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Sample records for tertiary teaching hospital

  1. 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 ...

  2. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

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    Colin Lee

    2015-06-01

    Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

  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. Tetanus immunization: perception of residents in a tertiary care teaching hospital in Western India

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    Dhande Priti P, Beri Shirish G, Patel Hardik R

    2013-04-01

    Full Text Available Background: Prevention of tetanus is far easier than its treatment where mortality is very high. Most cases of tetanus occur due to lack of proper vaccination against the disease and incomplete immunization on exposure. Residents in a tertiary care teaching hospital constitute the first contact physicians for patients. Aim: To assess the perception about Tetanus immunization among residents in a tertiary care teaching hospital of Pune city. Methodology: A pre tested questionnaire was used to assess the knowledge & recommendations about tetanus immunization among randomly selected 157 residents. Results: 73.25% residents were not aware of the number of doses of tetanus vaccine recommended for children under the age of 16 years. Around 50% residents were not aware of the recommended number of doses of tetanus vaccine for adults over the age of 16 years and during pregnancy. Nearly 60% of the residents considered the wound after every injury to be tetanus prone. 75.8% of residents thought burn injuries to be prone to the development of tetanus while 13.4% and 36.9% of the residents did not consider animal bite and human bite to be tetanus prone respectively. 99.4% residents considered tetanus toxoid administration in wound with rusted iron. The knowledge regarding tetanus immunization in relation to the wound categories depending on the immunization status of the patients was very poor amongst the residents. Conclusion: Better awareness and adherence of tetanus prophylaxis recommendations is needed in residents who are the first tier of health care providers in teaching hospitals.

  5. Muddy puddles - the microbiology of puddles located outside tertiary university teaching hospitals.

    Science.gov (United States)

    Furukawa, M; McCaughan, J; Stirling, J; Millar, B C; Bell, J; Goldsmith, C E; Reid, A; Misawa, N; Moore, J E

    2018-04-01

    In the British Isles, the frequency of rain results in the formation of puddles on footpaths and roads in/around hospitals. No data are available demonstrating the microbiological composition of such puddles and therefore a study was undertaken to examine the microbiology of puddles in the grounds of two tertiary university-teaching hospitals (18 sites) and compared with control puddles from non-hospital rural environments (eight sites), estimating (i) total viable count; (ii) identification of organisms in puddles; (iii) enumeration of Escherichia coli: (iv) detection of Extended Spectrum β-Lactamase producing organisms and (v) direct antimicrobial susceptibility testing. A mean count of 2·3 × 10 3  CFU per ml and 1·0 × 10 9  CFU per ml was obtained for hospital and non-hospital puddles respectively. Isolates (n = 77; 54 hospital and 23 non-hospital) were isolated comprising of 23 species among 17 genera (hospital sites), where the majority (10/16; 62·5%) of genera identified were Gram-negative approximately, a fifth (20·6%) were shared by hospital and non-hospital rural samples. Escherichia coli was detected in half of the hospital puddles and under-half (37·5%) of the rural puddles extended spectrum β-lactamase organisms were not detected in any samples examined. Rainwater puddles from the hospital and non-hospital environments contain a diverse range of bacteria, which are capable of causing infections. This study demonstrated the presence of a wide diversity of bacterial taxa associated with rainwater puddles around hospitals, many of which are capable of causing human disease. Of clinical significance is the presence of Pseudomonas aeruginosa isolated from a hospital puddle, particularly for patients with cystic fibrosis. The presence of potentially disease-causing bacteria in puddles in and around hospitals identifies a new potential environmental reservoir of bacteria. Furthermore work is now needed to define their potential of entering or

  6. Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital.

    LENUS (Irish Health Repository)

    Thomas, Arun Z

    2009-10-01

    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  7. Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India

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    Binit N Jhaveri

    2014-01-01

    Full Text Available Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer′s criteria (2012 and PRISCUS list (2010. Results: A total of 676 geriatric patients (52.12% females were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer′s criteria, at least one inappropriate medicine was prescribed in 590 (87.3% patients. Metoclopramide (54.3%, alprazolam (9%, diazepam (8%, digoxin > 0.125 mg/day (5%, and diclofenac (3.7% were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs in heart and renal failure patients was the commonly identified drug-disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06% patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.

  8. Drug-induced diseases (DIDs: An experience of a tertiary care teaching hospital from India

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    Vishal R Tandon

    2015-01-01

    Full Text Available Background & objectives: Drug-induced diseases (DIDs are well known but least studied. Data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR data collected form Pharmacovigilance Programme of India (PvPI to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India. Methods: The suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality. Results: DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99% accounted for maximum DIDs followed by adult (37.79% and paediatric (8.21%. Maximum events were probable (93.98% followed by possible (6.04%. All DIDs required intervention. Gastritis (7.43%, diarrhoea (5.92%, anaemia (4.79%, hypotension (2.77%, hepatic dysfunction (2.69%, hypertension (1.51%, myalgia (1.05%, and renal dysfunction (1.01% were some of the DIDs. Anti-tubercular treatment (ATT, anti- retroviral treatment (ART, ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs. Interpretation & conclusions: Our findings show that DIDs are a significant health problem in our country, which need more attention.

  9. Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

    Science.gov (United States)

    Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

    2017-10-23

    The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

  10. Medical Device-Associated Candida Infections in a Rural Tertiary Care Teaching Hospital of India

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    Sachin C. Deorukhkar

    2016-01-01

    Full Text Available Health care associated infections (HCAIs add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI, catheter-associated urinary tract infection (CA-UTI, intravascular catheter-related blood stream infections (CR-BSI, and ventilator-associated pneumonia (VAP, were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

  11. Methicillin-resistant Staphylococcus aureus bacteraemia at a tertiary teaching hospital.

    Science.gov (United States)

    Cheong, I; Samsudin, L M; Law, G H

    1996-01-01

    Between July and December 1994, 25 patients with MRSA bacteraemia were treated at the Hospital Kuala Lumpur, a tertiary hospital in Malaysia with 3000 beds. The patients included 15 males and 10 females whose mean age was 46.7 years (range 13-75). The sources of their MRSA were: Urology/Nephrology, 11; General ICU, six; Orthopaedic, four; Medicine, three; Surgery, one. Their underlying diseases were: end-stage and chronic renal failure, 11; burns, three; acute necrotising pancreatitis, two; haematological malignancies, two; and one each of fracture of the neck of the femur, pustular psoriasis, alcoholic cirrhosis, liver abscess, peptic ulcer (antrectomy), choledochol cyst, and abdominal aneurysm with gangrene of the legs. Six patients were also diabetic. A total of 19 infections were considered nosocomial. The duration of hospital stay ranged from one to 60 days, mean 16 days. On the day of blood culture, 20 patients (80%) were febrile and 15(60%) had leucocytosis. A total of 14 patients were considered to have received prolonged broad-spectrum antibiotics before the bacteraemia; of these, 11 had had either a third-generation cephalosporin and/or a quinolone. The primary foci of infection were: vascular access dialysis catheters, six; infected AV fistulae, three; non-surgical wounds, five; orthopaedic pin, one; multiple venous lines and catheters, nine; unknown, one. The sensitivities to anti-MRSA antibiotics were: vancomycin, 100%; fusidic acid, 96%; rifampicin, 96%; ciprofloxacin and perfloxacin 28% each. In all, 13 patients (52%) eventually died; nine of these deaths were directly attributed to MRSA bacteraemia. The microbiological eradication rate was 88%. Mortality was significantly associated with duration of hospital stay and failure to remove the infected catheters/peripheral lines after the development of MRSA bacteraemia.

  12. Clinical audit on documentation of anticipatory "Not for Resuscitation" orders in a tertiary australian teaching hospital

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    Naveen Sulakshan Salins

    2011-01-01

    Full Text Available Aim: The purpose of this clinical audit was to determine how accurately documentation of anticipatory Not for Resuscitation (NFR orders takes place in a major metropolitan teaching hospital of Australia. Materials and Methods: Retrospective hospital-based study. Independent case reviewers using a questionnaire designed to study NFR documentation reviewed documentation of NFR in 88 case records. Results: Prognosis was documented in only 40% of cases and palliative care was offered to two-third of patients with documented NFR. There was no documentation of the cardiopulmonary resuscitation (CPR process or outcomes of CPR in most of the cases. Only in less than 50% of cases studied there was documented evidence to suggest that the reason for NFR documentation was consistent with patient′s choices. Conclusion: Good discussion, unambiguous documentation and clinical supervision of NFR order ensure dignified and quality care to the dying.

  13. Neuroinfection survey at a neurological ward in a Brazilian tertiary teaching hospital

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    Paulo E Marchiori

    2011-01-01

    Full Text Available OBJECTIVES: This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward. INTRODUCTION: Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries. METHODS: From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, São Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded. RESULTS: Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5 + 13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV, herpes simplex virus 1 (HSV1, Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients. CONCLUSION: Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance.

  14. Adverse drug reaction profile of anti-snake venom in a rural tertiary care teaching hospital

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    Deshpande, Rushikesh Prabhakar; Motghare, Vijay Motiram; Padwal, Sudhir Laxman; Pore, Rakesh Ramkrishna; Bhamare, Chetanraj Ghanshyam; Deshmukh, Vinod Shivaji; Pise, Harshal Nutan

    2013-01-01

    Objectives The study was carried out with the aim of evaluation of the adverse drug reaction profile of anti-snake venom serum (ASV) in a rural tertiary care hospital. Methods An observational study was conducted in SRTR Medical College, Ambajogai, Maharashtra, India. A total number of 296 indoor case papers of snake bite from February to September 2011 and June to August 2012 were retrieved from the record section and the antivenom reactions were assessed. In addition, basic epidemiological data and prescribing practices of ASV were also analyzed. Results Vasculotoxic snake bites were more common (50.61%) than neuroparalytic ones (22.56%). Mild envenomation was the commonest presentation. A total of 92 (56.10%) patients who received ASV suffered from antivenom reactions. The most common nature of reaction was chills, rigors (69.56%) followed by nausea and vomiting (34.8%). 10-15% patients suffered from moderate to severe reactions like hypotension and sudden respiratory arrest. We did not find any dose response relationship of ASV to risk of reactions (odds ratio 0.37). Intradermal sensitivity test was performed in about 72% cases. Conclusion Our study showed a higher incidence of reactions to ASV at our institute. PMID:24396245

  15. Profile of Under-Five Malnourished Children Admitted in a Tertiary Care Teaching Hospital in Pune, India

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    Dhrubajyoti J Debnath

    2014-01-01

    Full Text Available Background: Malnutrition is a major public health problem in a developing country like India. Keeping this in mind a study was carried out to find the proportion of under-five children suffering from malnutrition among the under-five hospitalized children and to study co-morbid illnesses and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross sectional study carried out in the pediatric ward of a tertiary care teaching hospital in Pune, India. All under-five children suffering from malnutrition were studied over a period of 1 month. Results: Total number of under five children diagnosed as malnourished were 47 (39.83%. Moderate and severe/very severe malnutrition was statistically significantly higher in a girl child. The proportion of moderate and severe/very severe malnutrition was higher in low birth weight babies, children who were incompletely immunized for age. Faulty infant feeding practice was observed in 28 (59.6% children. Some of the co-morbid illnesses contributing to morbidity in the malnourished child were acute diarrheal diseases, acute respiratory infection, anemia, and septicemia. Conclusion: A large proportion of hospitalized children were malnourished. Girl child suffered from moderate to severe forms of malnutrition as compared to male child and this was the only statistically significant association. This may be due to neglect of girl child.

  16. Drug utilization pattern in a pain clinic of a tertiary care teaching hospital in Eastern India

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    Debjyoti Dutta

    2013-01-01

    Full Text Available Background: Patients attend the Pain Clinic with varieties of complains of pain, like low back pain, knee pain, shoulder pain, headache, facial pain, different neuralgias and other neuropathic pain states. They receive a multimodal treatment for their pain, Multimodal pain therapy is an integrated multidisciplinary treatment in small groups with a closely coordinated therapeutic approach. Drugs that are prescribed for treatment are not only NSAIDS or Opioids, but also various groups of adjuvant pain medications like anti-epileptics, antidepressants etc. Aim: To find out the drug utilization pattern in the Pain Clinic of a tertiary care medical college hospital in Eastern India. Materials and Methods: A cross sectional; unicentric study was conducted in the Pain Clinic during April 2013 to June 2013. New patients who were willing to participate in the study were enrolled as per selection criteria. A copy of prescriptions were collected from the patients. The drugs prescription patterns were analyzed. Result: 319 patients were included in this study in three months period and their prescriptions were analyzed. Female patients (222 were more in number than male (97. As single prescription and also as combination therapy, paracetamol was found to be the most frequently prescribed drug. Frequently used adjuvant pain medications were found to be pregabalin (21.63% and amitriptyline (16.92%.. Antacid was commonly prescribed as gastroprotective agent. Among drug combinations paracetamol (325 mg + tramadol (37.5 mg combination was used most frequently. (55.17%. Conclusion: In this uncentric study we found that patacetamol, tramadol, pregabalin and amitriptyline are the commonly used medications in a pain clinic. We need more multi-centric and comparative Indian studies.

  17. Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard Treatment Guidelines.

    Science.gov (United States)

    Datta, Supratim

    2016-12-01

    Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. Concerns pertaining to hypertension and its sequelae can be substantially addressed and consequent burden of disease reduced by early detection and appropriate therapy of elevated blood pressure. This cross-sectional observational study aims at analyzing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines. Prescriptions were screened for antihypertensives at the medicine outpatient department of a tertiary care teaching hospital. Medical records of the patients were scrutinized after which 286 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and comorbidities. The calcium channel blockers were the most frequently used antihypertensive class of drugs (72.3%). Amlodipine (55.6%) was the single most frequently prescribed antihypertensive agent. The utilization of thiazide diuretics was 9%. Adherence to the National List of Essential Medicines (NLEMs) was 65%. The combination therapy was used more frequently (51.5%) than monotherapy (48.8%). The use of angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers (ACE-I/ARB) was 41.4% in diabetes. The treatment pattern, in general, conformed to standard treatment guidelines. Few areas, however, need to be addressed such as the underutilization of thiazide diuretics, need for more awareness of drugs from the NLEMs and enhanced use of ACE-I/ARB in diabetic hypertensives.

  18. 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.

  19. Current Trends of Using Antimicrobial Drugs in the ICU at a Tertiary Level Teaching Hospital in Mymensingh.

    Science.gov (United States)

    Saha, S K; Shaha, K C; Haque, M F; Khatun, S; Akhter, S M; Akhter, H

    2016-10-01

    The aim of the present study was to investigate the current trends of using antimicrobial drugs in the ICU at a tertiary level teaching hospital in Mymensingh. The study of prescribing patterns seeks to monitor, evaluate and suggest modifications in clinicians prescribing habits so as to make medical care rational. It was an observational type of descriptive study, conducted in the Mymensingh medical college hospital, Mymensingh, during the study period of June 2016 to September 2016.The study was approved by the institutional ethical committee. Most patients in the ICU belonged to the older age group >60 years. Male patients were more than the female patients in ICU. Average duration of stay in ICU was 4.35 days. Admissions in ICU were common due to respiratory system related diseases and the present study showed that 31.68% of the reported cases belong to the respiratory system. Average number of drugs per prescription was 6.46. Average number of anti-microbial drugs per prescription was 1.38. Cephalosporin group and individually ceftriaxone was the most frequently prescribed antimicrobial group and agent respectively in the ICU. Most commonly used antimicrobial combination was Cephalosporin and Metronidazole (43.33%) followed by Carbapenem (Meropenem) and Metronidazole (13.33%). Most antimicrobial agents were prescribed without bacteriological culture and sensivity testing evidence. There is a need for motivating the physicians to prescribe antimicrobial agents with supportive bacteriological evidences.

  20. Knowledge of nurses towards dengue fever in a tertiary care teaching hospital in Nepal

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    S Valarmathi

    2014-01-01

    Full Text Available Background: Nurses are important health care professionals and should have wide knowledge about common diseases especially infectious diseases like dengue. Dengue is associated with shock and can lead to death. Aim: To assess the knowledge of nurses regarding dengue fever and to study the association between the demographic variables. Setting and design: A cross sectional study was conducted at the College of Medical Sciences-Teaching Hospital, Nepal among the nurses during December, 2010. Study tool: Semi structured question was prepared to assess the knowledge of nurses in which there was objective question and Yes or No type questionnaire. Statistical analysis: The filled questionnaires were collected and data were entered in Microsoft excel sheet and analyzed as per study objectives. Descriptive statistic was used to calculate the median (IQR and non parametric tests (Kruskal Wallis test and Mann Whitney test to compare the total scores with demographic profile of the subjects. Results: Of the study members 89% were from Proficiency Certificate level (PCL background and the mean (IQR age of the respondents was 21 years (20-22.75. Overall score of the nurses was 11 (9-13 with a maximum possible score of 17. There were no association between the respondents knowledge scores with age (p=0.14; educational qualifications (p=0.86; duration of experience (p=0.59; ward (p=0.28. Conclusion: The study findings report a low knowledge among the nursing practitioners on dengue fever and its complications and their knowledge did not have any association with their demographic variables. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 7-13 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9667

  1. Operating in a Yellow Nation; the frequency of hepatitis B and hepatitis C positive at a tertiary care teaching hospital

    International Nuclear Information System (INIS)

    Waheed, A.; Zafar-ul-Ahsan; Zaeem, F.A.; Shariff, M.M.; Qayyum, A.

    2010-01-01

    Objects contaminated with blood and other body fluids of patients suffering from hepatitis B and C are an occupational health hazard to the health care personnel and a source of nosocomial spread. This descriptive cross sectional study estimated the frequency of hepatitis B surface antigen (HBsAg) and anti hepatitis C antibody (Anti HCV) positive patients among those undergoing a urological procedure in a tertiary care teaching hospital. A sample size of 550 patients was estimated using Stat Calc for Epi Info. A cluster off 558 patients were included. Ninety five (17%) were positive for serum HBsAg and/or anti HCV by Elisa. Gender/sex, admission year, urological diagnosis did not predict statistically significant relationship with the positive status. Past surgical history was marginally significant. In conclusion, all patients undergoing a urological procedure should be checked for anti HCV and HBsAg. A solid policy outlining the preventive practices is needed to stop this high burden of hepatitis turning into public health disaster. (author)

  2. COMMON ORGANISMS AND ANTIBIOTIC SENSITIVITY OF E COLI IN URINARY TRACT INFECTION, IN A TERTIARY CARE TEACHING HOSPITAL, NORTHERN KERALA

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    Shanavas

    2015-11-01

    Full Text Available Urinary tract infection (UTI includes a spectrum of Asymptomatic Bacteruria (ABU, Cystitis, Prostitis and Pyelonephritis. Except in ABU, UTI is represented by symptomatic disease that warrants antimicrobial therapy. 1 Many of the studies have shown increasing antibiotic resistance to these agents. This study consists of a retrospective observational study of culture and sensitivity of 150 urinary samples, collected from patients who presented with symptoms of UTI, in a tertiary care teaching hospital, Northern Kerala, irrespective of their age and sex for a period of six months from June 2015 to November 2015. These results are then analyzed to find common organisms causing UTI in different age groups in either sex and their respective antibiotic resistance are noted. Out of 150 urinary samples 69.34% were sterile, while 30.66% were culture positive. Among the culture positive patients sex distribution was almost equal, with a slight female predominance, having a contribution of 54.35% females and 45.65% males. The most common organism was found to be E.coli, which contributed more than 50 per cent of total culture positivity (54.35%. Others include Staphylococci, Klebsiella Pnuemoniae, Proteus species, Pseudomonas, Enterococci, Candida Albicans etc. Collateral damage is an ecological adverse effect that resist the use of a highly efficacious drug to be considered as first line agent. Our study shows that drugs causing minimal collateral damages like Nitrofurantoin and Fosfomycin can be used as first line agent for treatment of UTI.

  3. KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

    OpenAIRE

    Raghupathi Mahitha; T. S. Arunprasath

    2016-01-01

    BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIA...

  4. Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa

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    Gediwon Negash

    2013-01-01

    Conclusion: Incidence and types of medication errors committed in Tikur Anbesa Specialized Hospital Adult Emergency Unit were substantiated; moreover, necessary information on factors within the healthcare delivery system that predispose healthcare professionals to commit errors have been pointed, which should be addressed by healthcare professionals through multidisciplinary efforts and involvement of decision makers at national level.

  5. Evaluation of pneumococcal vaccination rates after vaccine protocol changes and nurse education in a tertiary care teaching hospital.

    Science.gov (United States)

    Smith, Jennifer G; Metzger, Nicole L

    2011-11-01

    Pneumococcal vaccination in eligible patients is recommended by the Infectious Disease Society of America and the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices. Because hospitalization provides an opportunity to vaccinate patients at high risk for developing serious pneumonia complications, eligibility screening and administration of the pneumococcal vaccine prior to discharge in qualified patients are evaluated by the Joint Commission and the Centers for Medicare Medicaid Services (CMS) as part of pneumococcal vaccination core quality measures. Among patients with an inpatient diagnosis of pneumonia in 2008, 56% in our 580-bed tertiary care teaching hospital, compared with 84% nationwide, received pneumococcal vaccination. To improve pneumococcal vaccination rates for all patients in the study facility and not just those with pneumonia, a multifaceted intervention including a revised nurse screening tool, rescheduling of the vaccine order, storage of the vaccine in automated dispensing cabinets on the nursing unit, and creation of a vaccine tracking system was developed and implemented between August 2009 and October 2009. To determine the impact of a multifaceted intervention on pneumococcal vaccine screening and administration rates in eligible patients according to the CDC recommendations who were admitted to an internal medicine unit of a tertiary care teaching hospital. All patients aged 18 years or older from 2 internal medicine units were identified during 4-month time intervals before (pre-intervention, April through July 2009) and after (post-intervention, November 2009 through February 2010) implementation of the multifaceted pneumococcal vaccine protocol. Of these, 150 patients from each 4-month period were randomly selected for electronic medical record review. Eligibility for pneumococcal vaccination was derived from the CDC recommendations and consensus of the vaccine steering committee at the study institution; the

  6. An analysis of serious adverse drug reactions at a tertiary care teaching hospital

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    Kinjal Prajapati

    2016-01-01

    Full Text Available Objective: The objective of this study was to analyze the various aspects of serious adverse drug reactions (serious ADRs such as clinical presentation, causality, severity, and preventability occurring in a hospital setting. Materials and Methods: All serious ADRs reported from January 2010 to May 2015 at ADR Monitoring Centre, Department of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, were selected as per the World health Organization -Uppsala Monitoring Center (WHO-UMC criteria. A retrospective analysis was carried out for clinical presentation, causality (as per the WHO-UMC scale and Naranjo′s algorithm, severity (Hartwig and Siegel scale, and preventability (Schumock and Thornton criteria. Results: Out of 2977 ADRs reported, 375 were serious in nature. The most common clinical presentation involved was skin and appendageal disorders (71, 18.9%. The common causal drug group was antitubercular (129, 34.4% followed by antiretroviral (76, 20.3% agents. The criteria for the majority of serious ADRs were intervention to prevent permanent impairment or damage (164, 43.7% followed by hospitalization (158, 42.1%. Majority of the serious ADRs were continuing (191, 50.9% at the time of reporting, few recovered (101, 26.9%, and two were fatal. The majority of serious ADRs were categorized as possible (182, 48.8% followed by probable (173, 46.1% in nature. Conclusion: Antitubercular, antiretroviral, and antimicrobial drugs were the most common causal drug groups for serious ADRs. This calls for robust ADR monitoring system and education of patients and prescribers for identification and effective management.

  7. Presentation and outcome of surgically managed liver trauma: experience at a tertiary care teaching hospital

    International Nuclear Information System (INIS)

    Saaiq, M.; Din, N. U.; Zubair, M.; Shah, S. A.

    2013-01-01

    Objective: To document and analyse the presentation and outcome of surgical management of liver trauma. Methods: The study was a retrospective review of records of all surgeries carried out at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010. The study included all adult patients of either gender who presented with liver trauma and underwent operative management. Convenience sampling technique was employed. The study excluded patients who were managed conservatively. The data were collected through a proforma and analysed through SPSS 10. Results: Out of 113 cases of liver trauma, 91 (80.5%) were males and 22 (19.4%) were females. The mean age was 34.8+-9.7 years. Road traffic accidents were the leading cause (n=75; 66.3%) of injuries. There were 37 (32.7%) patients with grade I injury; 41 (36.2%) with grade II injury; 29 (25.6%) with grade III injury; and 7 (6.1%) patients with grade IV injury. Besides, 62 (54.8%) patients had associated extra-hepatic injuries. Majority of the patients presented with haemodynamic compromise (n= 97; 85.8%). Perihepatic packing was the commonest operative procedure instituted (n=43;38%). The in-hospital mortality was 9.7% (n=11). Conclusion: Liver trauma constitutes an important cause of emergency hospitalisation, morbidity and in-hospital mortality in our population. It predominantly affects the younger males and road traffic accidents are the leading cause. Majority of the patients are successfully managed with perihepatic packing. (author)

  8. Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute

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    Vasantmeghna Srinivasa Murthy

    2014-01-01

    Full Text Available Objectives: To evaluate subjective sleep quality, day-time sleepiness, prevalence of substance use, satisfaction with life among residents at our institute. To evaluate association of sleep qualitywith satisfaction with life and day-time sleepiness. To compare the findings between residents in clinical and para-clinical departments. Materials and Methods: Eighty-four residents filled questionnaires to obtain socio-demographic information and use of substance (s. Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, and Satisfaction With Life scale (SWLS were also used. Association between sleep quality and sleepiness and satisfaction with life was evaluated. From the data collected, comparisons were made between the clinical and para-clinical department residents. Results: A significant number of residents belonging to the clinical faculty were poorsleepers; reported high levels of abnormal day-time sleepiness and less satisfaction with life compared to residents in para-clinical faculties. The differences in correlation between sleepiness and satisfaction with life with sleep quality among the two groups were not found to be significant. A larger percentage of clinical residents reported use of at least one substance during the residency period compared to the para-clinical residents. Conclusions: Poor sleep quality is perceived greatly by the resident doctors in our public hospital, especially among clinical faculties. Interventions are thus necessary in order to ensure adequate sleep among them.

