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Sample records for tertiary hospital study

  1. AN EPIDEMIOLOGICAL STUDY OF POISONING IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Stephen; Sahajanand; Rangalakshmi; Kasim

    2015-01-01

    AIMS : The aim of this retrospective study was to analyze the rate and chara cteristics of acute poisoning cases admitted to adult intensive care unit ( ICU ) in a tertiary care medical college hospital. We report clinical features , demographic data , laboratory results , mortality rate , and the results of our treatment in cases who ca me with the history of poisoning. METHODS: The study was done in patients admitted with his...

  2. Cervical pap smear- A prospective study in a tertiary hospital

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    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  3. Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital.

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    Jagtap, Sunil Vitthalrao; Aher, Vidhya; Gadhiya, Suchi; Jagtap, Swati Sunil

    2017-08-01

    Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. To study the clinicopathologic characteristics and prevalence of different forms of gestational trophoblastic disease in a tertiary care hospital. The present study was descriptive, observational, analytical type done in Department of Pathology at tertiary care hospital from May 2012 to April 2016. All cases clinically suspected of GTD were included and confirmation was done by histopathological study on H&E stained slides. The cases of GTD were classified according to WHO classification. Detailed histomorphological features and beta human Chorionic Gonadotropin (hCG) levels were correlated. During study period, 18345 deliveries were reported; out of which 77 cases were diagnosed as GTD. Almost 97.40% cases were of hydatidiform moles, 1.30% cases of choriocarcinoma and 1.30% cases of Placental Site Trophoblastic Tumour (PSTT). Among the cases of hydatidiform mole 57.34% were complete mole and 41.33% cases were of partial mole. The common clinical presentation was per vaginal bleeding and amenorrhea. The blood group A was most commonly observed in patient (49.35%). In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD were done. Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination is helpful for confirmatory diagnosis. Follow up of such patients is essential for early detection of malignant trophoblastic tumours.

  4. Epidemiologic study of ankle fractures in a tertiary hospital.

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    Sakaki, Marcos Hideyo; Matsumura, Bruno Akio Rodrigues; Dotta, Thiago De Angelis Guerra; Pontin, Pedro Augusto; Dos Santos, Alexandre Leme Godoy; Fernandes, Tulio Diniz

    2014-01-01

    To evaluate the epidemiology of ankle fractures surgically treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo. Medical records of patients admitted with foot and ankle fractures between 2006 and 2011 were revised. Seventy three ankle fractures that underwent surgical treatment were identified. The parameters analyzed included age, gender, injured side, AO and Gustilo & Anderson classification, associated injuries, exposure, need to urgent treatment, time to definitive treatment and early post-operative complications. retrospective epidemiological study. Male gender was predominant among subjects and the mean age was 27.5 years old. Thirty nine fractures resulted from traffic accidents and type B fracture according to AO classification was the most common. Twenty one were open fractures and 22 patients had associated injuries. The average time to definitive treatment was 6.5 days. Early post-operative complications were found in 21.3% of patients. Ankle fractures treated in a tertiary hospital of a large city in Brazil affect young people victims of high-energy accidents and present significant rates of associated injuries and post-operative complications. Level of Evidence IV, Cases Series.

  5. A study on adverse drug reactions in a tertiary care hospital of ...

    African Journals Online (AJOL)

    Objective: Purpose of this study was to monitor adverse drug reactions reported from various departments of a tertiary care hospital in Northeast India. Reported adverse drug reactions were analysed for causality and severity assessment. Methods: This cross sectional study was conducted in a tertiary care hospital at ...

  6. A study on adverse drug reactions in a tertiary care hospital of ...

    African Journals Online (AJOL)

    Ratan J. Lihite

    2016-06-27

    Jun 27, 2016 ... Abstract Objective: Purpose of this study was to monitor adverse drug reactions reported from various departments of a tertiary care hospital in Northeast India. Reported adverse drug reactions were analysed for causality and severity assessment. Methods: This cross sectional study was conducted in a ...

  7. Abusive Head Trauma at a Tertiary Care Children's Hospital in Mexico City. A Preliminary Study

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    Diaz-Olavarrieta, Claudia; Garcia-Pina, Corina A.; Loredo-Abdala, Arturo; Paz, Francisco; Garcia, Sandra G.; Schilmann, Astrid

    2011-01-01

    Objectives: Determine the prevalence, clinical signs and symptoms, and demographic and family characteristics of children attending a tertiary care hospital in Mexico City, Mexico, to illustrate the characteristics of abusive head trauma among this population. Methods: This is a cross-sectional descriptive study of infants and children under 5,…

  8. Drug utilization study of antiepileptic drugs in tertiary care hospital

    OpenAIRE

    Asha Sureshrao Morge; Madhuri Kulkarni

    2016-01-01

    Background: Study of the epidemiology of epilepsy and is of immense value in understanding the causes, outcome and prevention of epilepsy. It is also useful in planning proper services for persons with epilepsy and improving their quality of life. There is an urgent need for studies regarding incidence of epilepsy, prevalence of epilepsy syndromes, risk factors, and pharmacotherapy data from developing countries such as India. Methods: A prospective observational study. All ages, either ge...

  9. TUBERCULOSIS AND HIV COINFECTION: A TERTIARY CARE HOSPITAL STUDY

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    Vivek

    2016-02-01

    Full Text Available OBJECTIVE The aim of the present study is to record the clinical, radiological profile of pulmonary and extra pulmonary tuberculosis (EPTB in HIV positive patients. To win the battle against AIDS we have to fight against TB. Unlike HIV/AIDS, TB is completely curable in the vast majority of cases. MATERIALS AND METHODS This prospective study was conducted in the department of pulmonary medicine, Gadag institute of medical sciences, Gadag. All newly diagnosed HIV patients during the study period were included and screened for TB. HIV infection was confirmed by enzyme linked immunosorbent assay using two different antigens and a rapid test as recommended by NACO. RESULTS Among 370 newly diagnosed HIV positive patients, 113(30.54% patients were diagnosed to have TB. Most common affected age group was 31-40years with a mean age of 38.08 years. Unprotected heterosexual contact was the most common mode of HIV transmission. Fever, weight loss and cough were the commonest symptoms at presentation. Pulmonary TB was diagnosed in 85(22.97% patients, EPTB in 21(5.67% and disseminated TB in 7(1.8% patients. Among the EPTB patients, 2(9.5% patients had extra thoracic lymphadenopathy. Cervical lymph node was the commonest lymph node involved. 14(66.66% patients had pleural effusion, 3(14.28% had abdominal TB, 1(4.76% had tubercular meningitis and 1(4.76% patient had TB testis. CONCLUSION The prevalence of HIV–TB co-infection was high. Moreover, HIV positive patients need early diagnosis and treatment of active TB. However large sample size prospective studies are needed to correlate the clinical and CD4 count with the occurrence of different types of tuberculosis.

  10. Drug utilization study on antidiabetic medications at SIMS-Shimoga a tertiary care hospital

    OpenAIRE

    H. Vedavathi; Shreenivas P. Revankar

    2015-01-01

    Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. DM is a leading cause of blindness, end stage renal disease, and nontraumatic lower extremity amputations. The objective of the study was to evaluate the drug utilization pattern of antidiabetic medications at a tertiary care hospital. Methods: Demographic details of the patient were noted. Evaluation of the written prescription was carried out according to the requ...

  11. Study on organophosphate poisoning analysis and pharmacotherapeutic outcome in tertiary care hospital

    OpenAIRE

    Shreenivas P. Revankar; H. Vedavathi

    2015-01-01

    Background: Organophosphate (OP) poisoning is the most common cause of poisoning and suicides in rural India as it is easily available and more often used in agriculture as a pesticide. In the present days, death due to OP is mainly due to draught, scarcity of rains and debt. Methods: The main objective of the study was to know the sociodemographic patterns, mode of presentation and outcome of treatment in the OP poisoning case that were admitted and treated in the tertiary care hospital a...

  12. A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis.

    Science.gov (United States)

    Elbey, Mehmet Ali; Akdağ, Serkan; Kalkan, Mehmet Emin; Kaya, Mehmet G; Sayın, M Raşit; Karapınar, Hekim; Bulur, Serkan; Ulus, Taner; Akıl, M Ata; Elbey, Hatice Köprü; Akyüz, Abdurrahman

    2013-09-01

    The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.

  13. Practices and challenges of infectious waste management: A qualitative descriptive study from tertiary care hospitals in Pakistan.

    Science.gov (United States)

    Kumar, Ramesh; Shaikh, Babar Tasneem; Somrongthong, Ratana; Chapman, Robert S

    2015-01-01

    Infectious waste management practices among health care workers in the tertiary care hospitals have been questionable. The study intended to identify issues that impede a proper infectious waste management. Besides direct observation, in-depths interviews were conducted with the hospital administrators and senior management involved in healthcare waste management during March 2014. We looked at the processes related to segregation, collection, storage and disposal of hospital waste, and identified variety of issues in all the steps. Serious gaps and deficiencies were observed related to segregation, collection, storage and disposal of the hospital wastes, hence proving to be hazardous to the patients as well as the visitors. Poor safety, insufficient budget, lack of trainings, weak monitoring and supervision, and poor coordination has eventually resulted in improper waste management in the tertiary hospitals of Rawalpindi. Study has concluded that the poor resources and lack of healthcare worker's training in infectious waste results in poor waste management at hospitals.

  14. Profile of Acute Poisoning Cases Treated in a Tertiary Care Hospital: a Study in Navi Mumbai

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    Amit Patil

    2014-03-01

    Full Text Available Background: Periodic epidemiological studies are necessary to understand the pattern of poisoning in each region. This study was designed to evaluate the pattern of acute poisoning cases treated in a tertiary care hospital in Navi Mumbai, India. Methods: This cross sectional study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre during July 2012 to July 2013. All cases of poisoning admitted to the hospital were included in this study. The patients’ data were obtained from medical records and were documented on a pre-structured proforma. Results: A total of 74 cases of acute poisoning were studied, of which 51.4% were men. Most of the patients aged 20 to 29 years (44.6%. In majority of cases, the route of exposure to poison was oral (86.5%. Most of the patients reside in urban areas (52.7%. Most of the patients were Hindus (85.1% followed by Muslims (14.9%. The exposure mostly occurred between 6:00 pm to 12:00 am (30% of cases. The majority of poisonings (44.6% was due to consumption of household products followed by pesticides (14.9% and pharmaceutical agents (13.5%. Neurologic manifestations were the most common clinical findings (64.8% followed by gastrointestinal manifestations (37%. All patients were treated successfully with no mortality. There was a significant correlation between gender and intention of poisoning (P < 0.001, as the suicidal attempts were higher in women (69.4%. Moreover, a significant relationship existed between marital status and intention of poisoning (P = 0.016 as the suicidal poisonings were most common among married individuals (45.7%.  Conclusion:The trend in poisoning is never static. Household products were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.   How to cite this article: Patil A, Peddawad R, Verma VCS, Gandhi H. Profile of Acute

  15. Anxiety and Depression in Patients with Coronary Heart Disease: A Study in a Tertiary Hospital

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    Ho Siew Eng

    2011-09-01

    Full Text Available Anxiety and depression could reduce the quality of life, and exacerbate physical symptoms and even mortality amongst patients with coronary heart disease (CHD. The aim of this study was to investigate the incidence of anxiety and depression in patients with acute CHD. In a period from March to December 2008, the views of 108 CHD patients, hospitalized in a tertiary hospital, were solicited using Hospital Anxiety and Depression Scale (HADS and sociodemographic questionnaires. Patients with CHD had a low level anxiety and depression scores. There was significant differences in the total HADS score of participants stratified for marital status (P=0.027 or co-morbidity of diseases (P=0.012. Also, there were significant differences in the scores of depression subscale stratified for marital status (P=0.021 or co-morbidity of disease (P=0.007. However, there was no significant difference between the total HADS score or depression subscale score of the participants stratified based on age, gender, race, education, or income. Moreover, unmarried CHD respondents possessed higher depression level compared to the married respondents, and CHD respondents with co-morbid diseases showed a high level of depression. The findings might be taken as evidence to suggest that CHD patients should be evaluated early for the detection of anxiety and depression for appropriate referral and support

  16. Drug utilization study in a burn care unit of a tertiary care hospital

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    Santoshkumar R Jeevangi

    2011-03-01

    Full Text Available Objective: To evaluate drug utilization and associated costs for the treatment of patients admitted in burn care unit of a tertiary care hospital. Methods: A prospective cross sectional study was conducted for a period of 15 months at Basaweshwara Teaching and General Hospital (BTGH, Gulbarga and the data collected was analyzed for various drug use indicators. Results: A total of 100 prescriptions were collected with 44% belonging to males and 56% to females. The average number of drugs per prescription ranged from 4.5 to 9.5. 9.5% of generics and 92% of essential drugs were prescribed. The opioid analgesics and sedatives were prescribed to all the patients who were admitted in burn care unit. The (Defined daily dose DDD/1 000/day for amikacin (359 was the highest followed by diclofenac sodium (156, pantoprazole (144, diazepam (130, ceftazidime (124, tramadol (115, ceftriaxone (84 and for paracetamol (4 which was the lowest. Conclusions: Significant amount of the money was spent on procurement of drugs. Most of the money was spent on prescribed antibiotics. The prescription of generic drugs should be promoted, for cost effective treatment. Hence the results of the present study indicate that there is a considerable scope for improvement in the prescription pattern.

  17. STUDY OF PRESCRIBING PATTERN OF ANTIMICROBIAL AGENTS IN SELECTED PATIENTS ATTENDING TERTIARY CARE HOSPITAL IN INDIA

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    Anjan Adhikari

    2013-06-01

    Full Text Available Antibiotics are the most commonly prescribed drugs in hospitals and their irrational use is one of the important factors for the development and spread of resistance. The objective of this study was to evaluate the antibiotic prescription pattern in the patient attending the tertiary care hospital. It was found that a total of 333 antibiotics where prescribed in 245 prescriptions. The average number of antibiotics per prescription was approximately1.4. The most commonly used antibiotics were moxifloxacin 19.5%, metronidazole 10.4%, amoxicillin + cloxacillin 10.2% and ciprofloxacin 6%. antibiotics were almost equally prescribed to both male and female. 45.5% of the antibiotics shows adherence with the National List of Essential Medicines of India. 76.6% of the antibiotics were single products while 23.4% were fixed dose combination. The most commonly used dosage forms were tablets (57%, drops (23.5% and creams (11.7%.57.3% were prescribed irrationally. Quinolones (48.2% and antifungals (21.5% were the most common types of prescribed antibiotics in which irrationality was found.

  18. DRUG UTILISATION STUDY IN THE TREATMENT OF HYPERTENSION IN A TERTIARY CARE HOSPITAL

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    Amol Chandrakant Deshmukh

    2017-11-01

    Full Text Available BACKGROUND Hypertension, a common clinical problem is considered as an ‘iceberg disease’ because its unknown morbidity far exceeds the known morbidity. In terms of attributable deaths, it is one of the leading behavioural and physiological risk factors amounting to 13% of global deaths. Drug selection is based on efficacy in lowering BP (blood pressure and in reducing Cardiovascular (CV endpoints like stroke, myocardial infarction and heart failure. This study was carried out to evaluate the pattern, extent, rationality and frequency of the use of antihypertensive drugs in the treatment of hypertension. The aim of the study is to analyse drug utilisation in the treatment of hypertension in a tertiary care hospital. MATERIALS AND METHODS This study was conducted during January 2014 to December 2015 in Medicine OPD (Outpatient Department in a tertiary care hospital. The sample size was selected as per the WHO recommendations on conducting Drug Utilisation Studies (DUS. Statistical Analysis- The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed by SPSS version 16. Settings and Design- Prospective, cross-sectional, observational study. RESULTS Out of 612 patients, 262 (42.81% were in the age group of 60 and above. Considering gender distribution, 328 (53.59% were males and 284 (46.41% were females. Of these, 274 (44.78% were prescribed monotherapy, 256 (41.83% were prescribed two-drug therapy, 72 (11.76% were prescribed three-drug therapy and 10 (1.63% were prescribed four-drug therapy. Among 274 (44.78% patients prescribed with monotherapy, 112 (40.87% were prescribed with CCB (calcium channel blocker, 76 (27.73% were given BB (B-blocker, 45 (16.42% were prescribed ACEI (angiotensin converting enzyme inhibitor, 35 (12.77% were prescribed with ARB (angiotensin receptor blocker and 6 (2.18% were prescribed with Diuretics (D. Of the total antihypertensive drugs prescribed, 68.30% were prescribed by generic name

  19. Blood Culture Contaminants in a Paediatric Population Retrospective study from a tertiary hospital in Oman.

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    El-Naggari, Mohamed A; Al-Mulaabed, Sharef W; Al-Muharrmi, Zakaria; Mani, Renjith; Abdelrahim, Rana; Abdwani, Reem

    2017-05-01

    Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. This retrospective study included all 225 children Oman, between July 2011 and December 2013. Blood cultures were reviewed to determine whether they were true-positive or contaminated. A total of 344 positive blood cultures were recorded during the study period, of which 185 (53.8%) were true-positive and 159 (46.2%) were contaminated. Most true-positive isolates (26.5%) were coagulase-negative Staphylococcus spp. (CONS) followed by Escherichia coli (9.7%), while the majority of contaminated isolates were CONS (67.9%) followed by Streptococcus spp. (6.9%). Children with contaminated cultures were significantly younger (P <0.001) while those with true-positive cultures required significantly more frequent hospital admissions, longer hospital stays and more frequent antibiotic prescriptions (P <0.001 each). Chronic illness and mortality was significantly more frequent among those with true-positive cultures (P <0.001 and 0.04, respectively). While white blood cell and absolute neutrophil counts were significantly higher in true-positive cultures (P <0.001 each), there was no significant difference in C-reactive protein (CRP) level (P = 0.791). In this population, CRP level was not an adequate marker to differentiate between true- and false-positive cultures. A dedicated well-trained phlebotomy team for paediatric patients is essential.

  20. A RETROSPECTIVE STUDY OF MANAGEMENT OF ACUTE PANCREATITIS IN A PERIPHERAL TERTIARY HOSPITAL

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    Thomas Karunahara

    2016-06-01

    Full Text Available BACKGROUND & OBJECTIVES Acute pancreatitis (AP is one of the most common diseases in gastroenterology. Two percent of all patients admitted to hospital are diagnosed with AP. During the last decade, an increasing incidence was observed, mostly because of a higher sensitivity of diagnostic tests. Treatment of Acute Pancreatitis is still symptomatic and no specific medication is available today. As a result of popular belief that the pancreas should be put to rest during acute pancreatitis, the parenteral route for nutrition is still predominantly used in Acute Pancreatitis. There has been increasing evidence; however, about gut being main source of microorganisms causing infectious pancreatic complications and multiorgan failure. In patients with severe pancreatitis, oral intake is inhibited by nausea and subileus. Although some reports show that enteral feeding is possible in acute pancreatitis and associated with fewer septic complications. Although the evidence is inconclusive to support enteral nutrition in all patients with severe acute pancreatitis, the enteral route may be used if tolerated. Supportive treatment is the most important line of management in acute pancreatitis. The aim is to study the management of acute pancreatitis in a peripheral tertiary hospital and to assess the outcome of the management. METHODS & MATERIALS Data Collection: Patients with acute abdominal pain are admitted in hospital and diagnosed as acute pancreatitis based on blood investigations and radiological findings. Patients categorised- Revised Atlanta Classification. Different medical management modes followed and outcomes recorded, tabulated and analysed. Research Design: Retrospective study. Research Settings: Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu. Duration: 5 yrs. (2010-2015 Sample Size: 186. Inclusion Criteria: Patients between 12 and 75 yrs. of age, patients admitted to the hospital as a case of acute pancreatitis, both sexes

  1. COMPREHENSIVE STUDY OF HYDATID DISEASE OF LIVER AND MANAGEMENT AT PERIPHERAL TERTIARY CARE HOSPITAL

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    Karunaharan Thomas

    2017-04-01

    Full Text Available BACKGROUND Hydatid Disease (HD is a zoonotic disease caused by the larvae of Echinococcosis granulosus, now become a rare clinical entity in teaching medical college hospitals. This is due to the public education about the disease, mode of spread and treatment available. The aim of the study is to review the epidemiology, clinical presentation, diagnostic methods available, organs affected and treatment available in the tertiary hospitals and outcome. MATERIALS AND METHODS Data Collection- Patients with upper right abdominal pain with radiological and ultrasound findings are included in the study. About twenty patients are taken for this study. Medical managements, surgical procedure done and outcomes are recorded, tabulated and analysed. Research Design- Prospective Study, Research Setting- KAPV Govt. Medical College and Mahatma Gandhi Memorial Govt. Hospital, Trichy, Tamilnadu. Duration- 7 yrs. (2009 to 2016 Sample Size- Twenty. Inclusion CriteriaPatients between 12 to 70 years of age of both sexes. Patient having right upper abdomen or epigastric pain with positive radiological and ultrasound findings. Patient willing to participate in the study. Exclusion Criteria- Patients more than 70 years not willing to participate in the study patients absconded in between the management. RESULTS Liver is a commonest solid organ affected by the hydatid disease. Most of the diagnosis are made accidentally when the patients are investigated for some other diseases. The commonest clinical presentation is right abdominal or epigastric pain with hepatomegaly. The average age group is 45 years. X-ray abdomen, ultrasound abdomen are the most useful investigations. Asymptomatic uncomplicated small cyst less than 5 cms are managed with medical treatment. Symptomatic large cysts are submitted for surgical intervention. CONCLUSION The main source of income in majority of rural population is agriculture and sheep and cattle grazing. WHO is working towards the

  2. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

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    Bheemsain Tekkalaki

    2017-01-01

    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  3. STUDY OF CLINICAL AND ENDOCRINE PROFILE OF PATIENTS WITH PITUITARY TUMOURS ATTENDING A TERTIARY CARE HOSPITAL

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    Binoy Kumar Mohanty

    2016-07-01

    Full Text Available BACKGROUND Pituitary tumours are relatively common endocrine tumours. They can present with symptoms related to hormone excess or hormone deficiency. They can also present with compressive symptoms like visual problems and headache. OBJECTIVE To study the various clinical presentations and endocrine profile of patients presenting with pituitary tumours to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 33 consecutive patients who presented to our department from March 2014 to February 2016 for evaluation of pituitary tumours. RESULTS Majority of the subjects studied belonged to 40-50 years group (33.34%.The most common type of pituitary tumour in our population was non-functioning pituitary tumours (45.45%. The next common cause was somatotroph adenoma (27.27% followed by prolactinoma (15.15% and corticotroph adenomas (12.13%. There was significant male predominance (60.60% among total cases. Among all patients, headache (54.54% was most common presentation followed by features related to hormone excess (51.51%. CONCLUSIONS Pituitary tumours can present with variety of symptoms. A detailed endocrine workup is essential in each case to reach at correct diagnosis. In our cohort, non-functioning pituitary tumour was the most common tumour subtype.

  4. STUDY OF CLINICAL PROFILE OF PATIENTS PRESENTING WITH SEXUAL PRECOCITY TO A TERTIARY CARE HOSPITAL

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    Binoy Kumar Mohanty

    2016-07-01

    Full Text Available BACKGROUND Precocious puberty is a common paediatric endocrine disorder seen in clinical practice. OBJECTIVE To study the various aetiologies and clinical presentations of patients presenting with sexual precocity to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 24 consecutive patients who presented to our department from January 2014 to December 2015 for evaluation of sexual precocity. RESULTS Most of the patients presenting to us had evidence of precocious puberty (n=16, followed by premature adrenarche (n=5 and premature thelarche (n=3 respectively. The females outnumbered males in our study (68.75% of total cases. Females presenting with central precocious puberty had no appreciable cause (idiopathic in majority (85.72% of cases. While, males presenting with central precocious puberty had an organic cause (60% in majority of cases. CONCLUSIONS Precocious puberty is more common among females as compared to males. Organic lesion must be ruled out in all patients presenting with central precocious puberty especially in males.

  5. Study of variables affecting critical value notification in a laboratory catering to tertiary care hospital.

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    Agarwal, Rachna; Chhillar, Neelam; Tripathi, Chandra B

    2015-01-01

    During post-analytical phase, critical value notification to responsible caregiver in a timely manner has potential to improve patient safety which requires cooperative efforts between laboratory personnel and caregivers. It is widely accepted by hospital accreditors that ineffective notification can lead to diagnostic errors that potentially harm patients and are preventable. The objective of the study was to assess the variables affecting critical value notification, their role in affecting it's quality and approaches to improve it. In the present study 1,187 critical values were analysed in the Clinical Chemistry Laboratory catering to tertiary care hospital for neuropsychiatric diseases. During 25 months of study period, we evaluated critical value notification with respect to clinical care area, caregiver to whom it was notified and timeliness of notification. During the study period (25 months), the laboratory obtained 1,279 critical values in clinical chemistry. The analytes most commonly notified were sodium and potassium (20.97 & 20.8 % of total critical results). Analysis of critical value notification versus area of care showed that critical value notification was high in ICU and emergency area followed by inpatients and 64.61 % critical values were notified between 30 and 120 min after receiving the samples. It was found that failure to notify the responsible caregiver in timely manner represent an important patient safety issue and may lead to diagnostic errors. The major area of concern are notification of critical value for outpatient samples, incompleteness of test requisition forms regarding illegible writing, lack of information of treating physician and location of test ordering and difficulty in contacting the responsible caregiver.

  6. DORSAL AND DORSOLUMBAR SPINE TUBERCULOSIS: A STUDY IN A TERTIARY CARE HOSPITAL

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    Raja Sekhar

    2015-08-01

    Full Text Available INTRODUCTION : Tuberculosis has been a major public health problem. The development and the introduction of antituberculous chemotherapeutic agents in the 1940’s reduced the death rate. Of all the patients with tuberculosis nearly 1 - 3% have involvement of the skeletal system. Vertebral tubercul osis is the most common form of skeletal tuberculosis with a reported incidence of up to 50%. Tuberculosis of the spine (Pott’s disease is the most common and most dangerous from of tuberculosis infection. Modification of surgical techniques and newer che motherapeutic agents has revolutionized the treatment of spinal tuberculosis. AIMS AND OBJECTIVES : To study and analyse the surgical and radiological results of patients who have been operated for dorsal and dorsolumbar caries. MATERIALS AND METHOD : It is a prospective study done in the Department of Neurosurgery, Government General Hospital,Kakinada from July 2014 to July 2015. It is a tertiary care hospital. 50 patients diagnosed with dorsal and dorsolumbar tuberculosis were recruited into the study and w ere managed. RESULTS: 50 patients with dorsal and dorsolumbar tuberculosis, with different symptoms were managed by a combination of surgical techniques and the improvement was assessed by various parameters. CONCLUSION: In this study, it was found that al l patients who underwent surgical decompression of the spinal cord there was improvement in the neurological status. The surgical approach and type of surgery is planned based on how the cord is compressed and the amount of instability. No single surgery w as found superior or inferior to any other and the results remain the same as far as neurological recovery is concerned

  7. A Study of Cervical Pap Smears in a Tertiary Care Hospital.

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    Dr Kruti Bhut

    2016-12-01

    Full Text Available Background: Cancer of the cervix is the leading cancer among females of India. Cancer of cervix is readily preventable, and can be diagnosed at the pre-invasive stage with adequate and repetitive cytological screening with Papanicolaou (Pap smears. Objectives: This is a retrospective study aimed to evaluate all previously conducted cervical smears examined at a teaching tertiary care hospital during one year period. Methods: Detailed clinical data and Pap smear cytology reports were obtained and data noted in a structured proforma. All the smears were reported as per the 2001 Bethesda system. Results: A total of 1436 Pap smears were examined. Maximum number of patients was in the age group of 31 – 40 years (fourth decade. There were 133(9.2% unsatisfactory or inadequate samples. A total of 1187 smears were reported as Negative for Intraepithelial Lesion or Malignancy (NILM and 390(22.7% were inflammatory. Out of a total of 1436 Pap smears, only 116(8.0% cases were reported to have epithelial cell abnormality. The 116 abnormal cases comprised of 36 cases with ASC-US, 27 cases of LSIL, 36 cases of HSIL, 7 cases of invasive squamous cell carcinoma. Conclusion: Premalignant and malignant lesions of cervix can be diagnosed easily by Pap smears. The epithelial cell abnormality rate in our study was 8.0%.

  8. Epidemiology of Traumatic Peripheral Nerve Injuries Evaluated with Electrodiagnostic Studies in a Tertiary Care Hospital Clinic.

    Science.gov (United States)

    Miranda, Gerardo E; Torres, Ruben Y

    2016-06-01

    To describe the etiologies and frequency of traumatic peripheral nerve injury (TPNI) seen in the electrodiagnostic laboratory of a tertiary care hospital in Puerto Rico. The charts of patients who underwent an electrodiagnostic study for a TPNI were revised. The main outcome measure was the frequency of each injury by anatomic location, specific nerve or nerves affected, injury mechanism, and injury severity. One hundred forty-six charts were included, and in them were listed a total of 163 nerve injuries; 109 (74.7%) cases were men and 37 (25.3%) were women. The mean age was 33.6 years. The facial nerve, the brachial plexus, and the ulnar nerve were more frequently injured than any other nerve or nerve bundle. The ulnar, sciatic, median, and radial nerves and the lumbosacral plexus were more commonly injured as a result of gunshot wounds than of any other mechanism of injury. The brachial plexus was most frequently injured in motor vehicle accidents and the facial nerve injuries most commonly had an iatrogenic cause. In terms of injury severity, 84.2% were incomplete and 15.8% were complete. TPNIs are common in young individuals and potentially can lead to significant disability. Further studies are needed to assess the socioeconomic impact of these injuries on our population.

  9. Antimicrobial drugs usage in a tertiary care hospital –A descriptive study

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    Priestly Vivekkumar

    2015-10-01

    Full Text Available Background: Emergence of resistant organisms is alarmingly high all over the world. Irrational and inappropriate prescription of antimicrobials is the major contributing factor for developing drug resistance in addition to poor patient compliance. It is the high time to create awareness of antimicrobial resistance among physicians and patients. Encouraging physicians/surgeons to undergo training programmes on infectious disease control periodically would be beneficial to combat the resistant organisms, so called super bugs.Objectives: To assess the pattern of antimicrobial usage in a tertiary care hospital, to determine whether antimicrobials are prescribed judiciously.Methods: A retrospective study was conducted to determine the current antimicrobial prescribing practices at Tagore Medical College Hospital. A randomised sample of 100 inpatient case sheets of General Medicine, OBG, General Surgery, Paediatrics, Chest Medicine, Skin, and ENT from Medical Records Department was analysed with respect to oral and parenteral (iv administration of antimicrobials.Results: In this study, 53% were males and 47% were females. Majority of patients were middle aged (17-60yrs. A total of 16 antimicrobials were prescribed for 100 inpatients. The most frequently used were Metronidazole and Ciprofloxacin. Duration of treatment was minimum 3 days, maximum of 13 days and mean duration was 5.5 days. The common route by which antimicrobials were administered was Parenteral as the patients were inpatients. The Parenteral (iv drugs were Metronidazole (52%, Ciprofloxacin (42%, Cefotaxime (27%, Amikacin (7%, Ceftriaxone (7%. Among 100 prescriptions, 63% were empirical prescriptions, 12% were directed and 25% were targeted prescriptions.Conclusions: The most frequently used antimicrobials were Metronidazole and Ciprofloxacin and the condition for which the antimicrobials were commonly used was acute gastroenteritis. The proportion of targeted prescriptions was low

  10. Outcomes of Short-Course Inpatient Stroke Rehabilitation Program in Tertiary Hospital: A Pilot Study.

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    Suksathien, Rachawan; Chaiyaphan, Yaowaluk; Roongyoosiri, Chantana; Muangkham, Phuwadol

    2015-11-01

    Stroke is one of the most common cause of disabilities in Thailand. Full-course comprehensive rehabilitation to achieve maximum goalfor each patient was uncommon in secondary and tertiary hospitals because of limited resources and budget, so short-course inpatient stroke rehabilitation program was developed for service in these circumstances. To evaluate the efficiency and cost of the short-course inpatient stroke rehabilitation in Maharat Nakhon Ratchasima Hospital. This prospective study included stroke patients with aged over 18 years old, able tofollow one-step command and admitted in rehabilitation ward for short-course rehabilitation program between January 1 and December 31, 2014. Patient's characteristic data, Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay (LOS), Thai HospitalAnxiety and Depression Scale (THAI HADS), WHOQOL-BREF-THAI, cost, and details oftraining were recorded Fifty stroke patients were included in the present study. The mean interval from onset of stroke to admission for this program was 29.9 days (1-143, SD 31.18). The mean age was 57 years (19-86, SD 12.7). Seventy-two percent of cases were ischemic stroke. The impairments of the patients were hemiparesis (100%), aphasia (36%), dysarthria (32%), incontinence (14%), cognitive problem or neglect (12%), and dysphagia (10%). The mean LOS was 9.38 days (3-27, SD 5.31). Mean BI score on admission and at discharge were 8.12 (0-18, SD 4.52) and 13.12 (2-20, SD 4.28). The mean of BI score change was 5 (2-10, SD 2.25): The BI efficiency was 0.56 points/day. Eight cases (22%) had anxiety and 10 cases (28%) had depression. The mean total cost was 7,729 baht (1,828-22,450, SD 4,330) or about 240 US dollar The short-course inpatient rehabilitation program could improve functional ability in stroke patients with low cost but high efficiency. This program is suitable for subacute stroke patients in hospitals with limited resources and budget.

  11. Epidemiology of Traumatic Peripheral Nerve Injuries Evaluated by Electrodiagnostic Studies in a Tertiary Care Hospital Clinic.

    Science.gov (United States)

    Torres, Ruben Y; Miranda, Gerardo E

    2015-01-01

    Describe the etiology and frequency of traumatic peripheral nerve injuries (TPNI) in the electrodiagnostic laboratory of a tertiary care hospital. The charts of patients who underwent an electrodiagnostic study for a TPNI were revised. The main outcome measure was the frequency of each injury by anatomic location, involved nerve, mechanism, and severity. 146 charts were included for a total of 163 injured nerves; 109 (74.7%) males and 37 (25.3%) females. The mean age was 33.6 years. The facial nerve and the brachial plexus followed by the ulnar nerve were more frequently involved. The ulnar, sciatic, median, radial nerve, and the lumbosacral plexus were more commonly injured by gunshot wounds, the brachial plexus by motor vehicle accidents, and the facial nerve by iatrogenic causes. The majority of the injuries were incomplete or partial (84.2% were incomplete and 15.8% complete injuries). TPNIs can lead to significant disability, but further investigation is needed to better understand their socio-economic impact.

  12. A clinical and microbiological study of puerperal sepsis in a tertiary care hospital in India.

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    Vanukuru, Jayasree; Bagga, Rashmi; Muthyala, Tanuja; Gautam, Vikas; Sethi, Sunil; Jain, Vanita; Sikka, Pooja

    2018-01-07

    This prospective study was carried out to evaluate the clinical profile and bacterial isolates among women with puerperal sepsis in a tertiary hospital in North India. Women with puerperal sepsis (n = 45) admitted from January 2015 to April 2016 were followed prospectively. Cultures were obtained from cervix, blood, urine, and pyoperitoneum. Initial antibiotics were cefotaxime or piperacillin with tazobactam plus amikacin plus clindamycin or metronidazole and were changed according to sensitivity. Out of 7887 deliveries during this period, 45 (0.2%) women had puerperal sepsis. 16 (35.5%) delivered in the present hospital, 25 (55.5%) at another health care facility, and 4 (8.9%) at home. Delivery was by cesarean section (CS) in 24/45 (53.3%) and vaginal in 21/45 (46.6%). Grade 1 sepsis occurred in 21, grade 2 in two, and grade 3 in 22 women. Majority (29/45 or 64.5%) had no risk factor for puerperal sepsis. There were two (4.4%) deaths and 13/45 (28.8%) had near-miss morbidity. Pathogenic bacteria were isolated in 33/45 (73.3%) in cervical swab (69%), blood, urine, or pus culture with no significant difference in the bacterial yield or species isolated between cotton or polyester swabs (p > .05). Escherichia coli were the commonest isolate and was sensitive to amikacin in all. Five had stillbirths and 4/40 neonates developed sepsis but recovered. Escherichia coli was the commonest pathogen and was uniformly sensitive to amikacin, which may be included among the initial antibiotics to treat puerperal sepsis in India.

  13. A HOSPITAL-BASED STUDY ON THE PREVALENCE OF DRY EYES IN A TERTIARY CARE HOSPITAL

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    Prashant V. Solanke

    2017-06-01

    Full Text Available BACKGROUND Dry eye syndrome is a common eye disease. Dry Eye Syndrome (DES, also known as Keratoconjunctivitis Sicca (KCS, is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge and easily fatigued eyes. Blurred vision may also occur. The symptoms can range from mild and occasional to severe and continuous. Scarring of the cornea may occur in some cases without treatment. Dry eye occurs when either the eye does not produce enough tears or when the tears evaporate too quickly. Tobacco smoke exposure or infection may also lead to the condition. Diagnosis is mostly based on the symptoms, though a number of other tests may be used. Prevalence of dry eyes are commoner in females than males. There is a positive relationship between glaucoma and ocular dryness as well as diabetic retinopathy and ocular dryness. Dry eye is a multifactorial disease of the tears and ocular surface. Ocular symptoms such as pain, irritation and poor vision can result from dry eye. The aim of the study is to study the prevalence, symptomatology and distribution of dry eyes. MATERIALS AND METHODS A cross-sectional study was conducted during July 2016 to March 2017. Study place was Outpatient Department of Ophthalmology at Sree Mookambika Institute of Medical Sciences, Kulasekharam. Sample size was calculated by 4PQ/d², which was 132. Systemic random sampling was used for the study. RESULTS Prevalence of dry eyes - 17.8%. Dry eyes in males - 16.8% and in females - 24.6%. Dry eyes in age 40 yrs. - 21.8%. Prevalence of dry eyes in contact lens wearers - 36.5%. Prevalence of dry eyes in glaucoma cases - 38.2%. Prevalence of dry eyes in farmers - 27.3%, in smokers - 36.7%. Dry eyes in emmetropes - 12.8% in myopes - 17.2% in hypermetropes - 28.6%. CONCLUSION Dry eyes prevalence obtained was 17.8%. Dry eyes were seen more in females. As age increases, prevalence of dry eyes increases. Ocular surface dryness was observed more in contact

  14. Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

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    Kotsikoris Ioannis

    2011-11-01

    Full Text Available Abstract Background The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1st January 2009 and 31st December 2010. Results Overall, 2452 (49.4% out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6% needed vascular surgical intervention. Conclusions The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.

  15. Drug utilization study of gynecology OPD: In a tertiary care hospital.

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    Baig MS, Bagle TR,Gadappa SN, Deshpande Sonali, Doifode SM

    2013-04-01

    Full Text Available Background: The treatment of diseases by use of essential medicines, prescribed by generic names, has been emphasized by WHO and National Health Policy of India. Drugs used in gynaecology are one of the top selling drugs in India; however they are least studied with respect to drug utilization. Thus present study was undertaken to analyze drug utilization pattern of gynecology OPD in a tertiary care hospital. Materials and Methods: A retrospective, cross sectional, observational study of prescriptions in Gynecology OPD. Data was obtained from an electronic medical record database of patients that attended Gynecology OPD during the study period. Prescription records of patients were screened as per inclusion and exclusion criteria and 300 prescriptions were randomly selected by Openepi software. Patient related and drug related information was collected on a customized data collection sheet. Results: The mean age of patients was 30.19+9.83 years and common age of presentation was >18-30 years. In infective cases, vaginal discharge (10.33% was common, and in non-infective cases, menstrual disorders (24% were common. The average number of drugs per prescription was 3.47+1.53. In drug category, minerals (30.94% were most commonly prescribed, followed by antimicrobials (24.98%, and NSAIDs (13.37%. Polypharmacy was observed in 96.33% of the prescriptions. Conclusion: It is only by drug utilization studies that burden of diseases and corresponding utilization of drugs in gynecology can be measured. In our study majority of the drugs prescribed were generic which were from the essential medical list NLEM and WHO.

  16. STUDY OF THE PREVALENCE OF MICROALBUMINURIA AND RETINOPATHY IN PREDIABETES IN A TERTIARY CARE HOSPITAL

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    Purushottam Rao

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVE: Diabetes is a chronic disease that has a prolonged prediabetic phase. Indians develop diabetes 10 years earlier tha n other ethnic groups (mean age 42.5 years . 1 Diet, environment, genetics play a major role in development of diabetes. Complications of diabetes are directly proportional to the duration of diabetes and dysglycemia. Prediabetes is a condition is which glucose levels are high to be considered as normal, eventhough they do not meet the criteria for diabetes. 10% - 50% of prediabetics may develop diabetes in 3 - 10 year period. Components of prediabetes include either an isolated impai red fasting glucose or impaired glucose tolerance or both. Microvascular complications can begin is the prediabetic stage itself. Present study has been done to know the prevalence of microalbuminuria and retinopathy is prediabetic stage and correlation of both in prediabetics. MATERIALS AND METHODS: This study was conducted in a tertiary care Hospital from June 2013 to May 2014. Screening was done and patients recruited into the study after fulfilling the inclusion and exclusion criteria. American Diabetes Association Criteria 2 was used for screening and results were correlated using various parameters to know the prevalence of microalbuminuria and retinopathy in prediabetes. Data was analyzed using statistical package for social sciences(spss version 20.0 . RESULTS: In this study, 500 patients were screened for diabetes. 100 patients were included in the study. Prevalence of prediabetes was seen in 20% of patients screened. 19% of prediabetics had microalbuminuria and 8% had retinopathy. Association of both conditions was seen is 7% of patients. CONCLUSION: Diabetic Microvascular complications like retinopathy and nephropathy in the form of microalbuminuria starts even in the prediabetic stage in a significant number of patients. Screening high risk individu als for diabetes and screening of prediabetics for microvascular

  17. Use of physical restraint in hospital patients: A descriptive study in a tertiary hospital in South Africa

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    Sebastiana Z. Kalula

    2016-02-01

    Full Text Available Background: The use of physical restraint in patient management is a common and emotive issue, and has legal and ethical dimensions.Objective: To document the prevalence of physical restraint use, patient characteristics associated with physical restraint use, and nurses’ and doctors’ knowledge and perceptions towards the practice.Methods: A cross-sectional study of 572 patients, of whom 132 were physically restrained, was conducted in acute wards of a tertiary hospital. Data were collected on the 132 physically restrained patients. Fifty-nine doctors and 159 nurses completed a specially constructed questionnaire. Descriptive statistics were derived and expressed as numbers and percentages.Results: Prevalence of restraint use was 23% (132/572. The distribution in acute wards was: medical 54.5%; surgical 44.7%; maternity 0.8%; psychiatry none. Mean age (SD of the restrained patients was 49 years (20.5; 53.8% were male. The commonest types of restraints used were bed rails 93% and wrist belts 12%. Restraints were used largely to protect medical devices and as protection from harm. Less than 15% of the nurses reported having received training and 36% of the doctors reported having received some guidance on the use of restraints. Only a minority of nurses and doctors knew of a hospital policy on restraint use. Documentation on the prescription and indication for the use of restraint was poor.Conclusion: Prevalence of restraint use is high and poorly coordinated. A policy on the use of restraint and comprehensive guidelines should be developed to guide health care practitioners in the management of patients where restraint cannot be avoided.

  18. Skin, a mirror reflecting diabetes mellitus: A longitudinal study in a tertiary care hospital in Gujarat

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    Roshni Vahora

    2013-01-01

    Full Text Available Context: Diabetes mellitus (DM is the most common of the endocrine disorders. Mucocutaneous manifestations of diabetes mellitus are many and vary from trivial to life-threatening. Sometimes, mucocutaneous disorders may herald the onset of diabetes. Aims: To study the pattern of mucocutaneous manifestations in diabetics and role of it in diagnosing diabetes mellitus and its complications. Settings and Design: It was a longitudinal observational study of patients having diabetes with skin complaints attending skin outdoor department or admitted in wards for any reason in a tertiary care hospital. Materials and Methods: Total 300 patients were included in the study. Detailed history, clinical examination, and relevant investigations were done to diagnose the mucocutaneous disorders, diabetes, and diabetic complications. Statistical Analysis Used: The data was analyzed by using Epi info software. Results: Demographic profile shown majority of cases (78.66% in more than 40 years of age with almost equal male and female preponderance. Mucocutaneous manifestations as presenting feature of diabetes were observed in 21.67% cases. Infections were most common in 119 (39.66% cases, followed by acanthosis nigricans in 46 (15.33% cases. Various associated complications like hypertension, retinopathy, hyperlipidemia, coronary artery disease, neuropathy, nephropathy, and diabetic ketoacidosis were observed in 160 (53.3%. Conclusions: Skin is the mirror, which reflects internal diseases; this aptly applies to skin and diabetes mellitus. Through awareness about cutaneous manifestations of DM, dermatologist can not only take credit for detecting DM but also facilitate early diagnosis of systemic complications of DM. This is immensely beneficial to patients in long run.

  19. A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru

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    M. Shashi Kumar; B. Ramakrishna Goud; Bobby Joseph

    2014-01-01

    Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH) measures in the Laundry Department and to assess the use of personal protective equipments (PPEs) among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teachin...

  20. The epidemiology of hematogenous vertebral osteomyelitis: a cohort study in a tertiary care hospital

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    Wright Neill M

    2010-06-01

    Full Text Available Abstract Background Vertebral osteomyelitis is a common manifestation of osteomyelitis in adults and associated with considerable morbidity. Limited data exist regarding hematogenous vertebral osteomyelitis. Our objective was to describe the epidemiology and management of hematogenous vertebral osteomyelitis. Methods We performed a 2-year retrospective cohort study of adult patients with hematogenous vertebral osteomyelitis at a tertiary care hospital. Results Seventy patients with hematogenous vertebral osteomyelitis were identified. The mean age was 59.7 years (±15.0 and 38 (54% were male. Common comorbidities included diabetes (43% and renal insufficiency (24%. Predisposing factors in the 30 days prior to admission included bacteremia (19%, skin/soft tissue infection (17%, and having an indwelling catheter (30%. Back pain was the most common symptom (87%. Seven (10% patients presented with paraplegia. Among the 46 (66% patients with a microbiological diagnosis, the most common organisms were methicillin-susceptible S. aureus [15 (33% cases], and methicillin-resistant S. aureus [10 (22%]. Among the 44 (63% patients who had a diagnostic biopsy, open biopsy was more likely to result in pathogen recovery [14 (93% of 15 with open biopsy vs. 14 (48% of 29 with needle biopsy; p = 0.003]. Sixteen (23% patients required surgical intervention for therapeutic purposes during admission. Conclusions This is one of the largest series of hematogenous vertebral osteomyelitis. A microbiological diagnosis was made in only approximately two-thirds of cases. S. aureus was the most common causative organism, of which almost half the isolates were methicillin-resistant.

  1. A retrospective study of low-vision cases in an Indian tertiary eye-care hospital

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    Khan Sarfaraz

    2000-01-01

    Full Text Available Purpose:To obtain data on the characteristics of low-vision patients seen at a tertiary eye care hospital in India. Methods:Records of 410 patients were retrospectively reviewed at the Centre for Sight Enhancement, L.V.Prasad Eye Institute, Hyderabad, India. Patients underwent a comprehensive clinical low-vision examination. Data obtained included age, gender, consangunity, visual acuity, visual fields, ocular conditions causing low vision and types of low-vision devices and methods prescribed. Results:Two hundred and ninety seven (72% of 450 patients were male. One-fifth were in the 11-20 years age group (21%. Visual acuity in the better eye was <6/18 - 6/60 in almost half these patients (49.3%. One hundred and twenty two patients (29.9% referred with a visual acuity of ≥ 6/18, either had difficulty in reading normal print or had restricted visual fields. The main causes for low vision were: retinitis pigmentosa (19%, diabetic retinopathy (13%, Macular diseases (17.7%, and degenerative myopia (9%. Visual rehabilitation was achieved using accurate correction of ametropia (174 patients, approach magnification (74 patients and telescopes (45 patients for recognising faces, watching television and board work. Spectacle magnifiers (187 patients, hand/stand magnifiers (9 patients, closed-circuit television (3 patients, overhead illumination lamp (143 patients and reading stand (24 patients were prescribed for reading tasks. Light control devices (146 patients were used for glare control, and cane (128 patients and flashlight (50 patients for mobility. Patients were trained in activities to improve their daily living skills, (54 patients; counselled in environmental modification (144 patients and ancillary care (63 patients for educational and vocational needs. Conclusion:Data obtained from this study elucidates the characteristics of low-vision patients. This information is likely to help in the development of appropriate low vision services.

  2. Endourology in a Nigerian Tertiary Hospital – current level of ...

    African Journals Online (AJOL)

    Background: Endourology is rapidly advancing in developed countries. However, the level of practice in public tertiary hospitals in developing countries is abysmally low. Objective: To review the current practice of endourology in a Nigerian public tertiary hospital and discuss the challenges faced during the study period.

  3. Biomedical waste management: Study on the awareness and practice among healthcare workers in a tertiary teaching hospital

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    L Joseph

    2015-01-01

    Full Text Available Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.

  4. Retrospective study on cost distribution of antiretroviral therapy in a tertiary care hospital

    OpenAIRE

    Shreenivas P. Revankar; H. Vedavathi

    2015-01-01

    Background: Acquired immunodeficiency syndrome (AIDS) is caused by human immunodeficiency virus (HIV), which is an RNA virus. The first case of AIDS in human beings was reported in 1981, and now spread of HIV infection is alarmingly high with around 20 million deaths. The objective of the study was to determine the cost distribution of antiretroviral therapy among autoimmune deficiency syndrome (AIDS) patient attending the anti-retroviral therapy (ART) center of the tertiary care center. M...

  5. FACTORS AFFECTING THE SUCCESS OF INTRAUTERINE INSEMINATION- A CASE COMPARATIVE STUDY IN A TERTIARY HOSPITAL

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    Priyasree Jayasimhan

    2016-12-01

    Full Text Available BACKGROUND IUI is one of the simple techniques of assisted reproductive technique for treating infertility by artificial insemination. It has the advantage of positioning good quality sperm with increased count prepared by special semen washing technique into the uterine cavity, so that factors like decreased sperm count, poor sperm motility, impenetrable or absent cervical mucus or antisperm antibodies can be overcome. Sperm preparation method includes wash and swim-up technique using Percoll gradient. IUI is done by simple method and does not require the elaborate setup, investment and personnel like the other procedures of ART. The aims and objectives- 1. Factors associated with effectiveness of IUI among couples with primary infertility. 2. Factors studied include- Age of female partner, duration of infertility, menstrual regularity, menstrual flow, ovarian stimulation protocol, timing of IUI, endometrial thickness, number of cycles of IUI, luteal support, semen analysis findings. MATERIALS AND METHODS This is a case comparative study conducted in a tertiary hospital during three year period in which the forty women who conceived were considered as “study group” and another forty non-conceived women selected at random were taken as “control group.” RESULTS Factors like age of female showed statistical significance- when the age of female increased from 20-24 years to 30 years and above, the rate of conception reduced from 50% to 9%. Other factors like menstrual regularity, menstrual flow timing of IUI and number of cycles of IUI yielded no significant association with conception rates. Regarding the mode of ovarian induction, 90% of conceived group was given controlled superovulation using clomiphene citrate and gonadotrophins and 39% had ovulation triggered by HCG, which were statistically significant. In the conceived group, the mean endometrial thickness was 9.3 mm contrary to 7.8 mm in the non-conceived group. Minimum duration of

  6. RISK FACTORS FOR GESTATIONAL TROPHOBLASTIC NEOPLASIA: A CASE CONTROL STUDY IN A TERTIARY HOSPITAL

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    Hema Sreedharan Nair

    2016-10-01

    Full Text Available BACKGROUND Gestational trophoblastic disease is a spectrum of proliferative abnormalities of the trophoblast. GTD represents a benign form of the disease while GTN is the malignant often metastatic lesion. 75-80 per cent of patients initially diagnosed as GTD will follow a benign course after dilatation and curettage. 15-20 per cent develop locally invasive disease and 3-5 per cent develop metastatic lesions. The study aims to assess the proportion of gestational trophoblastic neoplasia among women with gestational trophoblastic disease and identify the risk factors for chemotherapy in gestational trophoblastic neoplasia. MATERIALS AND METHODS This is a case-control study conducted in a tertiary hospital during a 5-year period. Cases are gestational trophoblastic neoplasia diagnosed by either rising beta-HCG levels or plateauing beta-HCG levels or by histological evidence of choriocarcinoma. Controls are cases of gestational trophoblastic disease post evacuation with normal HCG regression at 8 weeks. There were 306 controls and 57 cases. RESULTS Tabulated and analysed using SPSS package. Of the 363 patients of gestational trophoblastic disease, 57 (15.7% needed chemotherapy. 98.2% belonged to the age group of 20-35 years. 63% had gestational age of more than 12 weeks, 56.1% had pre-evacuation HCG of more than 40,000. 15.7% needed combination therapy. CONCLUSION 1. 83.1% of patients belonged to age group of 20-30 years. 2. Blood group distribution of patients with gestational trophoblastic disease did not show any significance. 3. 15.7% of total patients were diagnosed to have gestational trophoblastic neoplasia that necessitated chemotherapy. 4. When uterine size was more than 12 weeks, a statistically significant number of patients needed chemotherapy compared to non-chemotherapy group. 5. When BHCG values were more than 40,000, a statistically significant number of patients needed chemotherapy. 6. A risk score of seven or more was found to

  7. A STUDY OF MORPHOLOGICAL TYPES OF ANAEMIA IN A TERTIARY CARE HOSPITAL - A TWO-YEAR STUDY

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    Kiran Kumar Epari

    2016-08-01

    Full Text Available BACKGROUND In this tertiary care hospital, one of the common condition of all the patients attending the hospital is Anaemia, which is a decrease in haemoglobin content or decrease in haematocrit below the lower limit of the 95% reference range for the individual’s age and sex. The patient presents with varied symptoms of different grades, depending on the severity of anaemia, in different clinical settings. Common presenting symptoms of anaemia are generalised weakness, malaise, loss of appetite and muscular pains. METHODS All the patient samples received at the central laboratory for haemogram, complete blood counts and peripheral smear examination over the period of two years between June 2014 to May 2016 were included in the study. Anaemia cases were diagnosed depending on the criteria of the definition of anaemia, and morphological typing of anaemia was done based on the peripheral smear examination of all the cases with decreased haemoglobin level. Standard cell counter was used to estimate the Hb and other red cell indices, and corroborated with peripheral blood smear examination by standard Romanowsky stains. RESULTS A total of 810 cases of anaemia were diagnosed over the period of two years, of which morphological typing yielded 685 cases of Microcytic and hypochromic anaemia, 15 cases of Dimorphic anaemia, 22 cases of Macrocytic anaemia and 88 cases of Normocytic and normochromic anaemia. CONCLUSION Anaemia is one of the most common problems of patients attending this tertiary care hospital, and detection and morphological typing of anaemia is very helping in guiding the clinicians in diagnosis and further management of anaemias for better patient care.

  8. A PROSPECTIVE STUDY OF MANAGEMENT OF MALIGNANT TUMORS OF HYPOPHARYNX IN A TERTIARY HOSPITAL

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    Satyanarayana

    2015-05-01

    Full Text Available INTRODUCTION: Malignant growths of Hypo Pharynx are one of the common Head and Neck malignancies in India. Males are commonly affected due to their smoking habit and use of Tobacco products, chewing habits. The combined use of Smoking and alcohol has a synergistic role in causing these malignant tumors. Post cricoid region is commonly involved in the development of malignant growth in females. Iron deficiency plays an important role as an etiologic factor in causing P.V. Synd rome which is a pre malignant condition in women. Malignant growths of hypo pharynx are observed in patients aged above 55 years and rare in age groups below 30 years. Pyriform sinus is the common site of involvement. Squamous cell carcinoma is the common histological finding among these malignancies. It usually presents with the complaints of foreign body sensation on swallowing which is neglected by the patients. This is followed by Hoarseness of voice and Dysphagia. Confirmation is by Direct Laryngoscopy and Biopsy. Multiple modalities of treatment are available now which includes surgery, Radiotherapy and chemotherapy. Nowadays a combination of these modalities is being used frequently to achieve a 5 year survival of more than 60%. The present study is b ased on chemo radiation in stage III and IV malignant growths of hypo pharynx in a tertiary hospital in Telangana. The study attempts to review the demographic and etiological factors playing a role in the disease process. It also analyses the post therapy effects on normal tissue as well as tumor mass. A 3 year post chemo radiation follow up results are analyzed. MATERIALS AND METHODS: The study includes 30 patients attending the OPD of ENT department of GGH, Kurnool, with the complaints of foreign body sensation on swallowing, dysphagia and hoarse voice. Patients are investigated after a thorough history taking. The nature of the growths is confirmed by Biopsy and HPE examination. A treatment protocol consisting of

  9. Evaluation of blood stream infections by Candida in three tertiary hospitals in Salvador, Brazil: a case-control study

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    Maria Goreth Barberino

    Full Text Available Invasive infections caused by Candida spp. are an important problem in immunocompromised patients. There is scarce data on the epidemiology of blood stream candidiasis in Salvador, Brazil. This study evaluates the risk factors associated with candidemia, among patients admitted to three tertiary, private hospitals, in Salvador, Brazil. We conducted a case-control, retrospective study to compare patients with diagnosis of candidemia in three different tertiary hospitals in Salvador, Brazil. Patients were matched for nosocomial, acquired infections, according to the causal agent: cases were defined by positive blood cultures for Candida species. Controls were those patients who had a diagnosis of systemic bacterial infection, with a positive blood culture to any bacteria, within the same time period (± 30 days of case identification. The groups were compared for the main known risk factors for candidemia and for mortality rates. A hundred thirty-eight patients were identified. Among the 69 cases, only 14 were diagnosed as infected by Candida albicans. Candida species were defined in only eight cultures: C. tropicalis (4 cases, C. glabrata, C. parapsilosis, C. guillermondi, C. formata (1 case each. The main risk factors, identified in a univariate analysis, were: presence of a central venous catheter (CVC, use of parenteral nutrition support (PNS, previous exposure to antibiotics, and chronic renal failure (CRF. No association was detected with surgical procedures, diabetes mellitus, neutropenia or malignancies. Patients were more likely to die during the hospitalization period, but the rates of death caused by the infections were similar for cases and controls. The length of hospitalization was similar for both groups, as well as the time for a positive blood culture. Blood stream infection by Candida spp. is associated with CVC, PNS, previous use of antibiotics, and CRF. The higher mortality rate for cases probably better reflects the severity

  10. CaLD nurses transition to Australian tertiary hospital practice: Exposing the reality--A mixed methods study.

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    Holmes, Tina; Grech, Carol

    2015-01-01

    To investigate CaLD nurses' transition into the Australian workforce over the first 3 months of employment in tertiary hospitals. Descriptive mixed method design, informed by the critical paradigm. Survey questionnaire and a focus group were used for data collection. The existence of a specific hospital orientation program was identified as a crucial factor in participants' successful transition. Without a hospital based orientation program participants were more likely to experience failure to 'fit in'. This led to maladaptive behaviors where they did not actively seek, support or question practice through fear of drawing increased attention to themselves. WORKPLACE IMPLICATIONS: Results from the study raise serious implications for workplace safety of both the CaLD nurses and the patients they nurse. Government and health administrators need to invest in providing specific hospital orientation programs that support CaLD nurses' transition. The development of such hospital orientation programs need to be developed as to the specific learning requirements of these nurses or risk exposing them to maladaptive behaviors and potential adverse events as a result of this learned behavior.

  11. Study on hepatitis B vaccination coverage among workforce of a tertiary care hospital in North India

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    Fazili Anjum B

    2016-05-01

    Full Text Available Hepatitis B is one of the most serious of the 20 blood borne pathogens which are the major threat to health care workers (HCWs. While a vaccine for hepatitis B exists, its utilization among HCWs and factors surrounding its utilization in many developing countries are unknown. This study was carried out to find hepatitis B vaccination coverage among work force of a tertiary care institute and various factors affecting its acceptance among health care workers. Cross-sectional study was carried for a period of six months at Sher-i-Kashmir institute of Medical Sciences (SKIMS, Soura. All the employees who consented to participate were taken up for this study. A selfadministered, pre-structured questionnaire were used to collect data from all the participants. Of the 2763 employees studied, 71.4% were males and 28.6% were females with mean age of 40.46 years. 25.76% employees were completely vaccinated and 51.24% were unvaccinated. Among high risk group only 32.7% of employees were completely vaccinated. Also among fully vaccinated employees, no one had got their post vaccination titers done. Important reasons for not taking the vaccine were no knowledge regarding the vaccine (31.80 %, low level of perceived susceptibility for getting the infection (27.0% and unwillingness to spend money or cost of the vaccine (26.24%. More awareness and education among HCW’s is warranted to clear misconceptions and promote more acceptance of vaccine.

  12. A surveillance study of bacterial flora associated with mobile phones in a tertiary care hospital

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    Roy, Reshmi Chanda

    2013-01-01

    Nosocomial infection is an important problem in all hospitals which is contributed by the contaminated hand of the health care worker. The use of mobile phones in health care setting also play an important part as it may play as a reservoir of microorganism. This study is aimed to focus on the colonization of bacterial flora on mobile phones of health care workers.

  13. Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study

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    Karki Surendra

    2012-10-01

    Full Text Available Abstract Background Vancomycin-resistant Enterococcus (VRE has been established as a significant health-care associated problem since its first isolation in Australia in 1994. In this study, we measured the point prevalence and identified risk factors associated with vanB VRE colonisation in a tertiary care hospital in Melbourne, Australia where VRE has been endemic for 15 years. Methods A hospital-wide point prevalence survey was conducted on October 13, 2008 with colonisation detected using rectal swab culture. Patient’s demographic and medical information was collected through a review of medical records. Factors associated with VRE colonisation in univariate analysis were included in multivariate logistic regression model to adjust for confounding. Results The prevalence of VRE colonisation on the day of screening was 17.5% (95% CI, 13.7 to 21.9. VRE was detected from patients in each ward with the prevalence ranging from 3% to 29%. Univariate analysis showed the use of any antibiotic, meropenem, ciprofloxacin, diarrhoea and longer length of hospital stay were associated with increased risk of VRE colonisation (p0.05. Multivariate analysis showed the exposure to meropenem (p=0.004, age (≥65 years (p=0.036 and length of stay ≥7 days (p Conclusion Our study suggests that exposure to antibiotics may have been more important than recent cross transmission for a high prevalence of vanB VRE colonisation at our hospital.

  14. Pattern of liver disease admissions in a Nigerian tertiary hospital ...

    African Journals Online (AJOL)

    Objective: Liver disease is an important cause of morbidity and mortality globally. Its pattern varies in different geographical locations. This study aimed to determine the pattern and risk factors of liver disease in a Nigerian tertiary hospital. Study Design: Retrospective Study Site: University of Nigeria teaching hospital ...

  15. A study of antimicrobial use in children admitted to pediatric medicine ward of a tertiary care hospital.

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    Baidya, Sandip; Hazra, Avijit; Datta, Supratim; Das, Amal Kanti

    2017-01-01

    Antimicrobials are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in Eastern India, to generate a profile of antimicrobial use and suspected adverse drug reactions (ADRs) attributable to them. Hospitalized children of either sex, aged between 1 month and 12 years, were studied. Baseline demographic and clinical features, duration of hospital stay, antimicrobials received in hospital along with dosing and indications and details of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or death. Over the 1 year study period, 332 admissions were screened. The prevalence of antimicrobial use was 79.82%. The majority of the 265 children who received antimicrobials were males (61.10%) and hailed from rural and low socioeconomic background. Median age was 36 months. Six children died, 43 were transferred out, and the rest discharged. In most instances, either 2 (40%) or a single antibiotic (39.6%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antivirals, antimalarials, and antiprotozoals were used occasionally. Average number of antimicrobials per patient was 2.0 ± 1.27; the majority (84.1%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antimicrobial treatment ranged between 1 and 34 days, with a median of 7 days. Six ADRs were noted of which half were skin rash and the rest loose stools. The profile of antimicrobial use is broadly similar to earlier Indian studies. Apparent overuse of multiple antimicrobials per prescription and the parenteral route requires exploration. Antimicrobials are being used empirically in the absence of policy. ADRs to antimicrobials are occasional and usually mild. The baseline data can serve in situation analysis for antibiotic prescribing guidelines.

  16. STUDY ON KAP OF OCULAR COMPLICATIONS DUE TO DIABETES AMONG TYPE II DIABETICS VISITING A TERTIARY TEACHING HOSPITAL

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    Jacob Koshy

    2012-03-01

    Full Text Available Introduction: Diabetes mellitus is a major public health problem worldwide. Diabetic patients are at risk of developing blindness from diabetic retinopathy. While occurrence of diabetic retinopathy cannot be prevented, its complications can be minimized. This requires awareness of the sight-threatening potential of diabetes and the need for regular eye examinations. Aim: To study the knowledge of ocular complications of diabetes, among type II diabetics visiting a tertiary level hospital. Settings and Design: This was a prospective study in a tertiary care teaching hospital. Methods and Material: This was a questionnaire based study on 350 type II diabetics. All patients were interviewed by the same investigator. Statistical analysis used: The data was analysed using chi square test. Results: With increase in the duration of illness, the awareness about diabetic retinopathy is more. Even though the awareness of the disease increased with increasing duration of the disease, 51.4% of the diabetics did not know how diabetes can affect the eye, 49.7% of diabetics did not know if diabetic retinopathy can be treated and 67.4% had not heard of any treatment modality for diabetic retinopathy. This shows that lack of knowledge about the disease was significant. Conclusions: Prevention of non-communicable disease through increased awareness needs to be the thrust of the effort in resource poor contexts, where the treatment can be prohibitively costly. These measures would help to bring about more awareness and understanding about the disease among the patients and therefore prevent sight-threatening complications by timely intervention and management.

  17. HIV test counselling at a tertiary hospital

    African Journals Online (AJOL)

    AIDS training course presented either by the medical school or an AIDS training centre. In view of the perceived lack of training in general counselling, this would perhaps be most effective as part of a formal general counselling programme for all undergraduates. In a tertiary hospital one has the added benefit of a large.

