Diabetes awareness day - November 14, 2019

Yellow Fever Vaccinaton In Countries Like Zambia and South Africa

The South African Department of Health has issued a statement that all returning travelers from South Africa to Zambia and travelers from Zambia to South Africa will now require proof of yellow fever vaccination. All in-transit passengers between the two destinations, irrespective of the time period in transit, will also require proof of yellow fever vaccination.

Over the last several months there has been a lot of back and forth regarding this new policy. Often times the translation of the new policy has confused travelers like you. So what is the new policy stating?

In addition, also as of October 1, 2011 travelers coming from Zambia into South Africa will need a Yellow Fever certificate (World Health Organization card) to enter the country.

So in other words, South Africa’s Department of Health will need to see visual proof you are vaccinated for yellow fever (unless you’re in possession of a valid waiver certificate).

All travelers coming from a yellow fever risk country who are unable to produce a valid yellow fever vaccination certificate at the port of entry will either be refused entry or quarantined until their certificate becomes valid, with a max holding time of no more than 6 days.

According to International Health Regulation, a valid yellow fever certificate is required for all passengers over the age of one. Passengers in transit from Dakar (not leaving the aircraft), do not require a certificate.

For more about Yellow Fever and the required vaccination please consult your physician 8-12 weeks before departure.

 

Liposuction : Parts Of The Body That Can Be Worked On

If you do decide to have liposuction, there are quite a few areas of your body where you could choose to have it done. One area where many people have liposuction is their thighs. This includes both saddlebags and inner thighs; areas where excess fat often gets stored.

A lot of people also choose their hips and their ‘love handles’ as areas to have liposuction, because weight commonly gathers in these areas. Exercise and diet aren’t always effective at shifting the fat and so if these ‘normal’ solutions haven’t worked for you, you could consider liposuction as an alternative option. 

The abdomen is another place you might have liposuction, such as if you have been unable to shift excess fat on your stomach in another way.you are supposed to have a layer of fat on your body and so some will remain following surgery, but your liposuction surgeon will sit down with you to work out how much to remove and where.

If you have excess fat on your back, you might find that this is quite hard to get rid of and so liposuction could again be an option for you.  Your surgeon should take you through everything you need to know about the procedure, including the issue of recovery. It’s definitely worth making sure you know about it before getting liposuction in the orthopedic hospitals.

It is also possible to have liposuction on smaller, more specific areas of your body depending on the location of your excess fatty deposits. You should always speak to a doctor before having liposuction to make sure it’s the right option for you and that you will be safe.

Racial Disparities in Joint Replacement Care

Total joint arthroplasty is widely performed in patients of all races with severe osteoarthritis to relieve pain and improve joint function and mobility. Although several studies have suggested that racial minority patients are less likely to undergo joint replacement surgery little is known about the quality of arthroplasty care that African Americans receive as compared to Caucasians. 

Using data from the Medicare Provider Analysis and Review (MedPAR) files between 2002 and 2005, which contain information regarding hospitalization for Medicare beneficiaries, Cai and colleagues profiled US hospitals' quality of care. Quality was based on the rate of complications including sepsis, hemorrhage, pulmonary embolism, deep vein thrombosis and severe wound infection, as well as the number of deaths, experienced in the 90 days after total  joint replacement surgery 

To test for a racial difference in access to high-, intermediate- and low-quality hospitals, the authors then looked at 91,599 elderly patient admissions for knee replacement between July and December 2005 in 2,842 hospitals. 

Their analyses, which focused on Caucasian and African American patients only, showed that African American patients undergoing  were less likely to be admitted to high-volume hospitals. Instead, compared to Caucasian patients, they were more likely to be admitted to hospitals that perform few which have been correlated to lower-quality knee arthoplasty surgery. The fact that African American race was a predictor for admissions to low-quality hospitals, provides direct evidence of racial disparities in access to high-quality arthroplasty care.

Things To Be Known During Hip Replacement

Hip replacement is major surgery and, for the first few days, you will want to take it easy. However, it is important that you start some activities immediately to offset the effects of the anesthetic, help the healing, and keep blood clots from forming in your leg veins. Your doctor and physical and occupational therapists can give you specific instructions on wound care, pain control, diet, and exercise. They should also indicate how much weight you can put on your affected leg.

Pain management is important in your early recovery. Although pain after surgery is quite variable and not entirely predictable, it does need to be controlled with medication. Initially, you may get pain medication through an IV (intravenous) tube that you can control to get the amount of medication you need. It is easier to prevent pain than to control it and you do not have to worry about becoming addicted to the medication; after a day or two, injections or pills will replace the IV tube.