  9. Quality control in linen and laundry service at a tertiary care teaching hospital in India.

    Science.gov (United States)

    Singh, Dara; Qadri, Gj; Kotwal, Monica; Syed, At; Jan, Farooq

    2009-01-01

    The clean bedding and clean clothes installs psychological confidence in the patients and the public and enhances their faith in the services rendered by the hospital. Being an important Component in the management of the patients, a study was carried out to find out the current quality status and its conformity with the known standards and identify the areas of intervention in order to further increase the patient and staff satisfaction regarding the services provided by linen and laundry department Quality control practised in the Linen and Laundry Service was studied by conducting a prospective study on the concept of Donabedian model of structure, process and outcome. Study was done by pre-designed Proforma along with observation / Interviews / Questionnaire and study of records. The input studied included physical facilities, manpower, materials, equipments and environmental factors. The various elements of manpower studied consisted of number of staff working, their qualification, training, promotion avenues, motivation and job satisfaction. Process was studied by carrying out observations in linen and laundry service through a predesigned flow chart which was supplemented by interviews with different category of staff. Patient satisfaction, staff satisfaction and microbial count of laundered linen (quality dimensions) were studied in the outcome. The current study found that in spite of certain deficiencies in the equipment, manpower and process, the linen and laundry service is providing a satisfactory service to its users. However the services can be further improved by removing the present deficiencies both at structure and process level.

  10. Primary Germ Cell Tumors of the Mediastinum: 10 Years of Experience in a Tertiary Teaching Hospital

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    Chih-Jen Yang

    2005-09-01

    Full Text Available Germ cell tumors occur mostly in the gonad. Extragonadal germ cell tumors are rare, and most occur in the retroperitoneum and mediastinum. Primary mediastinal germ cell tumors are often found in the anterior portion of the mediastinum and include teratomas and non-teratomatous tumors. Non-teratomatous tumors include seminomas and malignant non-seminomatous germ cell tumors (MNSGCTs. MNSGCTs include yolk sac tumors, choriocarcinomas, embryonal carcinomas, and mixed type germ cell tumors. Teratomas are the most common germ cell tumors of the mediastinum, and seminomas are the most common non-teratomatous germ cell tumors of the mediastinum. Cases of primary mediastinal MNSGCT reported in the literature are rare. In this report, we review all primary mediastinal germ cell tumors from a 10-year period at the Chung-Ho Memorial Hospital of Kaohsiung Medical University. A total of 14 cases were reviewed, including 11 patients with mature teratomas, two with yolk sac tumors, and one with seminoma. We discuss the differences in clinical presentation, histopathologic characteristics, treatment, and prognosis.

  11. Modified supine versus prone percutaneous nephrolithotomy: Surgical outcomes from a tertiary teaching hospital

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    Madeleine Nina Jones

    2016-07-01

    Full Text Available Purpose: The traditional prone positioning of percutaneous nephrolithotomy (PCNL is associated with various anesthetic and logistic difficulties. We aimed to compare the surgical outcomes of PCNLs performed using our modified supine position with those performed in the standard prone position. Materials and Methods: A prospective group of 236 renal units (224 patients undergoing PCNL were included in this 2 site study: 160 were performed in the modified supine position were compared with 76 undergoing PCNL in the prone position. The outcomes of radiation dose, radiation time, stone free rate, body mass index (BMI, stone size, operative time, length of stay (LOS, in hospital and complications were compared. Chi-square and t-tests were used. Results: There were no significant differences in mean radiation time, radiation dose or stone size between the modified supine and prone groups. The supine group had a higher mean BMI (31 kg/m2 vs. 28 kg/m2 , p=0.03, shorter mean surgical time (93 minutes vs. 123 minutes, p<0.001, shorter mean LOS (2 days vs. 3 days, p=0.005 and higher stone free rate (70% vs. 50%, p=0.005. There were no differences in septic or bleeding complications but the prone group had a higher rate of overall complications. Conclusions: Modified supine PCNL has significantly lower operative time, shorter LOS and higher stone-free rate compared with prone in our series, while remaining a safe procedure.

  12. Emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in Western India.

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    Bhadade, Rakesh; Harde, Minal; deSouza, Rosemarie; More, Ashwini; Bharmal, Ramesh

    2017-01-01

    Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months. We studied clinical profile and outcome of 120 adult patients who developed VAP/HAP during the study period. We also analyzed the causative organisms, antibiotic sensitivity, and resistance pattern in these patients. Out of 120 patients, 29 patients were HAP and 91 patients were VAP. Mortality was 60% (72), and development of VAP and requirement of mechanical ventilation showed significant association with mortality (P antibiotiques et le modèle de résistance chez ces patients. Résultats: Sur 120 patients, 29 patients étaient HAP et 91 patients étaient VAP. La mortalité était de 60% (72), et le développement du VAP et l'exigence de ventilation mécanique ont montré une association significative avec la mortalité (P antibiotique maximale a été observée chez la pipéracilline + tazobactam (58,8%), suivie de l'imipénème (49,5%) et du méropénem (41,8%), alors que la résistance antibiotique maximale a été observée à cefépime (95,1%), suivie de ceftazidime et de l'amoxicilline (91,2%) . la pneumonie nosocomiale a montré une incidence élevée (17,44%) et la mortalité (60%). Les organismes communs identifiés étaient S. aureus et K. pneumoniae. La résistance était élevée pour les antibiotiques couramment utilisés et une forte sensibilité aux antibiotiques pour la pipéracilline + le tazobactam et le carbapénème.

  13. 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.

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

    Science.gov (United States)

    Joseph, L; Paul, H; Premkumar, J; Paul, R; Michael, J S

    2015-01-01

    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.

  15. Anesthesia-related and perioperative mortality: An audit of 8493 cases at a tertiary pediatric teaching hospital in South Africa.

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    Meyer, Heidi M; Thomas, Jenny; Wilson, Graeme S; de Kock, Marianna

    2017-10-01

    This study aimed to quantify the incidence of anesthesia-related and perioperative mortality at a large tertiary pediatric hospital in South Africa. This study included all children aged anesthesia caused the death; (ii) anesthesia may have contributed to or influenced the timing of death; or (iii) anesthesia was entirely unrelated to the death. There were 47 deaths within 30 days of anesthesia prior to discharge from hospital during this 12-month period. The in-hospital mortality within 24 h of administration of anesthesia was 16.5 per 10 000 cases (95% confidence intervals [CI]=7.8-25.1) and within 30 days of administration of anesthesia was 55.3 per 10 000 cases (95% CI=39.5-71.2). Age under 1 year (OR 4.5; 95% CI=2.5-8.0, P=.012) and cardiac surgery and interventional cardiology procedures (OR 2.5; 95% CI=1.2-5.2, Prisk of perioperative mortality. The overall 24-h and 30-day anesthesia-related and in-hospital perioperative mortality rates in our study are comparable with other similar studies from tertiary pediatric centers. © 2017 John Wiley & Sons Ltd.

  16. A cross-sectional evaluation of computer literacy among medical students at a tertiary care teaching hospital in Mumbai (Bombay

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    T S Panchabhai

    2011-01-01

    Full Text Available Background: Computer usage capabilities of medical students for introduction of computer-aided learning have not been adequately assessed. Aim: Cross-sectional study to evaluate computer literacy among medical students. Settings and Design: Tertiary care teaching hospital in Mumbai, India. Materials and Methods: Participants were administered a 52-question questionnaire, designed to study their background, computer resources, computer usage, activities enhancing computer skills, and attitudes toward computer-aided learning (CAL. The data was classified on the basis of sex, native place, and year of medical school, and the computer resources were compared. The computer usage and attitudes toward computer-based learning were assessed on a five-point Likert scale, to calculate Computer usage score (CUS - maximum 55, minimum 11 and Attitude score (AS - maximum 60, minimum 12. The quartile distribution among the groups with respect to the CUS and AS was compared by chi-squared tests. The correlation between CUS and AS was then tested. Results: Eight hundred and seventy-five students agreed to participate in the study and 832 completed the questionnaire. One hundred and twenty eight questionnaires were excluded and 704 were analyzed. Outstation students had significantly lesser computer resources as compared to local students (P<0.0001. The mean CUS for local students (27.0±9.2, Mean±SD was significantly higher than outstation students (23.2±9.05. No such difference was observed for the AS. The means of CUS and AS did not differ between males and females. The CUS and AS had positive, but weak correlations for all subgroups. Conclusion: The weak correlation between AS and CUS for all students could be explained by the lack of computer resources or inadequate training to use computers for learning. Providing additional resources would benefit the subset of outstation students with lesser computer resources. This weak correlation between the attitudes

  17. Epidemiology of paediatric poisoning reporting to a tertiary hospital ...

    African Journals Online (AJOL)

    Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital, a tertiary hospital in Ghana. Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61month period, with an average ...

  18. Accuracy of MRI diagnosis of internal derangement of the knee in a non-specialized tertiary level referral teaching hospital

    International Nuclear Information System (INIS)

    Challen, J.; Tang, Y. M.; Stuckey, S.; Hazratwala, K.

    2007-01-01

    Full text: This study was designed to assess the accuracy of knee MRl examinations carried out in a general tertiary referral hospital without a musculoskeletal fellowship trained radiologist. The study included all patients who had undergone a knee arthroscopy carried out within a 2-year period and who had had a prior MRl knee examination, where both were carried out at this institution. The accuracy of the MRl knee examination was determined by correlation to the arthroscopy report. The accuracy for diagnosis of meniscal and cartilage injuries, in this setting, was found to be similar to a published meta-analysis of previous studies correlating knee MRl and arthroscopy. The overall accuracy of this study was better than the previous similar study. However, the accuracy for diagnosing ACL injuries was lower than in the meta-analysis. The potential reasons for this and other sources of error are discussed

  19. Screening, diagnosing and treating deafness: the knowledge and conduct of doctors serving in neonatology and/or pediatrics in a tertiary teaching hospital

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    Patrícia Colozza

    Full Text Available CONTEXT AND OBJECTIVE: Infant hearing deficiency is a human disorder with devastating effects and serious implications for the development of speech and language. Early diagnosis of hearing loss should be the objective of a multidisciplinary team, and early-intervention programs should immediately follow this. The aim of this study was to investigate the knowledge and conduct of pediatricians and pediatric residents in a tertiary teaching hospital regarding deafness. DESIGN AND SETTING: Cross-sectional study in a tertiary hospital in the state of São Paulo, Brazil. METHODS: Eighty-eight questionnaires were randomly distributed to pediatricians and pediatric residents. RESULTS: Thirty-six questionnaires were analyzed. Most respondents (61.1% were residents in pediatrics and/or neonatology. Eighty-three percent of them performed special procedures on babies presenting a high risk of deafness, and 55% reported that they had no knowledge of techniques for screening hearing. Most of them were unaware of the classifications of level and type of hearing loss. According to 47.2% of them, infants could begin to use a hearing aid at six months of age. Most of them reported that infants could undergo hearing rehabilitation during the first six months of life, and all respondents stated 's responsibilities. CONCLUSIONS: Even though most of the participants followed special procedures with babies presenting a high risk of deafness, they did not routinely investigate hearing. All respondents believed that it is a doctor's responsibility to be concerned about child communication.

  20. Self-medication practices in patients attending a Tertiary Care Teaching Hospital in Urban North-West India

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    Shilpa Patrick

    2018-01-01

    Full Text Available Background: This study was designed to determine the frequency, reasons, and the association of self-medication with demographic and other factors reported by participants. Materials and Methods: This study was conducted in 500 patients visiting a tertiary hospital in Ludhiana, North Western India. Participants were interviewed with a preset questionnaire. Data were entered into Microsoft Excel and analysis was performed using SPSS software version 16. Frequencies and proportions were calculated. Results: Of 500 study participants, 93.8% reported self-medication with no gender difference. The participants who took self-medication were of the opinion that self-medication resulted in quick cure of illness 50.75%, saved their time 17.46%, and gave them a sense of independence in 17.06%, respectively. The common reasons self-medication 45.84% for fever, 18.34% for pain, and 10.87% for headache with nonsteroidal anti-inflammatory drugs 49.4% followed by antibiotics (11.6% be the common medication. The most common source of information is local chemists/pharmacy 39%. Conclusions: Self-medication is described as a double-edged sword in India, and regulation of over-the-counter sale of antibiotics prescription medication is necessary to safeguard the populace.

  1. Evaluation Of Prescription Pattern And Medication Adherence Of Antihypertensive Drugs In Stage 1 Essential Hypertensive Patients At Rural Tertiary Care Teaching Hospital Of Central India.

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    Chetan S. Urade

    2016-09-01

    Full Text Available Objectives- To study the prescription pattern of antihypertensive drugs and analyze the medication adherence to antihypertensive drugs at rural tertiary care teaching hospital.Materials and Methods- Prospective, observational, 12 weeks, questionnaire based study, conducted in rural tertiary care teaching hospital of central India. 214 antihypertensive prescriptions were analyzed by Morisky medication adherence scale. Statistical analysis was done by MS Excel and Graph pad prism 6.0.Results- 28.03% patients were not aware about the medicines taken, 29.90% patients were unacquainted about dose and route of administration whereas 32.71% patients were unfamiliar about frequency of administration of medicines. 53.27% patients were unaware about precautions to be taken while consuming medicines.  58.68% & 12.67% patients consumed amlodipine & atenolol respectively. In 16.43% patients, atenolol + amlodipine combination therapy was prescribed.  Amongst 214 patients 12, 58 & 144 showed high, medium & low adherence respectively.  No significant difference was found on gender basis at any level of adherence.Conclusion- In this study, physicians given preference to amlodipine than other antihypertensive drugs. However, thiazide is a first line drug in stage 1 hypertension, recommended by JNC VII guideline. This indicates that there is need of creating awareness about current management of hypertension to clinicians by organizing various workshops. We observed only 5.60% patients showed high adherence to antihypertensive therapy. Therefore educational strategies must be carried out for physicians focusing on causes for nonadherence to antihypertensive medications. Also raising patient trust in their physicians may improve patient motivation to prescribed medication. 

  2. Demographic and clinicopathological profile of patients with chronic pancreatitis in a tertiary referral teaching hospital of West Bengal: Personal experience.

    Science.gov (United States)

    Bhattacharjee, Prosanta Kumar; Mukerjee, Aishik; Adhikary, Chandranath

    2015-09-01

    There is a paucity of data on the demographic and clinicopathological profiles of patients with chronic pancreatitis from the eastern part of India. This study documents the demographic and clinicopathological profiles of patients with chronic pancreatitis presenting to a general surgery unit of a tertiary referral hospital of Kolkata. The records of 145 patients presenting with chronic pancreatitis over a 5-year period were scrutinized and their demographics, clinical profile, and complications and morphological changes of the pancreas are described. Of the 145 patients, more than 50% were under the age of 30 years. Males were affected more frequently than females (M/F = 3.8:1). While idiopathic pancreatitis was the most common form of chronic pancreatitis (41.4%), alcohol was found to be the most common etiology (37.9%). Pain was the most common presenting symptom (n = 143; 98.6%). Sixty-five subjects (45%) had diabetes of which 32 subjects were insulin-dependent. On contrast-enhanced computed tomography, ductal dilatation was seen in 80 (55.17%) subjects, while ductal calculi and ductal dilatation in 54 cases (37.2%). Parenchymal calcification was seen in 45 patients of whom 40 patients (89%) were under the age of 30 years. Pseudocyst was the most common complication (n = 16) followed by biliary obstruction (n = 8) and portal hypertension (n = 4). Patients with alcoholic pancreatitis had significantly higher frequency of severe abdominal pain, diabetes, and local complications as compared to the other forms of pancreatitis in our study. Idiopathic pancreatitis was the most common form of chronic pancreatitis in this study, followed by alcoholic pancreatitis and then tropical pancreatitis.

  3. Clinical Profile of Suspected and Confirmed H1N1 Influenza Infection in Patients admitted at a Tertiary Care Teaching Hospital

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    Basavaraju Jayadeva

    2015-11-01

    Full Text Available Introduction: This study aimed to evaluate the clinical profile and outcomes of adult patients screened and diagnosed with H1N1 influenza infection at a tertiary care hospital in India. Materials and Methods: This retrospective  study was conducted on all adult patients suspected of H1N1 influenza admitted at a teaching hospital during the epidemic period of January-March 2015. Patients were screened and classified into three categories of A, B, and C based on international guidelines. Home confinement was recommended for patients in category A, and subjects in category B received treatment with Oseltamivir capsules. In addition, patients in category C received inpatient treatment with oseltamivir capsules. Results: In total, 695 patients were screened for H1N1 influenza infection during the epidemic, out of whom 380 patients (54.6% were in category A, 264 (37.9% were in category B, and 51 (7.3% were in category C. Throat swabs were collected and examined for 192 ( 27.6% patients, and 59 ( 8.4% cases were positive for H1N1 infection. Conclusion: According to the results of this study, close vigilance over the symptoms of patients infected with H1N1 influenza is more important than treatment and screening of suspicious cases during the epidemics of this infection. This is a retrospective cross sectional study. Hence, there were no comparative controls. The limitation of this study is,  thus the lack of control.

  4. Intraoperative cardiac arrest and mortality in trauma patients. A 14-yr survey from a Brazilian tertiary teaching hospital.

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    Marcelo T O Carlucci

    Full Text Available BACKGROUND: Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009. METHODS: Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related. FINDINGS: Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001 and young adults (18-35 years (P=0.04 with ASA physical status IV or V (P<0.001 undergoing gastroenterological or multiclinical surgeries (P<0.001. Motor vehicle crashes and violence were the main causes of trauma (P<0.001. Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001. All cardiac arrests and deaths reported were totally related to trauma patient condition. CONCLUSIONS: Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.

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

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    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

  6. A Survey on Awareness about the Role of Anesthesia and Anesthesiologists among the Patients Undergoing Surgeries in a Tertiary Care Teaching Women and Children Hospital.

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    Marulasiddappa, Vinay; Nethra, H N

    2017-01-01

    Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital. A prospective cross-sectional survey with a sample size of 100 patients. Patients scheduled to undergo elective surgery in the age group of 18-65 years with the American Society of Anesthesiologists (ASA) Grades 1 and 2, who are willing to participate and given written informed consent. Patients whose age 0.05) between those with previous surgery and those without previous surgery regarding their knowledge of anesthesiology and anesthesiologist. Ninety percent did not know the complications, types of anesthesia and 44% did not know that anesthesiologist is a doctor. Most of the participants were not aware of the role of anesthesia and anesthesiologists inside and outside OT. Although this could be attributed to their lower level of education, the fraternity of anesthesiologists has to educate patients and surgeons about the role of anesthesia.

  7. KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

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    Raghupathi Mahitha

    2016-10-01

    Full Text Available BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIALS AND METHODS Cross sectional, questionnaire-based study among pharmacy students. RESULTS 229 pharmacy students participated in the study. The mean total knowledge score among participants was 2.69 (SD=2.260 out of the possible maximum of 11 and the mean total attitude score was 2.67 (SD=2.437 out of the possible maximum of 10. Lack of knowledge about vaccine was the main reason for not taking the vaccine. Knowledge about the vaccines improves the attitude towards it (p<0.0001. CONCLUSION There is a need to design education program for pharmacy students to increase awareness about HPV, which in turn will increase the awareness among public positively.

  8. Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia.

    Science.gov (United States)

    Demile, Biresaw; Zenebu, Amare; Shewaye, Haile; Xia, Siqing; Guadie, Awoke

    2018-05-31

    Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished. Cross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant. Among 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3-92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB. In AFRTH, lower prevalence of

  9. Antibiotic prescribing in women during and after delivery in a non-teaching, tertiary care hospital in Ujjain, India: a prospective cross-sectional study.

    Science.gov (United States)

    Sharma, Megha; Sanneving, Linda; Mahadik, Kalpana; Santacatterina, Michele; Dhaneria, Suryaprakash; Stålsby Lundborg, Cecilia

    2013-01-01

    Antibacterial drugs (hereafter referred to as antibiotics) are crucial to treat infections during delivery and postpartum period to reduce maternal mortality. Institutional deliveries have the potential to save lives of many women but extensive use of antibiotics, add to the development and spread of antibiotic resistance. The aim of this study was to present antibiotic prescribing among inpatients during and after delivery in a non-teaching, tertiary care hospital in the city of Ujjain, Madhya Pradesh, India. A prospective cross-sectional study was conducted including women having had either a vaginal delivery or a cesarean section in the hospital. Trained nursing staff collected the data on daily bases, using a specific form attached to each patient file. Statistical analysis, including bivariate and multivariable logistic regression was conducted. Of the total 1077 women, 566 (53%) had a vaginal delivery and 511 (47%) had a cesarean section. Eighty-seven percent of the women that had a vaginal delivery and 98% of the women having a cesarean section were prescribed antibiotics. The mean number of days on antibiotics in hospital for the women with a vaginal delivery was 3.1 (±1.7) and for the women with cesarean section was 6.0 (±2.5). Twenty-eight percent of both the women with vaginal deliveries and the women with cesarean sections were prescribed antibiotics at discharge. The most commonly prescribed antibiotic group in the hospital for both the women that had a vaginal delivery and the women that had a cesarean section were third-generation cephalosporins (J01DD). The total number of defined daily doses (DDD) per100 bed days for women that had a vaginal delivery was 101, and 127 for women that had a cesarean section. The high percentage of women having had a vaginal delivery that received antibiotics and the deviation from recommendation for cesarean section in the hospital is a cause of concern. Improved maternal health and rational use of antibiotics are

  10. Drug utilization study from a government sponsored pharmacy in a tertiary care teaching hospital of rural West Bengal: A cross-sectional study

    OpenAIRE

    Tanmoy Gangopadhyay; Ananya Mandal; Sonai Mandal; Bishan Basu; Tamoghna Maiti; Abhijit Das; Soumitra Mandal; Sekhar Mandal

    2016-01-01

    Context: Newly started government sponsored pharmacies providing discounts have been available to the public at the medical college hospitals in West Bengal. Aims: The present study was undertaken to evaluate the drug prescribing trends from the prescriptions at such a pharmacy at a tertiary care hospital. Methods: The study was a prospective cross-sectional study that spanned for a period of 1-month from 1 to 31 August 2015. Prescriptions were reviewed and analyzed using the World Health Org...

  11. [Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

    Science.gov (United States)

    2014-12-01

    Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect

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

    Directory of Open Access Journals (Sweden)

    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.

  13. A retrospective drug use evaluation of cabergoline for lactation inhibition at a tertiary care teaching hospital in Qatar

    Directory of Open Access Journals (Sweden)

    AlSaad D

    2016-02-01

    Full Text Available Doua AlSaad,1 Samah ElSalem,1 Palli Valapila Abdulrouf,1 Binny Thomas,1,2 Tayseer Alsaad,3 Afif Ahmed,1 Moza AlHail4 1Department of Pharmacy, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar; 2Department of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK; 3Department of Pediatrics, Hamad General Hospital, 4Clinical Support Service Unit, Hamad Medical Corporation, Doha, Qatar Background: Breastfeeding is considered as gold standard for infant nutrition and should be interrupted only when a compelling indication exists. Certain medical conditions such as abortion, stillbirth, HIV infection, or infant galactosemia and certain medications such as chemotherapy necessitate lactation inhibition to protect the health of mother and infant. Drug use evaluation (DUE studies are done to explore the current practice in a setting and help to identify areas in which further information and education may be needed by clinicians.Objective: The aim of this study was to conduct a DUE of cabergoline to assess indications for lactation inhibition, dosage regimen, and its safety.Method: A retrospective cross-sectional DUE study was conducted over a period of 4 months from September 1, 2013, till December 31, 2013, at the Women’s Hospital, Qatar. All cabergoline prescriptions written for lactation inhibition within 10 days of delivery or abortion were included in the study. A descriptive data analysis was undertaken.Results: Of the 85 patients included, stillbirth (50.6% was considered as the main reason for lactation inhibition, followed by abortion (27.1% and neonatal death (12.9%. The remaining 9.4% of the patients had live baby, and the majority of them were prescribed cabergoline for lactation inhibition because their maternal medical conditions required the use of drugs with insufficient safety data (n=6. Seventy-four percent of patients received cabergoline at accurate time and dose. However, 14% of the patients had preexisting

  14. 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.

  15. Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa.

    Science.gov (United States)

    Mnge, P; Okeleye, B I; Vasaikar, S D; Apalata, T

    2017-05-15

    Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.

  16. Characteristics of health problems in returned overseas travelers at a tertiary teaching hospital in a suburban area in Japan.

    Science.gov (United States)

    Hirata, Kazuki; Ogawa, Taku; Fujikura, Hiroyuki; Ogawa, Yoshihiko; Hirai, Nobuyasu; Nakagawa-Onishi, Tomoko; Uno, Kenji; Takeyama, Masahiro; Kasahara, Kei; Nakamura-Uchiyama, Fukumi; Konishi, Mitsuru; Mikasa, Keiichi

    2018-03-01

    Few studies have analyzed the characteristics of patients who develop physical disorders after overseas travel. We retrospectively reviewed the medical records of 183 patients who visited Nara Medical University Hospital from 2008 to 2016 because of physical problems after traveling abroad. The main travel destinations were Southeast Asia (n = 100), Africa (n = 27), and South Asia (n = 23). The main reasons for the travel were leisure (n = 96), business (n = 51), and volunteer work (n = 19). The most common final diagnosis was gastrointestinal disease (n = 72), followed by febrile disease (n = 59) and respiratory disease (n = 19). There were eight malaria cases, including one patient who was infected after travel. Additionally, 61 of 71 cases of travelers' diarrhea and 15 of 21 cases of dengue fever occurred after travel. 26 cases of vaccine preventable diseases, such as hepatitis A, typhoid fever, and influenza, were observed. Consequently, healthcare providers should notify Japanese overseas travelers that there is a non-negligible health risk inherent to short-term travel, while stressing on the importance of pre-travel medical consultation. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Back to basic: bio-burden on hands of health care personnel in tertiary teaching hospital in Malaysia.