  18. Clinico-Epidemiological study of poisoning in a tertiary care hospital in Bangladesh

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    Rabiul Hossain

    2017-01-01

    Full Text Available Objective: The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool. Methods: This prospective study was done at two medicine units (Unit 5 and 10 of Dhaka Medical College Hospital from July to December 2010 where all poisoning cases were seen. A total of 2890 patients were admitted out of which 600 were taken into the study. Results: Among the poisoning cases 29% were pesticide, 27% travel related poisoning, and 20% benzodiazepine. 70% of poisoning occurred below 30 years of age and male: female ratio was 3:2. Incidence of poisoning was highest among students (31% and housewives (25%. Majority of the patients were from urban area (76% and most common intention was suicidal (66%. Familial disharmony was the prime cause (63% behind poisoning. 42% cases got admitted between 5-8 hours of poisoning and more than 80% patients were admitted in the hospital directly without getting any first aid anywhere. Sixty-eight percent had Glasgow coma scale (GCS score above 10 during admission. Cardinal clinical features of poisoning were nausea/vomiting (63%, drowsiness (56%, miosis (31%. Seventy percent patients were treated with only general and supportive treatment and specific antidotes were used in 30% cases. Case fatality for pesticide, benzodiazepine/anti-psychotic, rodenticide and snake bite was 6.9%, 2.2%, 8.3% and 3.3% respectively. Conclusion: To assess the magnitude of problem, awareness of the public for prevention, immediate first aid measures and quick hospital admission is crucial component of poisoning.

  19. PREVALENCE OF GDM AND THEIR RISK FACTORS IN A TERTIARY HOSPITAL- A PROSPECTIVE STUDY

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    S. Ishwarya

    2017-11-01

    Full Text Available BACKGROUND Detecting the evidence of gestational diabetes mellitus is a major challenge as the condition is associated with diverse range of adverse maternal and neonatal outcome. Also, women detected with gestational diabetes mellitus have an increased incidence of diabetes especially type 2 diabetes mellitus in the later life and future development of obesity and diabetes in the offspring. Studies conducted in different populations and with different methodologies consistently reported an increase in GDM prevalence. A true increase in the prevalence of GDM aside from its adverse consequences for the infant and newborn period might reflect or contribute to the ongoing pattern of increasing diabetes and obesity. 1&2 The aim of the study is to1. Validate the Diabetes in Pregnancy Study Group of India (DIPSI recommended 75 grams glucose test for the diagnosis of gestational mellitus by comparing with the WHO criteria and ADA criteria. 2. Study the prevalence of gestational diabetes in antenatal population attending Government Kilpauk Medical College Hospital. 3. Study the prevalence of following risk factors in GDM. MATERIALS AND METHODS This prospective study was conducted in 350 antenatal women of 24-28 weeks gestational age who attended antenatal clinic in Government Kilpauk Medical College Hospital, Chennai. This study was done after getting clearance from ethical committee of Government Kilpauk Medical College Hospital. RESULTS Incidence of GDM was 4%. DIPSI criteria had a diagnostic accuracy, sensitivity and specificity of 98.86%, 100% and 98.82%. WHO criteria had a diagnostic accuracy, sensitivity and specificity of 99.43%, 100% and 99.41%. In both, the negative predictive value was 100%. From binary logistic regression, the associated risk factors were previous history of GDM, polyhydramnios and recurrent pregnancy loss evolved as significant risk factors. Polyhydramnios has an odds ratio of 13, previous history of GDM has an odds ratio of

  20. Clinico-epidemiological Study on Pesticide Poisoning in a Tertiary Care Hospital in Eastern Nepal.

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    Agrawaal, K K; Karki, P

    2014-01-01

    Pesticide poisoning is a major health problem worldwide. In Nepal the most common cause is suicidal and pesticides account for more than fifty percent of cases. The objective of the study was to look in detail regarding the pesticide poisoning cases admitted at BPKIHS; their epidemiological profile, presentation, treatment and their outcome during the hospital stay. It was a retrospective study which included 2621 patients with poisoning of which 1661 cases were related to pesticides. The mean duration of hospital stay was 6.7 days. The majority of patients 81.16% showed improvement whereas 6.6% of patients died within 24 hours of admission and 3.54% after 48 hours of admission. Among all the patients 0.5% patients were given ICU care and all others were managed in the different units of medicine ward. The total amount of atropine administered varied considerably. Most of the cases were under the influence of alcohol. All the patients had a psychiatry evaluation before discharge. Pesticide poisoning is increasing in incidence and it is one of the preventable public health problems and includes mainly the patients' age group 20-30 years. Due to easy availability of pesticides it is the most preferred method of suicide and the main reasons being impulsive act and increased indebtedness in the society.

  1. Patterns and Outcomes of Diabetic Admissions in a Tertiary Hospital ...

    African Journals Online (AJOL)

    The prevalence of diabetes mellitus is increasing globally. It also constitutes one of the common indications for admission into the medical wards of most hospitals. This study is aimed at examining diabetes –related admission and outcomes in a tertiary hospital located in a semi –urban community in Delta state, ...

  2. STUDY OF SPECTRUM OF PYREXIA OF UNKNOWN ORIGIN PATIENTS IN A TERTIARY CARE HOSPITAL IN COASTAL ANDHRA PRADESH

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    Suryaprakasa Rao Salla

    2017-09-01

    Full Text Available BACKGROUND Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO was defined in 1961 by Petersdorf RG and Beeson PB2 as the following- A temperature greater than 38.3°C (101°F on several occasions; more than 3 weeks' duration of illness; and failure to reach a diagnosis despite 1 week of inpatient investigation. The aim of the study is to study the spectrum of cases of Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO in a tertiary care hospital in coastal Andhra Pradesh. MATERIALS AND METHODS All patients with PUO admitted under the Department of General Medicine in the NRI Institute of Medical Sciences (Anil Neerukonda Hospital Sangivalasa, Visakhapatnam, during the period from 1st September, 2016, to 31st August, 2017, and who fulfil inclusion and exclusion criteria of classic PUO defined by Durrack and AC street1 were selected for the study. RESULTS The present study included 34 patients with pyrexia of unknown origin in which the patients’ age ranged from 15 years to 77 years. Most of the cases, 41.2% were in the age group 21 to 40 years and 35.3% in the age group 41 to 60 yrs. This indicates PUO is common in middle age group in our study. CONCLUSION Noninfectious causes like collagen vascular disease and neoplasms are becoming important differential diagnosis. But, in India, infections like tuberculosis, enteric fever are still the most common cause of FUO.

  3. The experiences of rural and remote families involved in an inter-hospital transfer to a tertiary ICU: a hermeneutic study.

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    Mackie, Benjamin; Kellett, Ursula; Mitchell, Marion; Tonge, Angela

    2014-11-01

    Inter-hospital transfers are necessary for critically ill patients to improve their chance of survival. Rural and remote families experience significant disruption to family life when critically ill patients are required to undergo a transfer to a tertiary hospital. What is not known is how ICU staff can assist these families who are involved in an inter-hospital transfer to a tertiary ICU. To gain an understanding of rural and remote critical care families' experiences during an inter-hospital transfer to a tertiary ICU. A hermeneutic phenomenological approach was adopted informed by the philosophical world views of Heidegger and Gadamer. Data collection occurred by in-depth conversational interviews from a purposeful sample of seven family members. Interview transcripts, field notes and diary entries formed the text which underwent hermeneutic analysis. Being confused, being engaged, being vulnerable and being resilient emerged as significant aspects of the rural and remote family members' experience during a transfer event. A better understanding of the experiences of rural and remote families during an inter-hospital transfer journey can inform the practice of ICU nurses. This study highlights the specific experiences of rural and remote families during an inter-hospital transfer journey to a tertiary ICU. It also informs nurses of the meaningful ways in which they can support these families with the uncertainty and chaos experienced as part of this journey. Copyright © 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  4. A Hospital Based Clinical Study on Corneal Blindness in a Tertiary Eye Care Centre in North Telangana

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    Raghu Veladanda

    2016-04-01

    Full Text Available Background: Worldwide there are nearly 2.7 million blind people due to corneal disease which is a major causes of blindness in the world today and remains second only to cataract. Aim & Objective: The present hospital based retrospective study was undertaken to estimate the prevalence of corneal blindness in patients attending tertiary eye care center in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar. Material and Methods: A hospital-based study was conducted over a period of 1 year from August 2014 to August 2015. Participants were patients attending outpatient department of Chalmeda Anand Rao Institute of Medical Sciences. Detailed history was taken and comprehensive ocular examination including Snellen E-chart for visual acuity, slit lamp bio microscopy, contact tonometry, posterior segment evaluation through B-scan and dilated retinal evaluation when indicated was performed at out patient department. Results: Overall, 33,566 patients were examined. Proportion of corneal blindness was 3.9% (CI-95% 3.6% - 4.3%. The proportion increased with age in elderly patients (5.7% and was higher among the females (5.2% compared to males (2.8%. The most common cause of corneal blindness in our study was ocular trauma which was 59.5%. Conclusion: The study ?findings demonstrate that currently ocular trauma, corneal ulceration, infectious keratitis, postsurgical bullous keratopathy, and corneal degenerations are responsible for the major burden of corneal blindness among the patients attending outpatient department.

  5. Diagnostic utility of coeliac disease: a descriptive study in a tertiary care hospital, oman.

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    Al Saidi, Safana Salim; Al Harthi, Salim Omar; Mula-Abed, Waad-Allah Sharef

    2013-07-01

    The prevalence of coeliac disease in Oman is unknown. We aim to estimate the prevalence of coeliac disease in at-risk subjects, describe the clinical characteristics and laboratory findings associated with coeliac disease and the validity of serological testing for coeliac disease at the Royal Hospital, Oman over a period of three years. This is a retrospective case finding study. The medical and laboratory records were reviewed for patients for whom serum antiendomysium IgA antibodies were requested at the Royal Hospital during a 3-year period (1(st) Jan 2006-31(st) Dec 2008). The data were extracted in order to assess the following: a) Prevalence rate of coeliac disease among at-risk subjects; b) Clinical characteristics in patients with coeliac disease and clinical manifestations for which the requesting clinicians considered coeliac disease as a possible diagnosis, including their specialties; c) Laboratory tests results in patients with coeliac disease; and d) Validity of antiendomysium antibodies testing in comparison with histopathology of jejunal biopsies for diagnosing coeliac disease. The study included 431 patients (250 females, 181 males) who were suspected of having (or screened for) coeliac disease. The median of age was 15 years (range: 9 months-74 years) with mean ± SD 18.95 ± 14.1 years. Of these, 15 (3.5%) patients (10 females, 5 males) with a median age of 19 years and mean 21.4 ± 13.0 years (range: 2.5-38 years), had positive antiendomysium antibodies results with median (range) of 160 (40-320) IU/L and mean± SD 204.5 ± 160 IU/L. Of these 15 patients, 13 had positive jejunal histopathological changes indicative of coeliac disease; the remaining 2 patients had no biopsy examination. Of the 44 patients with negative antiendomysium antibodies medical specialties has increased the number of diagnosed cases of coeliac disease. The requesting for serological test is being made mainly by endocrinologists and gastroenterologists.

  6. Epidemiology of Clostridium difficile infection in two tertiary-care hospitals in Perth, Western Australia: a cross-sectional study

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    N.F. Foster

    2014-05-01

    Full Text Available The epidemiology of Clostridium difficile infection (CDI has changed over time and between countries. It is therefore essential to monitor the characteristics of patients at risk of infection and the circulating strains to recognize local and global trends, and improve patient management. From December 2011 to May 2012 we conducted a prospective, observational epidemiological study of patients with laboratory-confirmed CDI at two tertiary teaching hospitals in Perth, Western Australia to determine CDI incidence and risk factors in an Australian setting. The incidence of CDI varied from 5.2 to 8.1 cases/10 000 occupied bed days (OBDs at one hospital and from 3.9 to 16.3/10 000 OBDs at the second hospital. In total, 80 patients with laboratory-confirmed CDI met eligibility criteria and consented to be in the study. More than half (53.8% had hospital-onset disease, 28.8% had community-onset and healthcare facility-associated disease and 7.5% were community-associated infections according to the definitions used. Severe CDI was observed in 40.0% of these cases but the 30-day mortality rate for all cases was only 2.5%. Besides a shorter length of stay among cases of community-onset CDI, no characteristics were identified that were significantly associated with community-onset or severe CDI. From 70 isolates, 34 different ribotypes were identified. The predominant ribotypes were 014 (24.3%, 020 (5.7%, 056 (5.7% and 070 (5.7%. Whereas this study suggests that the characteristics of CDI cases in Australia are not markedly different from those in other developed countries, the increase in CDI rate observed emphasizes the importance of surveillance.

  7. Urogenital fistulae: A prospective study of 50 cases at a tertiary care hospital

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    Mathur Rajkumar

    2010-01-01

    Full Text Available Introduction: The misfortunate incident of formation of a urogenital fistula remains a major challenge for surgical urologists worldwide. Such fistulae may not be a life-threatening problem, but surely the women face demoralization, social boycott and even divorce and separation. The fistula may be vaginal, recto-vaginal or a combination of the two. The World Health Organization (WHO has estimated that in the developing nations, nearly 5 million women annually suffer severe morbidity with obstetric fistulae being the foremost on the list. The objective of our study was to enunciate the patient demography, patient profile, incidence, type of surgery, as well as the long-term outcomes encountered in the management of all types of genital fistulae at a tertiary care centre. Materials and Methods: 50 consecutive patients, attending the outpatient department with urogenital fistulae, were studied during the period of 5 years from July 2005 to July 2009. All female patients with complaints of urinary incontinence and fecal incontinence and dribbling, patients having a history of obstructed labor, radiotherapy, instrumental delivery, foreign body or trauma and with a history of hysterectomy (abdominal/ vaginal and lower segment caesarean section (LSCS were included. A thorough urological examination included a dye study using methylene blue, Renal function tests, X-ray KUB and intravenous urography (IVU. Cystoscopy along with examination under anaesthesia (EUA were done to assess the actual extent of injury. All patients were subjected to appropriate surgical interventions via the same combination of surgeons . Post operatively, prophylactic antibiotics were administered to all patients and patients were managed till discharge and followed thereafter via regular outpatient visits for a period of 3 years. Results: Age of patients ranged from 21 to 40 years. 64% patients hailed from rural areas, 76% were from the lower socio-economic strata, 40

  8. Off-Label Medicine Use in Pediatric Inpatients: A Prospective Observational Study at a Tertiary Care Hospital in India

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    Mohd Masnoon Saiyed

    2014-01-01

    Full Text Available Background. In the absence of standard pediatric prescribing information, clinicians often use medicines in an off-label way. Many studies have been published across the globe reporting different rates of off-label use. There is currently no study based on Indian drug formulary. Methods. The prospective observational study included pediatric patients in ages between 0 and 12 years admitted in a tertiary care hospital. Off-label use was assessed using the National Formulary of India (NFI. Predictors of off-label use were determined by logistic regression. Results. Of the 1645 medications prescribed, 1152 (70% were off-label based on 14 possible off-label categories. Off-label medicines were mainly due to dose difference and use in restricted age limits as indicated in NFI. Respiratory medicines (82%, anti-infectives (73%, and nervous system medicines (53% had higher off-label use. Important predictors of off-label prescribing were pediatric patients in age of 0 to 2 years (OR 1.68, 95% CI; P<0.001 and hospital stay of six to 10 days (OR 1.91, 95% CI; P<0.001. Conclusion. Off-label prescribing is common among pediatric patients. There is need to generate more quality data on the safety and efficacy of off-label medicines to rationalize pediatric pharmacotherapy.

  9. Staff perception on biomedical or health care waste management: a qualitative study in a rural tertiary care hospital in India.

    Science.gov (United States)

    Joshi, Sudhir Chandra; Diwan, Vishal; Tamhankar, Ashok J; Joshi, Rita; Shah, Harshada; Sharma, Megha; Pathak, Ashish; Macaden, Ragini; Stålsby Lundborg, Cecilia

    2015-01-01

    Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. Two themes were identified: Theme (A), 'Challenges in integration of HCWM in organizational practice,' with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), 'Interventions to improve HCWM,' with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings.

  10. A qualitative study into the impact of fasting within a large tertiary hospital in Australia--the patients' perspective.

    Science.gov (United States)

    Carey, Sharon K; Conchin, Simone; Bloomfield-Stone, Susan

    2015-07-01

    This qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective. Fasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche. Qualitative descriptive design within a tertiary hospital in Sydney, Australia. Twelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used. Analyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again. Discomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority. It is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient

  11. Job satisfaction among doctors, a multi-faceted subject studied at a tertiary care hospital in Lahore.

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    Atif, Khaula; Khan, Habib Ullah; Maqbool, Shahzad

    2015-01-01

    To study the level of job satisfaction among doctors serving in a tertiary care hospital in Lahore and ascertain its co-relation with multiple demographic variables which had a profound impact. This cross sectional study with non-probability purposive sampling was conducted at Combined Military Hospital, Lahore, from February 2014 to November 2014. Subjects were doctors serving in that hospital for minimum six months duration. Pre-formed questionnaires were distributed to volunteers (average filling time was 3 ½ to 7 minutes). Multiple demographic features were independent variables. Outcome variable was job satisfaction. Statistical analysis was done via descriptive statistics (SPSS 20), data expressed as mean ± standard deviation (SD). Out of 263 doctors serving in hospital, 203 (77.91%) volunteered to participate; response rate by depositing the filled forms was 47.78% (97 doctors). Amongst the respondents, 10 (10.3%) doctors had below average job satisfaction, 32(33.0%), 21(21.6%), 21(21.6%) and 13(13.3%) had average, above average, well above average and outstanding job satisfaction respectively. There was significant relation between job satisfaction and age group of the doctors (p 0.025), education (p 0.015), service years (p 0.013) income per month (pjob (p 0.204), working hours (p 0.089), additional duties p 0.421) and socioeconomic class (p 0.104) on outcome variable. A significant number of doctors was found discontented with their job, which may consequently impact their yield/performance. The job satisfaction can be substantially improved if these contributory factors are aptly addressed at all tiers.

  12. Staff perception on biomedical or health care waste management: a qualitative study in a rural tertiary care hospital in India.

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    Sudhir Chandra Joshi

    Full Text Available Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management.A qualitative study was conducted using 10 focus group discussions (FGDs, with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i role of Health Care Waste Management (HCWM in prevention of health care associated infections, (ii awareness of and views about HCWM-related guidelines/legislation, (iii current HCWM practices, (iv perception and preparedness related to improvements of the current practices, and (v proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi and analysed using content analysis.Two themes were identified: Theme (A, 'Challenges in integration of HCWM in organizational practice,' with the categories (I Awareness and views about HCWM, (II Organizational practices regarding HCWM, and (III Challenges in Implementation of HCWM; and Theme (B, 'Interventions to improve HCWM,' with three categories, (I Educational and motivational interventions, (II Organizational culture change, and (III Policy-related interventions.A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings.

  13. Extrapulmonary Tuberculosis: A retrospective Study at a tertiary care hospital in Palpa, Nepal

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    Chandan Kumar Thakur

    2013-12-01

    Full Text Available Background: Extra-pulmonary tuberculosis (EPTB is a significant global health problem. Related studies to it in different places and diff erent durations are indicated by many previous research findings. Findings of this study could be beneficial for its preventive and control strategies. Methodology: Retrospective analysis of clinical specimens submitted to Central laboratory of Lumbini Medical College and Teaching Hospital (LMCTH for extrapulmonary tuberculosis was performed. Total 261 samples submitted from April 2011 to February 2013 were included for analysis in this study. Results: Total 20.7% (54/261 prevalence of EPTB was reported. Based on sites involved; lymph node 87.03%, pleural effusion7.40%, peritoneal5.55% were found. Genderwise equal prevalence was seen among male and females. Age-wise prevalence among patients between 21-40 years was reported. Conclusion: Our finding indicates great necessity for further large scale study on prevalence of EPTB in this location for its prevention and control.

  14. Allergic contact dermatitis due to cosmetics: A clinical and epidemiological study in a tertiary hospital.

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    Zaragoza-Ninet, V; Blasco Encinas, R; Vilata-Corell, J J; Pérez-Ferriols, A; Sierra-Talamantes, C; Esteve-Martínez, A; de la Cuadra-Oyanguren, J

    2016-05-01

    The incidence of allergic contact dermatitis (ACD) to cosmetics in the general population is rising with the increasing use of cosmetic products and their proliferation and diversification. The aims of this study were to determine the prevalence of ACD to cosmetics in our setting, analyze changes over time, describe the clinical and epidemiological features of this allergic reaction, and identify the allergens and cosmetics involved. We performed a prospective study at the skin allergy unit in Hospital General Universitario de Valencia in Spain between 2005 and 2013 and compared our findings with data collected retrospectively for the period 1996 to 2004. The 5419 patients who underwent patch testing during these 2 periods were included in the study. The mean prevalence of ACD to cosmetics increased from 9.8% in the first period (1996-2004) to 13.9% in the second period (2005-2013). A significant correlation was found between ACD to cosmetics and female sex but not atopy. Kathon CG (blend of methylchloroisothiazolinone and methylisothiazolinone), fragrances, and paraphenylenediamine were the most common causes of ACD to cosmetics during both study periods, and acrylates and sunscreens were identified as emerging allergens during the second period. Copyright © 2016 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  15. OCULAR INVOLVEMENT IN MUCOCUTANEOUS DISORDERS- A STUDY IN TERTIARY HOSPITAL IN SOUTH ORISSA

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    Sarita Panda

    2017-09-01

    Full Text Available BACKGROUND Diseases of skin, mucous membrane and mucocutaneous junctions may also affect the eyes. Physical findings of dermatological disorders and eyes overlap due to three factors- (i Genodermatoses often affects both skin and eyes because of origin from embryonic ectodermal layers, (ii Acquired dermatological disorders may affect the mucocutaneous tissue of periorbital regions, (iii Systemic diseases can manifest as diseases of skin and periocular mucocutaneous tissue because of their superficial anatomical locations. The aim of the present study was observation and interpretation of changes in the eye in different mucocutaneous disorders and correlation of the eye changes with severity of the diseases. MATERIALS AND METHODS A prospective study was undertaken in the Department of Ophthalmology, M.K.C.G. Medical College and Hospital, Berhampur, South Orissa, during the period of 2014 to 2016 including the referred patients after being diagnosed with mucocutaneous disease from Department of Dermatology, Paediatric and Medicine from the same hospital. A case study of 204 patients (M- 164, F-40 was done. All patients underwent detailed ophthalmic examination inclusive of ocular movements, VA, IOP, S/L exam, blood and urine investigation and fundus examination. RESULTS Out of 204 patients examined, i.e. 164 males and 40 females, the ocular involvement found was 132, i.e. 64%. Majority of patients having ocular lesions were affected by herpes (72.2% and leprosy (78.57%. Most common mucocutaneous syndrome in the study was herpes (35.29% and leprosy (27.45%. Most common ocular lesions in various mucocutaneous ocular syndrome was found to be conjunctivitis (45.4%, blepharitis (34.8% and periorbital vesicles (30.3%. The least common was found to be trichiasis and conjunctival membrane each 3%. After follow-up of 3 months, the following ocular sequelaes were observed, i.e. dry eye (9%, symblepharon (7.5%, corneal scar (4.5%, corneal vascularisation (3

  16. Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital.

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    Vo, Nhung Thi Tuyet; Phan, Trang Ngo Diem; Vo, Trung Quang

    2017-05-01

    In Vietnam, dengue fever is a major health concern, yet comprehensive information on its economic costs is lacking. The present study investigated treatment costs associated with dengue fever from the perspective of health care provision. This retrospective study was conducted between January 2013 and December 2015 in Cu Chi General Hospital. The following dengue-related treatment costs were calculated: hospitalisation, diagnosis, specialised services, drug usage and medical supplies. Average cost per case and treatment cost across different age was calculated. In the study period, 1672 patients with dengue fever were hospitalised. The average age was 24.98 (SD = 14.10) years, and 47.5% were males (795 patients). Across age groups, the average cost per episode was USD 48.10 (SD = 3.22). The highest costs (USD 56.61, SD = 48.84) were incurred in the adult age group (> 15 years), and the lowest costs (USD 30.10, SD = 17.27) were incurred in the paediatric age group (< 15 years). The direct medical costs of dengue-related hospitalisation place a severe economic burden on patients and their families. The probable economic value of dengue management in Vietnam is significant.

  17. Prediction of Wound Healing in Diabetic Foot Ulcers: an Observational Study in Tertiary Hospital in Indonesia

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    Pradana Soewondo

    2017-04-01

    Full Text Available Aim: to evaluate the role of clinical characteristics, functional markers of vasodilation, inflammatory response, and atherosclerosis in predicting wound healing in diabetic foot ulcer. Methods: a cohort study (February – October 2010 was conducted from 40 subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each subject underwent at least two variable measurements, i.e. during inflammatory phase and proliferation phase. The studied variables were clinical characteristics, complete peripheral blood count (CBC and differential count, levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG, marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA, endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery, and marker of vascular calcification (osteoprotegerin/OPG. Results: median of time achieving 50% granulation tissue in our study was 21 days. There were nine factors that contribute in the development of 50% granulation tissue, i.e. family history of diabetes mellitus (DM, previous history of wound, wound area, duration of existing wound, captopril and simvastatin medications, levels of ADMA, ET-1, and OPG. There were three out of the nine factors that significantly correlated with wound healing, i.e. wound area, OPG levels, and simvastatin medications. Conclusion: in acute diabetic foot ulcers, wound area and OPG levels had positive correlation with wound healing, whereas simvastatin medications had negative correlation with wound healing.

  18. SELF - MEDICATION PRACTICES AMONG NON TEACHING STAFF IN A TERTIARY CARE HOSPITAL: A QUESTIONNAIRE BASED STUDY

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    Padma

    2015-01-01

    Full Text Available AIM: To assess the prevalence and pattern of self - medication use. Material and methods: It was a cross - sectional questionnaire based survey conducted by the Department of Pharmacology at Dr. B. R. Ambedkar Medical College and Hospital in September 2014. 200 non - teaching staff were included in this study. RESULTS: Headache, common cold, cough and fever were the most common conditions for which people have used OTC drugs. NSAIDs (37.93% were the most commonly used group of drugs for self - medication . Easy availability of OTC drugs was the most common cause for using self - medication . Pharmacists, showing previous prescription were the most common methods for procuring drugs by the people. CONCLUSION: This study shows that majority of the people had poor knowledge about appropriate self - medication . It emphasises the need for specific pharmacovigilance where the patient, pharmacist and physician must be encouraged to report any adverse events. Periodic studies on the knowledge, attitude and practice of self - medication may give insight into the changing pattern of drug use in societies

  19. A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

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    Gautam Yogesh

    2009-01-01

    Full Text Available Background: According to WHO estimates India will be the global capital of diabetes by 2025, accounting for 57.2 million diabetics. Worsening the situation is the fact that diabetes affects the economically productive age-group (45-65 years in developing countries. Objective : To measure quality of life (QOL and study the clinical profiles and associated sociodemographic factors affecting diabetic patients aged 20 years and above. Materials and Methods: We conducted a hospital-based cross-sectional study using a generic instrument, Short-Form 36 (SF-36 of the Medical Outcome Study Group to measure QOL of diabetic subjects aged ≥20 years. Two hundred and sixty diabetics, including 91 males and 169 females, were selected from the clinics of SSK Hospital and Dr RML Hospital of New Delhi. Data was analysed using SPSS for Windows, version 12. Results: The mean age of the respondents was 49.7 years, with 80% of respondents being in the age-group of 40-69 years. The majority (52.1% of female respondents were illiterate and 91.1% were economically dependent. Of the male respondents, 65.9% were skilled workers. Substance abuse was present among 41.8% male subjects. Type 2 diabetes was the commonest, with 94.6% of the subjects having this form. The mean duration of diabetes was 6.96 ± 6.08 years. Oral hypoglycemic agents were being taken by 70.77% of the respondents. Among the diabetics the most common comorbidity was hypertension (30.8% and the commonest complication was neuropathy (26.2%. We calculated the body mass index (BMI of all subjects and found that, 46.2% of the male and 59.8% of the female respondents were either overweight or obese. As predicted by the waist/hip ratio (WHR, 53.8% of the male and 66.9% of the female respondents had high risk for CHD. Regular physical activity was undertaken by less than half of the subjects (46.5%. Out of eight domains of QOL in the SF-36, the two most affected were ′General Health′ and

  20. Safe abortion – Still a neglected scenario: A study of septic abortions in a tertiary hospital of Rural India

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    Shritanu Bhattacharya

    2010-07-01

    Full Text Available Background and Aims: In spite abortion has been legalized in India over three decades, unsafe abortion continues to be a significant contributor of maternal mortality and morbidity. The aim of the present study is to assess the magnitude of septic abortion in a tertiary care hospital over a period of three years with a special emphasis on maternal mortality and morbidity and various surgical complications. Settings and Design: Retrospective study of patients who were admitted with unsafe abortions over a three year period from 2005 to 2008 in a tertiary teaching Hospital of Rural India. Materials and Methods: Hospital records of the patients who were admitted with unsafe abortion in three years (2005-2008 were reviewed to evaluate the demographic and clinical profile in relation to age, parity, marital status, indication of abortion , the methods of abortion ,qualification of abortion provider complications and maternal mortality. Results: Unsafe abortion constitutes 11.6% ( n=132 of total abortion cases admitted over 3 years. Majority of women (70.45% were in their thirties, married (89%.Sixty percent wanted abortion for birth spacing. Abortion methods included various primitive methods (30% but majority by dilatation and evacuation. About 60% of abortionists were unqualified. Majority of women admitted with serious complications like peritonitis (70%, visceral injuries (60%, hemorrhagic and septic shock, renal failure (17.4%, and life threatening conditions like DIC, hepatic failure and encephalopathy. A total of 231 women died of unsafe abortion making it 12.55% of total maternal mortality in our institution. Out of 73 women requiring laparotomy, 22% were done within 24 hours of admission and majority (49% were performed beyond 24-48 hours. Interestingly no women died when early aggressive surgery was done. Conclusion: The present study confirms that unsafe abortion is a great neglected health care problem leading to a considerable loss of

  1. Patients' knowledge on Rheumatoid Arthritis - A study at a tertiary care hospital.

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    Khalil, Zarghoona; Salim, Babur; Nasim, Amjad; Malik, Sakina

    2017-02-01

    To determine the level of disease awareness among patients of rheumatoid arthritis. The cross-sectional study was conducted at the Fauji Foundation Hospital, Rawalpindi, Pakistan, from January to June 2015, and comprised patients with rheumatoid arthritis. A self-made questionnaire was used which was translated in Urdu. The questionnaire had three sets of questions. The first set gathered information on the gender, age, level of education and the duration of the disease of the patient. The second set included questions regarding the symptoms, possible complications and the treatment of rheumatoid arthritis. The third set focused on the aetiology, gender predominance and source of knowledge regarding rheumatoid arthritis. SPSS 21 was used for data analysis. Of the 200 participants,188(94%) were females and 12(6%) were males. The mean age of the participants was 50±12.96 years. Moreover, 96(48%) patients were aged between 51-70 years. Only 3(1.5%) patients were considered aware; 48(25%) were considered partially aware; and 149(74.5%) were considered unaware. Rheumatoid arthritis is a chronic inflammatory disease requiring long-term management and counselling. Due emphasis should be given to the counselling and education of the patients.

  2. PROSPECTIVE STUDY OF UTERINE LEIOMYOMAS I N A TERTIARY CARE HOSPITAL

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    Ch. Nirmala

    2015-04-01

    Full Text Available BACKGROUND: Fibroids are benign smooth muscle neoplasms that may occur singly, but more often are multiple. Uterine tumors are the most common and the leading cause of hysterectomy in women. METHODS: The present study is a prospective study conducted in the department of pathology, Andhra Medical College, King George Hospital, Visakhapatnam in the period of one year, from M arch 2014 to M arch 2015. RESULTS: We received a total of 368 hysterecto my and 5 myomectomy specimens during this period, out of which, 249(66.7% were single and 124(33.3% were multiple. The age group ranged from 20 to 69. The most common location was intramural 243(65.1% cases, subserosal were 51(13.7%, submucosal were 18 (4.8%, cervical were 7(1.8% and 2(0.5% were broad ligament fibroids. The size ranged from as large as 19 cm to as small as seedling fibroids of size 0.1cm. Microscopically, the most common degeneration was hyaline degeneration 80 cases, 5 myxoid, 5 cyst ic and one case of chondroid degeneration. 6 cases showed calcifications. The most common age group was seen in the age group of 40 - 49 which were 207 cases (55.5%. 51(13.7% cases were associated with adenomyosis. The results from our study were comparabl e with those reported in literature and provide a simple integrated pathogenetic view for further thinking, to establish new therapeutic options. CONCLUSIONS: The clinico - social and economic burden of uterine leiomyomas is increasing and requires future st udies to clarify the etiopathogenesis and elaborate new and effective therapies for this condition

  3. Study of Insulin Resistance and Dyslipidemia in Psoriasis Patients in a Tertiary Care Hospital, South India

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    Doddarangaiah R. Shivanand

    2016-01-01

    Full Text Available Background: Psoriasis is a chronic immune mediated inammatory skin disease with a prevalence of 1–3% in the general population. In recent years, psoriasis has been recognized as a systemic disease associated with metabolic syndrome or its components such as: obesity, insulin resistance, hypertension and atherogenic dyslipidemia. Aim & Objectives: To investigate the metabolic state in psoriatic patients in order to clarify the association of psoriasis with insulin resistance and dyslipidemia. Material and Methods: The study included 52 psoriasis patients who attended the Outpatient Department of Dermatology at Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, Karnataka, India. The cases were divided into mild (n=28 and severe (n=24 category based on the Psoriasis Area and Severity Index (PASI score. Fifty healthy controls were also included in the study. Fasting blood glucose, fasting insulin, insulin resistance by Homeostasis Model Assessment (HOMA-IR method and lipid prole were measured in both cases and controls. Results: The fasting insulin levels and insulin resistance measured by HOMA-IR method were signicantly (P<0.05 higher in mild and severe psoriasis cases when compared to healthy controls. Total Cholesterol, triacyl glycerol, LDLCholesterol levels were signicantly (P<0.05 higher in mild and severe psoriasis cases in comparison with controls. HDL-Cholesterol levels were signicantly (P<0.05 lower in both mild and severe cases when compared to controls. Conclusion: Our ndings in this study showed that psoriasis is associated with components of metabolic syndrome like insulin resistance and atherogenic dyslipidemia which are considered to be predisposing factors for diabetes mellitus and cardiovascular diseases. The early detection of insulin resistance and dyslipidemia in psoriasis patients could help them reduce the risk of development of diabetes mellitus and cardiovascular diseases by modifying

  4. Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan.

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    Hamid, Saima; Malik, Asmat Ullah; Kamran, Irum; Ramzan, Musarat

    2013-01-03

    Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse. A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients. All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, "Working in the spirit of serving humanity", "Working against all odds", and "Working in a functional system and facing pressures of increased accountability". Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system. The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures

  5. Opinion of hospital pharmacy practitioners toward the Continuing Pharmacy Education program: a study from a tertiary care hospital in central Nepal

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    Poudel RS

    2017-09-01

    Full Text Available Ramesh Sharma Poudel,1 Rano Mal Piryani,2 Shakti Shrestha,3 Roshan Chaurasiya,1 Bed Prakash Niure1 1Hospital Pharmacy, Chitwan Medical College Teaching Hospital, Chitwan, Nepal, 2Health Professionals Education and Research Centre, Chitwan Medical College Teaching Hospital, Chitwan, Nepal, 3Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal Background: Meeting participants’ needs and matching their preferences are important prerequisites for an effective Continuing Pharmacy Education (CPE program. The objective of this pilot study was to assess the opinion of hospital pharmacy practitioners with respect to the CPE program.Methods: The pretested questionnaires were distributed to 20 pharmacy practitioners working in a pharmacy at a tertiary care hospital in Nepal which asked for their opinions and suggestions with respect to the CPE program. Descriptive statistics were performed using IBM SPSS version 20.Results: Topics related to skills development (75% and recent innovations in pharmacy practice (65% were mostly preferred. Live (in-person presentations (80% and small group discussion (60% were the most suitable methods for delivery. Improving knowledge (75%, improving skills (60% and keeping up-to-date in the latest information (60% were major motivating factors to participate, while lack of time (75% was a major barrier. Approximately 55% of the participants believed that face-to-face interview was a suitable method for evaluating the effectiveness. Allocation of separate time for the program, assessing baseline knowledge and skills of the participants along with delivery of quality materials in an understandable way were the top common suggestions for improving the CPE program.Conclusion: Hospital pharmacy practitioners’ opinions and suggestions were assessed with respect to the CPE program and this was upgraded accordingly to meet their expectations. Keywords: continuing education, opinion, pharmacy, pharmacy

  6. Diagnostic Utility of Coeliac Disease: A Descriptive Study in a Tertiary Care Hospital, Oman

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    Safana Salim Al Saidi

    2013-07-01

    Full Text Available Objectives: The prevalence of coeliac disease in Oman is unknown. We aim to estimate the prevalence of coeliac disease in at-risk subjects, describe the clinical characteristics and laboratory findings associated with coeliac disease and the validity of serological testing for coeliac disease at the Royal Hospital, Oman over a period of three years.Methods: This is a retrospective case finding study. The medical and laboratory records were reviewed for patients for whom serum antiendomysium IgA antibodies were requested at the Royal Hospital during a 3-year period (1st Jan 2006-31st Dec 2008. The data were extracted in order to assess the following: a Prevalence rate of coeliac disease among at-risk subjects; b Clinical characteristics in patients with coeliac disease and clinical manifestations for which the requesting clinicians considered coeliac disease as a possible diagnosis, including their specialties; c Laboratory tests results in patients with coeliac disease; and d Validity of antiendomysium antibodies testing in comparison with histopathology of jejunal biopsies for diagnosing coeliac disease.Results: The study included 431 patients (250 females, 181 males who were suspected of having (or screened for coeliac disease. The median of age was 15 years (range: 9 months-74 years with mean ± SD 18.95 ± 14.1 years. Of these, 15 (3.5% patients (10 females, 5 males with a median age of 19 years and mean 21.4 ± 13.0 years (range: 2.5-38 years, had positive antiendomysium antibodies results with median (range of 160 (40-320 IU/L and mean± SD 204.5 ± 160 IU/L. Of these 15 patients, 13 had positive jejunal histopathological changes indicative of coeliac disease; the remaining 2 patients had no biopsy examination. Of the 44 patients with negative antiendomysium antibodies <10 IU/L who had jejunal biopsy, 41 were negative and 3 had histopathological changes suggestive of mild coeliac disease. All the 3 patients had serum total IgA levels

  7. Adverse reactions to blood donation: A descriptive study of 3520 blood donors in a Nigerian tertiary hospital

    OpenAIRE

    C Aneke John; U Ezeh Theodora; A Nwosu Gloria; E Anumba Chika

    2017-01-01

    Background: The occurrence of adverse reactions to blood donation significantly hampers donor retention and negatively impacts on the universal availability of adequate numbers of blood donor units. Objective: To analyze the spectrum and prevalence of adverse reactions in blood donors in a tertiary hospital-based blood bank in Nigeria. Subjects and Methods: The details of 3520 blood donors who presented for donation over a 12 months period were retrieved from the departmental archives for ana...

  8. A preliminary study on neonatal septicaemia in a tertiary referral hospital paediatric unit.

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    Karunasekera, K A; Pathirana, D

    1999-06-01

    To estimate the incidence of neonatal septicaemia, and to identify risk factors, clinical presentations and causal organisms. A cross-sectional study. Neonatal Care Unit, University Paediatric Unit, Colombo North Teaching Hospital. Neonates admitted from January to December 1996 with clinical evidence of septicaemia. Gestational age, birth weight and mode of delivery were evaluated as risk factors for septicaemia. Although diagnosis of septicaemia was made on clinical grounds, blood cultures were performed in all babies. Data was analysed by using Epi Info version 6. 98 babies had septicaemia. Incidence of septicaemia was 24.4 per 1000 live births and case fatality rate was 11.2%. Incidence was significantly higher in preterm babies, babies with low birth weight (LBW) and those born following instrumental delivery. 21.4% developed septicaemia on the first day of life, 74.5% between 2 and 7 days and 4.1% after the first week. Common presenting features were fever 61.2%, jaundice 52%, lethargy 37.8% refusal of feeds 25.5%, coffee grounds vomiting 22.4%, and fits 12.2%. Common bacteria identified were Klebsiella 26.5%, Staphylococcus aureus 15.3%, coliform bacilli 9.2% and spore forming bacilli 9.2%. Common sensitive antibiotics were amikacin 88.9%, amoxycillin + clavulanic acid 83%, ceftriaxone 78.1% and netilmicin 63.9%. Septicaemia is an important cause of morbidity, particularly in preterm babies, in babies with LBW and those with instrumentation at birth. The high incidence of late onset septicaemia together with the findings of Klebsiella and Staphylococcus aureus as common and resistant pathogens for septicaemia indicate that the majority were nosocomial infections.

  9. Understanding Technology and People Issues in Hospital Information System (HIS) Adoption: Case study of a tertiary hospital in Malaysia.

    Science.gov (United States)

    Zakaria, Nasriah; Mohd Yusof, Shafiz Affendi

    Hospital Information Systems (HIS) can improve healthcare outcome quality, increase efficiency, and reduce errors. The government of Malaysia implemented HIS across the country to maximize the use of technology to improve healthcare delivery, however, little is known about the benefits and challenges of HIS adoption in each institution. This paper looks at the technology and people issues in adopting such systems. The study used a case study approach, using an in-depth interview with multidisciplinary medical team members who were using the system on a daily basis. A thematic analysis using Atlas.ti was employed to understand the complex relations among themes and sub-themes to discover the patterns in the data. . Users found the new system increased the efficiency of workflows and saved time. They reported less redundancy of work and improved communication among medical team members. Data retrieval and storage were also mentioned as positive results of the new HIS system. Healthcare workers showed positive attitudes during training and throughout the learning process. From a technological perspective, it was found that medical workers using HIS has better access and data management compared to the previously used manual system. The human issues analysis reveals positive attitudes toward using HIS among the users especially from the physicians' side. Copyright © 2016. Published by Elsevier Ltd.

  10. Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital: a prospective study.

    Science.gov (United States)

    White, K; Scott, I A; Bernard, A; McCulloch, K; Vaux, A; Joyce, C; Sullivan, C M

    2016-12-01

    The characteristics of mature contemporary rapid response systems are unclear. To determine the patient characteristics, processes and outcomes, both in-hospital and post-discharge, of a well-established rapid response system in a tertiary adult hospital. This is a prospective study of consecutive rapid response team (RRT) activations between 1 July and 25 November 2015. Variables included patient characteristics, timing, location and triggers of RRT activations, interventions undertaken, mortality and readmission status at 28 days post-discharge. A total of 1151 RRT activations was analysed (69.1 per 1000 admissions), involving 800 patients, of whom 81.5% were emergency admissions. A total of 351 (30.5%) activations comprised repeat activations for the same patient. Most activations (723; 62.8%) occurred out of hours, and 495 (43%) occurred within 48 h of admission. Hypotension, decreased level of consciousness and oxygen desaturation were the most common triggers. Advanced life support was undertaken in less than 7%; 198 (17.2%) responses led to transfer to higher-level care units. Acute resuscitation plans were noted for only 29.1% of RRT activations, with 80.3% stipulating supportive care only. A total of 103 (12.6%) patients died in hospital, equalling 14 deaths per 100 RRT activations. At 28 days, 150 (18.8%) patients had died, significantly more among those with multiple versus single RRT activations (24.9 vs 16.6%; odds ratio 1.66, 95% confidence interval 1.31-2.44; P = 0.013). Relatively few RRT activations are associated with acute resuscitation plans, and most interventions during RRT responses are low level. The high rate of post-RRT deaths and transfers to higher-level care units calls for the prospective identification of such patients in targeting appropriate care. © 2016 Royal Australasian College of Physicians.

  11. Endemic and epidemic Acinetobacter baumannii clones: a twelve-year study in a tertiary care hospital

    OpenAIRE

    Villal?n, Pilar; Valdezate, Sylvia; Cabezas, Teresa; Ortega, Montserrat; Garrido, Noelia; Vindel, Ana; Medina-Pascual, Mar?a J; Saez-Nieto, Juan A.

    2015-01-01

    Background Nosocomial outbreaks of multidrug-resistant Acinetobacter baumannii are of worldwide concern. Using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and multiple locus variable number tandem repeat sequence (VNTR) analysis (MLVA), the present work examines the genetic diversity of the endemic and epidemic A. baumannii clones isolated in a single hospital over a twelve-year period. Results PFGE analysis of 405 A. baumannii-calcoaceticus complex isolates de...

  12. Improving mental health service users' with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study.

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    Cranwell, Kate; Polacsek, Meg; McCann, Terence V

    2016-07-26

    Mental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users' with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services. Experience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken. Thirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants' perspectives about factors that facilitated (clinicians' expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians' attitudes; and increasing caregiver participation) to service users' progress through tertiary medical and primary care services. A sixth theme, enhancing service users' transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services. EBCD is a useful approach to collaboratively develop strategies to improve service users' with medical co-morbidity and their caregivers' transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for

  13. Quantum and pattern of intimate partner violence: An epidemiological study in a tertiary care hospital of Srinagar, Uttarakhand

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    Sumeet Dixit

    2014-06-01

    Full Text Available Background: Intimate partner violence (IPV has been increasingly recognized as a public health problem associated with serious medical, family, and societal effects. Violence against women is a major public health problem and violations of women's human rights, with substantial repercussions for women’s physical, mental, sexual, and reproductive health. This necessitates information on quantum and pattern of IPV, for effective interventions. Methods: This cross-sectional, randomized hospital based survey of married women aged 15–49 years took place in a tertiary care hospital in Srinagar, Uttarakhand from November 2012 to March 2013, using the methodology of WHO Study on Women’s Health and Domestic Violence. Data analysis has been done using SPSS version 15.0 and Microsoft office excel 2007. To test significance, chi square test have been used as applicable. Results: Prevalence of current IPV was 31.83% in the present study. IPV was found significantly associated with socio-economic status of the family, education of the female, drinking behavior of the husband and economic dependence of female on husband. Religion, age of the female and duration of marriage were non-significant predictors for intimate partner violence in the present study. Conclusions: The study documented prevalence, patterns and determinants of intimate partner violence.  Efforts, targeting the most vulnerable, and measures like IPV awareness, Female education, vocational training program for females, legal literacy should be promoted. These measures can prove valuable for effective control of IPV and related mortality/morbidity/other significant repercussions on female well-being.

  14. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study.

    Science.gov (United States)

    Kamath, Sneha; Bhate, Priya; Mathew, Ginu; Sashidharan, Srijith; Daniel, Anjali B

    2011-09-01

    Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. A cross-sectional survey of 213 doctors working at a tertiary care hospital was conducted to determine their attitudes toward euthanasia. A self-administered questionnaire was used to assess attitudes and personal perceptions about euthanasia. The Chi square test was used to assess factors influencing attitudes toward euthanasia. A majority of the respondents (69.3%) supported the concept of euthanasia. Relief from unbearable pain and suffering was the most commonly (80.3%) cited reason for being willing to consider the option of euthanasia. Majority of those who were against euthanasia (66.2%) felt that the freedom to perform euthanasia could easily be misused. Disapproval of euthanasia was associated with religious affiliation (Peuthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  15. Needle stick injuries--risk and preventive factors: a study among health care workers in tertiary care hospitals in Pakistan.

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    Afridi, Asad Ali Khan; Kumar, Ameet; Sayani, Raza

    2013-04-14

    Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard. A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May 2008. Overall, 64% of the HCWs were exposed to at least one NSI during their career; among them 73% reported NSIs for two or more times. Factors found to be highly associated with NSIs were those practicing this occupation for more than five years (p nurse than doctor (p 0.001: OR = 2.12; 95% CI = 1.35-3.32). Having received booster dose of hepatitis B vaccine (p 0.02: OR = 1.85; 95% CI = 1.10-3.11), working in surgical specialty (p occupational infections among HCWs should be a priority. Formal training, by health authorities in the local area, about safe practices and availability of preventive facilities should be ensured regarding NSIs among HCWs.

  16. Diet Quality of patients with chronic Chagas disease in a tertiary hospital: a case-control study

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    Mariana Pereira de Castilhos

    Full Text Available Abstract INTRODUCTION: Nutritional status has been implicated in the modulation of the immune response, possibly augmenting the pathogenesis of Chagas disease (Cd. We evaluated diet quality and nutritional status in adults and elderly patients with chronic Cd in a tertiary hospital. METHODS: A case-control study of Cd patients was conducted, paired for gender, age, and co-morbidities with non-Cd patients. Anthropometric measurements and food frequency questionnaire was used, and diet quality was assessed by the Brazilian Healthy Eating Index-Revised (BHEI-R. The Estimated Average Requirement cut-off points were used to determine the dietary micronutrient adequacy. The Cd group was further grouped according to Los Andes classification. RESULTS: The study participants were 67 ± 10 years old, 73.6% elderly and 63% female. The prevalence of overweight/obesity and abdominal fat was high in both groups; however, Cd group showed a lower prevalence of obesity and increased risk of disease according to waist circumference classification. There was no difference in BHEI-R score between groups (p=0.145. The Cd group had sodium and saturated fat intake above recommendations and low intake of unsaturated fat, vitamin D, E, selenium, magnesium, and dairy products; but higher intake of iron. According to Los Andes classification, group III presented lower intake of whole fruit and dietary fiber. CONCLUSIONS: Patients with Cd were overweight and the quality of their diet was unsatisfactory based on the recommended diet components for age and sex.

  17. Utilization Pattern of Potentially Inappropriate Medications in Geriatric Patients in a Tertiary Care Hospital: A Retrospective Observational Study

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    Bhandare, Nikhil Narayan; Gouveia, Jonathan Joaquim; Bhandare, Padma Narayan

    2017-01-01

    Introduction Geriatric population is on the rise throughout the world, hence the quality and the safety of prescribing in the elderly is a global healthcare concern. It is important for the healthcare providers to be aware of the limitations in prescribing certain drugs to the elderly. This study was an attempt to shed light on the utilization pattern of Potentially Inappropriate Medications (PIMs) in elderly patients admitted in the medicine wards in a tertiary care hospital in Goa. Aim To measure the percentage prevalence of PIMs prescribed in the admitted geriatric patients. Materials and Methods In this retrospective observational study, 150 case records of patients aged 60 years or more were analysed. All the prescribed medications, for each case record, were then analysed by referring to the American Geriatrics Society (AGS) Beers Criteria 2015. Data was analysed using Statistical Package for Social Sciences (SPSS) software. Results Of the 150 patients, 99 (66%) received at least one PIM according to the Beers Criteria 2015 (including drugs to be used with caution). However, after excluding the drugs to be used with caution, the prevalence of PIMs decreased to 44%. The most commonly prescribed PIMs were ranitidine (17.33%) and prazosin (8.66%) and the most commonly prescribed drug to be used with caution was furosemide (35.33%). Conclusion As the medication needs of the geriatric population are unique, it is essential that the healthcare professionals are aware of these needs and also follow the available guidelines and tools. Formulation of hospital policies and protocols in this regard would help to improve the scenario. Increased education, awareness and reporting of drug-related problems along with more doctor-patient interaction in these situations are some of the factors that could play an important role in promoting better and safer prescribing practices and a better quality of life to the older generations of our communities. PMID:28571163

  18. Spectrum of types of thalassemias and hemoglobinopathies: study in a tertiary level children hospital in Bangladesh

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    Waqar A. Khan

    2017-05-01

    Full Text Available Thalassemias and hemoglobinopathies are the most common hemolytic congenital disorders in Bangladesh as in many parts of the world. This study was done to find the common types of thalassemias and abnormal hemoglobin variants seen in Bangladeshi populations. A total of 4813 samples were analyzed for hemoglobin disorders out of which 2308 (49.95% showed abnormalities. The samples were analyzed by Bio Rad D 10 Analyzer in 3914 (81.32% cases, BIORAD VARIANTβ thalassemia short program using the principle of high performance liquid chromatography in 474 (9.85% cases and by CAPILLARYS 2 FLEX PIERCING utilizing capillary electrophoresis in 425 (8.83% cases. The samples were analyzed in the Department of Biochemistry and Molecular Biology of Dhaka Shishu (Children Hospital, Dhaka, Bangladesh. The common hemoglobin disorders seen were β trait 863 (17.94%, Hb E trait 601 (12.50%, Hb E β thalassemia 524 (10.87%, β thalassemia major 192(4.00 %, Hb E disease 99 (2.05%. Other Hb abnormalities detected were Hb D trait 17 (0.35%, Sickle cell trait 4 (0.08%, hereditary persistence of fetal hemoglobin (HPFH 2 (0.04%, and Hb Lepore, δ β thalassemia, sickle cell β thalassemia, Sickle cell disease, compound heterozygote for HbE+D and Hb Q band one case each (0.02%.   与世界许多地方一样,地中海和血红蛋白病是孟加拉国最常见的溶血性先天性疾病。本研究的目的是找到孟加拉国人群的常见地中海贫血类型和异常血红蛋白变体。总共对4813例样本进行了血红蛋白疾病分析,其中2308例(49.95%)显示异常。3914例(81.32%)样本使用Bio Rad D 10分析仪分析,由BIORAD VARIANTβ地中海贫血症短期计划使用高效液相色谱法分析了474例(9.85%),由CAPILLARYS 2 FLEX PIERCING使用毛细管电泳分析了425例(8.83%)。样本在孟加拉达卡的达卡生化与分子生物学教研室进行分析。观察到的常见血红蛋白疾病是863例(17.94%

  19. A study of tobacco and substance abuse among mentally ill outpatients in a tertiary care general hospital

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    Anju Gupta

    2016-01-01

    Full Text Available Background: The comorbidity of substance abuse and mental disorder is known to exist and may cause many diagnostic, prognostic, and management difficulties. Indian data are sparse in this area. Objectives: The aim of the study was to identify the prevalence and pattern of substance abuse in psychiatric outpatients and to examine the relation between demographic variables and drug abuse pattern. Materials and Methods: Medical records of the patients attending psychiatry outpatient clinic at a tertiary care general hospital over a 3-month period were reviewed. Information was obtained from medical chart and Drug Abuse Monitoring Scale pro forma about substance abuse. Psychiatric diagnosis made by a qualified psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria, as recorded in the case record form, was used. Observation: The results revealed that 50.8% (half of all psychiatry outpatients were using one or more substances including tobacco in the last month prior to registration (1 month prevalence and 28.35% were using substances at any time in their life prior to the last month (lifetime prevalence. Male patients had 6 to 8 times higher substance abuse than female patients. Tobacco and alcohol were found to be the most common substances of abuse, followed by cannabis. Part-time and full-time employed male patients consumed more alcohol and tobacco than unemployed patients. Conclusions: Substance abuse was common among mentally ill outpatients and could be the cause of various health hazards and hence requires due attention.

  20. Candida infections in paediatrics: Results from a prospective single-centre study in a tertiary care children's hospital.

    Science.gov (United States)

    Mesini, Alessio; Bandettini, Roberto; Caviglia, Ilaria; Fioredda, Francesca; Amoroso, Loredana; Faraci, Maura; Mattioli, Girolamo; Piaggio, Giorgio; Risso, Francesco M; Moscatelli, Andrea; Loy, Anna; Castagnola, Elio

    2017-02-01

    To describe the epidemiology of invasive Candida infection in a tertiary care paediatric hospital. Prospective single-centre survey on all Candida strains isolated from normally sterile fluids and urines in the period 2005-2015 . A total of 299 ICI were documented in 262 patients. Urinary tract infection represented the most frequent diagnosis (62%), followed by fungaemia (34%) and peritonitis (4%). Fungaemia was most frequent in children with cancer (59%) or in low birth weight neonates (61%), while urinary tract infections were more frequent in patients with urinary tract malformation. C.albicans was the most frequently isolated species (60%) compared with C. non-albicans, but differences were present according to the site of isolation and underlying conditions. Overall 90-day mortality was 7%, 13% in fungaemias, 8% in peritonitis and 2% in urinary tract infections. The rates of invasive Candida infection increased during the study period. Invasive Candida infection is diagnosed with increasing frequency in children. Site of isolation and aetiology are frequently related with the presence of underlying, favouring conditions. Mortality was not negligible, especially in the presence of more invasive infections and specific underlying conditions. © 2016 Blackwell Verlag GmbH.

  1. Incidence and diagnosis of Acute kidney injury in hospitalized adult patients: a retrospective observational study in a tertiary teaching Hospital in Southeast China.

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    Cheng, Xiaoyan; Wu, Buyun; Liu, Yun; Mao, Huijuan; Xing, Changying

    2017-06-24

    Acute kidney injury (AKI) places a heavy burden on the healthcare system in China and is usually misdiagnosed. However, there are limited studies that have described the epidemiology and diagnosis of AKI in China. The aim of this study was to describe the incidence and diagnosis of AKI in hospitalized adult patients in a tertiary teaching hospital in southeast China. All adult patients hospitalized from October 1, 2013 to September 30, 2014 in the First Affiliated Hospital of Nanjing Medical University were screened using the Lab Administration Network. AKI definition and staging were based on the KDIGO AKI criteria. Demographic characteristics, laboratory examination, clinical data, and clinical outcomes of AKI patients were recorded and analyzed. The incidence of AKI was 1.6% (1401/87196). The 30-day mortality was 35.3%. AKI stage 1, 2, 3 and RRT accounted for 38.0% (532/1401), 22.0% (309/1401), 40.0% (560/1401), and 16.3% (228/1401) of patients, respectively. The Renal, other Internal Medicine, Surgery, and ICU Departments accounted for 7.4%, 37.1%, 30.1%, and 25.4% of AKI patients, respectively. The timely diagnosis rate, delayed diagnosis rate, and missed diagnosis rate were 44% (616/1401), 3.3% (46/1401), and 52.7% (739/1401), respectively. Patients hospitalized in the Renal Department had the highest AKI diagnosis rate (89.3%, 88/103), while missed diagnosis rate of the surgical patients was as high as 75.1% (317/422). Multivariable logistic regression analysis indicated that presence of tumors, higher serum albumin, and AKI stage 1 were associated with failure to timely diagnose AKI, whereas presence of chronic kidney disease, oliguria, higher blood urea nitrogen, and greater number of organ failures correlated with earlier diagnosis. AKI was characterized by a high incidence, high short-term mortality, and high missed diagnosis rate in hospitalized adult patients in our hospital. Interventions for improving diagnosis of AKI are urgently needed.

  2. Limbal transplantation at a tertiary hospital in Brazil: a retrospective study

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    Pedro Bertino Moreira

    2015-08-01

    Full Text Available ABSTRACTPurpose:Epidemiological analysis of limbal transplantation surgeries performed in the Ophthalmologic Hospital of Sorocaba.Methods:Retrospective medical records review of 30 patients who underwent limbal stem cell transplants between January 2003 and March 2008. Cases involving conjunctival limbal autograft were classified as group I, and those involving conjunctival limbal allograft as group II.Results:Two patients were excluded due to incomplete data during postoperative follow-up. Of the total sample of 28 patients, 53.6% constituted group I, whereas 46.4% were included in group II. Males were predominant (67.9%, and right eyes were the most prevalent (67.9%. The mean age was 40.3 years. Unilateral cases accounted for 60.7%. The most frequent pathology causing limbal system failure was chemical burns (53%. The mean length of time from diagnosis to surgery was 11.18 years. The limbal graft and amniotic membrane were associated in 75% of all cases, and tarsorrhaphy in 57.1%. The average follow-up period was 24.84 months. The uncorrected visual acuity improved in 38% of the cases, was unchanged in 28.5%, and deteriorated in 33.3%. There was no persistent epithelial defect in 75% of the patients. The conjunctivalization rate was similar between the groups (53.3% and 58.3%, respectively. The transparency improved in only 38.4% of the cases, and 28.5% of the surgeries performed were successful. The most prevalent complication was persistent epithelial defect, which occurred in 25% of the patients, followed by corneal melting in 14.2%. Other complications observed included infectious ulcers, limbal graft necrosis or ischemia, perforation, and descemetocele.Conclusion:Chemical burns remain the main cause of limbal stem cell deficiency. In these cases, limbal transplantation is the standard procedure to restore the ocular surface even though the success rate is low.

  3. Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study

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    Jeon, Eun-Gyu; Jung, Dong-Young; Lee, Jong-Sung; Seol, Guk-Jin; Choi, So-Young; Paeng, Jung-Young; Kim, Jin-Wook

    2014-01-01

    Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981∼1987 (Group A), 1995∼1999 (Group B), and 2008∼2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20∼29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents. PMID:27489843

  4. Postoperative nausea and vomiting at a tertiary care hospital in ...

    African Journals Online (AJOL)

    Background: Postoperative nausea and vomiting is one of the most distressing morbidities associated with surgery. This descriptive prospective study was conducted to determine the incidence, predictors and management of postoperative nausea and vomiting among patients attending a tertiary hospital in north-western ...

  5. Hand Washing Practices amongst Doctors in A Tertiary Hospital in ...

    African Journals Online (AJOL)

    Washing hand with soap and water is said to be the single most important intervention against hospital acquired infections. This study aimed to explore perceptions, attitudes and hand washing practices amongst doctors in a tertiary institution in Port Harcourt, Nigeria. This was a descriptive cross sectional survey carried out ...

  6. Blood donation trend in a tertiary hospital in Nigeria | Olawumi ...

    African Journals Online (AJOL)

    Background: Voluntary donors who ought to be the main source of donor blood are relatively few in Nigeria. There is therefore a need to study current patterns of blood donation and design strategies for improvement. Objectives: To determine the types , age and sex distribution of blood donors in a tertiary Hospital in ...

  7. A pilot study of comorbidities in patients with Rheumatoid Arthritis at a tertiary care hospital in Northeast India

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    Sukhjinder Singh

    2016-01-01

    Full Text Available On an average, rheumatoid arthritis is associated with one or more comorbid conditions and these comorbidities are associated with various risk factors and medications use in patients with RA. The aim of this study was to assess comorbidities in patients with RA at a tertiary care hospital of Northeast India. This cross sectional study was conducted for 8 months from August 2014 to April 2015. The data was collected from medicine (unit-III outpatient department of Gauhati Medical College and Hospital, Guwahati, Northeast India. Fifty one RA patients were found during study period. Patient's socio-demographic characteristics, comorbidities, risk factors for comorbidities, laboratory investigations, and past and current medications use were collected during their visit to hospital. DAS28 scale was used to assess the disease activity in RA patients. Descriptive statistics were used. Non-normally distributed continuous variables are presented in median and interquartile range. The median age of RA patients was 45(IQR;15. The disease activity was found high (DAS-ESR>5.1 in 34 (66.67% patients. The median DAS28 score was 5.64(IQR;1.44. Majority of the patients with RA were anaemic (n=34, 66.67% followed by infection (n=7, 13.73%, thyroid disease (n=5, 9.80%, renal disease (n=4, 7.84%, osteoporosis (n=3, 5.88%, cardiovascular disease (n=3, 5.88%, lung disease (n=3, 5.88%, and vasculitis (n=1, 1.96%. The commonly reported risk factor was hypertension (19.61% followed by diabetes (n=5, 9.80%, dyslipidemia (n=4, 7.84%, smoking (n=4, 7.84%, family history of CVD (n=2, 3.92%, and alcohol intake (n=1, 1.96%. Among DMARDS, methotrexate (92.16% was the most commonly prescribed drug followed by hydroxychloroquine (74.51% and sulfasalazine (27.45%. Anaemia was the most common comorbid condition found in RA patients. Disease activity was found high in anaemic patients with RA. [Biomed Res Ther 2016; 3(1.000: 454-459

  8. Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan

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    Hamid S

    2014-01-01

    Full Text Available Saima Hamid,1 Asmat Ullah Malik,2 Irum Kamran,3 Musarat Ramzan41Health Services Academy, Islamabad, Pakistan; 2Integrated Health Services, Islamabad, Pakistan; 3GIZ, Islamabad, Pakistan; 4Wah Medical College, Wah Cantt, University of Health Sciences, Wah, PakistanBackground: Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse.Methods: A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients.Results: All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system.Conclusion: The study shows that the presence of a well trained health workforce is vital, and that certain

  9. Study of drug–Drug interactions among the hypertensive patients in a tertiary care teaching hospital

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    Ansha Subramanian

    2018-01-01

    Conclusion: The study highlighted that patients with hypertension are particularly vulnerable to DDI. The comorbidities, advanced age, and polypharmacy are the important factors associated with the occurrence of DDI.

  10. Benign Vulvar Adnexal Tumours - A 5 Year Study in a Tertiary Care Hospital

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    Kanwardeep Kaur Tiwana

    2016-04-01

    Full Text Available Despite of the fact that the vulva contains a high density of apocrine and anogenital mammary glands in addition to eccrine glands and folliculosebaceous units, the benign vulvar adnexal tumours are rare. Though the varied clinical presentation and diverse histopathological spectrum of vulvar neoplasms has amazed the pathologists, only few studies have been reported in literature. The present five year study consists of only five cases of benign vulvar neoplasms depicting their rarity. Hidradenoma papilliferum and syringoma were the most common entities followed by Chondroid syringoma. The aim of our study is to explore and highlight the histopathological diversity of benign vulvar adnexal tumours reflecting the relative frequency of these structures.

  11. STUDY OF THYROID DYSFUNCTION IN ELDERLY PATIENTS AND ITS CLINICAL CORRELATION IN TERTIARY CARE HOSPITAL

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    Vidyasagar

    2016-03-01

    Full Text Available INTRODUCTION Thyroid dysfunction in elderly is not uncommon. Thyroid abnormalities were more among females than in males. Clinical diagnosis is difficult to make but Thyroid Function Tests always help in diagnosing the disease. Subclinical state is equally common as clinical state in elderly population. As the age advances the incidence of thyroid disorders increase. The study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate clinical symptoms with abnormal thyroid function. Thyroid disorders were present in 26%, overt hypothyroidism in 12%, subclinical hypothyroidism in 8% cases, hyperthyroidism in 3% and subclinical hyperthyroidism in 3% patients was noted. In this study, 36 patients were males and 64 were females. Females (20% had high incidence of thyroid disorders than males (6%.

