plaster immobilization. In 1955, G. A. Ilizarov was appointed head of the Traumatological and Orthopedic department of the Kurgan Regional Hospital for the Disabled of the Great Patriotic War, where he began to apply his invention. The first official scientific recognition of G. A. Ilizarov received his dissertation «Transosseous compression osteosynthesis by the author’s apparatus (experimental and clinical study)» in September 1968 in Perm. In 1966, on the basis of the 2nd city hospital of Kurgan, the problem laboratory of the Sverdlovsk Research Institute of Traumatology and Orthopedics was organized, the head of which was Gavriil Abramovich, and in 1969 the laboratory was transformed into a branch of the Leningrad Research Institute of Traumatology and Orthopedics named after R. L. Vreden and its director was appointed G. A. Ilizarov. Since 1982, the triumphant introduction of the Ilizarov method into the practice of leading foreign countries began, and the press gave the author the enthusiastic title of «Michelangelo in orthopedics». Gavriil Abramovich successfully engaged in public activities, was elected deputy of the district and regional Councils of Workers‘ Deputies, deputy of the Supreme Soviet of the RSFSR, People’s Deputy of the USSR. For his great achievements in medical science and outstanding services to the national and world health care, G. A. Ilizarov was awarded the highest state awards, academic and honorary titles of the USSR and many foreign countries. Academician Gavriil Abramovich Ilizarov died suddenly of heart failure on July 24, 1992 in Kurgan and was buried in the central alley of the new Riabkovskое cemetery in Kurgan.

Összefoglaló. Bevezetés: A 2019 végén Vuhanból kiinduló, SARS-CoV-2 okozta koronavírus-járvány jelentős hatást gyakorolt életünkre. Specifikus terápia hiányában az emberek egy része alternatív gyógymódokhoz fordult. Célkitűzés: Vizsgálatunk célja annak feltárása volt, milyen hatást gyakorolt a koronavírus-járvány a betegek komplementer gyógymódokhoz való viszonyulására elektív sebészeti műtétek előtt. Módszer: Egy magyarországi klinika és egy városi kórház elektív sebészeti műtétre váró betegei körében végeztünk anonim kérdőíves felmérést 2020. augusztus 3. és december 18. között. 279 kérdőívet dolgoztunk fel, a válaszadási arány 69,7% volt. Eredmények: A koronavírus-járvány hatására a válaszadók 91,4%-ának nem változott meg a véleménye a nem konvencionális kezelésekről, 8,2%-a bizakodóbban tekintett ezekre. A komplementer terápia betegségmegelőző hatása iránt a kitöltők 16,8%-a volt bizakodó, 25,4%-a elutasító, 57,7%-a nem formált véleményt. A válaszadók 24,7%-a vett igénybe élete során alternatív módszereket, a koronavírus-fertőzés megelőzésére csak a nyilatkozók 10%-a alkalmazna ilyen gyógymódokat. Kizárólag a pandémia hatására senki nem kezdett el komplementer gyógymódokat használni. A kérdőívet kitöltők 55,6%-a használt gyógynövénykészítményt élete során. A járvány ideje alatt a válaszadók 27,5%-a vett igénybe gyógynövénykészítményeket; a gyógymód alkalmazása és a vizsgált szociodemográfiai tényezők között nem találtunk összefüggést. A gyógynövények alkalmazása alacsonyabb mértékű volt a daganatos és a thromboemboliás betegek között. Következtetés: Vizsgálatunk alapján a komplementer gyógymódok használata feltehetően a járvány miatt elrendelt korlátozásokból adódóan csökkent, a gyógynövények alkalmazása azonban nem változott lényegesen. A válaszadók tizede használt komplementer gyógymódot a koronavírus-fertőzés megelőzésére. Orv Hetil. 2021; 162(42): 1678–1686. Summary. Introduction: The coronavirus epidemic caused by SARS-CoV-2 from Wuhan at the end of 2019 had considerable impact on our lives. In the absence of specific therapy, some people have resorted to alternative therapies. Objective: The aim of our study was to explore the effect of the coronavirus epidemic on the patients’ attitudes toward complementary and alternative medicine. Method: We have performed anonymous questionnaire survey among patients of a Hungarian university hospital and a city hospital waiting for elective surgery between August 3, 2020 and December 18, 2020. We received 279 questionnaires, the response rate was 69.7%. Results: As a result of the coronavirus epidemic, 91.4% of the respondents did not change their opinion about complementary and alternative treatments, 8.2% were more optimistic about them. 16.8% of respondents were optimistic, 25.4% rejected, and 57.7% did not form an opinion about the disease-preventing effect of complementary therapy. A quarter of respondents (24.7%) had used complementary therapies in their lifetime, with only 10% of respondents using such therapies to prevent coronavirus infection. As a result of the pandemic, no one started using complementary therapies. 55.6% of the respondents used a herbal preparation during their lifetime. In the course of the epidemic, a high proportion of respondents (27.5%) used herbal preparations; no correlation was found between the use of the treatment and the socio-demographic factors examined. The use of herbs was lower among cancer and thromboembolic patients. Conclusion: Based on our study, the use of complementary therapies presumably decreased due to the restrictions imposed in the epidemic, however, the use of herbs did not change significantly. One-tenth of the respondents used naturopathic cure to prevent coronavirus infection. Orv Hetil. 2021; 162(42): 1678–1686.