    Science.gov (United States)

    Wong, J L; Siti Azrin, A H; Narizan, M I; Norliah, Y; Noraida, M; Amanina, A; Nabilah, I; Habsah, H; Siti Asma, H

    2014-09-01

    Hands of Health Care Personnel (HCP) are one of the most common vehicles for the transmission of infection. Microorganisms can survive well on the hands of HCP for a certain duration. Therefore, the purpose of this study is to bring awareness to HCP that their hands can actually be contaminated with many microorganisms. These microbes on the hands of HCP can potentially infect their patients if they do not comply with the proper hand hygiene practice. This cross-sectional study was conducted at a randomly selected Intensive Care Unit (ICU) and general ward in a hospital. Twenty five HCP from each ward were randomly selected and their hands were imprinted on blood culture plates. Microorganism growth were quantified and identified. Data were analyzed and presented as descriptive analysis. One hundred blood agar plates were processed and analyzed. Majority (71%) of the samples had more than 50 colony-forming units (CFU) and only 17% of the samples had less than 25 CFU. Microorganisms identified include Staphylococcus spp., Acinetobacter spp., Enterobacteriaceae, Pseudomonas spp., Moraxella, Delftiaacidovorans and fungi. All isolated microorganisms were antibiotic sensitive strain. This study showed that the hands of HCP were contaminated with many microorganisms. Therefore, it is imperative that HCP must practice proper hand hygiene when taking care of their patients in the wards.

  18. Pediatric critical incidents reported over 15 years at a tertiary care teaching hospital of a developing country.

    Science.gov (United States)

    Abbasi, Shemila; Khan, Fauzia Anis; Khan, Sobia

    2018-01-01

    The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Incidents related to pediatric population from neonatal period till the age of 12 years were selected. A review of all CI records collected between January 1998 and December 2012, in the Department of Anaesthesiology of Aga Khan University hospital was done. This was retrospective form review. The Department has a structured CI form in use since 1998 which is intermittently evaluated and modified if needed. A total of 451 pediatric CIs were included. Thirty-four percent of the incidents were reported in infants. Ninety-six percent of the reported incidents took place during elective surgery and 4% during emergency surgery. Equipment-related events (n = 114), respiratory events (n = 112), and drug events (n = 110) were equally distributed (25.6%, 25.3%, and 24.7%). Human factors accounted for 74% of reports followed by, equipment failure (10%) and patient factors (8%). Only 5% of the incidents were system errors. Failure to check (equipment/drugs/doses) was the most common cause for human factors. Poor outcome was seen in 7% of cases. Medication and equipment are the clinical areas that need to be looked at more closely. We also recommend quality improvement projects in both these areas as well as training of residents and staff in managing airway-related problems in pediatric patients.

  19. Pattern of mri brain abnormalities in rheumatic patients with neurological involvement: a tertiary care teaching hospital experience

    International Nuclear Information System (INIS)

    Parvez, K.; Arfaj, A.; Naseeb, F.; Daif, A.K.

    2015-01-01

    Objective: To explore the pattern of abnormalities seen on MRI in rheumatic patients with neurological manifestations and to interpret the findings in relation to clinical picture. Study Design: Descriptive study. Place and Duration of Study: Rheumatology unit, King Khalid University Hospital, Riyadh, Saudi Arabia from January 2013 to February 2014. Patients and Methods: We prospectively included rheumatic patients with neurological symptoms and signs. The clinical data were correlated with MRI findings by a team comprising of a rheumatologist, neurologist and neuro-radiologist. Data was analyzed using simple statistical analysis. Results: Fifty patients were recruited with a mean age of 36.4 ± 10.76 years (range 17-62). Among SLE patients with seizures, focal deficit and headache white matter hyperintensities were found in 9 (64.28%), 4 (50%), 4 (80%) patients respectively. Out of seven SLE patients with global dysfunction, 3 (42.85%) had brain atrophy and 2 (28.57%) normal MRI. In Behcet disease with focal deficit, 3 (75%) patients had white matter hyperintensities and 1 (25%) had brainstem involvement. In Behcet disease with headache, 2 (50%) had normal MRI, 1 (25%) brainstem hyper-intensities and 1 (25%) had subacute infarct. Two (66%) of three Primary APS patients had white matter hyperintensities while third (33%) had old infarct. Both patients of polyarteritisnodosa, had white matter hyperintensities. Out of two Wegener granulomatosis one had white matter hyperintensities and other had ischemic changes in optic nerves. The only one scleroderma patient had white matter hyperintensities. Conclusion: We found that white matter hyperintensities was the most common MRI abnormality in our study group which in most of the cases had poor clinical correlation. No distinct pattern of CNS involvement on MRI was observed in various rheumatic disorders. (author)

  20. Developing marketing strategies for university teaching hospitals.

    Science.gov (United States)

    Fink, D J

    1980-07-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

  1. Maternal near miss and mortality in a tertiary care hospital in Rwanda

    NARCIS (Netherlands)

    Rulisa, S.; Umuziranenge, I.; Small, M; van Roosmalen, J.

    2015-01-01

    Background: To determine the prevalence and factors associated with severe ('near miss') maternal morbidity and mortality in the University Teaching Hospital of Kigali - Rwanda. Methods: We performed a cross sectional study of all women admitted to the tertiary care University Hospital in Kigali

  2. Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

    Directory of Open Access Journals (Sweden)

    Byeon HJ

    2016-02-01

    Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

  3. Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in SICU of a tertiary teaching hospital in central China

    Directory of Open Access Journals (Sweden)

    Longhua Hu

    2016-08-01

    Full Text Available The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested.All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum βlactamase genes tested, among which95.1% (39/41 of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1 and two ESBL genes (blaCTX-M-3 and blaTEM-104 . To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to 4 sequence types (STs including ST11, novel ST1854, novel ST1855 and ST1224. PFGE results displayed 3 PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41 including all 13 isolates from ventilators and 25 isolates from patients from 7 wards (18 from是ICU belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were

  4. Employees' Assessment Of Customer Focus In A Tertiary Hospital In ...

    African Journals Online (AJOL)

    Employees' Assessment Of Customer Focus In A Tertiary Hospital In ... tool 'Are we making progress?' were used by respondents to rate customer focus. ... that they were allowed to take decisions to solve problems for customers (p < 0.001).

  5. USE OF A COMPUTER-GUIDED GLUCOSE MANAGEMENT SYSTEM TO IMPROVE GLYCEMIC CONTROL AND ADDRESS NATIONAL QUALITY MEASURES: A 7-YEAR, RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE TEACHING HOSPITAL.

    Science.gov (United States)

    Tanenberg, Robert J; Hardee, Sandra; Rothermel, Caitlin; Drake, Almond J

    2017-03-01

    Inpatient hyperglycemia, hypoglycemia, and glucose variability are associated with increased mortality. The use of an electronic glucose management system (eGMS) to guide intravenous (IV) insulin infusion has been found to significantly improve blood glucose (BG) control. This retrospective observational study evaluated the 7-year (January 2009-December 2015) impact of the EndoTool ® eGMS in intensive and intermediate units at Vidant Medical Center, a 900-bed tertiary teaching hospital. Patients assigned to eGMS had indications for IV insulin infusion, including uncontrolled diabetes, stress hyperglycemia, and/or postoperative BG levels >140 mg/dL. This study evaluated time required to achieve BG control (180 mg/dL after control attained); and the impact of eGMS on hospital-acquired condition (HAC)-8 rates. Data were available for all treated patients (492,078 BG readings from 16,850 patients). With eGMS, BG levels were brought to target within 1.5 to 2.3 hours (4.5 to 4.8 hours for cardiovascular patients). Minimal hypoglycemia was observed (BG values 180 mg/dL once control was attained). HAC-8 rates were reduced from 0.083 per 1,000 patients (2008) to 0.032 per 1,000 patients (2011). The use of eGMS resulted in rapid, effective control of inpatient BG levels, including significantly reduced hypoglycemia rates. BG = blood glucose CMS = Centers for Medicare and Medicaid Services CV = coefficient of variation CV% = coefficient of variation percentage eGMS = electronic glucose management system GV = glycemic variability HAC = Hospital-Acquired Condition ICU = intensive care unit IU = intermediate unit IV = intravenous LOS = length of stay VMC = Vidant Medical Center.

  6. Grammar Teaching in Chinese Tertiary Education

    Institute of Scientific and Technical Information of China (English)

    LAN Hui-hui

    2016-01-01

    Grammar teaching, as one essential aspect of English language teaching (ELT), has been and continues to be an area of some controversy and debates, which entails the emergency of diverse classroom practices for language teachers:Focus on Form or Focus on FormS. Connected with the specific context of grammar teaching in Chinese higher education, this paper tends to re-consider the place of grammar teaching in the classroom, and come up with some feasible approaches to instructing grammar so as to make appropriate connections between grammatical forms and the meanings.

  7. Emergence of carbapenem-resistant Acinetobacter baumannii ST787 in clinical isolates from blood in a tertiary teaching hospital in Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Fan Hu

    2017-10-01

    Conclusion: To the best of our knowledge, this study is the first to describe the microbiological characteristics of CRAB ST787, which carried high genetic resistance to carbapenem, but remained susceptible to colistin. CRAB ST787 was the predominant clone in our hospital in the study period.

  8. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    Directory of Open Access Journals (Sweden)

    Guy-Armel Bounda

    2013-01-01

    Conclusion: Chinese patients on warfarin therapy should benefit from periodic educational efforts reinforcing key medication safety information. Patient education is not a once-off procedure. A complete patient education program run by a clinical pharmacist in a Cardio-thoracic ward can considerably improve and enhance to reduce the hospital stays and significantly enlighten the role of the patient education in adherence to therapy.

  9. Neuromuscular Monitoring, Muscle Relaxant Use, and Reversal at a Tertiary Teaching Hospital 2.5 Years after Introduction of Sugammadex: Changes in Opinions and Clinical Practice

    Directory of Open Access Journals (Sweden)

    Thomas Ledowski

    2015-01-01

    Full Text Available Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38% utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011. Furthermore, 53% of anesthetists identified with a practice of “deeper and longer” intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n=20 of respondents felt it provided “faster turnover,” less postoperative residual neuromuscular blockade (n=23; 79%, and higher anesthetist satisfaction (n=17; 59%. 45% (n=13 of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57% mildly overdosed, with 200 mg being the most commonly administered dose.

  10. Tertiary Educational Institutions for Teaching, Research and Development

    Science.gov (United States)

    Amoo, Sikiru A.

    2014-01-01

    This paper examines the quality of teaching and research in developing human resources to facilitate the development of tertiary education in the nation. It discusses the challenges and the roles of research in higher education. The author argues that the combination of content and pedagogical knowledge could help to develop human resources for…

  11. Evaluation of supportive care management outcomes in cancer chemotherapy: A prospective observational study in a tertiary care teaching hospital in South India

    Directory of Open Access Journals (Sweden)

    Reshma Susan Reji

    2018-01-01

    Full Text Available Aims: Evaluation of supportive care management of cancer patients experiencing drug-related problems (DRPs is a challenge because it might increase the cost due to additional therapy. The main objectives of this study were to estimate chemotherapy-associated drug-related hospital admissions in the department of medical oncology and to estimate the cost of managing chemotherapy-associated DRPs.Settings and Design: This study is a prospective observational study.Subjects and Methods: Patients with chemotherapy-related DRPs were prospectively identified from the patient's medical records. The contribution of DRPs and cost incurred due to each hospitalization was assessed.Statistical Analysis Used: Data were analyzed using SPSS® 20.0 version.Results: Out of 55 patients analyzed for DRPs, 25 (45.5% patients in the age group of 51–60 years experienced DRPs most frequently. Most commonly occurring DRP was adverse drug reactions 42 (76.4%, which were more frequent in females. DRPs were maximum with alkylating agents 15 (27.3% and the least with hormonal agents 1 (1.8%. The mean length of hospitalization was 9.6 ± 6.5 days. The total direct medical cost was Rs. 31,540 ± 42,476, of which medicine cost accounted for Rs. 16,550 ± 25,404, constituting a major share of the total medical costs.Conclusions: Pharmacists can provide better patient care by identifying and preventing DRPs and reducing drug-related morbidity and mortality.

  12. Overviewof Contraceptive Use In Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. Methods: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, ...

  13. A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal.

    Science.gov (United States)

    Upadhyay, Dinesh Kumar; Mohamed Ibrahim, Mohamed Izham; Mishra, Pranaya; Alurkar, Vijay M

    2015-02-12

    Patient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided. Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients' satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal. An interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient's satisfaction scores at baseline, three, six, nine and, twelve months' follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p ≤0.05). There were significant (p patients' satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients' related outcomes and their

  14. 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.

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

    Science.gov (United States)

    Gupta, Sandeep Kumar; Nayak, Roopa P; Sivaranjani, R

    2016-01-01

    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. 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. 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. 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). 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.

  16. Prevalance of ABO and Rhesus Blood Groups in Blood Donors: A Study from a Tertiary Care Teaching Hospital of Kumaon Region of Uttarakhand.

    Science.gov (United States)

    Garg, Parul; Upadhyay, Saloni; Chufal, Sanjay Singh; Hasan, Yuman; Tayal, Ishwer

    2014-12-01

    Backround: ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly for the immunologic safety of blood during transfusion. This study is aimed to determine the distribution pattern of the ABO and Rh blood groups among blood donors in Kumaon region of Uttarakhand and compare it with other data from similar studies within the India and all over the world. It is a retrospective study carried out at blood bank of Shushila Tewari Hospital of Government Medical College, Haldwani from January 2012 to December 2013. The study was conducted on 12,701 blood donors. ABO and Rh typing was done using slide agglutination method with antisera ABO and Rh (Tulip diagnostics ltd). Doubtful cases were confirmed by tube agglutination method and reverse grouping using known pooled A and B cells. The age group and sex of donors, frequency of ABO and Rh blood groups were reported in simple percentages. The predominant donors belonged to age group between 18-35years (84.28%). Male donors were more than female donors, ratio being 352:1. Replacement donors (99.71%) were much more than voluntary donors (0.91%). The most common blood group was B (32.07%) and least common being AB (10.53%). Blood group 'O' and 'A' had same frequency. The prevalence of Rhesus positive and negative distribution in the studied population was 94.49% and 5.51% respectively. Blood group frequency with respect to ABO and Rhesus positive was found to be shown by formula B> O>A >AB. The frequency for ABO and Rhesus negative was given by the formula B>A>O>AB. Knowledge of frequencies of the different blood groups is very important for blood banks and transfusion service policies that could contribute significantly to the National Health System.

  17. HIV test counselling at a tertiary hospital

    African Journals Online (AJOL)

    time period 25 - 27 August 1992 were identified. Fourteen interns were unavailable during the study period. The remaining 64 were approached and a pre-tested, self- administered questionnaire was completed by 61 of them. Permission for the study was granted by hospital administration. Interns were free to complete the.

  18. Patterns of Eye Diseases in Children Visiting a Tertiary Teaching ...

    African Journals Online (AJOL)

    Background: About 19 million children worldwide live with visual impairments resulting from different ocular morbidities. This study aimed to identify the different causes of eye diseases in children visiting a tertiary eye centre at Jimma University Hospital. Methods: We conducted a retrospective review of charts of patients of ...

  19. Constructivism in Teaching English for Special Purposes at Tertiary School

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    Anna Y. Polenova

    2017-09-01

    Full Text Available The article looks at some principles of constructivism philosophy and the ways they are realized in ESP teaching at tertiary school. The purpose of this article is to describe constructivist teaching approach in enhancing students’ use of appropriate ESP learning strategies. Constructivism is a theory that emphasizes the active role of students in building understanding and making sense of the information. The constructivist teaching is learner-centered where students are actively involved in knowledge construction rather than passive listeners. Students construct knowledge by transforming, organizing, reorganizing previous knowledge through social interaction in construction of knowledge and understanding. The paper is an attempt to examine the principles of constructivist teaching and learning by providing analysis of features of constructivist theory and the organization of a constructivist classroom.

  20. Incidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.

    Science.gov (United States)

    John, Jason; Seifi, Ali

    2016-08-01

    Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. We performed a retrospective cohort study on iatrogenic pneumothorax incidence from 2000 to 2012 using the Healthcare Cost and Utilization Project (HCUP) database. Pairwise t tests were performed. Odds ratios and P values were calculated, using a Bonferroni-adjusted α threshold, to examine differences in iatrogenic pneumothorax incidence in teaching vs. non-teaching hospitals. Our study revealed that after the year 2000, teaching hospitals had significantly greater iatrogenic pneumothorax incidence compared to non-teaching hospitals in every year of the study period (Ppneumothorax occurred with significantly greater incidence in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. This trend may have been enhanced by the residency duty-hour regulations implemented in 2003 in teaching institutions, or due to higher rates of procedures in teaching institutions due to the nature of a tertiary center. Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding. Published by Elsevier Inc.

  1. [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.

  2. Variations in Decision-Making Approach to Tertiary Teaching: A Case Study in Vietnam

    Science.gov (United States)

    Nguyen, Thanh Tien

    2016-01-01

    Although the question of what to teach and how to teach has received much attention from the literature, little was known about the way in which academics in teaching groups make decision on what and how to teach. This paper reports an analysis of variations in the decision-making approach to tertiary teaching through academics' practices of…

  3. Causes of maxillofacial patient mortality in a Nigerian tertiary hospital

    African Journals Online (AJOL)

    a Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bayero University, Kano and Consultant, Oral and Maxillofacial Surgeon,. Aminu Kano Teaching Hospital, Kano, Nigeria ... craniofacial trauma and stage IV malignancies [2, 3, 4]. Intraoperative deaths may also occur from anesthetic and/.

  4. Cataract Surgical Outreach in a Tertiary Hospital in Nigeria: An ...

    African Journals Online (AJOL)

    Odarosa M Uhumwangho

    the University of Benin Teaching Hospital (UBTH), Benin City. ... There is a great need to improve access to eye care services in general and cataract surgical ... world.[1] In Nigeria, 42.9% of blindness is caused by cataract. [2] A large number of the cataract blind have not had surgery ..... Change the definition of blindness.

  5. 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.

  6. General Practice Teaching--Within the Hospital

    Science.gov (United States)

    Drury, M.

    1976-01-01

    A program of integrated teaching by consultants and general practitioners is described. The teaching took place in the hospitals used for the purpose by the Medical Faculty of the University of Birmingham. (Author)

  7. Pattern of drug eruptions in a tertiary care hospital

    International Nuclear Information System (INIS)

    Tahir, Z.; Nadeem, N.; Aman, S.; Kazmi, A.H.

    2013-01-01

    Background: An adverse drug reaction is unintentional which occurs at doses used for prophylaxis, diagnosis or treatment. Objectives: To determine the frequency of various cutaneous drug eruptions that occur in patients in a tertiary care hospital setting. Patients and Methods: All patients with cutaneous drug eruptions seen at the Dermatology Department of Mayo Hospital, Lahore, over 6 months were enrolled and the pattern of drug eruptions like urticaria, angioedema, fixed drug eruption, maculopapular rash, erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis etc. were recorded, along with drugs that caused it. Results:A total of 160 patients (86 males, 74 females) were included in the study. Mean age of patients was 30.7+-15.4 years. Major eruptions were fixed drug eruption (21.3%) followed by urticaria without angioedema (10%), maculopapular rash (9.3%), lichenoid drug eruption (8.7%), acneiform drug eruption (7.5%), Stevens-Johnson syndrome (6.9%), vesiculobullous eruption (5.6%), erythema multiforme and eczematous eruption (5% each). Common drugs causing eruptions were sulfonamides (16.3%), followed by NSAIDs (14.4%), herbal and homeopathic medications (12.5%), penicillins (9.3%), tetracyclines (8.7%), antituberculous drugs, cephalosporins and antiepileptics (6.3% each). Conclusion: Fixed drug eruption and urticaria without angioedema were commonest eruptions while, sulfonamides and NSAIDs were the major causative drugs. Policy message: Reporting of adverse drug reactions is not done in Pakistan and needs to be done in each hospital. (author)

  8. Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania

    Directory of Open Access Journals (Sweden)

    Mashurano Marcellina

    2004-10-01

    Full Text Available Abstract Background Antimicrobial resistance is particularly harmful to infectious disease management in low-income countries since expensive second-line drugs are not readily available. The objective of this study was to implement and evaluate a computerized system for surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. Methods A computerized surveillance system for antimicrobial susceptibility (WHONET was implemented at the national referral hospital in Tanzania in 1998. The antimicrobial susceptibilities of all clinical bacterial isolates received during an 18 months' period were recorded and analyzed. Results The surveillance system was successfully implemented at the hospital. This activity increased the focus on antimicrobial resistance issues and on laboratory quality assurance issues. The study identified specific nosocomial problems in the hospital and led to the initiation of other prospective studies on prevalence and antimicrobial susceptibility of bacterial infections. Furthermore, the study provided useful data on antimicrobial patterns in bacterial isolates from the hospital. Gram-negative bacteria displayed high rates of resistance to common inexpensive antibiotics such as ampicillin, tetracycline and trimethoprim-sulfamethoxazole, leaving fluoroquinolones as the only reliable oral drugs against common Gram-negative bacilli. Gentamicin and third generation cephalosporins remain useful for parenteral therapy. Conclusion The surveillance system is a low-cost tool to generate valuable information on antimicrobial resistance, which can be used to prepare locally applicable recommendations on antimicrobial use. The system pinpoints relevant nosocomial problems and can be used to efficiently plan further research. The surveillance system also functions as a quality assurance tool, bringing attention to methodological issues in identification and susceptibility testing.

  9. Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab

    International Nuclear Information System (INIS)

    Ikram, A.; Shah, S.I.H.; Naseem, S.; Absar, S.A.; Safi-Ullah; Ambreen, T.

    2010-01-01

    To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals. Study Design: Survey. Place and Duration of Study: National Institute of Science and Technology, Islamabad, from June through August 2008. Methodology: Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods. Results: Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste. Conclusion: The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures. (author)

  10. Herpes–Zoster Infection in a Tertiary Hospital in Brazil

    Science.gov (United States)

    Antoniolli, Luciana; Azambuja, Aline; Rodrigues, Camila; Borges, Rafael; Goldani, Luciano

    2017-01-01

    Abstract Background herpes zoster (HZ) is a common infection with potential complications requiring hospital care, especially for patients with multiple comorbities. However, there is little information on HZ from hospital registries. Methods we searched for hospital-based records of B02 code (ICD-10) between March 2000 and January 2017 at Hospital de Clínicas de Porto Alegre, a tertiary, university hospital in south Brazil. To avoid misclassifications, we considered clinical evaluation for the diagnosis of cutaneous HZ and postherpetic neuralgia (PHN), ophthalmological evaluation for ophthalmic HZ and the combination of clinical, radiologic and cerebrospinal fluid analysis for HZ meningo-encephalitis (ME). We analyzed conditions associated with immune dysregulation, complications, length of hospital stay, and mortality. Chi-square test and Kaplan-Meier estimator were used for statistical analyses. P < 0.05 was considered statistically significant. Results there were 847 records for this period, of which 801 were confirmed according to our criteria and included in the analysis. Most patients were women (n = 448; 60%), with an average of 48.8 years, standard deviation of 22.2. There were more diagnoses in the inpatients group (74.4%), and fewer in the emergency room (22.4%) and outpatient (3.3%). The median length of hospital stay was 7 days (2-10, P25-P75) when HZ was the main reason for admission. Most patients presented cutaneous HZ (n = 743, 92.8%). There were fewer cases of PHN (6.1%), ophthalmic HZ (7.6%) and ME (4.1%). Seventy percent had some kind of immune dysregulation; more frequently AIDS (31%), use of immunosuppressive agents (18.7%) and malignant disease (16.2%). We followed the subjects for a median of 28.2 (2.8-77.5) months. During this period, there were 105 (13.1%) deaths. Five were related to HZ ME. The 30-day overall mortality rate was 1.5%. There was no statistical difference in cumulative survival (graph 1, P = 0.05) or incidence of

  11. Pylephlebitis: incidence and prognosis in a tertiary hospital.

    Science.gov (United States)

    Belhassen-García, Moncef; Gomez-Munuera, Mercedes; Pardo-Lledias, Javier; Velasco-Tirado, Virginia; Perez-Persona, Ernesto; Galindo-Perez, Inmaculada; Alvela-Suárez, Lucia; Romero-Alegría, Angela; Muñoz-Bellvis, Luis; Cordero-Sánchez, Miguel

    2014-01-01

    Septic thrombophlebitis of the portal vein or its branches, most often secondary to intra-abdominal infection is known as pylephlebitis. The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease. An observational retrospective study was conducted in a tertiary care hospital (University Hospital of Salamanca, Spain) from January 1999 to December 2008. A total of 7796 patients with intra-abdominal infection were evaluated, of whom 13 (0.6%) had been diagnosed with pylephlebitis. Diverticulitis was the most frequent underlying process, followed by biliary infection. Early mortality was 23%. Survivors had no recurrences, but one of them developed portal cavernomatosis. Pylephlebitis is a rare complication of intra-abdominal infection, with a high early mortality, but with a good prognosis for survivors. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Neonatal bloodstream infections in a Ghanaian Tertiary Hospital

    DEFF Research Database (Denmark)

    Labi, Appiah-Korang; Obeng-Nkrumah, Noah; Bjerrrum, Stephanie

    2016-01-01

    submitted to the microbiology department of the Korle-Bu Teaching Hospital was conducted from January 2010 through December 2013. We assessed the prevalence of bacteria and fungi involved in BSI and the susceptibility coverage of recommended empiric antibiotics by Ghana Standard Treatment guidelines...... and the WHO recommendations for managing neonatal sepsis. The national and WHO treatment guidelines recommend either ampicillin plus gentamicin or ampicillin plus cefotaxime for empiric treatment of neonatal BSI. The WHO recommendations also include cloxacillin plus gentamicin. We described the resistance...

  13. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Science.gov (United States)

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  14. 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.

  15. 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.