  12. Clinicohematological Profile of Pancytopenia: A Study from a Tertiary Care Hospital

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    Monika Gupta

    2016-03-01

    Full Text Available Objective: Pancytopenia is a clinicohematological prob­lem with wide spread discriminated diagnosis. A through evaluation of patient is necessary to identify the cause as large number of patients has reversible etiology and early diagnosis may be lifesaving. Diagnosis of pancyto­penia requires microscopic examination of bone marrow aspirates to assess the overall cellularity and morphol­ogy. This study was conducted with the aim to find out the cause of pancytopenia on the basis of bone marrow findings. Methods: The present study was conducted in the de­partment of pathology over a period of one year. A total of 169 patients were included in the study that fulfilled the criteria of pancytopenia. A detailed clinical history and physical examination followed by complete blood count, peripheral smear examination and bone marrow aspira­tion was done in all cases. Results: There was slight male predominance with male to female ratio of 1.2:1. The majority of patients were in second and third decade. The main cause of pancytope­nia was megaloblastic anemia followed by mixed nutri­tional deficiency anemia and others. Conclusion: This study emphasized that in developing countries like India majority of the patients had reversible etiology and patients can be put on a trial of hematinics and close haematological follow up.

  13. Cutaneous adverse drug reactions in a tertiary care teaching hospital in India: An intensive monitoring study

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    Sejal Thakkar

    2017-01-01

    Full Text Available Background: The epidemiological data based on intensive monitoring studies are limited for the cutaneous adverse drug reactions (CADRs in terms of incidence. Most of earlier Indian studies focused only on types and causative drugs of CADRs. Aim: The aim of this study is to analyze the CADRs with reference to the incidence, its subgroup analysis, causative drugs, and other clinical characteristics in Indian population. Methodology: Intensive monitoring study was carried out over a period of 3 years in the dermatology outpatient and inpatient department. CADRs due to only systematically administered drugs were considered. The WHO definition for CADR, the WHO causality definitions, modified Schumock and Thornton's criteria for preventability, and International Conference on Harmonisation E2A guidelines for seriousness were considered. Incidence was expressed in percentage and its 95% confidence interval. The incidence was analyzed on basis of characteristics of study population and CADRs. Results: A total of 171 CADRs were observed from 37,623 patients. The CADR incidence was 0.45% (95% CI: 0.39–0.53. The incidence did not significantly differ in different age groups and gender. Commonly observed CADRs were maculopapular rash (23.98%, urticaria (21.64%, and fixed drug eruptions (FDEs (18.13%. Antimicrobials (35.18% and nonsteroidal anti-inflammatory drugs (NSAIDs were suspected in all common CADRs. Anti-infective and NSAIDs were most commonly suspected drugs in overall CADRs, maculopapular rash, urticaria, FDEs, and erythema multiforme. The exact nature of drugs remained inaccessible in one-fourth cases due to use of the over-the-counter self-medications. The incidence of preventable and serious and fatal CADRs was 0.08% (95% CI: 0.05–0.11, 0.04% (95% CI: 0.02–0.06, and 0.003% (95% CI: 0.000–0.001, respectively. Conclusion: Ethnic characteristics should be considered while interpreting incidence from the international studies. The

  14. CLINICO – HISTOPATHOLOGICAL CORRELATION IN LEPROSY: A TERTIARY CARE HOSPITAL BASED STUDY

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    Deeptara Pathak Thapa

    2013-07-01

    Full Text Available Introduction: Leprosy is a chronic infectious disease affecting mainly cutaneous and peripheral nervous system. Histopathology is an important tool to diagnosis leprosy in situation where it mimics other clinical condition. This study was conducted to know the correlation between clinical and histopathological diagnosis of Leprosy. Material and Methods: This was a retrospective study and patients were enrolled in whom leprosy was clinically diagnosed or suspected and histo-pathological examinations were carried upon. Results: A total of 71 patients were studied. Of them 48 patients (67.6% were males and rest 23 (32.39% patients were females. Mean age of patients at presentation was 37.85 +/- 2.021 years. Clinically in 42 patients (59.1% type of leprosy could not be specified. Borderline tuberculoid was diagnosed in 7 patients (9.8%, Tuberculoid in 6(8.5%, Relapse in 3(4.2%, lepromatous in 6(8.5% and Borderline, borderline lepromatous 1(1.4, Indeterminate 1 patient (1.4%. In 7% cases, Hansens disease was considered as differential diagnosis along with other clinical conditions. In 47% cases, data was not available. On histopathological evaluation on skin biopsies, epidermal changes seen were 29.5%. Of the total 71 patient, dermal changes seen were granuloma (42%, dermal infiltrate (11%, adnexal infiltrate (7%, nerve infiltrate (11%, adnexal with nerve infiltrate (6%, perivascular with adnexal infiltrate (20% and nonspecific (3%. Dermal infiltrates in 46.4% cases constituted of lympho-histiocytes. In 48 patients (69% leprosy was histopathologically confirmed and in rest 31% cases diagnoses was non-specific in 20 patients (28.1%, vasculitis, Dariers and Fungal infection 1 patient each (1.4%. Borderline Tuberculoid (BT and TT was the most common diagnosis among leprosy patients around 29.2% each, followed by Indeterminate 25%, LL 8.3%, BL and and Pure neural 4.1% each. When clinical diagnosis and histopathological diagnosis was correlated it was

  15. Magnetic resonance angiographic evaluation of circle of Willis: A morphologic study in a tertiary hospital set up.

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    Naveen, Shankar Rao; Bhat, Venkatraman; Karthik, Gadabanahalli Ashok

    2015-01-01

    Anatomy of circle of Willis (CW) shows wide variation in different individuals, population groups, and has vital clinical significance in causation and presentation of clinical disease. This study evaluates the anatomical variations, incidence of various common anomalies of CW in south Indian tertiary hospital set up, using three-dimensional time-of-flight (3D-TOF) magnetic resonance angiography (MRA). A total of 300 patients referred for neuroimaging study over a period of 2-year were included in the analysis. In this prospective and retrospective study, 198 men and 102 women; mean age, 55 years) underwent 3D-TOF MR angiograms of the CW using a 1.5-tesla MR scanner. Images were reviewed for anatomical configuration of the CW using maximum intensity projection (MIP) and 3D volume rendered images. On analysis, a complete CW was seen in 50 (16.6%) of 300 subjects. An incomplete anterior and posterior CW was found in 66 (22%) The remaining 184 (61.3%) subjects had partially complete CW configuration. The most common type of CW in a single subject was anterior variant type A and posterior type variant E. We observed wide variation in CW configuration in our patients. The prevalence of complete configuration of the circle is 16.6%; slightly higher in females and younger subjects. Complete anterior circle was present in 77.3%. Most common anterior variant is type A (normal anterior configuration) with a prevalence of 66%. The most common posterior circle variant is type E (hypoplasia or absence of both PcomA) with 32.6%. Overall, CW variants are slightly more common among the women in comparison to men. Incidence of associated anomalies like aneurysm or arteriovenous malformation (AVM) was comparable to that described in literature.

  16. A study of drug-drug interactions in cancer patients of a south Indian tertiary care teaching hospital

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    G Kannan

    2011-01-01

    Full Text Available Background : Drug interactions in oncology are of particular importance owing to the narrow therapeutic index and the inherent toxicity of anticancer agents. Interactions with other medications can cause small change in pharmacokinetics or pharmacodynamics of chemotherapeutic agents that could significantly alter their safety and efficacy. Aim : To identify and document the potential drug-drug interactions in prescriptions of patients receiving cancer chemotherapy. Settings and Design : A tertiary care teaching hospital based prospective study. Materials and Methods : Patients admitted in the medical oncology wards with different types of malignancies and receiving cancer chemotherapy during the period of June 2009 to November 2009 were included in the study. A detailed data collection was done in a specially designed proforma with ethical approval and consent of patients and their prescriptions were subjected to drug-drug interaction screening using Drug Interaction Fact Software Version-4 and standard references. Incidence of drug-drug interactions, their types, correlation between age, cancer type, number of drugs prescribed and incidence of drug interactions were analyzed. Statistical Analysis : Logistic regression analysis and Odds ratio were performed to identify the incidence of drug-drug interactions and their correlation with the factors above mentioned. Results : A total of 75 patients (32 males and 43 females; median age 56 years, age range 23-74 were enrolled in the study and their prescriptions were screened. 213 interactions were identified of which, 21 were major, 121 were moderate and 71 were minor. There were 13 (6.1% clinically significant interactions between anticancer drugs and 14 (6.5% drug-drug interactions between anticancer drugs and other drugs prescribed for co-morbidities. There was a positive correlation between number of drugs prescribed and drug interactions (P=0.011; OR 0.903. Conclusion : Though there was not any

  17. Maternal care quality in near miss and maternal mortality in an academic public tertiary hospital in Yogyakarta, Indonesia: a retrospective cohort study

    OpenAIRE

    Mawarti, Yuli; Utarini, Adi; Hakimi, Mohammad

    2017-01-01

    Background Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. Methods A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta...

  18. Profile and risk factors for congenital heart defects: A study in a tertiary care hospital.

    Science.gov (United States)

    Abqari, Shaad; Gupta, Akash; Shahab, Tabassum; Rabbani, M U; Ali, S Manazir; Firdaus, Uzma

    2016-01-01

    Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects. A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015. All patients referred with complaints or clinical examination suggestive of CHDs were further evaluated with echocardiography. On Echocardiography, patients having CHDs were included as cases and those having a normal echocardiographic study were included as controls. Healthy controls were also included. 400 cases and 400 controls were thus identified; preterms having patent ductus arteriosus and patent foramen ovale and those with acquired heart defects were excluded. Risk factors among cases and controls were further studied. Acyanotic heart defects were 290 (72.50%) of the total heart defects, whereas the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, ventricular septal defect was the most common lesion with contribution of 152 (38%) cases, whereas among the cyanotic heart defects, Tetralogy of Fallot was the most common lesion (18% of total cases). Out of the total 400 cases, 261 were males (65.25%). On univariate analysis, paternal age (odds ratio, OR, 2.01), bad obstetric history (OR, 2.65), antenatal febrile illness (OR, 4.12), and advanced maternal age (OR, 3.28) were found to increase the risk of CHD whereas intake of multivitamin (OR, 3.02) was found to be protective. The risk factors were further analyzed with multivariate logistic regression analysis and all the above factors were found to be significantly associated. We noted that the profile of CHD in our population was similar to the published literature although many were missed

  19. Study of the pattern of maxillofacial fractures seen at a tertiary care hospital in north India.

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    Pandey, Sandeep; Roychoudhury, Ajoy; Bhutia, Ongkila; Singhal, Maneesh; Sagar, Sushma; Pandey, Ravindra Mohan

    2015-03-01

    The present study was planned to investigate the etiology of maxillofacial injuries and to analyze the pattern of maxillofacial factures as well as the various factors influencing their distribution. A one year cross-sectional study was done and 1,108 patients with maxillofacial fractures were analyzed consecutively from April 2010 to March 2011 who reported to the department of Oral and Maxillofacial Surgery in the Centre for Dental Education & Research and Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi. A performa was designed to collect the data that included age and sex distribution, etiology, influence of alcohol, type of fractures, use of restraints devices, associated injuries and treatment delivered. Out of 1,108 patients, 89.62 % were males with a male:female ratio of 8.63:1. The 21-30 year age group was found to be maximum (39.98 %). Road traffic accidents accounted for 49.01 %, followed by assault (22.38 %) and fall from height (21.66 %). Two wheelers were the most commonly involved vehicle. Out of 437 road traffic accident patients (excluding pedestrian, n = 106), only 52.40 % were found to be using restraints devices at the time of accident. Totally 25.45 % patients were under the influence of alcohol at the time of injury. According to anatomical distribution of fractures, mandibular fractures (33.57 %) were most prevalent, followed by maxilla (31.13 %), nasal (28.33 %) and zygoma (24.36 %). Head injuries (18.32 %) were found to be the most common associated injuries followed by lower limb fractures. The motive behind executing this article is to analyze the various trends of facial fractures and all those factors that affect their distribution. A perfect understanding of pattern of maxillofacial fracture will assist the executors of health care in the treatment planning and management of facial injuries. Knowledge gained from the present study would influence in assessing the effectiveness of existing preventive measures and

  20. STUDY OF CEREBRAL MALARIA IN PREGNANCY IN A TERTIARY CARE HOSPITAL OF EASTERN ODISHA

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    Bidyut Prava Das

    2017-05-01

    Full Text Available BACKGROUND The present work aimed at the clinical mode of presentation, degree of parasitaemia, complications and prognostic trends of pregnant women in cerebral malaria. Evaluation of mortality in different trimesters, varied complications and comparison with nonpregnant women was done. MATERIALS AND METHODS Thirty three pregnant women with cerebral malaria were studied. Twenty nonpregnant such cases of reproductive age group admitted to Department of Medicine, S.C.B. Medical College, Cuttack, Odisha, were taken as control. The cases were taken in random order. RESULTS Maximum numbers of cases (45.45% were primigravidae in second trimester of pregnancy. They exhibited higher incidence of anaemia and parasitaemia (2-10%, resulting in abortion and premature labour. CONCLUSION All the cases of cerebral malaria were found to be anaemic, but the severity of anaemia was more pronounced in primi (21% as compared to multigravidae (6.4%. High parasitaemia associated with leucocytosis (27.27% resulted in poor prognosis. Hypoglycaemia (15.15%, high level of urea, creatinine and alteration in parameters of liver function test further complicated the scenario leading to multiorgan failure. Recovery in cases of primigravidae was prolonged as compared to multigravidae.

  1. Clinico-microbiological profile and outcomes of nosocomial sepsis in an Indian tertiary care hospital--a prospective cohort study.

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    Saravu, Kavitha; Prasad, Madhura; Eshwara, Vandana Kalwaje; Mukhopadhyay, Chiranjay

    2015-07-01

    Nosocomial infections are linked to rising morbidity and mortality worldwide. We sought to investigate the pattern of nosocomial sepsis, device usage, risk factors for mortality and the antimicrobial resistance pattern of the causative organisms in medical intensive care units (ICUs) in an Indian tertiary care hospital. We conducted a single-centre based prospective cohort study in four medical ICUs and patients who developed features of sepsis 48 hours after admission to the ICUs were included. Patients' demographics, indwelling device usage, microbiological culture reports, drug resistance patterns and the outcomes were recorded. The Acute Physiology and Chronic Health Evaluation (APACHE) III score and the relative risk of variables contributing towards non recovery were calculated. Pneumonia (49%) was the commonest nosocomial infection resulting in sepsis, followed by urosepsis (21.8%), bloodstream infection (BSI) (10.3%) and catheter-related bloodstream infection (CRBSI) (5%). Sixty three percent of the Acinetobacter baumannii and 64.4% of the Pseudomonas aeruginosa were multidrug-resistant (MDR). Seventy percent of the Klebsiella pneumoniae were extended spectrum beta-lactamase producers and 7.4% were resistant to carbapenems. Forty three percent of the Staphylococcus aureus were methicillin-resistant S. aureus. Resistance to carbapenems was 35.2% in this study. High APACHE III scores (P = 0.006 by unpaired t-test) and chronic kidney disease (P = 0.023) were significantly associated with non-recovery. A high degree of multidrug resistance was observed among both Gram-positive and -negative organisms in nosocomial sepsis patients. Carbapenem resistance was a common occurrence. Chronic kidney disease and high APACHE III scores were significantly associated with non-recovery. Male gender and sepsis leading to cardiovascular failure were the independent predictors of mortality.

  2. Determination of risk factors for pre-eclampsia and eclampsia in a tertiary hospital of India: A case control study

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    Punyatoya Bej

    2013-01-01

    Full Text Available Background: Preeclampsia and eclampsia (PE are pregnancy specific syndromes that contribute to maternal and fetal morbidity and mortality. The identification of its predisposing factors in the pre-pregnancy and initial stage of pregnancy will help in reducing the morbidity and mortality. Aim: The aim of this study is to determine the risk factors for PE among pregnant women in a tertiary level hospital. Materials and Methods: In this study, 122 women who delivered beyond 22 weeks of gestation and diagnosed as preeclampsia or eclampsia were selected. Simultaneously, 122 controls with no diagnosis of preeclampsia or eclampsia were selected from the post natal ward. Cases and controls were administered the same pre-tested questionnaire containing different risk factors. Results and Conclusion: Logistic regression was applied in the statistical analysis. The factors that were found to be significant predictors of risk for development of PE were family history of preeclampsia (adjusted odds ratio [OR] 18.57 [1.93-178.16], P = 0.011, higher calorie intake (adjusted OR 14.12 [6.41-43.23] body mass index (adjusted P < 0.001, employment (adjusted OR 6.35 [1.56-25.82] P = 0.010], less protein intake (adjusted OR 3.87 [1.97-8.01] P < 0.001, increased OR 5.86 [02.48-13.8] P < 0.001, mild physical activities (adjusted OR 3.46 [1.06-11.24] P = 0.039. Past history of hypertension and diabetes mellitus were also associated with development of PE.

  3. Poor adherence to neonatal resuscitation guidelines exposed; an observational study using camera surveillance at a tertiary hospital in Nepal.

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    Lindbäck, Caroline; KC, Ashish; Wrammert, Johan; Vitrakoti, Ravi; Ewald, Uwe; Målqvist, Mats

    2014-09-16

    Each year an estimated 10 million newborns require assistance to initiate breathing, and about 900 000 die due to intrapartum-related complications. Further research is required in several areas concerning neonatal resuscitation, particularly in settings with limited resources where the highest proportion of intrapartum-related deaths occur. The aim of this study is to use CCD-camera recordings to evaluate resuscitation routines at a tertiary hospital in Nepal. CCD-cameras recorded the resuscitations taking place and CCD-observational record forms were completed for each case. The resuscitation routines were then assessed and compared with existing guidelines. To evaluate the reliability of the observational form, 50 films were randomly selected and two independent observers completed two sets of forms for each case. The results were then cross-compared. During the study period 1827 newborns were taken to the resuscitation table, and more than half of them (53.3%) were noted as not crying prior to resuscitation.Suction was used in almost 90% of newborns brought to the resuscitation table, whereas bag-and-mask ventilation was only used in less than 10%. The chance to receive ventilation with bag-and-mask for a newborn not crying when brought to the resuscitation table was higher for boys (AdjOR 1.44), low birth weight babies (AdjOR 1.68) and babies that were delivered by caesarean section (AdjOR 1.64).The reliability of the observational form varied considerably amongst the different variables analyzed, but was high for all variables concerning the use of bag-and-mask ventilation and the variable whether suction was used or not, all matching in over 91% of the forms. CCD camera technique was a feasible method to assess resuscitation practices in this low resource hospital setting. In most aspects, the staff did not adhere to guidelines regarding neonatal resuscitation. The use of bag-and-mask ventilation was inadequate, and suction was given excessively in terms of

  4. EVALUATION OF THE ADVERSE REACTIONS OF ANTIRETROVIRAL DRUG REGIMENS IN A TERTIARY CARE HOSPITAL IN KOLKATA: A PROSPECTIVE OBSERVATIONAL STUDY

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    Avishek Banerjea

    2016-09-01

    Full Text Available BACKGROUND The introduction of Highly Active Antiretroviral Therapy (HAART has led to a significant decrease in AIDS-related mortality and morbidity. However, adverse reactions to these drugs, being inevitable, have led to major obstacles in its success, especially in developing nations like India. Moreover, the latest changes made by W.H.O. in the treatment guidelines of ART naive patients would expectedly lead to changes in the Adverse Drug Reaction (ADR patterns as well. Hence, this study aimed at evaluating the ADRs of currently prescribed ART regimens in a tertiary care hospital in Kolkata (WB. METHODOLOGY 168 ART naive patients enrolled initially were studied prospectively over a period of 1 year; each patient being followed up individually for 6 months. All patients were asked to visit the ART centre once a month or whenever they developed any symptom. They were screened clinically and investigated suitably by the physician according to the latest NACO guidelines. RESULTS Majority were males (56% with an M:F ratio of 1:0.774; 93.3% patients belonging to the 15-49 yrs. age group. TDF+3TC+EFV (56% was the commonest 1st line regimen prescribed. 76.6% patients experienced ADRs. Total 184 ADRs were noted, of which, GIT contributed the most (27.17%. Majority (66.67% of neurological ADRs was contributed by neuropsychiatric manifestations. Rash (10.3% was the commonest cutaneous ADR. Anaemia (13.6% was the commonest haematological ADR with a statistically significant female preponderance. Most ADRs were grade 1 (63.04%. Majority ADRs were “possible” (65.76% while 34.24% were “probable” by Naranjo scale. Maximal ADRs (48.37% were noted from patients under AZT+3TC+NVP regime. IRIS was observed as a paradoxical reaction to ART in 10% cases. CONCLUSION It should not be forgotten that ADRs are the inevitable consequence of pharmacotherapy. Hence, proper implementation of current protocols designed for screening of patients especially during

  5. Pattern of biopsy-proven kidney disease in the elderly in a tertiary care hospital in India: a clinicopathological study.

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    Bagchi, Soumita; Mittal, Parmod; Singh, Geetika; Agarwal, Sanjay Kumar; Singh, Lavleen; Bhowmik, Dipankar; Mahajan, Sandeep; Dinda, Amit

    2016-04-01

    An aging population is an important demographic issue in India. The knowledge base about kidney diseases among the elderly Indians is inadequate. We aim to delineate the clinical profile and spectrum of biopsy-proven kidney disease in elderly patients. Records of all elderly patients (≥60 years) who had undergone kidney biopsy in the nephrology department from January 2010 to December 2014 were reviewed. Their clinical details and laboratory investigations at the time of biopsy were noted. Details of kidney biopsy were recorded from their biopsy reports. In total, 1728 patients underwent kidney biopsy during this period and 124 were elderly (7.2%). Their mean age was 64.9 ± 4.9 years, and they were predominantly males (63.7%). Mean serum creatinine was 3.0 ± 2.8 mg/dl, proteinuria was 4.0 ± 2.7 g/day, and 39.5% had microscopic hematuria. The most common indications for biopsy were nephrotic syndrome (NS)--39.5% and acute kidney injury/rapidly progressive glomerulonephritis (AKI/RPGN)--24.2%. Another 8.1% patients had NS with AKI. MN (39.0%) was the chief cause of NS, and pauci-immune crescentic glomerulonephritis (GN) (28.2%) was the leading cause of AKI/RPGN. MN, pauci-immune crescentic GN and acute on chronic tubulointerstitial nephritis (A/CTIN) and acute tubular injury (ATI) were more common in the elderly, while MCD, FSGS, IgA nephropathy and lupus nephritis were more frequent in the younger patients. 68.5% of the elderly patients biopsied were diagnosed with a renal disease which was potentially amenable to specific treatment. The spectrum of biopsy-proven kidney disease in the elderly Indians seen in our tertiary care hospital varies from the younger population. Kidney biopsy provides useful information with therapeutic and prognostic implications in these patients. The percentage of elderly patients among the total biopsied population is low in India, and these patients present late with renal dysfunction. Prospective studies are needed to assess the

  6. Adverse reactions to blood donation: A descriptive study of 3520 blood donors in a Nigerian tertiary hospital

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    C Aneke John

    2017-01-01

    Full Text Available Background: The occurrence of adverse reactions to blood donation significantly hampers donor retention and negatively impacts on the universal availability of adequate numbers of blood donor units. Objective: To analyze the spectrum and prevalence of adverse reactions in blood donors in a tertiary hospital-based blood bank in Nigeria. Subjects and Methods: The details of 3520 blood donors who presented for donation over a 12 months period were retrieved from the departmental archives for analysis. These included sociodemographic information, type of donor, type and frequency of adverse reactions to blood donation. Data were analyzed using the Statistical Package for Social Sciences version 20.0 (SPSS Inc., Chicago, IL, USA computer software. Descriptive and inferential statistics were employed to represent the distribution of donor characteristics (as percentages and compare reaction rates by gender and severity, respectively. Results: The prevalence of adverse reactions to blood donation was (56/3520 1.60%; this occurred more frequently in male and family replacement donors (55.35% and 100.0%, respectively. The spectrum of donor adverse reactions included anxiety 25 (44.64%, generalized body weakness 11 (19.64%, hematoma 10 (17.86%, fainting 5 (8.93%, and vomiting 5 (8.93%. Vasovagal reactions were the most frequent adverse reaction encountered among the donors (46/56; 82.14%. Conclusion: Vasovagal reactions are common adverse phenomena in our blood donor set; this has implications on transfusion safety and blood donor retention.

  7. A prospective study of acute inpatient gout diagnoses and management in a tertiary hospital: the determinants and outcome of a rheumatology consultation.

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    Teichtahl, A J; Clemens, L; Nikpour, M; Romas, E

    2014-11-01

    Despite acute gout frequently complicating hospital admissions, diagnosis and management are variable. Rheumatology input may improve patient outcomes. To examine acute episodes of inpatient gout in a tertiary hospital to determine (i) factors that may lead to rheumatology input being sought and (ii) the differences in outcomes when rheumatology input occurs. Data collection occurred between February and October 2012 for inpatients in a tertiary Australian hospital. Data were prospectively collected for all rheumatology consultations with a diagnosis of gout. Subjects who had an inpatient admission complicated by acute gout and who did not have rheumatology input were identified through health information coding from discharge summaries. Fifty-eight patients (41% with rheumatology input) were included in the study. Rheumatology input was significantly more likely when the patient was younger (68.9 years vs 78.4 years; P = 0.04) with knee joint involvement (41.7% vs 3.0%; P management and a follow-up plan. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  8. Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, northeastern Tanzania

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    Oneko Olola

    2011-07-01

    Full Text Available Abstract Background The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. Methods We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ≥ 750 mL, postpartum stay > 9 days, neonatal death, Apgar score Results Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86 and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35 were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16. Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral

  9. Obstetric intensive care admissions at a tertiary hospital in Limpopo ...

    African Journals Online (AJOL)

    Objective. To determine the characteristics of obstetric patients admitted to the intensive care unit (ICU) at a tertiary hospital in the Limpopo Province, South Africa. Methods. Hospital files of all obstetric patients admitted to the Pietersburg provincial referral hospital ICU from 1 January 2008 to 31 December 2012 were ...

  10. Hospital mortality in cirrhotic patients at a tertiary care center.

    Science.gov (United States)

    Zubieta-Rodríguez, R; Gómez-Correa, J; Rodríguez-Amaya, R; Ariza-Mejia, K A; Toloza-Cuta, N A

    Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital. A descriptive, observational, cohort study was conducted on adult patients with cirrhosis of the liver, admitted to a tertiary care center in Bucaramanga, Colombia, within the time frame of March 1, 2015 and February 29, 2016. Eighty-one patients with a mean age of 62 years were included in the study. The main etiology of the cirrhosis was alcoholic (59.3%). In-hospital mortality was 23.5% and the most frequent cause of death was septic shock (68.4%), followed by hypovolemic shock (10.5%). A MELD score≥18, a leukocyte count>12,000/ul, and albumin levels below<2.5g/dl were independent factors related to hospital mortality. In-hospital mortality in cirrhotic patients is high. Sepsis and bleeding are the 2 events leading to acute-on-chronic liver failure and death. A high MELD score, elevated leukocyte count, and low level of albumin are related to poor outcome during hospitalization. Adjusted prevention-centered public health measures and early and opportune diagnosis of this disease are needed to prevent the development of complications and to improve outcome in cirrhotic patients. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  11. Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study.

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    Ali, Solomon; Birhane, Melkamu; Bekele, Sisay; Kibru, Gebre; Teshager, Lule; Yilma, Yonas; Ahmed, Yesuf; Fentahun, Netsanet; Assefa, Henok; Gashaw, Mulatu; Gudina, Esayas Kebede

    2018-01-01

    Healthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described. Longitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection. The specimens were processed by standard microbiological methods to isolate and identify bacteria etiology. Clinical and laboratory data were collected using structured case report formats. The incidence rate of hospital acquired infection was 28.15 [95% C.I:24.40,32.30] per 1000 patient days while the overall prevalence was 19.41% (95% C.I: (16.97-21.85). The highest incidence of HAI was seen in intensive care unit [207.55 (95% C.I:133.40,309.1) per 1000 patient days] and the lowest incidence was reported from ophthalmology ward [0.98 (95% C.I: 0.05,4.90) per 1000patient days]. Among patients who underwent surgical procedure, the risk of HAI was found to be high in those with history of previous hospitalization (ARR = 1.65, 95% C.I:1.07, 2.54). On the other hand, young adults (18 to 30-year-old) had lower risk of developing HAI (ARR = 0.54 95% C.I: 0.32,0.93) Likewise, among non-surgical care groups, the risk of HAI was found to be high in patients with chest tube (ARR = 4.14, 95% C.I: 2.30,7.46), on mechanical ventilation (ARR = 1.99, 95% C.I: 1.06,3.74) and with underlying disease (ARR = 2.01, 95% C.I: 1.33,3.04). Furthermore, hospital aquired infection at the hosoital was associated with prolonged hospital stay [6.3 more days, 95% C.I: (5.16,7.48), t = 0.000] and increased in hospital mortality (AOR, 2.23, 95% CI:1.15,4.29). This study revealed high burden and poor discharge outcomes of healthcare

  12. A longitudinal study to determine association of various maternal factors with neonatal birth weight at a tertiary care hospital.

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    Misra, Akshay; Ray, Sougat; Patrikar, Seema

    2015-07-01

    Neonatal birth weight is a powerful predictor of infant growth and survival and maternal factors like poor knowledge and insufficient dietary intake are significant risk factors. Other preventable determinants like pre pregnant BMI weight gain (GWG) and anemia are also associated with low birth weight. This study was carried out to identify the impact of these maternal factors with risk of low birth weight (LBW). A longitudinal study was carried out on 124 booked antenatal cases at a tertiary care center. A validated protocol containing socio demography, food frequency and anthropometry was administered at the 3rd trimester. Birth weight of the newborn was noted after delivery. 26.28% children had low birth weight (weight gain of less than 9 kgs and 45.5% were anemic. 81.81% mothers with BMI >18.5 and 28.92% women who were educated till high school had a baby with LBW. Most mothers consumed milk and vegetables daily and a few consumed non vegetarian foods but quality and quantity of food were grossly inadequate. GWG levels and Hb levels were significantly different in different birth weight groups and also were significantly associated with low birth weight. Quality and quantity of maternal dietary intake during pregnancy, even in normal weight mothers (BMI > 18.5), are important determinants of birth weight. Nutritional counseling for mothers during the antenatal period is the cornerstone for healthy mother and healthy child.

  13. A study on risk factors of breast cancer among patients attending the tertiary care hospital, in Udupi district

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    Ramchandra Kamath

    2013-01-01

    Full Text Available Background: Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. An increasing trend in incidence is reported from various registries of national cancer registry project and now India is a country with largest estimated number of breast cancer deaths worldwide. Aim: To study the factors associated with breast cancer. Objectives: To study the association between breast cancer and selected exposure variables and to identify risk factors for breast cancer. Materials and Methods: A hospital based Case control study was conducted at Shirdi Sai Baba Cancer Hospital and Research Center, Manipal, Udupi District. Results: Total 188 participants were included in the study, 94 cases and 94 controls. All the study participants were between 25 to 69 years of age group. The cases and controls were matched by ± 2 years age range. Non vegetarian diet was one of the important risk factors (OR 2.80, CI 1.15-6.81. More than 7 to 12 years of education (OR 4.84 CI 1.51-15.46 had 4.84 times risk of breast cancer as compared with illiterate women. Conclusion: The study suggests that non vegetarian diet is the important risk factor for Breast Cancer and the risk of Breast Cancer is more in educated women as compared with the illiterate women. Limitation: This is a Hospital based study so generalisability of the findings could be limited.

  14. BACTERIAL PROFILE IN BURN WOUNDS WITH SPECIAL REFERENCE TO ANTIMICROBIAL AGENTS AND TOPICAL APPLICATIONS IN A TERTIARY CARE HOSPITAL- A 2 YEAR PROSPECTIVE STUDY

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    Rajesh Kumar Dora

    2017-08-01

    Full Text Available BACKGROUND Burn is one of the most devastating condition. It is seen in all age groups from a baby to the elderly. Burn injuries pose a big challenge to the medical fraternity. Burn injuries can have an effect on the skin, respiratory, cardio vascular, renal, haematological, G.I, musculoskeletal, eye, immune system, metabolism and nutrition. Burns may be Superficial or partial thickness where the epidermis is involved, full thickness when all the layers of skin are involved and deep burn. MATERIALS AND METHODS Total of 64 patients who have attended the OPD and Casualty with burn injuries and given consent for the study were studied in a period of 2 years duration in the Department of Surgery, S.C.B. Medical College and Hospital, Cuttack. RESULTS Burn injury is a common health hazard. These injurues are seen in low socio economic status because of poverty, overcrowding, poor condition of living and ignorance regarding precautions to be taken during fire accidents Incidence is high in females. Male burns are attributed to. Male burns may be attributed to alcohol, smoking and domestic violence which is seen in our study. Burns can be due to accidents, suicidal or homicidal. The percentage of body surface area in burns is calculated as per Wallace rule of nine’s. It helps to estimate the percentage of burn and the fluid estimation is done. Burn injuries produce irreversible cell protein denaturation. Cytoplasmic coagulation, blockage of thermolabile enzymes and cell death. Most burn deaths occur in the developing world particularly in South East Asia CONCLUSION Burn injuries are frequently seen. The contribute to almost 20% of admissions in the tertiary care hospitals. In the present study in S.C.B. Medical College and hospital, Cuttack, Odisha female burn patients in the third decade of life was the commonest. Those patients are mostly house wives and they have a close proximity to the kitchen. Some of the deaths were dowry related and are either

  15. Effectiveness of an intervention package on knowledge, attitude, and practices of food handlers in a tertiary care hospital of north India: A before and after comparison study.

    Science.gov (United States)

    Dudeja, Puja; Singh, Amarjeet; Sahni, Nancy; Kaur, Sukhpal; Goel, Sonu

    2017-01-01

    Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safety and Standards Act (FSSA), 2006, indicates the concern of our Govt. for food safety. Research on effectiveness of food safety interventions in our country is remarkably scarce. Hence, the present study was conducted in a tertiary care hospital of north India to create evidence-based results for food safety interventions. The study was before and after intervention trial which was registered with CTRI. Data collection was paperless using a software. All food handlers ( n  = 280) working inside the hospital were recruited. Intervention package comprised Self-Instructional Manual in Hindi for food handlers, short film for sensitization of food handlers on food safety titled 'Gravy Extra', and a documentary titled 'Food Safety from farm to Fork'. Chi square test, paired t test, and Wilcoxon sign rank test were used. The mean age of food handlers was 35 ± 2 years. Majority (61.7%) of food handlers were educated less than 10th standard. Nearly 60% of them had up to five years of experience. At base line majority (68.9%) had a fair knowledge about food safety issues. There was a significant improvement in food safety knowledge and practice score of food handlers after the intervention ( p  < 0.05). Their attitude toward food safety changed in a positive direction ( p  < 0.05). The intervention package was useful in improving the knowledge, creating a positive attitude and enhancing the food safety practices of food handlers working inside a tertiary care hospital.

  16. Profile of Mental and Behavioral Disorders Among Preschoolers in a Tertiary Care Hospital in Oman: A Retrospective Study

    OpenAIRE

    Al-Sharbati, Marwan M.; Al-Farsi, Yahya M.; Al-Sharbati, Zena M.; Fatima Al-Sulaimani; Allal Ouhtit; Samir Al-Adawi

    2016-01-01

    Objectives Early diagnosis and prompt treatment of mental and behavioral disorders in preschoolers is critical for a better prognosis, ultimately leading to improved quality of life for both the child and the family. Our study investigated the clinical profile of mental and behavioral disorders in children < 7 years of age, seeking consultation at Sultan Qaboos University Hospital, Muscat, Oman, between 1 June 2006 and 31 December 2010. The objective was to explore demographic variables, ...

  17. Study of Incidence, Risk Factors and Antibiotic Sensitivity Pattern of Acinetobacter baumannii in a Tertiary Care Hospital

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    Vijaya S Rajmane

    2015-01-01

    Full Text Available Background: Recently, Acinetobacter species has emerged as an important pathogen and the prevalence of infection has increased since last two decades worldwide. Objective: To see the impact of Acinetobacter infection in our hospital and antibiotic sensitivity and resistance pattern. Material and Methods: The study was carried out on clinical samples submitted to the Microbiology laboratory in Krishna institute of Medical Sciences and Research, Karad, over a period of one year (July 2012 to June 2013.Various risk factors like length of hospital stay, ICU admission, any interventions done were noted. Identification and antibiotic susceptibility of the isolates was performed using standard protocol. Results: Out of a total 2728 samples, 86 (3.15% were found to be due to Acinetobacter baumannii. Of the 86 isolates the organism was predominantly isolated from pus samples 48 (55.81% followed by sputum 17 (19.76%, urine 6 (6.97% and blood 4 (4.65%. Out of 86 Acinetobacter isolates, 76 (88.37% showed resistance to Cephalexin, 74 (86.04% each to Cefotaxime and Ceftazidime. The isolates also showed high level of resistance to Ciprofloxacin (82.55%, Ampicillin (77.90% and Gentamicin (74.41%. The isolates from urine samples showed 100% sensitivity to Nitrofurantoin. Imipenem and Meropenem were highly active against the isolate with least resistance of 12.79% each. Conclusion: The present study highlights Acinetobacter species as an important pathogen because of multidrug resistant strains jerking in the hospital environment.

  18. Oesophageal squamous cell cancer in a South African tertiary hospital

    African Journals Online (AJOL)

    Oesophageal squamous cell cancer in a South African tertiary hospital: a risk factor and presentation analysis. ... Methodology: Information on patients managed at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa, between 1 October 2013 and 31 December 2014 was retrieved from a prospective ...

  19. Spectrum of Glaucoma Presentation in a Nigerian Tertiary Hospital

    African Journals Online (AJOL)

    tulyasys

    of African descent to be four times greater than in. Spectrum of Glaucoma Presentation in a. Nigerian Tertiary Hospital. Olusola Olawoye1,2, Sarimiye Tarella1. 1Department of Ophthalmology, University College Hospital, Ibadan, 2Department of Ophthalmology, College of Medicine,. University of Ibadan, Ibadan, Nigeria.

  20. Probiotics in the Prevention of Antibiotic Associated Diarrhoea in a Tertiary Teaching Hospital in Pokhara: A Prospective Study

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    Sahisnuta Basnet

    2017-10-01

    Full Text Available Introduction: Diarrhoea is an undesirable side effect when treating common infections in children with antibiotics. Though studies have shown the effectiveness of probiotics in preventing antibiotic associated diarrhoea, and there is no documented research in Nepal regarding this issue. Aim: The objective of this study was to observe the efficacy of probiotics for the prevention of antibiotic associated diarrhoea when co-administered with an oral antibiotic in children with respiratory tract infections who attended the outpatient department in Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: A prospective interventional study was conducted from January 2016 to October 2016 in which 174 children attending the outpatient department in Manipal Teaching Hospital, Pokhara, Nepal and requiring antibiotics for respiratory tract infection were enrolled using convenient sampling method. Eighty-seven of the subjects received standard antibiotic treatment with amoxicillin and clavulanate (control group and another 87 children received the same antibiotic which was prescribed along with probiotics (probiotic group. Result: Out of the 174 eligible children enrolled in the study, diarrhoea occurred in 11/87 (12.6% of the patients in the control group and in 1/87 (1.1% patient in the probiotic group {relative risk, 12.45, 95% CI(1.57,98.67}. The co-administration of probiotic with amoxicillin and clavulanate significantly decreased the incidence of diarrhoea in the probiotic group (p= 0.003. Conclusion: Co-administration of probiotics in children receiving oral amoxicillin and clavulanic acid reduces the risk of diarrhoea.

  1. SOCIO-DEMOGRAPHIC PROFILE OF TRAUMATIC CATARACT IN WESTERN ODISHA: A STUDY AT A TERTIARY CARE HOSPITAL

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    Samarth Mishra

    2016-06-01

    Full Text Available AIM Ocular injuries are common in all age groups, be it from blunt trauma like cricket ball, bat, etc or penetrating injury from pen, pencil or stick with cataract being the most common complication. Other complications like corneal perforation with or without iris prolapse, total hyphema, lens subluxation with or without posterior capsular rupture, iridodialysis, uveitis, vitreous haemorrhage, retinal detachment, etc. may occur. The aim of the study was to find out the various causes of traumatic cataract and associated socio-demographic profile in western Odisha, in a single tertiary care centre. MATERIALS AND METHODS Retrospective study was conducted on 76 patients who had traumatic cataract and were admitted to VSS Institute of Medical Sciences and Research (VIMSAR, Burla, Odisha from March 2014 to March 2016, a total period of 2 years. Data related to the type of injury, duration of presentation, age, sex, occupation and initial visual acuity were taken. B-scans were done for all cases. X-ray and CT scans were done wherever required. RESULTS Traumatic injuries were most common in children and young adults. 27 cases (35.52% were children in age group less than 10 years. The incidences decreased with increase in age and were less frequent in the elderly. The most common form of injury was penetrating injury with stick injury as the cause in 19 cases (25%, followed by pen (19.73% and pencil (14.47%. Males were injured more frequently (63.15% than females (36.84%. 59 patients presented within 24 hours of injury which comprised 77.63% in total. Though most had poor visual acuity at initial presentation, postoperative prognosis was found to be good in general, if not associated with any other complications. CONCLUSION Since traumatic cataract is common in childhood, parents should be vigilant and should prohibit the use of sharp instruments in children. Occupational workers should use protective eye gears to avoid untoward incident. Though

  2. RETROSPECTIVE STUDY OF RELAPAROTOMY IN DEPARTMENT OF OBSTRETRICS, GYNAECOLOGY AND FAMILY PLANNING IN, RURAL TERTIARY CARE HOSPITAL, ANDHRA PRADESH, INDIA

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    Uma Thombarapu, Prabha Devi Kodey, GangadharaRao Koneru

    2015-07-01

    Full Text Available Introduction: Relaparotomy is biggest dilemma to the surgeon and critical to the patient to undergo second surgery within short span of time .It is challenging both physically and mentally to the patient. Aim: Aim of the study was to determine incidence of relaparotomy and its indication, management and outcome in the department of Obstetrics, Gynaecology and Family Planning (OBGYN & FP in NRI Medical College & General Hospital at Guntur District. Materials and Methods: It is a retrospective observational study for the duration of 3 and ½ years. Total number of surgeries -7, 718. Total number of relaparotomy- 27 which include referral cases. Results: Incidence for relaparotomy was 0.34%. Most important cause for relaparotomy was haemorrhagic causes (44.4%, followed by burst abdomen (33.3%. Relaparotomy can increase morbidity, mortality (14.8% of patients with increased hospital stay on an average of 27 days including Intensive Care Unit, further increasing the financial burden to the patient. Conclusion: Emergency relaparotomy is a life saving procedure. Good expertise in selection of primary surgery and right surgical technique, intra operative hemostasis, control of post operative infection can avoid relaparatomy

  3. Predictors of family caregiver burden in schizophrenia: Study from an in-patient tertiary care hospital in India.

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    Jagannathan, Aarti; Thirthalli, Jagadisha; Hamza, Ameer; Nagendra, H R; Gangadhar, B N

    2014-04-01

    Family caregivers experience significant burden in taking care of their patients with schizophrenia. Research on predictors of caregiver burden in India, where families are the primary caregivers of schizophrenia patients, is lacking. To study the predictors of burden experienced by the family caregivers of first admission in-patient schizophrenia patients in India. Family caregivers of 137 schizophrenia patients admitted to an in-patient facility of a hospital in south India were interviewed using the Burden Assessment Schedule. The coping, knowledge about schizophrenia, perceived social support of the caregivers and illness severity, psychopathology and disability experienced by the patients were also assessed. Bivariate correlation and multivariate regression analysis were used to study the association of different factors on burden. Duration of illness and levels of psychopathology and disability had significant direct correlation with total burden score; perceived social support had significant inverse correlation with total burden score. There was a high correlation between psychopathology and disability (pburden in addition to psychopathology and disability. During the first hospitalization, in addition to symptom reduction and disability limitation, focus should be on enhancing social support in order to reduce caregiver burden among family members of schizophrenia patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. A study of psoriasis and quality of life in a tertiary care teaching hospital of Kottayam, Kerala

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    V D Manjula

    2011-01-01

    Full Text Available Background: Psoriasis is a chronic skin disease which has an impact on health-related quality of life (QoL. The psoriasis disability index (PDI is a simple 15-item questionnaire which is used to assess overall psoriasis disability. Objectives: (1 To assess the health-related QoL among patients with psoriasis, attending dermatology OPD of Medical College Hospital, Kottayam. (2 To find out the association of QoL with age and gender. Materials and Methods: This was a descriptive case series study conducted in Dermatology OPD of Medical College Hospital, Kottayam, Kerala. Psoriasis patients attending the Dermatology OPD of Medical College Hospital for 2 months were assessed. Results: Out of the total 32 patients, 56.2% were males, whose mean age was 45; 72% were married, 47% had education above plus two and were employed. Also, 34% had income above Rs. 3000 per month. Among the PDI subsets, daily activities were affected the most (90.6%, followed by work (84.4%, leisure activities (71.9%, problems with treatment (68.7% and the least affected was personal relations (62.5%. Overall PDI score (median 14.5, interquartile range 4.5-22 showed that the QoL was affected in 75% of which 9.4% were mild (score 18. There was no association between the total PDI score and age or gender. Conclusion: QoL was affected in 75% of psoriasis patients. There was no association between QoL and age or gender.

  5. Profile of Mental and Behavioral Disorders Among Preschoolers in a Tertiary Care Hospital in Oman: A Retrospective Study

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    Marwan M. Al-Sharbati

    2016-09-01

    Full Text Available Objectives: Early diagnosis and prompt treatment of mental and behavioral disorders in preschoolers is critical for a better prognosis, ultimately leading to improved quality of life for both the child and the family. Our study investigated the clinical profile of mental and behavioral disorders in children < 7 years of age, seeking consultation at Sultan Qaboos University Hospital, Muscat, Oman, between 1 June 2006 and 31 December 2010. The objective was to explore demographic variables, intervention types, and annual trends. Methods: This retrospective, descriptive study was conducted by reviewing the electronic records of preschoolers seeking consultation on mental and behavioral disorders at the Department of Behavioral Medicine. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV criteria. Results: The total number of cases was 466, the majority (77.9% being boys. The cumulative frequencies and annual hospital-based prevalence rates were estimated for each category of mental and behavioral disorders. Our findings showed increased service utilization among preschoolers, as reflected in the annual trend and case-specific prevalence rates. While comorbidity was common, the most frequent disorders encountered were attention deficit hyperactivity disorder (70.8%, developmental language disorder (23.6%, autism spectrum disorders (20.2%, and disruptive behavior disorders (11.6%. The most commonly prescribed drugs/supplementation were risperidone (18.7%, atomoxetine (9.7%, omega-3 (8.8%, and methylphenidate (6.2%. Conclusions: Consultations for mental and behavioral disorders are being sought for Omani preschoolers. Beside pharmacotherapy, other interventions, which are an integral part of a much desired multidisciplinary approach should be introduced. Readdressing the missing needs is essential for a comprehensive approach to managing mental and behavioral disorders.

  6. Risk factors for Clostridium difficile infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case–control study

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    Vesna Šuljagić

    2017-03-01

    Full Text Available Abstract Background The objective of this study was to investigate independent risk factors (RFs connected with healthcare-associated (HA Clostridium difficile infection (CDI in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital. Methods Risk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI. Results The overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93–58.4, the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41–6.40, and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39. Patients with HA CDI had significantly higher in–hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84–43.43. Conclusions CDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.

  7. Benign proliferative breast diseases among female patients at a sub-Saharan Africa tertiary hospital: a cross sectional study.

    Science.gov (United States)

    Okoth, Christopher; Galukande, Moses; Jombwe, Josephat; Wamala, Dan

    2013-04-01

    Non-cancerous diseases of the breast have assumed increasing importance because of the public awareness of breast cancer. These benign diseases are a recognized important risk factor for later breast cancer which can develop in either breast. The risk estimate of these benign breast diseases has not been well established in sub Saharan Africa. Women with benign proliferative or atypical breast lesions have a two- fold risk of developing breast cancer in western populations. The purpose of this study therefore was to determine the prevalence of proliferative disease ( BPBD) with and without atypia among Ugandan Black women. A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened. Fine needle aspiration biopsies were taken for cytological examination. Of the 208 women with benign breast lumps screened, 195 were recruited in the study. The prevalence of BPBD was 18% (35/195). BPBD with atypia was 5.6% (11/195). The mean age and body mass index (BMI) were 28.4 years and 23.26 kg/m2 respectively. The commonest lesions were fibroadenomas for 57%, (111/195), and fibrocystic change were 21% (40/195). Most BPBD with atypia lesions were in the fibrocystic category. Benign proliferative breast diseases are common, found mostly among premenopausal women. A significant proportion of BPBD had atypical proliferation. An accurate breast cancer risk estimate study for BPBD is recommended.

  8. Study of Drug Utilization Pattern for Skin Diseases in Dermatology OPD of an Indian Tertiary Care Hospital - A Prescription Survey.

    Science.gov (United States)

    Pathak, Anuj Kumar; Kumar, Subodh; Kumar, Manish; Mohan, Lalit; Dikshit, Harihar

    2016-02-01

    Skin diseases are the major contributors of disease burden in society. It affects individuals of all ages, neonates to elderly. Owing to its chronic nature, it causes serious impact on quality of life and financial status of the sufferer and his family. The problem gets compounded with the inappropriate and irrational use of medicines. Periodic prescription audit in form of drug utilization study is a way to improve the quality of prescription and curb the menace of irrational prescribing which has become a global phenomenon. This study aims to determine the drug utilization pattern and assess the economic burden of the patient with skin disease. It was a prospective, cross-sectional study conducted over a period of three months from January to March 2015 in newly diagnosed cases attending outpatient department of Skin and VD, IGIMS, Patna. The prescriptions were analysed with the help of descriptive statistics and results were expressed in percentage. Total 752 prescriptions were analysed during the study. Male patients were lesser as compared to female as male to female ratio was 0.88. Over 50% of patients were in adolescent age group i.e. 21-40 years. Acne (17.95%) was most common disease in the study population followed by eczema and Dermatophytosis. Among the drugs, antihistaminics (24.13%) were prescribed most frequently followed by antifungals and antibiotics. Topical agents constituted almost 60% of the total prescription and average number of drugs per prescription was 5.13, irrespective of the dosage forms prescribed. This drug utilization study provides an insight to the prescriber regarding various issues related to polypharmacy, cost analysis and prevalent disease pattern in the region. This study also suggests periodic evaluation of prescription pattern to monitor and improve quality of prescription in other departments of the hospital.

  9. Comparison of Nulliparas Undergoing Cesarean Section in First and Second Stages of Labour: A Prospective Study in a Tertiary Teaching Hospital

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    Ayhan Sucak

    2011-01-01

    Full Text Available Objective. We performed a prospective observational audit study to compare neonatal and maternal outcomes of the primary cesarean sections performed in first stage versus second stage of labour. Methods. One thousand three hundred and eighty-nine nullipara women who had undergone cesarean section in a tertiary teaching hospital between February 1, 2009 and January 31, 2010 were included in the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury, requirement for hysterectomy, and duration of hospital stay. Results. A total of 1389 women underwent cesarean section at this 12 month time period. Of these 1389 cesarean sections, 1271 were in the first stage of the labour and 171 were in the second stage of the labour. Urinary injuries, transfusion requirement, and uterine atonia hysterectomy were significantly more frequent in women who underwent cesarean section in the second stage of the labour compared to women undergoing cesarean section in the first stage of the labour. Conclusion. Cesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing cesarean section in the second stage of the labour.

  10. Bio-social Predictors of Low Birth Weight- A Prospective study at a Tertiary care Hospital of North Karnataka, India

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    DP Paneru

    2013-12-01

    Full Text Available BACKGROUND: Low Birth Weight is a multi-factorial problem of health and social concern Worldwide. India accounts for 40 percent of Low birth weight (LBW babies of the developing World and more than half of those in Asia. Despite the multitude of services rendered to improve maternal health care, LBW remains a public health problem in India. Objective: To determine bio-social predictors of low birth weight amongst the institutional births in North Karnataka, India. METHODS: A prospective hospital based study was conducted in Belgaum district of north Karnataka during July 2012-March 2013. A total of 426 pregnant women registered within 20 weeks of gestation during July–September 2013; eventually delivered in the same hospital were included in the study. Birth weight was measured by a digital weighing scale of 100 gram accuracy. Data were collected through individual interviews using pretested questionnaire. Data were analyzed by SPSS (16.0 Version. Descriptive statistics and multivariate regression were applied. P value < 0.05 considered significant. RESULTS: Mean age of subjects was 23.2254±3.09 years. About 96.7% were literates. Mean age at first pregnancy was 21.37±2.70 years. Low birth weight was observed amongst 22.5% new born (Mean weight: 2089.58±268.31gm. Almost 10.0% were preterm births. Paternal education and occupation, socio-economic status, religion, maternal blood group and gestation age at delivery were found to be the independent and significant bio-social factors predicting the low birth weight. About 68.0% variations in the birth weight were explained by these predictors. CONCLUSIONS: Low paternal education and occupation (farmers/laborers, low socio-economic status, maternal blood group (A is protective and prematurity were found to be independent bio-social predicators of LBW. Programme targeting paternal education may be useful and study of biological plausibility associated with the maternal blood group is recommended.

  11. Causes of Death Among Patients Infected with HIV at a Tertiary Care Hospital in China: An Observational Cohort Study.

    Science.gov (United States)

    Xiao, Jiang; Du, Shuxu; Tian, Yunfei; Su, Wenjing; Yang, Di; Zhao, Hongxin

    2016-08-01

    The objective of this study was to elucidate the causes of death and mortality in a cohort of inpatients infected with HIV. The causes of death and mortality were evaluated by using the clinical data of 1,076 patients admitted to the Center for Infectious Diseases, Beijing Ditan Hospital, between January 1, 2009, and November 30, 2012, and who were followed for 6 months after discharge. During the 4-year study period, 216 patients had died by the 6-month follow-up (mortality rate, 20.1%). Opportunistic infections were the most common causes of death (42.0%), followed by malignancies (23.1%), unexplained central nervous system infections and occupying lesions (18.1%), infectious shock (10.2%), severe hepatitis and decompensated cirrhosis (3.2%), sudden death (1.4%), lactic acidosis (0.9%), and uremia (0.9%). The strong risk factors for mortality were cost constraints and unaffordable further diagnosis and treatment (adjusted hazard ratio [AHR] = 134.394, 95% confidence interval [CI] = 25.748-701.481, p HIV/AIDS patients in China. AIDS-related infections and malignancies were the most common causes of death in patients infected with HIV, and improvement of the etiological diagnosis would help physicians provide appropriate treatment and reduce mortality rates.

  12. A Study on Safe Injection Practices of Nursing Personnel in a Tertiary Care Hospital of Kolkata, West Bengal, India

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    Bobby Paul

    2011-12-01

    Full Text Available AIM: Although a safe injection does not harm to patient, unsafe injection practices may leads some health problems. The most affected category of health care providers are the nursing personnel. METHOD: This hospital based cross sectional observational study was conducted among 80 nurses involved in patient care to assess their knowledge regarding safe injection practices and to assess certain aspects of their practice while administering injection and disposal of the disposables. RESULTS: About 52.5% subjects were protected by hepatitis B vaccination. During the last 6 months, 6.3% nurses got accidental needle stick injury three or more times. About 12.5% study subjects washed their hands with soap and water before administering injection. About 60% of the nursing personnel maintained correct procedure during giving injection; while sterile gloves were used only by 3.7% nurses. During disposal of used needles, in 57.5% cases hub cutters were used, while needles were recapped in 42.5% of cases. Used syringes were disposed off correctly in 41.2% of cases. CONCLUSION: There is a need to educate, train and motivate service providers in proper method of handling injection equipments. A local policy and surveillance programme based on the WHO guidelines might be helpful in this situation. [TAF Prev Med Bull 2011; 10(6.000: 681-686

  13. Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas.

    Science.gov (United States)

    Huotari, Tiina; Antikainen, Harri; Keistinen, Timo; Rusanen, Jarmo

    2017-06-01

    The determination of an appropriate catchment area for a hospital providing highly specialized (i.e. tertiary) health care is typically a trade-off between ensuring adequate client volumes and maintaining reasonable accessibility for all potential clients. This may pose considerable challenges, especially in sparsely inhabited regions. In Finland, tertiary health care is concentrated in five university hospitals, which provide services in their dedicated catchment areas. This study utilizes Geographic Information Systems (GIS), together with grid-based population data and travel-time estimates, to assess the spatial accessibility of these hospitals. The current geographical configuration of the hospitals is compared to a normative assignment, with and without capacity constraints. The aim is to define optimal catchment areas for tertiary hospitals so that their spatial accessibility is as equal as possible. The results indicate that relatively modest improvements can be achieved in accessibility by using normative assignment to determine catchment areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Domestic violence against nurses by their marital partners: A facility-based study at a tertiary care hospital

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    Kamlesh Kumari Sharma

    2011-01-01

    Full Text Available Background: In recent times, domestic violence against women by marital partners has emerged as an important public health problem. Objectives: 1. To determine the prevalence, characteristics and impact of domestic violence against nurses by their marital partners, in Delhi, India. 2. To identify nurses′ perceptions regarding acceptable behavior for men and women. Materials and Methods: A facility-based pilot study was conducted at All India Institute of Medical Sciences (AIIMS, New Delhi. Data were collected using self-administered standardized questionnaire, among 60 ever married female nurses working at AIIMS hospital, selected by convenience sampling. The principal outcome variables were controlling behavior, emotional, physical and sexual violence by marital partners. Data were analyzed using SPSS 12 software. The test applied was Fisher′s exact test and 1-sided Fisher′s exact test. Results: Sixty percent of nurses reported marital partner perpetrated controlling behavior, 65% reported emotional violence, 43.3% reported physical violence and 30% reported sexual violence. About 3/5 th of nurses (58% opined that no reason justified violence, except wife infidelity (31.67%. Of the physically or sexually abused respondents, 40% were ever injured, and 56.7% reported that violence affected their physical and mental health. Conclusion: There is a high magnitude of domestic violence against nurses and this is reported to have affected their physical and mental health.

  15. Evaluation of Candida Scoring Systems to Predict Early Candidemia: A Prospective and Observational Study at a Tertiary Care Hospital, Uttarakhand.

    Science.gov (United States)

    Gupta, Priyanka; Gupta, Pratima; Chatterjee, Biswaroop; Mittal, Garima; Prateek, Shashank; Mohanty, Aroop

    2017-12-01

    Candidemia in critically ill patients is usually a severe and life-threatening condition. Furthermore, due to its nonspecific presentation, it is difficult to diagnose leading to delayed treatment, prolonged hospitalization, and increased health-care costs with increase in morbidity and mortality. In view of lack of data on "Candida scoring systems," this study was designed to evaluate the effectiveness of these scoring systems in predicting the development of candidemia among the Intensive Care Unit patients. The "Candida score" was calculated at the onset of systemic inflammatory response syndrome, sepsis, or shock. Various scoring systems were compared using the area under the receiver operating characteristic curve. Among all three bedside risk scoring systems to predict candidemia both Leon score and Wenzel score offered significant discrimination between candidemic and noncandidemic patients with P = 0.000 and 0.001, respectively. The area under the curve for the scoring systems was 0.946 (95% confidence interval [CI] = 0.89-1) and 0.818 (95% CI = 0.687-0.949). Leon scoring system was found to have highest specificity, diagnostic accuracy, and positive likelihood ratio among all. Thus, we might conclude that a Leon score of ≥2.5 was most suitable for diagnosis of candidemia with significant accuracy and shortening of turnaround time when compared to the gold standard of blood culture. To the best of our knowledge, this is the first report on the subject.

  16. STUDY OF HYPOMAGNESAEMIA IN CRITICALLY-ILL PATIENTS IN MEDICAL INTENSIVE CARE UNIT AT TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sumit Kamble

    2017-08-01

    Full Text Available BACKGROUND Magnesium is the second most abundant intracellular cation and the fourth most common cation in the body. The effect of magnesium on important biological processes such as glycolysis, oxidative phosphorylation, nucleotide metabolism, protein biosynthesis signifies the importance of magnesium in cellular metabolism. Magnesium plays a role in numerous enzymatic processes in the body and has direct role in activation of enzymes such as phosphofructokinase, creatine kinase, acetylate cyclase and sodium potassium ATPase. The aim of the study is to- 1. Study serum magnesium level in critically-ill patient. 2. Correlate serum magnesium level with patient outcomes. 3. Identify primary medical conditions and the factors predisposing or contributing to abnormalities of serum magnesium. MATERIALS AND METHODS Study of 100 cases admitted over a period of 2 years, i.e. between 2010 to 2012 in MICU at SSG Hospital, Vadodara. The patient admitted for critical illness in ICU was included in study. The patients who received magnesium before admission to MICU were excluded from study. A blood sample was collected for estimation of serum total magnesium level on admission to MICU. History and clinical finding were noted for each patient, other haematological, biochemical and radiological investigations were performed as indicated in every patient. RESULTS 66% were male and 34% were female patients. Hypomagnesaemia was found in 52%, normal level in 41% and hypomagnesaemia in 7%. Present study shows mortality and sepsis were statistically significant findings in study population, i.e. in patients with hypomagnesaemia (p<0.05. Statistically significant correlation was found with hypocalcaemia and hypoalbuminaemia in study populations (p<0.05. However, hypomagnesaemia doesn’t show significant association with duration of MICU stay, need of ventilator. CONCLUSION Hypomagnesaemia is a one of electrolyte imbalance in the critically-ill patients

  17. [Imported infectious diseases in tertiary hospital].

    Science.gov (United States)

    Rius Gordillo, N; Martín Nalda, A; Otero Romero, S; Soler-Palacín, P; Sulleiro Igual, E; Espiau Guarner, M; Fernández-Polo, A; Figueras Nadal, C

    2014-08-01

    An Imported Diseases Clinic was created in the hospital in 2009. The aim of this study was to asses its contribution in terms of capacity, quality of care and teaching offered. A retrospective study was conducted from 2009 to 2011, analyzing: A) development of knowledge by means of protocols and publications created, and subject taught; B) capacity and quality of care offered by the analysis of patients seen, the adequacy of the protocols and accessibility. The patients were classified into 3 groups. Group 1: immigrant patient screening, group 2: patient consultation after tropical or sub-tropical travel, group 3: screening of vertical transmission of imported disease. Six protocols have been developed and disseminated on the unit website, as well as 5 scientific publications. A total of 316 patients were evaluated: 191 included in group 1 (29 Adopted and 162 Immigrants), 57 in group 2 (94.7% Visiting Friends and Relatives and 81.5% without a pre-travel consultation). They consulted due to, gastrointestinal symptoms (52.6%) and fever (43.8%), with 68 included in group 3 at risk of imported disease by vertical transmission (62 Trypanosoma cruzi, 1 Human T Lymphotropic Virus and 5 Plasmodium spp.). The overall adherence to the protocols was about 77.1%. Infectious Diseases Units must adapt to the reality of the population and be flexible in its structure. Periodic assessment of the quality of care offered is essential, as well as an evaluation on the need for additional studies. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Study of knowledge and attitude regarding prenatal diagnostic techniques act among the pregnant women at a tertiary care teaching hospital in Mumbai.

    Science.gov (United States)

    Shidhaye, Pallavi R; Giri, Purushottam A; Nagaonkar, Shashikant N; Shidhaye, Rahul R

    2012-01-01

    Sex ratio, an important social indicator measuring extent of prevailing equity between males and females in society, is defined as number of females per 1000 males. Changes in sex ratio reflect underlying socioeconomic, cultural patterns of a society. As per 2011 census sex ratio in India is 914/1000 males, which continues to be significantly adverse towards women. This study was conducted to assess the knowledge and attitude regarding Prenatal Diagnostic Techniques (PNDT) Act among the pregnant women at a tertiary care teaching hospital in Mumbai. A cross-sectional study was carried out in the antenatal ward of Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai during the period of January to April 2008. A total of 143 women were included and a pre-designed and pre-tested questionnaire was used to get information regarding socio-demographic details of the pregnant women. They were asked regarding the knowledge and attitude towards the PNDT Act. Data was analyzed by using Statistical Package of Social Sciences (SPSS) 16.0. In the present study, out of 143 women, 105 (73.5%) knew about sex determination. Even out of those who had heard, the correct knowledge regarding PNDT act was very less. Sonography as a technique for sex determination done at private hospital was known to the majority of women. Education of women about gender equality and recommendations under PNDT act in order to improve declining sex ratio in our country must be done. Wide publicization in the media of the Act must be scaled up.

  19. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India

    Directory of Open Access Journals (Sweden)

    Uma Sinha

    2013-01-01

    Full Text Available Context: Polycystic ovarian syndrome (PCOS, the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications. Aims: The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects. Settings and Design: Cross-sectional hospital based survey-single centre observational case-control study. Materials and Methods: This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH, free thyroxine levels (free T3 and free T4, anti-thyroperoxidase antibody (anti-TPO Ab, clinical examination and ultrasound (USG of thyroid gland. Statistical Analysis Used: It was done by Student′s t-test and Chi-square test using appropriate software (SPSS version 19. Results: This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035. PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value < 0.05. There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value < 0.001. On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5% had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis. Conclusions: High

  20. Breast Fine Needle Aspiration Cytology in a Nigerian Tertiary Hospital

    African Journals Online (AJOL)

    Breast Fine Needle Aspiration Cytology in a Nigerian Tertiary Hospital. ... The sociodemographic data; cytology result, final histology result and the clinical staging for breast cancer were analyzed. Results: Eight hundred and ... false negative. Also, multi-disciplinary audits of difficult case should be part of the work routine.

  1. Disease pattern of hospitalized patients in two tertiary healthcare ...

    African Journals Online (AJOL)

    Background: The burden of communicable diseases is high, now the burden of non-communicable disease is also growing hence it important that the distributions of different disease in Tertiary Hospital is known. Unprecedented changes have occurred in the structure of the society that have impacted on health and ...

  2. Metastatic breast cancer in a Nigerian tertiary hospital | Adisa ...

    African Journals Online (AJOL)

    Metastatic breast cancer in a Nigerian tertiary hospital. ... Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome. Objective: To describe the pattern of clinical ... resource limitations. Improved awareness of the disease is advocated to reduce late presentation.