Introduction. According to available data, the frequency of prescribing antibacterial drugs to patients hospitalized with COVID-19 is many times higher than the level of bacterial infection recorded in them. This trend may make an extremely negative contribution to the problem of antibiotic resistance in the future, which makes it important to monitor and study the consumption of antibiotics in this category of patients.Aim of the study. To estimate the change in the consumption of antibacterial drugs in patients hospitalized with COVID-19 in a multidisciplinary hospital compared with the consumption in the pre-pandemic period, and to conduct a subsequent analysis of the detected changes.Materials and methods. This retrospective study, reviewed the medical records of patients hospitalized with COVID-19 in the Moscow city hospital No. 4 in the period from April 27 to December 31, 2020, as well as medical records of patients hospitalized in the same medical institution for the same period of 2019. Results of the use of antibacterial drugs were obtained. They were evaluated using the ATC/DDD methodology and then subjected to further analysis.Results. Total consumption increased from 31,576 DDD/100 bed-days to 220,609 DDD/100 bed-days among the patients hospitalized with COVID-19. The level of consumption of macrolides increased most significantly – from 0.024 DDD/100 bed-days to 147.898 DDD/100 bed-days. The level of consumption of penicillins increased from 2,346 DDD/100 bed-days to 15,892 DDD/100 beddays, cephalosporins – from 11.78 DDD/100 bed-days to 19,107 DDD/100 bed-days, fluoroquinolones – from 10,276 DDD/100 beddays to 25,535 DDD/100 bed-days.Conclusion. The consumption of antibiotics has increased dramatically on the backdrop of the COVID-19 pandemic. Based on the data of the frequency of bacterial complications in patients with COVID-19 (no more than 8%), a more rational approach to antibacterial therapy in this group of patients is needed to reduce the potential deterioration of the problem of antibiotic resistance.

In this study, it is aimed to determine the prominent themes related to the best practices of Yozgat, Isparta, Adana and Mersin City Hospitals. While best practices within existing city hospitals will guide other city hospitals to be opened in the future, it is aimed to benefit city hospital managers in order to improve processes, ensure sustainability and manageability. Using the in-depth interview technique as a qualitative research, face-to-face interviews lasting approximately 830 minutes were conducted with a total of 18 personnel in various positions from the top management to the lower levels of the city hospitals between April and July 2018. Data were collected with the participants through a semi-structured questionnaire. Interview questions are grouped under seven main functions. The functions of the study consist of facility management, human resources management, hotel services management, supply chain management, governance practices, patient safety practices and electronic health record-based value-added applications. In the NVIVO 12.0 qualitative analysis program, each function was evaluated separately and analyzed with the content analysis technique; themes and codes were determined, and good practices used in city hospitals were revealed. As a result, findings that will guide other hospitals on basic issues such as administrative functions and health informatics are included in order to minimize the possible problems that may be experienced in the city hospitals opened and planned to be opened in our country with best practices. The findings obtained as a result of the qualitative analysis were discussed and interpreted., Bu çalışmada Yozgat, Isparta, Adana ve Mersin Şehir Hastanelerinin iyi uygulama örnekleri ile ilgili öne çıkan tema, kategori ve kodların tespit edilmesi amaçlanmıştır. Mevcut şehir hastaneleri bünyesindeki iyi uygulama örneklerinin gelecekte açılacak olan diğer şehir hastanelerine yol göstermesi sağlanırken, süreçlerin iyileştirilmesi, sürdürülebilirliğin ve yönetilebilirliğin sağlanması adına şehir hastaneleri yöneticilerine de fayda sağlaması hedeflenmektedir. Nitel bir araştırma yöntemlerinden yüzyüze derinlemesine görüşme tekniği kullanılarak 2018 Nisan – Temmuz ayları arasında Şehir hastanelerinin üst ve orta düzey çeşitli pozisyonlarda görev yapan toplam 18 yönetici ile yaklaşık 830 dakika süren görüşmeler gerçekleştirilmiştir. Veriler katılımcılarla yarı-yapılandırılmış görüşme formu aracılığıyla toplanmıştır. Görüşme formunda yer alan sorular yedi tema altında toplanmıştır. Çalışmanın temalarını tesis yönetimi, insan kaynakları yönetimi, otelcilik hizmetleri yönetimi, tedarik zinciri yönetimi, yönetişim uygulamaları, hasta güvenliği uygulamaları ve elektronik sağlık kaydı temelli katma değerli uygulamalar oluşturmaktadır. NVIVO 12.0 nitel analiz programında her bir tema ayrı ayrı değerlendirilerek içerik analizi tekniği ile çözümlenmiş; kategori ve kodlar belirlenmiş, şehir hastanelerinde kullanılan iyi uygulamalar ortaya çıkarılmıştır. Sonuç olarak, Türkiye’de açılmış ve açılması planlanan şehir hastanelerinde yaşanması muhtemel problemlerin iyi uygulama örnekleri ile minimuma indirgenebilmesi için diğer hastanelere yönetsel fonksiyonlar ve sağlık bilişimi gibi temel konularda yol gösterici nitelikte olacak bulgulara yer verilmiştir. Nitel analiz sonucu elde edilen bulgular tartışılarak yorumlanmıştır.