  16. Indirect costs of teaching in Canadian hospitals.

    Science.gov (United States)

    MacKenzie, T A; Willan, A R; Cox, M A; Green, A

    1991-01-01

    We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

  17. Fungal Profile of Vulvovaginal Candidiasis in a Tertiary Care Hospital.

    Science.gov (United States)

    Kalaiarasan, Krishnapriya; Singh, Rakesh; Chaturvedula, Latha

    2017-03-01

    Vulvovaginal Candidiasis (VVC) is a common medical health problem of adult women. It is most commonly caused by Candida albicans . But there is a change in fungal profile. Sabouraud's Dextrose Agar (SDA) is the most common culture medium used where mixed fungal infection may be missed. It can be detected easily by using chromogenic culture medium. To know the fungal profile of vulvovaginal candidiasis using Candida CHROMagar and antifungal susceptibility pattern in patients attending tertiary care hospital. Culture confirmed cases of VVC presented at Department of Obstetrics and Gynaecology of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, from July 2015 to December 2015 were included in the cross-sectional study. Two high vaginal swabs were collected and inoculated on SDA and Candida CHROMagar (Hi-Media, Mumbai, India). After overnight incubation the colonies were counted and colour of the colonies were recorded from Candida CHROMagar. Candida spp. were identified by sugar fermentation and assimilation tests and other conventional tests. Antifungal susceptibility tests were performed by the disc diffusion method using fluconazole (25 μg) and voriconazole (1μg) as per the Clinical and Laboratory Standards Institute (CLSI - M44-A2) guidelines. A total of 50 culture confirmed (23.7%) cases were detected from 211 clinically suspected VVC cases. Candida glabrata (45.1%) was the most common isolate, followed by Candida tropicalis (23.5%) , Candida albicans (17.6%) , Candida krusei (9.8%) and Candida parapsilosis (3.9%) . One mixed infection of C. glabrata and C. albicans was identified on Candida CHROMagar. Mixed fungal infection was observed in 2% of positive culture and 0.5% of VVC cases. The antifungal susceptibility testing revealed that 15.7% and 9.8% isolates of Candida spp. were resistant and Susceptible Dose Dependent (S-DD) respectively to fluconazole. The increase resistant against fluconazole was because of

  18. Awareness about HIV infection among the paramedical staff in a tertiary care hospital in Delhi, India

    Directory of Open Access Journals (Sweden)

    Nikhil Gupta

    2012-01-01

    Full Text Available In India, acquired immunodeficiency syndrome (AIDS is a growing epidemic involving all sections of the society. Health care personnel are at increased risk of acquiring blood borne diseases like AIDS, hepatitis, etc. We aimed to assess the level of awareness of HIV infection among the paramedical staff working in a tertiary care hospital. A total number of 207 paramedical staff were asked to complete a questionnaire covering the various aspects of HIV and AIDS which was then critically reviewed. We observed that 57.54% of the staff was aware of the different aspects of HIV infection. Our results highlighted that awareness regarding the different facets of HIV varied among the nurses, lab technicians and support staff. Transmission of blood borne infections through needle stick injury is a harsh reality involving health care personnel. There is an urgent need to teach basic knowledge about HIV infection among high-risk populations.

  19. MONITORING OF THE CEPHALOSPORINS CONSUMPTION IN THE TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radmila Veličković-Radovanović

    2015-06-01

    Full Text Available Irrational antibiotic consumption, especially in the case when there is no appropriate indication for its usage, may be one of the most crucial global issues for public health care, leading to bacterial resistance and the increase of indirect medical expenses. According to the report of the European program for the monitoring of the antibiotic consumption, Serbia is on the fifth place among the countries which are not members of EU. The goal of this work is the evaluation of antibiotic consumption in the Clinical Centre Niš, from 2007 to 2013, with the focus on the monitoring of the cephalosporins utilization, as they are one of the most prescribed groups of antibiotics in the tertiary health care. The utilization of antibiotics in the Clinical Center Niš in the observed period was obtained from the computerized database of the Department of Pharmacotherapy and expressed as defined daily dose (DDD per 100 bed/days (DBD. Our results showed that there was an increase in antibiotic use of the whole group of cephalosporins and penicillin as well as a reduction of quinolones consumption within the observed period. Our analysis showed that ceftriaxone was the most frequently prescribed cephalosporin, followed by cefuroxime. Although antibiotic therapy and prophylaxis in our hospital are in keeping with the recommended guidelines, the obtained results may suggest that cephalosporin consumption, and especially ceftriaxone consumption is higher than in other European countries.

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

    Science.gov (United States)

    Rukewe, Ambrose; Fatiregun, Akinola; Oladunjoye, Adeolu O; Oladunjoye, Olubunmi O

    2012-01-01

    We assessed job satisfaction among anesthesiologists at a tertiary hospital in Nigeria and identified elements of job stress and dissatisfaction. 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. 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. Our results showed that despite the demanding nature of anesthesiology as a specialty, many anesthesiologists were contented with their job.

  1. Experience of Oesophageal atresia management in a tertiary Bangladeshi hospital.

    Science.gov (United States)

    Islam, Md Kabirul

    2018-01-16

    Background and aim: This study has been conducted to determine the clinical presentations and surgical outcome of patients with OA admitted in a tertiary level hospital in Bangladesh. A prospective analysis was conducted for 32 patients with confirmed OA between July 2007 and June 2015. Of them surgical correction was done in 25 cases. The other 7, in whom surgery could not be done, were excluded from the study. Of the 25 cases, that had been operated, 15 were full term and 52% were more than 48 hours old. Type-C OA with TOF was the commonest type (96%). 24 cases were operated through Right Thoracotomy. Of them 52% were done by Single Lung (left) ventilation. 'Division of the fistula' with 'end to end anastomosis' was done in all of them. Only 1 patient had a Gastric pull up surgery. Of the 25 cases, 16 survived (64%). In follow up all the patients were found thriving and showed no problem in swallowing. Our study which shows 64% survival is a great achievement for us but not satisfactory in international standard. However, the experience and encouragement that we are gathering, will guide us to achieve better result in near future.

  2. ANALYSIS OF ORGANOPHOSPHORUS POISONING, AT TERTIARY CARE HOSPITAL: A REPORT

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    Shakuntala

    2015-01-01

    Full Text Available BACKGROUND: Organophosphorus (OP compounds are the most common suicidal poison in developing countries and mortality continues to be high. The present study was aimed to know the pattern and outcome of the OP poisoning. METHODOLOGY: A record based retrospective study from January 2013 - December 2013 was Conducted in a tertiary care hospital and data regarding age, gender, domicile, type of poison, manner of poisoning, seasonal trends, marital status, motive behind poisoning , socio - economic status and outcome was collected in a pre - structured Performa. All data were documented, analyzed and interpreted as per the laid down protocol. RESULTS : out of total 1575 cases of OP compound poisoning, 71.73% (1130 were male, 28.27% (445 were female, 34.6% were in the age group 21 - 30 years, 70.95% were of low socio - economic status, Occupation wise agricultural workers were on top of the list (70.07%, The commonest (93.78% motive behind poisoning was suicidal in both males and females, Financial problem was one of the commonest (51.22% reasons of poisoning. The mortality rate in our study was 13.47%. CONCLUSION : Y oung and adult males of Low socio - economic class, rural, both literate and illiterate agriculturists commonly abuse this substance to commit suicide

  3. 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.

  4. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    Science.gov (United States)

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. MANAGEMENT OF POSTERIOR DISLOCATED INTRAOCULAR LENSES IN A TERTIARY HOSPITAL

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    Shashidhar

    2016-10-01

    Full Text Available BACKGROUND The aim of this study was to assess and compare the visual outcome of different approaches in the management of dislocated PCIOL. MATERIALS AND METHODS 20 eyes of 20 patients who underwent 3PPPV/anterior vitrectomy to refixate or IOL exchange for dislocation or subluxation of PCIOL from 2012 to 2015. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. This is a retrospective study of 20 eyes of 20 patients with dislocated/subluxated PCIOLs in a tertiary hospital from 2012 to 2015. STATISTICAL ANALYSIS Paired t-test statistical method. RESULTS We retrospectively analysed hospital records of patients who had undergone three PPPV/anterior vitrectomy for posteriorly dislocated/subluxated IOLs 20 eyes of 20 patients were analysed. SFIOLs were implanted in 12 patients, IOL refixation was done in four patients and four were left aphakic. Postoperative BCVA of 6/12 or better was achieved in 66.67% in primary SFIOL, secondary SFIOL and IOL refixation groups. BCVA of <6/60 was seen in all patients left aphakic. Early and late complications were most in aphakic patients. IOL refixation procedure had minimum early and late complications. Subluxated PCIOLs do better than dislocated lens where a successful SFIOL was placed. CONCLUSION IOL refixation procedure has the least complication rate. Early complications of SFIOL management resolve with time. Thus, 3PPPV/anterior vitrectomy with SFIOL and IOL refixation procedures offer a novel approach towards visual rehabilitation of patients with subluxated or dislocated PCIOLs.

  6. Male hypogonadism at a tertiary care hospital in Karachi, Pakistan.

    Science.gov (United States)

    Ram, Nanik; Asghar, Ali; Hashmi, Fauzan; Islam, Najmul

    2012-01-01

    Male hypogonadism is defined as 'inadequate gonadal function, manifested by deficiency in gametogenesis and/or secretion of gonadal hormones'. Signs and symptoms of hypogonadism depend primarily on the age of onset. It can be classified according to the site primarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this study was to determine the presentation and aetiology of male hypogonadism seen in a tertiary care hospital. This cross-sectional study was conducted at Endocrine Clinics, Aga Khan University Hospital Karachi. Data of male patients with hypogonadism who attended clinics during January 2009 to August 2011 were reviewed. All male patients with clinical and biochemical evidence of hypogonadism were included in the study. Patients with Diabetes Mellitus, Metabolic Syndrome, Andropause, AIDS, Chronic Renal Failure, and Cirrhosis were excluded. Mean +/- SD were computed for quantitative variables. Frequency and percentages were computed for qualitative variables. Aetiology of male hypogonadism was categorised as primary and secondary hypogonadism. A total of 85 patients with male hypogonadism attended the endocrine clinic. Mean age of patients was 25 +/- 10 years. Clinical presentations were small genitalia (65%), absent secondary sexual characteristics (53%), not attained puberty (47%), infertility (53%), erectile dysfunction (41%) and loss of libido (29%). Seventy-three (86%) patients had hypogonadotrophic hypogonadism (secondary hypogonadism) and 12 (14%) patients had hypergonadotrophic hypogonadism (primary hypogonadism). Among the patients with hypogonadotrophic hypogonadism 38 had idiopathic hypogonadotrophic hypogonadsim, 7 had pituitary adenoma, 6 had empty sella syndrome, 3 had Kallman's syndrome, and 1 patient had haemosiderosis due to thalassaemia major; 18 patients did not undergo brain imaging. Small genitalia, absent secondary sexual characteristics and infertility were the main presenting features of hypogonad

  7. Urgent tracheostomy: four-year experience in a tertiary hospital.

    Science.gov (United States)

    Costa, Liliana; Matos, Ricardo; Júlio, Sara; Vales, Fernando; Santos, Margarida

    2016-01-01

    Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely important. We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital. Indications, complications and clinical evolution of the patients were reviewed. The study included 56 patients (44 men and 12 women) with a median age of 55 years. The procedure was performed under local anesthesia in 21.4% of the patients. Two (3.6%) patients were subjected to conversion from cricothyrostomy to tracheostomy. Head and neck neoplasm was indicated in 44.6% of the patients, deep neck infection in 19.6%, and bilateral vocal fold paralysis in 10.7%. Stridor was the most frequent signal (51.8%). Of the 56 patients, 15 were transferred to another hospital. Among the other 41 patients, 21 were decannulated (average time: 4 months), and none of them were cancer patients. Complications occurred in 5 (12.2%) patients: hemorrhage in 3, surgical wound infection in 1, and cervico-thoracic subcutaneous emphysema in 1. No death was related to the procedure. Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with difficult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.

  8. Nasalseptal hematoma/abscess: management and outcome in a tertiary hospital of a developing country

    Directory of Open Access Journals (Sweden)

    Nwosu JN

    2015-07-01

    Full Text Available Jones N Nwosu, Peter C NnadedeDepartment of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, NigeriaBackground: Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency.Objective: To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution.Method: Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated.Results: Fifty-three patients (37 males and 16 females, age 5–65 years (with mean age of 23.10 years, were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases.Conclusion: Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess.Keywords: septal hematoma, abscess, facial deformity

  9. PAEDIATRIC OCULAR INJURIES IN A TERTIARY CARE HOSPITAL

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    K. Vinayagamurthy

    2017-08-01

    good because of prompt treatment. Facilities for treatment of ocular emergencies have significantly improved in tertiary hospitals located in mofussil areas.

  10. Hospital-acquired infections in a Nigerian tertiary health facility: An ...

    African Journals Online (AJOL)

    Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...

  11. 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.

  12. Experience of vascular trauma in a tertiary care hospital

    International Nuclear Information System (INIS)

    Imtiaz, N.

    2010-01-01

    To highlight the presentation and management of various vascular injuries and their outcome. Thirty nine cases of vascular trauma were referred to vascular surgeon CMH Rawalpindi, in the above mentioned period. These cases were evaluated for mechanism of injury, age, gender and time of presentation. Out of these, only thirty cases were found suitable for surgical intervention. These thirty cases were evaluated for site of vascular injury, associated injuries, type of surgery performed and the outcome. Blunt trauma was the predominant cause of vascular injuries in our study 16/39 (41%). Fourteen cases (35.8%) had gun shot wounds. Only thirty patients (76.9 %) underwent various surgical procedures. Primary end to end anastomosis was possible in only 5/30 cases (16.6%) while reversed venous graft was used in 13/30 cases (43.3%). Wound infection occurred in 2/30(6.6%) cases out of which 1 case (3.3%) ultimately had an amputation. The time period between injury and surgical intervention ranged between 1 to 20 hours for most of the vascular injuries while delayed presentation in the form of traumatic arteriovenous fistula or pseudoaneurysm was between 48 hours to 3 months. There are reasonable numbers of vascular trauma cases being referred to a tertiary care hospital. Most of these cases reach us quite late due to unnecessary investigations, delayed referral and transportation. Early intervention and revascularization definitely reduces amputation and complication rate. All gunshot wounds not only require thorough surrounding soft tissue debridement but also liberal excision of traumatised vessel itself, resulting in interposition graft repair. (author)

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

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    M S Maputle

    2008-11-01

    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

  14. STUDY OF GASTROINTESTINAL CANCERS IN A TERTIARY CARE HOSPITAL

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    Rema Nair Sarkar

    2017-11-01

    Full Text Available BACKGROUND Cancer is one of the leading cause of death both in developed and developing countries. In India, it accounts for 0.3 million deaths per year. Cancers of lung, GIT and oral cancers dominated among men while breast, cervix, ovary and oral cavity were commonest cancer seen in women. Among the gastrointestinal cancers, cancers of the oesophagus, stomach, colon, rectum and liver cancers were commonest. The aim of the study is to evaluate the incidence of the various GIT cancers in a tertiary hospital of Coastal Andhra when compared to other studies. MATERIALS AND METHODS In this retrospective study, a total of 509 health records of patients affected by cancers were studied and relevant details noted. RESULTS A total of 509 cancer cases were reported in this period of 18 months (January 2016 - June 2017 of which 85 cases (16.3% were of Gastrointestinal (GIT cancers. The age group between 40 and 60 recorded the maximum incidence of 47 cancers (55.1%. The incidence of gastrointestinal cancers were significantly higher in the men (56 cases (65.8% than the women (29 cases (34.11%. The commonest site of GIT cancers was the colorectal region (30 cases (35.7%. The most common type of cancer seen was adenocarcinoma seen in 73 cases (85.8%. CONCLUSION Public education and awareness for the warning symptoms should be increased to prevent reduction of the life span and health caused by the gastrointestinal cancers with intense awareness drive using various means including social media undertaken to educate the public regarding the warning symptoms and screening of such group for GIT cancers.

  15. Management and outcomes of acute ST-segment-elevation myocardial infarction at a tertiary-care hospital in Sri Lanka: an observational study

    OpenAIRE

    Bandara, Ruwanthi; Medagama, Arjuna; Munasinghe, Ruwan; Dinamithra, Nandana; Subasinghe, Amila; Herath, Jayantha; Ratnayake, Mahesh; Imbulpitiya, Buddhini; Sulaiman, Ameena

    2015-01-01

    Background Sri Lanka is a developing country with a high rate of cardiovascular mortality. It is still largely dependent on thrombolysis for primary management of acute myocardial infarction. The aim of this study was to present current data on the presentation, management, and outcomes of acute ST-segment-elevation myocardial infarction (STEMI) at a tertiary-care hospital in Sri Lanka. Methods Eighty-one patients with acute STEMI presenting to a teaching hospital in Peradeniya, Sri Lanka, we...

  16. Awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in Delhi.

    Science.gov (United States)

    Bhagawati, G; Nandwani, S; Singhal, S

    2015-01-01

    Health care institutions are generating large amount of Bio-Medical Waste (BMW), which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM) and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%), intermediate (50-80%) and unsatisfactory (less than 50%). Some major areas of deficit found were about knowledge regarding number of BMW categories (17%), mercury waste disposal (37.56%) and definition of BMW (47%).

  17. Awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in Delhi

    Directory of Open Access Journals (Sweden)

    G Bhagawati

    2015-01-01

    Full Text Available Health care institutions are generating large amount of Bio-Medical Waste (BMW, which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%, intermediate (50–80% and unsatisfactory (less than 50%. Some major areas of deficit found were about knowledge regarding number of BMW categories (17%, mercury waste disposal (37.56% and definition of BMW (47%.

  18. 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.

  19. Clinicomycological Characterization of Superficial Mycoses from a Tertiary Care Hospital in Nepal.

    Science.gov (United States)

    Khadka, Sundar; Sherchand, Jeevan Bahadur; Pokharel, Dinesh Binod; Pokhrel, Bharat Mani; Mishra, Shyam Kumar; Dhital, Subhash; Rijal, Basista

    2016-01-01

    Background . Superficial mycosis is a common fungal infection worldwide, mainly caused by dermatophytes. However, the prevalence of species varies geographically. In addition, fungal treatment is best guided according to species isolated. This study was carried out to determine the clinical as well as mycological profile of superficial mycoses in a tertiary care hospital, Nepal. Methods . This was a prospective case-control laboratory based study conducted over a period of six months from January to June 2014 at Tribhuvan University Teaching Hospital, Nepal. A total of 200 specimens were collected from the patients suspected of superficial mycoses. The specimens were macroscopically as well as microscopically examined. The growth was observed up to 4 weeks. Results. Out of total 200 specimens from the patients suspected of superficial mycoses, tinea corporis 50 (25%) was most common clinical types. KOH mount was positive in 89 (44.5%) and culture was positive in 111 (55.5%). Trichophyton mentagrophytes 44 (39.6%) was the most common isolate. Conclusions. The diagnostic yields of KOH mount and culture were found to be complementary to each other. Thus both the methods added with clinical findings are equally important to establish superficial mycosis.

  20. Clinicomycological Characterization of Superficial Mycoses from a Tertiary Care Hospital in Nepal

    Directory of Open Access Journals (Sweden)

    Sundar Khadka

    2016-01-01

    Full Text Available Background. Superficial mycosis is a common fungal infection worldwide, mainly caused by dermatophytes. However, the prevalence of species varies geographically. In addition, fungal treatment is best guided according to species isolated. This study was carried out to determine the clinical as well as mycological profile of superficial mycoses in a tertiary care hospital, Nepal. Methods. This was a prospective case-control laboratory based study conducted over a period of six months from January to June 2014 at Tribhuvan University Teaching Hospital, Nepal. A total of 200 specimens were collected from the patients suspected of superficial mycoses. The specimens were macroscopically as well as microscopically examined. The growth was observed up to 4 weeks. Results. Out of total 200 specimens from the patients suspected of superficial mycoses, tinea corporis 50 (25% was most common clinical types. KOH mount was positive in 89 (44.5% and culture was positive in 111 (55.5%. Trichophyton mentagrophytes 44 (39.6% was the most common isolate. Conclusions. The diagnostic yields of KOH mount and culture were found to be complementary to each other. Thus both the methods added with clinical findings are equally important to establish superficial mycosis.

  1. Pattern of nosocomial infection in two intensive care units of a tertiary care hospital in karachi

    International Nuclear Information System (INIS)

    Rizvi, M.F.; Hassan, Y.; Abdullah, M.; Shakeel, J.; Memon, A.R.; Razvi, M.F.; Saleem, S.; Shakeel, J.

    2007-01-01

    To determine the pattern of nosocomial infections in two ICUs' of a teaching hospital in terms of frequency, common sites of infection, the pathogens involved and the antibiotic sensitivity patterns. It was conducted in two medical ICUs (Neurology and Nephrology) of a public tertiary care hospital. Data was collected prospectively on patients suspected to have developed nosocomial infection after 48 hours of admission to the ICU according to objective. There were 101 cases of suspected nosocomial infection out of a total of 254 patients. The frequency of nosocomial infection was 39.7%. UTI developed in 44.6%, while 27% had blood stream infection, and 21% had pneumonia. Each of the three major sites of infection was strongly associated with the use of invasive devices. Escherichia (E.) coli was the most common organism isolated followed by Pseudomonas aeruginosa and Klebsiella. E. coli and Klebsiella showed a maximum sensitivity to Imipenem followed by Tazocin (pipericillin + tazobactam). Pseudomonas aeruginosa was sensitive to Amikacin and Fosfomycin. The high frequency of nosocomial infection suggests that more strict measures regarding invasive devices should be taken in future to control the infection and limit the emergence of antibiotic resistant organisms. (author)

  2. ABC-VED analysis of expendable medical stores at a tertiary care hospital.

    Science.gov (United States)

    Kumar, Sushil; Chakravarty, A

    2015-01-01

    The modern system of medicine has evolved into a complex, sophisticated and expensive treatment modality in terms of cost of medicines and consumables. In any hospital, approximately 33% of total annual budget is spent on buying materials and supplies including medicines. ABC (Always, Better Control)-VED (Vital, Essential, Desirable) analysis of medical stores of a large teaching, tertiary care hospital of the Armed Forces was carried out to identify the categories of drugs needing focused managerial control. Annual consumption and expenditure data of expendable medical stores for one year was extracted from the drug expense book, followed by classification on its annual usage value. Subsequently, the factor of criticality was applied to arrive at a decision matrix for understanding the need for selective managerial control. The study revealed that out of 1536 items considered for the study, 6.77% (104), 19.27% (296) and 73.95% (1136) items were found to be A, B and C category items respectively. VED analysis revealed that vital items (V) accounted for 13.14% (201), essential items (E) for 56.37% (866) and desirable accounted for 30.49% items (469). ABC-VED matrix analysis of the inventory reveals that only 322 (21%) items out of an inventory of 1536 drugs belonging to category I will require maximum attention. Scientific inventory management tools need to be applied routinely for efficient management of medical stores, as it contributes to judicious use of limited resources and resultant improvement in patient care.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  5. Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital.

    Science.gov (United States)

    Wani, Mohammad Ashraf; Tabish, S A; Jan, Farooq A; Khan, Nazir A; Wafai, Z A; Pandita, K K

    2013-01-01

    Cancer remains a major health problem in all communities worldwide. Rising healthcare costs associated with treating advanced cancers present a significant economic challenge. It is a need of the hour that the health sector should devise cost-effective measures to be put in place for better affordability of treatments. To achieve this objective, information generation through indigenous hospital data on unit cost of in-patient cancer chemotherapy in medical oncology became imperative and thus hallmark of this study. The present prospective hospital based study was conducted in Medical Oncology Department of tertiary care teaching hospital. After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96). This includes expenditure incurred both by the hospital and the patient (out of pocket). The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

  6. Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

    Science.gov (United States)

    Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

    2012-09-21

    To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital. No procedure-related mortalities occurred. Performing closure with endoscopic clipping reduced the C-reactive protein (CRP) titers. The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping

  7. The profile of meningitis in a tertiary paediatric hospital in South Africa

    African Journals Online (AJOL)

    Background. Meningitis in children is a major health problem worldwide, leading to high rates of mortality and morbidity. Objectives. To describe the profile of patients treated for meningitis at a leading tertiary paediatric hospital (Red Cross War Memorial Children's Hospital) in South Africa. Methods. This study describes all ...

  8. Smoking trends amongst young doctors of a tertiary care hospital - Mayo Hospital, Lahore - Pakistan

    International Nuclear Information System (INIS)

    Chudhary, M.K.; Younis, M.; Bukhari, M.H.

    2011-01-01

    The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)

  9. 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.

  10. 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

  11. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    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

  12. Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital

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    Appiah-Korang Labi

    2018-02-01

    Full Text Available Abstract Background Understanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians’ knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana. Methods We conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives. Results The survey was completed by 159 of 200 physicians (response rate of 79.5%. Of physicians, 30.1% (47/156 perceived antibiotic resistance as very important global problem, 18.5% (29/157 perceived it as very important national problem and only 8.9% (14/157 thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE and vancomycin resistant enterococci (VRE. In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE. Conclusions Physicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians.

  13. KNOWLEDGE AND ATTITUDE OF PUERPERAL WOMEN TOWARDS FAMILY PLANNING PRACTICES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Atmaja Nair

    2017-01-01

    Full Text Available BACKGROUND India is the second most populous country in the world after China. In an effort to stabilize the population, National Family Welfare Program was launched in 1951. There has been an increase in contraceptive prevalence and a reduction in total fertility rate since then. For better results, contraceptive use should start right from the post partum period. This also significantly reduces maternal and infant mortality rates. AIM To assess the knowledge and attitude about contraception in post-partum women in a tertiary care teaching hospital in North Kerala. MATERIALS AND METHODS This cross sectional study was conducted in the Department of Obstetrics and Gynaecology, IMCH, Govt. Medical College, Kozhikode, Kerala, between January 2016 and March 2016, using a prestructured questionnaire, in postpartum women. Their knowledge and attitude about contraception was assessed. RESULTS A total of 1500 postpartum women were included in the study. 80% were aware of some method of contraception. This knowledge increased with increasing education, parity and better socioeconomic class. Major source of information was health worker (46.67%. But only 18.33% had practiced any method of contraception before and 44% only showed willingness to use any contraception. The major reason for non-acceptance of contraception was the need for more children. CONCLUSION Low prevalence seen in the use of contraception can be overcome by promoting spacing methods like PPIUCD, injectables and pills. The couple should be counselled together to alleviate the anxiety in the husband.

