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Biomedical subjects

V Sivarajasingam

Publications and source records attributed to V Sivarajasingam.

At least 19 recordsLinked to original sources
PubMed2006

Confidential registration in health services: randomised controlled trial.

BACKGROUND: Human rights legislation safeguards the privacy and dignity of patients. OBJECTIVE: To assess the effectiveness in terms of patient assessed privacy of confidential registration. DESIGN: Randomised controlled trial. SETTING: Emergency Department, University Hospital of Wales. PARTICIPANTS: A total of 302 patients aged over 15 years. MAIN OUTCOME MEASURES: Binary choices and ordinal visual analogue scores from a validated questionnaire on self reported measures: patient ability and preference to speak to receptionists and disclose confidential information without being overhead and concern about disclosure of items of confidential personal information. RESULTS: Patients who registered in a screened area felt significantly more able to tell receptionists things they did not want others to hear. Control patients were significantly more concerned than intervention patients that others heard their name, address, date of birth, reason for emergency department attendance, and telephone number, but not their marital status. Overall, intervention patients were less concerned about disclosure of information and that they had been overheard. CONCLUSIONS: Patients value privacy when they register and are concerned if others can hear them tell receptionists who they are, how to contact them, and why they are there. Confidential registration should be instituted in health services. Confidential registration increased patient privacy and should be instituted in health services.

Adolescent↗
PubMed2005

Winning, losing, and violence.

BACKGROUND: Although international sports events attract huge interest, and results can be a barometer of popular national standing, their impact on violent behaviour has not been investigated. METHODS: Associations between assault related emergency department (ED) attendances and international sporting events (home and away rugby and soccer matches) in a European capital city (Cardiff) served by one ED, between 1 May 1995 and 30 April 2002 were investigated. The frequency of assault related ED attendances were studied relative to whether the national team won or lost, controlling for potential covariates: match attendance, match location (home/away), results (win/lose), net scores, and day of match (weekend/weekday). Multiple linear regression was used to identify significant associations with ED assault related attendances. RESULTS: Matches which the Wales team won (p = 0.03), match attendance (p<0.001), and weekend matches (p<0.001) were positively associated with ED assault related injury attendances. Assault frequency measured in this way was no different for home and away matches. CONCLUSIONS: Assault injury resulting in ED treatment was more frequent when national teams won than when they lost. Sport type made no difference. Violence prevention efforts should be increased on international match days, when the national team is expected to win, when match attendance is large, and for away as well as home matches.

Emergencies↗
PubMed2003

Effect of urban closed circuit television on assault injury and violence detection.

OBJECTIVE: To evaluate the effect of closed circuit television (CCTV) surveillance on levels of assault injury and violence detection. DESIGN: Intervention versus control study design. SETTING: Five town/cities with CCTV surveillance and five, matched control centres without CCTV surveillance in England. INTERVENTION: CCTV installation and surveillance. METHODS: Assault related emergency department attendances and violent offences recorded by the police in CCTV and control centres in the four years, 1995-99, two years before and two years after CCTV installation, were compared. RESULTS: Assault related emergency department attendances decreased in intervention centres (3% decrease, ratio 0.96; 95% confidence interval (CI) 0.93 to 0.99) and increased in control centres (11% increase, ratio 1.11; 95% CI 1.08 to 1.14). Overall, changes in emergency department assault attendance in CCTV and control centres were significantly different (t test, p<0.05). Police recorded violence increased in CCTV (11% increase, ratio 1.16; 95% CI 1.08 to 1.24) and control centres (5% increase, ratio 1.06; 95% CI 0.99 to 1.13). Overall, changes in police recording in CCTV and control centres were not significantly different (t test, p>0.05). In CCTV centres, decreases in assault related emergency department attendances and increases in police violence detection were not uniform. CONCLUSION: CCTV surveillance was associated with increased police detection of violence and reductions in injury or severity of injury. CCTV centre variation deserves further study.

Crime Victims↗
PubMed2002

Recording of community violence by medical and police services.

OBJECTIVES: To determine the extent to which community violence that results in injury treated in emergency departments appears in official police records and to identify age/gender groups at particular risk of under-recording by the police. METHODS: Non-confidential data for patients with assault related injury treated in the emergency departments of two hospitals in one South Wales city (Swansea) during a six month period were compared with data relating to all recorded crimes in the category "Violence against the person" in the police area where the hospitals were located. RESULTS: Over the six month period a total of 1513 assaults were recorded by Swansea emergency departments and the police (1019, 67.3% injured males and 494, 32.7% injured females). The majority of these assaults (993, 65.6%) were recorded exclusively by emergency departments; 357 (23.6%) were recorded only by the police and 163 (10.8%) were recorded by both emergency departments and the police. Equal proportions of males (67.3%) and females (67.5%) injured in assaults were recorded by both emergency departments and the police, but men were more likely to have their assault recorded exclusively in emergency departments (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.7 to 2.7) while women were more likely to have their assault recorded exclusively by the police (OR 2.5, 95% CI 2.0 to 3.2). There were no significant relationships between exclusive emergency department recording and increasing age (OR 1.0, 95% CI 0.9 to 1.2), exclusive police recording and increasing age (OR 1.1, 95% CI 1.0 to 1.2), or between age and dual recording (OR 0.9, 95% CI 0.8 to 1.0). CONCLUSIONS: Most assaults leading to emergency department treatment, particularly in which males were injured, were not recorded by the police. Assaults on the youngest group (0-10, particularly boys) were those least likely to be recorded by police and females over age 45, the most likely. Emergency department derived assault data provide unique perspectives of community violence and police detection.