  3. Perception of patients attending a tertiary hospital in Nigeria about ...

    African Journals Online (AJOL)

    2013-01-02

    Jan 2, 2013 ... Background: Criteria for a good dental practice as expressed by patients have influence on their behavior in terms of compliance with clinical advice, less pain and anxiety and more utilization of dental care. Objective: To assess the opinion of patients attending the dental clinic of a tertiary hospital ...

  4. Cost analysis of tuberculosis treatment in two tertiary hospitals in ...

    African Journals Online (AJOL)

    Cost analysis of tuberculosis treatment in two tertiary hospitals in South-East Nigeria. ... Abia State University Medical Students' Association Journal ... How free is it? Several governmental and non-governmental agencies support tuberculosis treatment to make the services accessible and affordable to patients.

  5. Colonoscopy in a Tertiary Hospital in Nigeria | Ismaila | Journal of ...

    African Journals Online (AJOL)

    Methodology: Results of colonoscopies performed by surgeons in the endoscopic unit of the Jos University Teaching Hospital, a tertiary medical centre in Plateau State, Nigeria were retrospectively analysed for a period of 6 months. The diagnostic yield and findings were analyzed. Results: A total of 43 colonoscopies were ...

  6. Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study.

    Science.gov (United States)

    Famoroti, Temitayo O; Fernandes, Lucy; Chima, Sylvester C

    2013-01-01

    The issue of stigma is very important in the battle against HIV/AIDS in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral (ARV) medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS (PLWHA) by health care workers (HCWs) at a tertiary hospital in KwaZulu-Natal (KZN) province, South Africa. The study investigated the impact of knowledge of HIV/AIDS by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA. A descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN. Overall HCWs had an above average knowledge about HIV/AIDS although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/AIDs (p ≤ 0.001); occupation and knowledge of HIV/AIDS (p ≤ 0.001); and gender and knowledge of HIV/AIDS (p = 0.004). Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA (p = 0.003). The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control. Although knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of

  7. Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study

    Science.gov (United States)

    2013-01-01

    Background The issue of stigma is very important in the battle against HIV/AIDS in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral (ARV) medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS (PLWHA) by health care workers (HCWs) at a tertiary hospital in KwaZulu-Natal (KZN) province, South Africa. The study investigated the impact of knowledge of HIV/AIDS by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA. Methods A descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN. Results Overall HCWs had an above average knowledge about HIV/AIDS although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/AIDs (p ≤ 0.001); occupation and knowledge of HIV/AIDS (p ≤ 0.001); and gender and knowledge of HIV/AIDS (p = 0.004). Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA (p = 0.003). The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control. Conclusions Although knowledge, attitude and comfort level of HCWs taking care of

  8. Impact of infection control activities on the rate of needle stick injuries at a tertiary care hospital of Pakistan over a period of six years: an observational study

    Directory of Open Access Journals (Sweden)

    Khowaja Khurshid

    2009-05-01

    Full Text Available Abstract Background Accidental exposure to blood and body fluids is frequent among health care workers. They are at high risk of nosocomial transmission of blood borne pathogens due to injuries caused by used sharps. We are reporting impact of surveillance and educational program on the rate of needle stick injuries among health care workers at a tertiary care hospital in Pakistan. Methods At Aga Khan University Hospital sharp injuries are reported to infection control office. To reduce these incidents a quality improvement project was inducted in the year 2005. Health care workers were educated; surveillance data from 2002 to 2007 was analyzed and compared with various risk factors. Results During study period 1382 incidents were reported. Junior doctors sustained highest number of injuries (n = 394; 28.5% followed by registered nurses (n = 283; 20.4%. Highest number of incidents was reported during blood collection (19%. An increasing trend was observed in the pre intervention years (2002–04. However noticeable fall was noted in the post intervention period that is in year 2006 and 2007. Major decline was noted among nurses (from 13 to 5 NSI/100 FTE/year. By relating and comparing the rates with various activities directly linked with the use of syringes a significant reduction in incidents were found including; hospital admissions (p-value 0.01, surgeries and procedures performed (p = 0.01, specimens collected in the laboratory (p = 0.001 and patients visits in clinics (p = 0.01. Conclusion We report significant reduction in needle stick injuries especially during post intervention study period. This is being achieved by constant emphasis on improving awareness by regular educational sessions, implemented as a quality improvement project.

  9. Drug Utilization Study on Acute Poisoning Cases Treated at a Tertiary Care Hospital in Western Part of India

    Directory of Open Access Journals (Sweden)

    Pratik D. Asari

    2016-03-01

    Conclusion: Use of antimicrobial medicines for poisoned patients was too high and irrational.  Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. Educational programs with emphasis on preventive measures for toxic exposures are necessary to create awareness among the general public.

  10. A study of the histopathologic pattern of orbito-ocular disease in a tertiary Hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Nwafor Chukwuemeka Charles

    2014-01-01

    Full Text Available Background: Estimates by WHO show show thatthere are about 37 million blind people and 161 million people with visual impairment. About 90% of these people live in developing countries. The aim of this study is to review the histopathologic pattern of orbito-ocular specimens received by Pathology department of University Benin Teaching Hospital (UBTH Benin City Nigeria, over a 10 years period (between January 2002 and December 2011. Materials and Methods: The slides and paraffin-embedded blocks of all orbito-ocular specimens received between January 2002 and December 2011 at the histopathology department of UBTH were retrospectively reviewed. were retrospectively reviewed. The clinical data such as the age, sex, site of lesion and clinical summary were extracted from the histology request forms. Results: Children (less than 15 years of age accounted for 28.6% (n = 30 of all the specimens seen, while adults accounted for 71.4% (n = 75. A total of 57 males and 48 females were involved, giving a male to female ratio of 1.2:1. The mean age was 31.3 years (range: 1 month-84 years, (range: 1 month-84 years. The common sites of pathologies were the conjunctiva (45.7%, n = 48, intraocular (29.5%, n = 31, eyelid (21.9%, n = 23 and orbit (2.9%, n = 3. Most of the eyelid lesions (45.5% and conjunctival lesions (43.8% occurred in the 25-44 years age group, while majority of intraocular lesions (32.3% occurred in the 1-4 years age group.. Malignant specimens were seen in 31.4% (n = 33 of cases, benign specimens 29.5% (n = 31, inflammatory specimens 21.9% (n = 23, degenerative specimens 10.5% (n = 11 and trauma-related specimens 6.7% (n = 7. Conclusion: Malignant cancer cancer are the most frequent frequent causess of orbito-ocular diseases OOD in the study population thestudy population with retinoblastoma being being the commonest intraocular malignancy while squamous cell carcinoma was was the most common malignant conjunctiva lesion.

  11. Presentation, aetiology and treatment of adult intussusception in a tertiary Sub-Saharan hospital: a 10-year retrospective study.

    Science.gov (United States)

    Ongom, Peter A; Opio, Christopher K; Kijjambu, Stephen C

    2014-05-05

    Adult intussusception is a rare clinical condition worldwide. It contributes to less than 5% of all cases of intussusception. Few studies have been conducted in low-income countries compared to high-income countries; particularly Sub-Saharan Africa. Based on anecdotal evidence, the authors hypothesized that the condition is not as rare in a Sub-Saharan setting in comparison with western countries. We set out to conduct the first review study of adult intussusception in Uganda. The medical records of 37 (out of a total of 62 cases) adolescent and adult patients with a postoperative diagnosis of intussusception at Mulago National Referral and Teaching Hospital, from January 2003 to December 2012, were analyzed. The clinical features, diagnosis, treatment and pathologic features of lesions for these patients were reviewed. Intraoperative findings were described with reference to: the site of the intussusception, and the triggering lesion (either idiopathic or with a lead point). The mean age was 33.6 years, with a range of 13 - 72 years. The male to female ratio was 1.85:1. The mean number of days for which symptoms had been present prior to presentation was 6.3 days, while the median was 4 days. All 37 patients presented with abdominal pain. Only 13 (35.1%) had the classical paediatric triad of abdominal pain, a palpable abdominal mass and bloody stool. Most of the remaining patients presented sub-acutely with non-specific symptoms. A lead point was present in 28 patients (75.7%). Of these, 24 (64.9%) cases involved tumours. Among the tumours, 54.2% were malignant. Treatment did not involve intussusception reduction in 14 patients (37.8%). Some form of operative surgery was conducted in 31 (83.8%) patients; mainly segmental bowel resections and hemi-colectomies. Adult intussusception is uncommon in the Uganda, though probably less so than in western countries. It presents sub-acutely or chronically and is often diagnosed at laparotomy. Lead points are the

  12. A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    Wang BZ

    2013-03-01

    Full Text Available Bob Z Wang, Elsie Chan, Rasik B Vajpayee The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia Background: The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR insertion during cataract surgery. Methods: A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained. Results: Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0% did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%. An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%. Postoperatively, the most common complications were a decentered intraocular lens (8.3% and persistent corneal edema (6.0%. Overall, 61 eyes (72.6% had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8% achieving vision of 20/40 or better. Conclusion: For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability. Keywords: capsular tension ring, cataract extraction, indications, outcomes

  13. Knowledge, Attitude and Practices of Diabetic Patients - A Cross Sectional Study in a Tertiary Care Hospital in Mysore.

    Science.gov (United States)

    Babu, M Suresh; Gowdappa, H Basavana; Kalpana, T; Vidyalaxmi, K; Nikhil, B; Chakravarthy, T

    2015-08-01

    The prevalence rates of diabetes are rising rapidly both in urban and rural India with the present prevalence in urban India being 12-19% and in rural India 4 - 10% in different published Indian studies.1 All involved in diabetes care agree that patients play a major role in the successful management of diabetes. There is an increasing amount of evidence that patient education is the most effective way to lessen the diabetic complications and its management.2 Education is likely to be effective if we know the characteristics of the patients in terms of knowledge, attitude and practices about diabetes. This study was conducted in Mysore to know the knowledge, attitude and practices of diabetic patients attending JSS Hospital. A total of 900 patients were included in the study. Five hundred sixteen (57.3%) patients were males, while 384 (42.7%) patients were females. Four hundred twenty-three (47%) patients were from urban area, while 477 (53%) were from rural area. Five hundred sixty-five (62.5%) diabetic patients were unaware of the diagnostic criteria for diabetes mellitus, 661 (73.4%) patients about cause of diabetes, 264 (29.3%) patients about common symptoms of diabetes, 256 (28.4%) patients about symptoms of hypoglycemia. Diabetes is a chronic disease which can affect many systems in the body like the heart, eyes, kidneys and nerves contributing to increased morbidity and mortality. 29%, 30.7%, 31.2% and 35.7% of diabetic patients were not aware of the diabetic complications to heart, eyes, kidneys and nerves respectively. Even patients with diabetes for more than 10 years, 18.8% were not aware of the heart complications while 21.5% were not aware of the diabetes complications to eyes, kidneys and nerves. 834 (92.6%) diabetic patients were not aware of HbA1C. 790 (87.7%) diabetic patients did not know that fruits can be eaten by diabetics. Eight hundred seventeen (90.8%) diabetic patients had not attended a formal diabetic education class. This possibly is a

  14. Survey of visual impairment in an Indian tertiary eye hospital

    Directory of Open Access Journals (Sweden)

    Herse Peter

    1997-01-01

    Full Text Available A retrospective survey of 4, 122 consecutive patient records was performed in a tertiary care eye hospital in Hyderabad, India. Data collected included age, gender, visual acuity after completion of treatment and diagnosis. 62.8% of the patients were male. After completion of treatment, 10.8% had low vision (best corrected visual acuity <6/18 to 3/60 in the better eye and 2.6% were blind (best correct visual acuity <3/60 in the better eye. Most cases of low vision were found in the 50 to 70 year age group (42.9%. The most common visual acuity range after treatment amongst patients with vision loss was <6/18 to 6/60 (71%. The 4 main causes of low vision were cataract (21.4% of low vision group, glaucoma (14.0%, diabetic retinopathy (13.0%, and retinitis pigmentosa (10.7%. The 4 main causes of blindness were glaucoma (16.3% of blind group, diabetic retinopathy (13.2%, corneal opacities (11.6% and retinitis pigmentosa (11.6%. It is suggested that patients with low vision at the conclusion of treatment be referred to a vision rehabilitation centre. Referral should be made in cases with a best corrected visual acuity <6/18 to 3/60 or with visual field loss to within 15° of fixation. Patients aged under 50 years of age are expected to achieve maximal rehabilitation success. Motivation and vocational requirements should be assessed in older or more complex cases before referral. The data of this study show that about 10% of patients seen at a tertiary care eye hospital in India could benefit from low vision rehabilitation.

  15. Incidence of Hospital Acquired Thrombosis (HAT) in a Tertiary Care Hospital.

    LENUS (Irish Health Repository)

    Khan, MI

    2017-04-01

    Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. In spite of guidelines, VTE prophylaxis continues to be underutilised, and hospital acquired thrombosis (HAT) continues to be a problem. This study was conducted to estimate the incidence of HAT in a tertiary referral centre and to examine whether VTE risk assessment and thromboprophylaxis (TP) were implemented. Patients 18 years and above, with a radiologically-confirmed acute VTE during the study period of 15 weeks were included. Acute VTE was diagnosed in 100 patients and HAT was diagnosed in 48. There were 12,024 admissions over the study period, therefore the incidence of HAT was 0.4%. TP was prescribed in only 35% of patients, and 65% did not receive any or appropriate TP. Hospitals without active implementation of a formal risk assessment tool and TP policy are likely to continue to have increased incidence of HAT.

  16. Adverse cutaneous drug reactions--a clinico-demographic study in a tertiary care teaching hospital of the Kashmir Valley, India.

    Science.gov (United States)

    Qayoom, Seema; Bisati, Shazia; Manzoor, Sheikh; Sameem, Farah; Khan, Kafeel

    2015-04-01

    Adverse cutaneous drug reactions (ACDRs) are caused by a wide variety of agents. The aim was to study the incidence and clinico-demographic profile of ACDRs to identify any potential risk factors and compare the results with other studies. A cross-sectional observational study was conducted over a period of one year from October 2012 to October 2013 in the outpatient department (OPD) of a tertiary care teaching hospital of the Kashmir valley in India and various ACDRs were recorded. The incidence of ACDRs was 0.16%. The mean age of patients was 39.36 ± 16.77 years. The male: female ratio was 0.97:1. The most frequently reported cutaneous reactions were with antimicrobials (57.33%) followed by NSAIDs (21.33%) and antiepileptic drugs (17.33%). Less common groups involved were steroids, antipsychotics and bisphosphonates (1.33% each). Fixed drug eruptions (FDEs) were the commonest (45.33%) followed by maculopapular (17.33%), photoallergic (8%), erythema multiforme (6.66%), Stevens-Johnson syndrome (5.33%) and lichenoid eruptions (4%). Less common patterns were urticaria, Drug Reaction with Eosinophilia and systemic symptoms (DRESS syndrome) and acneform eruptions (2.66% each) followed by angioedema, acute generalized exanthematous pustulosis (AGEP), exfoliative dermatitis and toxic epidermal necrolysis (1.33% each). Physicians should have adequate knowledge of adverse drug reactions, especially of newer drugs which are increasing every year in order to minimize such events.

  17. [Hospital admissions due to varicella in a tertiary hospital].

    Science.gov (United States)

    Guzmán Laura, K P; Periañez Vasco, A; Falcón Neyra, M D; Croche Santander, B

    2014-06-01

    Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Patterns of antimicrobial prescribing in a tertiary care hospital in Oman

    National Research Council Canada - National Science Library

    Al-Yamani, Abdulrahman; Khamis, Faryal; Al-Zakwani, Ibrahim; Al-Noomani, Hamed; Al-Noomani, Jaleela; Al-Abri, Seif

    2016-01-01

    ... in a tertiary care hospital in Oman. Methods: We conducted a retrospective audit of the appropriateness of antimicrobial prescribing in patients admitted to acute care settings in a tertiary care hospital in Oman over a fourweek period...

  19. Social, demographic and healthcare factors associated with stage at diagnosis of cervical cancer: cross-sectional study in a tertiary hospital in Northern Uganda.

    Science.gov (United States)

    Mwaka, Amos Deogratius; Garimoi, Christopher Orach; Were, Edward Maloba; Roland, Martin; Wabinga, Henry; Lyratzopoulos, Georgios

    2016-01-21

    To examine patient and primary healthcare factors and stage at diagnosis in women with cervical cancer in Northern Uganda with the intention to identify factors that are associated with advanced stages in order to inform policies to improve survival from cervical cancer in low income and middle income countries. Cross-sectional hospital-based study. Tertiary, not-for-profit private hospital in postconflict region. Consecutive tissue-diagnosed symptomatic patients with cervical attending care. Of 166 patients, 149 were enrolled and analysed. Cervical cancer stage at diagnosis. Most women were diagnosed at stages III (45%) or IV (21%). After controlling for age, marital status, educational attainment and number of biological children, there was evidence for association between advanced stage at diagnosis and pre-referral diagnosis of cancer by primary healthcare professionals (adjusted OR (AOR)=13.04:95% CI 3.59 to 47.3), and financial difficulties precluding prompt help seeking (AOR=5.5:95% CI 1.58 to 20.64). After adjusting for age, marital status and educational attainment, women with 5-9 biological children (AOR=0.27:95% CI 0.08 to 0.96) were less likely to be diagnosed with advanced stage (defined as stages III/IV) cancer. In this pilot study, there was no statistical evidence for associations between stage at diagnosis, and factors such as age at diagnosis and marital status. This study is a first attempt to understand the descriptive epidemiology of cervical cancer in rural Ugandan settings. Understanding individual patient factors, patients' behavioural characteristics and healthcare factors associated with advanced stage at diagnosis is essential for targeted effective public health interventions to promote prompt health seeking, diagnosis at early stage and improved survival from cervical cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. A molecular epidemiological study of human parainfluenza virus type 3 at a tertiary university hospital during 2013-2015 in Catalonia, Spain.

    Science.gov (United States)

    Godoy, Cristina; Peremiquel-Trillas, Paula; Andrés, Cristina; Gimferrer, Laura; Uriona, Sonia María; Codina, María Gema; Armadans, Lluis; Martín, María Del Carmen; Fuentes, Francisco; Esperalba, Juliana; Campins, Magda; Pumarola, Tomàs; Antón, Andrés

    2016-10-01

    Human parainfluenza virus type 3 (HPIV-3) is one of the most common respiratory viruses particularly among young children and immunocompromised patients. The seasonality, prevalence and genetic diversity of HPIV-3 at a Spanish tertiary-hospital from 2013 to 2015 are reported. HPIV-3 infection was laboratory-confirmed in 102 patients (76%, under 5 years of age). Among <5 years-old patients, 9 (11.5%) were under any degree of immunosuppression, whereas this percentage was significantly higher (19; 79.2%) among patients older than 5 years. HPIV-3 was detected at varying levels, but mainly during spring and summer. All characterized HN/F sequences fell within C1b, C5 and in other two closely C3a-related groups. Furthermore, a new genetic lineage (C1c) was described. Genetic similarity and epidemiological data confirmed some nosocomial infections, highlighting the importance of the HPIV-3 surveillance, particularly in high-risk patients. This study provides valuable information on HPIV-3 diversity due to the scarce information in Europe. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Congenital malformations among newborns admitted in the neonatal unit of a tertiary hospital in Enugu, South-East Nigeria - a retrospective study

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    Obu Herbert A

    2012-07-01

    Full Text Available Abstract Background Congenital abnormalities are not uncommon among newborns and contribute to neonatal and infant morbidity and mortality. The prevalence and pattern of presentation vary from place to place. Many a time the exact etiology is unknown but genetic and environmental factors tend to be implicated. Methods The objective of this study was to determine the prevalence of congenital malformations among newborns admitted in a tertiary hospital in Enugu, the nature of these abnormalities and the outcome/prognosis. For purposes of this study, congenital abnormalities are defined as obvious abnormality of structure or form which is present at birth or noticed within a few days after birth. A cross-sectional retrospective study in which a review of the records of all babies admitted in the Newborn Special Care Unit (NBSCU of the University of Nigeria Teaching Hospital (UNTH, Ituku/Ozalla, Enugu over a four year period (January 2007-April 2011 was undertaken. All babies admitted in the unit with the diagnosis of congenital abnormality were included in the study. Information extracted from the records included characteristics of the baby, maternal characteristics, nature/type of abnormalities and outcome. Data obtained was analyzed using SPSS 13. Rates and proportions were calculated with 95% confidence interval. The proportions were compared using students T-test. Level of significance was set at P  Results Seventeen (17 out of a total of six hundred and seven newborn babies admitted in the newborn unit of UNTH over the study period (Jan 2007-March 2011 were found to have congenital abnormalities of various types, giving a prevalence of 2.8%. Common abnormalities seen in these babies were mainly surgical birth defects and included cleft lip/cleft palate, neural tube defects (occurring either singly or in combination with other abnormalities, limb abnormalities (often in combination with neural tube defects of various types, omphalocoele

  2. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  3. CLINICAL PROFILE OF ANAEMIA IN A TERTIARY CARE HOSPITAL

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    Ather Akhtar

    2016-04-01

    22 and the morphology was normocytic normochromic in 20 cases. Tuberculosis leading to anaemia was seen in 24, Internal haemorrhoids/Fissures 5, Taenia infestation in 3, Haematological Malignancies 2, GI Malignancies 3, Connective tissues disorders 3, Nutritional iron deficiency 8 and Anaemia of chronic diseases in remaining cases. Among the 22 cases having macrocytic anaemia, 11 had vitamin B 12 deficiency, 6 had subclinical hypothyroidism, 5 had alcoholism. Among the 20 patients having normocytic normochromic blood picture, 4 had haemolytic anaemia, 1 had aplastic anaemia and remaining were having anaemia of chronic disease mainly chronic kidney disease. Regarding treatment, 23 patients were transfused blood. Out of total 100 patients included in the study, in-hospital mortality was 10. CONCLUSIONS Anaemia is associated with a variety of diseases. As Tuberculosis and B 12 Deficiency are among the leading causes of anaemia, hypochromic and microcytic picture was the predominant picture in peripheral blood smear. Among the patients having normocytic normochromic blood picture, majority were having chronic kidney disease which may be due to the fact that our hospital is a tertiary referral centre for chronic renal failure. In-hospital mortality due to anaemia alone is lower in tertiary care centres, but the mortality in our study is due to associated comorbid conditions like chronic renal failure and malignancy.

  4. Survival following orbital exenteration at a tertiary brazilian hospital

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    Juliana Mika Kato

    Full Text Available Objective: to analyze the epidemiology, clinical features and survival rate of patients undergoing orbital exenteration (OE in a tertiary referral hospital. Methods : we conducted a retrospective study of all patients undergoing OE at the Hospital das Clínicas, FMUSP between January 2007 and December 2012. We collected data records related to gender, age, origin, length of stay, duration of the disease, other treatments related to the disease, number of procedures outside of the face related to the disease, follow-up and histological diagnosis. Results : we treated 37 patients in the study period. The average survival in one year was 70%, in two years, 66.1%, and 58.3% in three years. There was no significant difference in the one-year survival related to histological diagnosis (p=0.15, days of hospitalization (p=0.17, gender (p=0.43, origin (p=0.78, disease duration (p=0.27 or the number of operations for the tumor (p=0.31. Mortality was higher in elderly patients (p=0.02. The average years of life lost was 33.9 in patients under 60 years, 14.7 in patients in the 61-80 years range and 11.3 in patients over 80 years. Conclusion : the present series of cases is significant in terms of prevalence of orbital exenteration; on the other hand, it shows one of the lowest survival rates in the literature. This suggests an urgent need for improved health care conditions to prevent deforming, radical resections.

  5. A study to assess completeness of project application forms submitted to Institutional Ethics Committees (IEC of a tertiary care hospital

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    Yashashri C Shetty

    2012-01-01

    Full Text Available Objectives: To review Ethics Committee (EC application forms and to find out similarities and differences in content of five ECs forms in India. Materials and Methods: The completeness of EC application forms was assessed on the following themes: title, study team, sponsor responsibility, scientific aspects, patient safety, regulatory permissions, Informed consent process from 2008-2009. Application forms (available online of 5 ECs were studied and compared. Results: A total of 445 application forms were analyzed, 382 were academic, 63 were sponsored. The common deficiencies in academic studies were inappropriate titles (25.13%, lack of budget details (90%. More than 95% studies had not mentioned the method of recruitment. The issue of vulnerability was not marked in more than 50% of studies. Compensation for participation/injury was poorly stated in academic (99% studies. Among industry sponsored studies, 98% were compliant with regulatory permissions and 41% were CTRI registered. The information pertaining to Informed Consent was mentioned in all forms. Comparative analysis of application forms of 5 ECs showed that the requirements for submission were similar except 1-2 ECs asked for additional information like percentage of time allotted by investigator for studies, GCP training of study team, certification by investigator regarding accuracy of local versions of Informed consent. Conclusion: Our study recommends that increased awareness and vigilance by investigators of academic studies regarding submission of applications to EC will increase efficiency and speed of review process. A common application form for all ECs across India would be an important step to achieve uniformity in functioning of ethics committees.

  6. Attitudes toward euthanasia among doctors in a tertiary care hospital in South India: A cross sectional study

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    Sneha Kamath

    2011-01-01

    Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  7. Probiotics in the Prevention of Antibiotic Associated Diarrhoea in a Tertiary Teaching Hospital in Pokhara: A Prospective Study

    OpenAIRE

    Sahisnuta Basnet; Eva Gauchan; Sudhir Adhikari; Brijesh Sathian

    2017-01-01

    Introduction: Diarrhoea is an undesirable side effect when treating common infections in children with antibiotics. Though studies have shown the effectiveness of probiotics in preventing antibiotic associated diarrhoea, and there is no documented research in Nepal regarding this issue. Aim: The objective of this study was to observe the efficacy of probiotics for the prevention of antibiotic associated diarrhoea when co-administered with an oral antibiotic in children with respiratory tra...

  8. Safety profile of fast-track extubation in pediatric congenital heart disease surgery patients in a tertiary care hospital of a developing country: An observational prospective study.

    Science.gov (United States)

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Minai, Fauzia; Wali, Amina Rehmat; Anwar-Ul-Haq; Aman-Ullah, Muneer; Ahsan, Khalid

    2014-07-01

    Early extubation after cardiac operations is an important aspect of fast-track cardiac anesthesia. In order to reduce or eliminate the adverse effects of prolonged ventilation in pediatric congenital heart disease (CHD) surgical patients, the concept of early extubation has been analyzed at our tertiary care hospital. The current study was carried out to record the data to validate the importance and safety of fast-track extubation (FTE) with evidence. A total of 71 patients, including male and female aged 6 months to 18 years belonging to risk adjustment for congenital heart surgery-1 category 1, 2, and 3 were included in this study. All patients were anesthetized with a standardized technique and surgery performed by the same surgeon. At the end of operation, the included patients were assessed for FTE and standard extubation criteria were used for decision making. Of the total 71 patients included in the study, 26 patients (36.62%) were extubated in the operating room, 29 (40.85%) were extubated within 6 h of arrival in cardiovascular intensive care unit and 16 (22.54%) were unable to get extubated within 6 h due to multiple reasons. Hence, overall success rate was 77.47%. The reasons for delayed extubation were significant bleeding in 5 (31.3%) cases, hemodynamic instability (low cardiac output syndrome) in 4 (25%) cases, respiratory complication in 2 (12.5%), bleeding plus hemodynamic instability in 2 (12.5) cases, hemodynamic instability, and respiratory complication in 2 (12.5%) cases and triad of hemodynamic instability, bleeding and respiratory complication in 1 (6.5%) case. There was no reintubation in the FTE cases. On the basis of the current study results, it is recommended to use FTE in pediatric CHD surgical patients safely with multidisciplinary approach.

  9. A STUDY TO FIND OUT THE BACTERIOLOGY OF TONSILLAR SURFACE AND CORE, AMONG PATIENTS UNDERGOING TONSILLECTOMY AT A TERTIARY CARE HOSPITAL IN SOUTH INDIA

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    Binu

    2016-05-01

    Full Text Available BACKGROUND The study was aimed at finding out the bacteriology of the tonsillar surface and core, in those patients undergoing tonsillectomy at a tertiary care hospital. The study was also planned to look for the antibiotic resistance pattern among organisms identified and to see whether a tonsillar surface swab can be used as a surrogate for finding out the aetiopathogenesis of tonsillar infections. METHODS This is a 2-year cross-sectional study of 100 patients undergoing who consented for the study, after taking a smear from the surface of the tonsil. Tonsillectomy was done by dissection and snare method. The core of the tonsil is then biopsied and microbiological culture and sensitivity is done. The bacteria were identified by morphology and staining characteristics and cultured using standard laboratory procedures. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. The data was digitalised using a data entry platform using Epidata and analysed using SPSS 16. Relativity between organism identified as the surface and core was tested using Chi-square tests and Kappa statistics. RESULTS There were significant differences between the organisms identified from the tonsillar surface and the core; out of the 200 specimens, only 48 showed a similar bacteriology. The viability between the surface and the core specimens were measured using Kappa statistics and was found to be 0.04, which shows a very poor agreement between them. Assessment of antibiotic sensitivity shows that Staph aureus was resistant to most of the commonly used antibiotics. H. influenza isolated showed 70% susceptibility to erythromycin and cotrimoxazole. While group A β haemolytic streptococci showed 95% susceptibility to ampicillin and 100% to erythromycin. CONCLUSION Staph. aureus, H. influenza, Streptococci pneumonia were the major pathogenesis identified from the tonsil of the patients undergoing tonsillectomy, and bacteriology was different between

  10. A time motion study in the immunization clinic of a tertiary care hospital of Kolkata, West Bengal

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    Amitabha Chattopadhyay

    2012-01-01

    Full Text Available Background: A time and motion study is used to determine the amount of time required for a specific activity, work function, or mechanical process. Few such studies have been reported in the outpatient department of institutions, and such studies based exclusively on immunization clinic of an institute is a rarity. Materials and Methods: This was an observational cross sectional study done in the immunization clinic of R.G. Kar Medical College, Kolkata, over a period of 1 month (September 2010. The study population included mother/caregivers attending the immunization clinics with their children. The total sample was 482. Pre-synchronized stopwatches were used to record service delivery time at the different activity points. Results: Median time was the same for both initial registration table and nutrition and health education table (120 seconds, but the vaccination and post vaccination advice table took the highest percentage of overall time (46.3%. Maximum time spent on the vaccination and post vaccination advice table was on Monday (538.1 s and nutritional assessment and health assessment table took maximum time on Friday (217.1 s. Time taken in the first half of immunization session was more in most of the tables. Conclusion: The goal for achieving universal immunization against vaccine-preventable diseases requires multifaceted collated response from many stakeholders. Efficient functioning of immunization clinics is therefore required to achieve the prescribed goals. This study aims to initiate an effort to study the utilization of time at a certain health care unit with the invitation of much more in depth analysis in future.

  11. STUDY OF LIPOPROTEIN (A LEVELS AS A RISK FACTOR IN PATIENTS WITH ESSENTIAL HYPERTENSION IN A TERTIARY CARE HOSPITAL

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    Arun S. Menon

    2016-06-01

    Full Text Available BACKGROUND Lipoprotein (a has been identified as an important, independent, causal risk factor for various cardiovascular diseases, but its association with hypertension has shown differing results. The studies regarding this association are limited. AIMS AND OBJECTIVES In the present study, the levels of Lp (a and other lipid parameters like Serum Total Cholesterol, Serum LDL Cholesterol, Serum HDL Cholesterol, serum triglycerides have been studied in hypertensive and non-hypertensive patients to investigate any significant relationship between the same. MATERIALS AND METHODS 30 essential hypertensive patients were selected and were compared with 30 controls matched in terms of age and sex. Lipid profile including Total cholesterol, LDL- Cholesterol, HDL- Cholesterol, Triglycerides and Lp (a were studied in both groups. RESULTS Hypertensive patients were observed to have higher levels of Serum Total Cholesterol, Serum Triglycerides, Serum LDL cholesterol, but it was not found to be significant. But lipoprotein (a was found to be significantly higher (p<0.01 in cases than in controls.

  12. A Study of Compliance to Antiretroviral Therapy among HIV Infected Patients at a Tertiary Care Hospital in North Karnataka.

    Science.gov (United States)

    Hasabi, Ishwar Siddappa; Shivashankarappa, Arun Beekanahalli; Kachapur, Chandrashekar; Kaulgud, Ram Suresh

    2016-05-01

    Compliance to Antiretroviral Therapy (ART) is a primary determinant of treatment success of HIV-AIDS. Many studies have shown inadequate compliance to ART in the Indian population. To assess the compliance to ART among HIV infected patients, to explore the factors affecting compliance and impact of compliance on CD4 count. A cross-sectional study was conducted with 200 adult patients attending ART center, KIMS, Hubli. The patients were randomly selected and compliance to ART over preceding 3 months was assessed. Reasons for non- compliance were assessed among those with inadequate compliance. Mean age of the study population was 40.07±9.99 years. The sex ratio was 1.02:1 (M:F). Majority of patients were in WHO stage 1 with treatment, with CD4 count above 500/μl. Pulmonary tuberculosis was the most common opportunistic infection. Most of the patients were on long term ART, more than 5 years {81 (40.5%)}. Most of the patients were on ZLN regimen {97 (48.5%)}. Compliance over the preceding 3 months was 94.84± 14.93% for ART and 88.97±23.75% for opportunistic infection prophylaxis. There was no significant difference in compliance in relation to age group, sex, educational status, residence, religion, habits, HIV status of spouse or child, the regimen of ART and frequency of dosing. The compliance was better among those on long term treatment, i.e., those on treatment for more than 5 years compared to those who started ART in last 1 year (p=0.06). The most common reasons given by patients for non-compliance were going away from home, busy with other work and simply forgot. Better compliance was associated with higher CD4 count. Compliance to ART was inadequate in the studied population, which is a major obstacle to success of ART.

  13. STUDY OF BACTERIAL FLORA OF HANDS OF HEALTH CARE GIVERS IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

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    Asim; Sayan, DE; Mohammed Aftab Alam; Nitesh Kumar; Hema4; Rohit; Shristi; Ripusudan; Shaan

    2015-01-01

    Bacterial contamination of palm of hand of health care givers like doctors and nurses can be an important source of nosocomial infections. Proper hand hygiene is hence key to prevent spread of such cross - infection. We studied the bacterial flora of palm of hand of 101 clinical staff ( D octors of clinical specialties and nurses) and compared it with bacterial flora of 99 non - clinical staff (Doctors of non - clinical specialties and lab technicians...

  14. Use of Antihypertensives in Patients Having Associated Renal Parenchymal Disorders: Cross Sectional Prescription Pattern Study in a Tertiary Care Hospital

    OpenAIRE

    Supratim Datta

    2011-01-01

    Hypertension is both a cause and a consequence of renal parenchymal disease. Once detected, formulation of an appropriate therapeutic strategy is imperative to not only control hypertension, but also to retard the progression of the renal pathology. Judicious and optimal use of the available antihypertensive agents is of utmost importance. This study aims at analyzing the influence of current guidelines on prescribing in this particular subset of patients. Case history of patients having hype...

  15. A prospective study on adverse drug reactions in outpatients and inpatients of medicine department in a tertiary care hospital

    OpenAIRE

    Harsha Ramakrishnaiah; Vasundara Krishnaiah; H. P. Pundarikaksha; Vedavathi Ramakrishna

    2015-01-01

    Background: No pharmacotherapeutic agent is completely free from noxious and unintended effects and thus adverse drug reactions (ADRs) are inevitable consequences of drug therapy. Incidence of ADRs in Indian population ranges between 1.8% and 25.1%. However, ADR reporting in India is inadequate. Developing awareness inpatients and healthcare professionals (HCPs) will help in reducing the ADRs, its suffering and socioeconomic impact. Hence, the present study of ADR monitoring in the outpatient...

  16. A Study of Depression in Adult Patients with Bronchial Asthma Presenting to a Tertiary Care Hospital in Eastern India.

    Science.gov (United States)

    Misra, Swapnendu; Kundu, Susmita; Majumder, Debabrata; Kundu, Somenath; Ghoshal, Aloke Gopal; Mitra, Ritabrata

    2015-01-01

    Bronchial asthma is a serious global health problem. Depression, the most common mood disorder, is often found to be higher among people with chronic health conditions like bronchial asthma. Patients with newly diagnosed to have bronchial asthma (n = 100) who fulfilled the study criteria were evaluated for depression with Beck Depression Inventory (BDI) score. Severity and level of bronchial asthma control were determined as per Global Initiative for Asthma (GINA) guidelines. Subjective asthma severity was assessed by Perceived Control of Asthma Questionnaire. Follow-up evaluation was done after three months of asthma management with the same study tools. In our study population, 65% asthma patients showed depression on first visit (95% Confidence interval [CI] 55.65-74.35). Correlation coefficient between subjective asthma severity and severity of depression was -0.945 (p asthma severity and depression severity was 0.066 (p = 0.515). In follow-up visit after asthma management 63% patients still had depression (95% CI 53.54-72.46). Correlation coefficient between objective asthma control and depression severity was 0.1 (p = 0.320). Correlation coefficient between subjective asthma severity and severity of depression was -0.979 (p asthma patients. There is a high inverse correlation between depression and patient's perception of asthma control. However, no significant correlation could be observed between objective measures of asthma severity and depression.

  17. Iron profile in children with behavioural disorders: a prospective study in a tertiary care hospital in north India.

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    Mahajan, Garima; Sikka, Meera; Rusia, Usha; Bhatia, M S

    2011-06-01

    Iron deficiency anemia is the most frequent micronutrient deficiency in the developing countries like India especially affecting pregnant women and young children. Iron is an essential element involved in myelin formation, neurotransmitter synthesis and neuro-metabolism. Several behavioural disturbances have been reported in iron deficient children. In the present study, we determined the prevalence of iron deficiency anemia in children with behavioural disorders and assessed the improvement in terms of symptoms (by child behaviour check list), haematological parameters and iron status after treatment with oral iron. In this prospective study, 44 children in the age group of 3-12 years who were diagnosed with behavioural disorders were evaluated. Complete blood counts using automated hematology analyzer and iron parameters (serum iron, total iron binding capacity, % transferrin saturation and serum ferritin) were measured in all the patients to assess the prevalence of iron deficiency in these children. Thirty age matched controls were also studied. Iron deficiency was found in 32 (73%) children, as assessed by transferrin saturation <16% and/or serum ferritin <16 μg/l. Following treatment with iron for 100 ± 10 days, there was a statistically (P ≤ 0.05) significant improvement in the clinical features, haematological profile and iron status. The presence of iron deficiency in children with behavioural disorders and subsequent improvement in clinical features, haematological profile and iron status suggests a possible causal relationship between iron deficiency and behavioural disorders.

  18. STUDY OF THE ISOLATES OF SUSPECTED VAP, PREVALENCE OF THE DIFFERENT ORGANISMS AND MIC PATTERNS IN A TERTIARY CARE HOSPITAL

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    Swagnik Roy

    2017-01-01

    Full Text Available BACKGROUND The development of nosocomial infections mostly ventilator-associated pneumonia due to prolonged stay in the ICUs varies grossly in different outcomes including increased morbidity and mortality. The American Thoracic Society (ATS guidelines recommend that quantitative cultures can be performed on ETA or samples collected either bronchoscopically or nonbronchosopically. 1 More importantly, recent small trials have repeatedly shown that there is no advantage of bronchoscopic cultures over quantitative endotracheal aspirate. 2,3,4 Detection of causative organisms and their antibiotic MIC determination is absolutely necessary to initiate the specific antibiotic with appropriate dose thereby reducing the adverse effects of inadequate antibiotic treatment on the patient prognosis. MATERIALS AND METHODS The prospective study was carried out during the period from August 2012 to January 2015 in Department of Microbiology from the samples those were received as a routine culture from VAP suspected patients from the ICU. There were 373 samples from which 123 were culture positives. Inclusion criteria were all the patients 18 years and more age group who were intubated in mechanical ventilator and others were excluded in the study. Clinical Pulmonary Infection Score (CPIS was given to each patient included in the study on daily basis. CPIS of greater than six was used as diagnostic criteria for VAP. 5 Clinically diagnosed ventilator-associated pneumonia were observed and clinical parameters were recorded from their medical records and bedside charts. All patients with clinical and radiological signs suggestive of pneumonia on admission. Endotracheal aspirate was collected by using a 22-inch Romsons suction catheter. Chest vibration or percussion for 10 mins. was used. Only 1 ETA sample was collected from each patient and was immediately taken to the laboratory for processing. RESULTS Klebsiella pneumonia was isolated 39.02%, Pseudomonas

  19. Mastalgia: Prevalence at a Sub-Saharan African Tertiary Hospital

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    T. Makumbi

    2014-01-01

    Full Text Available Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16% were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13% and 5/168 (3%, respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006. Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.

  20. Descriptive analysis of neurological in-hospital consultations in a tertiary hospital.

    Science.gov (United States)

    Aller-Alvarez, J S; Quintana, M; Santamarina, E; Álvarez-Sabín, J

    2017-04-01

    In-hospital consultations (IHC) are essential in clinical practice in tertiary hospitals. The aim of this study is to analyse the impact of neurological IHCs. One-year retrospective descriptive study of neurological IHCs conducted from May 2013 to April 2014 at our tertiary hospital. A total of 472 patients were included (mean age, 62.1 years; male patients, 56.8%) and 24.4% had previously been evaluated by a neurologist. Patients were hospitalised a median of 18 days and 19.7% had been referred by another hospital. The departments requesting the most in-hospital consultations were intensive care (20.1%), internal medicine (14.4%), and cardiology (9.1%). Reasons for requesting an IHC were stroke (26.9%), epilepsy (20.6%), and confusional states (7.6%). An on-call neurologist evaluated 41.9% of the patients. The purpose of the IHC was to provide a diagnosis in 56.3% and treatment in 28.2% of the cases; 69.5% of the patients required additional tests. Treatment was adjusted in 18.9% of patients and additional drugs were administered to 27.3%. While 62.1% of cases required no additional IHCs, 11% required further assessment, and 4.9% were transferred to the neurology department. Of the patient total, 16.9% died during hospitalisation (in 37.5%, the purpose of the consultation was to certify brain death); 45.6% were referred to the neurology department at discharge and 6.1% visited the emergency department due to neurological impairment within 6 months of discharge. IHCs facilitate diagnosis and management of patients with neurological diseases, which may help reduce the number of visits to the emergency department. On-call neurologists are essential in tertiary hospitals, and they are frequently asked to diagnose brain death. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital

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    M Kaur

    2015-01-01

    Full Text Available Purpose : Central venous catheters (CVCs though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC-BSI in the intensive care unit (ICU patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO and Gram staining methods. Biofilm production in catheters was detected by ′tissue culture plate′ (TCP method. The results were analysed using the computer-based program statistical package for the social sciences (SPSS. Results : In 25/115 patients, definite diagnosis of CVC-BSI was made. The mean age was 48.44 ± 17.34 years (cases vs 40.10 ± 18.24 years (controls and the mean duration of catheterisation was 25.72 ± 8.73 days (cases vs 11.89 ± 6.38 days (controls. Local signs of infection (erythema, tenderness and oozing were found more significantly in CVC-BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non-albicans Candida were common CVC-BSI pathogens. Multidrug-resistant (MDR strains were isolated in bacterial agents of CVC-BSI. Non-albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion : The incidence of CVC-BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC-BSI cases. The menace of multidrug resistance and

  2. Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000–2010: a registry based study

    Science.gov (United States)

    2012-01-01

    Background Perinatal mortality reflects maternal health as well as antenatal, intrapartum and newborn care, and is an important health indicator. This study aimed at classifying causes of perinatal death in order to identify categories of potentially preventable deaths. Methods We studied a total of 1958 stillbirths and early neonatal deaths above 500 g between July 2000 and October 2010 registered in the Medical Birth Registry and neonatal registry at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. The deaths were classified according to the Neonatal and Intrauterine deaths Classification according to Etiology (NICE). Results Overall perinatal mortality was 57.7/1000 (1958 out of 33 929), of which 1219 (35.9/1000) were stillbirths and 739 (21.8/1000) were early neonatal deaths. Major causes of perinatal mortality were unexplained asphyxia (n=425, 12.5/1000), obstetric complications (n=303, 8.9/1000), maternal disease (n=287, 8.5/1000), unexplained antepartum stillbirths after 37 weeks of gestation (n= 219, 6.5/1000), and unexplained antepartum stillbirths before 37 weeks of gestation (n=184, 5.4/1000). Obstructed/prolonged labour was the leading condition (251/303, 82.8%) among the obstetric complications. Preeclampsia/eclampsia was the leading cause (253/287, 88.2%) among the maternal conditions. When we excluded women who were referred for delivery at KCMC due to medical reasons (19.1% of all births and 36.0% of all deaths), perinatal mortality was reduced to 45.6/1000. This reduction was mainly due to fewer deaths from obstetric complications (from 8.9 to 2.1/1000) and maternal conditions (from 8.5 to 5.5/1000). Conclusion The distribution of causes of death in this population suggests a great potential for prevention. Early identification of mothers at risk of pregnancy complications through antenatal care screening, teaching pregnant women to recognize signs of pregnancy complications, timely access to obstetric care, monitoring of labour

  3. Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000-2010: a registry based study.

    Science.gov (United States)

    Mmbaga, Blandina T; Lie, Rolv Terje; Olomi, Raimos; Mahande, Michael Johnson; Olola, Oneko; Daltveit, Anne Kjersti

    2012-12-02

    Perinatal mortality reflects maternal health as well as antenatal, intrapartum and newborn care, and is an important health indicator. This study aimed at classifying causes of perinatal death in order to identify categories of potentially preventable deaths. We studied a total of 1958 stillbirths and early neonatal deaths above 500 g between July 2000 and October 2010 registered in the Medical Birth Registry and neonatal registry at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. The deaths were classified according to the Neonatal and Intrauterine deaths Classification according to Etiology (NICE). Overall perinatal mortality was 57.7/1000 (1958 out of 33 929), of which 1219 (35.9/1000) were stillbirths and 739 (21.8/1000) were early neonatal deaths. Major causes of perinatal mortality were unexplained asphyxia (n=425, 12.5/1000), obstetric complications (n=303, 8.9/1000), maternal disease (n=287, 8.5/1000), unexplained antepartum stillbirths after 37 weeks of gestation (n= 219, 6.5/1000), and unexplained antepartum stillbirths before 37 weeks of gestation (n=184, 5.4/1000). Obstructed/prolonged labour was the leading condition (251/303, 82.8%) among the obstetric complications. Preeclampsia/eclampsia was the leading cause (253/287, 88.2%) among the maternal conditions. When we excluded women who were referred for delivery at KCMC due to medical reasons (19.1% of all births and 36.0% of all deaths), perinatal mortality was reduced to 45.6/1000. This reduction was mainly due to fewer deaths from obstetric complications (from 8.9 to 2.1/1000) and maternal conditions (from 8.5 to 5.5/1000). The distribution of causes of death in this population suggests a great potential for prevention. Early identification of mothers at risk of pregnancy complications through antenatal care screening, teaching pregnant women to recognize signs of pregnancy complications, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn

  4. Exploratory Study on the Ayurvedic Therapeutic Management of Cerebral Palsy in Children at a Tertiary Care Hospital of Karnataka, India

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    U. Shailaja

    2014-01-01

    Full Text Available Cerebral palsy (CP is the leading cause of childhood disability affecting cognitive function and developments in approximately 1.5 to 3 cases per 1000 live births. Based on Ayurvedic therapeutic principles, CP patients were subjected to Abhyanga (massage with Moorchita Tila Taila (processed sesame oil and Svedana (fomentation with Shastikashali Pinda Sveda (fomentation with bolus of drugs prepared with boiled rice. Study group received Mustadi Rajayapana Basti (enema with herbal decoction and Baladi Yoga (a poly-herbo-mineral formulation, while the placebo group received Godhuma Vati (tablet prepared with wheat powder and saline water as enema. Treatment with Mustadi Rajayapana Basti and Baladi Yoga improved the activities of daily life by 8.79%, gross motor functions by 19.76%, and fine motor functions 15.05%, and mental functions like memory retention got improved by 15.43%. The placebo group showed an improvement of 0.21% in daily life activities, 2.8% in gross motor, and 2.4% in fine motor functions. Mustadi Rajayapana Basti and Baladi Yoga proved to be more supportive in improving the motor activities and gross behavioral pattern. Further clinical trials are required to evaluate and validate the maximum effect of the combination therapy in a large sample with repetition of the courses for longer duration.

  5. Assessment of thymus size in healthy term neonates using sonography - A study from tertiary care hospital of Central India.

    Science.gov (United States)

    Mehta, S

    2015-01-01

    A cross-sectional study was done to assess the size of thymus in term healthy infants using sonography and to assess its variation in size, shape, location, echogenicity and echotexture for both male and female reference population. A total of 250 term healthy neonates of either sex were subjected to thymic sonography. The shape, size in maximal anteroposterior, longitudinal, and transverse dimensions of both right and left lobes of thymus was evaluated. Their echotexture and echogenicity were determined and standards for reference population were calculated. The results were statistically evaluated. According to the shape; the thymus was quadrilateral in 156 neonates (62%), round in 37 (15%), bilobate in 32 (13%), and crescent shaped in 25 (10%) in transverse scan. According to the echo texture, the thymus echogenicity was homogeneous and almost similar or slightly less to that of the liver and spleen in most cases 200 [80%] and was coarse in 50 (20%). In all subjects, the echogenicity of the thymus was less than that of the thyroid gland. Variations in location of the thymus were found in 70 (28%) neonates. The range of mean AP diameter was 0.39-2.36 cm (mean 1.43 ± 0.3), that of transverse 1.4 - 4.3 cm (mean 2.16 ± 0.54) and that of thymic index 1.2-5.1 cm2 (mean 2.98 ± 0.64). A normative range was calculated for standard population, which can be used as a reference for comparing thymus size for both normal and diseased neonates for various immunological diseases.

  6. Quality indicators for esophagogastroduodenoscopy: A comparative study of outcomes after an improvement programme in a tertiary hospital.

    Science.gov (United States)

    Córdova, Henry; Sánchez-Montes, Cristina; Delgado-Guillena, Pedro G; Morales, Victor J; Sendino, Oriol; González-Suárez, Begoña; Cárdenas, Andrés; Pellisé, Maria; Araujo, Isis K; Ginés, Àngels; Llach, Josep; Fernández-Esparrach, Gloria

    2017-11-01

    There is an opportunity for improvement in the recording and measuring of quality indicators. However, no previous experiences exist in our field in terms of their compliance in esophagogastroduodenoscopy (EGD). To analyse compliance with EGD quality criteria and evaluate improvement after conducting a training programme. Comparative study of 2 cohorts: one retrospective (control group) and one prospective (intervention group), before and after a training programme consisting of an information session and the report writing improvement programme. The quality indicators proposed by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology were used. A total of 1,200 EGDs were included in a sequential manner (600 in each group). Following the training programme, a significant improvement was observed in the following indicators: documented indication (93 vs. 99.8%; P<0.01), documented full examinations (94.7 vs. 97.3%; P<0.01), correct performance (63.7 vs. 87.9%; P<0.01), appropriate biopsies according to protocols (57.9 vs. 83.8%; P<0.01), photo-documentation of described lesions (84.1 vs. 94.9%; P<0.01), photo-documentation per segment (52.9 vs. 70.5%; P<0.01) and correct overall assessment (56,9 vs. 90.5%; P<0.01). Biopsies for coeliac disease, documented indication, full examination and correct performance, if it went ahead, exceeded the recommended standard. A very simple training programme improves EGD quality indicators, with the majority reaching the standards recommended by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  7. Unsatisfactory rate in liquid-based cervical samples as compared to conventional smears: A study from tertiary care hospital

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    Nalini Gupta

    2016-01-01

    Full Text Available Background: Developed countries adopted liquid-based cytology (LBC cervical cytology, partly because of its lower proportions of unsatisfactory (U/S/inadequate samples. This study was carried out to evaluate effect on the rate of U/S samples after introduction of LBC in our laboratory. Materials and Methods: An audit of U/S cervical samples was performed, which included split samples (n = 1000, only conventional Pap smear (CPS smears (n = 1000, and only LBC samples (n = 1000. The smears were reviewed by two observers independently, and adequacy for the samples was assessed as per The Bethesda System 2001. The reasons for U/S rate in split samples were categorized into various cytologic and/or technical reasons. Results: U/S rate was far less in only LBC samples (1.2% as compared to only CPS (10.5% cases. Cases in the satisfactory but limited category were also less in only LBC (0.4% as compared to only CPS (3.2% samples. The main reasons for U/S smears in split samples were low cell count (37.2% in CPS; 58.8% in LBC. The second main reason was low cellularity with excess blood and only excess blood in CPS samples. Conclusion: There was a significant reduction of U/S rate in LBC samples as compared to CPS samples, and the difference was statistically significant. The main cause of U/S samples in LBC was low cellularity indicating a technical fault in sample collection. The main cause of U/S rate in CPS was low cellularity followed by low cellularity with excess blood. Adequate training of sample takers and cytologists for the precise cell count to determine adequacy in smears can be of great help in reducing U/S rate.

  8. Unsatisfactory rate in liquid-based cervical samples as compared to conventional smears: A study from tertiary care hospital

    Science.gov (United States)

    Gupta, Nalini; Bhar, Vikrant S.; Rajwanshi, Arvind; Suri, Vanita

    2016-01-01

    Background: Developed countries adopted liquid-based cytology (LBC) cervical cytology, partly because of its lower proportions of unsatisfactory (U/S)/inadequate samples. This study was carried out to evaluate effect on the rate of U/S samples after introduction of LBC in our laboratory. Materials and Methods: An audit of U/S cervical samples was performed, which included split samples (n = 1000), only conventional Pap smear (CPS) smears (n = 1000), and only LBC samples (n = 1000). The smears were reviewed by two observers independently, and adequacy for the samples was assessed as per The Bethesda System 2001. The reasons for U/S rate in split samples were categorized into various cytologic and/or technical reasons. Results: U/S rate was far less in only LBC samples (1.2%) as compared to only CPS (10.5%) cases. Cases in the satisfactory but limited category were also less in only LBC (0.4%) as compared to only CPS (3.2%) samples. The main reasons for U/S smears in split samples were low cell count (37.2% in CPS; 58.8% in LBC). The second main reason was low cellularity with excess blood and only excess blood in CPS samples. Conclusion: There was a significant reduction of U/S rate in LBC samples as compared to CPS samples, and the difference was statistically significant. The main cause of U/S samples in LBC was low cellularity indicating a technical fault in sample collection. The main cause of U/S rate in CPS was low cellularity followed by low cellularity with excess blood. Adequate training of sample takers and cytologists for the precise cell count to determine adequacy in smears can be of great help in reducing U/S rate. PMID:27382408

  9. Knowledge, attitude and practice of type 2 diabetic patients regarding obesity: study in a tertiary care hospital in Bangladesh

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    Farzana Saleh

    2012-03-01

    Full Text Available Prevention and management of obesity largely depends on patient motivation and education and these, in turn, can be greatly facilitated by adequate baseline data on the knowledge, attitude and practice (KAP of patients. The aim of this study is to assess KAP on obesity among Bangladeshi type 2 diabetics. Under a cross-sectional design 160 type 2 diabetics were selected from outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders. A standard questionnaire was constructed in local language and interview was administrated. Age and body mass index (BMI of the respondents were 45.17±5.68 years and 25.6 ±4 kg/m2 respectively. Among them 45% were male, 38% had primary education, 25% belonged to normal weight, 1/2 of them were overweight and rest were obese. KAP score of the respondents was [mean ±SD(%] 60.03±13.82, 79.30±8.27, 55.50±19.21 respectively. Majority were unaware about ideal body weight, energy requirement and the weight measurement techniques. A substantial proportion of the respondents considered fast food, soft drinks, mayonnaise as healthier food. Majority of them positively agreed on willingness to follow proper diet, maintaining ideal body weight, dietary management and exercise. More than half of the normal weight and overweight respondents did exercise >45 min, while 1/3 obese did not do exercise (35%. KAP score were significantly associated with respondents’ level of education (P=0.0001, P=0.007, P=0.05 respectively practice score was significantly associated with sex (P=0.0001, occupation (P=0.003 and BMI (P=0.0001. There is a need for increased effort towards developing and making education programs focusing on empowering the persons to transform their knowledge and attitude into practice.

  10. Acceptance and attitudes of healthcare staff towards the introduction of clinical pharmacy service: a descriptive cross-sectional study from a tertiary care hospital in Sri Lanka.

    Science.gov (United States)

    Shanika, Lelwala Guruge Thushani; Wijekoon, Chandrani Nirmala; Jayamanne, Shaluka; Coombes, Judith; Coombes, Ian; Mamunuwa, Nilani; Dawson, Andrew Hamilton; De Silva, Hithanadura Asita

    2017-01-18

    Multidisciplinary patient management including a clinical pharmacist shows an improvement in patient quality use of medicine. Implementation of a clinical pharmacy service represents a significant novel change in practice in Sri Lanka. Although attitudes of doctors and nurses are an important determinant of successful implementation, there is no Sri Lankan data about staff attitudes to such changes in clinical practice. This study determines the level of acceptance and attitudes of doctors and nurses towards the introduction of a ward-based clinical pharmacy service in Sri Lanka. This is a descriptive cross-sectional sub-study which determines the acceptance and attitudes of healthcare staff about the introduction of a clinical pharmacy service to a tertiary care hospital in Sri Lanka. The level of acceptance of pharmacist's recommendations regarding drug-related problems (DRPs) was measured. Data regarding attitudes were collected through a pre-tested self-administered questionnaires distributed to doctors (baseline, N =13, post-intervention period, N = 12) and nurses (12) worked in professorial medical unit at baseline and post-intervention period. A total of 274 (272 to doctors and 2 to nurses) recommendations regarding DRPs were made. Eighty three percent (225/272) and 100% (2/2) of the recommendations were accepted by doctors and nurses, respectively. The rate of implementation of pharmacist's recommendations by doctors was 73.5% (200/272) (95% CI 67.9 - 78.7%; P Sri Lanka Clinical Trials Registry SLCTR/2013/029 Date: 13 September 2013; retrospectively registered.

  11. Phenotypic and antibiogram pattern of V. cholerae isolates from a tertiary care hospital in Mumbai during 2004-2013: a retrospective cross-sectional study.

    Science.gov (United States)

    Torane, V; Kuyare, S; Nataraj, G; Mehta, P; Dutta, S; Sarkar, B

    2016-11-25

    Cholera is a major gastroenteric disease with reports on fluctuation and resistance. Hence, the objective is to determine the trend in seasonality, resistance pattern, prevalent biotypes, serotypes and phage types between 2004 and 2013 among Vibrio cholerae isolates. A retrospective cross-sectional study. A single-centre study was carried out at a tertiary care hospital in a metropolitan city (Mumbai) of a developing country (India). Records of stool specimen cultures of patients with suspected cholera from January 2004 to December 2013 were analysed. The organisms were identified as per standard protocol. Antimicrobial susceptibility testing was performed as per Clinical Laboratory Standard Institute. Biotyping, serotyping and phage typing were carried out. From the confirmed cases of cholera, demographic and laboratory details were noted. Descriptive analysis was used and the data were presented in the form of percentages. Vibrio cholerae was predominant in males and was isolated from 9.41% (439/4664) of stool specimens. Variability was found in terms of the gross appearance of stool specimens, seasonal trend and antibiotic resistance pattern. The antimicrobial susceptibility showed a waxing and waning pattern for most of the antibiotics (ampicillin, cefuroxime, chloramphenicol, tetracycline) tested, while for a few others the strains were either uniformly sensitive (gentamicin, norfloxacin) or resistant (trimethoprim-sulfamethoxazole, nalidixic acid). All isolates belonged to subgroup O1 and biotype El Tor. The most common serotype was Ogawa. The predominant phage type was T2 (old scheme) and T27 (new scheme). The predominant biotype, serotype and phage type were El Tor, Ogawa and T27 phage, respectively. The changing trends in antimicrobial resistance pattern over the years necessitate continued epidemiological and microbiological surveillance of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  12. A Prospective, Observational Study to Determine the Prevalence and Clinical Profile of Patients of Hypertensive Crisis in a Tertiary Care Hospital.

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    Salagre, Santosh B; Itolikar, Shobha M; Gedam, Kapil

    2017-06-01

    Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality. To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. This prospective observational year-long study was conducted after due ethical considerations on 120 adult non-pregnant patients who presented with blood pressure of >180/120 mm Hg in the emergency medical services of a tertiary care hospital. The available data was statistically analyzed using the t-test for continuous variables and chi-square test for categorical variables. Sixty two (51.67%) patients presented with hypertensive urgency and fifty eight (48.33%) with hypertensive emergency. Together they constituted 0.59% of total medical admissions and 18.04% of ICU admissions. Mean age of patients was 48.34 years and 52.48 years in HU and HE groups respectively. Headache (49.2%) and giddiness (43.3%) were the common presenting symptoms. Focal neurological deficit (p=0.001), psychomotor agitation (p=0.024), visual disturbances (p=0.048), oliguria (p=0.036) were noted significantly in patients with HE. Systolic and diastolic blood pressures were significantly elevated (p=0.001) in HE as compared to HU. Circadian peaks were noted between 2pm - 4 pm followed by 2am - 4 am and circannual peaks were noted in hot and humid months of May and October. Occurrence of HE was significantly linked with male gender (p=0.037), alcoholism (phypertensive emergencies (p=0.021), smoking (p=0.05), dyslipidemia(p=0.002), diabetes mellitus(p=0.003), cardiovascular (p=0.002) and cerebrovascular involvement(p=0.015). This study showcases the characteristic features of hypertensive crises in Indian subjects, thus allowing us a better understanding of the natural history of this medical emergency.

  13. Study of knowledge, attitude and practices regarding dengue in the urban and rural field practice area of a tertiary care teaching hospital in Pune, India

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    Samir Singru

    2013-01-01

    Full Text Available Context: Dengue is the most common disease among all the arthropod-borne viral diseases. There is no specific treatment or vaccine available for dengue. The sole method of prevention and control is the knowledge attitude and practices (KAP for the same. Although, dengue is considered an urban- and semi-urban disease, in recent years, due to water storage practices and large-scale development activities in rural areas, dengue has become endemic in rural areas of India as well. Aims: To assess the KAP regarding dengue. Settings and Design: Urban and rural field practice area of a Tertiary Care Teaching Hospital in Pune, India. Materials and Methods: A pre-tested, semi-structured questionnaire was used to study the knowledge, attitude, and practices regarding dengue. Stratified random sampling technique was used. A modified B. G. Prasad criterion was used for socio-economic classification. Statistical Analysis Used: KAP represented as proportion (%. Chi-square test was used as a test of significance. P value < 0.05 was considered as statistically significant. Results: 68.4% in urban areas and 40.4% in rural area knew that dengue is transmitted by mosquito. 62.6% in urban areas and 48% in rural areas respectively stated fever as a symptom of dengue. The use of anti-adult mosquito measures was 48.05% and 51.42% in urban and rural area respectively Conclusions: There is a definite need to increase the information education communication activities for dengue in the study area.

  14. Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study

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    Mingmei Du

    2017-12-01

    Full Text Available Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP is widely performed as a treatment for biliary and pancreatic illness in China; however, there are few data available regarding post-ERCP infections. This study aimed to describe the overall incidence of post-ERCP infections and the epidemiological characteristics of infected patients in a large tertiary-care hospital in China. Methods Real-time surveillance was performed from 2012 through 2015 to identify all healthcare-associated infections (HAIs that occurred after ERCP, using an automatic system. All HAIs (e.g., cholangtitis, bacteremia were identified by infection control practitioners and doctors. Inpatient data were automatically collected by the surveillance system. Results A total of 1743 ERCP operations were included in the study, among these, 132 (7.57% HAIs were identified. ERCP postoperative infections occurred following different surgical procedures, with infection rates ranging from 3.58 to 13.51%. The most prevalent HAI was biliary tract infection (4.02%, followed by transient bacteremia (1.14%. Overall, 62 cases of bacteremia occurred following ERCP surgery and 34 (54.84% cases occurred on the day of the operation or 1-day post-surgery. The most prevalent isolates detected during bacteremia were Enterococcus faecium (12/58 and Escherichia coli (11/58. A large proportion (72.73% of the E. coli isolates and all of the E. faecium isolates were resistant to ciprofloxacin. In addition, only 37.50% of the E. coli isolates were susceptible to ceftriaxone. Conclusions The high incidence of post-ERCP infection and the prevalence of drug resistance suggests that employing second generation cephalosporin or ceftriaxone as the antibiotic of choice for prophylaxis before ERCP, as recommended by the Chinese clinical application of antibacterial drugs guidelines, may not be effective.

  15. Predictors of Patient Satisfaction with Tertiary Hospitals in Korea

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    Hye-Sook Ham

    2015-01-01

    Full Text Available This study examined the general and system-related predictors of outpatient satisfaction with tertiary health care institutions in Korea. A cross-sectional descriptive study design was employed. The subjects were 1,194 outpatients recruited from 29 outpatient clinics of a university medical center in Korea. Measurements included 5 outpatient service domains (i.e., doctor service, nurse service, technician service, convenience, and physical environment of facility and patient satisfaction. Of the five domains, nurse service was the domain with the highest mean score M=4.21 and convenience was the domain with the lowest mean score M=3.77. The most significant predictor of patient satisfaction was the constructs of convenience β=0.21. The results of this study suggest that the concept of patient satisfaction with health care institutions in modern hospitals reflects an integrative process that includes not only the concerned health care personnel but also improved convenience such as user-friendly reservation system and comfortable waiting areas.

  16. "Human immunodeficiency virus serostatus disclosure-Rate, reactions, and discrimination": A cross-sectional study at a rural tertiary care hospital

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    Umesh S Joge

    2013-01-01

    Full Text Available Background: From the moment scientists identified Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS, social responses of fear, denial, stigma, and discrimination have accompanied the epidemic. Aims: To assess the rate of disclosure of HIV serostatus, reactions by the HIV/AIDS patients and their spouse, and discrimination faced by the patients. Methods: The present cross-sectional study was conducted at Antiretroviral Therapy (ART center of a rural tertiary care hospital, situated in Marathawada region of Maharashtra state from November 2008 to October 2010. Totally, 801 HIV-positive patients coming to ART center for treatment were included after ensuring confidentiality and taking informed consent. A preformed questionnaire was used to enquire about reaction after diagnosis, disclosure, and discrimination faced by the patients. The data analyzed using descriptive statistics and Chi-square test. Results: The most common immediate reaction by the HIV patients after getting diagnosed as seropositive was fear (593, 74.03% followed by depression (385, 48.06% and suicidal thoughts (98, 12.25%. Out of 801 patients, 769 (96% had spouse and of these maximum number of patients (653, 84.92% had disclosed HIV status to their spouses. Most common immediate reaction by spouse after disclosure was crime (324, 42.13% followed by horror (294, 38.23% and anger (237, 36.29%. Maximum number of patients were discriminated by friends (120, 71.01% followed by discrimination at workplace (49, 67.12%, by neighbors (32, 56.14%, and by relatives (53, 43.80%. Conclusion: Male positives were granted greater acceptance, care, and support by their spouses. More percentage of females discriminated by neighbors, relatives, and friends and at workplace which might be due to factors like customs, morals, and taboos.