  14. Incidence and risk factors of ventilator associated pneumonia in a tertiary care hospital.

    Science.gov (United States)

    Charles, Mv Pravin; Easow, Joshy M; Joseph, Noyal M; Ravishankar, M; Kumar, Shailesh; Umadevi, Sivaraman

    2013-01-01

    Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia associated with increased morbidity and mortality. Knowledge about the incidence and risk factors is necessary to implement preventive measures to reduce mortality in these patients. A prospective study was conducted at a tertiary care teaching hospital for a period of 20 months from November 2009 to July 2011. Patients who were on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals for development of VAP using clinical and microbiological criteria until discharge or death. Of the 76 patients, 18 (23.7%) developed VAP during their ICU stay. The incidence of VAP was 53.25 per 1,000 ventilator days. About 94% of VAP cases occurred within the first week of MV. Early-onset and late-onset VAP was observed in 72.2% and 27.8%, respectively. Univariate analysis showed chronic lung failure, H2 blockers usage, and supine head position were significant risk factors for VAP. Logistic regression revealed supine head position as an independent risk factor for VAP. VAP occurred in a sizeable number of patients on MV. Chronic lung failure, H2 blockers usage, and supine head position were the risk factors associated with VAP. Awareness about these risk factors can be used to inform simple and effective preventive measures.

  15. Measuring case-mix complexity of tertiary care hospitals using DRGs.

    Science.gov (United States)

    Park, Hayoung; Shin, Youngsoo

    2004-02-01

    The objectives of the study were to develop a model that measures and evaluates case-mix complexity of tertiary care hospitals, and to examine the characteristics of such a model. Physician panels defined three classes of case complexity and assigned disease categories represented by Adjacent Diagnosis Related Groups (ADRGs) to one of three case complexity classes. Three types of scores, indicating proportions of inpatients in each case complexity class standardized by the proportions at the national level, were defined to measure the case-mix complexity of a hospital. Discharge information for about 10% of inpatient episodes at 85 hospitals with bed size larger than 400 and their input structure and research and education activity were used to evaluate the case-mix complexity model. Results show its power to predict hospitals with the expected functions of tertiary care hospitals, i.e. resource intensive care, expensive input structure, and high levels of research and education activities.

  16. The need for a population-based, dose optimization study for recombinant tissue plasminogen activator in acute ischemic stroke: A study from a tertiary care teaching hospital from South India

    Directory of Open Access Journals (Sweden)

    Siju V Abraham

    2017-01-01

    Full Text Available Context: The guideline recommended dose of intravenous (i.v recombinant tissue-type plasminogen activator (rt-PA for acute ischemic stroke is 0.9 mg/kg in the European and American populations. In Asiatic population, some studies have shown that a lower dose of i.v rt-PA is equally efficacious. Aims: To assess if there is a need for a dose optimization for i.v rt-PA study among Indians. Setting and Design: A prospective, observational database of acute stroke cases that presented to a tertiary care institute over a period of 1 year was made. Methods: The data procured using a prestructured elaborate pro forma. Based on the dose of rt-PA received, the individuals were divided into three groups; Group 1 (0.6–0.7 mg/kg, Group 2 (0.7–0.8 mg/kg, and Group 3 (0.8–0.9 mg/kg. Improvement was assessed in each group and between the thrombolysed and nonthrombolysed individuals. Statistical Analysis Used: The nonparametric Mann–Whitney U-test (Wilcoxon rank-sum test was applied for assessing improvement of National Institutes of Health Stroke Scale score with significance level of α < 0.05 (P < 0.012 and compliance level at 95%. Results: Between the thrombolysed (n = 46 and nonthrombolysed (n = 113 group, there was a statistically significant neurological improvement in the thrombolysed group. Clinical improvement was noted in 75%, 85.7%, and 66.7% of individuals receiving rt-PA in Groups 1, 2, and 3, respectively. Four out of the five who developed a clinically significant intracranial hemorrhage were thrombolysed at a dose of 0.8–0.9 mg/kg rt-PA (Group 3. Conclusion: There is a need for a properly randomized, dose optimization study of i.v rt-PA in the Indian subcontinent.

  17. Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

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    Elad Asher

    Full Text Available OBJECTIVE: To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists. STUDY DESIGN: A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel. RESULTS: Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97% felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87% physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60% follow court rulings concerning medical practices, and 85 (73% physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings. CONCLUSIONS: Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

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

    African Journals Online (AJOL)

    HP

    hypertensive patients (> 18 years) visiting a referral hospital in Enugu, southeastern Nigeria between. June and July .... Class of hypertension by blood pressure measurement ..... beneficial effects in secondary prevention of cardiovascular ...

  19. 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.

  20. Neglect Contributing to Tertiary Hospitalization in Childhood Asthma.

    Science.gov (United States)

    Boxer, Gary H.; And Others

    1988-01-01

    The study examined the extent to which child neglect and family dysfunction have contributed to the need for hospitalization of asthmatic children. Using a measure of global functioning, psychologic morbidity is associated with medical neglect. (Author/DB)

  1. Male factor in infertility: study from a tertiary care hospital

    OpenAIRE

    Kalavathi D. Biradar

    2016-01-01

    Background: Infertility is a condition with important psychological, economic, demographic and medical implications. Male infertility refers to a male's inability to result pregnancy in a fertile female. Methods: The present hospital based study was conducted in the Department of Obstetrics and Gynaecology, East Point Hospital, Bangalore. Duration of the study was for 6 months from October 2015 to March 2016. A total of 250 infertile couples couple coming for evaluation to the outpatient d...

  2. Ocular disorders in stroke patients in a tertiary hospital in Nigeria

    African Journals Online (AJOL)

    2015-08-06

    Aug 6, 2015 ... Abstract. Background: Stroke is a medical emergency of public health ... Aim: To determine the prevalence of ocular disorders in patients with stroke in a Tertiary Hospital in Nigeria. ... Risk factors include old age, high blood pressure, previous .... such as cataract, refractive errors, and age‑related changes.

  3. Review of six year cardiovascular mortality at a tertiary hospital in ...

    African Journals Online (AJOL)

    Review of six year cardiovascular mortality at a tertiary hospital in south-east Nigeria. ... E Iheanyi, OM Oghale, K Uwanuruochi, CO Odigwe, A Chuku ... The mean age at death was highest for stroke, 65.0years, likewise the mean duration of ...

  4. Clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital

    OpenAIRE

    Qureshi, Fawad; Shafi, Azhar; Ali, Sheeraz; Siddiqui, Neelam

    2016-01-01

    Objective: To determine the clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital. Methods: This was a cross-sectional study conducted on 200 patients undergoing first line chemotherapy with minimum of two cycles at inpatient department and chemotherapy bay of Shaukat Khanum Memorial Cancer Hospital and Research Centre Pakistan. Anticipatory nausea and vomiting develops before administration of chemotherapy. Clinical signs and symp...

  5. Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview.

    Science.gov (United States)

    Pandey, Anita; Ahuja, Sanjiv; Madan, Molly; Asthana, Ajay Kumar

    2016-11-01

    Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by 'Synergy' waste management Pvt. Ltd. The practice of BMW Management was lacking in 30

  6. Association of maternal periodontitis with low birth weight in newborns in a tertiary care hospital

    International Nuclear Information System (INIS)

    Khan, N.S.; Ashraf, R.N.; Rahman, M.U.; Mashhadi, S.F.; Rashid, Z.; Nazar, A.F.; Syed, R.

    2016-01-01

    Background: Low birth weight is a major public health problem in Pakistan. So there is a need for identification of its modifiable risk factors like periodontitis which will reduce its burden on the society. The objectives of the study were to find out the association between maternal periodontitis and low birth weight in new-borns of all gestational ages delivered in a tertiary care hospital of Abbottabad as well as to see the frequency of periodontitis severity in these subjects. Methods: A hospital-based matched case-control study was conducted among 160 postpartum mothers in Gynaecology/Obstetrics-B ward Ayub Teaching Hospital, Abbottabad. The 80 cases were mothers of low birth weight babies (<2,500 g), the 80 controls were mothers of normal weight babies (=2,500 g) matched with maternal age and gestational age. Data was collected through the hospital records, interview and a periodontal examination. Results: Periodontitis was more in the cases than in the controls (OR: 4.167, 95 percentage CI: 2.142-8.109, ρ=0.000). On multivariate logistic regression, periodontitis was found to be a significant independent risk factor for low birth weight (aOR: 3.173, 95 percentage CI: 1.429-7.047, ρ=0.005). Other significant risk factors were educational level (aOR: 3.408, 95 percentage CI: 1.452-7.996, ρ=0.005), socioeconomic status (aOR: 3.173, 95 percentage CI: 1.366-7.368, ρ=0.007), maternal nutrition (aOR: 3.071, 95 percentage CI: 1.392-6.778, ρ=0.005) and moderate/severe anaemia (aOR: 3.035, 95 percentage CI: 1.052-8.756, p=0.040). Conclusions: Periodontitis is found to be a strong, independent, and clinically significant risk factor for low birth weight. So periodontal therapy should form a part of the antenatal care of the pregnant women in Abbottabad. (author)

  7. 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

  8. The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

    Science.gov (United States)

    Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

    2018-02-23

    To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

  9. 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. To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. Methods. We did a prospective descriptive study of ...

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

    African Journals Online (AJOL)

    2013-01-02

    Jan 2, 2013 ... and 15 patients through separate focus group discussion using a question ... Oral educative posters should be on the walls. The receptionist ... Spacious adequate cubicles with no congestion/crowding of people .... [19] also found that patient image of ... across many hospitals in Nigeria will consider a large.

  11. Experience with Hirschsprung's Disease at a Tertiary Hospital in ...

    African Journals Online (AJOL)

    latter group had more readmission episodes, longer lengths of hospital stays, higher loss to follow up rates and an average time to completion of care of. 1000 days. One-stage pull-through may limit the effects of colostomy creation we have documented in this study. In any case, an argument for earlier closure for those who ...

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

    African Journals Online (AJOL)

    a cross-sectional study carried out in Burdwan Medical College and Hospital in West ... beyond the uterus to the parametrium, tubes, and ovaries or pelvic peritoneum; grade III: Generalized peritonitis and/or ... 1297 cases of abortion were admitted among which 107 were septic ..... Obstetric infection disease emergencies.

  13. Experience with gynaecological laparoscopy in a tertiary hospital ...

    African Journals Online (AJOL)

    All the case notes of patients that had diagnostic laparoscopy during the stated period were retrieved and analyzed. Results: A total of 975 gynaecological ... The mean duration of hospital stay was 1.9 ±0.9days, making our laparoscopy, therefore, not completely an outpatient procedure. Conclusion: Diagnostic laparoscopy ...

  14. Maternal mortality ratio in a Tertiary Hospital offering free maternity ...

    African Journals Online (AJOL)

    Materials and Methods: Data were collected from available hospital records from inception on 24th February 2010 to 31st December 2014 and analysed using Microsoft Excel 2010 software. Statistical Analysis: Data analysis was done using descriptive statistics. Categorical variables were expressed as frequency ...

  15. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  16. 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.

  17. The Perception of Tertiary Institutions Prospective Teachers on the Benefits of Teaching Practice

    Directory of Open Access Journals (Sweden)

    Hassan Olusola

    2017-03-01

    Full Text Available This study assessed the perception of two tertiary institutions prospective teachers’ on the Benefits of Teaching Practice in Ogun State. Survey research design was adopted for the study. A sample of four hundred students was randomly selected for the study. Prospective Teachers Perception on Teaching practice Benefits Questionnaire (PTPTPBQ with the reliability coefficient of 0.80 was administered on the respondents. Data collected was analyzed using Mean Score, Charts, Percentages and t-test of significance. The study reveals that prospective teachers have low perception on the benefits of teaching practice also, finance and housing were the two major challenges faced by prospective teachers.. It is evident from the findings that there is need for concerted effort by school to orientate prospective teachers on the benefits of teaching practice. Also the major challenges faced by prospective teachers should also be addressed to allow them have good grasp from the benefits of teaching practice.

  18. Binocular diplopia in a tertiary hospital: Aetiology, diagnosis and treatment.

    Science.gov (United States)

    Merino, P; Fuentes, D; Gómez de Liaño, P; Ordóñez, M A

    2017-12-01

    To study the causes, diagnosis and treatment in a case series of binocular diplopia. A retrospective chart review was performed on patients seen in the Diplopia Unit of a tertiary centre during a one-year period. Diplopia was classified as: acute≤1 month since onset; subacute (1-6 months); and chronic (>6 months). Resolution of diplopia was classified as: spontaneous if it disappeared without treatment, partial if the course was intermittent, and non-spontaneous if treatment was required. It was considered a good outcome when diplopia disappeared completely (with or without treatment), or when diplopia was intermittent without significantly affecting the quality of life. A total of 60 cases were included. The mean age was 58.65 years (60% female). An acute or subacute presentation was observed in 60% of the patients. The mean onset of diplopia was 82.97 weeks. The most frequent aetiology was ischaemic (45%). The most frequent diagnosis was sixth nerve palsy (38.3%), followed by decompensated strabismus (30%). Neuroimaging showed structural lesions in 17.7% of the patients. There was a spontaneous resolution in 28.3% of the cases, and there was a good outcome with disappearance of the diplopia in 53.3% at the end of the study. The most frequent causes of binocular diplopia were cranial nerve palsies, especially the sixth cranial nerve, followed by decompensated strabismus. Structural lesions in imaging tests were more than expected. Only one third of patients had a spontaneous resolution, and half of them did not have a good outcome despite of treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Acute appendicitis in Olabisi Onabanjo University Teaching Hospital ...

    African Journals Online (AJOL)

    The hospital is a tertiary care facility in competition with a large number of private hospitals with different levels of competence. Objective: The objective of the study is to review the outcome of the surgical management of acute appendicitis in our hospital. Method: A retrospective study of subjects who had appendectomy for ...

  20. Cost-effectiveness analysis of three different combinations of inhalers for severe and very severe chronic obstructive pulmonary disease patients at a tertiary care teaching hospital of South India.

    Science.gov (United States)

    Altaf, Mohammed; Zubedi, Ayesha Mubeen; Nazneen, Fareesa; Kareemulla, Shaik; Ali, Syed Amir; Aleemuddin, N M; Hannan Hazari, Md Abdul

    2015-01-01

    This study aims at simplifying the practical patient management and offers some general indications for pharmacotherapeutic choice by the implementation of (Global Initiative for Chronic Lung Disease) guidelines. This study was designed to evaluate the clinical and economic consequences of salmeterol/fluticasone (SF), formoterol/budesonide (FB), and formoterol/fluticasone (FF) in severe and very severe chronic obstructive pulmonary disease (COPD) patients. The aim was to find out the most cost-effective drug combination between the three combinations (SF/FB/FF) in COPD patients. A prospective observational comparative study (cost-effectiveness analysis), in which 90 severe (30 ≤ forced expiratory volume in 1 s [FEV1] days (SFDs), number of moderate and severe exacerbations, Number of days of hospitalization and direct, indirect, and total cost to assess the cost-effectiveness of SF/FB/FF. Comparison of cost and effects was done during the period of 6 months of using SF/FB/FF. The average FEV1 for Group I, Group II, and Group III subjects at initial visit was 33.47%, 33.73%, and 33.20% and was increased to 36.60%, 35.8%, and 33.4%, respectively. A 3% increment in FEV1 was reported for Group I subjects (SF) and was highly significant statistically (t = -8.833, P = 0.000) at 95% CI. For Group II subjects (FB), a 2% increment in FEV1 was reported and was highly significant statistically (t = -9.001, P = 0.000) at 95% CI. For Group III (FF) subjects 0.2% increment in FEV1. The overall mean total cost for Group I, Group II, and Group III subjects during the 6 months period was found to be Rs. 29,725/-, Rs. 32,602/- and Rs. 37,155/-. Incremental cost-effectiveness of FB versus SF was Rs. 37,781/- per avoided exacerbation and Rs. 661/-per SFD. This study highlights the favorable therapeutic performance of combined inhaled bronchodilators and corticosteroids (SF/FB/FF), thus suggesting that healthcare costs would be also affected positively. Results from our study showed

  1. CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Venkata Anantha Lakshmi Manabala; Krishna Mohan Narayanrao

    2016-01-01

    INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS ...

  2. Third delay of maternal mortality in a tertiary hospital

    International Nuclear Information System (INIS)

    Shah, N.; Khan, N.H.

    2007-01-01

    To assess the magnitude, causes and substandard care factors responsible for the third delay of maternal mortality seen in our unit III, Department of Obstetrics and Gynecology, Civil Hospital, Karachi. This Cross-sectional, retrospective study was carried out on 152 mothers who died over a period of eight years from 1997 to 2004 at Civil Hospital Karachi. Death summaries of all maternal deaths were reviewed from death registers and were studied for substandard care factors which could have been responsible for the third delay of maternal mortality. The frequency of maternal mortality was 1.3 per 100 deliveries. The mean age was 29+-6.49 years and mean parity was 3.24+-3.25. The main causes of death were hypertensive disorders in 52/152 (34.21%), hemorrhage in 40/152 (26.31%), unsafe abortion in 16/152 (10.52%), puerperal sepsis in 14/152 (9.21%) and obstructed labor in 11/152 (7.2%) cases. Substandard care factors were present in 76.7% of patients, which included inappropriate management of pulmonary edema, delay in arranging blood for hemorrhaging patients and delay in surgical intervention. Substandard care factors were present in majority of cases of maternal deaths. Improvement of maternity care services in Civil Hospital Karachi is needed on an urgent basis. (author)

  3. Implementation of Enterprise Imaging Strategy at a Chinese Tertiary Hospital.

    Science.gov (United States)

    Li, Shanshan; Liu, Yao; Yuan, Yifang; Li, Jia; Wei, Lan; Wang, Yuelong; Fei, Xiaolu

    2018-01-04

    Medical images have become increasingly important in clinical practice and medical research, and the need to manage images at the hospital level has become urgent in China. To unify patient identification in examinations from different medical specialties, increase convenient access to medical images under authentication, and make medical images suitable for further artificial intelligence investigations, we implemented an enterprise imaging strategy by adopting an image integration platform as the main tool at Xuanwu Hospital. Workflow re-engineering and business system transformation was also performed to ensure the quality and content of the imaging data. More than 54 million medical images and approximately 1 million medical reports were integrated, and uniform patient identification, images, and report integration were made available to the medical staff and were accessible via a mobile application, which were achieved by implementing the enterprise imaging strategy. However, to integrate all medical images of different specialties at a hospital and ensure that the images and reports are qualified for data mining, some further policy and management measures are still needed.

  4. CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Venkata Anantha Lakshmi Manabala

    2016-06-01

    Full Text Available INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS This is a prospective study done in our hospital where 110 cases of peritonitis due to appendicular perforation were selected for our study. All the cases where peritonitis was due to appendicular perforation at laparotomy were included. The study period was from January 2014 to December 2015. The cases of peritonitis due to other causes like duodenal, gastric, enteric perforation were excluded. Patients with acute abdominal emergency with clinical diagnosis of peritonitis were examined carefully with detailed history and clinical examination. Necessary investigations were done and patients taken up for emergency surgery. CONCLUSIONS Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. Age incidence of appendicular perforation is maximum in the age group of 21–30 years. Next common age group is 31–40 yrs. Incidence is more in males. Male to female ratio is 2.4:1. Pain abdomen, vomiting, fever and anorexia were common symptoms in all the patients. Majority of the patients came late to the hospital accounting for the cause of perforation and subsequent mortality and morbidity.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors

    Directory of Open Access Journals (Sweden)

    Mazhar F

    2017-03-01

    Full Text Available Background: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. Objective: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. Methods: This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. Results: A total of 328 patients (138 in surgical and 198 in medical were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6% were reconciliation errors. The errors affected 177 patients (54%. The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (p<0.001. In both groups, the most frequent reconciliation error was the omission (43.5% and 51.2%. Lipid-lowering (12.4% and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17

  7. Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Aniekan Monday Abasiattai

    2011-02-01

    Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

  8. Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria.

    Science.gov (United States)

    Abasiattai, A M; Utuk, M N; Ojeh, S O; Eyo, U E

    2011-01-01

    BACKGROUND: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. OBJECTIVE: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. METHODOLOGY: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. RESULTS: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. CONCLUSION: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers' and also providers' attitude towards combined pills in our environment.

  9. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital.

    Science.gov (United States)

    Ekwunife, Okechukwu Hyginus; Ugwu, Jideofor Okechukwu; Okoli, Chinedu C; Modekwe, Victor Ifeanyichukwu; Osuigwe, Andrew N

    2015-01-01

    Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3%) and 122 (36.2%), respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9%) preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3%) patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

  10. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Okechukwu Hyginus Ekwunife

    2015-01-01

    Full Text Available Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. Patients and Methods: This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. Results: A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3% and 122 (36.2%, respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9% preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3% patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Conclusion: Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

  11. Perceptions and concerns of women undergoing Pap smear examination in a tertiary care hospital of India.

    Science.gov (United States)

    Tiwari, A; Kishore, J; Tiwari, A

    2011-01-01

    Cervical cancer is one of the major causes of deaths due to cancer among women in India. Pap smear is one of the best methods to detect early changes in cervix. However, there is lack of data on awareness level of women about Pap smear and various risk factors for cervical cancer. To study the awareness about various risk factors for cervical cancer, health-seeking behavior and hygienic practices among women and to assess the distress experienced by these women before the Pap smear examination. This cross-sectional study was carried out on women coming for a Pap smear examination in a tertiary teaching hospital in New Delhi. A pretested interview schedule was used to get information after obtaining their informed consent. Fifty-seven percent stated that they did not consult a doctor when they noticed the symptoms the first time. Sixty-one percent did not know what a cervical cancer is and a same percentage of women did not know what a Pap smear examination was. Older age group, Muslim and literate women had higher number of abnormal Pap smear results. Women who reported being stressed in their lives had higher number of abnormal smears as compared to women who claimed to lead a stress free life. Poor hygienic practices among these women from urban areas were also associated with abnormal Pap smear results. The study concluded that factors such as poor awareness, shyness, poor hygiene, and old age could be responsible for abnormal Pap smears and this needs special attention in cancer prevention activities of the government.

  12. Diseases causing acute renal failure in a tertiary care hospital

    International Nuclear Information System (INIS)

    Khan, G.; Hussain, K.; Rehman, A.

    2011-01-01

    Objective: This study was done to evaluate frequency of acute renal failure ( ARF ), its causes and out come of the patients. Study Design: Descriptive analytic study Place and Duration of Study: March to Dec 2007 at Combined Military Hospital Lahore. Patients and Methods: All patients, admitted in different wards of the hospital, who developed acute renal failure (doubling of serum creatinine measured on two occasions 12 hours apart), were included in this study. Results: A total of 39 patients were included in the study. Males were 19 (48.71%) and 20 (51.28%) were female. Mean age of patients was 40.2 years (SD=18.0). The major cause was acute Gastroenteritis seen in 23 (58.97%) cases. Others developed ARF due to, Abruptio Placentae 5 (12.82%), Postoperative 5 (12.82%), Eclampsia 3 (7.69%) and Drug induced 3 (7.69%) . Oliguric phase developed in 28 (71.79%) patients and lasted for 8.45 +- 4.16 days. Of these 17 (60.71%) patients had acute gastroenteritis. Conclusion: Gastroenteritis is the most common and important cause of ARF though gynaecological and surgical etiologies must be kept in mind. It is evident that the gynaecological and surgical patients need critical peri-partum and peri-operative monitoring to prevent development of ARF. Early institution of therapy will prevent subsequent morbidity associated with this disease. (author)

  13. Did recent changes in Medicare reimbursement hit teaching hospitals harder?

    Science.gov (United States)

    Konetzka, R Tamara; Zhu, Jingsan; Volpp, Kevin G

    2005-11-01

    To inform the policy debate on Medicare reimbursement by examining the financial effects of the Balanced Budget Act of 1997 (BBA) and subsequent adjustments on major academic medical centers, minor teaching hospitals, and nonteaching hospitals. The authors simulated the impacts of BBA and subsequent BBA adjustments to predict the independent effects of changes in Medicare reimbursement on hospital revenues using 1997-2001 Medicare Cost Reports for all short-term acute-care hospitals in the United States. The authors also calculated actual (nonsimulated) operating and total margins among major teaching, minor teaching, and nonteaching hospitals to account for hospital response to the changes. The BBA and subsequent refinements reduced Medicare revenues to a greater degree in major teaching hospitals, but the fact that such hospitals had a smaller proportion of Medicare patients meant that the BBA reduced overall revenues by similar percentages across major, minor, and nonteaching hospitals. Consistently lower margins may have made teaching hospitals more vulnerable to cuts in Medicare support. Recent Medicare changes affected revenues at teaching and nonteaching hospitals more similarly than is commonly believed. However, the Medicare cuts under the BBA probably exacerbated preexisting financial strain on major teaching hospitals, and increased Medicare funding may not suffice to eliminate the strain. This report's findings are consistent with recent calls to support needed services of teaching hospitals through all-payer or general funds.

  14. vanishing bone disease in a tertiary teaching hospital in uganda

    African Journals Online (AJOL)

    prior to the above presentation and review of systems were unremarkable. General examination revealed a ... syndrome or disease, massive osteolysis, disappearing bone disease, vanishing bone disease, idiopathic ... patient symptoms and anatomic location. Medical treatment involves, radiation therapy, anti-osteoclastic.