Aim of the study: to investigate chest compression parameters by city hospital staff under simulated conditions with and without the use of a sensor device for quality control of chest compressions.Materials and Methods. The study was conducted in Moscow's multidisciplinary hospitals. The study included 359 medical staff members. The participants were divided into 4 groups: physicians (n=97) and nurses (n=82) from intensive care units (ICU) and physicians (n=92) and nurses (n=88) from specialized departments. Participants performed 2 minutes of chest compressions without a chest compressions quality control (CCQC) sensor, followed by 2 minutes of chest compressions using a defibrillator sensor with audiovisual prompts from the device turned on. The percentage of target compressions, rate and depth of compressions were analyzed.Results. Compression parameters in the group of ICU doctors were outside the reference range (% target compression — 0.5 (0.0; 14.5)%, rate 124.1±17.8 per minute, depth 5.6±1.1 cm), in the group of ICU nurses, the percentage of target compressions was 0.0 (0.0; 3.5)%, rate — 123.6±23.7 per minute, depth — 5.3±1.2 cm, in the group of specialist doctors the percentage of target compressions was 0.0 (0.0; 1.2) %, rate — 123.8±23.2 per minute, depth — 5.8±1.2 cm, in specialized nurses group the percentage of target compressions was 0.0 (0.0; 6.1)%, rate — 119.7±29.5 per minute, depth — 5.6±1.2 cm. There was a significant improvement in compression performance in all groups when the sensor device was used: in ICU physicians the percentage of target compressions was 81.6 (64.80; 87.90)%, rate — 124.1±17.8 per minute, depth — 5.5±0.2 cm; in ICU nurses the percentage of target compressions was 69.1 (47.4; 80.6), rate — 123.6±23.7 per minute, depth — 5.3±0.3 cm, in specialist doctors the percentage of target compressions was 69.30 (50.50; 78.70), rate — 123.8±23.2 per minute, depth — 5.4±0.3 cm, in specialized nurses the percentage of target compressions reached 63.70 (42.90; 75.80), rate — 119.7±29.5 per minute, depth — 5.4±0.3 cm. There were no differences in analysed compression parameters between staff in different departments or positions.Conclusion. Compression parameters (percentage of target compressions, rate, depth) were not influenced by the department where the staff member worked and the position held (doctor or nurse). The use of a compression quality sensor device has improved compression parameters by reducing rate and normalizing depth. The use of the sensor does not increase the percentage of target compressions to the maximum values, indicating the need for training by an instructor.

Vitiligo commonly begins in childhood or young adulthood with peak onset between 10 to 30 years. From this study results it was found that females 83(55.3%)were more commonly affected with vitiligo than males 67(44.7%) and the most common affected age group is 31-50 (35.33%) and the most common site of onset of vitiligo was equal in upper limb and face seen in 71(47.33%) patients each, followed by lower limb sseenin50(33.33%) patients. The most common site involved in males was upper limb 32(47. 76%)and females was face 42(50.6%)were observed. The common type was common clinical type of vitiligo documented was vitiligo vulgaris, seen in 69(46%) patients. This was followed by mucosal vitiligo 36(24%), acrofacial22 (14.67%), segmental17 (11.33%) and vitiligo are ata6 (4%) and reported to be more common in B positive patients.

Objectives To determine the relative number of acute musculoskeletal injuries sustained by children due to different sports in a region of the UK, and assess the burden upon the NHS, through a cross sectional study. Methods Collection of data for every child aged 6-18 seen at the Peterborough City Hospital fracture clinic, whose sports injury was from 1st September 2018 – 31st August 2019 (1 school year; n=689). Data was gathered throughout the year by three children's orthopaedic surgeons, who consulted the clinic records, notes and x-rays of all children who had attended clinic. Results Boys were 2.7 times more likely to sustain injury than girls. Children aged 6-9 had few injuries (mean 24 injuries each year group), 10-15 had a large number of injuries (mean 84), and 16-18 again had few injuries (mean 35). Football and rugby were responsible for the majority of injuries (61% between them), as well as the majority of physiotherapy appointments (72%). Sports with the highest likelihood that an injury will be sufficiently serious to require surgery were equestrian (42% of injuries required surgery), gymnastics (27%), ice skating (25%) and rugby (22%). Popular sports in which injuries were relatively rare include swimming, athletics, cricket, hockey, tennis and badminton. Conclusion The sports that caused the most injuries were football and rugby. Considering relative participation in different sports, it is clear that rugby has a disproportionate number of musculoskeletal injuries in total, of severe injuries requiring surgery, and requiring rehab from physiotherapy.

Empathy is a process which helps a person to understand the feelings, thoughts and emotions of the other person by putting oneself in that person’s shoes. Nursing is a profession that requires emphatic skills in which communication between people is important in patient care. Not being able to approach the patient and the patient family with empathy, not being able to understand others can create a perception of providing incomplete service and is one of the causes of burnout in nurses. Burnout is important as it may cause anorexia, insomnia and lack of motivation individually in nurses, and also a decrease in the quality of nursing services. The aim of this study is to examine the association between nurses’ empathic skills and their burnout levels. The study was conducted with 289 nurses working in Elazığ Fethi Sekin City Hospital between July and September2020. The data were collected by using a questionnaire form prepared by the researchers, Empathic Skills Scale B-Form and Maslach Burnout Inventory. The study was designed as a correlational study to find out the association between nurses’ empathic skill levels and burnout levels. Mean age of the nurses in the study was 35.83±9.72. Mean working time in the profession was 12.57±9.7 years. Total mean score of nurses from Empathic Skills Scale was 138.93±18.11, while their mean scores from Masclach Burnout Inventory were 22.8±7.2 in emotional exhaustion subscale, 9.1±4.2 in depersonalization subscale and 20.0±6.3 in personal accomplishment subscale. Statistically significant difference was found between empathic skills scale and depersonalization subscale (p0.05). Negative association was found between empathic skills scale and depersonalization subscale. As the empathic scale scores increase, depersonalization subscale scores decrease.