Adolescent↗
PubMed2001

Trends in community violence in England and Wales 1995-1998: an accident and emergency department perspective.

OBJECTIVES: To identify overall, seasonal, sex and age specific national trends in community violence from an accident and emergency (A&E) department perspective. DESIGN AND SETTING: Prospective collection of national violence data from a stratified random sample of 33 A&E departments in England and Wales. METHODS: Data were analysed for the three years from May 1995 to April 1998. Time series statistical methods were used to detect trends among those aged 0-10, 11-17, 18-30, 31-50 and 51 + years. RESULTS: 121475 assaults were identified: 89533 (74%) men sustained injury. Forty five per cent were aged 18-30. The significant trends were an increase in injured women and those aged 31-50. Significant seasonal trends were identified for both sexes and all age groups: peaks were found in July to September and troughs in February to April. CONCLUSIONS: There was no overall significant change in levels of violence between 1995-1998 from an A&E department perspective. Numbers of women injured and those aged 31-50 increased significantly. The incidence of injury sustained in community violence is biphasic: is highest during July to September and lowest during February to April. National A&E department violence surveillance provides a unique perspective.

Adolescent↗
PubMed2001

Secondary bone grafting of alveolar clefts: a densitometric comparison of iliac crest and tibial bone grafts.

OBJECTIVE: To evaluate changes in the optical density of secondary alveolar cleft bone grafts obtained from two different donor sites over time and to determine whether one donor site gives a higher recipient bone density than the other. METHODS: A prospective study was performed evaluating 40 healthy patients with congenital cleft lip and palate undergoing secondary alveolar bone grafting, 20 (14 boys and 6 girls) having iliac crest and 20 (12 boys and 8 girls) receiving tibial bone grafts. Bone harvest and grafting was carried out by one operator (G.P.). Optical density of iliac and tibial grafts measured using a computerized densitometer, was compared at 6 days, 6 weeks, and 3 months. Due to interference from orthodontic appliances, optical density measurements for 16 subjects were not possible, and these patients were excluded from the study. The length of hospital stay postoperatively for both grafting procedures were recorded. RESULTS: A significant decrease in relative bone density was demonstrated during the 3-month postoperative period in both iliac and tibial bone graft groups (p < .05). The difference in densities between iliac crest and tibial groups were not significantly different at any of the time points (paired t test, p > .05). Subjects undergoing iliac crest grafts stayed an average of 5 days in the hospital postoperatively, compared with subjects with tibial grafts who stayed an average of 3 days postoperatively. CONCLUSION: Optical density measurements of bone grafted into alveolar clefts, reported here for the first time, provide a valuable objective assessment of graft progress. Tibial and iliac crest grafts gave similar optical densities at recipient sites over the first 3 months. Iliac crest grafts required significantly longer postoperative stay; an important consideration in selecting donor sites for secondary bone grafting.

Absorptiometry, Photon↗
PubMed2000

Conservative approach in the management of mandibular fractures in the early dentition phase. A case report and review of the literature.

A case is described of the management of bilateral fractures of mandible as a result of being kicked by a horse, in a 2-year-old child. The fractures were treated without any surgical intervention and the child made a good recovery with good function and appearance. The fractured mandible in children under the age of 5 years provides us with difficult treatment options. By encompassing the anatomical and developmental potential of facial tissues, both hard and soft, the majority of these cases can be managed conservatively. This negates the disadvantages of attempting potentially growth disturbing interventional surgery.

Animals↗
PubMed1999

Ultrasound-guided needle aspiration of lateral masticator space abscess.

Shortly after admission with facial space infection, ultrasound-guided needle aspiration of lateral masticator space abscess was carried out in 2 adult patients. One abscess was associated with pericoronitis and the other with post-extraction infection. Successful aspiration of pus was followed by an instantaneous improvement in the ability to open the mouth for a period of at least 24 hours. This obviated the need for conscious nasoendoscopic intubation and allowed orotracheal intubation for conventional drainage. We concluded that ultrasonography can be beneficial in the management of orofacial infections.

Adult↗
PubMed1999

Effect of closed circuit television on urban violence.