  15. Evaluation of Data Recording at Teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Hasan Karbasi

    2009-02-01

    Full Text Available Background and purpose: Medical records of patients have an undeniable role on education, research and evaluation of health care delivery, and also could be used as reliable documents of past in casesof patients’ legal complains. This study was done to evaluate medical data recording at teaching hospital of Birjand University of Medical Sciences in 2004.Methods: In this descriptive-analytic study, 527 patients’ records of patients who had been discharged from general wards of the hospitals after 24 hours of hospitalization were randomly selected. 18 standard titles of records include in each patient’s record were evaluated using checklists. Data were analyzed using frequency distribution tables, independent t-test and Chi-square test.Results: Items on records’ titles were completed in a range of 0-100%. Titles of neonates and nursing care with 96% completeness were the most completed ones~ Titles of recovery, pre-delivery care, medical history, summary, and progress notes with 50% to 74% completeness were categorized as moderately completed titles; and titles of vital signs, pre-operation care and operation report were weak. Records of the infectious diseases ward were the most completed records (68% and the least completed were from ophthmology ward (35.8%. There were significant differences between the hospitals and between different wards.Conclusion: Results of this study show the need for further education on record writing, taking medical history, and order writing and more importantly the need for a system of continuous monitoringof the records.Keywords: MEDICAL RECORD, TEACHING HOSPITAL, EVALUATION

  16. 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.

  17. EPIDEMIOLOGICAL CORRELATES OF POSTMENOPAUSAL BLEEDING IN A TERTIARY CARE HOSPITAL

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    Sonia Arora

    2012-06-01

    Full Text Available Background: A woman is considered menopausal after 12 months of amenorrhea. The most feared symptom during menopause is postmenopausal bleeding which unless proved otherwise indicates genital malignancy. Objectives: To study Socio-demographic factors related to postmenopausal bleeding and to find time lapse between bleeding and reporting of these cases. Material and Methods: This cross sectional was done in the Department of Obstetrics & Gynecology, Pt. J. N. M. Medical College & DR. B. R. Ambedkar Memorial, Hospital, Raipur (C. G. The participants were 146 women who came with the complaint of postmenopausal bleeding. A detailed, preceded, pre-tested, structured, close ended questionnaire was used to collect the data. By interviewing these women, information was collected about different demographic factors like age, socio-economic status, parity etc. The collected data was put in the master chart and analyzed. Results: The proportion of postmenopausal bleeding cases was 3.5% .Maximum cases(50% with postmenopausal bleeding were found in the age group of 45-54yrs . 60 % of patients were from rural areas and 62% were illiterate. 65% of the patients were grand multipara (Parity4. Most of the patients belonged to lower socioeconomic strata. Almost half (48% of patients presented after, more than 6 months since the first episode of bleeding . Conclusions: The proportion of postmenopausal bleeding is high, requiring immediate investigation. Lack of awareness led to very late presentation of most of the patients, so education at community level is required to reduce this time lapse for earlier diagnosis and management

  18. Medical tourism in India: perceptions of physicians in tertiary care hospitals.

    Science.gov (United States)

    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

  19. 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

  20. Platelet transfusion practice in a tertiary care hospital

    International Nuclear Information System (INIS)

    Rehman, Z.; Alam, M.

    2002-01-01

    Objective: Pakistan is a developing country where platelet concentrates are prepared and administered to patients in only a few large centres of the country. A study was designed for appraisal of the current situation and to review the progress made so far. Design: It was a prospective, non-interventional study. Place and duration of study: The study was conducted at PNS Shifa, Karachi from January, 1995 to December, 1998. Subjects and Methods: During this study 588 random donor platelet concentrates were transfused to 66 patients 148 occasions. Random donor platelet concentrates were prepared by fractionation of whole blood using triple blood collecting bags. Pre-transfusion and one hour posttransfusion platelet counts of the patients were done. The efficacy of the platelet transfusion was monitored by noting the clinical response as well as doing one hour posttransfusion corrected counts increment (CCI).Results: On 114 (77%) occasions platelets were transfused prophylactically and 34 (23%) times therapeutically to stop major bleeding episodes. The mean pre-transfusion platelet count varied from 15.5 x 10/sup 9/1 to 28.5 x 10/sup 9/l in different clinical conditions. On average, 4 random donor platelet concentrates were administered on each occasion. The best response was observed in patients of aplastic anaemia and worst in cases of disseminated intravascular coagulation (DIC). Conclusion: Platelet concentrates administration was inappropriate in significant number of patients, therefore, each hospital should form transfusion committee to review transfusion practices guidelines for blood components usage and compliance to these guidelines by the clinicians. (author)

  1. 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.

  2. FAT MYRINGOPLASTY IN A TERTIARY CARE GOVERNMENT HOSPITAL

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    Paidi Ramesh Chandra

    2017-12-01

    Full Text Available BACKGROUND Myringoplasty is the surgical procedure performed for the closure of perforations of pars tensa of the tympanic membrane. Various graft materials are used such as temporalis fascia, periosteum, perichondrium, vein, dura and adipose tissue (fat. Fat myringoplasty is a simple, cost effective and outpatient procedure. This study is performed to evaluate the operative outcome of fat myringoplasty in patients with Chronic Suppurative Otitis Media (CSOM. The aim of the study is to assess graft uptake to assess hearing improvement and to assess the operative outcome in relation to the site of perforation after fat myringoplasty. MATERIALS AND METHODS This study was performed in Government ENT Hospital, Andhra Medical College, Visakhapatnam. A total of 20 patients between the age group of 18-50 years suffering from tubotympanic type of chronic suppurative otitis media were taken up for study. The study period was for 18 months from October 2015 to March 2017. RESULTS Results were analysed in terms of graft uptake and hearing improvement. Average audiometric gain after 6 months was 10.58 dB. Successful closure of perforation was achieved in 90% cases. Perforations involving posterior quadrant showed 100% graft uptake, compared to anterior quadrant perforations, which showed 75% graft uptake. No major postoperative complications were noted. CONCLUSION Fat myringoplasty can be safely performed in dry, small central perforations of tympanic membrane especially belonging to posterior quadrant. Ear lobule constitutes convenient source of fat graft. The procedure can be performed as a day care surgery. Proper selection of cases is necessary to obtain good results.

  3. [Status of subjective well-being for medical staff in a tertiary hospital].

    Science.gov (United States)

    Deng, Yunlong; Liu, Yan; Xu, Shaorong; Zhao, Min; Li, Junping; Xiong, Yan

    2016-06-28

    To investigate the status of subjective well-being (SWB) for medical staffs who contact with patients directly in a tertiary hospital.
 Staffs from a tertiary hospital in Hunan province were investigated the SWB Scale (SWBS-cc20) from 2012 to 2014.
 The scores of SWB for medical staffs are high (81.67±12.33). Among the 10 sub-dimensions of SWB, medical staffs performed the best in family atmosphere, personal growth, and interpersonal adaptation, while performed the worst in physical health, mental health and material contentment. Title, job nature, education and occupation significantly affected the status of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not (t=-4.80, Pmental health (OR=1.315, 95% CI 1.023 to 1.690, Phealth (OR=1.313, 95% CI 1.029 to 1.677, Pmental health and physical health.

  4. Weekend versus weekday hospital deaths: analysis of in-patient data in a Nigerian tertiary healthcare center.

    Science.gov (United States)

    Nwosu, B O; Eke, N O; Obi-Nwosu, A; Osakwe, O J; Eke, C O; Obi, N P

    2013-01-01

    This study aims at comparing weekday deaths to weekend deaths of in-patients of a tertiary hospital in Nigeria. This is a 10-year retrospective survey conducted at the Nnamdi Azikiwe University Teaching Hospital in which the death records of the hospital were accessed from the various wards and health records department to extract relevant data pertaining to the time of hospital death. Tests of statistical significance were done using Chi-square test at 95% confidence intervals. A total of 3934 deaths were recorded during the period of study. The ages ranged from a few hours to 94 years with a mean age of 38.5 years. The male to female ratio was 1.2:1. An average of 547 weekend deaths and 568 weekday deaths were recorded, giving a ratio of 0.96:1. A ratio of weekend to weekday death rate of 0.99:1 and 0.93:1 for the males and females, respectively was noted. The labor ward, followed by the intensive care unit (ICU) had the highest weekend to weekday death ratio of 1.72:1 ( P = 0.0461) and 1.41:1 ( P = 0.1440), respectively. Weekend deaths were less in the other wards, with the gynaecological ward having the least ratio of 0.63:1 ( P = 0.7360). The rate of hospital deaths was generally found not to vary significantly over the weekends and weekdays in the hospital except for the labor ward which had significantly higher weekend to weekday death rates of 1.72:1. There is therefore need for confidential enquiry into the causes of hospital deaths, especially in the labor ward, in order to identify and prevent avoidable deaths.

  5. 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

  6. Major limb amputations: A tertiary hospital experience in northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    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

  7. Neuro-ophthalmic and clinical characteristics of brain tumours in a tertiary hospital in Ghana

    International Nuclear Information System (INIS)

    Tagoe, N. N.; Essuman, V. A.; Fordjuor, G.; Akpalu, J.; Bankah, P.; Ndanu, T.

    2015-01-01

    Anecdotally, increasing number of patients are seen at Korle Bu Teaching Hospital (KBTH) with brain tumour. Neuro-ophthalmic symptoms and signs may help in timely diagnosis and intervention. The objective of this study is to evaluate the neuro-ophthalmic and clinical characteristics of brain tumour in patients presenting at a tertiary hospital in Ghana. The study design involved a prospective case series involving 36 consecutive patients newly diagnosed with brain tumour from November 2010 to October 2011, at the Ophthalmology, Neurosurgery and Endocrine units of KBTH, Ghana. All patients had clinical diagnosis of brain tumour with confirmation by computerized tomography (CT) or magnetic resonance imaging (MRI). Thirteen patients had histological confirmation of diagnosis. The outcome measures of the study include presenting visual acuity, colour vision, visual fields and cranial nerve deficits. Data of 36 patients were analysed. The results of the study showed that ages ranged from 3 to 69 years, mean (SD) 42.56(±16.6 years). Twenty-six (72%) were females. Tumours included pituitary adenoma (20, 55.5%), meningioma (10, 27.8%), choroid plexus tumour (1, 2.8%), medulloblastom (1, 2.8%), craniopharyngioma (1, 2.8%), haemangioblastoma (1, 2.8%), thalamic tumour (1, 2.8%) and haemangioma (1, 2.8%). Histologically confirmed tumours included pituitary adenoma (9, 69.2%), meningioma (3, 23.1%), craniopharyngioma (1, 7.7%). One patient had both a pituitary adenoma and meningioma. Blurred vision (30, 83.3%), headache (28, 77.8%) and photophobia (13, 36.1%) were predominant symptoms. Commonest neuro-ophthalmic signs were impaired colour vision (62 eyes, 88.6%), optic atrophy (26, 74.3%), unilateral or bitemporal hemianopia (15, 41.5%) and relative afferent pupillary defect (12, 34.3%). Seven (19.4%) patients were visually impaired and nine (25%) blind. Thirty-three of 72(45.8%) eyes had monocular blindness. Common neuro-ophthalmic characteristics were blurred vision

  8. The design of diagnostic imaging and nuclear medicine facilities in a major new teaching hospital

    International Nuclear Information System (INIS)

    Causer, D.A.

    2010-01-01

    Full text: The design of the layout and radiation shielding for diagnostic imaging and nuclear medicine facilities in a modern teaching hospital requires the collaboration of persons from a number of professions including architects, engineers, radiologists, nuclear medicine physi cians, medical imaging technologists and medical physicists. This paper discusses the design of such facilities, including PET/CT and T-131 ablation therapy suites for a major new tertiary hospital in Perth. The importance of involving physicists on the planning team from the earliest stages of the design process is stressed, design plans presented, and some of the problems which may present themselves and their solutions are illustrated.

  9. CLINICAL PROFILE AND COMMON CAUSES OF HAEMOLYTIC ANAEMIA IN A TERTIARY CARE HOSPITAL, NORTHERN KERALA

    OpenAIRE

    Jog Antony; Reeta J; Sreelakshmi S; Rohit Mathew4; Adarsh Surendran

    2016-01-01

    BACKGROUND Haemolytic anaemia is a well-recognised clinical problem. This study looks into the clinical profile of haemolytic anaemia and also attempts to find out the common underlying causative disease. It also tries to group the patients according to the clinical manifestations and underlying causes. MATERIALS AND METHODS This is a hospital-based observational study conducted in a tertiary care centre in Northern Kerala. Forty-four adult patients with clinical manifestati...

  10. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    OpenAIRE

    Mosam Phirke; Harshal Sathe; Nilesh Shah; Sushma Sonavane; Anup Bharati; Avinash DeSousa

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014...

  11. Clinicomycological Characterization of Superficial Mycoses from a Tertiary Care Hospital in Nepal

    OpenAIRE

    Khadka, Sundar; Sherchand, Jeevan Bahadur; Pokharel, Dinesh Binod; Pokhrel, Bharat Mani; Mishra, Shyam Kumar; Dhital, Subhash; Rijal, Basista

    2016-01-01

    Background. Superficial mycosis is a common fungal infection worldwide, mainly caused by dermatophytes. However, the prevalence of species varies geographically. In addition, fungal treatment is best guided according to species isolated. This study was carried out to determine the clinical as well as mycological profile of superficial mycoses in a tertiary care hospital, Nepal. Methods. This was a prospective case-control laboratory based study conducted over a period of six months from Janua...

  12. Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

    OpenAIRE

    Uttam Kumar Sarkar; Anish Chatterjee; Suprit Basu; Atanu Pan; Sumit Periwal

    2017-01-01

    Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically s...

  13. Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

    OpenAIRE

    Sonia R. B D'Souza; Leslie Edward Lewis; Vijay Kumar; Ramesh Bhat Y; Jayashree Purkayastha; Hari Prakash

    2017-01-01

    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...

  14. NEEDLESTICK INJURY AMONG HEALTHCARE WORKERS IN A TERTIARY CARE HOSPITAL, KERALA

    OpenAIRE

    Chintha Sujatha; Jacquilene Vadasseril; Govind Jayaprakash; John K. Joy

    2017-01-01

    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 ...

  15. Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

    OpenAIRE

    Benjamin Louis Moresco; Benjamin Louis Moresco; Clinton Woosley; Clinton Woosley; Morris Sauter; Utpal Bhalala; Utpal Bhalala

    2018-01-01

    ObjectivesThis study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children’s hospital.MethodsThis was a retrospective, observational study of children (0–18 years old) in The Children’s Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for “severe sepsis” and “shocks.” Patients in the adhere...

  16. Teaching Design in Adolescent Environments: Twinning Secondary and Tertiary Learning Experiences

    Directory of Open Access Journals (Sweden)

    David Jones

    2004-06-01

    Full Text Available Increasingly our landscape architecture teaching and educational pedagogies are facing an internationalisation in approach and expectation. We are positioned within a tertiary learning layer in a tripartite educational system for which each layer assumes certain expectations and outcomes. But their vertical linkages are unclear, and we incorrectly assume continuity of knowledge and skill learning strategies. It is a horizontally stratified teaching setting that we have to work within and while we can think of internationalisation as occurring within our level we need to appreciate that internationalisation is also occurring at the secondary level. This paper discusses the educational environment within which globalisation is occurring, and reviews a project model that builds bridges vertically between secondary and tertiary learning environments. The project displays possibilities in both secondary and tertiary educational sectors, but especially in enhancing and improving the design fluency of our annual incoming cohorts who often possess a naive understanding of built environmental design. Commencing in 1998 as an experimental project, it has been recognised at the South Australian state level as a forward-thinking initiative that has radically transformed secondary school Design teacher's perspectives as to educational possibilities, and substantially matured attitudes to landscape design by both suites of participants. As a consequence, it is an educational project that has experienced requests from numerous secondary schools around the State to participate.

  17. 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.

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

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    Abdulrahman Al-Yamani

    2016-01-01

    Full Text Available Objectives: 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. 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 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. Results: 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. Conclusions: 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.

  19. Surveillance of multidrug resistant suppurative infection causing bacteria in hospitalized patients in an Indian tertiary care hospital

    OpenAIRE

    Nabakishore Nayak; Rajesh K. Lenka; Rabindra N. Padhy

    2014-01-01

    Objective: To examine antibiograms of a cohort of suppurative bacteria isolated from wound-swabs from hospitalized patients of all economic groups of a typical Indian teaching hospital. Methods: In surveillance, antibiotic resistance patterns of 10 species of suppurative bacteria isolated from wound-swabs over a period of 24 months were recorded. Those were subjected to antibiotic sensitivity test, using 16 prescribed antibiotics of 5 different groups (3 aminoglycosides, 4 beta-lactams, 3 ...

  20. Prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus in a tertiary Greek hospital.

    Science.gov (United States)

    Kachrimanidou, M; Tsorlini, E; Katsifa, E; Vlachou, S; Kyriakidou, S; Xanthopoulou, K; Tsergouli, K; Samourli, T; Papa, A

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of health- and community-associated infections; its prevalence in Greece is among the highest in Europe. We investigated the prevalence and molecular epidemiology of MRSA in a tertiary Greek hospital. Spa typing and random polymorphic DNA analysis were used to investigate the molecular epidemiology of 28 MRSA isolates during May 2010 to May 2011 in a tertiary hospital in Northern Greece. Nine spa types were detected; t003 was the predominant (32.1%) one, detected in various wards and throughout the study period, while t037 was recovered only from intensive care unit patients, and only in April 2011, suggestive of an epidemic. Additional rare types were detected for the first time in Greece. Spa typing and random polymorphic DNA analysis gave an insight into the epidemiology of MRSA in a Northern Greece hospital. Concerning the distribution in the hospital, the predominant spa type t003 was present in various wards, and was constantly detected throughout the study period, very suggestive of an epidemic, while other types were detected only in specific wards. Our data underline the need for surveillance, typing and constant reassessment of existing strategies to control MRSA.

  1. Environment surveillance of filamentous fungi in two tertiary care hospitals in China.

    Science.gov (United States)

    Hao, Zhen-feng; Ao, Jun-hong; Hao, Fei; Yang, Rong-ya; Zhu, He; Zhang, Jie

    2011-07-05

    Invasive fungal infections have constituted an increasingly important cause of morbidity and mortality in immunocompromised patients. In this study, a surveillance project was conducted in three different intensive care units of two large tertiary hospitals in China. A one-year surveillance project was conducted in two tertiary hospitals which located in northern China and southwest China respectively. Air, surfaces and tap water were sampled twice a month in a central intensive care unit, a bone marrow transplant unit, a neurosurgery intensive care unit and a live transplant department. Environmental conditions such as humidity, temperature and events taking place, for example the present of the visitors, healthcare staff and cleaning crew were also recorded at the time of sampling. The air fungal load was 91.94 cfu/m(3) and 71.02 cfu/m(3) in the southwest China hospital and the northern China hospital respectively. The five most prevalent fungi collected from air and surfaces were Penicillium spp., Cladospcrium spp., Alternaria spp., Aspergillus spp. and Saccharomyces spp. in the southwest China hospital, meanwhile Penicillium spp., Fusarium spp., Aspergillus spp., Alternaria spp. and Cladospcrium spp. in the northern China hospital. The least contaminated department was intensive care units, and the heaviest contaminated department was neurosurgery intensive care unit. Seventy-three percent of all surfaces examined in the northern China hospital and eighty-six percent in the southwest China hospital yielded fungi. Fifty-four percent of water samples from the northern China hospital and forty-nine percent from the southwest China hospital yielded fungi. These findings suggested that the fungus exist in the environment of the hospital including air, surface and water. Air and surface fungal load fluctuated over the year. Air fungal load was lower in winter and higher in summer and autumn, but seldom exceeded acceptable level. The higher values were created during

  2. CLINICAL AND RADIOLOGICAL EVALUATION OF NEW - ONSET EPILETIC SEIZURES IN A TERTIARY CARE HOSPITAL

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    Chalapathi Rao

    2015-09-01

    Full Text Available BACKGROUND: Epilepsy is one of the most familiar neurological disorders which can cause bodily injury and death from inadequately treated or untreated cases. The imaging and EEG of new onset seizures is done with different indications, to identify an acute illness as the underline course for the seizure and possible neurological deficit. To this purpose we have evaluated new onset seizures in adult patients in correlation with their clinical profile, Electroencephalography (EEG and Computerized tomography (CT imaging of brain. METHODS: This cro ss sectional study was studied in 100 adult patients, presenting with seizures attending the Emergency department, General Medicine and Neurology wards and OPD of Tertiary care teaching hospital during the period of March 2006 to March 2008. All the patien ts were examined clinically and subjected to CT imaging of brain and EEG. Other necessary blood investigations were also done. Correlation between various seizures and CT scan brain and EEG were studied. Descriptive statistics were used to analyze the data . RESULTS: 63% of patients were in the age group of 20 - 39 years, 63% were males and 37% were females. 65% presented with GTCS, 35% with partial seizures. CT scan was found abnormal in 49.2% patients in GTCS, 71.4% in partial seizures. EEG showed abnormal p attern in 39% patients. 40% of the patients with partial seizures had epileptic form discharges. 33% patients had focal lesions on CT brain with normal EEG. CONCLUSION: Generalized Tonic clonic seizures were the commonest type of seizures was present, seen mostly in male patients. CT scan brain was abnormal in 57% of the patients. Neurocysticercosis and calcified granuloma were the commonest causes for seizures up to 3 rd decade of life. Majority of the patients with focal lesions on CT scan brain had epileptic form discharges on EEG which indicate a strong correlation of EEG with CT findings. Initiating the treatment with antiepileptic drugs was

  3. Caesarean delivery-related blood transfusion: correlates in a tertiary hospital in Southwest Nigeria.

    Science.gov (United States)

    Akinlusi, Fatimat M; Rabiu, Kabiru A; Durojaiye, Idayat A; Adewunmi, Adeniyi A; Ottun, Tawaqualit A; Oshodi, Yusuf A

    2018-01-10

    Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011. A comparison was made between 188 women who underwent blood transfusion and 718 who did not. Data were obtained on a daily basis by investigators from patients, clinical notes and referral letters using structured pre-tested data collecting form. Socio-demographic characteristics; antenatal, perioperative and intraoperative details; blood loss; transfusion; and puerperal observations were recorded. EPI-Info statistical software version 3.5.3 was used for multivariable analysis to determine independent risk factors for blood transfusion. Of the 2134 deliveries during the study period, 906 (42.5%) had caesarean deliveries and of which 188 (20.8%) were transfused. The modal unit of blood transfused was 3 pints (41.3%). The most common indication for caesarean section was cephalo-pelvic disproportion (25.7%).The independent risk factors for blood transfusion at caesarean section were second stage Caesarean Section (aOR = 76.14, 95% CI = 1.25-4622.06, p = 0.04), placenta previa (aOR = 32.57, 95% CI = 2.22-476.26, p = 0.01), placental abruption (aOR = 25.35, 95% CI = 3.06-211.02, p blood transfusion (aOR = 0.24, 95% CI = 0.09-0.61, p = 0.0024). The overall risk of blood transfusion in cesarean delivery is high. Paturients with the second stage Caesarean section, placenta previa, abruptio placentae and

  4. Evaluation of health literacy status among patients in a tertiary care hospital in coastal karnataka, India.

    Science.gov (United States)

    U P, Rathnakar; Belman, Madhuri; Kamath, Ashwin; B, Unnikrishnan; Shenoy K, Ashok; A L, Udupa

    2013-11-01

    People with limited health literacy are more likely to make medication errors, and they have less health knowledge, worse health status, more hospitalizations, and higher healthcare costs than people with adequate literacy. The objective of this study is to assess the health literacy status among patients who are able to read and understand English attending a tertiary care hospital by using Rapid Estimate of Adult Literacy in Medicine [REALM] technique and to compare the health literacy levels to educational status and other baseline characteristics. A widely used word recognition method [REALM] was used to assess the HL status of 200 patients attending a tertiary care hospital in Southern India. The number of correctly pronounced words was used to assign a grade-equivalent reading level. Scores 0 to 44 indicate reading skills at or below the 6th grade level, scores from 45 to 60 represent skills at the 7th or 8th grade level, and scores above 60 indicate skills at the high-school level or higher. HL status was found below adequate level in more than 50% of the patients. Younger age group showed better HL scores compared to those aged more than 25 years. General education level or the medium of education does not truly reflect HL levels as brought out in the study. Even those with postgraduate qualification had poor HL skills. The study was carried out to find out the HL levels among patients attending a tertiary care hospital. It was assumed that the general education levels may not reflect true HL status. In view of the results of this study it can be concluded that patient's HL skills should not be taken for granted and adequate attention should be paid in educating and briefing patients whenever patients are required to interpret and understand health care related documents.

  5. Case Mix Complexity Differences between Teaching and Nonteaching Hospitals.

    Science.gov (United States)

    Ament, Richard P.; And Others

    1981-01-01

    The differences between teaching and nonteaching hospitals in complexity and variety of cases seen are described. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor. (Author/MLW)

  6. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  7. Lessons learned from the development of health applications in a tertiary hospital.

    Science.gov (United States)

    Park, Joong-Yeol; Lee, Guna; Shin, Soo-Yong; Kim, Jeong Hun; Han, Hye-Won; Kwon, Tae-Wan; Kim, Woo Sung; Lee, Jae Ho

    2014-03-01

    Adoption of smart devices for hospital use has been increasing with the development of health applications (apps) for patient point-of-care and hospital management. To promote the use of health apps, we describe the lessons learned from developing 12 health apps in the largest tertiary hospital in Korea. We reviewed and analyzed 12 routinely used apps in three categories-Smart Clinic, Smart Patient, and Smart Hospital-based on target users and functions. The log data for each app were collected from the date of release up until December 2012. Medical personnel accessed a mobile electronic medical record app classified as Smart Clinic an average of 452 times per day. Smart Hospital apps are actively used to communicate with each other. Patients logged on to a mobile personal health record app categorized as Smart Patient an average of 222 times per day. As the mobile trend, the choice of supporting operating system (OS) is more difficult. By developing these apps, a monitoring system is needed for evaluation. We described the lessons learned regarding OS support, device choice, and developmental strategy. The OS can be chosen according to market share or hospital strategic plan. Smartphones were favored compared with tablets. Alliance with an information technology company can be the best way to develop apps. Health apps designed for smart devices can be used to improve healthcare. However, to develop health apps, hospitals must define their future goals and carefully consider all the aspects.