Background: A preliminary survey of prospective researchers in the Kendari City General Hospital especially in the Emergency Installation (ER), the number of emergency room visits has decreased in the last 3 years, in 2017 the total number of patients treated in the ER was 10.869 patients, then in 2018 the number of visits decreased to 10.768 patients, and in 2019 the number of visits fell to 9.747 patients. Meanwhile, based on the data in the last few months in 2020 there was a very large spike in decline in the last month, in January 2020 the number of patient who visited, were 849 people, then in February 2020 the number of the patient were 1202 patients, March 2020 the number of visits was 1216 patients and finally in April 2020 it fell to 451 people. The purpose of this study is to analyse the effect of separation of the initial assessment documents on Length of Stay in Emergency Installation in Kendari City General Hospital. Methods: The research design was experimental with design pretest post-test one group design. The research location was in the Emergency Room of the Kendari City Regional General Hospital which was carried out during February 2021. The population of all patients who were hospitalized was> 17 years old while the sample was 18 people with the sampling technique of separated random sampling. Result: This study found separation of the initial assessment documents affected significantly to Length of Stay patients in Emergency room in Kendari City General Hospital (p- value = 0.045 < 0.05). Conclusion: Separation technique of the initial assessment documents on Length of Stay was effective to reduce the Length of Stay patients in Emergency room in Kendari City Hospital.

Objective: to study the use of RRT methods and their influence on the results of treatment of patients with severe COVID-19.Subjects and methods. We retrospectively analyzed the data of 283 patients with COVID-19 in the intensive care units of Moscow City Hospital no. 40 in 2020 who had received RRT as one of the treatment methods.Results. Frequency of RRT in COVID-19 patients in ICU of Moscow City Hospital no. 40 for 2020 made 5.7% (504 out of 8.711 patients treated in ICU received RRT). In 86% of cases, RRT was performed for renal indications. At the time of initiation of RRT, the studied groups did not differ according to SOFA score. The frequency of using dialysis units with high and low cut-off point in the groups of survived and deceased patients differed significantly. The surgery itself started at relatively the same time from the onset and statistically significantly earlier in the group of survivors from the beginning of tracheal intubation (4.9 ± 0.5 vs 6.8 ± 0.3 days, p = 0.0013). Against the background of ongoing therapy, overall severity of the state progressed in the group of deceased patients to 9.9 ± 0.2 SOFA scores, while in the group of survivors there was an improvement to 6.1 ± 0.4 scores.

Aim It is a rare need for IHT that an existing hospital is scheduled to be closed. In this study, the process of Mass Transport due to the relocation of five different hospitals to a single target hospital is discussed. Methods Meetings were held with hospital administrators to plan the Mass Transport and an emergency transport action plan was decided. During the planning phase of the Mass Transport, each hospital was examined separately and in-hospital and inter-hospital transfer routes were created. During the Mass Transport, spare ambulances were activated to avoid disrupting the daily workflow of emergency medical services (EMS). In addition, EMS administrations of nearby provinces were asked to send their spare ambulances to Ankara. While 1 driver and 2 paramedics were assigned to a stable patient transport team, 1 driver, 1 paramedic and 1 doctor were assigned to a critical patient transport team. Results The patients who were transported from the clinics comprised 24.95% (n = 130) of all transported patients. Of all patients transported, 56.81% (n = 296) were males. The mean age of all transported patients was 46.33 ± 26.04 years (min-max; 0 - 93) (46.21 ± 26.45 years for females, 46.43 ± 25.56 years for males). Conclusion Pre-transport planning and measures are crucial for the safe transport of patients, especially in large-scale IHTs. In addition, an effective communication system ensures a trouble-free transport.

The aim of the study is to improve the organization and provision of surgical care to civilians with gunshot wounds to the chest in the context of armed conflict on the example of the Chechen campaign.Materials and methods. The work is based on the analysis of medical care provided to 106 wounded with gunshot wounds to the chest from the civilian population in the period from 1991 to 2000. Medical care was provided on the basis of the surgical hospital of the city hospital No. 9 in Grozny.Results and discussion. Found that providing medical care to wounded with gunshot wounds of the chest when massive flow in terms of actual hostilities rendered by the forces and means of civil hospitals, has a certain specificity. It is due to the fact that in such conditions, in contrast to military medical organizations, there are no stages of evacuation, often the wounded are delivered by non-specialized and unsuitable vehicles on destroyed roads, while they are not given or given insufficient pre-medical care. In such conditions, the workload of medical personnel of civil medical institutions associated with the provision of medical care increases. In this regard, in our opinion, it is necessary to develop measures aimed at improving the algorithm aimed at minimizing various errors that occur in civilian medical institutions during the mass admission of wounded.

The objective of the study: to analyze the frequency of admission of tuberculosis patients to general medical units, to describe medical and social parameters of patients – sources of tuberculous mycobacteria which form a nosocomial center of tuberculosis infection.Subjects and methods. The following sources of information were used: Reporting Form no. 8 on Active Cases of Tuberculosis, data from the Annual Reporting Form on Analysis of Infectious Diseases Carrying drawn up by City Center for Medical Prevention in Yekaterinburg, Register of Infectious Diseases (Form no. 060/y), and 74 documents of Medical File of the Patient Receiving In-Patient Treatment (Form no. 003/y) for tuberculosis patients admitted to a therapy department of the city hospital.Results. Despite the decreasing tuberculosis incidence among Yekaterinburg residents, there was no significant decrease in the frequency of hospital admissions of patients with this disease to general medical units. Of all tuberculosis patients admitted to general medical units, 40.0 ± 2.7% were admitted to therapy departments. Duration of stay in a therapy department of tuberculosis patients excreting tuberculous mycobacteria made more than 7 days for 70% of such cases before they were discharged. The destruction phase was diagnosed in 56.8 ± 5.8%, 13.5 ± 4.0% had massive bacterial excretion documented by sputum microscopy. The frequency of TB/HIV co-infection made 43.2 ± 5.8%.Conclusion. In a therapy department, there is a high risk of getting infected with tuberculosis infection among patients and personnel who are exposed to a tuberculosis case.