OBJECTIVE: To evaluate the effect of city and town centre closed circuit television (CCTV) surveillance on violence in terms of accident and emergency (A&E) department and police assault data. METHODS: A&E department and local police assault data in three centres in Wales (Cardiff, Swansea, and Rhyl) two years before and two years after the installation of CCTV were studied. British Crime Survey and police crime statistics were used as control data. RESULTS: A&E records of 24,442 assault patients and 3228 violent offences recorded by the police were studied. Data from two A&E departments (Swansea (+3%) and Rhyl (+45%)) showed increases in recorded assaults after CCTV installation but a decrease (12%) in the largest centre, Cardiff. There was an overall reduction in town/city centre violence from the A&E department perspective of 1% in the two years after CCTV installation. In contrast, police data demonstrated changes in the opposite direction (-44%, -24%, and +20% respectively) contributing to an overall decrease of 9%. British Crime Survey and police statistics for England and Wales demonstrated no overall change and a 16% increase respectively. CONCLUSIONS: City centre CCTV installation had no obvious influence on levels of assaults recorded in A&E departments. There was a negative relationship between police and A&E recording in all three centres. A&E departments are important and unique sources of information about community violence.

Crime Victims↗
PubMed1999

Bilateral reflex fracture of the coronoid process of the mandible. A case report.

Bilateral fractures of the coronoid process of the mandible occurred following a blow to the left temporal region in an assault. There was no evidence of direct trauma and the zygoma and other facial bones were intact. The probable cause was acute reflex contraction of the temporalis muscles leading to bilateral stress coronoid fractures. Conservative management was followed by complete resolution of symptoms.

Adult↗
PubMed1997

Dental students' knowledge and compliance in cross infection control procedures at a UK dental hospital.

OBJECTIVES: To assess the knowledge and clinical practice of dental students in infection control procedures at a UK dental hospital. DESIGN: A questionnaire concerning various aspects of infection control was completed by all clinical dental students under examination conditions. Their actual clinical practice was later observed and certain aspects recorded. SETTING: A UK dental hospital. SUBJECTS: One hundred and eleven dental students from three clinical years completed the questionnaire. Clinical practice for all 3 years was observed in a total of 280 treatment events. METHODS: The questionnaire was marked by two of the authors and observations recorded by another author. MAIN OUTCOME MEASURES: Degree of compliance with recognised policy for infection control. RESULTS: Knowledge of infection control procedures was variable particularly concerning duties usually undertaken by the dental nurse. The suggested high compliance with masks and eye protection was not always apparent in clinical practice, although virtually all students washed their hands prior to donning gloves, which were worn by all students. CONCLUSION: There can be marked differences between what students say they would do and what they actually do in clinical practice. The topic of infection control requires a pro-active approach throughout the course, since results for the final year were not significantly different from the other clinical years. Ways of improving compliance are discussed.

Cross Infection↗
PubMed1996

A virus, the vice chancellors and principles of vaccination.

The Committee of Vice Chancellors and Principles have stated that from 1996, all students entering medical or dental school must show evidence of non-infectivity and satisfactory completion of immunisation against hepatitis B. This is believed to be the first time that immunisation status has been part of a requirement for admission to university. The problems associated with such a programme are discussed, not the least of which is the setting of a precedent that if followed to its logical conclusion, will eventually see screening for other viral infections such as HCV and HIV, but so it seems, only when we have a vaccine.

HIV Infections↗
PubMed1995

Hepatitis B vaccination: knowledge among clinical dental staff and students in Dundee.

It is now generally acknowledged that all health care workers should be vaccinated against hepatitis B. To this end, a questionnaire was sent to 132 clinical dental students and 70 staff in August 1993 at a British dental hospital, to assess their vaccination status. Approximately 10% of subjects had not completed their course of immunisation. Furthermore a significant number of subjects had failed to follow up their vaccination by an antibody titre test. Our results suggest that approximately 1 in 7 cases failed to seroconvert, emphasising that mere vaccination may not offer sufficient protection against hepatitis B. Thus adequate cross-infection control measures must be maintained in the interest of all patients.

Dental Staff↗
PubMed1995

Measurements of human minor salivary gland secretions from different oral sites.

Unstimulated secretions from labial (upper and lower), buccal, lingual and palatal minor glands were measured with a Periotron 6000 model 2 (Proflow) in 99 non-medicated, healthy individuals aged from 17 to 81 yr (49 males and 50 females). The palatal minor glands had the lowest flow rates, buccal and anterior lingual glands the highest, and labial glands (upper and lower) intermediate secretory rates. Lower labial glands (p < 0.01) in both sexes and upper labial glands in females (p < 0.05) demonstrated a significant decrease in unstimulated output with age, while buccal glands in both sexes (p < 0.05) showed a significant decrease in flow rates only after the age of 50 yr. Thus minor glands show regional variation in their secretory rates and labial and buccal glands appear to show a decreased unstimulated flow in older individuals.

Adolescent↗