  8. Molecular epidemiology and spatiotemporal analysis of hospital-acquired Acinetobacter baumannii infection in a tertiary care hospital in southern Thailand.

    Science.gov (United States)

    Chusri, S; Chongsuvivatwong, V; Rivera, J I; Silpapojakul, K; Singkhamanan, K; McNeil, E; Doi, Y

    2017-01-01

    Acinetobacter baumannii is a major hospital-acquired pathogen in Thailand that has a negative effect on patient survival. The nature of its transmission is poorly understood. To investigate the genotypic and spatiotemporal pattern of A. baumannii infection at a hospital in Thailand. The medical records of patients infected with A. baumannii at an 800-bed tertiary care hospital in southern Thailand between January 2010 and December 2011 were reviewed retrospectively. A. baumannii was identified at the genomospecies level. Carbapenemase genes were identified among carbapenem-resistant isolates associated with A. baumannii infection. A spatiotemporal analysis was performed by admission ward, time of infection and pulsed-field gel electrophoresis (PFGE) groups of A. baumannii. Nine PFGE groups were identified among the 197 A. baumannii infections. All A. baumannii isolates were assigned to International Clonal Lineage II. bla OXA-23 was the most prevalent carbapenemase gene. Outbreaks were observed mainly in respiratory and intensive care units. The association between PFGE group and hospital unit was significant. Spatiotemporal analysis identified 20 clusters of single PFGE group infections. Approximately half of the clusters involved multiple hospital units simultaneously. A. baumannii transmitted both within and between hospital wards. Better understanding and control of the transmission of A. baumannii are needed. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. The study of knowledge, attitude and practice of medical law and ethics among doctors in a tertiary care hospital

    International Nuclear Information System (INIS)

    Tahira, Q.U.A.; Lodhi, S.; Haider, S.T.; Abaidullah, S.

    2013-01-01

    Objective: To assess the knowledge, attitude and practice regarding medical law and ethics among doctors of a medical unit in a tertiary care teaching hospital in Lahore. Study Design: Descriptive cross sectional study. Methodology: A three part self - administered structured questionnaire designed to test the knowledge and practices regarding medical law and ethics was distributed among doctors in a medical unit in Mayo Hospital, Lahore during September - October, 2012. Results: The 52 respondent doctors included in the study comprised of 20 (38.5%) house officers, 22 (42.3%) postgraduate residents and 10 (19.2%) consultants. In keeping with the Pakistan Medical and Den-tal Council code of ethics, the correct responses of house officers, postgraduate residents and consultants regarding knowledge of medical law and ethics were respectively 50%, 27.3% and 10% for patient's autonomy, 40%, 36.4% and 10% for adhering to patient's wishes, 10%, 63.6% and 50% for breaching confidentiality, 35%, 36.4% and 0% for informed consent, 10%, 22.7% and 10% for doing best regardless of patient's opinion, 5%, 31.8% and 10% for informing patient's relatives, 15%, 4.5% and 0% for treating violent patients. The practical application part of the questionnaire was a general reflection of the knowledge and attitudes. Conclusion: Most of the doctors were poorly acquainted with PMDC code of ethics. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. An Overview of Teaching Listening in Islamic Tertiary Level of Education

    Directory of Open Access Journals (Sweden)

    Andang Saehu

    2016-12-01

    Full Text Available The ultimate aim of this paper is to depict listening activities in teaching Basic Listening designed by lecturers in an EFL classroom observation of Islamic tertiary level of education in Indonesia. Qualitative methods, used to collect and analyze data gained from observation and interview. The result showed that the lecturer designed various activities in teaching Basic Listening in the EFL class, which they were set up in three stages: pre-listening, while-listening, and post-listening. The activities in the pre-listening were aimed at generating students’ interest, activating student’s prior knowledge, and trying to anticipate any difficult vocabularies.  The while-listening stage is to invite students to be involved at listening through various physical movements, such as story telling, dialogue, listening to songs, and drama. The post-listening stage is to internalize what they have heard with other language skills and to check students’ comprehension. 

  13. Plasma electrolytes in patients with asthma in a tertiary hospital in ...

    African Journals Online (AJOL)

    Background: We compared plasma electrolytes in patients with and without asthma. Methods: Subjects for the study comprised of 17 male and 45 female asthmatics attending the Chest Clinic of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. These patients had questionnaires administered and the ...

  14. Teaching the teachers of teaching : tertiary teacher education in Papua New Guinea

    OpenAIRE

    McLaughlin, Glenn Denis

    1991-01-01

    This thesis is centred upon the development, implementation and evaluation of the Bachelor of Education (Tertiary) BEd T. program at the University of Papua New Guinea, which aims to promote quality teacher educators. The program has its in rationale cognitive development theory, research on approaches to learning and the literature concerning adult and teacher development in the Melanesian context. The theoretical position adopted is that teacher development is a form of adult development...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital.

    Science.gov (United States)

    Burns, Kara; Belton, Suzanne

    2013-09-01

    Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in northern Australia, examining the legal and ethical implications of this practice. A framework of Northern Territory law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of 'occurrence', 'image use', 'quality of consent', 'cameras and technology', 'confidentiality', 'data storage and security', 'hospital policy and law' and 'cultural issues'. One hundred and seventy surveys and eights interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labeling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and noncompliance with policy and mobile phone use, patients' data is at risk of being distributed into the public domain where unauthorised publication may cause

  18. 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.

  19. Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

    Science.gov (United States)

    Ruangkriengsin, Darat; Phisalprapa, Pochamana

    2014-03-01

    Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

  20. Hospital-acquired malnutrition in children at a tertiary care hospital

    African Journals Online (AJOL)

    Del-Rossi Sean Quadros

    As such, there is a need for hospitals to monitor its occurrence using cost- effective but accurate tools. Table 1: General .... Malades Hospital, France.2. Our study ... daily weight loss, which is the critical threshold for an adverse clinical outcome ...

  1. Paediatric utilisation of a teaching hospital and a community health ...

    African Journals Online (AJOL)

    to Red Cross Children's Hospital (RXH) that could be more ... better access and perceived quality. S Atr Med ... tertiary resources, low levels of efficiency and staff ... However, central to improved patterns of utilisation is the .... the modei were: (/) age of the child; (it) duration of residence ... There was no significant association.

  2. Hospital management principles applicable to the veterinary teaching hospital.

    Science.gov (United States)

    Harris, Donna L; Lloyd, James W; Marrinan, Mike

    2004-01-01

    The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.

  3. 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.

  4. Subtypes of dissociative (conversion) disorder in two tertiary hospitals in Bangladesh.

    Science.gov (United States)

    Ahsan, M S; Mullick, S I; Sobhan, M A; Khanam, M; Nahar, J S; Salam, M A; Ali, R; Islam, M; Kabir, M S

    2010-01-01

    Dissociative (conversion) disorders are common among the patients attending in and out patients of Psychiatry Department of tertiary hospitals in Bangladesh. This study was done to see the subtypes of dissociative (conversion) disorder according to International Classification of Diseases, Tenth Revision (ICD-10). This is a descriptive, cross sectional study done on 100 consecutive patients from the Departments of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH). Study period was July 2005 to June 2006. Among the patients of dissociative (conversion) disorder, mixed dissociative (conversion) disorder was found highest 34%, followed by dissociative convulsion 33%, dissociative motor disorders 19%, dissociative anaesthesia and sensory loss 5%, dissociative amnesia 4%, dissociative fugue 3%. However, the researcher did not find any multiple personality disorder which is relatively common in North America. This finding reflected that there are differences in prevalence of sub types of dissociative disorders in Bangladesh and Western countries.

  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. Noise and room acoustic conditions in a tertiary referral hospital in Seoul, Korea

    DEFF Research Database (Denmark)

    Jeong, Cheol-Ho; Cho, Wan-Ho; Chang, Ji-ho

    2018-01-01

    Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital in Korea, are investigated. Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over...... level for the first night was 66 dBA, which came down to 56 dBA for the next day. The reason for the higher noise level for the first night in the ICU was frequent alarm sound and treatment noise related to a critical patient. The noise level in the measured ERs is about 10 dB lower than those measured...... about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured: examination rooms, operating rooms, nurse stations, patient rooms, and audiometric rooms. The equivalent A-weighted noise level, LAeq, ranges from 54 to 56 dBA in two ERs. In an ICU, the noise...

  7. Distribution of HIV among pregnant women visiting a tertiary care hospital in Kathmandu, Nepal

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    Manish Rijal

    2014-09-01

    Full Text Available Objective: To explore the distribution of HIV among the pregnant women visiting a tertiary care hospital in Kathmandu. Methods: A total of 1 440 blood samples from pregnant women were collected and tested for antiHIV antibodies using rapid screening assay kits and ELISA in Paropakar Maternity and Women ’s Hospital during May to November, 2011. Results: The overall sero-prevalence of HIV among pregnant women was 0.62%, the prevalence being highest (1.4% in age group 35-39 years old, and during second trimester of gestation (0.75%. Similarly, it was found to be highest among the illiterates (1.92%, commercial sex worker (10.00% and those having multiple sexual partners (30.00%. Conclusions: Sero-prevalence of HIV infection was higher among the pregnant women of Kathmandu.

  8. Utilization of arterial blood gas measurements in a large tertiary care hospital.

    Science.gov (United States)

    Melanson, Stacy E F; Szymanski, Trevor; Rogers, Selwyn O; Jarolim, Petr; Frendl, Gyorgy; Rawn, James D; Cooper, Zara; Ferrigno, Massimo

    2007-04-01

    We describe the patterns of utilization of arterial blood gas (ABG) tests in a large tertiary care hospital. To our knowledge, no hospital-wide analysis of ABG test utilization has been published. We analyzed 491 ABG tests performed during 24 two-hour intervals, representative of different staff shifts throughout the 7-day week. The clinician ordering each ABG test was asked to fill out a utilization survey. The most common reasons for requesting an ABG test were changes in ventilator settings (27.6%), respiratory events (26.4%), and routine (25.7%). Of the results, approximately 79% were expected, and a change in patient management (eg, a change in ventilator settings) occurred in 42% of cases. Many ABG tests were ordered as part of a clinical routine or to monitor parameters that can be assessed clinically or through less invasive testing. Implementation of practice guidelines may prove useful in controlling test utilization and in decreasing costs.

  9. PROFILE OF SYPHILIS PATIENTS ATTENDING THE DERMATOLOGY VENEREOLOGY OPD AT A GOVERNMENT TERTIARY HOSPITAL

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    Vasuki Shanmugam

    2017-08-01

    Full Text Available BACKGROUND Syphilis is one of the major sexually transmitted infections, which is showing a raising trend across the globe. The aim of the study is to study the prevalence of syphilis among Sexually Transmitted Infection (STI clinic attendees of a tertiary care hospital of south India. MATERIALS AND METHODS This was a cross-sectional study of one year duration conducted at STI clinic of a government tertiary hospital in South India. Patients who have been diagnosed to have syphilis were analysed with respect to demographic profile and their sexual behaviour pattern. RESULTS 40 were persons diagnosed to have syphilis among a total of 1790 STI clinic attendees. The mean age of patients with syphilis found to be 31 years. Male-to-female ratio is 7:1. 80% of patients with syphilis had higher school level and college level education. Homosexual behaviour pattern was predominant and it was found among 60% of them (p value 0.011. 62.5% of them were alcoholic. Safe sex practices were minimal in spite of knowledge about condom. CONCLUSION There was a raising trend of syphilis among STI clinic attendees during 2016. Early infectious stage of disease is more and was found more commonly among Men Having Sex with Men (MSM.

  10. 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.

  11. 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 (Pwork experience with SE and OC. This research showed that SE and OC ?are moderate. SE and OC have strong correlation with turnover, critical thinking, job satisfaction, and individual and organizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.

  12. Profile of extrahepatic portal venous obstruction (ehpvo) in a tertiary care hospital in pakistan

    International Nuclear Information System (INIS)

    Shah, S.K.; But, J.A.; Awan, A.

    2007-01-01

    To study the clinical and laboratory profile of patients with EHPVO in a tertiary care hospital of Pakistan and to differentiate EHPVO from cirrhosis of liver and to see the effect on liver function tests. This is a prospective observational study conducted at Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad. Twenty five patients of 12-55 years of age with the features of portal hypertension were included in this study. After careful history and physical examination patients were subjected for laboratory investigations including liver function test, renal function test, blood CP, PT, APTT, HbsAg and anti HCV, other specialized procedures including endoscopy, liver biopsy and ultra sound was also done in all patients. Portal vein thrombosis was the predominant cause of EHPVO, accounting for 88% of cases. All patients were presented with upper GI bleeding, splenomegaly was observed in 88% of patients. None of the patients had clinical, biochemical or liver biopsy evidence of chronic liver disease. The diagnosis of extra hepatic portal venous obstruction and differentiation from cirrhosis can be easily made by characteristic clinical features, normal liver function tests and doppler ultrasound. Portal vein thrombosis (PVT) is the predominant cause of EHPVO in Pakistani patients, as seen at this tertiary care hospital in Pakistan. (author)

  13. [Experience of the surgical management of the esophageal achalasia in a tertiary care hospital].

    Science.gov (United States)

    Barajas-Fregoso, Elpidio Manuel; Romero-Hernández, Teodoro; Sánchez-Fernández, Patricio Rogelio; Fuentes-Orozco, Clotilde; González-Ojeda, Alejandro; Macías-Amezcua, Michel Dassaejv

    2015-01-01

    Achalasia is a primary esophageal motor disorder. The most common symptoms are: dysphagia, chest pain, reflux and weight loss. The esophageal manometry is the standard for diagnosis. The aim of this paper is to determine the effectiveness of the surgical management in patients with achalasia in a tertiary care hospital. A case series consisting of achalasia patients, treated surgically between January and December of 2011. Clinical charts were reviewed to obtain data and registries of the type of surgical procedure, morbidity and mortality. Fourteen patients were identified, with an average age of 49.1 years. The most common symptoms were: dysphagia, vomiting, weight loss and pyrosis. Eight open approaches were performed and six by laparoscopy, with an average length of cardiomyotomy of 9.4 cm. Eleven patients received an antireflux procedure. The effectiveness of procedures performed was 85.7 %. Surgical management offered at this tertiary care hospital does not differ from that reported in other case series, giving effectiveness and safety for patients with achalasia.

  14. 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.

  15. Cost effectiveness of screening of all newly recruited employees for diabetes at a tertiary care hospital.

    Science.gov (United States)

    Ali, Niloufer Sultan; Khuwaja, Ali Khan

    2007-01-01

    Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources. However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over a period of 5 months (August 2004 to December 2004). Out of 360 subjects, 326, whose information was found to be complete, were included for final analysis. Mean age of the study subjects was 25.3 +/- 4.7 years and their mean casual plasma glucose level was 99.1 +/- 16.3 mg/dl. 315 (96.6%) study subjects had casual plasma glucose level of 139 mg/dl or less. Only 10 (3.1%) study subjects had casual plasma glucose levels between 140 to 199 mg/dl. Just one employee, 41 years old, was found to have casual plasma glucose level of 213 mg/dl. In this study, screening of all individuals for diabetes had a very low yield. Recommendation of universal screening for diabetes does not represent a good use of resources and perhaps not cost-effective. However, periodic screening of high risk individuals should be warranted.

  16. Sexually Transmitted Infections: Experience in a Multidisciplinary Clinic in a Tertiary Hospital (2010-2013).

    Science.gov (United States)

    Moreno-Ribera, N; Fuertes-de Vega, I; Blanco-Arévalo, J L; Bosch-Mestres, J; González-Cordón, A; Estrach-Panella, T; García-de Olalla, P; Alsina-Gibert, M

    2016-04-01

    The number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital. This was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis. The study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection. This study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  17. How Do Patients Perceive and Expect Quality of Surgery, Diagnostics, and Emergency Services in Tertiary Care Hospitals? An Evidence of Gap Analysis From Pakistan.

    Science.gov (United States)

    Fatima, Iram; Humayun, Ayesha; Anwar, Muhammad Imran; Iftikhar, Adil; Aslam, Muhammad; Shafiq, Muhammad

    2017-07-01

    Service quality is one of the important gears to appraise services and determine the gray areas that need improvement. In countries with a resource-poor health system, the first step of measuring quality is yet to be taken. This study seeks to inform policy makers in developing contextual service quality models by identifying service quality gaps in tertiary care teaching hospitals using patients' perspective. A cross-sectional study was performed using multistage cluster sampling, and a modified version of the SERVQUAL (SERV-service, QUAL-quality) instrument was administered to determine patient's expectations and perceptions. A total of 817 completed questionnaires were obtained from patients and/or their attendants using convenience sampling. Data analysis revealed statistically significant negative quality gaps between expectations and perceptions of tangibility, reliability, empathy, assurance, responsiveness, and communication. The difference in mean expectation and perception for responsiveness across the sexes was significant ( p quality were independent of sex. Educational status showed significant difference in expectation and perception in responsiveness ( p quality: p quality of hospitals. Tertiary care hospitals failed to meet patients' expectations in all major areas of service quality, posing a question of how hospitals implement and evaluate their quality assurance policy.

  18. Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

    Science.gov (United States)

    Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

    2013-01-01

    Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

  19. Prevalence and causes of blindness at a tertiary hospital in Douala, Cameroon

    Science.gov (United States)

    Eballé, André Omgbwa; Mvogo, Côme Ebana; Koki, Godefroy; Mounè, Nyouma; Teutu, Cyrille; Ellong, Augustin; Bella, Assumpta Lucienne

    2011-01-01

    Purpose 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. PMID:21966211

  20. Risk factors for acquiring MDR pathogen in a tertiary care hospital

    International Nuclear Information System (INIS)

    Noman, F.; Usmani, B.; Imtiaz, A.; Mahmood, F.

    2012-01-01

    Objective: To find out common risk factors in patients from whose samples Multi-Drug Resistant pathogens were isolated. Study Design Prospective observational study. Setting: Microbiology department of Liaquat National Hospital Karachi, a 750-bedded tertiary care Hospital. Material and Method All multi-drug resistant pathogens (resistant to representative antibiotics of at least three different classes of antimicrobial agents including carbapenems) isolated from samples like blood, bronchial wash, sputum, pus, etc, received from different units of hospital at Microbiology laboratory Liaquat National Hospital from December 2006 through February 2007 were included in this study. Patient information was collected from their personal file and through concerned treating physicians. Results and Conclusion A total of 228 MDR pathogens were isolated from different samples in 3 months, these included: Acinetobacter spp 184 (81 %) and Pseudomonas aeruginosa 44 (19%). Majority were from lower respiratory tract specimen, followed by blood. Most (86%) patients were in intensive care unit or high dependency unit. Mechanical ventilation was predominant finding in patients with Acinetobacter spp while surgical procedures were more frequently associated with Pseudomonas aeruginosa. Only 3% of Acinetobacter spp and 7 % of Pseudomonas aeruginosa were isolated during first 48 hours of hospital stay. (author)

  1. KNOWLEDGE AND AWARENESS REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG EMPLOYEES OF A TERTIARY CARE HOSPITAL

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    Manoj Bansal

    2013-05-01

    Full Text Available Background: A hospital is an establishment where the persons suffering with the variety of communicable and non communicable diseases are visiting to take medical care facilities. Hospitals and other healthcare establishments in India produce a significant quantity of waste, posing serious problems for its disposal, an issue that has received scant attention. Objective: To assess the level of knowledge regarding biomedical waste and its management among hospital personnel. Material and Methods: The present study was a cross sectional study carried out in a tertiary care hospital of Gwalior in year 2008. Medical, para-medical and non-medical personnel working at their current position for at least 6 months were included as study participants. Self made scoring system was used to categorize the participants as having Good, Average and Poor knowledge. Statistical Analysis: Percentage and Proportion were applied to interpret the result. Results: The score was highest for medical and least for non-medical staff. Conclusion: The present study concludes that regular training programs should be organized about the guidelines and rules of biomedical waste management at all level.

  2. 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.

  3. Microbiological burden in air culture at various units of a tertiary care government hospital in Nepal

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    Binaya Sapkota

    2016-01-01

    Full Text Available Background The environmental matrices (water, air, and surfaces play a vital role as reservoirs of Legionella spp. and Pseudomonas aeruginosa (Pseudomonas spp.. Hence, hospital environment control procedures are effective measures for reducing nosocomial infections. Aims This study was carried out to explore the profiles of microorganisms in air culture at various wards/units of a tertiary care hospital in Nepal. Methods A descriptive cross-sectional study was carried out at various wards/units of a tertiary care hospital in Nepal between January and September 2015 to explore the microbiological burden in inanimate objects. Each week one ward or unit was selected for the study. Bed, tap, the entire room, trolley, computer, phone, rack handles, table, chair, door, stethoscope, oxygen mask, gown, cupboard handles, and wash basins were selected for air culture testing. Ten different wards/units and 77 locations/pieces of equipment were selected for air culture by employing a simple random sampling technique. Information about the organisms was entered into the Statistical Package for the Social Sciences (SPSS Version 22 (IBM: Armonk, NY and descriptive analyses were carried out. Results Staphylococcus aureus (S. aureus, Micrococcus, coagulase negative staphylococcus (CONS, Bacillus, Pseudomonas aeruginosa, yeast, and Acinetobacter were the most commonly detected organisms. In the postoperative ward, S. aureus was the most frequently detected microorganism. Micrococcus was detected in four out of 10 locations. In the x-ray unit, S. aureus was detected in three out of four locations. Conclusion S. aureus, Micrococcus, CONS, Bacillus, Pseudomonas, yeast, and Acinetobacter were the most common organisms detected.

  4. Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

    Institute of Scientific and Technical Information of China (English)

    Sameer singhal; Pankaj Banode; Nitish Baisakhiya

    2009-01-01

    Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

  5. 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.

  6. Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.U.

    2014-01-01

    Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

  7. Characteristics of Infective Endocarditis in a Tertiary Hospital in East China

    Science.gov (United States)

    Xu, Huimin; Cai, Siyu

    2016-01-01

    The epidemiology, clinical presentation, and treatment of infective endocarditis (IE) has significantly changed over the past few years in developed countries. However, relevant data from developing countries are different and remain scarce. The objective of this study was to evaluate the clinical presentations, treatment and outcomes of IE patients in a tertiary hospital in East China over an 8-year period. This was a retrospective observational study of consecutive cases of definite or possible IE as per the modified Duke criteria between January 2008 and December 2015. A total of 135 definite and 39 probable IE cases were identified. The mean age was 47.8 ± 15.7 years, with a male preponderance (1.9: 1). Degenerative valve disease accounted for 30.5% cases of IE, followed by congenital heart disease (29.9%) and rheumatic heart disease (14.9%). Native cardiac valves were present in 93.7% of the IE patients. Echocardiography and blood culture were performed in all patients, of whom 55.2% were found to have large vegetations (≥10 mm) and the positive rate of blood culture was 60.3%. Streptococcus remained the chief causative agent that was identified in 61.9% of culture-positive patients. Glycopeptide antibacterials and cephalosporins were the most frequently used antimicrobial drugs for IE therapy. Seventy-six (43.7%) of the IE patients were surgically treated. The mortality rate during hospital stay was 10.9%. Our data reflected clinical and microbiological profile, and treatment of IE in a tertiary hospital located in the East China. PMID:27861628

  8. Characteristics of Infective Endocarditis in a Tertiary Hospital in East China.

    Science.gov (United States)

    Xu, Huimin; Cai, Siyu; Dai, Haibin

    2016-01-01

    The epidemiology, clinical presentation, and treatment of infective endocarditis (IE) has significantly changed over the past few years in developed countries. However, relevant data from developing countries are different and remain scarce. The objective of this study was to evaluate the clinical presentations, treatment and outcomes of IE patients in a tertiary hospital in East China over an 8-year period. This was a retrospective observational study of consecutive cases of definite or possible IE as per the modified Duke criteria between January 2008 and December 2015. A total of 135 definite and 39 probable IE cases were identified. The mean age was 47.8 ± 15.7 years, with a male preponderance (1.9: 1). Degenerative valve disease accounted for 30.5% cases of IE, followed by congenital heart disease (29.9%) and rheumatic heart disease (14.9%). Native cardiac valves were present in 93.7% of the IE patients. Echocardiography and blood culture were performed in all patients, of whom 55.2% were found to have large vegetations (≥10 mm) and the positive rate of blood culture was 60.3%. Streptococcus remained the chief causative agent that was identified in 61.9% of culture-positive patients. Glycopeptide antibacterials and cephalosporins were the most frequently used antimicrobial drugs for IE therapy. Seventy-six (43.7%) of the IE patients were surgically treated. The mortality rate during hospital stay was 10.9%. Our data reflected clinical and microbiological profile, and treatment of IE in a tertiary hospital located in the East China.

  9. Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

    Science.gov (United States)

    Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

    2015-01-01

    Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

  10. Vancomycin resistant enterococci in urine cultures: Antibiotic susceptibility trends over a decade at a tertiary hospital in the United Kingdom.

    Science.gov (United States)

    Toner, Liam; Papa, Nathan; Aliyu, Sani H; Dev, Harveer; Lawrentschuk, Nathan; Al-Hayek, Samih

    2016-03-01

    Enterococci are a common cause of urinary tract infection and vancomycin-resistant strains are more difficult to treat. The purpose of this surveillance program was to assess the prevalence of and determine the risk factors for vancomycin resistance in adults among urinary isolates of Enterococcus sp. and to detail the antibiotic susceptibility profile, which can be used to guide empirical treatment. From 2005 to 2014 we retrospectively reviewed 5,528 positive Enterococcus sp. urine cultures recorded in a computerized laboratory results database at a tertiary teaching hospital in Cambridge, United Kingdom. Of these cultures, 542 (9.8%) were vancomycin resistant. No longitudinal trend was observed in the proportion of vancomycin-resistant strains over the course of the study. We observed emerging resistance to nitrofurantoin with rates climbing from near zero to 40%. Ampicillin resistance fluctuated between 50% and 90%. Low resistance was observed for linezolid and quinupristin/dalfopristin. Female sex and inpatient status were identified as risk factors for vancomycin resistance. The incidence of vancomycin resistance among urinary isolates was stable over the last decade. Although resistance to nitrofurantoin has increased, it still serves as an appropriate first choice in uncomplicated urinary tract infection caused by vancomycin-resistant Enterococcus sp.