Objective: We aimed to investigate whether there is a predisposition to COVID-19 with ABO and Rh blood group systems. Methods: The clinical data of 455 patients with COVID-19 seen between April 17, 2020, and June 30, 2020, at the Necip Fazıl City Hospital were retrospectively analyzed studied. The differences in the ABO blood group distribution between COVID-19 patients and the control group (7844 cases) were analyzed. Results: The percentage of patients with type O blood in the COVID-19 group was significantly lower than that in the control group (29.7% vs. 35.6%, p = 0.009). The percentage of patients with type A and B blood in the COVID-19 set was higher than in the control group however, there were no significant differences, respectively (44.4% vs. 40.8%, 19.3% vs.16.6%, p = 0.134, p=0.123). Patients with blood group O had a lower risk of COVID-19 than A, B blood group patients (respectively; OR = 0.732, OR=0.594, p = 0.023, p=0.001). The risk of COVID-19 was higher for patients with blood groups A and B than with a blood group 0 (OR = 1.365, OR= 1.684, p = 0.023, p=0.001). The Rh blood group phenotype was not statistically significant in determining a patient’s vulnerability. Conclusion: The results of the present study suggest that while the blood group 0 had a low risk and decreased risk for infection with SARS-CoV-2, whereas blood group A and B were associated related with an increased risk, indicating that certain specific ABO blood groups were connected correlated with SARS-CoV-2 susceptibility.

OBJECTIVE To investigate the prognostic value of tumor diameter in the short term of 3 and 5 years in patients operated for gastric cancer. STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Kartal Dr Lutfi Kirdar City Hospital, Istanbul, Turkey, from January 2014 to December 2018 Methodology: A total of 125 patients with stage 2 or 3 gastric cancer, followed up in the Department of General Surgery, were included. Demographic information, clinical, laboratory, and pathology reports were analysed in terms of postoperative 30-day mortality. RESULTS The mean age of the patients was 63.9±11.9 (31-88) years. Forty-four (35.2%) were in stage 2, and 81 (64.8%) were in stage 3 cancers. The mean tumor diameter was 6.5±3.1 cm, and the mean metastatic lymph node rate was 35.6±29.8%. The mean follow-up period was 31.8±21 months. The 3-year and 5-year survival rates were 39.8% and 17.6%, respectively. Tumor diameter was not directly related to survival, differentiation, number of resected lymph nodes, number of metastatic lymph nodes, and metastatic lymph node rate in stage 2 and 3 cases (p>0.05 for each). The 5-year mortality risk was 1.2-fold higher in those with tumor diameter over 6.5 cm (95% CI 0.7-2.0; p=536). CONCLUSION The tumor size did not have a direct effect on prognosis. It did not provide reliable data about short-term prognosis such as 3 and 5 years in stage 2 and 3 gastric cancer cases. Key Words: Gastric cancer, Stage 2, Stage 3, Tumor size, Prognosis.

Objective Our aim is to determine the incidence and distribution of anomalies found in the pregnant women referred to the first obstetric radiology outpatient clinic of our hospital for ultrasound (US) examination in 2019. Methods A total of 5661 obstetric US examinations were performed in 4018 pregnant women, 588 of whom were foreigners, for routine control, follow-up and screening purposes between January 1 and December 31, 2019, and their results were analyzed retrospectively after obtaining the approval of ethics committee. All US examinations were conducted by a single radiologist (ŞT) with Canon Aplio 500 ultrasound device (Canon Medical Systems Corporation, Tokyo, Japan) using 3.5 Mhz convex probe. The results of the cases with anomalies were accessed and grouped systematically, and their incidence and distribution were reviewed by comparing with the literature. Results As a result of the reviewed obstetric US examinations, a total of 62 fetuses with anomalies, 17 of whom were from the foreign pregnant women, were found to have anomalies. Of these anomalies, 29 were craniospinal, 10 were genitourinary, 6 were cardiac, 6 were skeletal, 3 were gastrointestinal, 2 were thoracic and 6 were unclassified. The pregnant women were between 17 and 43 (27.5±7.21) years old and their weeks of gestation were varying between 11 and 39 (22.3±8.63) weeks. There were 8 (13%) pregnant women younger than 20 years old, 43 (69%) pregnant women between 20 and 35 years old, and 11 (18%) pregnant women older than 35 years old. Anomaly diagnosis was established during first trimester in 14 (22.5%) fetuses, 26 (42%) fetuses during second trimester, and 22 (35.5%) fetuses during third trimester. Conclusion We found in our study that the incidence of fetuses with congenital anomaly was 1.54% in total, 2.89% in foreigners and 1.31% in Turkish citizens. The most common anomaly is acrania with 7 (0.15%) cases, and the diagnosis was established during first trimester in six of them. Detailed fetal screening during first trimester is very important for the detection of non-chromosomal anomalies. However, second- and third-trimester examinations are also important for the accurate diagnosis in pregnancies without follow-up.