  17. Intranasal Analgesia and Sedation in Pediatric Emergency Care-A Prospective Observational Study on the Implementation of an Institutional Protocol in a Tertiary Children's Hospital.

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    Nemeth, Marcus; Jacobsen, Nils; Bantel, Carsten; Fieler, Melanie; Sümpelmann, Robert; Eich, Christoph

    2017-01-24

    Children presenting with acute traumatic pain or in need of therapeutic or diagnostic procedures require rapid and effective analgesia and/or sedation. Intranasal administration (INA) promises to be a reliable, minimally invasive delivery route. However, INA is still underused in Germany. We hence developed a protocol for acute pain therapy (APT) and urgent analgesia and/or sedation (UAS). Our aim was to evaluate the effectiveness and safety of our protocol. We performed a prospective observational study in a tertiary children's hospital in Germany. Pediatric patients aged 0 to 17 years requiring APT or UAS were included. Fentanyl, s-ketamine, midazolam, or combinations were delivered according to protocol. Primary outcome variables included quality of analgesia and/or sedation as measured on age-appropriate scales and time to onset of drug action. Secondary outcomes were adverse events and serious adverse events. One hundred pediatric patients aged 0.3 to 16 years were enrolled, 34 for APT and 66 for UAS. The median time onset of drug action was 5 minutes (ranging from 2 to 15 minutes). Fentanyl was most frequently used for APT (n = 19). Pain scores decreased by a median of 4 points (range, 0-10; P < 0.0001). For UAS, s-ketamine/midazolam was most frequently used (n = 25). Sedation score indicated minimal sedation in most cases. Overall success rate after the first attempt was 82%. Adverse events consisted of nasal burning (n = 2) and vomiting (n = 2). No serious adverse events were recorded. A fentanyl-, s-ketamine-, and midazolam-based INA protocol was effective and safe for APT and UAS. It should then be considered where intravenous access is impossible or inappropriate.

  18. Perceived nursing service quality in a tertiary care hospital, Maldives.

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    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.

  19. Experience with tetanus in a tertiary hospital in South East Nigeria ...

    African Journals Online (AJOL)

    Background: Tetanus has for long been an avoidable source of morbidity and mortality particularly in developing countries. The aim of this study was to review the experience with managing tetanus in a regional tertiary hospital in Nigeria. Methods: A retrospective study of patients who were admitted with a clinical diagnosis ...

  20. Hospital-based surveillance of Japanese encephalitis at a tertiary hospital in Manila.

    Science.gov (United States)

    Alera, Ma Theresa P; Velasco, John Mark S; Ypil-Cardenas, Charity Ann; Jarman, Richard G; Nisalak, Ananda N; Thaisomboonsuk, Butsaya; Gibbons, Robert V; Dimaano, Efren M; Yoon, In-Kyu

    2013-09-01

    Japanese encephalitis virus (JEV) is endemic in the Philippines but the incidence and burden of disease are not well established. We conducted a prospective hospital-based study at San Lazaro Hospital, a tertiary level hospital in Manila, from September 2005 to December 2006. Cases were determined using an in-house dengue and Japanese encephalitis (JE) enzyme-linked immunosorbent assay in order to detect the proportion of JE cases among the acute encephalitis syndrome (AES) cases admitted to our hospital. Fifteen patients were found to have AES, of whom 6 (40%) had confirmed JE. Of the JE cases, 4 were females and 2 were males with an age range of 3-14 years. Three of the 6 JE cases occurred during July. The most common signs and symptoms on admission among JE cases were: fever, headache, loss of appetite, neck rigidity and altered sensorium. JE likely comprises a significant proportion of hospitalized AES cases among children from Manila and nearby provinces. Further studies on the nation-wide prevalence and distribution of JE in the Philippines are needed to guide health authorities in disease control and prevention strategies.

  1. Factors Associated to Prevalence and Incidence of Carbapenem-Resistant Enterobacteriaceae Fecal Carriage: A Cohort Study in a Mexican Tertiary Care Hospital.

    Directory of Open Access Journals (Sweden)

    Pedro Torres-Gonzalez

    Full Text Available Carbapenem-resistant Enterobacteriaceae (CRE infections have emerged as a serious threat to health worldwide. They are associated with increased morbidity and mortality and are capable of silently colonizing the gastrointestinal tract. Because of this, there is great interest to characterize the epidemiology of CRE carriage and acquisition in healthcare facilities. The aim of this study was to determine the prevalence and factors associated with CRE fecal carriage (CRE-fc, and risk factors for incident cases.A cohort study was conducted at a tertiary care hospital from January 1st to April 30th, 2014 during a CRE outbreak. Weekly rectal swabs were performed in patients considered at risk until discharge. CRE-fc prevalence was 10.9% (CI 95% 7.7-14.7 among 330 patients. Treatment with carbapenems (OR 2.54, CI 95% 1.15-5.62; transfer from an institution (OR 2.16, CI 95% 1.02-4.59; multi-drug resistant infection within the previous six months (OR 2.81, CI 95% 1.47-5.36; intensive care unit admission (OR 0.42, CI 95% 0.20-0.88; hematologic malignancy (OR 4.02, CI 95% 1.88-8.06; invasive procedures (OR 2.18, CI 95% 1.10-4.32; and sharing a room with a known CRE carrier (OR 3.0, CI 95% 1.43-6.31 were independently associated factors for CRE-fc. Risk factors associated with CRE-fc incidence were determined for 87 patients initially negative and with subsequent screening; the incidence rate was 2.5 cases, per 1000 person-years (CI 95% 1.5-3.9. Independently associated risk factors were carbapenem treatment (HR 2.68, CI 95% 1.03-6.98, hematologic malignancy (HR 5.74, 95% CI 2.46-13.4 and a mean daily colonization pressure ≥10% (HR 5.03, IC 95% 1.77-14.28. OXA-48-like (OXA-232 and CTX-M-15 were the predominantly identified mechanisms of resistance.We found an elevated incidence and prevalence of CRE-fc in our hospital. Hematologic patients need to be considered a population at risk, and antibiotic stewardship along with infection control programs need to

  2. Job satisfaction among anesthesiologists at a tertiary hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Ambrose Rukewe

    2012-01-01

    Full Text Available Background : We assessed job satisfaction among anesthesiologists at a tertiary hospital in Nigeria and identified elements of job stress and dissatisfaction. Methods : A cross-sectional study design was employed; a structured self-administered questionnaire was distributed, which focused on sociodemographic data, rating of job satisfaction, identification of stressors, and work relationships. Results : Out of 55 questionnaires distributed, 46 (83.6% completed questionnaires were returned. Overall, 27 (58.7% of the anesthesiologists were satisfied with their job. While 8.7% were very satisfied (grade 5, 6.5% were very dissatisfied (grade 1 with their job. The stressors identified by the respondents were time pressures, long working hours with complaints of insufficient sleep, and employment status. Among the respondents, the medical officers were the most discontented (9 out of 12, 75%, followed by senior registrars (5 out of 9, 56%. A high percentage of participants (54.1% declared that the one change if implemented that would enhance their job satisfaction was having a definite closing time. Conclusion : Our results showed that despite the demanding nature of anesthesiology as a specialty, many anesthesiologists were contented with their job.

  3. After-hour physiotherapy services in a tertiary general hospital.

    Science.gov (United States)

    Lim, Edwin C W; Liu, Jinyu; Yeung, Meredith T L; Wong, Wai Pong

    2008-01-01

    The aims of the present study were to describe the after-hour physiotherapy services in a tertiary general hospital, the patients and their demographics, and to determine which independent variables would predict physiotherapists' referrals to after-hour physiotherapy. A retrospective record review from April 1, 2004, to April 30, 2005, identified 992 patients (mean age 63.8 years; 95% confidence interval [CI] 62.6-65.0 years) who were either referred by daytime physiotherapists (68%) or referred by medical practitioners for urgent attendance after hours (32%). Pneumonia was formally diagnosed medically in 20% (n=197) of the patients. Of all the patients who had surgery, upper abdominal or thoracic incisions formed the majority (61%; n=236). Whether patients had upper abdominal/thoracic surgery (estimated odds ratio 3.4; 95% CI 2.3-4.9) and the presence of pneumonia (2.8; 95% CI 1.9-4.2) were two independent factors identified from a logistic regression model predicting daytime physiotherapists' referral of patients to after-hour service. This model correctly predicted 65.5% of the cases. Most patients were seen for mucociliary clearance. Referral behaviour by physiotherapists reflects the basis of their clinical decision making and has implications for practice, training, and further research.

  4. Profile of children admitted with seizures in a tertiary care hospital of Western Nepal

    OpenAIRE

    Adhikari, Sudhir; Sathian, Brijesh; Koirala, Deepak Prasad; Rao, Kalipatnam Seshagiri

    2013-01-01

    Background Seizure is one of the common causes of childhood hospitalization with significant mortality and morbidity. There is limited data regarding acute seizures episodes form the developing countries. Current study aims to find the common etiology of seizure and classify seizure types in various age groups presenting to tertiary center in Western Nepal. Methods This was a hospital based retrospective study carried out in the data retrieved from the records maintained in the Department of ...

  5. Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland

    OpenAIRE

    Bloch-Infanger, Constantine; B?ttig, Veronika; Kremo, J?rg; Widmer, Andreas F.; Egli, Adrian; Bingisser, Roland; Battegay, Manuel; Erb, Stefan

    2017-01-01

    Objective The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland. Methods At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospit...

  6. Prognostic Implications of Level-of-Care at Tertiary Heart Centers Compared With Other Hospitals After Resuscitation From Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Kjaergaard, Jesper; Bro-Jeppesen, John

    2015-01-01

    BACKGROUND: Studies have found higher survival rates after out-of-hospital cardiac arrest and admission to tertiary heart centers. The aim was to examine the level-of-care at tertiary centers compared with nontertiary hospitals and the association with outcome after out-of-hospital cardiac arrest....... METHODS AND RESULTS: Consecutive out-of-hospital cardiac arrest patients (n=1078) without ST-segment-elevation myocardial infarction admitted to tertiary centers (54%) and nontertiary hospitals (46%) were included (2002-2011). Patient charts were reviewed focusing on level-of-care and comorbidity....... The adjusted odds of predefined markers of level-of-care were higher in tertiary centers: admission to intensive care unit (odds ratio [OR], 1.8 [95% confidence interval, 1.2-2.5]), temporary pacemaker (OR, 6.4 [2.2-19]), vasoactive agents (OR, 1.5 [1.1-2.1]), acute (

  7. Mothers’ experiences of labour in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    M S Maputle

    2008-01-01

    Full Text Available The purpose of the study was to explore and describe experiences of mothers during childbirth in a tertiary hospital in the Limpopo Province. This was achieved through a qualitative research study which was exploratory, descriptive, contextual and inductive in nature. A sample of 24 mothers participated in this study. Data obtained from unstructured in-depth interviews were analysed according to the protocol by Tesch (1990, cited in Cresswell, 1994:155. Five themes were identified, namely mutual participation and responsibility sharing, dependency and decision-making; information sharing and empowering autonomy and informed choices; open communication and listening; accommodative/non-accommodative midwifery actions; and maximising human and material infrastructure. The themes indicated experiences that foster or promote dependency on midwifery care. Guidelines on how to transform this dependency into a mother-centered care approach during childbirth are provided. Opsomming Die doel van die studie was om moeders se belewenis van kindergeboorte in ’n tersiêre hospitaal in die Limpopo Provinsie te verken en te beskryf. Dit is gedoen deur middel van kwalitatiewe navorsing wat verkennend, beskrywend, en kontekstueel was. ‘n Steekproef van 24 moeders het aan die studie deelgeneem. Inligting is verkry deur middel van ongestruktureerde in-diepte onderhoude. Hierdie inligting is geanaliseer aan die hand van Tesch (1990: aangehaal in Creswell, 1994:155 se protokol. Die volgende kategorieë is geïdentifiseer, wedersydse deelname en gedeelde verantwoordelik- hede, afhanklikheid en besluitneming, deel van inligting, bemagtiging tot outonomie en ingeligte keuse, oop kommunikasie en luister, akkommoderende/nie-akkommoderende vroedvrou-aksies en bevordering van menslike en materiële infrastrukture. Die resultate van die onderhoude het belewenisse blootgelê wat dui op die bevordering van afhanklikheid in vroedvrouversorging. Riglyne om hierdie

  8. Vitamin D Levels in Malnourished Children under 5 Years in a Tertiary Care Center at Muhimbili National Hospital, Dar es Salaam, Tanzania-A Cross-sectional Study.

    Science.gov (United States)

    Walli, Nahida Z; Munubhi, Emmanuel K; Aboud, Said; Manji, Karim P

    2017-06-01

    : To evaluate vitamin D levels/deficiency among malnourished children <5 years admitted at a tertiary care center, the Muhimbili National Hospital, Dar es Salaam, Tanzania. Children with malnutrition may have co-existing vitamin D deficiency (VDD), which may be severe. : Serum vitamin D and alkaline phosphatase were evaluated, and X-ray of the wrist was carried out on 134 children. : VDD was found in 41 of 134 children (30.6%). The mean vitamin D level was 74.8 nmol/l. The mean alkaline phosphatase level was 176.6 U/l. Sixty-four (48%) children were found to have severe stunting, of whom 20 (31.2%) were vitamin D deficient. Marasmic children had higher odds of VDD compared with other forms of malnutrition. : The high prevalence of VDD in malnourished children underlines the need for active surveillance and aggressive management.

  9. Maternal care quality in near miss and maternal mortality in an academic public tertiary hospital in Yogyakarta, Indonesia: a retrospective cohort study.

    Science.gov (United States)

    Mawarti, Yuli; Utarini, Adi; Hakimi, Mohammad

    2017-05-22

    Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta, and maternal near misses were used as controls. Data were obtained from medical records from February 1, 2011 to September 30, 2012. Three groups of variables were measured: (1) timeliness of care, (2) adherence to a standard of process indicators, and (3) associated extraneous variables. Variables were analysed using logistic regression to explore their effects on maternal mortality. The mean of triage response time and obstetric resident response time were longer in maternal deaths (8 ± 3.59 and 36.17 ± 23.48 min respectively) compared to near misses (1.29 ± 0.24 and 18.78 ± 4.85 min respectively). Near misses more frequently received oxytocin treatment than the maternal deaths (OR 0.13; 95%CI 0.02-0.77). Magnesium sulfate treatment in severe-preeclampsia or eclampsia was less given in maternal deaths although insignificant statistically (OR 0.19; 95% CI 0.03-1.47). Prophylactic antibiotic was also more frequently given in near misses than in maternal deaths though insignificant statistically (OR 0.3; 95% CI 0.06-1.56). Extraneous variables, such as caesarean sections were less performed in maternal deaths (OR 0.15; 95% CI 0.04-0.51), vaginal deliveries were more frequent in maternal deaths (OR 3.47; 95% CI 1.05-11.54), and more women in near misses were referred from other health care facilities (OR 0.09; 95% CI 0.01-0.91). The near misses had relatively received better quality of care compared to the maternal deaths. The near misses had received faster response time

  10. Septic Abortion Managed in a Tertiary Hospital in West Bengal ...

    African Journals Online (AJOL)

    Background: Septic abortion is still a challenging problem and a major cause of maternal mortality and morbidity in developing countries. Aim: The present study was conducted to estimate incidence, causes, risk factors, associated microorganisms, and treatment modalities of cases of septic abortion managed in a tertiary ...

  11. Nurses' communication and patient satisfaction in a tertiary hospital ...

    African Journals Online (AJOL)

    Nurses' communication of nursing care provision in tertiary health facilities and patient satisfaction are closely related. This has remained a yardstick for measuring success of the services provided in many health facilities. This study investigated the influence of nurses' communication of nursing care on patient satisfaction ...

  12. Prevalence of QT interval prolonging drug-drug interactions (QT-DDIs) in psychiatry wards of tertiary care hospitals in Pakistan: a multicenter cross-sectional study.

    Science.gov (United States)

    Khan, Qasim; Ismail, Mohammad; Haider, Iqbal; Khan, Fahadullah

    2017-12-01

    Background QT prolongation and associated arrhythmias, torsades de pointes (TdP), are considerable negative outcomes of many antipsychotic and antidepressant agents frequently used by psychiatric patients. Objective To identify the prevalence, levels, and predictors of QT prolonging drug-drug interactions (QT-DDIs), and AZCERT (Arizona Center for Education and Research on Therapeutics) classification of drugs involved in QT-DDIs. Setting Psychiatry wards of three major tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan. Method This was a multicenter cross-sectional study. Micromedex DrugReax was used for identification of QT-DDIs. TdP risks were identified by the AZCERT classification. Multivariate logistic regression analysis was performed to identify predictors of QT-DDIs. Main outcome measure Prevalence of QT-DDIs (overall, age-wise and gender-wise) and their levels of severity and documentation; AZCERT classes of drugs involved in QT-DDIs; and odds ratios for predictors of QT-DDIs. Results Of 600 patients, 58.5% were female. Median age was 25 years (IQR = 20-35). Overall 51.7% patients had QT-DDIs. Of total 698 identified QT-DDIs, most were of major-severity (98.4%) and fair-documentation (93.7%). According to the AZCERT classification, 36.4% of the interacting drugs were included in list-1 (known risk of TdP), 26.9% in list-2 (possible risk of TdP) and 27.5% in list-3 (conditional risk of TdP). Drugs commonly involved in QT-DDI were olanzapine (n = 146), haloperidol (138), escitalopram (122), risperidone (91), zuclopenthixol (87), quetiapine (n80) and fluoxetine (74). In multivariate logistic regression analysis, QT-DDIs were significantly associated with 6-7 prescribed medications (p = 0.04) and >7 medications (p = 0.03). Similarly, there was significant association of occurrence of QT-DDIs with 2-3 QT drugs (p 3 QT drugs (p QT-DDIs in psychiatry. There is a need to implement protocol for monitoring the outcomes of QT-DDIs.

  13. Missed Opportunities for Influenza Vaccination Among Hospitalized Children With Influenza at a Tertiary Care Facility.

    Science.gov (United States)

    Rao, Suchitra; Williams, Joshua T B; Torok, Michelle R; Cunningham, Maureen A; Glodè, Mary P; Wilson, Karen M

    2016-09-01

    To identify the extent and characteristics of missed opportunities for influenza vaccination among children hospitalized with influenza at a tertiary children's hospital. We conducted a retrospective cohort study of hospitalized patients with polymerase chain reaction-confirmed influenza admitted to Children's Hospital Colorado from 2010 to 2014. We reviewed medical records for vaccination status and previous visits. The primary outcome was the proportion of underimmunized patients hospitalized with influenza with at least 1 missed opportunity visit (visit before influenza diagnosis in which an eligible patient did not receive the influenza vaccine). The relationship between sociodemographic characteristics and the primary outcome were examined using χ(2) tests and nonparametric tests, and variables with P vaccination. Multivariate analysis demonstrated that high-risk status (adjusted odds ratio 6.9, 95% confidence interval 3.8-12.4) was associated with increased odds of having a missed opportunity visit. Most missed opportunity visits were to subspecialty clinics (42%), and most visits (71%) occurred from September to November. More than 40% of hospitalizations for influenza in children are associated with at least 1 missed opportunity visit at a tertiary center. Our findings highlight the potential role of tertiary care institutions in increasing influenza vaccination rates among children. Copyright © 2016 by the American Academy of Pediatrics.

  14. Educational Module Intervention for Radiographers to Reduce Repetition Rate of Routine Digital Chest Radiography in Makkah Region of Saudi Arabia Tertiary Hospitals: Protocol of a Quasi-Experimental Study.

    Science.gov (United States)

    Almalki, Abdullah A; Abdul Manaf, Rosliza; Hanafiah Juni, Muhamad; Kadir Shahar, Hayati; Noor, Noramaliza Mohd; Gabbad, Abdelsafi

    2017-09-26

    Repetition of an image is a critical event in any radiology department. When the repetition rate of routine digital chest radiographs is high, radiation exposure of staff and patients is increased. In addition, repetition consumes the equipment's life span, thus affecting the annual budget of the department. The aim of this study is to determine the impact of a printed educational module on reducing the repetition rate of routine digital chest radiography among radiographers in Makkah Region tertiary hospitals. A quasi-experimental time series with a control group will be conducted in Makkah Region tertiary hospitals for 8 months starting in the second quarter of 2017. Four hospitals out of 5 in the region will be selected; 2 of them will be selected as the control group and the other 2 as the intervention group. Stratification and a simple random sampling technique will be used to sample 56 radiographers in each group. Pre- and postintervention assessments will be conducted to determine the radiographer knowledge, motivation, and skills and repetition rate of chest radiographs. Radiographs of the chest performed by sampled radiographers in the selected hospitals will be collected for 2 weeks before and after the intervention. A piloted questionnaire will be distributed and collected by a researcher in both groups. One-way multivariate analysis of variance and 2-way repeated multivariate analysis of variance will be used to analyze the data. It is expected that the repetition rate in the intervention group will decline after implementing the intervention and the change will be statistically significant (Pintervention group will increase significantly among radiographers after implementation of the intervention (Peducational material in reducing the repetition rate of routine digital chest radiographs among radiographers in tertiary hospitals in the Makkah Region of Saudi Arabia.

  15. Management for the children with otitis media with effusion in the tertiary hospital.

    Science.gov (United States)

    Choung, Yun-Hoon; Shin, You Ree; Choi, Seong Jun; Park, Keehyun; Park, Hun Yi; Lee, Jong Bin; Han, Dong Hee; Kahng, Hison

    2008-12-01

    Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study. Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months. Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05). In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.

  16. Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany-a prevalence screening study.

    Science.gov (United States)

    Neidhart, S; Zaatreh, S; Klinder, A; Redanz, S; Spitzmüller, R; Holtfreter, S; Warnke, P; Alozie, A; Henck, V; Göhler, A; Ellenrieder, M; AbouKoura, M; Divchev, D; Gümbel, D; Napp, M; Steinhoff, G; Nienaber, C; Ekkernkamp, A; Mittelmeier, W; Güthoff, C; Podbielski, A; Stengel, D; Bader, R

    2017-12-21

    As methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in humans are a global challenge. In Mecklenburg and Western Pomerania (Germany) 1,517 patients who underwent surgical interventions were systematically screened for MRSA and MSSA colonization on the day of hospital admission and discharge. Demographic data, risk factors and colonization status of the (i) nose, (ii) throat, (iii) groin, and (iv) thorax or site of surgical intervention were determined. Of the 1,433 patients who were included for further evaluation, 331 (23.1%) were colonized with MSSA, while only 17 (1.2%) were MRSA carriers on the day of hospital admission. A combination of nose, throat and groin swabs returned a detection rate of 98.3% for MSSA/MRSA. Trauma patients had lower prevalence of MRSA/MSSA (OR 0.524, 95% CI: 0.37-0.75; p < 0.001) than patients with intended orthopedic interventions. Males showed significantly higher nasal S. aureus carrier rates than females (odds ratio (OR) = 1.478; 95% CI: 1.14-1.92; p = 0.003). Nasal S. aureus colonization was less frequent among male smokers as compared to non-smokers (chi2 = 16.801; phi = 0.154; p < 0.001). Age, gender and smoking had a significant influence on S. aureus colonization. Combining at least three different swabbing sites should be considered for standard screening procedure to determine S. aureus colonization at patients scheduled for cardiac or orthopedic interventions at tertiary care hospitals.

  17. Time trends in pediatric hospitalizations for varicella infection are associated with climatic changes: a 22-year retrospective study in a tertiary Greek referral center.

    Science.gov (United States)

    Critselis, Elena; Nastos, Panagiotis T; Theodoridou, Kalliopi; Theodoridou, Maria; Tsolia, Maria N; Hadjichristodoulou, Christos; Papaevangelou, Vassiliki

    2012-01-01

    The transmission rate of air-borne infectious diseases may vary secondary to climate conditions. The study assessed time trends in the seasonality of hospitalized varicella cases in a temperate region in relation to climatic parameters prior to the implementation of universal varicella immunization. A retrospective descriptive study was conducted among all pediatric and adolescent varicella patients (n = 2366) hospitalized at the "Aghia Sophia" Children's Hospital during 1982-2003 in Athens, Greece. Date of infection was computed based on hospital admission date. Seasonal and monthly trends in the epidemiology of varicella infection were assessed with time series analysis (ARIMA modeling procedure). The correlation between the frequency of varicella patients and the meteorological parameters was examined by the application of Generalized Linear Models with Gamma distribution. During 1982-2003, the occurrence of hospitalized varicella cases increased during summer (p = 0.025) and decreased during autumn (p = 0.021), and particularly in September (p = 0.003). The frequency of hospitalized varicella cases was inversely associated with air temperature (p<0.001). In contrast, the occurrence of hospitalized varicella cases was positively associated with wind speed (p = 0.009). Pediatric hospitalizations for varicella infection rates have increased during summer and decreased during autumn in the examined temperate region. Time trends in hospitalized varicella cases are associated with climatic variables.

  18. Ocular trauma: A tertiary hospital experience from Oman.

    Science.gov (United States)

    Al-Mahrouqi, Haitham H; Al-Harthi, Naila; Al-Wahaibi, Maryam; Hanumantharayappa, Kishore

    2017-01-01

    To describe the epidemiology of ocular trauma in a tertiary hospital setting in Muscat, Oman. Medical records of all cases of ocular trauma which presented to the Emergency Department at Al-Nahdha Hospital and were seen by the ophthalmology service from January 1, 2013 to June 30, 2013 (6 months) were reviewed to collect data on ocular trauma according to the World Eye Injury Registry initial reporting form which uses the Birmingham Eye Trauma Terminology System. There were 27,951 patients seen at the Emergency Department and 611 of which were ocular trauma cases (cumulative incidence 2.2% [confidence interval 2.0-2.4]). The mean age of the patients was 23 years and males comprised the majority of the cases (72%). Thirty-two patients had bilateral injury giving a total of 643 eyes injured. More than half of all injuries were caused by either blunt or large sharp objects. The cornea was the most frequently injured tissue (49%), but most injuries were minor in nature. More than three quarters (77%) of all eyes had a visual acuity of 0.3 (LogMAR) or better on presentation. There were 35 eyes (6%) with open globe injuries (OGI) and three-quarters of them occurring in the manual laborers. Ocular trauma is a common presentation at Al-Nahdha Hospital. Although the majority of trauma cases were minor without any visual disability sequelae, OGI could have been prevented with better ocular protection in the workplace.

  19. An epidemiological evaluation of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals.

    Science.gov (United States)

    Joeris, Alexander; Lutz, Nicolas; Wicki, Bárbara; Slongo, Theddy; Audigé, Laurent

    2014-12-20

    Children and adolescents are at high risk of sustaining fractures during growth. Therefore, epidemiological assessment is crucial for fracture prevention. The AO Comprehensive Injury Automatic Classifier (AO COIAC) was used to evaluate epidemiological data of pediatric long bone fractures in a large cohort. Data from children and adolescents with long bone fractures sustained between 2009 and 2011, treated at either of two tertiary pediatric surgery hospitals in Switzerland, were retrospectively collected. Fractures were classified according to the AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF). For a total of 2716 patients (60% boys), 2807 accidents with 2840 long bone fractures (59% radius/ulna; 21% humerus; 15% tibia/fibula; 5% femur) were documented. Children's mean age (SD) was 8.2 (4.0) years (6% infants; 26% preschool children; 40% school children; 28% adolescents). Adolescent boys sustained more fractures than girls (p fractures was falls (27%), followed by accidents occurring during leisure activities (25%), at home (14%), on playgrounds (11%), and traffic (11%) and school accidents (8%). There was boy predominance for all accident types except for playground and at home accidents. The distribution of accident types differed according to age classes (p fracture distribution were sex and age related. Overweight and obese patients seemed to be at increased risk of sustaining fractures. Our data give valuable input into future development of prevention strategies. The AO PCCF proved to be useful in epidemiological reporting and analysis of pediatric long bone fractures.

  20. Provision of an emergency theatre in tertiary hospitals is cost-effective

    African Journals Online (AJOL)

    Provision of an emergency theatre in tertiary hospitals is cost-effective: Audit and cost of cancelled planned elective general surgical operations at Pietersburg Hospital, Limpopo Province, South Africa.

  1. [Delays in the arrival of patients with subarachnoid haemorrhage at a tertiary hospital].

    Science.gov (United States)

    Pérez-Nellar, J; Scherle-Matamoros, C E; Montes de Oca, F; González-González, J L; Hierro-Garcia, D

    Patients with subarachnoid haemorrhage should be referred to a tertiary hospital as early as possible. The aim of this research was to study how long these patients take to reach a tertiary care centre in Havana. We conducted a prospective study of patients with subarachnoid haemorrhage who were admitted to the Stroke Unit at the Hospital Hermanos Ameijeiras between January 2005 and December 2007. The time of arrival at the hospital was determined and a comparison was carried out between patients who arrived after 72 hours and those who reached the hospital sooner. The sample studied comprised 94 patients. Only 34 (36%) arrived during the first three days, whereas 13 (13.8%) reached the hospital within the first 24 hours. None of the sociodemographic and clinical variables that were studied was associated with early remission. The length of time spent in hospital by patients admitted during the first 72 hours was 14.9 days, while in the other cases it was 17.57 days (p = 0.248). The greatest impact on early remission to the tertiary centre was on the outcome at discharge on the Rankin scale, which was lower in those who arrived early compared to the rest of the cases (p = 0.05); the same was true of mortality, which was 5.9% in those who arrived within the first 72 hours versus 11.7% in the others (p = 0.04). Only a third of the cases reached hospital during the first 72 hours and this group had a more favourable course.

  2. Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

    Directory of Open Access Journals (Sweden)

    Pravin K. Nair

    2013-12-01

    Full Text Available Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited treatment options associated with these organisms. Thus, the present study was conducted in our tertiary care hospital in Mumbai, to retrospectively analyze the prevalence of CRE in the hospital. Methods: The study was carried out in the microbiology department of the tertiary care hospital over a period of 12 months. The samples tested were clinical samples from hospitalized and Out-Patient Department (OPD patients sent to the department for microbiological testing. CRE isolates were identified using the Vitek 2- Compact system (BioMérieux, France. Results: A CRE prevalence rate of 12.26% was obtained from the study, from which the majority of the isolates were detected in urine samples (46%. Although most of the CRE isolates were detected in patient samples from the wards (42% and the ICU (26%, a significant number of isolates was also detected from the OPD patients (19%. Conclusion:Thus, the study shows a significant rate of carbapenem resistance among Enterobacteriaceae isolated from hospitalized and OPD patients. This emphasizes the urgent need for CRE control at the hospital and community level, and to rationalize the use of antibiotics. J Microbiol Infect Dis 2013;3(4: 207-210

  3. Effectiveness of mask ventilation performed by hospital doctors in an Irish tertiary referral teaching hospital.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    The objective of this study was to assess the effectiveness of mask ventilation performed by 112 doctors with clinical responsibilities at a tertiary referral teaching hospital. Participant doctors were asked to perform mask ventilation for three minutes on a Resusci Anne mannequin using a facemask and a two litre self inflating bag. The tidal volumes generated were quantified using a Laerdal skillmeter computer as grades 0-5, corresponding to 0, 334, 434, 561, 673 and > 800 ml respectively. The effectiveness of mask ventilation (i.e. the proportion of ventilation attempts which achieved a volume delivery of > 434 mls) was greater for anaesthetists [78.0 (29.5)%] than for non anaesthetists [54.6 (40.0)%] (P = 0.012). Doctors who had attended one or more resuscitation courses where no more effective at mask ventilation than their colleagues who had not undertaken such courses. It is likely that first responders to in-hospital cardiac arrests are commonly unable to perform adequate mask ventilation.

  4. Tertiary paediatric hospital admissions in children and young people with cerebral palsy.

    Science.gov (United States)

    Meehan, E; Freed, G L; Reid, S M; Williams, K; Sewell, J R; Rawicki, B; Reddihough, D S

    2015-11-01

    Many previous studies that have investigated hospital admissions in children and young people with cerebral palsy lack information on cerebral palsy severity and complexity. Consequently, little is known about factors associated with the frequency and type of hospital admissions in this population. This study used hospital admission data available for all children and young people known to a population-based cerebral palsy register to describe the patterns of use of tertiary paediatric hospital services over a 5-year period. This was a retrospective cohort analysis of routinely collected admission data from the two tertiary paediatric hospitals in the Australian state of Victoria. Data on admissions of individuals born between 1993 and 2008 registered on the Victorian Cerebral Palsy Register were analysed (n = 2183). Between 2008 and 2012, 53% of the cohort (n = 1160) had at least one same-day admission, and 46% (n = 996) had one or more multi-day admissions. Those with a moderate to severe motor impairment and those with a co-diagnosis of epilepsy had more admissions, and for multi-day admissions, longer lengths of stay, P children and young people with cerebral palsy. This study highlights priority areas for prevention, early diagnosis and medical management in this group. Improved primary and secondary prevention measures may decrease non-elective hospital admissions and readmissions in this group and reduce paediatric inpatient resource use and healthcare expenditure attributable to cerebral palsy. © 2015 John Wiley & Sons Ltd.

  5. Pattern of Pediatric Dermatoses in a Tertiary Care Hospital of Western Nepal

    OpenAIRE

    Yogesh Poudyal; Annu Ranjit; Santosh Pathak; Nagendra Chaudhary

    2016-01-01

    Pediatric dermatoses are one of the most common presentations in a dermatology clinic and reflect the health and hygiene status of children. The incidence and severity of these skin lesions are influenced by geographical area, seasonal and cultural factors, and socioeconomic status. This study was done to show the prevalence of different pediatric dermatoses in a tertiary care hospital of Western Nepal. Chart reviews of children aged one day to 17 years, presenting to Universal Medical Colleg...

  6. An appraisal of medical waste management in four tertiary hospitals ...

    African Journals Online (AJOL)

    Results: The study revealed that waste segregation is carried out in only one hospital. Hospital wastes are collected with wheel barrows and trolleys. Refuse is transported to treatment or disposal site by open trucks in two centres, the other two by Enugu State Waste Management Agency (ESWAMA) refuse trucks. Only one ...

  7. Adverse obstetrical and perinatal outcome in adolescent mothers associated with first birth: a hospital-based case-control study in a tertiary care hospital in North-East India

    Science.gov (United States)

    Medhi, Robin; Das, Banani; Das, Arpana; Ahmed, Mansur; Bawri, Sonika; Rai, Suditi

    2016-01-01

    Purpose To analyze the adverse obstetrical and perinatal outcome of adolescent mothers associated with first birth. Patients and methods This prospective case-control study was conducted in a tertiary care teaching hospital of North-East India between January 2014 and December 2014. All adolescent primigravidae completing 28 weeks of gestation with singleton pregnancy and delivered at our institution were included in the study group. Primigravidae aged between 20 and 25 years were taken as a control group. Mothers having pregnancy complicated with diabetes mellitus, renal disorder, thyroid disorders, and cardiac diseases were excluded from the study. Demographic data, maternal complications like severe anemia, pre-eclampsia, eclampsia, gestational age at delivery, mode of delivery, and postpartum complications were compared. Among fetal complications, low-birth weight, preterm birth, neonatal intensive care unit admission, still birth, and early neonatal death were compared. All the patients were interviewed regarding contraceptive knowledge and its use preceding the pregnancy. Results Quality antenatal care was received by 80.6% of adolescent mothers. The adolescent mothers had a higher incidence of pre-eclampsia (odds ratio [OR] 2.017 95% confidence interval [CI]: 1.045–3.894, P=0.03), preterm deliveries (OR: 1.655, 95% CI: 1.039–2.636, P=0.03). Among fetal outcomes, the low- birth weight babies (OR: 1.59, 95% CI: 1.016–2.478), low mean birth weight (2,544.4±622.09 g versus 2,701.6±582.51 g), and higher admission to neonatal intensive care unit (OR: 1.957, 95% CI: 1.120–3.417) were significantly associated with adolescent mothers. There was no significant difference found regarding the mode of delivery, still birth, and early neonatal death. Moreover, contraceptive knowledge and its use were found to be poor among adolescent mothers. Conclusion With quality antenatal, intranatal, and postnatal care, the obstetric risk of childbirth in adolescent mothers

  8. Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

    Science.gov (United States)

    Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

    2016-04-01

    Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, pcosts for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

  9. Patterns of Antimicrobial Prescribing in a Tertiary Care Hospital in Oman.

    Science.gov (United States)

    Al-Yamani, Abdulrahman; Khamis, Faryal; Al-Zakwani, Ibrahim; Al-Noomani, Hamed; Al-Noomani, Jaleela; Al-Abri, Seif

    2016-01-01

    Antimicrobial stewardship programs have been designed to measure and improve the use of antimicrobials to achieve optimal clinical outcomes and reduce bacterial resistance. The aim of this study was to review patterns of antimicrobial prescribing for hospitalized patients in the acute care setting and assess the appropriateness of antimicrobial use among prescribers in a tertiary care hospital in Oman. We conducted a retrospective audit of the appropriateness of antimicrobial prescribing in patients admitted to acute care settings in a tertiary care hospital in Oman over a four-week period (1 November to 28 November 2012). The data of all discharged patients were retrieved from the department databases. Patient records and prescriptions were reviewed by an infectious disease consultant. The rationality of antimicrobial use was evaluated, analyzed, and judged based on local standard guidelines and the experience of the evaluating consultant. There were 178 patients discharged from acute medical teams over the study period. Sixty-four percent of the patients received a total of 287 antimicrobial agents during admission. The average number of antimicrobials prescribed per patient in those prescribed antimicrobials was 2.5±1.1. The most commonly prescribed antimicrobial agent was piperacillin/tazobactam. Most patients had infections from gram-negative organisms, and high rates of extended spectrum beta-lactamase producing organisms were observed. Cultures were obtained before antimicrobial initiation in 25% of patients. Variability in antimicrobial selection for common infections was observed. National guidelines for the management of common infections are needed to minimize the overuse and misuse of antimicrobial agents in tertiary care hospitals. A large surveillance study on antimicrobial prescribing appropriateness in different hospital settings is warranted.

  10. Needle stick injuries in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Jayanth S

    2009-01-01

    Full Text Available Background: Accidental needle stick injuries (NSIs are an occupational hazard for healthcare workers (HCWs. A recent increase in NSIs in a tertiary care hospital lead to a 1-year review of the pattern of injuries, with a view to determine risk factors for injury and potential interventions for prevention. Methods: We reviewed 1-year (July 2006-June 2007 of ongoing surveillance of NSIs. Results: The 296 HCWs reporting NSIs were 84 (28.4% nurses, 27 (9.1% nursing interns, 45 (21.6% cleaning staff, 64 (21.6% doctors, 47 (15.9% medical interns and 24 (8.1% technicians. Among the staff who had NSIs, 147 (49.7% had a work experience of less than 1 year ( P < 0.001. The devices responsible for NSIs were mainly hollow bore needles ( n = 230, 77.7%. In 73 (24.6% of the NSIs, the patient source was unknown. Recapping of needles caused 25 (8.5% and other improper disposal of the sharps resulted in 55 (18.6% of the NSIs. Immediate post-exposure prophylaxis for HCWs who reported injuries was provided. Subsequent 6-month follow-up for human immunodeficiency virus showed zero seroconversion. Conclusion: Improved education, prevention and reporting strategies and emphasis on appropriate disposal are needed to increase occupational safety for HCWs.

  11. Experience of intravitreal injections in a tertiary Hospital in Oman.

    Science.gov (United States)

    Al-Hinai, Ahmed S

    2015-01-01

    To find out statistical data regarding intravitreal injections in an outpatient department setup at a tertiary center in Oman. Retrospective chart review. Data collection of patients who underwent intravitreal injections from November 2009 to May 2013 at Sultan Qaboos University Hospital. Throughout a period of 42 months, a total of 711 intravitreal injections were performed. That included 214 patients (275 eyes). Around one-third of the eyes received two injections or more. The injected agents were bevacizumab (59.8%), ranibizumab (32.3%), triamcinolone (7.5%), and very few patients with endophthalmitis received intravitreal antibiotics and antifungal agents. The three most common indications for the injection therapy were diabetic macular edema (50.9%), choroidal neovascularization (24.3%), and retinal vein occlusive diseases (11.5%). Serious adverse events were rare, and they occurred as ocular (0.9% per patient) and systemic (3.3% per patient). There were 42 eyes received intravitreal triamcinolone, and 24% of them developed intraocular hypertension that required only medical treatment. Different intravitreal agents are currently used to treat many ocular diseases. Currently, therapy with intravitreal agents is very popular, and it carries a promising outcome with more efficiency and safety.

  12. Epilepsy surgery in a pediatric population: a retrospective study of 129 children from a tertiary care hospital in a developing country along with assessment of quality of life.

    Science.gov (United States)

    Dagar, Amit; Chandra, P Sarat; Chaudhary, Kapil; Avnish, Chauhan; Bal, C S; Gaikwad, Shailesh; Garg, Ajay; Sarkar, Chitra; Srivastava, A; Padma, M V; Rekha, Diwedi; Gulati, Sheffali; Paul, Vinod; Prasad, K; Singh, M B; Tripathi, Manjari

    2011-01-01

    To assess the outcome of a pediatric population operated for drug-resistant epilepsy from a large tertiary care center in India. Retrospectively: quality of life (QOL); prospectively: preoperative assessment included interictal EEG, MRI (as per epilepsy protocol), video-EEG. Ictal SPECT (with subtraction) and PET were performed when required. QOL scores were assessed using the HASS or SSQ for seizure severity, Quality of Life in Childhood Epilepsy (QOLCE) for QOL, and Child Behavior Check List (CBCL) for behavior. 142 were operated from January 2000 to June 2011 by the senior author. 118 patients with at least 1 year of follow-up were included in the study. Mean age at surgery was 9.8 ± 4.3 years. In addition, 40 patients underwent QOL assessment prospectively both before and after surgery. Mean duration of epilepsy was 5.3 ± 3.3 years. A class I outcome (Engel's) was seen in 79.5% patients, class II in 8.6%, class III in 10.7%, and class IV in 1 patient. As per surgical procedures, class I outcome in patients who underwent temporal resection, hemispherotomy and extratemporal resection was 76, 87 and 72%, respectively. QOL scores correlated with duration of seizures, epileptic encephalopathy and outcome of surgery, but not with side of surgery, age and sex. This study, the largest reported from India, has demonstrated satisfactory results for epilepsy surgery in children. Copyright © 2011 S. Karger AG, Basel.

  13. Tertiary centres have improved survival compared to other hospitals in the Copenhagen area after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Wachtell, Kristian; Nielsen, Søren Loumann

    2013-01-01

    -term mortality after OHCA at tertiary heart centres and non-tertiary university hospitals. METHODS AND RESULTS: Data from the Copenhagen OHCA registry from June 2002 through December 2010 included a total of 1218 consecutive patients treated by the same mobile emergency care unit (MECU) with either return...

  14. Severe acute maternal morbidity (SAMM in postpartum period requiring tertiary Hospital care

    Directory of Open Access Journals (Sweden)

    Seema Bibi

    2012-01-01

    Full Text Available Background: Postpartum period is the critically important part of obstetric care but most neglected period for majority of Pakistani women. Only life threatening complications compel them to seek for tertiary hospital care. We describe the nature of these obstetric morbidities in order to help policymakers in improving prevailing situation. Objective: To find out the frequency and causes of severe post-partum maternal morbidity requiring tertiary hospital care and to identify the demographic and obstetrical risk factors and adverse fetal outcome in women suffering from obstetric morbidities. Materials and Methods: This prospective cross-sectional study was carried out in the Department of Gynecology and Obstetrics, Liaquat University Hospital Hyderabad, between April 2008-July 2009. The subjects comprised of all those women who required admission and treatment for various obstetrical reasons during their postpartum period. Women admitted for non-obstetrical reasons were excluded. A structured proforma was used to collect data including demographics, clinical diagnosis, obstetrical history and feto-maternal outcome of index pregnancy, which was then entered and analyzed with SPSS version 11. Results: The frequency of severe postpartum maternal morbidity requiring tertiary hospital care was 4% (125/3292 obstetrical admissions. The majority of them were young, illiterate, multiparous and half of them were referred from rural areas. Nearly two third of the study population had antenatal visits from health care providers and delivered vaginally at hospital facility by skilled birth attendants. The most common conditions responsible for life threatening complications were postpartum hemorrhage (PPH (50%, preeclampsia and eclampsia (30% and puerperal pyrexia 14%. Anemia was associated problem in 100% of cases. Perinatal death rate was 27.2% (34 and maternal mortality rate was 4.8%. Conclusion: PPH, Preeclampsia, sepsis and anemia were important causes

  15. Severe acute maternal morbidity (SAMM) in postpartum period requiring tertiary Hospital care.

    Science.gov (United States)

    Bibi, Seema; Ghaffar, Saima; Memon, Shazia; Memon, Shaneela

    2012-03-01

    Postpartum period is the critically important part of obstetric care but most neglected period for majority of Pakistani women. Only life threatening complications compel them to seek for tertiary hospital care. We describe the nature of these obstetric morbidities in order to help policymakers in improving prevailing situation. To find out the frequency and causes of severe post-partum maternal morbidity requiring tertiary hospital care and to identify the demographic and obstetrical risk factors and adverse fetal outcome in women suffering from obstetric morbidities. This prospective cross-sectional study was carried out in the Department of Gynecology and Obstetrics, Liaquat University Hospital Hyderabad, between April 2008-July 2009. The subjects comprised of all those women who required admission and treatment for various obstetrical reasons during their postpartum period. Women admitted for non-obstetrical reasons were excluded. A structured proforma was used to collect data including demographics, clinical diagnosis, obstetrical history and feto-maternal outcome of index pregnancy, which was then entered and analyzed with SPSS version 11. The frequency of severe postpartum maternal morbidity requiring tertiary hospital care was 4% (125/3292 obstetrical admissions). The majority of them were young, illiterate, multiparous and half of them were referred from rural areas. Nearly two third of the study population had antenatal visits from health care providers and delivered vaginally at hospital facility by skilled birth attendants. The most common conditions responsible for life threatening complications were postpartum hemorrhage (PPH) (50%), preeclampsia and eclampsia (30%) and puerperal pyrexia 14%. Anemia was associated problem in 100% of cases. Perinatal death rate was 27.2% (34) and maternal mortality rate was 4.8%. PPH, Preeclampsia, sepsis and anemia were important causes of maternal ill health in our population. Perinatal mortality was high.

  16. Reasons for admission and neonatal outcome in the neonatal care unit of a tertiary care hospital in Addis Ababa: a prospective study

    Directory of Open Access Journals (Sweden)

    Tekleab AM

    2016-03-01

    Full Text Available Atnafu Mekonnen Tekleab,1 Gesit Metaferia Amaru,1 Yemisrach Abeje Tefera21Department of Pediatrics and Child Health, 2Department of Public Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia Background: The neonatal mortality rate in Ethiopia remains greater than 35 per 1,000 live births. Hence, identifying the reasons for neonatal admission and mortality in a hospital setting is crucial to improve the quality of existing practices in the hospital. The objective of this study was to describe the reasons for admission and the magnitude of neonatal mortality in the neonatal care unit of St Paul's Hospital Millennium Medical College. Methods and subjects: A prospective cohort study was conducted. A total of 216 neonates who were admitted to the neonatal care unit of St Paul's Hospital Millennium Medical College from March 1, 2015, to May 31, 2015, were included in this study. Data fields, determined prospectively, were collected by monitoring the neonates until discharge or death. The independent variables were demographic, obstetric, and clinical characteristics, while the dependent variable was neonatal mortality. Data were analyzed using simple frequencies, odds ratio, and finally binary logistic regression analysis for mortality outcome. Results: The most common primary diagnoses at admission to the neonatal care unit were prematurity with respiratory problem (36.6%, neonatal sepsis (22.7%, and asphyxia (16.2%. Out of the 216 neonates studied, 50 (23.2% died. High case fatality was observed among neonates with the diagnosis of prematurity with respiratory problem (40.5% and asphyxia (40.0%. Under multivariate analysis, diagnosis of asphyxia was an independent predictor of mortality (adjusted odds ratio =5.817; 95% confidence interval: 1.611–20.977, while gestational age above the mean of the study population (36.6 weeks was protective of mortality (adjusted odds ratio =0.683; 95% confidence interval: 0.588–0

  17. An analytical framework for assessing drug and therapeutics committee structure and work processes in tertiary Brazilian hospitals.

    Science.gov (United States)

    Lima-Dellamora, Elisangela da Costa; Caetano, Rosângela; Gustafsson, Lars L; Godman, Brian B; Patterson, Ken; Osorio-de-Castro, Claudia Garcia Serpa

    2014-09-01

    University teaching hospitals usually provide tertiary care and are subject to early adoption of new technologies, which may compromise healthcare systems when uncritically adopted. Knowledge on the decision-making process - drug selection by drug selection committees or DTCs - is crucial to improve the quality of care. There are no models for studying the selection of drugs in Brazilian healthcare services. This study aims to discuss DTC structure and the processes regarding adoption of medicines in tertiary university hospitals in Brazil and to propose an analytical structure for providing direction for the future. State of the art content regarding drug selection processes and DTC procedures was reviewed in three databases. Information on the medicine selection process in a Brazilian gold standard teaching hospital was collected through observations and a review of existing procedures. A structured discussion on medicine selection and DTC procedures in tertiary hospitals ensued. This discussion resulted in findings that were organized in three dimensions, composing an analytical framework for the application in tertiary Brazilian hospitals (i) motivations for the adoption of drugs; (ii) necessary structural and organizational aspects for decision-making; and (iii) criteria and methods employed by the decision-making process. We believe that the suggested framework is compatible with tertiary Brazilian hospitals, because a gold standard in the country was able to conduct all its procedures in the light of WHO and international recommendations. We hope to contribute in producing knowledge which may hopefully be adopted in tertiary hospitals across Brazil. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  18. A study on feeding practice of under 6 months infants attending the Nutrition Clinic of a tertiary care hospital of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Prabha Shrivastava

    2013-06-01

    Full Text Available Background: while breast feeding is a natural act, it is also a learned behavior. The right technique of feeding in the right position is the key to success of breastfeeding.Methods: to assess the feeding practice including positioning, attachment and suckling of under 6 months’ infants, a cross-sectional study was undertaken at R. G. Kar Medical College and Hospital, India, among 99 mothers in 2010.Results: 59.8% mothers completed feeding from one breast before going to the next breast. 77.3% mothers alternated their breasts during subsequent feeds. 41.2% babies were well attached, 47.4% babies were correctly positioned.Conclusions: there is a need to teach the mothers  the techniques of correct positioning and attachment, especially, in the post natal period before discharge from the hospital after delivery. 

  19. Risk factors associated with carbapenemase-producing Klebsiella pneumoniae fecal carriage: A case-control study in a Spanish tertiary care hospital.

    Science.gov (United States)

    Madueño, Ana; González García, Jonathan; Ramos, Maria José; Pedroso, Yanet; Díaz, Zaida; Oteo, Jesus; Lecuona, María

    2017-01-01

    Asymptomatic colonization of the gastrointestinal tract by carbapenemase-producing Enterobacteriaceae is an important reservoir for transmission that may precede infection. This prospective, observational, case-control study was designed to identify risk factors for carbapenemase-producing Klebsiella pneumoniae (CPKP) fecal carriage. This study included 87 cases and 200 controls. Multivariate analysis identified length of stay (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.01-1.03; P = .03), previous hospitalization (OR, 5.89; 95% CI, 1.73-20.68; P = .01), antibiotic use (OR, 0.20; 95% CI, 0.65-0.62; P = .01), and corticosteroid use (OR, 0.33; 95% CI, 0.15-0.74; P = .007) as independent risk factors for CPKP rectal carriage. Length of hospital stay, previous hospitalization, corticosteroid use, and antimicrobial exposure are important risk factors for CPKP rectal colonization. Adherence to infection control practices and directed surveillance programs appear to be critical components for CPKP control programs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. A prospective, non-interventional study of assessment and treatment adequacy of pain in the emergency department of a tertiary care cancer hospital

    Directory of Open Access Journals (Sweden)

    P N Jain

    2013-01-01

    Full Text Available Introduction: Pain is the most common reason for emergency department (ED visits by the cancer patients. Treatment inconsistency and inadequacy are reported worldwide in the management of ED pain. We conducted a non-interventional observational study of 100 patients visiting ED with moderate to severe pain in a tertiary care cancer center. Aims: The goal of this study was to describe the characteristics of pain and its treatment by oncologists in ED. Materials and Methods: Management of 100 adult patients with complaints of moderate to severe pain was observed by the investigator in ED. Treatment was provided by the doctors of respective oncological services. Later, patients were interviewed by the investigator to collect data about the details of their pain and treatment adequacy. Results: On arrival to ED, about 65% patients reported severe pain, however no formal pain assessment was performed and no patient received strong opioids. Poor compliance for prescribed analgesic medications was noted in a large number of patients (31%, primarily due to suboptimal pain relief and lack of awareness. Protocol based analgesic treatment was non-existent in ED. Majority of patients remained in significant pain after 30 min of analgesic administration and 24% patients could never achieve more than 50% pain relief at the time of discharge. Conclusion: Due to lack of formal pain assessment and laid down protocols, suboptimal pain management is commonly prevalent in ED. Use of strong opioids continues to be scarce in management of severe pain. There is a need to formulate pain management protocols for ED pain.

  1. Drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children: 20 years study in a tertiary care hospital.

    Science.gov (United States)

    Techasatian, Leelawadee; Panombualert, Sunee; Uppala, Rattapon; Jetsrisuparb, Charoon

    2017-06-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe lifethreatening skin conditions. The most common cause of these manifestations is medications. Beside discontinued of the culprit drug, systemic corticosteroids were used as a primary treatment option among pediatric population. This study aimed to explore causative drugs (drug group/ latent period), treaments, complications, and treatment outcome (morbidity, mortality, length of hospital stay) of SJS and TEN in children. A retrospective chart was reviewed during the period of 1992 to 2012 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. SJS and TEN were clinically diagnosed and confirmed by pediatric dermatologists. Other possible causes other than druginduced SJS and TEN were excluded. A total of 30 patients was recorded, including 24 (80%) SJS patients and 6 (20%) TEN patients. The mean age was 6.9 years (SD 4.4). Male to female ratio was 1.5:1. Antiepileptic drug group was the most common causative drug (n=18, 60%), followed by antibiotic drug group (n=8, 26.6%), and others (n=4, 13.3%) which included nonsteroidal antiinflammtory drugs (NSAIDs) and chemotherapy drugs. Systemic corticosteroids were used in 29 patients (96.6%). Intravenous immunoglobulin was used in one TEN patient (3.3%). There was a medium correlation between time to treatment (systemic corticosteroids) and the length of hospital stay (Spearman correlation coefficient=0.63, P=0.005). Two TEN patients (6.6%) died. Carbamazepine was the most common causative drug of SJS and TEN in our study. The severity of skin detachment is not correlated to severity of ocular findings. However, the persistent of ocular complications up to one year is suggested for promptly appropriate ocular treatment in all SJS and TEN patients. Our data suggested that early administration of systemic corticosteroid may reduce the length of hospital stay and should be considered for the treatment of pediatric

  2. Validity of subjective global assessment as a screening method for hospital malnutrition. Prevalence of malnutrition in a tertiary hospital.

    Science.gov (United States)

    Moriana, Miriam; Civera, Miguel; Artero, Ana; Real, Jose T; Caro, Juan; Ascaso, Juan F; Martinez-Valls, Jose F

    2014-04-01

    Hospital malnutrition is a highly prevalent problem that affects patient morbidity and mortality resulting in longer hospital stays and increased healthcare costs. Although there is no single nutritional screening method, subjective global assessment (SGA) may be a useful, inexpensive, and easily reproducible tool. A cross-sectional, observational, randomized study was conducted in 197 patients in a tertiary hospital. SGA, anthropometric data, and biochemical parameters were used to assess the nutritional status of study patients. Fifty percent of subjects were malnourished according to SGA. A higher prevalence of malnutrition was found in medical (53%) as compared to surgical departments (47%). Half the subjects (50%) had malnutrition by SGA, but only 37.8% received nutritional treatment during their hospital stay. Mean hospital stay was longer for patients malnourished (13.5 days) or at risk of malnutrition (12.1 days) as compared to well nourished subjects (6.97 days). SGA significantly correlated (Pmalnutrition parameters. Prevalence of hospital malnutrition is very high in both medical and surgical departments and is inadequately treated. SGA is a useful tool for screening hospital malnutrition because of its high degree of correlation with anthropometric and biochemical parameters. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  3. A review of stroke admissions at a tertiary hospital in rural ...

    African Journals Online (AJOL)

    A review of stroke admissions at a tertiary hospital in rural Southwestern ... Background: Stroke is a common neurological disorder and is the third leading cause of ... Hypertension (85.2%), diabetes mellitus (23.8%), and tobacco smoking ...

  4. review article urinary tract infections in a tertiary hospital in abuja

    African Journals Online (AJOL)

    boaz

    URINARY TRACT INFECTIONS IN A TERTIARY HOSPITAL IN ABUJA, NIGERIA. Iregbu KC*,Nwajiobi-Princewill PI. Department of Medical Microbiology and Parasitology, National Hospital Abuja, P.M.B 425, Nigeria. *Corresponding Author: Iregbu KC, Department of Medical Microbiology, National Hospital, Abuja. Nigeria.

  5. The perception of safety culture among nurses in a tertiary hospital in Central Saudi Arabia.

    Science.gov (United States)

    Alonazi, Noufa A; Alonazi, Aisha A; Saeed, Elshazaly; Mohamed, Sarar

    2016-01-01

    Developing a patient safety culture was one of the recommendations made by the Institute of Medicine (IOM) to assist hospitals in improving patient safety. Nurses are the key to safety improvements in hospitals. It is necessary to know their awareness and perception regarding institutional safety climate. The aim of this study is to explore perceptions of patient safety among nursing staff in a tertiary hospital in Central Saudi Arabia in different discipline units. The current study was conducted at Prince Sultan Military Medical City (PSMMC), a tertiary center in Riyadh, Central Saudi Arabia. In November 2014, five hundred nurses were randomly selected to participate in this study. A survey questionnaire with Likert scale was adopted covering characteristics of participants together with their views on patient safety issues. Two hundred and twenty-four participants filled the questionnaire with a response rate of 44.8%. The overall perception of patient safety among participants was (57.9%). The majority (74.1%) thought that the existing system is good at preventing errors and only one third indicated that they have patient safety problems. Most of the participants were happy with the existing patient safety culture including organizational learning/continuous improvement (95.5%), and errors feedback and communication (76.64%). In conclusion, this study showed that perception of patient safety was sub-optimal among nurses and there are several areas for improvement regarding safety culture.

  6. Health Literacy Levels among Outpatients at a Tertiary Hospital in Delhi, India

    Directory of Open Access Journals (Sweden)

    Monika Sahoo

    2015-03-01

    Full Text Available Background: Health literacy is defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health. This study was conducted to determine health literacy levels and the associated factors among patients attending the outpatient departments of a tertiary care hospital in Delhi. Methods: A hospital-based cross-sectional study was carried out in a tertiary care teaching hospital in Delhi over a period of four months. A total of 150 patients were included in the study. Fifty patients from the Diabetes Clinic, 50 patients from the Hypertension Clinic, and 50 patients with anemia from the Antenatal Outpatient Department (OPD were selected using a convenience sampling method. Data was analyzed using Epi Info software. Statistical analysis was conducted with the chi-square test and the Fisher’s exact test. P values less than 0.05 were considered significant. Results: Out of 50 diabetic subjects, 37 (74% understood the information about their blood sugar levels as explained to them by the doctor. Similar results were found among hypertensive subjects as well. Furthermore, education status was significantly associated with health literacy. In terms of understanding the regimen of medications, significant association was seen with age, sex, and education. Conclusion: Education status, age, and gender are important determinants of health literacy. Our results support that innovative strategies of communication should be used to improve health literacy among patients.

  7. Nosocomial bloodstream infections in a Finnish tertiary care hospital: a retrospective cohort study of 2175 episodes during the years 1999-2001 and 2005-2010.

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    Huttunen, Reetta; Åttman, Emilia; Aittoniemi, Janne; Outinen, Tuula; Syrjänen, Jaana; Kärki, Tommi; Lyytikäinen, Outi

    2015-01-01

    Nosocomial infections are major causes of morbidity in hospitalized patients. Retrospective laboratory-based surveillance during 1999-2001 and 2005-2010 identified 2175 cases of nosocomial bloodstream infections (BSIs) in Tampere University Hospital (TAUH), Finland. Analysis revealed that 57% of BSIs were caused by a gram-positive organism, 27% by a gram-negative organism, 5% by a fungal organism, and 11% were polymicrobial. The most common cause of nosocomial BSI was coagulase-negative staphylococci (23%). Candida species caused 5% of the infections. The 7-day and 30-day case fatalities were 8% (161/2158) and 15% (313/2175), respectively, and were highest in BSIs caused by Candida albicans (22% and 44%) and Pseudomonas aeruginosa (17% and 25%). The median age of patients was 54 years in 1999-2001, 57 years in 2005-2007, and 60 years in 2008-2010 (p nosocomial BSI decreased during the years studied: 7-day and 30-day case fatalities were 9% and 16% during 1999-2001, 8.5% and 16% during 2005-2007, and 5% and 12% during 2008-2010, respectively (p infections predominate in nosocomial BSIs. The median age of patients with nosocomial BSI has risen during the study years. The case fatality associated with nosocomial BSI has decreased.

  8. Employees' Assessment of Leadership in a Tertiary Hospital in ...

    African Journals Online (AJOL)

    Background/Objective: There is some evidence that weak leadership in health institutions contributes to underutilization of health services, resulting in high levels of morbidities and mortalities. Employee-rated leadership gaps in a hospital, as done in this study, can promote employee engagement in leadership capacity ...

  9. Cervical epithelial changes in a tertiary hospital in northern Nigeria ...

    African Journals Online (AJOL)

    Methodology: This was a cross sectional study conducted among patients that presented for cervical cancer screening at the Jos University Teaching Hospital, Jos, Plateau State, North Central Nigeria over a Five-year period (1st August, 2006-31st July, 2011). Data was analyzed for frequencies using EPI Info 3.5.1, CDC, ...

  10. Spectrum of glaucoma presentation in a Nigerian Tertiary Hospital ...

    African Journals Online (AJOL)

    Purpose: The aim of this study was to report the types and severity of glaucoma at presentation in patients attending the glaucoma clinic of the University College Hospital, Ibadan, Nigeria. This information will help in designing an awareness and management strategy that will help in reducing glaucoma blindness. Materials ...

  11. Incidence of Epistaxis in a Tertiary Hospital in Ghana | Awuah ...

    African Journals Online (AJOL)

    Epistaxis is defined as bleeding from the nasal cavity. It is a very common Otorhinolaryngological problem that often presents as an emergency to the outpatient departments of most hospitals worldwide. Its true incidence is often very difficult to assess. This study was aimed at analyzing aetiology, treatment and management ...

  12. Monitoring of antibiotic consumption and development of resistance by enterobacteria in a tertiary care hospital.

    Science.gov (United States)

    Veličković-Radovanović, R; Stefanović, N; Damnjanović, I; Kocić, B; Antić, S; Dinić, M; Petrović, J; Mitić, R; Catić-Djordjević, A

    2015-08-01

    Antibiotics are the most frequently used drugs in hospitalized patients, but studies have shown that the prescribed antibiotics may be inappropriate and may contribute to antibiotic resistance. We carried out a survey of antibiotic consumption and antibiotic resistance in our tertiary care university hospital, from 2005 to 2013. We focus on cephalosporins, one of the most prescribed groups of antibiotics in the tertiary health care. The objective was to identify any relationship between ceftriaxone consumption and resistance by enterobacteria. Antibiotics consumption and antimicrobial resistance were monitored in the tertiary care university hospital from 2005 to 2013. Data on the use of antibiotics in surgical inpatients were obtained and expressed as defined daily doses per 100 bed days. Bacterial resistances were given as percentages of resistant isolates. There was an increasing trend in cephalosporins consumption from 9·56 DBD (2005) to 23·32 DBD (2013), with ceftriaxone as the most frequently used cephalosporin, 3·6 DBD (2005) to 10·78 DBD (2013). E. coli and P. mirabilis resistance to ceftriaxone increased significantly from 22% in 2005 to 47% in 2013 and from 31% in 2005 to 60% in 2013, respectively. We found a significant correlation between ceftriaxone consumption and E. coli resistance (r = 0·895, P < 0·05). Our study shows that cephalosporin consumption increased from 2005 to 2013, with ceftriaxone as the most prescribed antibiotic. E. coli and P. mirabilis resistance to ceftriaxone increased significantly over the study period. E. coli resistance increased with ceftriaxone consumption. © 2015 John Wiley & Sons Ltd.

  13. AN AUDIT OF PRESCRIPTION FOR ANTIBIOTIC IN A TERTIARY CARE HOSPITAL IN KOLKATA, INDIA

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    Anjan Adhikari

    2012-12-01

    Full Text Available Antibiotics are most commonly prescribed drugs in tertiary care hospitals; more than 30% of the hospitalised patients were treated with antibiotics. Rational use of antibiotics is very important to ensure the optimum treatment outcomes and to limit the emergence of bacterial resistance. Present study is a hospital based cross-sectional study carried out for a period of three months in different clinical departments of a tertiary care hospital to find out the antibiotics prescribing pattern. Out of total 551 evaluated prescriptions, an antibiotic was prescribed in 45.5% cases. The most commonly prescribed antibiotics were Moxifloxacin 19.5%, Metronidazole 10.4% and Amoxicillin+Cloxacillin 10.2%, broad spectrum antibiotics usage was higher & 87.7% of the antibiotics were prescribed by brand names. The appropriate use of antibiotic is a greatest need of the current situation all over the world. The rising antibiotic resistance is a global problem which is directly related with the irrational prescription of antibiotics.

