A study on the surgical pathology of the Cao Bang hospital in the summer- autumn, 2000 has shown that the emergency operation: included the digestive operation (mainly) folowings were traumatic, cardiovascular operations, cranial and cerebral operation and urological operation(rarely). The schedule operations comprised the thyroid disease, plastic surgeries and the digestive operation. The results suggested that it should strengthen the medical equipments for the digestive operation theatre and traumatic operation theatre.
Operations Research ; Milieu Therapy

Delivery Of Health Care ; Research ; Health ; Operations Research

From 25 January 2002 to 11 May 2004, there were 200 patients operated at National Hospital of Endocrinology for treatment of Grave’s disease. Ratios of male/female were approximately 2/8. Most of them were in the range of age from 20 to 49 years old (81.0%). The operative indication included the euthyroid cases. The preoperative preparing by Lugol solution, prednisolon was necessary. The techniques of operation included: total thyroidectomy for 14 patients (7%), near total thyroidectomy with small amount of thyroid tissue left at the superior pole for 9 (4.5%), and with posterior wall remnant for 177 (88.5%). The total thyroidectomy was performed for patients who were accompanied with nodules, were allergic to synthesis anti-thyroid drugs, or severe ophthalmopathy. There were no mortality as well as thyroid storm and tarchycardia after operation. There were 3 cases had to be reoperated due to hemorrhage, 3 cases of transient hoarseness (1.5%), 19 cases of transient hypocalcaemia (9.5%).Only 64 patients came to hospital for reexamination at 3 months after operation. Among them, there were 58 euthyroid cases (90.7%) with FT4 in normal limit
Graves Disease, Operations Research, Therapeutics, Surgery

Operations Research (OR), also called Operational Research in the United Kingdom (UK), uses various computational tools for solutions to complex problems within a system. It deals with challenges in planning, scheduling, forecasting, process analysis and decision analysis. It also addresses individual components of the system. The methodology used for decisions based upon stochastic (random) processes can also be adapted for the common general medical ward round. Operational Research techniques add speed, efficiency, quality and consistency to the documentation in the case notes, and reduces the time taken for ward rounds. There is obvious benefit to the individual patient. It also acts as a learning tool which can be audited, and lends itself to research questions.
Humans ; Medical Audit ; Operations Research ; Quality Assurance, Health Care ; methods

Operations research (OR) focuses on the application of analytical methods to facilitate better decision-making. Despite its usefulness and proliferation of papers in the academic literature, there are still major issues around getting OR models widely accepted and used as part of mainstream decision-making by clinicians, health managers and policy-makers. This article aims to raise the awareness of healthcare managers with regard to practical OR applications.
Decision Making ; Health Facility Administrators ; Humans ; Models, Theoretical ; Operations Research

Background: The COVID-19 pandemic posed challenges in making time-bound hospital management decisions. The University of the Philippines -Philippine General Hospital (UP-PGH) is a tertiary COVID-19 referral center located in Manila, Philippines. The mismatch of increasing suspected or confirmed COVID-19 infected mothers with few documented cases of infected infants has caused significant patient overflow and manpower shortage in its NICU. Objective: We present an evaluated scheme for NICU bed reallocation to maximize capacity performance, staff rostering, and resource conservation, while preserving COVID-19 infection prevention and control measures. Methods: Existing process workflows translated into operational models helped create a solution that modified cohorting and testing schemes. Staffing models were transitioned to meet patient flow. Outcome measurements were obtained, and feedback was monitored during the implementation phase. Results: The scheme evaluation demonstrated benefits in (a) achieving shorter COVID-19 subunit length of stay; (b) better occupancy rates with minimal overflows; (c) workforce shortage mitigation with increased non-COVID workforce pool; (d) reduced personal protective equipment requirements; and (e) zero true SARS-CoV-2 infections. Conclusion Designed for hospital operations leaders and stakeholders, this operations process can aid in hospital policy formulation in modifying cohorting schemes to maintain quality NICU care and service during the COVID-19 pandemic.
COVID-19 ; Operations Research ; Intensive Care Units, Neonatal

The photon energy spectrum of KRISS 60Co irradiation system (AECL Eldorado 8) was calculated by means of the Monte Carlo method. The collimators were modeled realistically, and the material and dimensions of the 60Co sealed source were extracted from the source certificate given by the manufacturer. It was confirmed that the photon energy spectrum of KRISS 60Co irradiation system was in similar shape with those of NRC and BIPM.
Monte Carlo Method

The Monte Carlo method cannot have been used for routine treatment planning because of heavy time consumption for the acceptable accuracy. Since calculation time is proportional to particle histories, we can save time by decreasing the number of histories. However, a small number of histories can cause serious uncertainties. In this study, we proposed Monte Carlo dose computation time and uncertainty reduction method using specially designed filters and adaptive denoising process. Proposed algorithm was applied to 6 MV photon and 21 MeV electron dose calculations in homogeneous and heterogeneous phantoms. Filtering time was negligible comparing to Monte Carlo simulation time. The accuracy was improved dramatically in all situations and the simulation of 1% to 10% number of histories of benchmark in photon and electron dose calculation showed the most beneficial result. The empirical reduction of necessary histories was about a factor of ten to fifty from the result.
Monte Carlo Method ; Uncertainty

The dose verification methods in advanced radiotherapy are elaborated in this paper. The usage and application results for various dosimeters in dose verification are explained. As a theoretical method, Monte Carlo simulation, which has been developed greatly in recent years based on the technical progress in computer science, can be also used in dose verification with unique advantages. On the other hand, the principle of dose verification on proton and heavy-ion therapy is discussed briefly. Finally, the evaluation criteria for verification and the future development for dose verification are presented.
Humans ; Monte Carlo Method ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted

OBJECTIVETo study population pharmacokinetics of phenytoin in pediatric patients by using sparse data.

METHODSWe used routinely collected therapeutic drug monitoring data, derived from the steady state serum concentrations of phenytoin in 42 pediatric outpatients with epilepsy. Depending on whether the patients were administered with phenytoin alone or coadministered with phenobabital or clonazepam, the subjects were divided into two groups: phenytoin group and coadministration group. The population parameter and individual parameter of phenytoin in children were estimated using Monte Carlo method.

RESULTSThe children's phenytoin population pharmacokinetic parameters Vm and Km were 9.8 mg.kg(-1).d(-1) and 2.73 mg/L in phenytoin group; and 9.2 mg.kg(-1).d(-1) and 3.24 mg/L in coadministration group. There were good relationship between predicted and determined concentrations with correlation coefficient of 0.999 and 0.984, respectively.

CONCLUSIONThe coadministration of phenobarbital or clonazepam obviously affected the pharmacokinetics of phenytoin. The population pharmacokinetics of phenytoin in children may provide a usefull index for individualization of dosage regimen.