Besides the pain medication, you will also need antibiotics and blood-thinners to help prevent blood clots from forming in the veins of your thigh and calf.

You may lose your appetite and feel nauseous or constipated for a couple of days. These are ordinary reactions. You may have a urinary catheter inserted during surgery and be given stool softeners or laxatives to ease the constipation caused by the pain medication after surgery. You will be taught to do breathing exercises to keep your chest and lungs clear.

A physical therapist will visit you, usually on the day after your surgery, and teach you how to use your new joint. It is important that you get up and about as soon as possible after hip replacement surgery. Even in bed, you can pedal your feet and pump your ankles regularly to keep blood flowing in your legs. You may have to wear elastic stockings and/or a pneumatic sleeve to help keep blood flowing freely.

Joint Replacement Program Gives Good Care, Better Outcomes

Joint pain, primarily from arthritis, affects thousands of adults across the country. According to the American Academy of Orthopaedic Surgeons, 454,652 total knee replacements were performed in 2004, and in the same year, add to that number 232,857 total hip replacements, 41,934 total shoulder replacements, and 12,055 other joint replacements.

Started in 2005, the Total Joint Replacement Program is an all-inclusive program for patients having total hip, total knee, or total shoulder replacement. Once a patient enters the program, he or she receives step-by-step guidance throughout the procedure—from preadmission, to the admission office and stay, and after outpatient discharge and therapy.

The program is offered at Johnson City Medical Center, Indian Path Medical Center in Kingsport, and Johnston Memorial Hospital in Abingdon, Virginia. The only qualification for the entering is a need for total joint replacement. There is no charge for participating.

Patients learn about the program either through community education, such as hip and knee pain classes, or through their orthopedist's office, where the patient is given a guidebook and watches a video in office. He or she is then referred to the coordinator's office for a 90-minute preoperative class. The patient is also instructed on starting an exercise routine before the surgery.

Once admitted to the hospital for surgery, the process is streamlined, with standardized care protocols. Patients typically stay for three days, and then they are discharged to their outpatient home and outpatient therapy.

"The quality measures that we have in place within the program, such as timely antibiotics administration, are being met 100%," shared Spano. "In turn, we have decreased infection and decreased blood clots, huge improvements in patient care.

"I can't stress enough the comprehensiveness of this program. Our outcomes are just amazing. Before we had it, 80 percent of our patients used to go to a skilled nursing or rehab-type setting. We have flipped those numbers; now 80 to 85% of our patients go home, which also decreases infection rate."

"Patients are directly admitted to their room before the surgery, and we try to make it as much like a hotel experience as possible.

 

 

Joint Replacement Program Gives Good Care, Better Outcomes

Joint pain, primarily from arthritis, affects thousands of adults across the country. According to the American Academy of Orthopaedic Surgeons, 454,652 total knee replacements were performed in 2004, and in the same year, add to that number 232,857 total hip replacements, 41,934 total shoulder replacements, and 12,055 other joint replacements.

Started in 2005, the Total Joint Replacement Program is an all-inclusive program for patients having total hip, total knee, or total shoulder replacement. Once a patient enters the program, he or she receives step-by-step guidance throughout the procedure—from preadmission, to the admission office and stay, and after outpatient discharge and therapy.

The program is offered at Johnson City Medical Center, Indian Path Medical Center in Kingsport, and Johnston Memorial Hospital in Abingdon, Virginia. The only qualification for the entering is a need for total joint replacement. There is no charge for participating.

Patients learn about the program either through community education, such as hip and knee pain classes, or through their orthopedist's office, where the patient is given a guidebook and watches a video in office. He or she is then referred to the coordinator's office for a 90-minute preoperative class. The patient is also instructed on starting an exercise routine before the surgery.

Once admitted to the hospital for surgery, the process is streamlined, with standardized care protocols. Patients typically stay for three days, and then they are discharged to their outpatient home and outpatient therapy.

"The quality measures that we have in place within the program, such as timely antibiotics administration, are being met 100%," shared Spano. "In turn, we have decreased infection and decreased blood clots, huge improvements in patient care.

"I can't stress enough the comprehensiveness of this program. Our outcomes are just amazing. Before we had it, 80 percent of our patients used to go to a skilled nursing or rehab-type setting. We have flipped those numbers; now 80 to 85% of our patients go home, which also decreases infection rate."

"Patients are directly admitted to their room before the surgery, and we try to make it as much like a hotel experience as possible.