Objectives: This study aims to investigate Chest CT findings and RT-PCR results in patients hospitalized with suspicion of COVID-19. Materials and Methods: Between 15 March and 15 May 2020, patients hospitalized in Yozgat City Hospital with suspicion of Covid-19 were evaluated retrospectively. Chest CT findings were classified according to the modified COVID-19 reporting system created for this study. RT-PCR reference diagnostic test was accepted and the diagnostic performance of CT was evaluated. Results: A total of 498 patients [54±22 (0;96)] were included in the study. The number of male patients [323 (65%)] was higher than female [175 (35%)]. RT-PCR test was positive in 94 (19%) of the patients. Patients with positive test results were found to be younger than negative ones. Chest CT was positive in 173 (35%) patients: 13% COVID-19 typical findings, 7% high suspect findings, 15% low suspect findings. The sensitivity of CT was 49%, the specificity was 69%, and the sensitivity of RT-PCR was 69%. Infiltrations in CT positive cases were seen in the following areas: 52% in both lungs, 40% in all lobes, 34% in lower lobes, 47% in the posterior, 43% in the anterior and posterior lung regions, 60% in the peripheral, 30% peripheral and central lung regions. Conclusion: The sensitivity of chest CT in the diagnosis of COVID-19 was relatively low, but had high specificity. It may be more beneficial to use CT for rapid diagnosis in regions with a high prevalence of COVID-19. Using a standardized report format to evaluate CT findings seems necessary for patient management. © 2021 Journal of Food Science and Technology (Iran). All rights reserved.

Introduction In this study, the use of lung ultrasonography (LUS) to diagnosis lung findings was evaluated in patients with suspected COVID-19 who were admitted to the emergency department (ED). Methods This observational clinical study was conducted in the ED of the Ankara City Hospital during the period April 1–30, 2020. Patients who were admitted to the ED were triaged as COVID-19 infected and who agreed to undergo LUS/LCT (lung computed tomography) were included in the study. Results Included in the study were 40 patients who had been prediagnosed with COVID-19. Pneumonia was detected with LCT in 32 (80%) patients, while the LUS examination identified pneumonia in 23 patients. The most common finding in LCT was ground-glass opacity (n = 29, 90.6%). Of the 23 patients with pneumonia findings in LUS, 15 (65.2%) had direct consolidation. Among the 32 patients who were found to have pneumonia as a result of LCT, 20 (62.5%) had signs of pneumonia on LUS examination, and 12 had no signs of pneumonia. In addition, 3 patients showed no signs of pneumonia with LCT, but they were misdiagnosed with pneumonia by LUS. The sensitivity of LUS in the diagnosis of pneumonia in the COVID-19 patients was 62.5%, while its specificity was 62.5%. In addition, its positive predictive value was 87.0%, and its negative predictive value was 29.4%. Conclusion LUS may also be used in the diagnosis of pneumonia in COVID-19 patients because it is a valuable and accessible bedside diagnostic tool. Electronic supplementary material The online version of this article (10.1007/s10049-020-00807-3) shows RT-PCR results of patients with a definitive diagnosis of COVID-19 by lung computed tomography and patients with pneumonia detected by lung ultrasonography. The article and additional material are available at www.springermedizin.de. Please enter the title of the article in the search field. You will find the additional material under “Ergänzende Inhalte” in the article.

Nurse job satisfaction is one of the factors affecting work productivity. Job satisfaction is influenced by the leadership style applied by the chief nurse in leading his subordinates. The purpose of this study was determined the relationship between the leadership style of the chief nurse and the nurse's job satisfaction in the inpatient room at Idaman City Hospital in Banjarbaru. This research approach used cross sectional. The population was all nurses in the inpatient room with a total of 119 nurses. Sampling used quota sampling as many as 102 respondents. There were 3 research instruments used, consisted of questionnaire respondent characteristics, nurse job satisfaction and leadership style of the chief nurse. The method used by events that carry out actions on respondents, has been observed. The correlational and survey approaches used in this study were to present a questionnaire. The leadership style of nurse manager has an average of 57.90 (50-72). Nurse job satisfaction has rather average of 62,82 (38-96). There was a relationship between the leadership style of the chief nurse and the nurse's job satisfaction in the inpatient room at Idaman City Hospital in Banjarbaru (p-value = 0,000

The objective of the research - to determine the the T786C polymorphism of nos3 gene effect on the level of nitric oxide metabolites among patients with non-valvular paroxysmal atrial fibrillation.Material and methods. To achieve this goal, a prospective study was conducted on the basis of the communal uncommercial company “City Hospital № 10” of Zaporizhzhia City Council. The sample of patients was conducted in the period from 2014 to 2019. The results of the study are based on data from a comprehensive examination and dynamic monitoring of 176 patients with paroxysmal atrial fibrillation on the background of coronary heart disease combined with hypertension, of which 98 were from the city of Zaporizhzhia and 78 were from rural areas. Almost healthy 31 volunteers were examined on an outpatient basis.Results. Plasma NO2 levels in both groups area urban and rural patients - 7.02 [5.74 ; 8.14] mmol/L and 6.77 [5.47 ; 7.98] mmol/l, respectively, were significantly lower compared to 8.46 [7.45 ; 9.45] mmol/L in the healthy group (p0.05). Conclusions. Decreased nitric oxide metabolites occur among patients with non-valvular paroxysmal atrial fibrillation compared with the healthy group. The level of nitrate-ions in the group of patients from the city was significantly lower than in the group of patients from the rural areas. The level of nitrite-ions was lower among patients with the C allele of the T786C polymorphism of the 3 type of nitric oxide synthase gene, whereas the value of nitrate-ions did not depend on this polymorphism.

Privat-docept of Kazan University in the Department of Nervous and Mental Diseases and Assistant at the Department of Psychiatry, Doctor of Medicine B.I. Vorotynskiy was appointed senior physician of psychiatr. dep. Odessa city hospital. We sincerely congratulate Dr. B. I. Vorotynsky on his appointment and are glad that the Odessa City Administration has chosen a person of high quality and serious scientific and practical training, which we are well aware of. The society of neuropathologists and psychiatrists, with regret, is parted with him, as with one of the most active of its members, and the editorial board of our magazine with a secretary who has performed this duty since the foundation of the Society and the journal.