  14. A STUDY ON ADVERSE DRUG REACTIONS INVOLVING CENTRAL NERVOUS SYSTEM, ITS SEVERITY AND CAUSALITY ASSESSMENT IN PEDIATRIC PATIENTS ADMITTED TO A TERTIARY CARE HOSPITAL

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    Arati

    2015-09-01

    Full Text Available A retrospective study was conducted in Department of pediatrics SCB Medical College and SVPPGIP for a period of 2 years i.e. September 2012 to August 2014 . All the patients from birth to 14 years admitted to the pediatric ward in this study were under ADR surveillance. Patients admitted to our hospital with adverse drug reaction o r patients developing adverse drug reaction in our hospital were studied; only those cases where the central nervous system was involved were taken in our study. The cases were compiled and the causality of offending drugs was found using WHO - UMC causality assessment score. The severity of drug reaction in every case was determined by using HARTWIG’s severity scoring scale. Total 350 Adverse reactions were reported in this period with prevalence rate of 2.04% i.e. 20 out of 1000 children faced ADR due to dr ugs, with annual incidence rate of 0.9% and 1.14% over two years. Out of total 350 cases dermatological system was most commonly involved i.e. 207 cases (59.14%. This is followed by involvement of central nervous system 46 number of cases (13.14%. The GI system was involved in 34 cases i.e. (9.71%. Life threatening reactions like anaphylaxis, angioedema and shock like immediate life threatening ADRs were reported in 16 cases. Our study group was the patient in whom the ADR involved the CNS. Out of 46 suc h cases, there were 25 female and 21 male. Various reaction due to drug were encephalopathy , eps, febrile seizure, tremor, head reeling, ototoxicity, persistant cry, pseudotumor cerebri, psychosis, seizure, status epilepticus, toxic amblyopia, tremor, atax ia etc. The most common CNS manifestation was Extra pyramidal side effects (EPS involving 21% of cases. The most common Drug causing CNS manifestation was ATT (HRZE causing blindness, Eps, psychosis , toxic amblyopia blindness etc.

  15. Comparison of the Results of Cox Proportional Hazards Model and Parametric Models in the Study of Length of Stay in A Tertiary Teaching Hospital in Tehran, Iran

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    Ali Zare

    2011-10-01

    Full Text Available Survival analysis is a set of methods used for analysis of the data which exist until the occurrence of an event. This study aimed to compare the results of the use of the semi-parametric Cox model with parametric models to determine the factors influencing the length of stay of patients in the inpatient units of Women Hospital in Tehran, Iran. In this historical cohort study all 3421 charts of the patients admitted to Obstetrics, Surgery and Oncology units in 2008 were reviewed and the required patient data such as medical insurance coverage types, admission months, days and times, inpatient units, final diagnoses, the number of diagnostic tests, admission types were collected. The patient length of stay in hospitals leading to recoverys was considered as a survival variable. To compare the semi-parametric Cox model and parametric (including exponential, Weibull, Gompertz, log-normal, log-logistic and gamma models and find the best model fitted to studied data, Akaike's Information Criterion (AIC and Cox-Snell residual were used. P<0.05 was considered as statistically significant. AIC and Cox-Snell residual graph showed that the gamma model had the lowest AIC (4288.598 and the closest graph to the bisector. The results of the gamma model showed that factors affecting the patient length of stay were admission day, inpatient unit, related physician specialty, emergent admission, final diagnosis and the number of laboratory tests, radiographies and sonographies (P<0.05. The results showed that the gamma model provided a better fit to the studied data than the Cox proportional hazards model. Therefore, it is better for researchers of healthcare field to consider this model in their researches about the patient length of stay (LOS if the assumption of proportional hazards is not fulfilled.

  16. Evaluation of nurses' workload in intensive care unit of a tertiary care university hospital in relation to the patients' severity of illness: A prospective study.

    Science.gov (United States)

    Kraljic, Snjezana; Zuvic, Marta; Desa, Kristian; Blagaic, Ana; Sotosek, Vlatka; Antoncic, Dragana; Likic, Robert

    2017-11-01

    Costs of intensive care reach up to 30% of the hospital budget with workforce expenses being substantial. Determining proper nurse-patient ratio is necessary for optimizing patients' health related outcomes and hospitals' cost effective functioning. To evaluate nurses' workload using Nine Equivalents of Nursing Manpower Use Score and Nursing Activities Score scoring systems while assessing correlation between both scores and the severity of illness measured by Simplified Acute Physiology Score II. A Prospective study SETTINGS: Cardiac Surgery Intensive Care Unit of the Clinical Hospital Centre Rijeka, Croatia, from October 2014 to February 2015. This Intensive Care Unit has 3 beds that can be expanded upon need. The study included 99 patients treated at this Unit during the study's period. The scores were obtained by 6 nurses, working in 12h shifts. Measurements were obtained for each patient 24h after admission and subsequently twice a day, at the end of the day shift (7pm) and at the end of the night shift (7 am). The necessary data were obtained from the patient's medical records. Nursing Activities Score showed significantly higher number of nurses are required for one 12h shift (Z=3.76, p<0.001). Higher scores were obtained on day shifts vs. night shifts. (Nursing Manpower Use Score, z=3.25, p<0.001; Nursing Activities Score, z=4.16, p<0.001). When comparing Nursing Activities Score and Nursing Manpower Use Score during the week, we calculated higher required number of nurses on weekdays than on weekends and holidays, (Nursing Manpower Use Score, p<0.001; Nursing Activities Score, p<0.001). Correlation analysis of Nursing Activities Score and Nursing Manpower Use Score with Simplified Acute Physiology Score II has shown that Nursing Manpower Use Score positively associated with severity of disease, while Nursing Activities Score shows no association. Both scores can be used to estimate required number of nurses in 12-h shifts, although Nursing Activities Score

  17. Economic burden of inflenza at a tertiary hospital in Vietnam

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    Trung Quang Vo

    2017-03-01

    Full Text Available Objective: To estimate cost of illness based on provider perspective of influenza treatment at Hospital of Tropical Diseases, Ho Chi Minh city. Methods: A retrospective study was conducted between January 2013 and December 2015 at Hospital of Tropical Diseases, Ho Chi Minh City. Demographic and clinical information was collected from medical records. Treatment cost was composed of cost of hospital bed, diagnosis test, X-ray/imaging, operation, pharmaceuticals and consumable materials. Results: Average cost per episode of all aged group was (112.58 ± 239.60 USD, the highest cost was contributed by adults group [(313.28 ± 560.5 USD],whereas the lowest cost was children group [(80.62 ± 120.80 USD]. According to high risk factor group, the average cost per day is 42.14 USD for any cardiovascular disorders group; diabetes-cardiovascular patient (41.15 USD, and elderly patient groups (48.52 USD. Conclusions: Direct medical cost of influenza-related hospitalizations imposes a heavy burden on patients and their families in Vietnam. Further study is needed to provide more comprehensive evidence on the economic burden of influenza.

  18. Neuroprotective body hypothermia among newborns with hypoxic ischemic encephalopathy: three-year experience in a tertiary university hospital. A retrospective observational study

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    Mauricio Magalhães

    Full Text Available CONTEXT AND OBJECTIVE:Neonatal hypoxic-ischemic encephalopathy is associated with high morbidity and mortality. Studies have shown that therapeutic hypothermia decreases neurological sequelae and death. Our aim was therefore to report on a three-year experience of therapeutic hypothermia among asphyxiated newborns.DESIGN AND SETTING:Retrospective study, conducted in a university hospital.METHODS:Thirty-five patients with perinatal asphyxia undergoing body cooling between May 2009 and November 2012 were evaluated.RESULTS:Thirty-nine infants fulfilled the hypothermia protocol criteria. Four newborns were removed from study due to refractory septic shock, non-maintenance of temperature and severe coagulopathy. The median Apgar scores at 1 and 5 minutes were 2 and 5. The main complication was infection, diagnosed in seven mothers (20% and 14 newborns (40%. Convulsions occurred in 15 infants (43%. Thirty-one patients (88.6% required mechanical ventilation and 14 of them (45% were extubated within 24 hours. The duration of mechanical ventilation among the others was 7.7 days. The cooling protocol was started 1.8 hours after birth. All patients showed elevated levels of creatine phosphokinase, creatine phosphokinase- MB and lactate dehydrogenase. There was no severe arrhythmia; one newborn (2.9% presented controlled coagulopathy. Four patients (11.4% presented controlled hypotension. Twenty-nine patients (82.9% underwent cerebral ultrasonography and 10 of them (34.5% presented white matter hyper-echogenicity. Brain magnetic resonance imaging was performed on 33 infants (94.3% and 11 of them (33.3% presented hypoxic-ischemic changes. The hospital stay was 23 days. All newborns were discharged. Two patients (5.8% needed gastrostomy.CONCLUSION:Hypothermia as therapy for asphyxiated newborns was shown to be safe.

  19. Extrapulmonary tuberculosis: a retrospective review of 194 cases at a tertiary care hospital in Karachi, Pakistan.

    Science.gov (United States)

    Chandir, Subhash; Chandir, Subash; Hussain, Hamidah; Salahuddin, Naseem; Amir, Mohammad; Ali, Farheen; Lotia, Ismat; Khan, Amir Javed

    2010-02-01

    To describe the types and treatment outcomes of the extra-pulmonary tuberculosis (EPTB) cases in a tertiary care hospital in a high burden tuberculosis country. A retrospective case series study was conducted at Liaquat National Hospital (LNH), the largest private tertiary care hospital in Karachi, Pakistan. All cases diagnosed and treated as EPTB between November 2005 and February 2007 were included. Data was retrieved from medical records on demographics, clinical, laboratory, and outcome status. A total of 194 patients treated for EPTB were identified. Mean age of patients was 34 +/- 16.4 years, and 75% of patients were female. Lymph nodes and spine were the most common sites involved (60%). The cure rate was 40.7%. There was no difference in cure rate of males and females (p=0.99). EPTB is an important clinical problem in Pakistan. Due to lack of guidelines for diagnosis and duration of treatment in EPTB most physicians in Pakistan treat patients based on clinical symptoms and for prolonged duration of 12, to even as long as 24 months. The National TB Program, and chest and infectious disease societies must develop standardized guidelines for the diagnosis and treatment of EPTB.

  20. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman

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    Zena Al-Sharbati

    2012-02-01

    Full Text Available Objectives: There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. Methods: An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. Results: The majority of referrals were females (59%, aged 18–34 years, employed (38%, had ≤12 years of formal education (51%, and were single (54%. A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder, while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn, contemptuous envy (Hassad, evil eye (Ain and sorcery (Sihr which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Conclusion: Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

  1. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman.

    Science.gov (United States)

    Al-Sharbati, Zena; Hallas, Claire; Al-Zadjali, Hazar; Al-Sharbati, Marwan

    2012-02-01

    There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. The majority of referrals were females (59%), aged 18-34 years, employed (38%), had ≤12 years of formal education (51%), and were single (54%). A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder), while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn), contemptuous envy (Hassad), evil eye (Ain) and sorcery (Sihr) which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

  2. Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

    Science.gov (United States)

    Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum concentrations of IL-6 in subgroups of well-nourished and malnou...

  3. STUDY OF CERVICAL PAP SMEAR STUDY AND ITS UTILITY IN CANCER SCREENING- AN EXPERIENCE IN A TERTIARY CARE HOSPITAL OF TRIPURA, NORTH EASTERN STATE OF INDIA

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    Sutanuka Khasnabish

    2017-06-01

    Full Text Available BACKGROUND Cancer of cervix is a global health problem and is a leading cause of morbidity and mortality of women in India. It is one of the most preventable and curable of all cancers. Simple, noninvasive screening procedures like Papanicolaou smears can help in detection and quick and effective timely treatment. The objective of the study is to assess the role of Pap smear in detecting premalignant, malignant and nonneoplastic lesions of cervix in our institute. MATERIALS AND METHODS This is a one year prospective and four year retrospective study of 1,349 women in age group of 20-80 years carried over a period of 5 years from January 2012-December 2016 in the cytology wing of Department of Pathology, Tripura Medical College. Patients clinically presenting with dyspareunia, postcoital bleeding, vaginal bleeding, frothy vaginal discharge with itching and pain in hypogastrium were included in the study. Samples were collected under direct vision of Cusco’s speculum and transferred to glass slides, fixed and stained by Papanicolaou stain and were examined and reported. Reporting was done as per Bethesda system. RESULTS A total of 1,349 number of cases were screened, out of which 639 number of patients had abnormal Pap smears and 13.63% had unsatisfactory or inadequate samples. LSIL was the most common premalignant lesion with 113 (8.37% number of cases, SCC in 39 (5.2% number of cases, ASCUS in 15 (1.11% and adenocarcinoma in 2 (0.14% number of cases. CONCLUSION It was found that premalignant and malignant lesion in cervix is not uncommon in our setup and Pap smear appears to be an elementary, economical, safe and yet highly sensitive screening test for early detection of various cervical lesions.

  4. Estimation of Need for Palliative Care among Noncancer Patients Attending a Tertiary Care Hospital.

    Science.gov (United States)

    Prasad, Parvathy; Sarkar, Sonali; Dubashi, Biswajit; Adinarayanan, S

    2017-01-01

    Palliative care services, until recently, were mainly restricted to cancer patients with incurable diseases. Hence, evaluative studies of palliative care are sparse in areas other than oncology. To estimate what proportion of patients attending the Departments of Neurology, Cardiology, and Nephrology of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, required palliative care and to identify the palliative care needs of those patients. This was an exploratory descriptive study conducted in the three departments of JIPMER. There was no predetermined sample size for the study. The participants were all adult inpatients and outpatients who were in need of palliative care in the departments of Cardiology, Nephrology, and Neurology on the day of study. Percentage distribution was used to analyze the categorical variables such as education, gender, age, patients in need of palliative care, and their needs. The study showed that one in ten non-cancer patients in tertiary care hospitals may require palliative care services. Apart from issues in physical domain, a substantial proportion of participants also had issues in the psychological, emotional, and financial domains. This study highlights the need for incorporation and initiation of palliative care services in other non-cancer specialties in tertiary care hospitals to ensure holistic management of such cases. Counseling service has also to be rendered as part of palliative care since a good share of the patients had psychological and emotional issues.

  5. Association between stage at diagnosis and knowledge on cervical cancer among patients in a Kenyan tertiary hospital: a cross-sectional study.

    Science.gov (United States)

    Wamburu, Kabura; Busakhala, Naftali; Owuor, Kevin; Nyagero, Josephat

    2016-01-01

    In Kenya, cervical cancer is the second most common cancer among women; almost half of all women with invasive cervical cancer are diagnosed at a late stage. Few women are aware of the symptoms and risk factors of cervical cancer and that its precursor lesions are detectable through screening thus most women seek treatment when the cancer is at an advanced stage. The study explored the influence of cervical cancer awareness on stage at diagnosis in patients attending Kenyatta National Hospital. A cross-sectional survey was adapted to obtain socio-demographic information, knowledge on symptoms and risk factors from 361 women with histological diagnosis of cervical cancer conveniently sampled at Kenyatta National Hospital. Associations between stage at diagnosis and knowledge on cervical cancer were tested using chi-square statistic and fisher's exact test at 95% confidence interval. Seven in every 10 women (72.6%) presented with advanced stage cervical cancer. Knowledge on the sexually transmitted nature of cervical cancer was inadequate, 22% of women with early stage and 23.7% of women with advanced stage cervical cancer (p=0.874). Majority of the women were not aware of the causative link between cervical cancer and human papillomavirus (HPV), 8 (13.1%) of women with early stage and 5 (3.5%) of women with advanced stage cervical cancer (p=0.036). Stage at presentation was advanced and knowledge on the role of a sexually transmitted virus in the cervical cancer aetiology was poor among the women. Increasing screening programs and providing information highlighting this association is necessary.

  6. Clinical characteristics and pregnancy outcomes of Syrian refugees: a case-control study in a tertiary care hospital in Istanbul, Turkey.

    Science.gov (United States)

    Erenel, Hakan; Aydogan Mathyk, Begum; Sal, Veysel; Ayhan, Isil; Karatas, Suat; Koc Bebek, Arzu

    2017-01-01

    We aimed to compare the clinical characteristics and pregnancy outcomes in women who are Syrian refugees and Turkish women who are non-refugees at a maternity center in Istanbul, Turkey. A total of 600 singleton pregnancies who delivered at Sisli Hamidiye Etfal Training and Research Hospital were included in the study. Demographic data, obstetrical history, clinical findings, obstetrical and neonatal outcomes were compared between 300 Syrian refugees and 300 control patients. The Syrian refugee patients were significantly younger than Turkish patients. The percentage of adolescents aged 12-19 years were significantly higher in the Syrian patients (14.3 vs. 5.3 %, p refugee patients had no antenatal care. However, this ratio was only 7.7 % for the control group (p refugee control patients, refugee women in our study had poor antenatal care but no adverse perinatal outcomes were observed. Further larger multicenter studies may provide more convincing data about obstetric outcomes in the Syrian refugee population as well as adolescent pregnancies in this population.

  7. Caregivers' Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal.

    Science.gov (United States)

    Neupane, Dipika; Dhakal, Sarmila; Thapa, Sabita; Bhandari, Parash Mani; Mishra, Shiva Raj

    2016-01-01

    Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual's and their caregiver's physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers' attitude towards people with mental illness and perceived stigma. We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out. Overall median score for the domains: attitude (score range: 18-90) and perceived stigma (score range: 12-60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (pmental illness (pstigma score varied significantly by caregiver's sex (pmental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver's relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma.

  8. Discovery of outpatient care process of a tertiary university hospital using process mining.

    Science.gov (United States)

    Kim, Eunhye; Kim, Seok; Song, Minseok; Kim, Seongjoo; Yoo, Donghyun; Hwang, Hee; Yoo, Sooyoung

    2013-03-01

    There is a need for effective processes in healthcare clinics, especially in tertiary hospitals, that consist of a set of complex steps for outpatient care, in order to provide high quality care and reduce the time cost. This study aimed to discover the potential of a process mining technique to determine an outpatient care process that can be utilized for further improvements. The outpatient event log was defined, and the log data for a month was extracted from the hospital information system of a tertiary university hospital. That data was used in process mining to discover an outpatient care process model, and then the machine-driven model was compared with a domain expert-driven process model in terms of the accuracy of the matching rate. From a total of 698,158 event logs, the most frequent pattern was found to be "Consultation registration > Consultation > Consultation scheduling > Payment > Outside-hospital prescription printing" (11.05% from a total cases). The matching rate between the expert-driven process model and the machine-driven model was found to be approximately 89.01%, and most of the processes occurred with relative accuracy in accordance with the expert-driven process model. Knowledge regarding the process that occurs most frequently in the pattern is expected to be useful for hospital resource assignments. Through this research, we confirmed that process mining techniques can be applied in the healthcare area, and through detailed and customized analysis in the future, it can be expected to be used to improve actual outpatient care processes.

  9. Characteristics and Outcomes of Patients Readmitted to The Medical Intensive Care Unit: A Retrospective Study in a Tertiary Hospital in Taiwan

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    Ching-Lung Liu

    2017-12-01

    Conclusion: Readmitted ICU patients, especially the geriatric group, had a very poor prognosis. The worsened APACHE score might be a good predictor for readmission survival. The Charlson score was an important hospital survival predictor.

  10. Multiple hospitalizations at the Department of Internal Medicine of a tertiary hospital.

    Science.gov (United States)

    Etxeberria-Lekuona, D; Casas Fernández de Tejerina, J M; Méndez López, I; Oteiza Olaso, J; Arteaga Mazuelas, M; Jarne Betran, V

    2015-01-01

    Patient who require multiple hospitalizations result in a considerable consumption of healthcare resources. In this study, we analyzed the factors associated with the multiple hospitalizations of a cohort of patients treated at a department of internal medicine. A total of 613 consecutive hospitalizations were analyzed. A multiple-hospitalization patient was defined as one who at the time of admission had been hospitalized 3 or more times in the past year. We analyzed the relationship between demographic, clinical and societal factors on one hand and having been hospitalized on multiple occasions on the other. We also analyzed readmissions in the 6 months after discharge, as well as mortality during the hospitalization and in the 6 and 12 months after discharge. When compared with patients who have not been hospitalized on multiple occasions, multiple-hospitalization patients are more likely to be male, younger and to have greater comorbidity, greater consumption of medicines and higher Katz Index scores. The main cause for admission for multiple-hospitalizations patients was chronic disease decompensation (87.3%). The diseases that were most obviously associated with multiple hospitalizations were heart failure, diabetes mellitus and chronic obstructive pulmonary disease. In the first 6 months after discharge, multiple-hospitalization patients had a greater number of readmissions. During the study period, 40.4% of the multiple-hospitalization patients died, and 28.8% of the nonmultiple-hospitalization patients died. Multiple-hospitalization patients have a greater clinical complexity than nonmultiple-hospitalization patients, and multiple hospitalizations are associated with chronic diseases, polypharmacy, functional impairment and high mortality rates. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  11. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India

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    Sandeep Kumar Gupta

    2016-01-01

    Full Text Available Background: The promotional activities by medical representatives (MRs of the pharmaceutical companies can impact the prescribing pattern of doctors. Hence, the interaction between doctors and the pharmaceutical industry is coming under increasing scrutiny. Objective: The primary objective was to assess the attitude of the doctors toward the interaction with the MRs of the pharmaceutical company. The secondary objective was to assess the awareness of the doctors about regulations governing their interaction with the pharmaceutical company. Materials and Methods: This was a cross-sectional study. This study was carried out using a pretested questionnaire containing 10 questions between June and September 2014. The doctors working in the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur (Tamil Nadu during the study period was included. Results: A total of 100 pretested questionnaires were distributed, and 81 doctors responded (response rate 81%. 37% doctors responded that they interacted with MR once a week whereas 25.9% told that they interact with MRs twice a month. About 69.1% doctors think that MR exaggerate the benefits of medicines and downplays the risks and contraindications of medicine(P = 0.000. 61.7% doctors think that MR has an impact on their prescribing (P = 0.000. 63% doctors stated that they had received promotional tools such as stationery items, drug sample, textbooks or journal reprints from MR in last 12 months (P = 0.0012. Unfortunately, 70.4% doctors have not read the guidelines about interacting with the pharmaceutical industry or its representative (P = 0.000. Conclusion: Rather than forbidding any connection between doctors and industry, it is better to establish ethical guidelines. The Medical Council of India code is a step in the right direction, but the majority of doctors in this study have not read the guidelines about interacting with the pharmaceutical industry or its representative.

  12. Primary salivary gland tumors in eastern Nepal tertiary care hospital.

    Science.gov (United States)

    Nepal, A; Chettri, S T; Joshi, R R; Bhattarai, M; Ghimire, A; Karki, S

    2010-04-01

    The knowledge of the distribution and pattern of salivary gland tumors in the tertiary care center can provide overview of the disease pattern in the region. It also helps in planning the strategies to treat the disease and launch the awareness program in the community to this largely curable disease. A retrospective observational study of all the salivary gland tumors treated in the department of Otolaryngology, B. P. Koirala Institute of Health Sciences during April 2004 to March 2009 was done. Age, sex, presenting features, radiological findings, histopathological type of the tumor and type of surgery were recorded and descriptive analysis was done to calculate frequencies, percentage and their relations. Out of total 51 cases, 81% (n=41) were benign and 19% (n=10) malignant tumors. Male to female ratio was 1:2.1. Mean age for benign and malignant tumors were 32.3 and 46.5 years respectively. Parotid tumor outnumbered all other sites comprising 69%, followed by submandiibular 18% and minor glands 13%. Pleomorphic adenoma was the commonest tumor (76%) of all primary salivary gland tumors. Benign to malignant tumor ratio of parotid, submandibular and minor glands were 6:1, 3.5:1 and 1.3:1 respectively. Adenoid cystic carcinoma (40%) and mucoepidermoid carcinoma (30%) were commonest malignant tumors. The principal site for salivary gland tumors in eastern Nepal population was the parotid and the pleomorphic adenoma outnumbered all other tumors. Most of the cases in both benign and malignant group presented with painless lump often misleading the gravity of disease.

  13. A Study of impact of Education onAwareness, Personal Hygiene and Practices of food handlers of a Tertiary Care Hospital in Kashmir, India

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    Pandita K.K

    2013-01-01

    Full Text Available Background Each year 9.4 million people suffer from food borne diseases throughout the world; everyday cases related to food borne diseases are recorded in all countries from the most to the least developed ones. A major risk of food contamination lies with the food handlers.Several food borne disease outbreaks have been reported to have been associated with poor personal hygiene of people handling food stuffs. Method A questionnaire was structured for the purpose of data collection to find out effect of educational background on personal hygiene, awareness regarding transmission of food borne infections and routine practices among food handler of the food establishments of a super speciality teaching hospital of Kashmir. Results Out of 121 respondents (33.05 percent cooks, 42.97 percent stewards and 23.97 percent dishwashers, 90.90 percent were males and 9.10 percent females. Majority (90.90 percent have educational background below high school level (group B and the rest (9.10% have education above 10th standard (group A. Soap was used by majority(90.9% of group A in comparison to group B(59.1% before entering kitchen.72.7% of group A employees change their shoes and use kitchen slippers in the kitchen, whereas only 31.8% of group B employees do so and the rest(68.2% do not change the foot wear before entering the kitchen.While 81.8% of group A employees responded that diarrhoeal diseases spread by contaminated food,majority of group B(62.7% responded other reasons.81.8% of group A feel it necessary to chlorinate or filter visibly clean water, whereas only 52.7% of group B feel so. Conclusion Food handlers of any food establishment, in particular hospital kitchen should have high standard of educational background to have enough awareness regarding food borne diseases and importance ofpersonal hygiene to prevent transmission of diseases. Because of poor educational background, the food handlers in our study didn’t know the importance of use

  14. Culture of Safety among Nurses in a Tertiary Teaching Hospital in ...

    African Journals Online (AJOL)

    Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...

  15. Acute mesenteric ischemia: experience in a tertiary care hospital.

    Science.gov (United States)

    Hussain, Dildar; Sarfraz, Shahid Latif; Baliga, Suresh K; Hartung, Rolf

    2009-01-01

    Acute mesenteric ischemia is an abdominal catastrophe. This has been described as a complex of diseases rather than a single clinical entity. The incidence in United States is 1 in 1000 hospital admissions. The objective of this descriptive study was to determine the clinical presentations and out come after surgery of patients with acute mesenteric ischemia. It was conducted at Dubai Hospital, Dubai, United Arab Emirates. All patients having per operative or histopathological diagnosis of acute mesenteric ischemia from 2002 to 2006 were included. There were 16 patients in all. Their mean age was 51 years, 12 were male and 4 were female. Abdominal pain was present in 16 patients, vomiting in 12 and anorexia in 9 patients. Abdominal tenderness was present in 16 patients, abdominal distension and rebound tenderness in 12 patients. Five patients had hypertension, 4 had myocardial infarction and 4 had diabetes mellitus as risk factors. X-Ray abdomen was done in 13 patients, Ultrasound in 9 and CT Scan in one patient. Resection of bowel was done in 14 patients. Post operatively 5 patients developed pneumonia, 3 had wound dehiscence, 3 had sepsis, and 3 had Lower GI bleeding. Five patients were expired after surgery in the hospital. Four patients were lost to follow up. We should have a high index of suspicion for mesenteric ischemia in patients with unexplained abdominal pain. Early diagnosis and prompt surgical intervention improves the outcome.

  16. Efficacy and Safety of Intravenous Ferric Carboxymaltose in Geriatric Inpatients at a German Tertiary University Teaching Hospital: A Retrospective Observational Cohort Study of Clinical Practice

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    Matthias Bach

    2015-01-01

    Full Text Available Current iron supplementation practice in geriatric patients is erratic and lacks evidence-based recommendations. Despite potential benefits in this population, intravenous iron supplementation is often withheld due to concerns regarding pharmacy expense, perceived safety issues, and doubts regarding efficacy in elderly patients. This retrospective, observational cohort study aimed to evaluate the safety and efficacy of intravenous ferric carboxymaltose (FCM, Ferinject in patients aged >75 years with iron deficiency anaemia (IDA. Within a twelve-month data extraction period, the charts of 405 hospitalised patients aged 65–101 years were retrospectively analysed for IDA, defined according to WHO criteria for anaemia (haemoglobin: <13.0 g/dL (m/<12.0 g/dL (f in conjunction with transferrin saturation <20%. Of 128 IDA patients screened, 51 (39.8% received intravenous iron. 38 patient charts were analysed. Mean cumulative dose of intravenous FCM was 784.4 ± 271.7 mg iron (1–3 infusions. 18 patients (47% fulfilled treatment response criteria (≥1.0 g/dL increase in haemoglobin between baseline and hospital discharge. AEs were mild/moderate, most commonly transient increases of liver enzymes (n = 5/13.2%. AE incidence was comparable with that observed in patients <75 years. No serious AEs were observed. Ferric carboxymaltose was well tolerated and effective for correction of Hb levels and iron stores in this cohort of IDA patients aged over 75 years.

  17. Dermatology consultations significantly contribute quality to care of hospitalized patients: a prospective study of dermatology inpatient consults at a tertiary care center.

    Science.gov (United States)

    Galimberti, Fabrizio; Guren, Lauren; Fernandez, Anthony P; Sood, Apra

    2016-10-01

    Cutaneous abnormalities are common in hospitalized patients but are frequently missed or misdiagnosed by admitting teams. Inpatient dermatology consultations provide important information to help diagnose and manage these patients. However, few studies have analyzed dermatology inpatient consultations and their effect. We prospectively collected information for 691 consecutive dermatology consultations from November 2013 to November 2014. Patients ranged in age from newborns to 97 years old. The internal medicine service requested the most consultations (45%). Only 6.5% of consultations were requested within 24 hours of appearance of cutaneous findings. Before consultation, 70.3% of patients did not receive treatment for or based on their cutaneous findings. Dermatology consultation resulted in treatment change in 81.9% of patients. The most common diagnoses were drug rash and contact dermatitis. Biopsies confirmed 71.7% of the initial bedside diagnoses by the dermatology consultation team. Common skin diseases were responsible for the majority of dermatology consultations. Most patients were not treated for their cutaneous conditions before the dermatology consultation. Dermatology consultations resulted in treatment changes in the majority of cases. © 2016 The International Society of Dermatology.

  18. A STUDY OF CLINICAL PROFILE OF ADULT PATIENTS WITH ACUTE ENCEPHALITIS SYNDROME COMING TO A TERTIARY CARE HOSPITAL OF NORTH EAST INDIA

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    Anupam Dutta

    2016-06-01

    Full Text Available CONTEXT Acute encephalitis syndrome (AES is a public health problem in north east India with Japanese encephalitis being a major aetiology. Government of India initiated an adult JE vaccination in Assam in 2011. AIMS We aim to study the clinical profile and outcome in adult AES and JE patients after Government’s JE vaccination. SETTINGS AND DESIGN Adult AES patients from 1st May 2014 to 31 st October 2014 were included in this open label, observational, prospective study. METHODS AND MATERIALS Data was collected regarding clinical history and outcome. JE confirmation was done by CSF and sera samples screened to detect JEV- specific immunoglobulin M (IgM. STATISTICAL ANALYSIS USED Data analysis was done using GraphPad Prism software version 6.0. RESULTS 141 (96 males, 45 females patients of AES, were studied. With average hospital stay of 5.87 days, 100% had fever, 99.3% headache, 56.7% vomiting, 93.6% altered sensorium, 87.2% dizziness and 51.1% had seizure. 44% AES improved, 29.07% suffered residual neurological deficit and 26.65% expired. Out of 38 patients who died, 29(76.31% patients had a GCS ≤ 7. JE was detected in 26 patients, equivocal in 2 patients and negative in 113 patients. 14(53.84% JE patients improved, 9(34.61% suffered residual neurological deficit and 3(11.53% expired. JE vaccination was present in 7(4.96% patients. CONCLUSIONS JE positive cases have reduced in adults AES patients after Government vaccination program but vaccination coverage among the AES patients was low. Clinical presentation of adult AES patients differs from most reported paediatric AES cases. However, the mortality and morbidity of AES and JE still remains high, GCS < 7 being a bad prognostic marker.

  19. Attitude towards diabetes and social and family support among type 2 diabetes patients attending a tertiary-care hospital in Bangladesh: a cross-sectional study.

    Science.gov (United States)

    Shawon, Md Shajedur Rahman; Hossain, Fariha Binte; Adhikary, Gourab; Das Gupta, Rajat; Hashan, Mohammad Rashidul; Rabbi, Md Fazla; Ahsan, G U

    2016-05-26

    Bangladesh has been suffering from an epidemiological transition from infectious and maternal diseases to non-communicable lifestyle-related diseases like diabetes, cardiovascular diseases, cancers etc. The burden of diabetes has been increasing rapidly due to high incidence as well as poor glycemic control leading to various macro and micro-vascular complications. In this study, we aim to assess the attitude towards diabetes and social and family support among the Bangladeshi type 2 diabetic mellitus (T2DM) patients. This was a cross-sectional study among 144 patients with T2DM at the medicine outpatient department of Dhaka Medical College Hospital (DMCH) in Dhaka, Bangladesh between 1 July and 31 July 2014. Data collection was done by interviewing patients using structured questionnaire. Understanding diabetes, education/advice received, attitude towards diabetes, family and friend support were measured by validated scales adapted from diabetes care profile. This study includes a total of 144 patients (101 males and 43 females) with type 2 diabetes aged between 20 and 84 years. 87 % of the patients had inadequate blood glucose control (fasting blood sugar >7.2 mmol/L or >130 mg/dl). Statistically significant differences were observed in the mean scores of various attitude scales (i.e. positive, negative, care ability and self-care adherence scale) among patients with adequate and inadequate blood glucose control (p family support. Self-satisfaction with diabetic care was significantly associated with adequate blood glucose control (p = 0.05). Positive attitude towards diabetes management and support from friends and family were associated with adequate diabetes management. Appropriate public health interventions should be designed to educate and motivate the family members to offer greater support to the diabetes patients.

  20. Patch Test Results from an Occupational and Contact Dermatitis Clinic in a Tertiary Care Hospital of Southern India: A Retrospective Study.

    Science.gov (United States)

    Sadagopan, Kumaravel; Kalappan, Deepa; Sivaprakasam, Nirmala; Vinoth

    2017-08-01

    Occupational contact dermatitis, accounting for 95% of cases of occupational dermatoses, is the most common occupational skin disease. To find out the various allergens in different occupational and environmental settings causing contact allergy, from our patients presented with contact dermatitis. It was a retrospective study from the data in hospital outpatient register over one year period, which includes patients with age ranging from 11 years to 73 years. Patch test was done with total of 24 allergens from Indian standard battery and Indian standard series and with materials suspected to cause contact allergy. Result was expressed in terms of percentage. Contact dermatitis constitutes about 0.75% of total dermatological cases in our Dermatology Outpatient Department. A total of 358 contact dermatitis were included in this study with M:F ratio 2.25:1 and majority of the cases in the age group of 26-55 years. Out of 358 cases, 157 cases were positive to at least one allergen. Building construction workers constitute about 35.75% (128 cases) of total contact dermatitis cases, among which potassium dichromate (39 out of 57) is the most common allergen, followed by nickel (31) and cobalt (28). In other occupations, contact allergy to parthenium, hair dye, foot wear, paint, kum-kum , turmeric, detergents and cosmetics were also present in significant number and none was positive for vegetables, dettol, kerosene and native medication. This study gives an idea about the common occupation and population who are prone to develop contact dermatitis in our environmental setting and also about the most common sensitizers involved in various occupation and environment.

  1. Varied presentations of moyamoya disease in a tertiary care hospital of north-east India

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    Papori Borah

    2014-01-01

    Full Text Available Introduction: Moyamoya disease is a chronic progressive cerebrovascular disorder, characterized by stenosis or occlusion of bilateral internal carotid arteries (ICAs, anterior cerebral arteries (ACAs and middle cerebral arteries (MCAs, accompanied by a collateral network of vessels formed at the base of the brain. Ischemia and intracranial hemorrhage are the common typical manifestations. However moyamoya disease has been associated with atypical presentations like headache, seizures and involuntary movements. Although frequently reported from Asian countries like Japan, China and Korea, only few studies reported on clinical manifestations of moyamoya disease from India. Objectives: To study the varied presentations of moyamoya disease in a tertiary care hospital of north-east India. Material and Methods: Relevant investigations were done to rule out other causes of moyamoya syndrome. Results: We report 6 cases of moyamoya disease with varied presentations from a tertiary care referral government hospital. Case 1, 2 and 6 presented with alternating hemiparesis. Case 3 had amaurosis fugax. Case 4 had history suggestive of ischemic stroke and presented with hemichorea. Case 4 had focal seizure as the only manifestation. Cases 4 and 5 notably had stenosis of posterior cerebral artery (PCA in addition to stenosis of bilateral ICAs, ACAs and MCAs. Conclusion: Owing to its low incidence in India, moyamoya disease is easily overlooked as a possible diagnosis. However, because of its progressive nature, it is imperative to diagnose this disease early and offer surgical treatment to the patients.

  2. Antibiotic-Related Adverse Drug Reactions at a Tertiary Care Hospital in South Korea

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    In Young Jung

    2017-01-01

    Full Text Available Background. Adverse drug reactions (ADRs are any unwanted/uncomfortable effects from medication resulting in physical, mental, and functional injuries. Antibiotics account for up to 40.9% of ADRs and are associated with several serious outcomes. However, few reports on ADRs have evaluated only antimicrobial agents. In this study, we investigated antibiotic-related ADRs at a tertiary care hospital in South Korea. Methods. This is a retrospective cohort study that evaluated ADRs to antibiotics that were reported at a 2400-bed tertiary care hospital in 2015. ADRs reported by physicians, pharmacists, and nurses were reviewed. Clinical information reported ADRs, type of antibiotic, causality assessment, and complications were evaluated. Results. 1,277 (62.8% patients were considered antibiotic-related ADRs based on the World Health Organization-Uppsala Monitoring Center criteria (certain, 2.2%; probable, 35.7%; and possible, 62.1%. Totally, 44 (3.4% patients experienced serious ADRs. Penicillin and quinolones were the most common drugs reported to induce ADRs (both 16.0%, followed by third-generation cephalosporins (14.9%. The most frequently experienced side effects were skin manifestations (45.1% followed by gastrointestinal disorders (32.6%. Conclusion. Penicillin and quinolones are the most common causative antibiotics for ADRs and skin manifestations were the most frequently experienced symptom.

  3. Self esteem and organizational commitment among health information management staff in tertiary care hospitals in Tehran.

    Science.gov (United States)

    Sadoughi, Farahnaz; Ebrahimi, Kamal

    2014-12-12

    Self esteem (SE) and organizational commitment (OC)? have significant impact on the quality of work life. This study aims to gain a better understanding of the relationships between SE and OC among health information management staff in tertiary care hospitals in Tehran (Iran). This was a descriptive correlational and cross sectional study conducted on the health information management staff of tertiary care hospitals in Tehran, Iran. A total of 155 participants were randomly selected from 400 staff. Data were collected by two standard questionnaires. The SE and OC was measured using Eysenck SE scale and Meyer and Allen's three component model, respectively. The collected data were analyzed with the SPSS (version 16) using statistical tests of of independent T-test, Pearson Correlation coefficient, one way ANOVA and F tests. The OC and SE of the employees' were 67.8?, out of 120 (weak) and 21.0 out of 30 (moderate), respectively. The values for affective commitment, normative commitment, and continuance commitment were respectively 21.3 out of 40 (moderate), 23.9 out of 40 (moderate), and 22.7 out of 40 (moderate). The Pearson correlation coefficient test showed a significant OC and SE was statistically significant (Porganizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.

  4. Implementation of subcutaneous insulin protocol for non-critically ill hospitalized patients in andalusian tertiary care hospitals.

    Science.gov (United States)

    Martínez-Brocca, María Asunción; Morales, Cristóbal; Rodríguez-Ortega, Pilar; González-Aguilera, Beatriz; Montes, Cristina; Colomo, Natalia; Piédrola, Gonzalo; Méndez-Muros, Mariola; Serrano, Isabel; Ruiz de Adana, Maria Soledad; Moreno, Alberto; Fernández, Ignacio; Aguilar, Manuel; Acosta, Domingo; Palomares, Rafael

    2015-02-01

    In 2009, the Andalusian Society of Endocrinology and Nutrition designed a protocol for subcutaneous insulin treatment in hospitalized non-critically ill patients (HIP). To analyze implementation of HIP at tertiary care hospitals from the Andalusian Public Health System. A descriptive, multicenter study conducted in 8 tertiary care hospitals on a random sample of non-critically ill patients with diabetes/hyperglycemia (n=306) hospitalized for ≥48 hours in 5 non-surgical (SM) and 2 surgical (SQ) departments. Type 1 and other specific types of diabetes, pregnancy and nutritional support were exclusion criteria. 288 patients were included for analysis (62.5% males; 70.3±10.3 years; 71.5% SM, 28.5% SQ). A scheduled subcutaneous insulin regimen based on basal-bolus-correction protocol was started in 55.9% (95%CI: 50.5-61.2%) of patients, 63.1% SM vs. 37.8% SQ (P<.05). Alternatives to insulin regimen based on basal-bolus-correction included sliding scale insulin (43.7%), diet (31.3%), oral antidiabetic drugs (17.2%), premixed insulin (1.6%), and others (6.2%). For patients previously on oral antidiabetic drugs, in-hospital insulin dose was 0.32±0.1 IU/kg/day. In patients previously on insulin, in-hospital insulin dose was increased by 17% [-13-53], and in those on insulin plus oral antidiabetic drugs, in-hospital insulin dose was increased by 26.4% [-6-100]. Supplemental insulin doses used for<40 IU/day and 40-80 IU/day were 72.2% and 56.7% respectively. HbA1c was measured in 23.6% of patients (95CI%: 18.8-28.8); 27.7% SM vs. 13.3% SQ (P<.05). Strategies are needed to improve implementation of the inpatient subcutaneous insulin protocol, particularly in surgical departments. Sliding scale insulin is still the most common alternative to insulin regimen based on basal-bolus-correction scheduled insulin. Metabolic control assessment during hospitalization should be encouraged. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  5. PRISMA Analysis of 30 Day Readmissions to a Tertiary Cancer Hospital

    DEFF Research Database (Denmark)

    Cooksley, Tim; Merten, Hanneke; Kellett, John

    2015-01-01

    BACKGROUND: Hospital readmissions are increasingly used as a quality indicator. Patients with cancer have an increased risk of readmission. The purpose of this study was to develop an in depth understanding of the causes of readmissions in patients undergoing cancer treatment using PRISMA...... methodology and was subsequently used to identify any potentially preventable causes of readmission in this cohort. METHODS: 50 consecutive 30 day readmissions from the 1st November 2014 to the medical admissions unit (MAU) at a specialist tertiary cancer hospital in the Northwest of England were analysed...... retrospectively. RESULTS: Q25(50%) of the patients were male with a median age of 59 years (range 19-81). PRISMA analysis showed that active (human) factors contributed to the readmission of 4 (8%) of the readmissions, which may have been potentially preventable. All of the readmissions were driven by a medical...

  6. Factors contributing to nursing team work in an acute care tertiary hospital.

    Science.gov (United States)

    Polis, Suzanne; Higgs, Megan; Manning, Vicki; Netto, Gayle; Fernandez, Ritin

    Effective nursing teamwork is an essential component of quality health care and patient safety. Understanding which factors foster team work ensures teamwork qualities are cultivated and sustained. This study aims to investigate which factors are associated with team work in an Australian acute care tertiary hospital across all inpatient and outpatient settings. All nurses and midwives rostered to inpatient and outpatient wards in an acute care 600 bed hospital in Sydney Australia were invited to participate in a cross sectional survey between September to October 2013. Data were collected, collated, checked and analysed using Statistical Package for the Social Sciences (SPSS) Version 21. Factors reporting a significant correlation with where p team leadership were 3.6 (S.D. 0.57) and 3.8 (SD 0.6) respectively. Leadership and communication between nurses were significant predictors of team work p team work.

  7. Caregivers’ Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal

    Science.gov (United States)

    Neupane, Dipika; Dhakal, Sarmila; Thapa, Sabita; Bhandari, Parash Mani; Mishra, Shiva Raj

    2016-01-01

    Background Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual’s and their caregiver’s physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers’ attitude towards people with mental illness and perceived stigma. Methods We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out. Results Overall median score for the domains: attitude (score range: 18–90) and perceived stigma (score range: 12–60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (pmental illness (pstigma score varied significantly by caregiver’s sex (pmental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver’s relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma. PMID:27336391

  8. Caregivers' Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal.

    Directory of Open Access Journals (Sweden)

    Dipika Neupane

    Full Text Available Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual's and their caregiver's physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers' attitude towards people with mental illness and perceived stigma.We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out.Overall median score for the domains: attitude (score range: 18-90 and perceived stigma (score range: 12-60 were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (p<0.05, educational status of caregiver (p<0.001, sex of patient (p<0.05 and type of mental illness (p<0.05. Perceived stigma score varied significantly by caregiver's sex (p<0.05, marital status (p<0.001, educational status (p<0.001, occupation (p<0.05, relation with the patient (p<0.005 and use of alternative treatment modalities (p<0.05.Sex of participant, educational status, sex of patient and type of mental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver's relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma.

  9. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan

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    Zaman Shakila

    2010-01-01

    Full Text Available Abstract Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees and from the patient's perspective was 79 US$ (5278 rupees. The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees and 204 US$ (13678 rupees from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74% of households had a monthly income of less than 149 US$ (10000 rupees. Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare.

  10. Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah, Saudi Arabia - a matched case-control study.

    Science.gov (United States)

    Al-Gethamy, Manal M; Faidah, Hani S; Adetunji, Hamed Ademola; Haseeb, Abdul; Ashgar, Sami S; Mohanned, Tayeb K; Mohammed, Al-Haj; Khurram, Muhammad; Hassali, Mohamed A

    2017-06-01

    Objective To determine risk factors for multi-drug-resistant Acinetobacter baumannii (MDR-AB) nosocomial infections in intensive care units in a tertiary care hospital, Makkah, Saudi Arabia. Methods We performed a hospital-based, matched case-control study in patients who were admitted to Al Noor Specialist Hospital between 1 January 2012 and 31 August 2012. The study included cases of A. baumannii nosocomial infection and controls without infection. Controls were matched to cases by age and ward of admission. Results The most frequent site of infection was the respiratory tract (77.3%). Susceptibility to antimicrobial MDR-AB was 92.0% for ceftazidime and ciprofloxacin, while it was 83.3% for imipenem, 83.0% for trimethoprim, 79.0% for amikacin, and 72.7% for gentamicin. Multiple logistic regression of risk factors showed that immunosuppression (OR = 2.9; 95% CI 1.5-5.6; p = 0.002), clinical outcome (OR = 0.4; 95% CI 0.3-0.9; p = 0.01), invasive procedures (OR = 7.9; 95% CI 1.8-34.2; p = 0.002), a central venous catheter (OR = 2.9; 95% CI 1.5-5.6; p = 0.000), and an endotracheal tube (OR = 3.4; 95% CI 1.6-7.3; p = 0.001) were associated with MDR-AB. Conclusions Acinetobacter nosocomial infections are associated with admission to the ICU (Intensive care unit) and exposure to invasive procedures.

  11. Distribution of extended-spectrum β-lactamase types in a Brazilian tertiary hospital

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    Keite da Silva Nogueira

    2015-04-01

    Full Text Available INTRODUCTION: Epidemiological data on the prevalence of extended-spectrum β-lactamases (ESBLs are scarce in Brazil despite the fact that these data are essential for empirical treatment and control measures. The objective of this study was to evaluate the prevalence of different ESBLs by type and distribution in a tertiary hospital in southern Brazil. METHODS: We evaluated 1,827 enterobacterial isolates between August 2003 and March 2008 isolated from patients at a tertiary hospital. Samples were identified using a Vitek automated system and were confirmed by biochemical testing. The identified ESBL strains were characterized by phenotypic methods, polymerase chain reaction (PCR, and sequencing. Genetic similarities were evaluated by pulsed-field gel electrophoresis. RESULTS: It was 390 (21.3% ESBL-producing strains, which expressed the ESBLs CTX-M (292, SHV (84, CTX and SHV (10, TEM (2, and PER (2. CONCLUSIONS: The prevalence of ESBL-expressing strains was high, especially in Klebsiella pneumoniae and Enterobacter spp. CTX-M was the predominant type of ESBL observed, and its genetic variability indicates a polyclonal distribution.

  12. Obstetric intensive care admissions at a tertiary hospital in Limpopo ...

    African Journals Online (AJOL)

    Hospital files of all obstetric patients admitted to the Pietersburg provincial referral hospital ICU from 1 January 2008 to 31. December 2012 were retrospectively reviewed. Age, parity, admission diagnosis, length of stay, information on the referring hospitals, and maternal outcomes were analysed. Results. There were 138 ...

  13. Pediatric intussusception in a Saudi Arabian tertiary hospital | Al ...

    African Journals Online (AJOL)

    Because of this, we reviewed the cases and management of intussusception, seen at Aseer Central Hospital over a 7-year period. Materials and methods: Thirty four pediatric patients admitted at Aseer Central Hospital over a 7-year period (from 1993 to 2000) at Aseer Central Hospital, Southwestern region of Saudi Arabia ...

  14. Provision of an emergency theatre in tertiary hospitals is cost ...

    African Journals Online (AJOL)

    Background. Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. Objectives. ... at PTB Hospital and ZAR2 100 at district hospitals, and the total cost per cancelled operation was ZAR25 860. .... unfortu nate cause of postponement of operations, accounting for two cases ...

  15. A retrospective epidemiologic study to define risk factors, microbiology, and clinical outcomes of infective endocarditis in a large tertiary-care teaching hospital.

    Science.gov (United States)

    Mostaghim, Anahita S; Lo, Hoi Yee Annie; Khardori, Nancy

    2017-01-01

    This study aims to define risk factors as well as their association with microbiology and clinical outcomes in a large US infective endocarditis population. Hospital records were searched for appropriate infective endocarditis-related ICD codes from 16 July 2007 to 13 August 2015. A total of 363 cases were retrospectively identified that met definite Modified Duke Criteria for infective endocarditis and were analyzed by age group, causative organism, and associated risk factors for use of valvular surgical intervention, 30/90/180-day mortality after admission, and embolic phenomena. Chronic hemodialysis was the most common risk factor (26.7% of cases). Of all age groups, those aged 78+ years had the lowest 30-day mortality but those aged 58-77 years had the highest mortality (p = 0.039). Staphylococcus aureus was the most prevalent causative organism. Those aged 78-97 years were more likely to have enterococcal infective endocarditis than those aged 18-27 years (p = 0.0144). Chronic hemodialysis associated infective endocarditis was more likely to be caused by coagulase-negative staphylococcus (p = 0.0121) and have a higher 30-day mortality (p = 0.141) than intravenous drug use associated infective endocarditis. Intravenous drug use and chronic hemodialysis were similarly likely to be caused by S. aureus. Intravenous drug use associated infective endocarditis was more likely to be caused by viridans group streptococci (p = 0.0001). Fungal infective endocarditis was most likely to embolize. Chronic hemodialysis patients were less likely to undergo valvular surgery (p = 0.001) and those with chronic hemodialysis who did had lower mortality than those only managed medically that did not reach statistical significance (p = 0.2991). Infective endocarditis caused by coagulase-negative staphylococci had the greatest 30-day mortality at 31.3% but did not reach statistical significance over all other causative organisms (p = 0

  16. Retrospective analysis of nosocomial infections in an Italian tertiary care hospital.

    Science.gov (United States)

    Mancini, Alessio; Verdini, Daniele; La Vigna, Giorgio; Recanatini, Claudia; Lombardi, Francesca Elena; Barocci, Simone

    2016-07-01

    Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions. A retrospective study was carried out from March 2011 to June 2014, based on the bacterial isolate reports of a hospital located in Central Italy. During the 40-month study period, a total of 1547 isolates were obtained from 1046 hospitalized patients and tested for their antibiotic sensitivity. The most common isolates belonged to the Enterobacteriaceae family (61.7%), followed by Enterococcus species (12.4%), Pseudomonas species (10.7%) and S. aureus (10.0%). The incidence density rate of nosocomial infections was 7.4 per 1000 patient days, with a significant difference among the 3 annual infection rates (Pinfection prevalence rate was found in Internal Medicine Unit (41.3%), followed by Intensive Care Units (12.4%), Surgical Units (9.0%,) and Cardiology (7.1%).

  17. Management of traumatic spinal column injury: A tertiary hospital experience

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    Md. Kamrul Ahsan

    2016-07-01

    Full Text Available Background: Trauma is the leading cause of disability in the first four decades of life and third most common cause of death. Spinal trauma poses considerable threats to survival and quality of life.Objective: Aims of this study is to assess the demographics, mode of trauma, hospital stay, complications, neurological improvement and mortality.Methods: Retrospective Cross sectional analysis of the records of spinal injury patients admitted in the Spine Unit of Bangabandhu Sheikh Mujib Medical University (BSMMU Hospital from October 2003 to December 2013 was carried out. The demo­graphics, mode of trauma, involved vertebral level, co-morbid factors; neurological status and its improvement by Ameri­can Spinal Injury Association (ASIA Score, duration of hospital stay and complications during hospital stay was assessed. Results were analyzed by SPSS.Results: Out of 1288 patients admitted, 192(14.90% patients(range, 8-72 years sustained spinal injuries and most (63.02%of them were young (range, 21-40 years. Male to female ratio was 5:1. Cervical spine was most commonly ( 44.66% affected followed by lumbar (35 .41 % , thoracic (13 .54% , thoraco-lumbar (06.25% and Cervico-thoracic (03.13% region. Fracture through intervertebral disc was most common in cervical spine. Among the common causes were road traffic accidents (44.47%, fall from height (29.69%, heavy weight bearing (14.58% and assault with gunshot (07.29%. Paraparesis was most frequent (51.05% clinical presentation followed by quadriparesis (45.83%. Significant number of patients (83.33% required operative treatment (p<0.05 and 09.89% were managed conservatively. Mortality rate (03.64% was insignificant (p>0.05% and 03.12% patient refused to take treatment. Of these patients, 77.01 % had shown neurological improvement of at least one grade according to ASIA Score.Conclusion: Wide varieties of patients are encountered and managed varying from conservative to surgery. Carefully selected

  18. Adolescents with sickle cell anaemia: Experience in a private tertiary hospital serving a tertiary institution.

    Science.gov (United States)

    John-Olabode, Sarah; Awodele, Ibironke; Oni, Omolade

    2015-01-01

    Many adolescents with sickle cell disease (SCD) have adjustment difficulties in the transition period from paediatric care to the adult system because they find themselves in unfamiliar waters where they have to learn to manage themselves. The aim of this study is to evaluate the prevalent crises and morbidities associated with SCD in adolescents in Babcock University Teaching Hospital (BUTH), to also assess the level of knowledge of these adolescents about SCD and to determine their emotional response to the disease. This was a retrospective review of case notes of adolescents with sickle cell anaemia that were seen in BUTH, from May 2013 to April 2014. Data extracted from the case notes was entered into a Microsoft (MS) Excel and analysed using descriptive statistics. Results were presented in tables. A total of 50 subjects were seen in the department during this study period. Vaso-occlusive crises in the form of bone pains (93.1%) were the commonest crises encountered. Associated morbidities were malaria 34 (85%), tonsilitis 1 (2.5%), pneumonia 1 (2.5%), leg ulcer 1 (2.5%), azotaemia 1 (2.5%) and subarachnoid haemorrhage 2 (5%). Majority (88%) had adequate knowledge about general health maintenance while knowledge on nutrition and appropriate analgesia use is still inadequate. Eleven (22%) had symptoms of depression, four (8%) had suicidal ideation while one (2%) had a history of attempted suicide. This study emphasizes the importance of psychosocial intervention as part of a comprehensive health management for people with SCD.

  19. Burnout among middle-grade doctors of tertiary care hospital in Saudi Arabia.

    Science.gov (United States)

    Agha, Adnan; Mordy, Ayedh; Anwar, Eram; Saleh, Noha; Rashid, Imran; Saeed, Mona

    2015-01-01

    Burnout Syndrome is a mental condition caused by chronic exposure to work related stress and is identified by the presence of any of the three distinct elements of emotional exhaustion, depersonalization and lack of personal accomplishment. Middle grade doctors are the backbone of any tertiary care hospital / medical institution, partaking in unscheduled and inpatient care. The aim of this study was to assess the presence of burnout syndrome in the middle grade doctors in a tertiary care hospital in Saudi Arabia. The study was conducted at the Armed Forces Hospital Southern Region, Khamis Mushyt, from August to October 2012 in departments with at least fifty inpatient admissions per month and with at least five middle grade (Resident, Registrar and Senior Registrar) doctors. The departments were Obstetrics and Gynecology, Internal Medicine, Pediatrics, Emergency, General Surgery and Nephrology. This was a cross sectional descriptive and analytical study using the Maslach Burnout Inventory-Health Services Survey and a self-reported stressor-identifying questionnaire to ascertain possible precursors of, or contributing factors to, Burnout Syndrome. A total of 96 proformas/questionnaires were collected anonymously to maintain confidentiality and burnout syndrome was identified in as high as 88.5% of the respondents with high emotional exhaustion in 68.8%, high depersonalization in 63.6% and low personal accomplishment in 38.5%. The authors concluded that burnout syndrome is high among the middle-grade doctors in this medical facility and that urgent steps are needed to address this problem to ensure that these physicians remain physically and mentally healthy.

  20. Perception of leadership among health managers working in tertiary level hospitals.

    Science.gov (United States)

    Shahzad, Saadia; Zareen, Humaira

    2012-01-01

    Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.

  1. Methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary surgical and trauma hospital in Benghazi, Libya.

    Science.gov (United States)

    Buzaid, Najat; Elzouki, Abdel-Naser; Taher, Ibrahim; Ghenghesh, Khalifa Sifaw

    2011-10-13

    Methicillin resistant Staphylococcus aureus (MRSA) is a multidrug resistant organism that threatens the continued effectiveness of antibiotics worldwide and causes a threat almost exclusively in hospitals and long-term care settings. This study investigated the prevalence of MRSA strains and their sensitivity patterns against various antibiotics used for treating hospitalized patients in a major tertiary surgical hospital in Benghazi, Libya. We investigated 200 non-duplicate S. aureus strains isolated from different clinical specimens submitted to the Microbiology Laboratory at Aljala Surgical and Trauma Hospital, Benghazi, Libya from April to July 2007. Isolates were tested for methicillin resistance by the oxacillin disc-diffusion assay according to Clinical and Laboratory Standards Institute guidelines. MRSA strains were tested for antimicrobial resistance (i.e., vancomycin, ciprofloxacin, erythromycin, chloramphenicol and fusidic acid) using commercial discs. Information on patient demographics and clinical disease was also collected. Of the isolates examined 31% (62/200) were MRSA. No significant differences were observed in the prevalence of MRSA among S. aureus from females or males or from different age groups. Most MRSA were isolated from burns and surgical wound infections. Antibiotic resistance patterns of 62 patients with MRSA to vancomycin, ciprofloxacin, fusidic acid, chloramphenicol and erythromycin were 17.7%, 33.9%, 41.9%, 38.7% and 46.8% of cases, respectively. MRSA prevalence in our hospital was high and this may be the case for other hospitals in Libya. A sound surveillance program of nosocomial infections is urgently needed to reduce the incidence of infections due to MRSA and other antimicrobial-resistant pathogens in Libyan hospitals.

  2. Design and reliability of a specific instrument to evaluate patient safety for patients with acute myocardial infarction treated in a predefined care track: a retrospective patient record review study in a single tertiary hospital in the Netherlands.

    Science.gov (United States)

    Eindhoven, Daniëlle C; Borleffs, C Jan Willem; Dietz, Marlieke F; Schalij, Martin J; Brouwers, Corline; de Bruijne, Martine C

    2017-03-20

    Numerous studies have shown that a substantial number of patients suffer from adverse events (AEs) as a result of hospital care. However, specific data on AEs in acute cardiac care are scarce. The current manuscript describes the development and validation of a specific instrument to evaluate patient safety of a predefined care track for patients with acute myocardial infarction (AMI). Retrospective patient record review study. A total of 879 hospital admissions treated in a tertiary care centre for an AMI (age 64±12 years, 71% male). In the first phase, the medical records of patients with AMI warranting coronary angiography or coronary intervention were analysed for process deviations. In the second phase, the medical records of these patients were checked for any harm that had occurred which was caused by the healthcare provider or the healthcare organisation (AE) and whether the harm that occurred was preventable. Of all 879 patients included in the analysis, 40% (n=354) had 1 or more process deviation. Of these 354 patients, 116 (33%) had an AE. Patients with AE experienced more process deviations compared with patients without AE (2±1.7 vs 1.5±0.9 process deviations per patient, p=0.005). Inter-rater reliability in assessing a causal relation of healthcare with the origin of an AE showed a κ of 0.67 (95% CI 0.51 to 0.83). This study shows that it is possible to develop a reliable method, which can objectively assess process deviations and the occurrence of AEs in a specified population. This method could be a starting point for developing an electronic tracking system for continuous monitoring in strictly predefined care tracks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Birth preparedness and complication readiness in pregnant women attending urban tertiary care hospital

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    Vasundhara Kamineni

    2017-01-01

    Full Text Available Background: Birth preparedness and complication readiness (BP/CR is a strategy to promote the timely use of skilled maternal and neonatal care and is based on the theory that preparing for childbirth and being ready for complications reduce delay in obtaining care. Study Objective: The objective of this study was to evaluate the incidence and predictors of birth preparedness, knowledge on danger signs, and emergency readiness among pregnant women attending outpatient clinic of a tertiary care hospital. Patients and Methods: Six hundred pregnant women attending the outpatient department of a tertiary care hospital for the first time in an urban setting were interviewed using a tool adapted from the “Monitoring BP/CR-tools and indicators for maternal and new born health” of the “JHPIEGO.” The outcomes of the study were birth preparedness, knowledge of severe illness, and emergency readiness. Results: Six hundred pregnant women were in the study. Mean age of respondents was 25.2 (±4 years. The mean gestation at enrolment was 18.7 ± 8 weeks. Among the women who participated in the survey, 20% were illiterate, 70% were homemakers and nearly 70% had a monthly family income >Rs. 15,197 (n = 405. Three hundred and sixteen mothers (52% were primigravida. As defined in the study, 71.5% were birth prepared. However, 59 women (9.8% did not identify a place of delivery, 102 (17% had not started saving money, and 99 mothers (16.5% were not aware of purchasing materials needed for delivery. The predictors of birth preparedness are multiparity (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.4–3.1, registration in the antenatal clinic in the first trimester (OR: 3.7, 95% CI: 2.2–6.1, educational status of women (OR: 1.9, 95% CI: 1.2–3.0, and pregnancy supervison by a doctor (OR: 5, 95% CI: 2.8–6.6. One hundred and sixty-four women (27% made no arrangements in the event of an emergency, 376 women (63% were not aware of their blood group

  4. Improving the performance of reflex Human Papilloma Virus (HPV) testing in triaging women with atypical squamous cells of undetermined significance (ASCUS): A restrospective study in a tertiary hospital in United Arab Emirates (UAE).

    Science.gov (United States)

    Fakhreldin, Marwa; Elmasry, Karim

    2016-02-03

    Cervical cancer is the second commonest cancer in women worldwide. Infection with oncogenic types of human Papillomavirus (HPV) is the most important risk factor for developing cervical cancer. Reflex High risk HPV (HR-HPV) testing is of significant value in the assessment of Papanicolaou (Pap) smear results where ASCUS are identified. To improve the performance of reflex HR-HPV testing in triage of ASCUS and analyze the factors impacting it. In this study, we generated a database of 9641 women who had cervical smears collected during the study period from the cytopathology record in a large tertiary hospital in UAE. These included 297 smears with ASCUS diagnosis. All cases were retrospectively followed up with a mean duration of 2.44 years. We analyzed data according to the outcome based on several follow-up Pap smear analysis as the reference assessment. We detected HR-HPV infection in 17.9% of cases. 9.1% ASCUS cases can be more accurate in premenopausal women upon adding age group and presenting complaint as a triage item. This improves the performance of reflex HPV testing and the subsequent selection of high risk patients for colposcopy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Antihypertensive Drug Prescribing in a Tertiary Hospital in Eastern ...

    African Journals Online (AJOL)

    Purpose: To determine the pattern of antihypertensive medication prescription in a referral hospital in Nigeria and its use by patients. Methods: By method of convenience sampling, 4954 prescriptions were collected from 376 files of hypertensive patients (> 18 years) visiting a referral hospital in Enugu, southeastern Nigeria ...

  6. Overnight Emergency CT Imaging: A 10-Year Experience at an Irish Tertiary Referral Hospital.

    LENUS (Irish Health Repository)

    2018-01-01

    In recent years there has been increased utilisation of computed tomography (CT) imaging in developed countries, however there is a paucity of data regarding the utilisation of CT in the emergency overnight setting. We retrospectively analysed trends in ‘overnight’ (midnight to 8am) CT utilisation over a ten-year period at a single Irish tertiary referral hospital. Over the study period, we observed a significant increase in the proportion of CT imaging that was carried out overnight. There was no significant variation in the yield of pathological findings over the study period, which remained low (64% of CT studies were normal or had non-critical findings). The multiple factors which have contributed to the increased utilization of overnight emergency CT in recent years, the potential for reporting errors overnight and the implications therein for patient safety warrant consideration.

  7. Comorbidities are frequent in patients with gastroesophageal reflux disease in a tertiary health care hospital

    Directory of Open Access Journals (Sweden)

    Joaquim Prado P Moraes-Filho

    2009-01-01

    Full Text Available INTRODUCTION: Several aspects of gastroesophageal reflux disease (GERD have been studied, but the frequency of comorbidities is not yet fully understood. OBJECTIVES: To study the prevalence of GERD comorbidities in a tertiary care hospital. METHODS: We prospectively studied 670 consecutive adult patients from the outpatient department of our facility. A diagnosis was established using clinical, endoscopic and/or pHmetry-related findings. Each patient's medical file was reviewed with respect to the presence of other medical conditions and diagnoses. RESULTS: Of the 670 patients, 459 (68.6% were female, and the mean age was 55.94 (17-80 years. We registered 316 patients (47.1% with the erosive form of GERD and 354 patients (52.9% with the non-erosive form. A total of 1,664 instances of comorbidities were recorded in 586 patients (87.5%, with the most common being arterial hypertension (21%, hypercholesterolemia (9%, obesity (9%, type II diabetes mellitus (5% and depression (4%. Two or more comorbidities were present in 437 individuals (64.8%. The occurrence of comorbidities increased with age and was higher in patients with the non-erosive form of GERD. CONCLUSIONS: In a tertiary referral population, comorbidities were very common, and these may have worsened the already impaired health-related quality of life of these patients. Clinicians caring for GERD patients in this setting must be aware of the likelihood and nature of comorbid disorders and their impact on disease presentation and patient management.

  8. Socioeconomic status and utilization of amblyopia services at a tertiary pediatric hospital in Canada.

    Science.gov (United States)

    Sharma, Abhishek; Wong, Agnes M F; Colpa, Linda; Chow, Amy H Y; Jin, Ya-Ping

    2016-12-01

    To evaluate whether socioeconomic status is associated with equal utilization of amblyopia services at The Hospital for Sick Children (SickKids), a pediatric tertiary hospital in Canada. This is a retrospective, cross-sectional study. The medical records of children aged under 7 years diagnosed with amblyopia at SickKids from 2007 to 2009 were reviewed. Socioeconomic status was derived from patients' residential postal codes through linking with income data in the 2006 Canadian census report. Patients were divided into 5 income quintiles to compare with amblyopia service utilization. The main outcome measure was the observed distribution of amblyopia patients by socioeconomic status versus the expected distribution of 20% for each quintile. The analyses included 336 patients. Children with amblyopia at SickKids were more likely to come from the richest neighbourhood (32.5%), whereas children from each of the 3 lowest quintiles (14.6%-15.5%) were less likely to present at SickKids. These results differed significantly from the expected 20% for each quintile (p amblyopia were significantly under-represented for children from the lower socioeconomic groups. When analyses were stratified by travel distance to the hospital, a significant inequality between the lower and higher income quintiles remained for nonmetropolitan Toronto patients, but not for metropolitan Toronto patients. Despite a publicly funded health-care system in Canada, children from lower socioeconomic neighbourhoods in distant areas utilize the amblyopia services in a tertiary pediatric centre less often than those from higher socioeconomic status. Copyright © 2016 Canadian Ophthalmological Society. All rights reserved.

  9. Cost estimate of hospital stays for premature newborns in a public tertiary hospital in Brazil

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    Claudia Maria Desgualdo

    2011-01-01

    Full Text Available OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasindice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased.

  10. Maternal Death Reviews of a Tertiary Care Hospital

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    Indira Upadhyaya

    2014-03-01

    Full Text Available Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH" Thapathali Kathmandu, Nepal. Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period. Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year were 36.36%. Primipara accounted for more deaths (51.51%. Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS. Haemorrhage is the main contributing cause behind maternal mortality.

  11. The process, logistics and challenges of implementing clinical supervision in a generalist tertiary referral hospital.

    Science.gov (United States)

    Brunero, Scott; Lamont, Scott

    2012-03-01

    Clinical supervision (CS) has been identified within nursing as a process for improving clinical practice and reducing the emotional burden of nursing practice. Little is known about its implementation across large tertiary referral hospitals. The purpose of this study is to evaluate the implementation of clinical supervision across several different nursing specialities at a teaching hospital in Sydney, Australia. Using a model of nursing implementation science, a process was developed at the study site that facilitated the development, implementation and evaluation of the project. After a 6-month study period, the CS groups were postevaluated using a survey tool developed for the project. A total of nine CS groups were in operation over the 6-month study period. A predominant focus within the sessions was one of the collegial support and developing standards of practice. The process was able to achieve wide hospital-based support for the role of CS from the senior nurse executives to junior nurses. Whilst there was overall positive support for the CS groups, logistical and resource challenges remain, in the effective roll out of CS to large numbers of nurses. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  12. Ocular trauma: A tertiary hospital experience from Oman

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    Haitham H Al-Mahrouqi

    2017-01-01

    CONCLUSION: Ocular trauma is a common presentation at Al-Nahdha Hospital. Although the majority of trauma cases were minor without any resultant visual disability, OGI could have been prevented with better ocular protection in the workplace.

  13. Prevalence of multidrug resistance among retreatment pulmonary tuberculosis cases in a tertiary care hospital, Hyderabad, India

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    Subhakar Kandi

    2013-01-01

    Full Text Available Background: India is one of the high tuberculosis (TB burden countries in the world. India ranks second in harboring multi drug resistant (MDR-TB cases. About 50,000 of MDR cases are recorded in retreatment pulmonary TB cases. This study was conducted in a tertiary care facility (Government General and Chest Hospital in Hyderabad, India. Objectives: Toassess: Proportion of the TB patients having MDR-TB at the initiation of retreatment regimen; the prevalence of isoniazid (INH resistance in this geographical area. Materials and Methods: An analytical, observational, prospective cohort study of patients attending the out-patient department from December 2010 to March 2011. Results: Sputum samples from 100 patients were subjected to acid fast bacilli (AFB culture and drug sensitivity testing. Of these, 28 (28% were MDR-TB, 42 (42% were non-MDR-TB and 39% being INH resistance. Conclusions: In conclusion, one third of the retreatment pulmonary TB cases attending a tertiary care institute for TB will be MDR-TB at the initiation of treatment and there is a need to include ethambutol in the continuation phase of new TB case treatment in view of high INH resistance.

  14. Automated anesthesia carts reduce drug recording errors in medication administrations - A single center study in the largest tertiary referral hospital in China.

    Science.gov (United States)

    Wang, Ying; Du, Yingying; Zhao, Yingying; Ren, Yang; Zhang, Wei

    2017-08-01

    To clinically evaluate a type of patented automated anesthesia cart in medication administrations in anesthesia. This was a prospectively randomized open label clinical trial. In 10 designated operating suits in the First Affiliated Hospital of Zhengzhou University, in China. 1066 cases originated from 10,812 medication administrations in anesthesia were randomized. 78 registered anesthesiologists managed the medication. The patients received medication administrations in anesthesia with either an automated or a conventional manual cart. American Society of Anesthesiologists (ASA) score, sex, duration of anesthesia and surgical specialty, errors in administration of medications (incorrect medication given (substitution), medication not given (omission) and drug recordings errors"), compliance and satisfaction were recorded. The total error rate was 7.3% with the automated anesthesia carts (1 in 14 administrations) and 11.9% with conventional manual carts (1 in 8 administrations). Automated anesthesia carts significantly reduced the drug recording error rate compared to conventional manual carts (Perrors omission errors was found between groups of automated anesthesia carts and conventional manual carts. The anesthesiologists' compliance with the automated anesthesia carts was unsatisfactory, and all the errors in medication recordings with the automated anesthesia carts were due to the incorrect use of the carts. Most of the participating anesthesiologists preferred the automated anesthesia carts (Perrors in medication administrations of anesthesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Assessment of Drug-Drug Interactions among Renal Failure Patients of Nephrology Ward in a South Indian Tertiary Care Hospital

    OpenAIRE

    Mylapuram Rama; Gayathri Viswanathan; Leelavathi D Acharya; R P Attur; Reddy, P. N.; Raghavan, S. V.

    2012-01-01

    Polypharmacy is common in drug prescriptions of chronic kidney disease patients. A study of the prescription patterns of drugs with potential interactions would be of interest to prevent drug related adverse events. A prospective observational study of six months (Dec 2009-May 2010) was carried out among the chronic kidney disease patients admitted to the nephrology ward of a South Indian tertiary care hospital. The pattern and rates of drug-drug interactions seen in the prescriptions of thes...

  16. An Audit of Rational Use of Antibiotics in a Tertiary Hospital

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    Tanzima Begum

    2014-07-01

    Full Text Available Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%. Out of 500 prescriptions, 68(14% prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics.

  17. The epidemiology and outcomes of infective endocarditis in a tertiary care hospital in Oman.

    Science.gov (United States)

    Al Abri, Seif Salem; Zahedi, Faisal Iqbal; Kurup, Padmamohan J; Al-Jardani, Amina K; Beeching, Nicholas J

    2014-01-01

    We undertook this study to describe the epidemiological and clinical features of infective endocarditis (IE) and to study the complications and management of IE in a tertiary care hospital in Oman. This is a retrospective study of 58 adult patients (>13 years of age) admitted to the Royal Hospital with IE from June 2006 to June 2011. Of the 58 patients, 40 (69%) were males, and 18 (31%) were females (ratio 2.2). The median age was 43.6 years (range: 14-85). Forty-eight cases (82.7%) had native valves, nine patients (15.6%) had prosthetic valves, and one case (1.7%) had a pacemaker. The most commonly involved valves were mitral (33, 56.9%) and aortic (23, 39.7%). The blood cultures were positive in 47 (81%) patients, and the most commonly isolated organisms were Streptococci spp., which were found in 20 (34.5%) patients, and Staphylococci spp., which were found in 19 (32.8%) patients. The complication rate was 21%. A total of 15 (25.9%) patients underwent surgical intervention, and the in-hospital mortality rate was 27.6%. Native-valve IE is the predominant type of endocarditis and is more of an acute disease. The prevalence of Staphylococci spp. IE is similar to that of Streptococci spp. IE, and its associated mortality remains high. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  18. Needle stick injuries among health care workers in a tertiary care hospital of India.

    Science.gov (United States)

    Muralidhar, Sumathi; Singh, Prashnat Kumar; Jain, R K; Malhotra, Meenakshi; Bala, Manju

    2010-03-01

    Percutaneous injuries caused by needlesticks, pose a significant risk of occupational transmission of bloodborne pathogens. Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non existent problem. The present study was carried out to determine the occurrence of NSI among various categories of health care workers (HCWs), and the causal factors, the circumstances under which these occur and to, explore the possibilities of measures to prevent these through improvements in knowledge, attitude and practice. The study group consisted of 428 HCWs of various categories of a tertiary care hospital in New Delhi, and was carried out with the help of an anonymous, self-reporting questionnaire structured specifically to identify predictive factors associated with NSIs. The commonest clinical activity to cause the NSI was blood withdrawal (55%), followed by suturing (20.3%) and vaccination (11.7%). The practice of recapping needles after use was still prevalent among HCWs (66.3%). Some HCWs also revealed that they bent the needles before discarding (11.4%). It was alarming to note that only 40 per cent of the HCWs knew about the availability of PEP services in the hospital and 75 per cent of exposed nursing students did not seek PEP. The present study showed a high occurrence of NSI in HCWs with a high rate of ignorance and apathy. These issues need to be addressed, through appropriate education and other interventional strategies by the hospital infection control committee.

  19. The use of amiodarone for in-hospital cardiac arrest at two tertiary care centres.

    Science.gov (United States)

    Pollak, P Timothy; Wee, Vinnie; Al-Hazmi, Ahmed; Martin, Janet; Zarnke, Kelly B

    2006-03-01

    Although amiodarone significantly increases survival to hospital admission when used in resuscitation of out-of-hospital pulseless ventricular tachycardia and fibrillation, there are limited data on its utility for in-hospital arrests. To determine whether the use of amiodarone, as recommended by the year 2000 American Heart Association Advanced Cardiac Life Support guidelines, improved survival following its introduction to the resuscitation algorithm at two tertiary care institutions. Charts of 374 cardiac resuscitations were retrospectively studied at the two institutions. Basic survival outcomes and demographic data were recorded for cardiac arrests with ventricular tachyarrhythmias qualifying for administration of antiarrhythmic agents. Qualifying rhythms were present in 95 patients. Clinical uptake of amiodarone was limited. In the 36 patients who received amiodarone, survival of resuscitation was 67% versus 83% (P=0.07) in the 59 patients receiving only other antiarrhythmic agents (chiefly lidocaine [94%]), while survival to discharge was 36.1% and 55.9% (P=0.06) in these two groups, respectively. Following two years' experience with the introduction of intravenous amiodarone for resuscitation in the institutions, use was less than 50% and no clinically observable survival benefit could be documented. Possible explanations for the difference between this experience and that found in out-of-hospital resuscitation trials include differing patient populations and operator bias during resuscitation. These results should provoke other institutions to question whether amiodarone has improved survival of cardiac arrest under the conditions prevailing in their hospitals. A patient registry or prospective, randomized trial will be required to assess what parameters affect the success of intravenous amiodarone for resuscitation in-hospital.

  20. Open globe injury in a tertiary hospital in Northern Taiwan: A 10-year review

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    Hsu-Chieh Chang

    2016-01-01

    Full Text Available Background: Major ocular trauma is an injury with potential blindness in ophthalmology. The aim of this study was to evaluate the demographic and etiologic factors of major ocular trauma in a tertiary hospital in Northern Taiwan. Subjects and Methods: A retrospective review of patients who suffered from open globe injuries and underwent management in a tertiary hospital between January 1, 2005, and December 31, 2014, was conducted. Patients with prior ocular trauma, preexisting ocular conditions affecting the visual acuity (VA and those with a history of previous intraocular or refractive surgery was excluded from this study. Results: Totally 199 eyes of 195 patients were enrolled in this study. Open globe injury occurred more frequently in males than in females (136 vs. 63 patients, P < 0.0001. Workplace is the most common place of injury (56.3%, followed by home (23.1%. Among patients younger than 18-year-old, domestic-related injury was the predominant cause (78.6%, while among those aged above 18 years, occupational injuries were the most common cause (62.0%. Compared with VA measured on admission, final VA was improved in 38.6%, unchanged in 48%, and worse in 13.4%. The visual outcome was found to be significantly associated with the initial VA, posterior extent injury, length of wound, and presence of vitreous prolapse. Conclusions: Unfavorable prognostic factors for final visual outcome in these patients are related to initial VA, posterior extent injury, length of wound, and presence of vitreous prolapse. Results of this study help predict visual outcomes of open globe-injured patients in emergent counseling.

  1. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital

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    Dilnasheen Sheikh

    2017-06-01

    Full Text Available The objective of the study is to assess the medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital. A prospective observational study was carried out for a period of 8 months from June 2015 to February 2016 at tertiary care hospital. At inpatient department regular chart review of patient case records was carried out to assess the medication errors. The observed medication errors were assessed for level of harm by using NCCMERP index. The outpatient prescriptions were screened for adherence to WHO prescription writing guidelines. Out of 200 patients, 40 patients developed medication errors. Most of the medication errors were observed in the age group above 61 years (40%. Majority of the medication errors were observed with drug class of antibiotics 9 (22.5% and bronchodilators 9 (22.5%. Most of the errors were under the NCCMERP index category C. Out of 545 outpatient prescriptions, 51 (9.37% prescriptions did not have prescriber’s name and all of the prescriptions lack prescriber’s personal contact number. Eighteen prescriptions did not have patient’s name and 426 (78.2% prescriptions did not have patient’s age. The prevalence of medication errors in this study was relatively low (20% without any fatal outcome. Omission error was the most frequently observed medication errors 31 (77.5%. In the present study, the patient’s age was missing in 78.2% of the prescriptions and none of the prescriptions had patient’s address and the drug names were not mentioned by their generic names.

  2. INCIDENCE OF OCULAR TRAUMA IN A TERTIARY HOSPITAL IN VISAKHAPATNAM

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    Venkata Madusudanarao Kanukollu

    2017-07-01

    Full Text Available BACKGROUND Ocular trauma is a major cause of preventable ocular blindness in the world. The present available data represents the tip of iceberg. The data pertaining to ocular trauma is just hospital based data which does not accurately represent the population at risk. The ocular morbidity may be disproportionate to the severity of injury. Though eyes represent only 0.21% of body surface area and 4% of facial area, they are the third most common trauma exposed areas after hands and feet. MATERIALS AND METHODS Our study group consisted of 341 patients who attended ophthalmology OPD with history of ocular trauma of whom 221 were males and 121 were females. The study was conducted over a period of one year. A complete anterior and posterior segment evaluation of all the patients was done. Other accessory ocular and systemic investigations wherever essential were done. RESULTS The ocular trauma was more common in males (64.52% predominantly affecting patients of 20-40 years age group (36.07%. Most often the injuries were occupation related (73.90% and the most common work related injury observed was extraocular foreign body in 134 patients (39.29%. Closed globe injuries were more common as compared to open globe injuries. Eyes with better visual acuity at presentation had better visual prognosis. Blinding trauma was observed in 29 patients (8.50%. CONCLUSION Ocular injuries are more commonly occupation related and mostly effect young males who are the main work force of our society. Stringent implementation of preventive norms in industries to all the workers and safety precautions during sports, driving need to be enforced.

  3. Perception of intellectual stimulation, creativity and innovation among health managers working in tertiary level hospitals.

    Science.gov (United States)

    Shahzad, Saadia; Zareen, Humaira

    2011-01-01

    Management in health sector is becoming focus of attention world over being an important subject due to resource crunch particularly in developing countries. Beside sociodemographic factors, poor management in health sector is also an important factor responsible for poor health in developing countries. Moreover, there is gross lack of effective leadership in our national setup. It is necessary for health managers to be well versed with the knowledge about emerging theories, concepts and new philosophies of management/administration and leadership. This anthropological study was done to assess the perception and knowledge of Intellectual stimulation, creativity and innovation among the health managers working in the tertiary level hospitals of Lahore. This qualitative study was conducted in two public sector tertiary care hospitals of Lahore. Observation and in-depth interviews were conducted for data collection. Open ended questionnaire, developed on the lines of Multifactor Leadership Questionnaire was used. One main domain of Intellectual stimulation and its variables were developed and emergence of different themes was noted. In the domain of Intellectual stimulation all the participants of the study showed positive themes for the variable of creativity. Seven of the health managers showed positive themes for the variable of innovation, where as three health managers showed negative responses. Health managers with management/administration qualification had better concept about the key ideas of Intellectual stimulation, creativity and innovation; as compared to those who were working at these managerial posts on the basis of their long term experience only. Female health managers were stronger in building their team members on a broader horizon as a wholesome personality and not just taking the daily routine work.

  4. Primary Immunodeficiency Diseases in Oman: 10-Year Experience in a Tertiary Care Hospital.

    Science.gov (United States)

    Al-Tamemi, Salem; Naseem, Shafiq Ur Rehman; Al-Siyabi, Nabila; El-Nour, Ibtisam; Al-Rawas, Abdulhakim; Dennison, David

    2016-11-01

    Primary immunodeficiency (PID) diseases are rare, complex medical disorders that often are overlooked in clinical settings. There are emerging reports of PID from Middle Eastern populations. This study describes the features of PID patients in a tertiary care setting in Oman and compares them with regional and worldwide reports. Sultan Qaboos University Hospital (SQUH) is an academic tertiary care-level hospital for specialized healthcare, including PID patients. At the time of diagnosis, patients' sociodemographics, clinical features, laboratory investigations, and management were entered in electronic form. This study included patients seen between August 2005 and July 2015. One hundred forty patients were registered with a minimum estimated population prevalence of 7.0/100,000. The male/female ratio was 1.6:1, the median age of onset of symptoms was 8 months, and diagnosis was 21 months with a delay of 13 months. Family history was positive in 44 %, consanguinity was present in 76 %, death of a previous sibling was present in 36 %, and there was an overall mortality in 18 %, with an 85 % probability of survival 10 years following diagnosis. The most common type of immunodeficiency was phagocytic disorders (35.0 %), followed by predominantly antibody disorders (20.7 %), combined immunodeficiency (17.8 %), other well-defined PID syndromes (15.0 %), immune dysregulation syndromes (3.5 %), complement deficiencies (3.5 %), and unclassified immunodeficiency (4.2 %). The commonest presenting infection was pneumonia (47.1 %). PID is not a rare condition in Oman. The prevalence is in concordance with reports from the region but higher than in Western populations. The findings of the current study would help to improve the awareness and management of, and policy making for PID.

  5. Gestational age at initiation of antenatal care in a tertiary hospital ...

    African Journals Online (AJOL)

    Gestational age at initiation of antenatal care in a tertiary hospital, Southwestern Nigeria. ... care is still prevalent in our environment. Therefore, pregnant women should be adequately informed about the concept of early antenatal registration. Keywords: Antenatal care, gestational age, initiation, Nigeria, Southwestern ...

  6. A 5 - year surveillance of wound infections at a rural tertiary hospital ...

    African Journals Online (AJOL)

    Background: Wound infections are associated with increased morbidity and mortality. Objectives: To determine the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection among in- and- out patients at a rural tertiary hospital in Nigeria, within a 5 year period. Methods: Wound swabs collected ...

  7. Factors associated with perceived participation three months after being discharged from a tertiary hospital.

    Science.gov (United States)

    Chen, Xuemei; He, Yanan; Meng, Xianmei; Zhou, Lanshu

    2017-09-01

    To describe how first-stroke survivors perceive their participation and the problems with such participation in life and to determine the factors associated with perceived participation at three months after hospital discharge. A cross-sectional study. Patients were recruited from a tertiary hospital in Shanghai, China and they were followed up in their homes. Two hundred and fifty-seven first-stroke survivors discharged for three months participated in this study. The Chinese version of the Impact on Participation and Autonomy questionnaire, Barthel Index, Chinese Stroke Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale. One hundred thirty-four (52.1%) and 147 (57.2%) participants perceived their participation as poor to very poor in the domains of family role and autonomy outdoors, respectively. Conversely, 208 (80.9%) and 228 (88.7%) participants perceived their participation to be fair to good in the domains of social relations and autonomy indoors, respectively. The ability to perform activities of daily life was the strongest correlate of participation in the domains of autonomy indoors, family role, and autonomy outdoors, whereas anxiety was the strongest correlate of participation in the domain of social relations. Activities of daily living were significantly associated with perceived participation in almost all domains. In contrast, anxiety was an important factor in predicting participation in the domain of social relations. These findings suggest the need to explore different strategies of promoting participation for each domain.

  8. Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland.

    Science.gov (United States)

    Bloch-Infanger, Constantine; Bättig, Veronika; Kremo, Jürg; Widmer, Andreas F; Egli, Adrian; Bingisser, Roland; Battegay, Manuel; Erb, Stefan

    2017-01-01

    The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland. At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospitalizations. Hundred ninety five of 2'544 and 516 of 6'243 asylum seekers registered at the national asylum reception and procedure centre Basel were referred to the University Hospital Basel in 2004/05 and 2014/15, and originated mainly from Europe (62.3%, mainly Turkey) and Africa (49.1%, mainly Eritrea), respectively. Median age was similar in both study periods (26.9 and 26.2 years). Infectious diseases in asylum seekers increased from 22.6% to 36.6% (pmigration-associated neglected infections. Physicians should be aware of these new challenges.

  9. Incidence of Maternal "Near-Miss" Events in a Tertiary Care Hospital of Central Gujarat, India.

    Science.gov (United States)

    Parmar, Niyati T; Parmar, Ajay G; Mazumdar, Vihang S

    2016-10-01

    Constant decline in maternal mortality ratio has given rise to the need of a new indicator. This search has motivated investigation of severe maternal morbidity-"maternal near-miss" (MNM) event. World Health Organization (WHO) defines MNM as "a woman who, being close to death, survives a complication that occurred during pregnancy, delivery or up to 42 days after the end of her pregnancy". A hospital-based cross-sectional study was carried out at Sir Sayajirao General Hospital (SSGH), a tertiary care referral hospital in Vadodara, Central Gujarat, from May to September 2012. MNM events were identified according to either WHO or Mantel et al. criteria or both. During study period, 1929 live births, 18 maternal deaths and 46 "near-miss" cases were recorded. Among these 46 near-miss cases, 57 near-miss events were identified. Calculated MNM ratio was 23.85/1000 live births, MNM rate was 20.6/1000 obstetric admissions, the ratio of maternal death to MNM event was 1:2.6, and overall Mortality index was 28.1 %. Among near-miss cases, percentage of preterm delivery was 42 % and stillbirth rate was 35 % (16/46). Out of 46 MNM, pregnancies were continued in 3 while 43 pregnancies were terminated. (25 live births, 16 stillbirths, 2 abortions). Identification of preventable factors and special preventive actions should be taken for management of complications in such near-miss cases.

  10. Point Prevalence of Chronic Wounds at a Tertiary Hospital in Nigeria.

    Science.gov (United States)

    Iyun, Ayodele O; Ademola, Samuel A; Olawoye, Olayinka A; Michael, Afie I; Oluwatosin, Odunayo M

    2016-02-01

    Chronic wounds are a drain on resources both for the patient and health institution. Management of chronic wounds based on evidence-based practice requires baseline data for adequate planning. This study was carried out to determine the point prevalence of chronic wounds in a tertiary hospital (University College Hospital, Ibadan, Nigeria) and utilize this information for subsequent wound care planning. The study was carried out within a 1-month period and included all patients seen in the hospital with chronic wounds. The data obtained was entered into a designed form and was subsequently analyzed. There were 48 patients with 78 wounds representing approximately 11% of patients seen in the Department of Plastic, Reconstructive, and Aesthetic Surgery each month. Their ages ranged from 3 months to 80 years; the median age was 48 years. The male to female ratio was 1.6 to 1. The duration of the wounds ranged from 6 weeks to 780 weeks; the median duration of the wounds was 10 weeks. The area of the wounds ranged from 1 cm(2) -1,248 cm(2) (median 24 cm(2)). The most common chronic wounds were diabetic wounds, followed by pressure ulcers, postinfection ulcers, posttraumatic ulcers, burn wounds, malignant ulcers, and venous ulcers. The point prevalence data serves as a basis for wound care planning. This, in turn, should result in improved wound management grounded in evidence-based practices.

  11. Usutu virus in cerebrospinal fluid: A 2-year survey in a Tertiary Care Hospital, Geneva, Switzerland.

    Science.gov (United States)

    Cordey, Samuel; Vieille, Gael; Turin, Lara; Kaiser, Laurent

    2017-10-04

    In 2009, the Usutu virus (USUV) was first reported as a cause of human neuroinvasive disorders. In Switzerland, USUV has been detected in wild birds with a seroprevalence of up to 6.59% in captive specimens sampled from zoo enclosures. This study investigates the clinical prevalence of USUV in human acute neuroinvasive disorders in Switzerland. Two hundred and fifty-eight cerebrospinal fluid samples collected between 2015 and 2017 for routine clinical care in a tertiary level hospital (Geneva) were tested for USUV by rRT-PCR. No samples were found positive, suggesting the absence, or the extremely low circulation of USUV in Western Switzerland. © 2017 The Authors. Journal of Medical Virology Published by Wiley Periodicals, Inc.

  12. Antihistamines prescribed off-label among paediatric patients at a tertiary care hospital setting in Malaysia.

    Science.gov (United States)

    Tan, Rou Wei; Mohamed Shah, Noraida

    2016-10-01

    Background Antihistamines are widely prescribed to children but should be used with caution in young children. Objective To determine the paediatric prescribing pattern of antihistamines with a focus on the off-label prescribing and factors that influence such prescribing. Setting Paediatric wards of a tertiary care hospital setting in Malaysia. Methods The pharmacy-based computer system and medical records were used to collect the required data. Labelling status of each antihistamine was determined based on the information provided in the product leaflets. Main outcome measure Antihistamines prescribed off-label and factors associated with such prescribing. Results Of the 176 hospitalised children aged higher than the recommended dose (30.2 %). Binary logistic regression showed that children aged studied locations and warrants further investigation on the consequences of such prescribing.

  13. Risk factors and costs of oral cancer in a tertiary care hospital in Delhi.

    Science.gov (United States)

    Goyal, Sandeep; Tiwari, Vijay Kumar; Nair, Kesavan Sreekantan; Raj, Sherin

    2014-01-01

    The present study conducted with 100 oral cancer patients at a private tertiary care hospital in Delhi demonstrated that stage III cancer was associated with longer use of tobacco and poor oral hygiene. There was also statistically significant association (ptobacco and alcohol. More than 60% treatment expenditure was on surgery followed by accommodation (9%) and investigations (8%). The effect of tobacco was well known among patients as 76% of the patients knew that common cancer in tobacco chewer is 'oral cancer', 22% of the patients however responded that they did not know which cancer is common in tobacco chewers. 58% said that they learnt about ill effects of tobacco from media while 24% said they learnt from family and friends. Out of 78 tobacco users, 60 (77%) said that they never received help to quit tobacco while 18(23%) have received help to quit.

  14. Major limb amputations: A tertiary hospital experience in northwestern Tanzania

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    Chalya Phillipo L

    2012-05-01

    Full Text Available Abstract Background Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. Results A total of 162 patients were entered into the study. Their ages ranged between 2–78 years (mean 28.30 ± 13.72 days. Males outnumbered females by a ratio of 2:1. The majority of patients (76.5% had primary or no formal education. One hundred and twelve (69.1% patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality

  15. Major limb amputations: a tertiary hospital experience in northwestern Tanzania.

    Science.gov (United States)

    Chalya, Phillipo L; Mabula, Joseph B; Dass, Ramesh M; Ngayomela, Isdori H; Chandika, Alphonce B; Mbelenge, Nkinda; Gilyoma, Japhet M

    2012-05-11

    Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. A total of 162 patients were entered into the study. Their ages ranged between 2-78 years (mean 28.30 ± 13.72 days). Males outnumbered females by a ratio of 2:1. The majority of patients (76.5%) had primary or no formal education. One hundred and twelve (69.1%) patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality rate was 16.7%. Complications of diabetic foot ulcers and trauma

  16. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

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    Jeevan Acharya

    Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

  17. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

  18. Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

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    Sonia R. B D'Souza

    2017-10-01

    Full Text Available Background: Advances in neonatal care have resulted in improved survival of neonates admitted to the intensive care of the Neonatal Intensive Care Unit (NICU. However, the NCU may be an inappropriate milieu, with presence of overwhelming stimuli, most potent being the continuous presence of noise in the ambience of the NICU. Aim and Objectives: To determine and describe the ambient noise levels in the acute NICU of a tertiary referral hospital. Material and Methods: The ambient noise, in this study was the background sound existing in the environment of the acute NICU of a tertiary referral hospital in South India. The ambient noise levels were analyzed by an audiologist and acoustical engineer using a standardized and calibrated Sound Level Meter (SLM i.e., the Hand Held Analyzer type 2250, Brüel and Kjær, Denmark on a weighted frequency A and reported as dB (A. Results: The ambient noise levels were timed measurements yielded by the SLM in terms of L eq, L as well as L exceeded the standard A 10 Aeqmax levels (Leq< 45 dB, L ≤ 50 dB, and Lmax ≤ 65 10 dB.The L eq ranged from 59.4 to 62.12 dB A. A Ventilators with alarms caused the maximum amount of ambient noise yielding a L Sound Pressure Level AF (SPL of 82.14 dB A. Conclusion: The study has found high levels of ambient noise in the acute NICU. Though there are several measures to reduce the ambient noise levels in the NICU, it is essential to raise awareness among health care personnel regarding the observed ambient noise levels and its effects on neonates admitted to the NICU.

  19. A Survey of Hand Hygiene Facilities in a Tertiary Hospital in Nigeria

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    Olusegun Adesola Busari

    2012-10-01

    Full Text Available Introduction: Hand hygiene causes a significant reduction in the carriage of potential pathogen in the hand. Inadequate hand hygiene facilities is one of the factors affecting compliance with hand hygiene by health care workers. The objective of the study was to evaluate the availability and accessibility of hand hand hygiene facilities and supplies of hand hygiene agents in the inpatient wards of a tertiary hospital in Nigeria. Methods and Materials: The study was conducted in a federal tertiary hospital in Nigeria. A modified survey checklist that assessed the condition of hand hygiene sink and other facilities was adapted and pretested. Direct observations of existing hand hygiene facilities in all the inpatient wards were carried out by one of the authors. Results: Of the 28 sinks, 22 (78.6% were accessible but 13 (46.4% had blocked drain. All the taps were hand operated with only 4 (14.3% working. Majority of the sinks (67.9% had no soap and no sink had antiseptic solution. Only 8 (28.6% sinks had hand drying material which was a cloth towel. No sink had hand hygiene instructions displayed on or close to it. Conclusion: There is gross inadequacy of hand hygiene facilities in Ido-Ekiti, Nigeria. There is an urgent need for health managers to give priority to provision of hand hygiene facilities at all levels of health care delivery. Infection Control Unit should be established and strengthened in each facility for effective implementation of infection control policies. [TAF Prev Med Bull 2012; 11(5.000: 571-576

  20. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India.

    Science.gov (United States)

    Phalke, Vaishali D; Phalke, Deepak B; Syed, M M Aarif; Mishra, Anjeney; Sikchi, Saudamini; Kalakoti, Piyush

    2011-01-01

    Prescription is a written order from physician to pharmacist which contains name of drug, its dose and its method of dispensing and advice over consuming it. The frequency of drug prescription errors is high. Prescribing error contributes significantly towards adverse drug events. The present study was undertaken to understand the current prescription writing practices and to detect the common errors in them at a tertiary health care centre situated in a rural area of Western Maharashtra, India. A cross sectional study was conducted at a tertiary level hospital located at a rural area of Maharashtra state, India during October 2009-March 2010. 499 prescriptions coming to medical store during period of one month were considered for data analysis. Important information regarding the patient, doctor, drug and the general description of the prescription were obtained. All the prescriptions were on the hospital pad. A significant number of the prescriptions (n=88, 17.6%) were written in illegible handwriting and not easily readable. The name, age and sex of the patient were mentioned is majority of the prescriptions. All the prescriptions (100%) failed to demonstrate the presence of address, height and weight of the patient. Only the brand name of the drugs was mentioned in all the prescriptions with none of them having the generic name. The strength, quantity and route of administration of the drug were found on 73.1%, 65.3% and 75.2% prescriptions. There are widespread errors in prescription writing by the doctors. Educational intervention programs and use of computer can substantially contribute in the lowering of such errors. A short course on prescription writing before the medical student enters the clinical field and strict monitoring by the administrative authorities may also help alleviate the problem.

  1. Intestinal parasitoses in a tertiary-care hospital located in a non-endemic setting during 2006–2010

    OpenAIRE

    Calderaro, Adriana; Montecchini, Sara; Rossi, Sabina; Gorrini, Chiara; De Conto, Flora; Medici, Maria Cristina; Chezzi, Carlo; Arcangeletti, Maria Cristina

    2014-01-01

    Background The aim of this study was to assess the epidemiology of intestinal parasitoses during a 5-year period in patients attending a tertiary-care hospital in a non-endemic setting. Methods In the period 2006–2010, 15,752 samples from 8,886 patients with clinically suspected parasitosis were subjected to macroscopic and microscopic examination, to parasitic antigen detection assays, and to cultures for protozoa and nematodes. Real-time PCR assays for the differentiation of Entamoeba histo...

  2. A Study to Assess the Factors and Out of Pocket Expenditures in the Patients of Road Traffic Accidents Admitted in a Tertiary Care Hospital in a Central India District

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    Srivastava DK

    2014-12-01

    Full Text Available Background: Road traffic injuries are estimated to be the eighth leading cause of death globally, with an impact similar to that caused by many communicable diseases, such as malaria. road traffic injuries are estimated to cost low- and middle-income countries between 1–2 % of their Gross Domestic Product (GDP, an estimate of about US$ 100 billion a year. Objectives: To study the epidemiological profile of Road Traffic Injuries among the patients admitted in a tertiary care centre and too find out the various out of pocket expenditure in the patients of Road Traffic Accidents. Material and Method: The present study was a hospital based Descriptive Prospective Study. A list of all the patients admitted due to Road Traffic Accident in last one week was obtained from the ward sisters of Orthopedic Department. All the selected participants were interviewed on the two fixed days. A pre tested structured open ended questionnaire was used for data collection. Results: Of the 48 participants interviewed, 34male and 14 females. Most common age group affected was 21-25 years followed by 16-20 years. The rate of accidents was most common on the weekends. The rate of accidents was more in users of two wheelers. Majority of the expenditure in the First week of admission was on the purchase of medicines followed by diagnosis. Majority of the victims also suffered huge financial loss due to loss of salary, closure of shop, loss due to daily wages etc. Conclusion: The present study hereby concludes that there is an urgent need for creating awareness about Road Traffic Accident. The study also concludes that majority of the out of pocket expenditure in the first week of admission is on the medication.

  3. Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

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    Teemul Karen

    2004-12-01

    Full Text Available Abstract Background Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals. The liberal use of third-generation cephalosporins (3GCs in these hospitals has been associated with the emergence of extended-spectrum beta- lactamases (ESBLs presenting concerns for bacterial resistance in therapeutics. We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic prescribed these drugs. Methods Clinical data of patients (≥ 13 years admitted to the General Hospital, Port of Spain (POSGH from January to June 2000, and who had received 3GCs based on the Pharmacy records were studied. The Sanford Antibiotic Guide 2000, was used to determine appropriateness of therapy. The agency which procures drugs for the Ministry of Health supplied the cost of drugs. Results The prevalence rate of use of 3GCs was 9.5 per 1000 admissions and was higher in surgical and gynecological admissions (21/1000 compared with medical and orthopedic (8 /1000 services (p Conclusions There is extensive inappropriate 3GC utilization in tertiary care in Trinidad. We recommend hospital laboratories undertake continuous surveillance of antibiotic resistance patterns so that appropriate changes in prescribing guidelines can be developed and implemented. Though guidelines for rational antibiotic use were developed they have not been re-visited or encouraged, suggesting urgent antibiotic review of the hospital formulary and instituting an infection control team. Monitoring antibiotic use with microbiology laboratory support can promote rational drug utilization, cut costs, halt inappropriate 3GC prescribing, and delay the emergence of resistant organisms. An ongoing antibiotic peer audit is suggested.

  4. Prevalence of Clostridium difficile infection and colonization in a tertiary hospital and elderly community of North-Eastern Peninsular Malaysia.

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    Zainul, N H; Ma, Z F; Besari, A; Siti Asma, H; Rahman, R A; Collins, D A; Hamid, N; Riley, T V; Lee, Y Y

    2017-10-01

    Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C. difficile antigen and toxins were tested by enzyme immunoassay. Stool samples were subsequently analyzed by culture and molecular detection of toxin genes, and PCR ribotyping of isolates. To examine awareness among hospital staff and students, participants were asked to complete a self-administered questionnaire. For the hospital and community studies, the prevalence of non-toxigenic C. difficile colonization was 16% and 2%, respectively. The prevalence of CDI among hospital inpatients with diarrhea was 13%. Out of 22 C. difficile strains from hospital inpatients, the toxigenic ribotypes 043 and 017 were most common (both 14%). In univariate analysis, C. difficile colonization in hospital inpatients was significantly associated with greater duration of hospitalization and use of penicillin (both P prevalent in a Malaysian hospital setting but not in the elderly community with little or no contact with hospitals. Awareness of CDI is alarmingly poor.

  5. Obstetric Outcome in Twin Gestation in a Nigerian Tertiary Hospital ...

    African Journals Online (AJOL)

    BACKGROUND: Twin pregnancies are high risk pregnancies. Foetal and maternal complications are common in twin pregnancies. Therefore, periodic review is necessary to improve on the twin pregnancy outcome. OBJECTIVE: To determine the incidence and outcome of twin pregnancies in the hospital. MATERIALS AND ...

  6. HIV test counselling at a tertiary hospital | Louw | South African ...

    African Journals Online (AJOL)

    A questionnaire was distributed to 64 of the 78 interns working at a teaching hospital in Cape Town in August 1992 to examine their attitudes and practice in respect of HIV test counselling. The questionnaire was completed by 61 interns. Thirteen per cent of those who responded counselled all patients, 49% counselled ...

  7. Lower Limb Amputations at a Nigerian Private Tertiary Hospital ...

    African Journals Online (AJOL)

    The incidence is on the rise in Nigeria due mainly to increasing motorcycle accidents and increased prevalence of uncontrolled diabetes complicated by neuropathy, vasculopathy and diabetic foot gangrene. OBJECTIVE: To determine the ... Postoperative hospital stay ranged from 21 to 72 days. CONCLUSION: Most lower ...

  8. Underreporting and overreporting of hepatitis B at a tertiary hospital

    African Journals Online (AJOL)

    computer records. Hospital inpatient charts of patients notified for hepatitis 8 as wetl as patients with a discharge diagnosis of hepatitis a were retrieved and examined for corresponding hepatitis B laboratory test results, clinical evidence of hepatitis B virus. Infection and evidence of previous notification. An underreporting ...

  9. Incidence of Traumatic Brain Injury in a Ghanaian Tertiary Hospital ...

    African Journals Online (AJOL)

    External cause of injury was classified according to International Classification of Diseases (ICD) guidelines as Road Traffic Accidents (RTA) (irrespective of type), fall from height, assault, gunshot, game or sport related accident and other causes. Road traffic accident accounts for relatively high incidence of hospitalized TBI.

  10. Surgical inpatient mortality in a Nigerian Tertiary Hospital

    African Journals Online (AJOL)

    2015-09-10

    Sep 10, 2015 ... Aim: The determination of the pattern of mortality in a surgical unit helps in planning, provision of quality surgical care .... Cancer. Surgical complications. Congenital anomalies. GI Obstructions. Others. %. Figure 2: Primary cause of mortality. Table 2: The time between presentation to the hospital and death.

  11. vanishing bone disease in a tertiary teaching hospital in uganda

    African Journals Online (AJOL)

    do not have pathologists or radiologists. We therefore present a case of Gorham's disease which was initially thought to be a malignant disease, diagnosed in Mulago. Teaching Hospital in Uganda. CASE REPORT. A 27 year-old male presented to the Orthopaedic out- patient clinic with a 5 month history of a painful mass.

  12. Profile of injured patients presenting to a tertiary hospital in a developing country.

    Science.gov (United States)

    Musharrafieh, Umayya; Rahi, Amal C; Taha, Assaad; Shamseddine, Wael; Steitieh, Suzanne; Jamali, Faek; Tamim, Hala

    2011-01-01

    In most developing countries including Lebanon, trauma research is lacking and warranted. Objectives of the current study were to describe trauma patients referred to a tertiary care center during one year and identify outcomes and patterns of injury. Review of hospital charts of every 12th consecutive patient presenting to the emergency unit (ED) after a traumatic event during the year 2001-2002. Data collected include: demographics, injury description, and hospital data. A total of 736 patients were included, 212 pediatric, 455 young, and 62 geriatric patients. The most common body regions injured were the extremities followed by the face. The most encountered mechanism of injury was fall from less than 15 feet (38.2%) followed by penetrating/gunshot injury (14.8%), and road traffic accidents (11.8%). The rates of hospital admission and surgical intervention were highest among geriatric patients (p = 0.03 and p < 0.001). Most injuries occurred during the evening shift and the average time spent in the ED was 86 minutes. The police was informed in 6.6% of the cases. Falls represent a worrisome mechanism across all age groups. This may be an indication for unaddressed occupational hazards for the working young and lack of awareness about the need for more children supervision. More rigorous investigation of intentional and unintentional firearm injuries, and their predisposing factors are needed.

  13. Factors associated with hand hygiene compliance at a tertiary care teaching hospital.

    Science.gov (United States)

    Kowitt, Benjamin; Jefferson, Julie; Mermel, Leonard A

    2013-11-01

    To identify factors associated with hand hygiene compliance during a multiyear period of intervention. Observational study. A 719-bed tertiary care teaching hospital. Nursing, physician, technical, and support staff. Light-duty staff performed hand hygiene observations during the period July 2008-December 2012. Infection control implemented hospital-wide hand hygiene initiatives, including education modules; posters and table tents; feedback to units, medical directors and the executive board; and an increased number of automated alcohol hand hygiene product dispensers. There were 161,526 unique observations; overall compliance was 83%. Significant differences in compliance were observed between physician staff (78%) and support staff (69%) compared with nursing staff (84%). Pediatric units (84%) and intensive care units (84%) had higher compliance than did medical (82%) and surgical units (81%). These findings persisted in the controlled multivariate model for noncompliance. Additional factors found to be significant in the model included greater compliance when healthcare workers were leaving patient rooms, when the patient was under contact precautions, and during the evening shift. The overall rate of compliance increased from 60% in the first year of observation to a peak of 96% in the fourth year, and it decreased to 89% in the final year, with significant improvements occurring in each of the 4 professional categories. A multipronged hand hygiene initiative is effective in increasing compliance rates among all categories of hospital workers. We identified a variety of factors associated with increased compliance. Additionally, we note the importance of continuous interventions in maintaining high compliance rates.

  14. [Epidemiology of acute kidney injury in a tertiary care university hospital according to the RIFLE criteria].

    Science.gov (United States)

    Long, Thorir Einarsson; Sigurdsson, Martin Ingi; Indridason, Olafur Skuli; Sigvaldason, Kristinn; Sigurdsson, Gísli Heimir

    2013-11-01

    Acute kidney injury (AKI) is a common problem in hospitalized patients, requiring extensive treatment and carries a high mortality rate. This study was designed to assess the epidemiology of AKI, and risk factors and outcome of patients with severe AKI in a tertiary care university hospital in Iceland. All adult patients with measured serum creatinine (SCr) in Landspitali University Hospital from January 2008 to December 2011, who had a measured baseline SCr in the preceeding six months, were included. Patients were categorized according to the RIFLE-criteria into risk (stage 1), injury (stage 2) and failure (stage 3) groups based on their highest SCr, using the lowest SCr in the previous six months as baseline. A total of 17,693 individuals (out of 74,960) had a baseline SCr and their data were used for analysis. AKI occurred in 3,686 (21%) with 12%, 5% and 4% of stage 1, 2 and 3, respectively. There were more females in stage 1 and stage 2 and more males in stage 3 (p 90 days. One year survival was 52%. Acute kidney injury is common in Iceland and the prognosis of those with severe AKI is dismal. Majority of those patients were taking drugs that increase risk of AKI, providing a target for preventive measures.

  15. A study of the clinical profile and management of malaria in pediatric age group in a tertiary care hospital in Mangalore

    OpenAIRE

    Prasad Nayak N; Nayak, Roopa P.; Santhosh T. Soans; Samith Alva; Zaheer Ahamed; Suresh Kotinakanot

    2014-01-01

    Objective: To study the clinical profile and management of malaria in the paediatric age group. Methods: This retrospective study was done at AJ Institute of Medical Sciences, Mangalore in Karnataka, India. The prescriptions case records of patients diagnosed with malaria, treated as inpatients in the Department of Paediatrics, AJ Institute of Medical Sciences from January 2010 to July 2012 were collected. The data (demographic profile, clinical features, investigation, treatment ...

  16. Knowledge attitude and practice study on biomedical waste management among health care professionals and paramedical students in a Tertiary Care Government Hospital in South India

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    Vetrivel Chezian Sengodan

    2014-01-01

    Conclusion: The results of our study revealed that the project for upgrading safety in health care initiative taken by the Government of Tamil Nadu to create awareness of biomedical waste management among health-care professionals have certainly improved the KAP on biomedical waste management. Hence, such a program is mandatory to improve the biomedical waste management in health-care centers.

  17. Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.

    Science.gov (United States)

    Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A

    2017-11-03

    This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.

  18. Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

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    Aman Deep

    2010-03-01

    Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

  19. Microbial profile of corneal ulcers in a tertiary care hospital in South India

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    Chittur Y Ranjini

    2016-01-01

    Full Text Available Purpose: To identify the prevalence and microbial profile of infectious keratitis in a tertiary eye care hospital, and to test for the in vitro antimicrobial resistance of the bacterial isolates. Methods: A total of 312 patients presenting to a tertiary eye care hospital with infected corneal ulcer were enrolled in this study. Their socio-demographic data and risk factors were recorded. Corneal scrapings collected from the edge of the ulcer were processed for direct gram stain and KOH mount. Culture was recovered on blood agar, chocolate agar, MacConkey agar and Sabouraud′s dextrose (SDA agar in multiple C shaped streaks. After overnight incubation, bacterial culture was followed by standard biochemical tests and antimicrobial sensitivity according to the clinical and laboratory standards institute (CLSI guidelines. Inoculated SDA was inspected daily for up to 10 days and the growth was identified by its colony morphology, pigment production and lacto-phenol cotton blue mount examination. Results: Of 312 patients, a microbial etiology was established in 117 cases (37.5%. Of these, 72 (61.5% were male. The age range of 41-60 years was the most affected group. Of 117 positive cases, 52 (44.5% were bacterial, 58 (49.5% were fungal and 7 (6% patients showed mixed bacterial and fungal infection. The most common isolated fungus was Fusarium which was detected in 36 (31% cases, followed by Aspergillus spp in 13 (11% subjects. Staphylococcus aureus was the most common isolated bacteria. All Gram positive cocci were susceptible to vancomycin followed by gatifloxacin, whereas all Gram negative bacilli were susceptible to gatifloxacin. Conclusion: Routine microbiological examination of patients with corneal ulcer is necessary in order to analyze and compare the changing trends of the etiology and their susceptibility patterns.

  20. EVALUATION OF BIOMEDICAL WASTE MANAGEMENT PRACTICES IN MULTI-SPECIALITY TERTIARY HOSPITAL

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    Shalini Srivastav

    2010-06-01

    Full Text Available Background: Biomedical Waste (BMW, collection and proper disposal has become a significant concern for both the medical and the general community The scientific “Hospital waste Management “is of vital importance as its improper management poses risks to the health care workers ,waste handlers patients, community in general and largely the environment. Objectives: (i To assess current practices of Bio-medical Waste management including generation, collection, transportation storage, treatment and disposal technologies in tertiary health care center. (ii To assess health andsafetypracticesfor the health care personnel involved in Bio-Medical waste Management. Materials and Methods: Waste management practices in tertiary care-centre was studied during May 2010 June 2010. The information/data regarding Bio-Medical Waste Management practices and safety was collected by way of semi structured interview, proforma being the one used for WASTE AUDITING QUESTIONNAIRE. The information collected was verified by personal observations of waste management practices in each ward of hospital. Results : SRMS-IMS generates 1. 25Kgs waste per bed per day and maximum waste is generated in wards. The institute has got separate color coded bins in each ward for collection of waste but segregation practices needs to be more refined. The safety measures taken by health care workers was not satisfactory it was not due to unavailability of Personal protective measures but because of un-awareness of health hazards which may occur due to improper waste management practices. Thus it is concluded that there should be strict implementation of a waste management policy set up in the institute, training and motivation must be given paramount importance to meet the current needs and standard of bio-medical waste management.

  1. A STUDY OF SILVER STAINING NUCLEOLAR ORGANISING REGIONS AGNOR SCORE AS PROGNOSTIC MARKER IN BREAST LESIONS IN A TERTIARY CARE HOSPITAL IN HYDERABAD

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    Bhavani Shankar Nithyananda

    2017-10-01

    Full Text Available BACKGROUND Nucleolar Organising Regions (NORS are segments of DNA closely associated with nucleolus, which code for ribosomal DNA consisting of non-histone proteins, which are argyrophilic. They are demonstrated as black, brown spots on staining with silver colloidal staining technique. Hence, they are called AgNORs. The assessment of AgNORs correlates with rate of proliferation, cell cycle time, since shorter the cell cycle, greater the ribosomal activity and protein synthesis higher AgNOR count. 1 AgNORs have been studied on NHL, GIT neoplasms, skin, gynaecological neoplasms, pulmonary neoplasms, prostate, bladder and breast cancer. In breast cancer, AgNOR can be used for early detection, grading and staging of disease. In this study, we have tried to correlate AgNOR character to morphological prognostic markers. MATERIALS AND METHODS A total of 159 cases presenting with lump in the breast were included in the study. Specimens were subjected to histopathological examination. Sections cut three micron thickness were stained for AgNOR with silver colloidal AgNOR staining technique. AgNOR count was done on both benign and malignant lesions. RESULTS Benign breast lesions were more common compared to malignant lesions. The age of the patients ranged from 15-79 yrs. The mean age for benign lesions was 31 yrs. and for malignant lesions 43 yrs. The most common benign lesion was fibroadenoma and most common malignant lesion was infiltrating ductal carcinoma. AgNOR spots were seen as black/brown spots. AgNOR score was higher in malignant lesions when compared to benign lesions. Among malignant lesions, AgNOR score was found to be higher in high grade, metastatic tumours. CONCLUSION AgNOR count is a useful technique, which can supplement other prognostic markers like Ki-67, mitotic index. A long follow up study is required to confirm the prognostic utility of AgNOR count done in this study

  2. Risk of low birth weight on adulthood hypertension - evidence from a tertiary care hospital in a South Asian country, Sri Lanka: a retrospective cohort study.

    Science.gov (United States)

    Ediriweera, Dileepa Senajith; Dilina, Nuwani; Perera, Usha; Flores, Francisco; Samita, S

    2017-04-24

    Although low birth weight (LBW) is common in South Asian region there are not many studies being done to evaluate LBW and adulthood hypertension association in this region, including in Sri Lanka. Although this association has been studied in other regions, most studies have not evaluated this association in the presence of socioeconomic and lifestyle factors. This study was conducted to investigate whether low birth weight (LBW) is associated with adulthood hypertension after adjusting for other potential risk factors of hypertension. Nearly 15,000 individuals born during 1950 to 1965 were selected and invitations were sent to their original addresses. Out of them 217 individuals responded and among them birth weight was recovered for 122 individuals. Separate linear logistic models were fitted to model high systolic blood pressure (SBP: systolic blood pressure > 140 mmHg), high diastolic blood pressure (DBP: diastolic blood pressure > 90 mmHg) and hypertension (either SBP > 140 mmHg or DBP > 90 mmHg). Separate linear logistic model fitting revealed LBW having a significant association with high SBP (OR = 2.89; 95% CI: 1.01 to 8.25; P = 0.04), and hypertension (OR = 3.15; 95% CI: 1.17 to 9.35; P = 0.03), but not with high DBP (OR = 0.75; 95% CI: 0.22 to 2.16; P = 0.62), when effect of LBW was studied after adjusting for all other potential risk factors. LBW has a tendency to cause high adult blood pressure in South Asian region, and the findings are consistent with previous work on LBW and adulthood hypertension association in other regions of the world.

  3. Indicators and outcomes of transfer to tertiary pediatric hospitals for patients with testicular torsion.

    Science.gov (United States)

    Preece, Janae; Ching, Christina; Yackey, Katelyn; Jayanthi, Venkata; McLeod, Daryl; Alpert, Seth; DaJusta, Daniel

    2017-08-01

    Testicular torsion threatens testicular viability with increased risk of loss with delayed management. Still, healthy adolescents continue to be transferred from community hospitals to tertiary hospitals for surgical management for torsion even though adult urologists may be available. We sought to determine reasons behind patient transfer and to evaluate whether transfer to tertiary centers for testicular torsion leads to increased rates of testicular loss. A retrospective chart review was performed for patients presenting to our free-standing pediatric tertiary care facility with surgically confirmed testicular torsion during the 5-year period between January 2011 and January 2016. Data was collected regarding transfer status, patient demographics, time of presentation to our facility, duration of symptoms, patient workup, and surgical outcomes. Patients with perinatal or intermittent torsion were excluded. One-hundred and twenty-five patients met the inclusion criteria. Thirty-six of those were transferred from outside facilities while 89 presented directly to our hospital. A greater proportion of the transferred patients presented during nights or weekends than those presenting directly to our facility (77.8% versus 51.7%, p = 0.009). Eighty-nine patients presented with symptom duration of less than 24 h and had potentially viable testicles. Of those, 23 were transferred and 66 presented directly to our hospital. Differences are shown in the Table. Transferred patients had twice the rate of testicular loss as those not transferred, although the results were not significant (30.4% versus 15.2%, p = 0.129). Patients undergoing ultrasound prior to transfer had prolonged symptom duration and faced higher rates of testicular loss when compared with patients not transferred, although the latter was not significant (mean duration 8.0 versus 4.9 h, p = 0.025, and testicular loss 40.0% versus 15.2%, p = 0.065, respectively). Patients transferred over 30 miles

  4. Assessment of antimicrobial self-medication in undergraduate medical students in a rural tertiary care teaching hospital: a cross-sectional questionnaire-based study

    OpenAIRE

    Deepika Gurappanavar; Ravishankar Manchukonda; Shwetha Shivamurthy

    2015-01-01

    Background: According to WHO's definition, and ldquo;self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms and rdquo;. A sensible clinical use of antimicrobials is crucial to prevent the occurrence of antimicrobial resistance. As undergraduate medical students are aware of the various antimicrobial agents and diseases, this study assessing antimicrobial self- medication carries a significant value. Methods: A cross-sectional qu...

  5. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: A cross-sectional study at a tertiary care hospital in India

    Directory of Open Access Journals (Sweden)

    Suchita R Gawde

    2013-01-01

    Full Text Available Context: Ayurveda is most commonly practiced form of complementary and alternative medicine (CAM in India. There are very few studies showing the knowledge, attitude, and practices (KAP of allopathic doctors about Ayurvedic drugs and its use. Aims: The study was initiated to assess KAP toward Ayurvedic medicine use among allopathic resident doctors. Settings and Design: Cross-sectional and prospective study. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, allopathic resident doctors from clinical departments were approached personally. They were given pre-formed validated questionnaire to assess KAP toward Ayurvedic medicine use. Statistical Analysis Used: Descriptive statistics. Results: Allopathic residents had little knowledge about basic concepts of Ayurveda, that is, ′panchakarma′ and ′tridosha′. Majority residents (99% had no opportunity to learn basics of Ayurveda, but 67% residents prescribed Ayurvedic medicines to patients. However, many residents (76% mentioned that cross practice should not be allowed due to lack of knowledge. One resident knew that cross-practice was not allowed by law. The commonly prescribed proprietary Ayurvedic medicines were Liv-52 (39%, Shatavari (13%, Cystone (12% and common ailments for which these medicines prescribed were liver disorders (34%, arthritis (18%, cough and cold (13%, kidney stones (11%, and piles (10%. Nearly 76% residents felt incorporation of Ayurveda with modern medicine would attract more patients and at the same time most residents (92% agreed that Ayurvedic medicines need scientific testing before use. Though 50% of the residents agreed for voluntary training in Ayurveda, 80% denied compulsory training. Nearly 63% residents recommended Ayurveda among all CAMs. Most of residents heard of Ayurveda from their colleagues. Conclusions: This study reveals that allopathic resident doctors had little knowledge about Ayurveda and Ayurvedic

  6. Knowledge, attitude and practices of antibiotic usage among the medical undergraduates of a tertiary care teaching hospital: an observational cross-sectional study

    OpenAIRE

    Padmanabha T. S.; Nandini T.; Manu G.; Madhav K. Savkar; Ravi Shankar M.

    2016-01-01

    Background: Social aspect of antibiotic management forms a significant way to overcome the rapidly intensifying problem of antibiotic resistance. Medical students should not only be made aware of the current emerging health issues but also be directed towards rational antibiotics prescribing behavior as future medical practitioners. Aims and objective of the study was to assess the knowledge, attitude and practices (KAP) related to antibiotic usage in second year medical undergraduate student...

  7. EVALUATION OF METABOLIC SYNDROME, ITS CORRELATION WITH CLINICAL AND ANGIOGRAPHIC PROFILE IN PATIENTS WITH CORONARY ARTERY DISEASE- A PROSPECTIVE STUDY AT TERTIARY HOSPITAL

    OpenAIRE

    Eruvaram Srikanth; Ravi Srinivas; Adikesava Naidu Otikunta; Y. V. Subba Redd

    2016-01-01

    BACKGROUND Coronary artery disease has a major share for cardiovascular disease in a developing country like India, which is in epidemic proportion. There are number of risk factors for development of coronary artery disease. According to INTERHEART study, there were 9 modifiable risk factors with population attributable risk of 90 percent in men and 94 percent in women. Metabolic syndrome cluster of risk factors, which include insulin resistance, subclinical inflammation, incr...

  8. A single centre retrospective study to analyze and compare mortality amongst geriatric and non-geriatric population presenting to a tertiary care hospital in Delhi

    OpenAIRE

    Subhash Giri; Mukul P Agarwal; Shashank Garg; Sourabh Aggarwal; Raya Ranga; Vishal Sharma

    2012-01-01

    Introduction: India is a country currently undergoing a phase of demographic transition. Increased fertility rate and decreased mortality rate due to advancing health care facilities have contributed to the aging population. The geriatric age group is vulnerable period of life and has health problems and related morbidity and mortality which are very different from other age groups. The present study was conducted to compare and analyze the causes of mortality among patients of geriatric and ...

  9. Quality of Life After "Total Mesorectal Excision (TME)" for Rectal Carcinoma: a Study from a Tertiary Care Hospital in Northern India.

    Science.gov (United States)

    Wani, Rauf Ahmad; Bhat, Ikhlaq-Ul-Aziz; Parray, Fazl Qadir; Chowdri, Nisar Ahmad

    2017-12-01

    Quality of life (QoL) is a key element in rectal cancer (RC) patients. There is not much data regarding this from North India. This study assesses QoL following low anterior resection (LAR) and abdominoperineal resection (APR), operated for low rectal tumors at a high-volume center in northern India. One-hundred-thirty patients of rectal carcinoma were prospectively assessed for quality of life using the European Organization for Cancer QLQ-30 and CR29 questionnaires and compared with reference data population. There was no significant difference in the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 functional or symptom score between the study group and reference data population. Specific functional and symptom QoL scores of the study group were comparable to that of reference data population. There was no significant difference in the EORTC QLQ-C30 functional or symptom score between APR and LAR groups, except for the symptom of nausea and vomiting which was reported significantly more by the LAR group patients than APR group ( p  = 0.001). LAR patients had significantly higher scores with regard to nausea and vomiting than patients with an APR ( p  Quality of life after APR and LAR for rectal carcinoma was found to be comparable to the reference data population, and the QoL after APR was similar to that after LAR barring a few symptoms.

  10. Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital.

    Science.gov (United States)

    Ahmed, Syed M; Das, Bikramjit; Nadeem, Abu; Samal, Rajiv K

    2014-01-01

    Organophosphorus (OP) compound poisoning is one of the most common poisonings in India. The aim of the study was to study the outcomes and predictors of mortality in patients with acute OP poisoning requiring mechanical ventilation. A retrospective study was conducted in the intensive care unit and 117 patients were included. Diagnosis was performed from the history taken either from the patient or from the patient's relatives. Demographic data, month of the year, mode of poisoning, common age group, duration of mechanical ventilation, time of starting pralidoxime (PAM), and mortality were recorded. Chi square test, Pearson correlation test, and multivariate binary logistic regression analysis was used. Data are presented as mean ± SD. 91.86% (79/86) of cases were suicidal and remaining cases were accidental. Duration of mechanical ventilation varied from less than 48 hours to more than 7 days. Mortality rate was 33.3%, 7.2%, and 100% in those who required mechanical ventilation for more than 7 days, 5 to 7 days, and 2 to 4 days, respectively. Lag time was less than 6 hrs in 13 patients and all of them survived. 17.1% and 28.1% patients died in whom PAM was started 6 to 12 hrs and 13 to 24 hrs after poisoning, respectively. There was statistically significant positive correlation between lag time of starting of PAM with duration of mechanical ventilation and total dose of PAM (P ventilation were independent predictors of death. Overall mortality rate was 18.6%. Mortality from OP compound poisoning is directly proportionate to the severity of poisoning, delay in starting PAM, and duration of mechanical ventilation. Death is not dependent on a single factor, rather contributory to these factors working simultaneously.

  11. PREVALENCE OF VITAMIN D DEFICIENCY IN CHRONIC KIDNEY DISEASE: A SINGLE CENTERED STUDY FROM A RURAL TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Ravi

    2016-03-01

    Full Text Available BACKGROUND Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD. Accumulating evidence indicates the associations of vitamin D deficiency with morbidities and mortality in patients with CKD. The recent Kidney Disease Outcomes Quality Initiative (KDOQI Clinical Practice Guidelines for Bone Mineral Metabolism and Disease in Chronic Kidney Disease had recommended the measurements of 25-hydroxyvitamin D levels in patients with CKD who are not on dialysis. Little is known about the magnitude of vitamin D deficiency in patients with CKD living in rural South India. AIM To assess the prevalence of vitamin D deficiency among the patients with chronic kidney disease. METHODOLOGY The prevalence of 25-hydroxyvitamin D3 (25OHD deficiency (defined as a level <20 ng/ml were examined in 100 patients with CKD. Patients on dialysis and those receiving medication known to influence vitamin D, were excluded. CKD was diagnosed based on history, clinical features, USG abdomen and renal function test and eGFR. We examined the levels of 25OHD in 100 patients with CKD stages 3 and 4. Patients were investigated for hemogram, renal function tests, serum vitamin D level, fasting blood sugar and ECG. RESULTS The overall prevalence of vitamin D deficiency among the CRF patients in our study was 69% and the insufficiency was present in 17% of the CRF patients and only 14% of the study subjects had normal vitamin D levels. Among the various factor influencing the prevalence of vitamin D deficiency in CRF patients, diabetes and hypertension are the most important factors. In our study the mean levels of vitamin D was much lower in patients with diabetes and hypertension when compared to patients without diabetes and hypertension and the difference was found to be statistically significant (p=0.003. CONCLUSION Our study concluded that vitamin D deficiency is highly prevalent among CKD patients. Diabetes and hypertension are the most important

  12. [Systolic blood pressure and progression of renal dysfunction in the elderly patients with moderate to severe chronic kidney disease: a cohort study from a tertiary hospital].

    Science.gov (United States)

    Zhao, Hui; Wang, Yu; Meng, Liqiang; Zhang, Luxia; Qang, Fang; Li, Xiaomei

    2015-03-01

    To study the effect of blood pressure (BP) control on the progression of renal function in elderly patients with chronic kidney disease ( CKD) stages 3 and 4. Patients aged 65 years or older in our CKD clinic with baseline CKD stages 3 and 4 and with more than one-year followup until February 2014 were included in this study. Those who had an annual loss of epidermal growth factor receptor (eGFR) for more than 5 ml x min(-1) x 1.73 m(-2), or reached CKD stage 5, and/or initiated renal replacement therapy were regarded as progression of CKD. Cox regression was used to analyze the effect of BP control on the progression of CKD. Results A total of 118 patients [57 men, mean age (73.8 +/- 5.1) years] were enrolled in the final analysis with median baseline eGFR of 37.9 (29.3, 46.7) ml- min(-1.73) m(-2). The baseline BP was (137.0 +/- 18.0)/(72.5 +/- 10.3) mmHg (1 mmHg = 0.133 kPa). During the median 26 months (12-94 m) follow-up period, the average treated BP was (136.2 +/- 12.1)/ (70.5 +/- 6.9) mmHg. Among all the subjects, 64.4% of them reached the BP target (elderly patients with CKD stage 3 and stage 4.