Tujuan penelitian ini adalah untuk mengetahui dan menganalisis pengaruh ambient condition, desain factor, dan social factor, secara bersama-sama terhadap kepuasan pelanggan RSUD Kota Bogor. Penelitian ini akan dilaksanakan di Rumah Sakit Umum Daerah (RSUD) Kota Bogor. Populasi penelitian ini adalah pasien Farmasi RSUD Kota Bogor, dengan kondisi pasien yang sudah lebih dari dua kali atau lebih berobat dan mengambil obat di Instalasi Farmasi RSUD Kota Bogor, yaitu sebanyak 340. Dalam penelitian ini jumlah sampel yang di ambil berjumlah 184 dengan rumus slovin. Analisis data menggunakan regresi linear dengan bantuan program SPSS. Hasil penelitian menunjukkan (1) Terdapat pengaruh positif dan signifikan ambient condition terhadapkepuasan pelanggan dengan nilai t hitung variable ambient condition= 2.176 lebih besar dari nilai t tabel 1,972, dengan nilai signifikansi 0,031 < 0,05. (2) Terdapat pengaruh positif dan signifikan desain factor terhadap kepuasan pelanggan dengan nilai t hitung variabel desain factor = 11.255 lebih besar dari nilai t tabel 1,972, dengan nilai signifikansi 0,000 < 0,05. (3) Terdapat pengaruh positif dan signifikan variable social factor terhadap kepuasan pelanggan dengan nilai t hitung variabelsocial factor = 7.466 lebih besar dari nilai t tabel 1,972, dengan nilai signifikansi 0,000 < 0,05. (4) Terdapat pengaruh positif dan signifikan variabel ambient condition, desain factor, dan social factor secara bersama-sama terhadap kepuasan pelanggan dengan nilai F hitung 48.493 > F table 2,653.

At Makassar City Hospital, one of the service indicators that has not been achieved is in incomplete medical record files and medical record files that are returned more than 2x24 hours after service. This study aims to analyze the implementation of the completeness of filling in and the timeliness of returning inpatient medical record files at the Makassar City Hospital. This type of research is mixed methods research. The study design used a cross-sectional approach. The study was conducted in September - October 2020. The results showed that the implementation of completeness of filling in and the timeliness of returning medical record files was still low, this has led to the accumulation of medical record files in the treatment room and delays in returning the files of inpatients to the medical record installation of the City Hospital Makassar. Training on the implementation of medical records has not been comprehensive for all officers at the Makassar City Hospital. The result of the delay in returning the documents is the delay in payment of insurance claims to the hospital. Accumulation of medical records in the treatment room from incomplete medical records and returned to the treatment room. Health workers who forget to fill in complete medical records are only given a sanction in the form of a warning during a meeting with the medical committee. Availability of SOP on filling and returning medical record files at the hospital. The facilities and infrastructure in the implementation of medical records are still insufficient for medical record employees at Makassar City Hospital. It is recommended that the hospital improve the implementation of the completeness and timeliness of returning medical record files, provide incentives or rewards for completing filling in, increase the number of computers and expand the room in the medical record installation, and review the medical record format at Makassar City Hospital

Vascular closure devices, used for over 20 years as an alternative to manual compression to achieve hemostasis. Although the clinical effi cacy and safety of clip application devices type VCD have been confi rmed in several studies, their use remains controversial due to complications in the access by using these devices. The purpose of this study — comparing the frequency of formation of regional vascular complications , risk factors for these complications, hemostatic time, duration of immobilization, the period of stay in hospital and the patients comfort level after percutaneous coronary interventions (PCI) with the traditional manual hemostasis and using VCD. For a retrospective analysis of medical records were selected 246 adult patients from City Hospital of Moscow n.a. M.P. Konchalovskiy, SMRC in Moscow which was performed PCI. The main group, where hemostasis after endovascular procedures was achieved with the help of clip application device StarClose SE (Abbott Vascular), made up of 128 patients, control group — 118 patients with carrying out manual hemostasis. Evaluation of subjective sensations (pain, numbness, etc.) was carried out using a rating scale. The frequency of complications in the study group was 6.25% in the control group — 6.78%. The comfort level of patients was higher in the study group. The results showed that the use of StarClose device to achieve hemostasis after PCI does not increase the frequency of regional vascular complications compared with manual hemostasis. At the same time, the use of vascular closure devices is an eff ective way to reduce hemostasis time, can reduce the period of immobilization of the patient, which increases patient comfort and reduces the patient’s stay in the hospital.

Keputusan Menteri Kesehatan tentang Standar Pelayanan Minimal menyatakan bahwa diharapkan tidak adanya kejadian kesalahan pemberian obat sebesar 100%, hal itu berarti bahwa seharusnya kejadian kesalahan pemberian obat atau medication error tidak boleh terjadi satupun dalam pelayanan kesehatan. Terjadinya medication error di instalasi Rawat Inap RSUD Kota Padangsidimpuan tahun 2015-2017 sebanyak 13 kejadian, meskipun sebagian besar kasus tidak terjadi dampak yang sangat fatal. Penelitian ini bertujuan untuk menganalisis faktor yang berpengaruh terhadap terjadinya medication error yang dilakukan perawat Instalasi Rawat Inap RSUD Kota Padangsidimpuan. Jenis penelitian ini adalah survei analitik dengan menggunakan pendekatan cross sectional. Populasi adalah seluruh perawat yang secara langsung berinteraksi dengan pasien. sebesar 122 perawat yang terbagi dari 11 ruangan didapat sampel sebanyak jumlah sampel keseluruhan sebanyak 93 perawat. Data diperoleh dengan wawancara menggunakan kuesioner dan dianalisis menggunakan uji regresi logistik berganda dengan α = 0,05 dan tingkat kepercayaan 95%. Hasil penelitian menunjukkan bahwa variabel yang memberikan pengaruh signifikan terhadap variabel terhadap terjadinya medication error yang dilakukan perawat Instalasi Rawat Inap RSUD Kota Padangsidimpuan adalah variabel kondisi lingkungan dengan nilai p value = 0,002, variable beban kerja dengan nilai p value = 0,007, dan variable edukasi dengan nilai p value = 0,001. Kesimpulan diperoleh bahwa manajemen RSUD Kota Padangsidimpuan perlu memberikan sosialisasi di bidang pengetahuan dan keterampilan mengenai obata-obatan atau farmakologi maupun medication error guna meminimalisir angka kejadian medication error hingga 0 untuk dapat memenuhi Standar Pelayanan Minimal Rumah Sakit.

The incidence of meningioma is known to vary by gender and ethnicity. This study aimed to describe the epidemiological characteristics of a 10-year cohort of patients undergoing meningioma resection at Auckland City Hospital, Auckland, New Zealand. Of particular interest was whether there was any difference in meningioma incidence and recurrence rates between New Zealand Maori and Pacific Island patients compared with other ethnic groups. The study was a retrospective analysis of 493 patients with pathologically confirmed meningioma over the period 1 January 2002 to 31 December 2011. Based on this neurosurgical cohort, the minimum incidence of meningioma in the Auckland region was 3.39 per 100,000 population per year (95% C.I. 3.02-3.80) for the study period. Meningioma was significantly more common in women than men by a ratio of 4.2:1. New Zealand Maori and Pacific Island patients had a significantly higher incidence of meningioma than other ethnic groups. New Zealand Maori had a meningioma incidence 2.74 times that of Europeans (95% C.I. 2.01-3.73, p 0.001). Pacific Island patients had 2.03 times higher incidence of meningioma than Europeans (95% C.I. 1.42 - 2.89, p 0.001). The overall meningioma recurrence rate was 21.6% with a mean follow-up of 77 months. Recurrence rates for meningioma among Pacific Island patients were significantly higher than for other ethnic groups (hazard ratio 1.73, p = 0.008). Multivariate analysis of clinical variables confirmed the significance of traditional prognostic factors such as WHO tumour grade and Simpson grade of surgical excision in predicting meningioma recurrence.

BACKGROUND: The New Zealand Government announced a four-level COVID-19 alert system soon after the first confirmed case in the country New Zealand moved swiftly to the highest alert level 4, described as lockdown, as the epidemic curve quickly accelerated Auckland City Hospital saw a temporary change in acute surgical admissions The aim of this study is to evaluate the impact of the national lockdown on emergency general surgery METHODS: A retrospective analysis was performed of all patients admitted to Auckland City Hospital via the Acute Surgical Unit during lockdown from 26 March to 27 April 2020 A comparison group was collected from the 33 days prior to lockdown, 22 February to 25 March 2020 RESULTS: The number of admissions decreased by 26% (p-value 0 000) A 56 8% decrease in patients presenting with trauma was found (p-value 0 002) After exclusion of trauma patients, no statistical difference in discharge diagnosis was found There was a 43 6% reduction in operations performed (p-value 0 037) There was a difference found in the management of appendicitis and cholecystitis (p-value 0 003) Median length of stay was decreased from 1 8 to 1 3 days (p-value 0 031) CONCLUSION: Auckland City Hospital had a decrease in admissions and operations during the COVID-19 lockdown These findings suggest people with serious pathology were staying at home untreated or being treated in the community This is a snapshot of our experience in managing emergency general surgical patients in this unusual period This article is protected by copyright All rights reserved

Offering the attention of comrades a report on the maternity ward of the Odessa City Hospital for 1893 and having in mind to publish such reports annually, I think it is not without interest to preface a few words about the internal structure of this department and about the procedures established during the birth of a woman in childbirth and birth in period.

Although almost every day in the literature there are accumulated cases of extrauterine pregnancy, which were operated with excellent outcomes, but to this day, ectopic pregnancy does not cease to be of particular interest to practitioners, not only for the excellent results of surgical intervention, but mainly, for difficulties diagnosis and in its topographic diversity, in view of which in the following I will cite two stories of patients with ectopic pregnancy, operated by me in the Saratov city hospital in 1893/4.

Introduction: Tracheostomy is one of the most common procedures that done to critical patients such as head injury ones to improve their situation. It is done by creating an anterior stoma in the neck and inserting a short tube to maintain stoma open. Objective: The objective of this study was to determine if there were benefits of early tracheostomy and the following components: ICU stay, hospital stay, ventilation- associated-pneumonia, weaning from Mechanical Ventilator, Glasgow Coma Scale, and decannulation. Methods: This study was done retrospectively, and non-random sampling involved 56 head injury patients with a tracheostomy who were admitted to ICU in King Abdulaziz medical city (KAMC). Out of 56 head injury patients who underwent an early tracheostomy (≤12 days) were 25 patients and late tracheotomy (>12 days) were 31 patients. Using data collection form which contains demographic data, intubation duration, tracheostomy, decannulation, MV, Glasgow coma scale, VAP, ICU, and hospital stay. Results: Total of 56 head injury patients with tracheostomy; their age ranges from 18-80 years with the mean 41.77years, height 168.95cm, and weighs 69.07kg. Head injury patient in this paper was classified according to the day that was done the procedure on after the injury occurred. Which result in 25 patients had early tracheostomy ≤12 days with a mean of (9.8 days) and median (10), whereas 31 patients had late tracheostomy >12 with mean of (17.677 days) and median (16).Patients with early tracheostomy showed significant (P-value