  13. Prediction of difficult intubations using conventional indicators; Does rapid sequence intubation ease difficult intubations? A prospective randomised study in a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Gangadharan Lakshmi

    2011-01-01

    Full Text Available Background : Endotracheal intubations performed in the Emergency Department. Aims : To assess whether conventional indicators of difficult airway can predict a difficult intubation in the Emergency Setting and to investigate the effect of rapid sequence intubation (RSI on ease of intubation. Settings and Design : A prospective randomized study was designed involving 60 patients requiring intubation, over a period of 4 months. Materials and Methods : Demographic profile, details of methods used, airway assessment, ease of intubation, and Cormack and Lehane score were recorded. Airway assessment score and ease of intubation criteria were devised and assessed. Statistical Analysis : Descriptive statistical analysis was carried out. Chi-square/2 × 2, 2 × 3, 3 × 3, Fisher Exact test have been used to find the significance of study parameters on categorical scale between two or more groups. Results : Patients with a Mallampatti score of three or four were found to have worse laryngoscopic views (Cormack-Lehane score, 3 or 4. Of all airway indicators assessed, an increased Mallampatti score was found to have significant correlation with increased difficulty in intubation. The use of RSI was associated with better laryngoscopic views, and easier intubations. Conclusions : An airway assessment using the Mallampatti score is invaluable as a tool to predict a difficult airway and should be performed routinely if possible. RSI aids intubation ease. If not otherwise contraindicated, it should be performed routinely for all intubations in the ED.

  14. SPECTRUM OF CERVICAL LESIONS IN CIMS, BILASPUR: A 5 YEAR RETROSPECTIVE STUDY OF 215 CASES IN A TERTIARY HOSPITAL OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Sadhna

    2015-10-01

    Full Text Available BACKGROUND AND OBJEC TIVE: Cancer of the cervix is a leading cause of morbidity and mortality among women W orld W ide. Therefore to curb the disease there is need of awareness of this disease. This study is aimed to categorize the premalignant and malignant lesions at the earliest, to reduce the mortality and morbidity. It also aimed to know the incidence of malignancies at our set up and to calculate distribution of patient in relation to parity and symptoms. DESIGN AND SETTING: Study included 215 patients with complain of white dis charge per vagina, per vaginal bleeding and backache attending the gynecology OPD over a period of 05 years. PATIENT AND METHODS: Patients were subjected to cervical biopsy and biopsies were sent to pathology department. Detailed clinical history, age, age at marriage, parity and socio - economic status was obtained. RESULT: Result were classified histopathological l y as inflammatory lesions 70 cases, polypoidal lesion were 30, LSIL accounted for 32 cases and HSIL were 20 cases and 30 were malignant lesions. U nder malignant category moderately differentiated squamous cell carcinoma was the commonest. Maximum numbers of patients were subjected to cervical biopsies in 3 rd decade of life. Malignancies were common in 3 rd & 4 th decade of life. Most of the cases were of parity 4. CONCLUSION : Tissue biopsy is a valuable diagnostic procedure on which surgeons and radiologists still rely.

  15. EVALUATION OF METABOLIC SYNDROME, ITS CORRELATION WITH CLINICAL AND ANGIOGRAPHIC PROFILE IN PATIENTS WITH CORONARY ARTERY DISEASE- A PROSPECTIVE STUDY AT TERTIARY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Eruvaram Srikanth

    2016-10-01

    Full Text Available BACKGROUND Coronary artery disease has a major share for cardiovascular disease in a developing country like India, which is in epidemic proportion. There are number of risk factors for development of coronary artery disease. According to INTERHEART study, there were 9 modifiable risk factors with population attributable risk of 90 percent in men and 94 percent in women. Metabolic syndrome cluster of risk factors, which include insulin resistance, subclinical inflammation, increased future risk of diabetes and coronary artery disease. In south Asian people are increased tendency to develop metabolic syndrome because of their high percentage of body fat, abdominal obesity and insulin resistance. Metabolic syndrome has more mortality and morbidity from CAD. It is desirable identifying this subset of patients, which could improve patient or physician adherence to risk-reducing behaviours or interventions and improve clinical outcomes. There are reports in literature on association inflammatory markers and insulin resistance with severity of disease in CAD. There are few studies, which correlated severity of CAD with SYNTAX score in patients with metabolic syndrome, so in these study prospectively evaluated clinical and angiographic profile in patients with CAD in subset patients with metabolic syndrome, CAD severity was assessed with SYNTAX scoring system and thrombus burden was evaluated. MATERIALS AND METHODS Among 101 patients who were diagnosed to have metabolic syndrome according to ATP III guidelines were evaluated in the study. All patients were evaluated by clinical examination including waist circumference, body mass index, routine blood investigations were carried out. Lipid profile, ECG and 2D echo was done. Then, patients were evaluated with coronary angiogram and among patients who underwent coronary angiography, the lesions were classified according to AHA/ACC classification into type A, type B and type C for assessing lesion

  16. Reasons for referral and diagnostic concordance between physicians/surgeons and the consultation-liaison psychiatry team: An exploratory study from a tertiary care hospital in India

    Science.gov (United States)

    Grover, Sandeep; Sahoo, Swapnajeet; Aggarwal, Shivali; Dhiman, Shallu; Chakrabarti, Subho; Avasthi, Ajit

    2017-01-01

    Background: Very few studies have evaluated the reasons for referral to consultation-liaison (CL) psychiatry teams. Aim: This study aimed to evaluate the psychiatric morbidity pattern, reasons for referral and diagnostic concordance between physicians/surgeons and the CL psychiatry team. Materials and Methods: Two hundred and nineteen psychiatric referrals made to the CL psychiatry team were assessed for reason for referral and diagnostic concordance in terms of reason of referral and psychiatric diagnosis made by the CL psychiatry team. Results: In 57% of cases, a specific psychiatric diagnosis was mentioned by the physician/surgeon. The most common specific psychiatric diagnoses considered by the physician/surgeon included depression, substance abuse, and delirium. Most common psychiatric diagnosis made by the CL psychiatric services was delirium followed by depressive disorders. Diagnostic concordance between physician/surgeon and psychiatrist was low (κ psychiatric diagnosis considered by the physician/surgeon and the psychiatrist for delirium and depression; however, the concordance rates for substance dependence and suicidal behavior are acceptable. PMID:28827863

  17. ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY GUIDED FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSING INTRA-ABDOMINAL LESIONS- A 6-YEAR RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN MANIPUR

    Directory of Open Access Journals (Sweden)

    Ratan Konjengbam

    2017-07-01

    Full Text Available BACKGROUND Fine-Needle Aspiration Cytology (FNAC is a widely used method, which is accurate and safe in a readily palpable masses. But, in those inaccessible lesions and deeper organs are safely aspirated using fine needle radiological procedure like ultrasound or computed tomography guided. The aim of the study is to assess the utility of FNAC in the diagnosis of intra-abdominal lesions and different pattern of lesions in particular to the sites. MATERIALS AND METHODS This retrospective study was done in the Department of Pathology, Regional Institute of Medical Sciences (RIMS, Imphal, between June 2010 and June 2016. The study included 128 intra-abdominal masses. Giemsa and Papanicolaou’s stains were used. The cytological diagnosis was correlated with clinical and radiological data to arrive at a final diagnosis. RESULTS Reports on FNAC smears were retrospectively analysed, which had been done in various anatomic sites- liver (70 cases, colon (19 cases, gallbladder (17 cases, mesenteric lymph nodes (12 cases, ovary (3 cases, adrenals (2 cases and 1 case each of pancreas, peritoneal wall, pelvic, suprapubic and flank masses. The mean age was 42.16 years with M:F of 1.3:1. The diagnostic yield was 85.2% in combination for Ultrasound Guided (USG and Computed Tomography (CT guided aspiration. The smears were classified as benign neoplastic, malignant neoplastic, non-neoplastic, inconclusive and unsatisfactory for interpretation. There were 79 (61.7% malignant neoplastic lesion, 5 (3.9% benign neoplastic lesion, 25 (19.5% non-neoplastic lesion, one (0.7% inconclusive lesions and 18 (14.1% unsatisfactory smears. The liver and the colon were the most common sites. Adenocarcinomas and Hepatocellular Carcinoma (HCC were the most common malignant lesions comprising of 35 (44.3% and 25 (31.6% of the total malignant lesions diagnosed. CONCLUSION Intra-abdominal FNA is a simple, economical and a safe procedure with high sensitivity, specificity and

  18. Safety and treatment outcomes of first-line pazopanib in renal cell carcinoma: A prospective observational study in a single Malaysia tertiary hospital

    Directory of Open Access Journals (Sweden)

    Azmi Nor Mohd Farez Ahmat

    2017-12-01

    Full Text Available Introduction: Pazopanib is the standard of care for metastatic renal cell carcinoma (mRCC. Previous studies on this indication were limited to patients who were selected on the basis of a fairly preserved performance status and normal organ function. Thus, the clinical trial population may not be representative of all patients seen in real-world practice. Based on these considerations, this prospective single-centre observational study was designed to evaluate the treatment outcomes and safety profile of pazopanib in Malaysian population. Patients and methods: Patients prescribed with pazopanib between June 2015 and June 2017 were recruited and followed up for 2-years or till death whichever comes first. Progression-free survival (PFS and overall survival (OS were evaluated. Multivariate and survival analysis were performed. Results: Twenty-seven patients were treated with pazopanib where 89% had clear cell histology.  Sixteen patients (59% were intermediate risk and 41% were poor risk based on Memorial Sloan Kettering Cancer Center (MSKCC criteria. All patients experienced at least one adverse event. The most common were cutaneous toxicity (92% followed by proteinuria, hypertension, diarrhoea and mucositis. Treatment interruption was needed in 15 patients. The median PFS and OS were 9.57 months and 15.5 months, respectively. In multivariate analysis, MSKCC risk score demonstrates strong predictive treatment outcome. The median PFS was 14.5 months in intermediate risk and 3.96 months in poor risk (OR: 0.2, p<0.001. However, the median OS is still immature to be reported since 63% of intermediate risk group is still alive at 2-years follow-up. Conclusion: In mRCC patients, treatment with pazopanib was effective in patients with intermediate risk group. In terms of safety, patient tolerated pazopanib quite well with mostly experienced grade 1 to 2 adverse events.

  19. HOSPITAL BASED BIRTH DEFECTS SURVEILLANCE WITH SPECIAL REFERENCE TO NEURAL TUBE DEFECTS: A STUDY OF ONE YEAR STATISTICS FROM A TERTIARY CARE GOVERNMENT TEACHING HOSPITAL OF NORTH COASTAL ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Manda Venkata

    2016-05-01

    Full Text Available INTRODUCTION Birth defects (also called congenital anomalies are defined as abnormalities of both structures or functions that are present at birth and are of prenatal origin. They contribute to a significant proportion of perinatal, neonatal & childhood mortality as well as morbidity. AIM To study at birth, prevalence of selected birth defects among babies delivered at King George Hospital, Visakhapatnam, from Jan 2015 to December 2015, appropriate management strategy of the most common neural tube defects. RESULTS Among the total deliveries of 6088 in the above period, the incidences of birth defects were 88 (1.44%, the most common among them were neural tube defects. CONCLUSION Birth defect surveillance and standardisation of the data is essential to understand the public health burden and to design appropriate prenatal prevention programs.

  20. NEEDLESTICK INJURY AMONG HEALTHCARE WORKERS IN A TERTIARY CARE HOSPITAL, KERALA

    Directory of Open Access Journals (Sweden)

    Chintha Sujatha

    2017-10-01

    Full Text Available BACKGROUND Needlestick Injury (NSI is a major occupational health and safety issue among Healthcare Workers (HCWs. In India, incidence of NSI is high, but surveillance is poor with scarce authentic data. The aim of the study is to determine the occurrence of NSI, its associated factors and assessment of knowledge and practice of preventive measures and post exposure prophylaxis among HCWs in a tertiary care hospital in Kerala. MATERIALS AND METHODS A cross-sectional study was conducted among 515 HCWs who included doctors, house surgeons, final year medical students, nurses, student nurses and lab technicians of a government sector tertiary care hospital in Kerala. All HCWs of the institution present during the study time were included and only those unwilling to participate excluded. Ethical clearance and administrative permission was obtained along with informed consent from subjects after ensuring confidentiality. Content validated, structured questionnaire consisting of questions regarding demographic data, incidence and prevalence of needlestick injury, circumstances leading to it, response of subjects to NSI and knowledge of study subjects on post exposure prophylaxis was administered to the study subjects. The technique of data collection was self-reporting by the study subjects. Data collected was analysed using statistical software Epi Info 7. RESULTS Overall, 55.7% HCWs had sustained at least one NSI in this hospital, while 35% of them had a NSI during the current year. NSIs were sustained during blood withdrawal (34%, injections (20.5%, suturing (20.2% and cannula insertion (12%. Recapping the needle (26% was the most frequent cause followed by collision with others (24%, manipulation of needle in patient (23% and during/in transit to disposal (10%. Majority (84% did not report the incident, 8.4% underwent post exposure follow up, 82% of the HCWs were fully hepatitis B vaccinated, 44% had received training, 62% used gloves, 49

  1. Prevalence and severity of disordered mineral metabolism in patients with chronic kidney disease: A study from a tertiary care hospital in India

    Directory of Open Access Journals (Sweden)

    Sanjay Vikrant

    2016-01-01

    Full Text Available Background: Disordered mineral metabolism is common complications of chronic kidney disease (CKD. However, there are limited data on the pattern of these disturbances in Indian CKD population. Materials and Methods: This was a prospective observational study of CKD-mineral and bone disorder (CKD-MBD over a period of 3 years. The biochemical markers of CKD-MBD, namely, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH, and 25-hydoxyvitamin Vitamin D3 (25OHD, were measured in newly diagnosed CKD Stage 3–5 and prevalent CKD Stage 5D adult patients. Results: A total of 462 patients of CKD Stage 3–5D were studied. The frequency of various biochemical abnormalities was hypocalcemia (23.8%, hypercalcemia (5.4%, hypophosphatemia (2.8%, hyperphosphatemia (55.4%, raised alkaline phosphatase (56.9%, secondary hyperparathyroidism (82.7%, and hypoparathyroidism (1.5%. 25OHD was done in 335 (72.5% patients and 90.4% were found to have Vitamin D deficiency. About 70.6% of the patients had iPTH levels were above kidney disease outcomes quality initiative (KDOQI target range. Nondiabetic CKD as compared to diabetic CKD had a higher alkaline phosphatase (P = 0.016, a higher iPTH (P = 0.001 a higher proportion of patients with iPTH above KDOQI target range (P = 0.09, and an elevated alkaline phosphatase (P = 0.004. The 25OHD levels were suggestive of severe Vitamin D deficiency in 33.7%, Vitamin D deficiency in 45.4%, and Vitamin D insufficiency in 11.3% patients. There was a significant positive correlation between iPTH with alkaline phosphatase (r = 0.572, P = 0.001, creatinine (r = 0.424, P = 0.001, and phosphorus (r = 0.241, P = 0.001 and a significant negative correlation with hemoglobin (r = −0.325, 0.001, age (r = −0.169, P = 0.002, and 25OHD (r = −0.126, P = 0.021. On multivariate logistic regression analysis, an elevated alkaline phosphatase was a significant predictor of hyperparathyroidism (odds ratio 9.7, 95

  2. SEVA TB ELISA - Multi antigen and antibody assays for serodiagnosis of suspected cases of pulmonary and extra pulmonary tuberculosis in tertiary care hospital -A retrospective study

    Directory of Open Access Journals (Sweden)

    Pranita J Waghmare

    2012-10-01

    Full Text Available Objective: To assess the usefulness of in-house developed multiantigen and antibody assays, in diagnosis of both pulmonary and extra-pulmonary tuberculosis. Method: Clinically suspected cases of 31 pulmonary and 171 extra-pulmonary tuberculosis (TB were screened by ELISA using cocktail (ES-31 + EST-6 antigen and their specific antibodies (anti ES-31 + anti EST-6 IgG for detection of antibody and and antigen (circulating antigen and immune complexed antigen respectively and correlated with antituberculosis therapy in retrospective study. Results: Out of 31 cases of pulmonary TB screened, 15 patients showed ELISA positivity out of which five cases were given antituberculosis therapy. Out of 171 cases of EPTB screened, 76 cases showed ELISA positivity out of which 18 were given antituberculosis therapy. Further 4 EPTB cases which showed AFB negativity were given ATT. The data was further analyzed based on PTB & EPTB, adults and children, OPD and IPD patients to understand false positivity in clinically suspected PTB and EPTB cases. There was significant correlation (108/202 cases with ELISA negativity and no ATT advised in clinically suspected PTB and EPTB patients. Conclusions: In house developed multi antigen and antibody assays have been observed to be quite useful as adjunct test in serodiagnosis of suspected cases of tuberculosis in particular extrapulmonary tuberculosis.

  3. Comparative study of Smear Microscopy, Rapid Slide Culture, and Lowenstein - Jensen culture in cases of pulmonary tuberculosis in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Ravish Kumar Muddaiah

    2013-01-01

    Full Text Available Background: Tuberculosis (TB, a dreadful disease known to mankind continues to be a problem in a developing country like India. The incidence of people getting infected with TB is on the rise due to compounding factors like coinfection with the human immunodefiency virus and multidrug-resistant strains. There is a definitive need for early diagnosis and treatment of TB to curb transmission of the infection. Direct smear microscopy, though cheap and rapid, lacks sensitivity. Isolation of Mycobacterium tuberculosis in culture requires a long time, because of which there is a need for a rapid method which has good sensitivity and specificity for the detection of M. tuberculosis. The present study was undertaken to determine the test which diagnoses TB rapidly and to compare the sensitivity of smear microscopy, concentration method, rapid slide culture, and Lowenstein - Jensen (LJ culture. Materials and Methods: Sputum samples of 200 patients were subjected to direct smear and concentration by modified Petroff′s method. The concentrated sputum was also taken for slide culture using human blood medium and inoculated on LJ media. Results: LJ culture was positive in 47 (23.5% cases, of which three were nontubercular mycobacteria. Using LJ culture as the standard method, the sensitivity of direct smear, concentration method, and rapid slide culture method was 68, 83, and 89%, respectively, and specificity was 100% in all the three tests. Conclusion: Rapid slide culture showed good sensitivity which was comparable to and next in efficacy to LJ culture and this technique can be adopted in the Revised National Tuberculosis Control Program (RNTCP as it is a rapid, cheap, sensitive, and specific method.

  4. Unintentional injuries among children admitted in a tertiary care hospital in North Kerala.

    Science.gov (United States)

    Sheriff, Akbar; Rahim, Asma; Lailabi, M P; Gopi, Jibin

    2011-01-01

    World Health Organization global disease update (2004) points out injuries as the sixth leading cause of morbidity and mortality in childhood. A descriptive hospital based study was conducted to find out the common types of unintentional injuries among children admitted for management of unintentional injuries in Pediatric Surgery department and Intensive Care Unit of a tertiary care hospital of North Kerala and to find out the contributing risk factors. A total of 400 children admitted during the study period of 6 months of 2009 constituted the study population. Mechanical injuries comprising of Road traffic accidents and accidental fall were the major cause of unintentional injuries (36%), followed by Poisoning (22.3%). A higher proportion of unintentional injuries were noted to occur among children of younger mothers, overactive child, children belonging to extended or joint families, child left alone or with friends, pre-school children, male child and from urban dwellings. The study highlights the need to identify the different types of unintentional injuries and the risk factors of childhood injuries which require hospitalisation. Identification of risk factors will help to formulate strategies aimed at risk reduction and prevention of childhood injuries.

  5. [Functional echocardiography in the neonatal intensive care unit; experience in a tertiary level hospital].

    Science.gov (United States)

    Hernández-Benítez, Rodrigo; Becerra-Becerra, Rosario

    The Hospital Infantil de Mexico Federico Gómez is a tertiary level hospital with a neonatal intensive care unit (NICU), which is one of the most important units in the treatment of newborn's diseases in México. In this unit, the decisions are taken based on some clinic parameters such as respiratory rate, heart rate, arterial pressure, urinary output and lactate levels. The functional echocardiography is a useful tool which improves the hemodynamic evaluation and decisions in neonatal care. Data on its use in neonatal units in Mexico is lacking. A prospective study conducted in NICU patients during 3 months from August to October 2015 at the Hospital Infantil de Mexico Federico Gómez. Gestational age, birth weight, admission criteria, days of life at examination, indication for functional echocardiography and changes in treatment were evaluated and finally, we performed a new study 24hours later. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA; myocardial function: ejection fraction/shortening fraction, left ventricular output, right ventricular output, systemic blood flow; and signs of pulmonary hypertension. 30 echocardiographic studies were performed in 15 patients. The average age was 9.6 days, the variability in gestational ages were 37 to 42 weeks; the average weight was 2.583kg. The most frequent diagnosis was respiratory distress, and the principal indications for echocardiography were hemodynamic instability and sepsis (53.3%). In 11 cases (73.3%), the treatment was modified posteriorly to functional echocardiography, and in 10 cases we observed improvements in the 24hours after control. Functional echocardiography is a useful tool in NICU, which may assist with clinical decision-making. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

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    Medici, André

    2015-01-01

    Current legislation transferred public tertiary hospitals in Bolivia from the Municipalities to the Regional Level. However, the Regional Governments are experiencing technical and financial constraints to reform infrastructure, modernize equipment and introduce reforms to allow better governance, management and sustainability of these hospitals. This articles summarizes the recent experience of the Government of Santa Cruz de la Sierra in Bolivia where five tertiary hospitals and blood bank (most of them in precarious working conditions) has been transferred in 2012 from the Municipal Government of Santa Cruz (the capital) to the Regional Government of Santa Cruz. To face the challenges, the Regional Government of Santa Cruz implement several improvements, such as contract new clinical and administrative personal, increases hospital budgetary autonomy, outsource hospitals' auxiliary services, take measures to eliminate waiting lists and make several new investments to modernize and equip the hospitals. The World Bank was contracted to evaluated the future financial sustainability of these investments and to advice the Government to propose changes to increase the hospitals' management performance. The article describes the remaining challenges in these hospitals and the proposals from the World Bank Study. In the area of quality of care, the main challenge is to improve client satisfaction and continuous outcomes monitoring and evaluation according quality standards. In the area of financing, the challenge is how to assure the sustainability of these hospitals with the current level of health financing and the insufficient financial transfers from the National Government. In the area of Governance, reforms to streamline and simplify internal processes need to be introduced in order to establish mechanisms to increase transparency and accountability, allowing the hospital to have a good administration and adequate participation of the main actors in the guidance of

  7. Perception of pharmacovigilance among doctors in a tertiary care hospital: influence of an interventional lecture.

    Science.gov (United States)

    Sanghavi, Dhara R; Dhande, Priti P; Pandit, Vijaya A

    2013-01-01

    One of the important pillars of an efficient pharmacovigilance system is contribution by healthcare professionals in the form of spontaneous reporting. This study was aimed at investigating the knowledge, attitude and practice of spontaneous ADR reporting among doctors in a teaching hospital in Pune, and to analyze the effect of an informative lecture about Pharmacovigilance on the same. This was an interventional study conducted among 220 doctors at a tertiary care teaching hospital, Pune. Each participant was explained the purpose of study and asked to fill in a questionnaire about their knowledge, attitude and practice of pharmacovigilance. Only 80 of them attended the interventional lecture on Pharmacovigilance and again filled up the questionnaire after a period of one month from this intervention. Merely 7.5% of the participants knew ADR reporting system in India. Majority of the respondents (95%) knew that, as doctors, they could report ADRs but were unaware about the methodology to report (92.5%) which affected their practice of Pharmacovigilance. All (100%) the participants expressed that proper training should be provided to clinicians for ADR reporting & 81% felt ADR reporting should be made mandatory. Only 80 participants (36.4%) attended the interventional lecture which reflected a poor response. Intervention improved their (96%) knowledge about ADR reporting system and now majority of them (92%) agreed that all sort of ADRs should be reported (p pharmacovigilance.

  8. Hand hygiene compliance in the intensive care units of a tertiary care hospital

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    Sarit Sharma

    2011-01-01

    Full Text Available Context: Hand hygiene (HH is the most important measure to prevent hospital-acquired infections but the compliance is still low. Aims: To assess the compliance, identify factors influencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW. Settings and Design: Cross-sectional study conducted in 42 bedded Medical (Pulmonary, Medicine and Stroke intensive care units (ICU of a tertiary care hospital. Materials and Methods: HCWs (doctors and nurses were observed during routine patient care by observers posted in each ICU and their HH compliance was noted. Thereafter, questionnaire regarding knowledge, perception and attitudes toward HH was filled by each HCW. Statistical Analysis: Percentages and χ2 test. Results: The overall compliance was 43.2% (394/911 opportunities. It was 68.9% (31/45 in the intensivists, 56.3% (18/32 in attending physicians, 40.0% (28/70 in the postgraduate residents and 41.3% (301/728 in the nurses. Compliance was inversely related to activity index. Compliance for high, medium and low risk of cross-transmission was 38.8% (67/170, 43.8% (175/401 and 44.7% (152/340, respectively. Conclusions: Compliance of the study group is affected by the activity index (number of opportunities they come across per hour and professional status. The HCWs listed less knowledge, lack of motivation, increased workload as some of the factors influencing HH.

  9. 46. Nurses perception of rapid response team in a tertiary hospital in Saudi Arabia

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    Emad Mraweh Mustafa

    2015-10-01

    Full Text Available For the last 30 years, the goal of improving the survival rate for patients post cardiopulmonary arrest has remained unattainable. This apparent failure to rescue opened the door to devise new strategies to improve patient outcomes at the onset of subtle deterioration, rather than at the point of cardiac arrest. Institute for Healthcare Improvement (IHI introduced the Rapid Response Team (RRT as one of the six preventative steps to save lives. Nurses’ perceptions of the RRT influenced by the content and process support provided. Nurses are responsible to detect the early signs of deterioration, and activate the RRT service. The aim of this cross sectional descriptive study was to examine nurses’ perceptions about the effect of the RRT and perceived content and process support in managing patient deterioration by using mental model maintenance and building at individual, group and hospital levels in a tertiary hospital in the Kingdom of Saudi Arabia. 300 nurses were recruited using a convenience sampling method. The study findings showed that the overall perceptions about the RRT were high. There was a significant positive correlation between the frequent utilization of the RRT and the perceived content support. The analysis of the open ended questions indicated that there were more advantages to have the RRT service than disadvantages. This study suggested that RRT service is influential in improving nurses’ perceptions about managing Patients’ deterioration. Training program about RRT utilization should include both content and process support, which may enhance building and maintaining mental model.

  10. Awareness and practices of standard precautions for infection control among nurses in a tertiary care hospital.

    Science.gov (United States)

    Acharya, Anita S; Khandekar, Jyoti; Sharma, Amit; Tilak, H R; Kataria, Asha

    2013-01-01

    Nursing personnel are at a greater risk of acquiring and transmitting blood-borne pathogens. Knowledge about standard precautions and practicing them is very critical in preventing blood borne transmitted infections. This cross sectional hospital-based study sought to assess the level of knowledge and practices regarding standard precautions for infection control amongst nurses and to determine their source of information. In a tertiary care hospital in Delhi, 293 nurses were administered a semi structured questionnaire in December 2011. Questions were asked on knowledge and practices about standard precautions, transmission of blood-borne pathogens, use of gloves, hand washing. Data was entered and analysed in SPSS version 12. The study revealed that the nurses had poor knowledge about standard precautions (97.9%). 189 (64.5%) nurses had inadequate knowledge about the transmission of blood-borne pathogens; more than three-fourth (77.5%) were aware about hepatitis-B vaccine; majority (72.7%) practiced washing soiled hands immediately; and more than half (58.7%) used Gowns and Gloves very often. Refresher training (34.5%) was the major source of information. This study has highlighted major gaps between the knowledge and practices of nurses regarding standard precautions.

  11. Experiences of health professionals with nutritional support of critically ill patients in tertiary hospitals in Malawi.

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    Bunyani, A; Mtimuni, B; Kalimbira, A; Kamalo, P

    2015-03-01

    Nutritional support is a recognized determinant of outcome in critically ill patients. Development of critical care services in low-income countries has not been accompanied by certain appropriate ancillary services and interventions, such as adequate nutritional support. This study was designed to investigate the experiences of health professionals who have provided nutritional supportive care to critically ill patients admitted to two major central hospitals in Malawi, with the aim of identifying the common practices in nutritional support in these settings. A cross-sectional study in which 50 health professionals working in intensive care and high dependency units, admitting both adult and pediatric patients, were interviewed using a semi-structured questionnaire. Data were coded and then analyzed using SPSS version 16.0. Responses between the two hospitals were compared using Fisher's exact test. There was no difference in the composition of respondents from the two hospitals. About 60% of respondents had had experience with nutritional supplementation in their patients-mainly enteral. The most commonly used formulations were the "ready-to-use therapeutic feeds," followed by modified milk. A high percentage of respondents (40%) reported having used dextrose solution as the sole nutritional supplement. Lack of in-service training, nonexistent nutrition protocols pertaining to acutely and critically ill patients, and a lack of clinical nutritionists were the major challenges identified. Knowledge of nutrient supplementation was poor among the respondents. The use of ready-to-use therapeutic feeds was quite common, although there is no evidence of its effectiveness in care of acutely critically ill patients. There is a need to establish nutritional support teams in these tertiary hospitals. Clinical nutritionists would ideally help train and play leadership roles in such teams, who would be responsible for assessing patients for their nutritional needs, and

  12. Level of adherence to an extravasation protocol over 10 years in a tertiary care hospital.

    Science.gov (United States)

    Molas-Ferrer, Gloria; Farré-Ayuso, Elisabet; doPazo-Oubiña, Fernando; deAndrés-Lázaro, Ana; Guell-Picazo, Jaume; Borrás-Maixenchs, Núria; Corominas-Bosch, Lourdes; Valverde-Bosch, Montserrat; Creus-Baró, Natalia

    2015-04-01

    Extravasation of chemotherapy is an undesirable complication related to the administration of antineoplastic therapy. Establishing the real incidence is difficult. Because of the importance of a quick intervention after an extravasation, every hospital should have an extravasation protocol. The purpose of this study was to determine the degree of observance of an extravasation protocol by nursing staff and to determine extravasation incidence. This descriptive, longitudinal, retrospective study was set in a tertiary-level hospital. The researchers reviewed 117 extravasation notification forms received by the pharmacy department during a 10-year period. Nursing actuation, particularly observance of the extravasation protocol, was analyzed. Protocol adherence was 89%. Twelve deviations from the protocol in the application of recommended measures were detected. An antidote was used in 41 patients, and temperature measures were applied in 14 cases. Ninety-nine patients had at least one episode of reported follow-up. No cases of necrosis or skin ulcers were described, except by one patient, who developed a delayed skin ulcer to vinorelbine. Drugs most frequently reported were etoposide, carboplatin, and paclitaxel. Nursing staff should be continuously trained in extravasation protocol because a rapid actuation can prevent skin lesions.

  13. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital

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    Leelavathi D Acharya

    2016-01-01

    Full Text Available Background: The impact of diabetes on health-care expenditures has been increasingly recognized. To formulate an effective health planning and resource allocation, it is important to determine economic burden. Objective: The objective of this study is to assess the cost of illness (COI for diabetic inpatients with or without complications. Methodology: The study was conducted in the medicine wards of tertiary care hospital after ethical approval by the Institutional Ethical Committee. A total of 116 each diabetic with or without complications were selected and relevant data were collected using COI questionnaire and data were analyzed using SPSS version 20. Mann–Whitney U test is used to assess the statistical significant difference in the cost of treatment of diabetes alone and with complications'. P ≤ 0.05 was considered statistically significant. Results: Total COI includes the cost of treatment, investigation, consultation fee, intervention cost, transportation, days lost due to work, and hospitalization. The median of total COI for diabetic care without any complication was Rs. 22,456.97/- per patient per annum and with complication was Rs. 30,634.45/-. Patients on dialysis had to spend 7.3 times higher, and patients with cardiac intervention had to spend 7.4 times higher than diabetic patients without any complication. Conclusion: Treatment costs were many times higher in patients with complications and with cardiac and renal interventions. Complications in diabetic patients will increase the economic burden to family and also to the society.

  14. Frequency of IgA Nephropathy Presenting at a Tertiary Care Hospital in Pakistan.

    Science.gov (United States)

    Arshi, Shahana; Nasir, Humaira; Butt, Ghias-Ud-Din; Niazi, Aasiya; Mamoon, Nadira; Qamar, Sana Roshan; Mushtaq, Rabia

    2016-08-01

    To determine the frequency of IgAnephropathy presenting at a tertiary care hospital. Across sectional, observational study. Pakistan Institute of Medical Sciences, Islamabad and Shifa International Hospital, Islamabad, Pakistan, from November 2008 to November 2014. This was a retrospective analysis of renal biopsies for the diagnosis of nephropathy during the study period. Biopsies were stained with fluorescence isothyocyanate (FITC) labelled antibodies against IgG, IgA, IgM, C3, C4 and C1q for fluorescent microscopy. For histopathological examination, the specimens were stained with hematoxylin and eosin, Periodic acid Schiff and methanamine silver stains for light microscopy. Out of total 1,658 renal biopsy cases, 142 (8.6%) were diagnosed as IgA nephropathy on light and immunofluorescence microscopy. Majority of IgAnephropathy patients were young (mean age = 33.2) and presented with proteinuria. The frequency rose from 2% in 2008 to 9.4% in 2014. IgAnephropathy was present in younger population and has a rising trend in our population.

  15. Carriage of antibiotic-resistant Enterobacteriaceae in hospitalised children in tertiary hospitals in Harare, Zimbabwe.

    Science.gov (United States)

    Magwenzi, Marcelyn T; Gudza-Mugabe, Muchaneta; Mujuru, Hilda A; Dangarembizi-Bwakura, Mutsa; Robertson, Valerie; Aiken, Alexander M

    2017-01-01

    Extended-spectrum β-lactamase-producing and gentamicin resistant Enterobacteriaceae are increasingly recognised as a major cause of infection in low-income countries. We assessed the prevalence of gastrointestinal carriage of these bacteria in hospitalised children in Harare, Zimbabwe. We conducted a cohort study in paediatric inpatients at two tertiary-referral hospitals between May and July 2015. Rectal swabs and faecal samples were collected within 24 h of admission and further follow-up samples were collected on alternate days during hospitalization. Disc-based, selective and enrichment methods were used to detect carriage of these two forms of resistance. Standard methods were used to confirm resistance status and determine the susceptibility of resistant isolates to other commonly-used antibiotics. One hundred and sixty four paediatric inpatient admissions (median age = 1.0 year, IQR = 0.2-2.2years) were enrolled, and an average of 1.9 faecal samples per patient were collected. On admission, 68/164 (41%) patients had both ESBL and gentamicin-resistant Enterobacteriaceae detected, 18 (11%) had ESBL only, 17 (10%) had gentamicin resistance only and 61 (37%) had negative screening for both forms of resistance. During hospitalisation, 32/164 (20%) patients were found to have a type of resistant organism which was not present in their admission sample. We found that faecal samples and use of a selective enrichment broth enhanced the detection of resistant organisms. Amongst resistant bacteria isolated, there were high levels of resistance to ciprofloxacin and chloramphenicol, but not ertapenem. More than half of children had enteric carriage of a clinically-relevant form of antibiotic resistance on admission to public-sector hospitals in urban Zimbabwe. Additionally, a fifth of children acquired a further form of resistance during hospitalisation. Urgent action is needed to tackle the spread of antibiotic resistant enteric bacteria in African hospitals.

  16. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

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    Xiu-Bin Tao

    2014-10-01

    Full Text Available A single-day hospital-acquired infections (HAIs point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26% among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%, followed by surgical site infection (22.99%. The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumoniae (14.00% and Escherichia coli (14.00%.

  17. Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland

    Science.gov (United States)

    Bloch-Infanger, Constantine; Bättig, Veronika; Kremo, Jürg; Widmer, Andreas F.; Egli, Adrian; Bingisser, Roland; Battegay, Manuel; Erb, Stefan

    2017-01-01

    Objective The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland. Methods At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospitalizations. Results Hundred ninety five of 2’544 and 516 of 6’243 asylum seekers registered at the national asylum reception and procedure centre Basel were referred to the University Hospital Basel in 2004/05 and 2014/15, and originated mainly from Europe (62.3%, mainly Turkey) and Africa (49.1%, mainly Eritrea), respectively. Median age was similar in both study periods (26.9 and 26.2 years). Infectious diseases in asylum seekers increased from 22.6% to 36.6% (p<0.001) and were the main reasons for hospitalizations (33.3% of 45 and 55.6% of 81 hospitalized patients, p = 0.017) in 2004/05 compared to 2014/15. The leading infectious diseases in hospitalized patients were tuberculosis (n = 4) and bacterial skin infections (n = 2) in 2004/05; Malaria (n = 9), pneumonia (n = 6), Chickenpox (n = 5), other viral infections (n = 5) and bacterial skin infections (n = 5) in 2014/15. Infectious diseases like malaria, cutaneous diphtheria, louseborne-relapsing fever or scabies were only found in the second study period. Almost one third of the admitted asylum seekers required isolation precautions with median duration of 6–9.5 days in both study periods. Conclusions The changing demography of asylum seekers arriving in Switzerland in the current refugee crisis has led to a shift in disease patterns with an increase of infectious diseases and the re-emergence of migration-associated neglected infections. Physicians should be aware of these new challenges. PMID:28617860

  18. Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland.

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    Constantine Bloch-Infanger

    Full Text Available The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland.At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospitalizations.Hundred ninety five of 2'544 and 516 of 6'243 asylum seekers registered at the national asylum reception and procedure centre Basel were referred to the University Hospital Basel in 2004/05 and 2014/15, and originated mainly from Europe (62.3%, mainly Turkey and Africa (49.1%, mainly Eritrea, respectively. Median age was similar in both study periods (26.9 and 26.2 years. Infectious diseases in asylum seekers increased from 22.6% to 36.6% (p<0.001 and were the main reasons for hospitalizations (33.3% of 45 and 55.6% of 81 hospitalized patients, p = 0.017 in 2004/05 compared to 2014/15. The leading infectious diseases in hospitalized patients were tuberculosis (n = 4 and bacterial skin infections (n = 2 in 2004/05; Malaria (n = 9, pneumonia (n = 6, Chickenpox (n = 5, other viral infections (n = 5 and bacterial skin infections (n = 5 in 2014/15. Infectious diseases like malaria, cutaneous diphtheria, louseborne-relapsing fever or scabies were only found in the second study period. Almost one third of the admitted asylum seekers required isolation precautions with median duration of 6-9.5 days in both study periods.The changing demography of asylum seekers arriving in Switzerland in the current refugee crisis has led to a shift in disease patterns with an increase of infectious diseases and the re-emergence of migration-associated neglected infections. Physicians should be aware of these new challenges.

  19. Pattern of Pediatric Dermatoses in a Tertiary Care Hospital of Western Nepal

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    Yogesh Poudyal

    2016-01-01

    Full Text Available Pediatric dermatoses are one of the most common presentations in a dermatology clinic and reflect the health and hygiene status of children. The incidence and severity of these skin lesions are influenced by geographical area, seasonal and cultural factors, and socioeconomic status. This study was done to show the prevalence of different pediatric dermatoses in a tertiary care hospital of Western Nepal. Chart reviews of children aged one day to 17 years, presenting to Universal Medical College Teaching Hospital, Nepal, from 1 September 2014 to 30 august 2015, were done. Descriptive analysis and two-sided chi-square test were done. Among 23992 patients visiting the dermatology outpatient department (OPD, 5398 (22.5% were of pediatric age groups (male/female: 1.2/1; most of them belonged to young teens and teenagers (n=3308; 61.3%. Three most common dermatoses were fungal infections (18.5%, eczema (14.4%, and acne (10.1%. Fungal infections (n=653; 65.4% and acne (n=284; 51.9% were common in males, whereas eczema (n=402; 51.7% was more common in females. Fungal infection (P<0.001, eczema (P<0.001, pigmentation disorders (P<0.001, and acne (P<0.01 were significantly more during summer, while scabies was more in winter (P<0.001. Dermatophytosis, pyoderma, and warts comprised frequently occurring fungal, bacterial, and viral infections, respectively.

  20. High Frequency of Acinetobacter soli among Acinetobacter Isolates Causing Bacteremia at a Tertiary Hospital in Japan

    Science.gov (United States)

    Yano, Hisakazu; Kanamori, Hajime; Inomata, Shinya; Aoyagi, Tetsuji; Hatta, Masumitsu; Gu, Yoshiaki; Tokuda, Koichi; Kitagawa, Miho; Kaku, Mitsuo

    2014-01-01

    Acinetobacter baumannii is generally the most frequently isolated Acinetobacter species. Sequence analysis techniques allow reliable identification of Acinetobacter isolates at the species level. Forty-eight clinical isolates of Acinetobacter spp. were obtained from blood cultures at Tohoku University Hospital. These isolates were identified at the species level by partial sequencing of the RNA polymerase β-subunit (rpoB), 16S rRNA, and gyrB genes. Then further characterization was done by using the PCR for detection of OXA-type β-lactamase gene clusters, metallo-β-lactamases, and carO genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing were also performed. The most frequent isolate was Acinetobacter soli (27.1%). Six of the 13 A. soli isolates were carbapenem nonsusceptible, and all of these isolates produced IMP-1. PFGE revealed that the 13 A. soli isolates were divided into 8 clusters. This study demonstrated that A. soli accounted for a high proportion of Acinetobacter isolates causing bacteremia at a Japanese tertiary hospital. Non-A. baumannii species were identified more frequently than A. baumannii and carbapenem-nonsusceptible isolates were found among the non-A. baumannii strains. These results emphasize the importance of performing epidemiological investigations of Acinetobacter species. PMID:24403303

  1. An overview of the health status of Syrian refugee children in a tertiary hospital in Turkey.

    Science.gov (United States)

    Bucak, Ibrahim Hakan; Almis, Habip; Benli, Samet; Turgut, Mehmet

    2017-01-01

    Migration is a problem affecting all family members, but particularly children. Child refugees are the highest risk group for the health systems of receiving countries. We investigated the health of 104 Syrian child refugees presenting to a tertiary hospital in Turkey. A retrospective study was conducted in the pediatric clinic. The medical files of Syrian refugee children (0-18 years) presenting to Adiyaman University Hospital, Pediatric Clinic between 01 and 30 November 2015, were investigated. Demographic data, body measurements, and laboratory results obtained from patients' medical records were evaluated. Mean age of patients was 53.5 ± 49.6 (2-198) months; 63 were male and 41 were female. Seventy-two patients (69.2%) were under 5 years of age. Weight in 20 patients (19.2%), height in 33 (31.7%), head circumference in 2 (1.9%), and body mass index in 7 (6.7%) were below the third percentile. All patients with body weight below the third percentile had chronic malnutrition. Anemia was present in 35 (50%) of the 70 patients for whom complete blood count data were available. Health workers involved with Syrian refugee children must consider the two preventable conditions; malnutrition and anemia.

  2. Survey of complementary and alternative medicine use at a tertiary children's hospital.

    Science.gov (United States)

    Lim, Alissa; Cranswick, Noel; Skull, Susan; South, Mike

    2005-08-01

    The use of complementary and alternative medicine (CAM) within the Australian community is common. The objective of this study was to determine the prevalence and pattern of CAM usage in children attending a tertiary children's hospital. We conducted a cross-sectional survey of children attending the Royal Children's Hospital, Melbourne. Children were identified by consecutive acute admissions and attendance at outpatient clinics. A structured questionnaire with items about the use of CAM in the preceding year was administered by means of a face-to-face interview. Based on the 503 children surveyed, 51% reported CAM use in the preceding year. Forty-three percent had used at least one CAM medication. The most common medicinal CAM used were multivitamins, vitamin C, herbal remedies and homeopathic treatments. Non-medicinal CAM was used by 23% of the participants. The most commonly used therapies were chiropractic, naturopathy, aromatherapy, therapeutic massage and dietary restriction. The main reasons stated for CAM usage included promotion of general health and treatment of colds. Sixty-three percent of those reporting CAM use had not discussed this with their treating doctor. The use of CAM by children is common. Complementary and alternative medicine is particularly used for the treatment of common illnesses and conditions of childhood. Importantly, use is not always conveyed to treating physicians. Given the potential risk of adverse events associated with the use of CAM or interactions with conventional management, doctors should ask about their use as a part of routine history taking.

  3. Ertapenem resistance in 2 tertiary-care hospitals: Microbiology, epidemiology, and risk factors.

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    Maldonado, Natalia; Castro, Bibiana; Berrio, Indira; Manjarrés, Miguel; Robledo, Carlos; Robledo, Jaime

    2017-10-01

    Carbapenems resistance is a growing phenomenon and a threat to public health because of the reduced therapeutic options for resistant infections. A retrospective case-control study was conducted in 2 tertiary-care hospitals in Medellín, Colombia. Fifty patients infected with ertapenem-resistant enterobacteriaceae were compared with a control group consisting of 100 patients with infections caused by ertapenem susceptible enterobacteriaceae. A multivariate logistic regression model was used to identify factors that best explain ertapenem-resistant enterobacteriaceae infections. The factors associated with ertapenem-resistant enterobacteriaceae infections were prior exposure to carbapenems (adjusted OR 3.43; 95% IC 1.08-10.87) and prior exposure to cefepime (adjusted OR 6.46; 95% IC 1.08-38.38). Prior exposure to antibiotics is the factor that best explains the ertapenem-resistant enterobacteriaceae infection in this population, highlighting the importance of antimicrobial stewardship programs in hospitals. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital.

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    Chandramouleeswaran, Susmita; Edwin, Natasha C; Braganza, Deepa

    2014-07-01

    It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship. A modified version of the health consultant's job stress and satisfaction questionnaire (HCJSSQ) was used to assess and quantify aspects of internship that were perceived as stressful and satisfying. Methods used to cope with work place stress were explored. A prospective cohort study was undertaken among 93 medical interns doing a rotating internship at the Christian Medical College and Hospital, a tertiary-care hospital in southern India. After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants. The data were entered into Statistical Package for the Social Sciences (SPSS) Version 9 by double data entry technique. Percentages of interns reporting high levels of stress, satisfaction were calculated. While 63.4% of interns reported high levels of satisfaction, 45.2% of the interns experienced high levels of stress, 17.6% coped with work stress by using alcohol and nicotine, and 37% coped through unhealthy eating habits. More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

  5. Validation of the palliative performance scale in the acute tertiary care hospital setting.

    Science.gov (United States)

    Olajide, Oludamilola; Hanson, Laura; Usher, Barbara M; Qaqish, Bahjat F; Schwartz, Robert; Bernard, Stephen

    2007-02-01

    Physicians are often asked to prognosticate patient survival. However, prediction of survival is difficult, particularly with critically ill and dying patients within the hospitals. The Palliative Performance Scale (PPS) was designed to assess functional status and measure progressive decline in palliative care patients, yet it has not been validated within hospital health care settings. This study explores the application of the PPS for its predictive ability related to length of survival. Other variables examined were correlates of symptom distress in a tertiary academic setting. Patients were assigned a score on the PPS ranging from 0% to 100% at initial consultation. Standardized symptom assessments were carried out daily, and survival was determined by medical record review and search of the National Death Index. Of 261 patients seen since January 2002, 157 had cancer and 104 had other diagnoses. PPS scores ranged from 10% to 80% with 92% of the scores between 10% and 40%. Survival ranged from 0 to 30 months, with a median of 9 days. By 90 days, 83% of patients had died. Proportional hazards regression estimates showed that a 10% decrement in PPS score was associated with a hazard ratio of 1.65 (95% confidence interval [CI]: 1.42-1.92). Proportional odds regression models showed that a lower PPS was significantly associated with higher levels of dyspnea. The PPS correlated well with length of survival and with select symptom distress scores. We consider it to be a useful tool in predicting outcomes for palliative care patients.

  6. Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes.

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    Dimitra Koukou

    Full Text Available Rotavirus (RV infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units.Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age.A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers.Positive for RV were 126/415 samples (30.4%. Mean age of onset was 18 days. Seventy four cases (58% were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%, G1P[8] (14.7%, G12P[8] (9.3%, G3P[8] (9.3%, G12P[6] (5.3%, G9P[8] (1.3% and G2P[4] (1.3%. RV cases presented with: diarrhea (81%, vomiting (26.2%, fever (34.9%, dehydration (28.6%, feeding intolerance (39.7%, weight loss (54%, whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found.Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity.

  7. Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes.

    Science.gov (United States)

    Koukou, Dimitra; Chatzichristou, Panagiota; Trimis, Georgios; Siahanidou, Tania; Skiathitou, Anna-Venetia; Koutouzis, Emmanouil I; Syrogiannopoulos, George A; Lourida, Athanasia; Michos, Athanasios G; Syriopoulou, Vassiliki P

    2015-01-01

    Rotavirus (RV) infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units. Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age. A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers. Positive for RV were 126/415 samples (30.4%). Mean age of onset was 18 days. Seventy four cases (58%) were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%), G1P[8] (14.7%), G12P[8] (9.3%), G3P[8] (9.3%), G12P[6] (5.3%), G9P[8] (1.3%) and G2P[4] (1.3%). RV cases presented with: diarrhea (81%), vomiting (26.2%), fever (34.9%), dehydration (28.6%), feeding intolerance (39.7%), weight loss (54%), whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found. Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity.

  8. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India

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    Vaishali D Phalke

    2011-01-01

    Full Text Available BackgroundPrescription is a written order from physician to pharmacistwhich contains name of drug, its dose and its method ofdispensing and advice over consuming it. The frequency ofdrug prescription errors is high. Prescribing errorcontributes significantly towards adverse drug events. Thepresent study was undertaken to understand the currentprescription writing practices and to detect the commonerrors in them at a tertiary health care centre situated in arural area of Western Maharashtra, India.MethodA cross sectional study was conducted at a tertiary levelhospital located at a rural area of Maharashtra state, Indiaduring October 2009-March 2010. 499 prescriptions comingto medical store during period of one month wereconsidered for data analysis. Important informationregarding the patient, doctor, drug and the generaldescription of the prescription were obtained.ResultsAll the prescriptions were on the hospital pad. A significantnumber of the prescriptions (n=88, 17.6% were written inillegible handwriting and not easily readable. The name, ageand sex of the patient were mentioned is majority of theprescriptions. All the prescriptions (100% failed todemonstrate the presence of address, height and weight ofthe patient. Only the brand name of the drugs wasmentioned in all the prescriptions with none of them havingthe generic name. The strength, quantity and route ofadministration of the drug were found on 73.1%, 65.3% and75.2% prescriptions.ConclusionThere are widespread errors in prescription writing by thedoctors. Educational intervention programs and use ofcomputer can substantially contribute in the lowering ofsuch errors. A short course on prescription writing beforethe medical student enters the clinical field and strictmonitoring by the administrative authorities may also helpalleviate the problem.Word count: 2980Tables: 2

  9. Spectrum of antihypertensive therapy in South Asians at a tertiary care hospital in Pakistan

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    Ehtamam Anabia

    2011-09-01

    Full Text Available Abstract Background Despite available guidelines on hypertension (HTN, use of antihypertensives is variable. This study was designed to ascertain frequency of patients on monotherapy and > 1 antihypertensive therapy and also to ascertain proportion of patients on diuretic therapy. Methods It was a crossectional study conducted on 1191 adults(age > 18 yrshypertensive patients selected by computerized International Classification of Diseases -9-coordination and maintenance (ICD-9-CM presenting to a tertiary care hospital in Pakistan. Data on demographics, comorbids, type of antihypertensive drug, number of antihypertensive drug and mean duration of antihypertensive drug was recorded over 1.5 year period (2008-09. Blood pressure was recorded on admission. Primary outcome was use of combination therapy and secondary outcome was use of diuretic therapy. Results A total of 1191 participants were included. Mean age(SD was 62.55(12.47 years, 45.3%(540 were males. Diabetes was the most common comorbid; 46.3%(551. Approximately 85% of patients had controlled hypertension. On categorization of anti hypertensive use into 3 categories;41.2%(491 were on monotherapy,32.2%(384 were on 2 drug therapy,26.5%(316 were on ≥3 drug therapy. Among those who were on monotherapy for HTN;34%(167 were on calcium channel blockers,30.10%(148 were on beta blockers, 22.80%(112 were on Angiotensin converting enzyme (ACE inhibitors,12%(59 were on diuretics and 2.20%(11 were on Angiotensin receptor blockers(ARB. Use of combination antihypertensive therapy was significantly high in patients with ischemic heart disease(IHD(p Conclusion Most patients presenting to our tertiary care center were on combination therapy. Calcium channel blocker is the most common anti hypertensive drug used as monotherapy and betablockers are used as the most common antihypertensive in combination. Only a third of patients were on diuretic as an antihypertensive therapy.

  10. Medical tourism in India: perceptions of physicians in tertiary care hospitals.

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    Qadeer, Imrana; Reddy, Sunita

    2013-12-17

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  11. Medical tourism in india: perceptions of physicians in tertiary care hospitals

    Science.gov (United States)

    2013-01-01

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  12. Genotyping of methicillin resistant staphylococcus aureus from tertiary care hospitals in Coimbatore, South India

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    Toms John Peedikayil Neetu

    2016-01-01

    Full Text Available Background: Globally, methicillin resistant Staphylococcus aureus (MRSA is one of the most common pathogens that causes hospital- and community-acquired infections. The use of molecular typing methods is essential for determining the origin of the isolates, their clonal relations, and also epidemiological investigations. Objective: The purpose of this study was to determine the prevalence of antibiotic-resistant MRSA investigate the accessory gene regulator (agr and staphylococcal cassette chromosome mec (SCCmec types and perform multilocus sequence typing (MLST. Furthermore, the minimum inhibitory concentration of MRSA isolates was determined for vancomycin and daptomycin. Materials and Methods: Two hundred and fifty-nine MRSA isolates were collected from Tertiary Care Hospitals in Coimbatore. Disk diffusion method was employed to assess the sensitivity of MRSA isolates to selected antibiotics and genetic analysis was performed using SCCmec, agr, and MLST typing by multiplex-polymerase chain reaction strategy. Minimal inhibitory concentration (MIC was determined using Ezy MIC (vancomycin and Biomerieux (daptomycin E-test strip. Results: Of 259 MRSA isolates, 209 (80.7% were confirmed as methicillin resistant. Antibiotic susceptibility pattern revealed that all the MRSA isolates were 100% sensitive to linezolid, rifampicin, teicoplanin, and vancomycin. MIC results showed that of 209 MRSA isolates, 10 were found to be vancomycin intermediate S. aureus and 100% of the MRSA isolates were daptomycin-susceptible. The agr group I and SCCmec Type III were the major type among MRSA isolates. In addition to these MLST typing revealed the prevalence of sequence type (ST 239 (SLV of ST8 among the MRSA isolates. Conclusion: This study confirms that ST239 (Brazilian clone of MRSA is predominant in this region which is responsible for the hospital-acquired MRSA infections. Thus, the study also suggests that vancomycin and daptomycin can still be used as an

  13. A cross-sectional study of quality of life in a cohort of enteral ostomy patients presenting to a tertiary care hospital in a developing country in South Asia.

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    Jayarajah, Umesh; Samarasekera, Dharmabandhu N

    2017-01-31

    Enteral ostomy creation affects the quality of life (QOL) of stoma patients significantly. Studying the QOL and its determinants is important as it may help in the early identification of those with poor QOL leading to appropriate intervention. This study was aimed to assess the possible contributory factors of QOL of stoma patients. A cross sectional study was conducted among 43 ostomy patients who presented for follow up at a surgical clinic of a tertiary care hospital in Sri Lanka over a period of 1 year. Relevant demographic and ostomy related data were collected using an interviewer administered questionnaire. Stoma quality of life scale (Stoma-QOL) and stoma care self-efficacy scale (SCSE) which are validated questionnaires were used to assess QOL and self-efficacy in managing stoma respectively. Associations were established using independent samples t test and Spearman's correlation. The median age of the study participants was 47.5 years (range 18-83). The median follow up duration was 38 months (range 6-183). The mean overall QOL score was 53.07 ± SD 12.68. Approximately 70% of the study participants scored less than 60. Higher QOL was associated with female sex, colostomies, comfortable income and satisfactory sexual activity. Significantly lower overall QOL was found in those who reported a significant change in the style of dressing (p < 0.05), those who felt depressed (p < 0.05), and those who had thoughts of self-harm soon after surgery (p < 0.05). There was a significant positive correlation between QOL and self-efficacy (p < 0.01). Those who took longer time to learn to take care of the stoma had lower QOL (p < 0.05). The overall QOL score was considerably low in our study. The QOL was significantly associated with self-efficacy which indicates the importance of patient education and training during follow up visits to maintain a higher QOL. Furthermore integrating with other non-surgical specialities to address multi

  14. Greater retention in care among adolescents on antiretroviral treatment accessing "Teen Club" an adolescent-centred differentiated care model compared with standard of care: a nested case-control study at a tertiary referral hospital in Malawi.

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    MacKenzie, Rachel K; van Lettow, Monique; Gondwe, Chrissie; Nyirongo, James; Singano, Victor; Banda, Victor; Thaulo, Edith; Beyene, Teferi; Agarwal, Mansi; McKenney, Allyson; Hrapcak, Susan; Garone, Daniela; Sodhi, Sumeet K; Chan, Adrienne K

    2017-11-01

    There are numerous barriers to the care and support of adolescents living with HIV (ALHIV) that makes this population particularly vulnerable to attrition from care, poor adherence and virological failure. In 2010, a Teen Club was established in Zomba Central Hospital (ZCH), Malawi, a tertiary referral HIV clinic. Teen Club provides ALHIV on antiretroviral treatment (ART) with dedicated clinic time, sexual and reproductive health education, peer mentorship, ART refill and support for positive living and treatment adherence. The purpose of this study was to evaluate whether attending Teen Club improves retention in ART care. We conducted a nested case-control study with stratified selection, using programmatic data from 2004 to 2015. Cases (ALHIV not retained in care) and controls (ALHIV retained in care) were matched by ART initiation age group. Patient records were reviewed retrospectively and subjects were followed starting in March 2010, the month in which Teen Club was opened. Follow-up ended at the time patients were no longer considered retained in care or on 31 December 2015. Cases and controls were drawn from a study population of 617 ALHIV. Of those, 302 (48.9%) participated in at least two Teen Club sessions. From the study population, 135 (non-retained) cases and 405 (retained) controls were selected. In multivariable analyses, Teen Club exposure, age at the time of selection and year of ART initiation were independently associated with attrition. ALHIV with no Teen Club exposure were less likely to be retained than those with Teen Club exposure (adjusted odds ratio (aOR) 0.27; 95% CI 0.16, 0.45) when adjusted for sex, ART initiation age, current age, reason for ART initiation and year of ART initiation. ALHIV in the age group 15 to 19 were more likely to have attrition from care than ALHIV in the age group 10 to 14 years of age (aOR 2.14; 95% CI 1.12, 4.11). This study contributes to the limited evidence evaluating the effectiveness of service delivery

  15. Assessment of hospital processes using a process mining technique: Outpatient process analysis at a tertiary hospital.

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    Yoo, Sooyoung; Cho, Minsu; Kim, Eunhye; Kim, Seok; Sim, Yerim; Yoo, Donghyun; Hwang, Hee; Song, Minseok

    2016-04-01

    Many hospitals are increasing their efforts to improve processes because processes play an important role in enhancing work efficiency and reducing costs. However, to date, a quantitative tool has not been available to examine the before and after effects of processes and environmental changes, other than the use of indirect indicators, such as mortality rate and readmission rate. This study used process mining technology to analyze process changes based on changes in the hospital environment, such as the construction of a new building, and to measure the effects of environmental changes in terms of consultation wait time, time spent per task, and outpatient care processes. Using process mining technology, electronic health record (EHR) log data of outpatient care before and after constructing a new building were analyzed, and the effectiveness of the technology in terms of the process was evaluated. Using the process mining technique, we found that the total time spent in outpatient care did not increase significantly compared to that before the construction of a new building, considering that the number of outpatients increased, and the consultation wait time decreased. These results suggest that the operation of the outpatient clinic was effective after changes were implemented in the hospital environment. We further identified improvements in processes using the process mining technique, thereby demonstrating the usefulness of this technique for analyzing complex hospital processes at a low cost. This study confirmed the effectiveness of process mining technology at an actual hospital site. In future studies, the use of process mining technology will be expanded by applying this approach to a larger variety of process change situations. Copyright © 2016. Published by Elsevier Ireland Ltd.

  16. ANTIBIOTIC PRESCRIBING PATTERN IN PAEDIATRICS OUTPATIENT IN A TERTIARY CARE HOSPITAL

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    Budhia Majhi

    2017-06-01

    Full Text Available BACKGROUND The invention of antimicrobials emerged as a transformational turning point in the reduction of the burden of communicable disease in the 20 th century. Antimicrobials are among the most widely prescribed therapeutic agents across the world. The use of antibiotics among children is different from adults due to a number of reasons like a lack of data on pharmacokinetics, pharmacodynamics, efficacy and safety of drugs, different physiological spectrum among different age groups- preterm neonates, full-term neonates, infants and toddlers, older children and adolescents, paediatrics populations being vulnerable to the majority of the illnesses and the adverse effect of irrational use of antimicrobials being more serious among children than adults. However, antibiotic use is not explored much in a paediatric population. Existing reports of population-based antibiotic use in children are relatively few, so the present study was carried out in Berhampur city with the objectives of finding out the pattern of oral antibiotic use in children in the outpatient setting of a tertiary care hospital. MATERIALS AND METHODS This cross-sectional study was carried out on a convenience sample of 216 patients treated with oral antibiotics in the Paediatrics Outpatient Department in MKCG Medical College, Berhampur. Data was collected and analysed from the prescriptions after obtaining informed written consent of the patient’s attendant and there was no interaction with the patients. Any prescription with an oral antibiotic prescribed was included for the study. The main outcome measures were the pattern of oral antibiotic prescription. The data were expressed as proportions and analysed using GraphPad Prism software (trial version. RESULTS Of the 216 prescriptions analysed, the most common disease entity for which a prescription with an oral antibiotic was made was acute respiratory infections (68.05%. Cefpodoxime was the commonly prescribed antibiotic

  17. Explaining the uptake of paediatric guidelines in a Kenyan tertiary hospital--mixed methods research.

    OpenAIRE

    Irimu, GW; Greene, A; Gathara, D; Kihara, H; Maina, C; Mbori-Ngacha, D; Zurovac, D; Santau, M; Todd, J; English, M

    2014-01-01

    BACKGROUND: Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. METHODS: We conducted mixed methods research in a tertiary hospital in a l...

  18. Review of contributory factors in maternity admissions to intensive care at a New Zealand tertiary hospital.

    Science.gov (United States)

    Sadler, Lynn C; Austin, Diana M; Masson, Vicki L; McArthur, Colin J; McLintock, Claire; Rhodes, Sharon P; Farquhar, Cindy M

    2013-12-01

    The purpose of this study was to identify factors that contributed to severe maternal morbidity, defined by admission of pregnant women and women in the postpartum period to the intensive care unit (ICU) from 2010-2011 at Auckland City Hospital (ACH), a tertiary hospital that delivers 7500 women/year, and to determine potentially avoidable morbidity with the use of local multidisciplinary review. All admissions of pregnant women and women in the postpartum period (to 6 weeks) to the ICU at ACH from 2010-2011 were identified from hospital databases. Case notes were summarized and discussed by a multidisciplinary team. The presence of contributory factors and potentially avoidable morbidity were determined by consensus with a tool that was developed by the New Zealand Perinatal and Maternal Mortality Review Committee for the review of maternal and perinatal deaths. Specific recommendations for clinical management were identified by the multidisciplinary group. Nine pregnant women and 33 women in the postpartum period were admitted to the ICU from 2010-2011. Contributory factors were identified in 30 cases (71%); 20 cases (48%) were considered to be potentially avoidable; personnel factors were the most commonly identified avoidable causes. Specific recommendations that resulted from the study included the need for the development of guidelines for puerperal sepsis, improved planning for women at known risk of postpartum hemorrhage, enhanced supervision of junior staff, and enhanced communication through multidisciplinary meetings. Forty-eight percent of severe maternal morbidity, which was defined as admission to the ICU at ACH from 2010-2011, was considered to be potentially avoidable by a local multidisciplinary review team; priorities were identified for improvement of local maternity services. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. Prevalence and causes of blindness at a tertiary hospital in Douala, Cameroon

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    Eballé AO

    2011-09-01

    Full Text Available André Omgbwa Eballé1,4, Côme Ebana Mvogo1,3, Godefroy Koki2, Nyouma Mounè3, Cyrille Teutu5, Augustin Ellong2,3, Assumpta Lucienne Bella2,41Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; 2Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; 3General Hospital of Douala, Ophthalmology Unit, Douala, Cameroon; 4Cameroon National Blindness Control Programme, Ministry of Public Health, Yaoundé, Cameroon; 5Higher Institute of Health Sciences, Mountain University, Banganté, CameroonPurpose: The aim of this study was to determine the prevalence and causes of bilateral and unilateral blindness in the town of Douala and its environs based on data from the ophthalmic unit of a tertiary hospital in Douala.Methods: We conducted a retrospective epidemiological survey of consultations at the eye unit of the Douala General Hospital over the last 20 years (from January 1, 1990 to December 31, 2009.Results: Out of the 1927 cases of blindness, 1000 were unilateral, corresponding to a hospital prevalence of 1.84% and 927 cases were bilateral, corresponding to a hospital prevalence of 1.71%. No statistically significant difference was noted between the two (P = 0.14. The leading causes of bilateral blindness were cataract (50.1%, glaucoma (19.7%, and diabetic retinopathy (7.8% while the leading causes of unilateral blindness were cataract (40.4%, glaucoma (14.1%, and retinal detachment (9.1%. Cataract (51.2%, cortical blindness (16.3%, and congenital glaucoma (10% were the leading causes of bilateral blindness in children aged less than 10 years.Conclusion: Blindness remains a public health problem in the Douala region with a hospital prevalence which is relatively higher than the national estimate given by the National Blindness Control Program.Keywords: bilateral blindness, unilateral blindness, prevalence, Douala, Cameroon

  20. Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections.

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    Maestre-Moreno, J F; Fernández-Pérez, M D; Triguero-Cueva, L; Gutiérrez-Zúñiga, R; Herrera-García, J D; Espigares-Molero, A; Mínguez-Castellanos, A

    Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR=2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.