  11. Vancomycin resistant enterococci in urine cultures: Antibiotic susceptibility trends over a decade at a tertiary hospital in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Liam Toner

    2016-03-01

    Full Text Available Purpose: Enterococci are a common cause of urinary tract infection and vancomycin-resistant strains are more difficult to treat. The purpose of this surveillance program was to assess the prevalence of and determine the risk factors for vancomycin resistance in adults among urinary isolates of Enterococcus sp. and to detail the antibiotic susceptibility profile, which can be used to guide empirical treatment. Materials and Methods: From 2005 to 2014 we retrospectively reviewed 5,528 positive Enterococcus sp. urine cultures recorded in a computerized laboratory results database at a tertiary teaching hospital in Cambridge, United Kingdom. Results: Of these cultures, 542 (9.8% were vancomycin resistant. No longitudinal trend was observed in the proportion of vancomycin- resistant strains over the course of the study. We observed emerging resistance to nitrofurantoin with rates climbing from near zero to 40%. Ampicillin resistance fluctuated between 50% and 90%. Low resistance was observed for linezolid and quinupristin/ dalfopristin. Female sex and inpatient status were identified as risk factors for vancomycin resistance. Conclusions: The incidence of vancomycin resistance among urinary isolates was stable over the last decade. Although resistance to nitrofurantoin has increased, it still serves as an appropriate first choice in uncomplicated urinary tract infection caused by vancomycin- resistant Enterococcus sp.

  12. Management of malaria at Juba Teaching Hospital: a clinical audit

    African Journals Online (AJOL)

    2012-08-03

    Aug 3, 2012 ... Medical Department of Juba Teaching Hospital (JTH). The World ... Assess vital signs: • temperature .... March 2012. NICE 2002 Principles for best practice in Clinical Audit. 4. ... A clinical audit cycle has a number of phases: 1.

  13. Risk factors for stillbirths at Universty of Maiduguri teaching hospital ...

    African Journals Online (AJOL)

    Risk factors for stillbirths at Universty of Maiduguri teaching hospital, ... Background:Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. ... Key words: stillbirth, prevalence, aetiologic determinants ...

  14. Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano ...

    African Journals Online (AJOL)

    Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano, Nigeria: a 5 ... Nigerian Journal of Medicine ... Open Access DOWNLOAD FULL TEXT ... it a prevalence of 0.9% of medical conditions and 3.4% of all cardiovascular cases.

  15. Childhood pneumonia at the University of Ilorin Teaching Hospital ...

    African Journals Online (AJOL)

    owner

    2013-01-09

    Jan 9, 2013 ... which was significantly higher ... University of Ilorin Teaching Hospital between 1st July ..... two organisms formed more than 40% of the isolates. ... Educational Services; 2007:425-. 41. 3. ... Brazilian children in a metropoli-.

  16. Abdominal Injuries in University of Port Harcourt Teaching Hospital

    African Journals Online (AJOL)

    operative findings, postoperative complications, and outcome of management. Data analysis was performed using the Statistical Package for Social Sciences version 16. Abdominal Injuries in University of Port Harcourt. Teaching Hospital. Amabra ...

  17. Trends in incidence of low birth weight deliveries in a tertiary hospital, in Northern Nigeria

    OpenAIRE

    O Hassan; Z Muhammad

    2011-01-01

    Background: Low birth weight is an important determinant of both infant and neonatal mortality rates and is also an indicator of social and economic development. The World Health Organization described any baby with birth weight of less than 2.5kg as low birth weight baby. Objective: To determine the incidence of low birth weight deliveries in Aminu Kano Teaching Hospital, Kano. Study design: A retrospective descriptive study. Results: The overall incidence of low birth weight delive...

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

    Directory of Open Access Journals (Sweden)

    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

  19. [How do Turkish immigrants evaluate cultural sensitivity in a German tertiary hospital?].

    Science.gov (United States)

    Giese, Arnd; Uyar, Müberra; Henning, Bernhard F; Uslucan, Haci H; Westhoff, Timm; Pagonas, Nikolaos

    2015-01-01

    Culturally adequate medical care is a goal in Germany, but quantitative data concerning inpatients is lacking. Inpatients of a German tertiary hospital: Turkish migrants (T) and Germans (G) were interviewed in their respective native language. 121 T and 121 G were interviewed. 97.5% of T were Muslims, 82.6% of G were Christians. 88.5% of T judged religion as "important" or "very important" (G: 35.8%). 50.8% of T saw their opportunity to pray in the hospital as "bad" or "very bad" (G: 0.9%). Keeping to Islamic dietary rules in the hospital was "difficult" or "very difficult" for 90% of T. For 79.0% of female T care by a same-sex staff was "important" or "very important" (female G: 36.3%, male T: 40.0%, male G: 7.7%). The presence of a same-sex person during examinations or treatments was "much" or "very much" appreciated by 69.7% of female T, if same-sex care was impossible (female G: 25.4%, male T: 28.9%, male G: 6.1%). A retrospective analysis revealed that 5.8% of all 8988 hospital admissions during the period of study recruitment were Turkish migrants. To meet the needs of Turkish migrants German hospitals should improve the opportunity for Muslims to pray. Additionally, the cooperation with local imams should be sought. Precise descriptions of food ingredients or an adapted menu could help T to deal with Muslim dietary commandments. A culturally sensitive hospital should take into account that female as well as male T prefer to be cared of by same-sex physicians and nurses. Georg Thieme Verlag Stuttgart.

  20. HOSPITALIZATIONS DUE TO RESPIRATORY PROBLEMS DURING DIWALI FESTIVAL IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Raghu

    2016-02-01

    Full Text Available BACKGROUND The burning of firecrackers during Diwali festival produces an adverse respiratory outcome. However, there are no published articles on the impact of fireworks on hospital admission due to acute respiratory issues, hospital stay, and respiratory mortality during Diwali in India. MATERIALS AND METHODS This was a prospective, open label, observational study. It was conducted in patients admitted to the pulmonary emergency unit with respiratory symptoms 15 days before and after Diwali. It was conducted after the approval of ethics committee and written informed consent. RESULTS The number of admissions post-Diwali were significantly more compared to pre-Diwali from both rural and urban locations (p<0.001. The mean duration of hospital stay was significantly less pre-Diwali (7.59±0.74 days compared to post-Diwali (9.46±0.44 days. Also, significantly increased number of patients required ventilator support post Diwali. CONCLUSION The findings from the present study validate the deterioration of respiratory health during Diwali festival in India. There should be more awareness campaigns about the harmful effects of fire-crackers. Patients suffering from respiratory problems should be advised to avoid heavy exposure to fireworks

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

    International Nuclear Information System (INIS)

    Khan, R.A.W.; Ahmed, W.; Alam, S.E.; Arif, A

    2011-01-01

    Objectives: To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Settings and duration: Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. Patients and Methods: A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre (tertiary care public sector hospital), other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex fourth Generation ELISA kits. Results: A total of 2965 cases were referred in a year. Overall sero prevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private hospitals/clinics were 7.2%, and self-referred patients was 5.6%. Anti HCV positivity rates amongst these cases were 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. Breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1% in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally (20.3%) seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the

  4. Creative payment strategy helps ensure a future for teaching hospitals.

    Science.gov (United States)

    Vancil, D R; Shroyer, A L

    1998-11-01

    The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received.

  5. Frequency of different valvular lesions of rheumatic heart disease presenting to a tertiary care hospital

    International Nuclear Information System (INIS)

    Rehman, J.U.; Shah, I.

    2015-01-01

    Rheumatic Hearth Disease (RHD) is still prevalent in our country and a great source of morbidity. This study was done with an objective to determine relative frequency of different valvular lesions of RHD presenting in a tertiary care hospital. Methods: This cross sectional study was conducted at the Cardiology Department of Hayatabad Medical Complex, Peshawar. A total of 171 cases of RHD were included through consecutive sampling technique. Results: There were 64.33% females. Mean age was 25.6 ± 6.95 years ranging from 15 to 40 years. The different percentage of valvular lesions in RHD were MR (59.06%), MS (46.78%), AR (43.85%) and mixed lesions (38.59%). Conclusion: Rheumatic heart disease is a very common disease in our community and mitral regurgitation is a predominant lesion at presentation. Females are usually affected more than males. (author)

  6. Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    V S Tshisevhe

    2017-01-01

    Full Text Available The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

  7. Treatment of self-poisoning at a tertiary level hospital in Bangladesh

    DEFF Research Database (Denmark)

    Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha

    2017-01-01

    OBJECTIVES: Approximately 10,000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. METHODS: Data on direct costs to families, sources of funds for treatment...... and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. RESULTS: Agrochemicals were the most common...... as organophosphorus poisoning in 17(.) 0% of agrochemical cases resulted in increased cost to patients. Only 51(.) 9% of patients had indicators of wealth; 78(.) 1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21(.) 30 per patient) were markedly lower than costs to patients...

  8. 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.

  9. A study on workplace violence against health workers in a Nigerian tertiary hospital.

    Science.gov (United States)

    Ogbonnaya, G U; Ukegbu, A U; Aguwa, E N; Emma-Ukaegbu, U

    2012-01-01

    Workplace violence is a common phenomenon which cuts across all work settings. Its prevalence is particularly high in the health sector and adversely affected service delivery. However, in Nigeria there are limited data on the magnitude of the problem. In this study, we aim to describe the prevalence of workplace violence against health workers in a tertiary hospital located in Abia state, Nigeria. In this descriptive cross-sectional study, data was collected using self-administered questionnaires distributed to 395 health workers of the clinical services division of the hospital to assess their experience of workplace violence in the preceding year. The response of 303 was returned and analyzed. Most (88.1%) of the respondents had experienced workplace violence with more than half (54.4%) of all violent incidents occurring in the wards. Psychological violence was more prevalent than physical violence. Verbal abuse (85.4%) was the most prevalent while sexual harassment (4.5%) was the least. Approximately one quarter (25.1%) of all the respondents had been physically assaulted in the preceding year. Patients and their relations were the main perpetrators of physical assault and threats. Senior colle agues were the main workplace bullies. The prevalence of workplace violence was high in this hospital.

  10. Red Cell Alloimmunization to Rhesus Antigen Among Pregnant Women Attending a Tertiary Care Hospital in Oman

    Directory of Open Access Journals (Sweden)

    Tamima Al-Dughaishi

    2016-01-01

    Full Text Available Objectives: The detection of maternal alloimmunization against red cell antigens is vital in the management of hemolytic disease of the fetus and newborn. We sought to measure the presence of allosensitization to Rhesus D (RhD antibodies in antenatal women attending a tertiary care hospital and assess the fetal outcome in sensitized women. Methods: We conducted a retrospective review of pregnant Omani women who registered at the Sultan Qaboos University Hospital between June 2011 and June 2013. Pregnant women were tested for ABO blood type and were screened for RhD antigen and antibodies at their first antenatal clinic visit. In women who tested positive for the RhD antibodies, an antibody titer was performed to evaluate the severity of their case. Results: Data was available on 1,251 pregnant women who were managed and delivered at Sultan Qaboos University Hospital. The prevalence of RhD negative pregnant women was 7.3%. Blood group O was the most common followed by A, B, and AB. The rate of RhD negative alloimmunization was 10%, and anti-D was the most common antibody detected. There were no stillbirths or neonatal deaths. Postnatal transfusion was necessary for only one baby. Conclusions: The prevalence of RhD negativity was comparable to other Asian countries. Previous RhD alloimmunization and history of miscarriages were the most common maternal medical history.

  11. Microbial Carriage of Cockroaches at a Tertiary Care Hospital in Ghana

    Directory of Open Access Journals (Sweden)

    Patience B. Tetteh-Quarcoo

    2013-01-01

    Full Text Available Cockroaches are common in the environment of many hospitals in Ghana; however, little is known about their public health risks. To evaluate potential risks, we investigated the external and internal microbial flora of 61 cockroaches from a tertiary hospital in Ghana and evaluated the antibiotic resistance profiles of the common bacterial species. Standard methods were used in all the microbiological investigations and antibiotic susceptibility testing. A rotavirus carriage rate of 19.7% was observed among the cockroaches. Four types of intestinal parasites were carried externally by the cockroaches, and the most prevalent was Hookworm (4.9%. Eight nosocomial bacteria were isolated from the cockroaches, and the most prevalent was Klebsiella pneumoniae , which occurred internally in 29.5% of the cockroaches and 26.2% externally. Multiple drug resistance among common bacteria isolated from the cockroaches ranged from 13.8% ( Escherichia coli to 41.1% ( Klebsiella pneumoniae . Cockroaches constitute an important reservoir for pathogenic microorganisms, and may be important vectors of multiple resistant nosocomial pathogens in the studied hospital.

  12. Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

    Directory of Open Access Journals (Sweden)

    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.

  13. Frequency of causes of primary postpartum haemorrhage in a tertiary care hospital

    International Nuclear Information System (INIS)

    Munir, S.I.

    2015-01-01

    Objective: To study the frequency of causes of primary postpartum hemorrhage (PPH) in women managed in a tertiary care Hospital. material and Methods: The study was conducted in the department of Obstetrics and Gynecology, Unit - 1, Lady Willingdon Hospital King Edward Medical University, Lahore from July 2013 to December 2013. All the women having postpartum haemorrhage after vaginal delivery in the labour room or referred with primary postpartum haemorrhage were included in the study and were evaluated to see the frequency of postpartum haemorrhage as well as the causes of PPH in women being treated in a tertiary care unit. Results: During the study period 1344 women delivered in unit I and 250 patients developed postpartum haemorrhage giving frequency of primary postpartum haemorrhage 18.60%. Majority of the women 29.6% (n = 74) were between 26 - 30 years of age, mean and SD was 28.43 ± 4.76 years. The gestation of 55.2% (n = 138) patients was between 37 - 40 weeks. The frequency of postpartum haemorrhage in booked women during antenatal period was recorded as 25.2% (n = 63) while 74.8% (n = 187) were not booked in any health facility. Among patients who developed PPH, uterine atony was the most common cause 57.6% (n = 144), followed by genital tract teats which was 29.2% (n = 73). The rest of the causes of PPH were retained placenta in 10% (n = 25), uterine rupture in 3.6% (n = 9) and uterine inversion in 1.6% (n = 4). Conclusions: Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to under utilization of health facilities, the major cause is uterine atony followed by perineal tears. (author)

  14. Assessment of medication errors and adherence to WHO prescription writing guidelines in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    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.

  15. Inpatient dermatology: Characteristics of patients and admissions in a tertiary level hospital in Eastern India

    Directory of Open Access Journals (Sweden)

    Arpita Sen

    2016-01-01

    Full Text Available Introduction: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. Aims and Objectives: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India. Materials and Methods: We undertook a retrospective analysis of the admission and discharge records of all patients, collected from the medical records department, admitted to our indoor facility from 2011 to 2014. The data thus obtained was statistically analyzed with special emphasis on the patient's demographic profile, clinical diagnosis, final outcome, and duration of stay. Results and Analysis: A total of 375 patients were admitted to our indoor facility during the period. Males outnumbered females, with the median age in the 5th decade. Immunobullous disorders (91 patients, 24.27% were the most frequent reason for admissions, followed by various causes of erythroderma (80 patients, 21.33% and infective disorders (73 patients, 19.47%. Other notable causes included cutaneous adverse drug reactions, psoriasis, vasculitis, and connective tissue diseases. The mean duration of hospital stay was 22.2±15.7 days; ranging from 1 to 164 days. Majority of patients (312, 83.2% improved after hospitalization; while 29 (7.73% patients died from their illness. About 133 patients (35.64% required referral services during their stay, while 8 patients (2.13% were transferred to other departments for suitable management. Conclusion: Many dermatoses require inpatient care for their optimum management. Dermatology inpatient services should be expanded in India to cater for the large number of cases with potentially highly severe dermatoses.

  16. 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.

  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

    2018-06-01

    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. Nature and pattern of primary teeth extractions in a tertiary care hospital setting in South India

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    Shini Susan Samuel

    2018-01-01

    Full Text Available Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. Results: A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6–9-year-old and the second primary molar among 10–15-year-old. The majority of primary teeth extractions were performed in the age group of 6–9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. Conclusions: This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

  20. Paediatric mild head injury: is routine admission to a tertiary trauma hospital necessary?

    Science.gov (United States)

    Tallapragada, Krishna; Peddada, Ratna Soundarya; Dexter, Mark

    2018-03-01

    Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014. Data were collected regarding demographics, clinical findings, mechanism of injury, head computed tomography scan findings, neurosurgical intervention, outcome and length of admission. Wilcoxon paired test was used with P value <0.05 considered significant. Four hundred and ten children were analysed. Three hundred and eighty-one (93%) children were managed conservatively, 18 (4%) underwent evacuation of extradural haematoma (TBI surgery) and 11 (3%) needed fracture repair surgery. Two children evolved a surgical lesion 24 h post-admission. Only 17 of 214 children transferred from peripheral hospitals needed neurosurgery. Overall outcomes: zero deaths, one needed brain injury rehabilitation and 63 needed child protection unit intervention. Seventy-five percentage of children with non-surgical lesions were discharged within 2 days. Eighty-three percentage of road transfers were discharged within 3 days. Children with small intracranial haematomas and/or skull fractures who need no surgery only require brief inpatient symptomatic treatment and could be safely managed in primary hospitals. Improved tertiary hospital transfer guidelines with protocols to manage clinical deterioration could have cost benefit without risking patient safety. © 2017 Royal Australasian College of Surgeons.

  1. Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital

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    Andrea Blotsky

    2016-01-01

    Full Text Available Background. Medical emergency teams (METs or rapid response teams (RRTs facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging. Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system’s impact on time to intervention, code blue rates, and ICU transfer rates. Results. Ninety-five calls were placed for 82 patients. Median time from patient decompensation to intervention was 5 min (IQR 1–10, compared to 3.4 hours (IQR 0.6–12.4 before system implementation (p<0.001. Total number of ICU admissions from the CTU was reduced from 4.8/1000 patient days (±2.2 before intervention to 3.3/1000 patient days (±1.4 after intervention (IRR: 0.82, p=0.04 (CI 95%: 0.69–0.99. CTU code blue rates decreased from 2.2/1000 patient days (±1.6 before intervention to 1.2/1000 patient days (±1.3 after intervention (IRR: 0.51, p=0.02 (CI 95%: 0.30–0.89. Conclusion. Our local ward-based response system achieved a significant reduction in the time of patient decompensation to initial intervention, in CTU code blue rates, and in CTU to ICU transfers without necessitating additional usage of financial or human resources.

  2. Weekend versus weekday hospital deaths: Analysis of in‑patient ...

    African Journals Online (AJOL)

    2013-02-15

    patients of a tertiary hospital in Nigeria. Materials and Methods: This is a 10‑year retrospective survey conducted at the Nnamdi Azikiwe University Teaching. Hospital in which the death records of the hospital were accessed from ...

  3. Stroke Among Young Adults at the LAUTECH Teaching Hospital ...

    African Journals Online (AJOL)

    Stroke Among Young Adults at the LAUTECH Teaching Hospital, Osogbo, Nigeria. AF Mustapha, EO Sanya, TO Bello. Abstract. Background: Stroke in young adults is relatively rare and there are very few hospital reports about it in Nigeria. The aetiologic mechanisms of stoke among young adults are quite distinct from ...

  4. Monitoring of Frequency and Antimicrobial Susceptibility of Pathogens on the Hands of Healthcare Workers in a Tertiary Hospital

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    Tselebonis Athanasios

    2016-09-01

    Full Text Available Objective: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward and explore differences between departments, professions and genders.

  5. Iron Deficiency Anaemia and Its Predisposing Causes among Women Undergoing Antenatal Checkup at a Tertiary Care Hospital in Allahabad

    OpenAIRE

    Shweta Rajput1; Manish Kumar Singh2

    2016-01-01

    "Background: Anaemia is a major health problem affecting about 50% of pregnant women and associated with poor pregnancy outcome. Objective: To know the prevalence of iron deficiency anemia in pregnancy and its determinants Method: A hospital based cross sectional study was carried out among 400 pregnant women aged >16 years and and #8804; 45 years with sin-gleton pregnancy attending antenatal care clinic at a tertiary care hospital in Allahabad over a period of 1 year 8 months. ...

  6. A tertiary hospital audit of the use of medical imaging in the 24 h preceding death.

    Science.gov (United States)

    Liu, D; Weil, J; Boughey, M; Sutherland, T

    2016-02-01

    This study aims to investigate the number, modality and indication for imaging studies performed on acute hospital inpatients in the 24 h prior to death. Data were obtained from retrospective analysis of deceased patients from a university affiliated tertiary hospital over a 2-year period and it was found that around one in five inpatients received medical imaging in the last 24 h of their life (364 of 1855, 19.6%). © 2016 Royal Australasian College of Physicians.

  7. Epidemiology of road traffic injury patients presenting to a tertiary hospital in Hyderabad, India.

    Science.gov (United States)

    Howley, Isaac W; Gupta, Shivam; Tetali, Shailaja; Josyula, Lakshmi K; Wadhwaniya, Shirin; Gururaj, Gopalkrishna; Rao, Mohan; Hyder, Adnan A

    2017-12-01

    Road traffic injuries kill more people in India than in any other country in the world, and these numbers are rising with increasing population density and motorization. Official statistics regarding road traffic injuries are likely subject to underreporting. This study presents results of a surveillance program based at a public tertiary hospital in Hyderabad, India. All consenting patients who presented to the casualty ward after a road traffic injury over a 9-month period were enrolled. Interviews were performed and data abstracted from clinical records by trained research assistants. Data included demographics, injury characteristics, risk factors, safety behaviors, and outcomes. A total of 5,298 patients were enrolled; their mean age was 32.4 years (standard deviation 13.8) and 87.3% were men; 58.2% of patients were injured while riding a motorcycle or scooter, 22.5% were pedestrians, and 9.2% used motorized rickshaws. The most frequent collision type was skid or rollover (40.9%). Male victims were younger than female victims and were overrepresented among motorized 2-wheeler users. Patients were most frequently injured from 1600 to 2400. A total of 27.3% of patients were admitted. Hospital mortality was 5.3%, and 48.2% of deaths were among motorized 2-wheeler users. This is one of the few prospective, hospital-based studies of road traffic injury epidemiology in India. The patient population in this study was similar to prior hospital-based studies. When compared to government surveillance systems, this study showed motorized 2-wheeler users to be more frequently represented among the overall population and among fatalities. Further research should be done to develop interventions to decrease mortality associated with 2-wheeled vehicles in India. Copyright © 2017. Published by Elsevier Inc.

  8. Pseudomonas aeruginosa: evaluation of pathogen burden and drug-resistance trends in a tertiary care hospital

    International Nuclear Information System (INIS)

    Saeed, M.; Hussain, S.; Ahmad, A.

    2018-01-01

    To evaluate the pathogen burden and antibiotic-resistance trends of Pseudomonas aeruginosa among hospitalised patients at a tertiary care hospital. Study Design:Retrospective, hospital record-based, cross-sectional study. Place and Duration of Study:Microbiology Laboratory, Allama Iqbal Medical College/Jinnah Hospital, Lahore, from January 2014 to December 2016. Methodology:A total of 5,960 samples were collected from clinically suspected cases of bacterial infections, admitted to the hospital. Microbial identification and antibiotic susceptibility pattern were carried out and analysed. Results:Out of a total of 5,960 samples, Pseudomonas aeruginosawas isolated from 1,268 (21.2%) specimens. Department-wise isolation rate was n=600 (42.9%), n=268 (15.4%), n=201 (12.6%), and n=199 (16.0%) from intensive care unit (ICU), surgical units, medical units, and Gynae wards, respectively (p<0.0001). Sample-wise isolation rate was, wound swabs n=448 (35%), urine n=356 (28%), sputum n=187 (14 %), tracheal aspirate n=127 (10%), blood n=99 (7%), and broncho-alveolar lavage n=51 (4%) (p<0.0001). Drug-resistance pattern showed low rates for carbapenems (meropenem n=440 (35%), Imipenem n=436 (34%) and beta-lactam + beta-lactamase inhibitor combination (piperacillin+ tazobactam n=437 (34%) while alarming rates were observed for cephalosporins (ceftazidime n=716 (56%), fluoroquinolones (ciprofloxacin n=690 (54%), cefoperazone+sulbactam n=685 (54%), aminoglycosides (gentamicin, n=669 (53%), amikacin n=608 (48%), and monobactams (aztreonam n=666 (52%). Decreasing trend was observed only for amikacin 63% to 37%, aztreonam showed similar pattern throughout, while there was an increasing trend of drug resistance in all groups of antibiotics. Conclusion:Emerging drug-resistant strains of Pseudomonas aeruginosaare probably linked to the injudicious use of antibiotics, leading to ineffective empirical therapy. Therefore, we suggest that culture and antimicrobial susceptibility testing should

  9. Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China.

    Science.gov (United States)

    Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping

    2017-01-01

    Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.

  10. Spectrum of neonatal admissions and their outcome in a tertiary care hospital

    International Nuclear Information System (INIS)

    Yasmeen, S.; Waheed, K.A.I.; Gul, R.

    2017-01-01

    Objective: To study the spectrum of neonatal admissions and their outcome in a tertiary care hospital. Study Design: A descriptive observational study. Place and Duration of Study: The study was conducted in Neonatal Unit of The Children's Hospital and Institute of Child Health, Lahore for a period of one year from 1st Jan 2015 to 31st Dec 2015. Material and Methods: Data of all admitted patients during the study period were reviewed and analysed in terms of gender, gestational age, age at presentation, weight, cause of admission and their outcome. Neonates with incomplete data were excluded subsequently. Diagnosis were made on clinical examination, radiological findings and laboratory investigations. Data were analysed using SPSS version 20. Results: Out of 11427 neonates admitted during the study period, 397 were excluded because of deficient record. Of the 11030 neonates males were 7673 (69.6%) and females were 3353 (30.4%). Full-term neonates were 8123 (73.64%) while preterm were 2907 (26.35%). Low birth weight (LBW) babies were 5636 (51.1%). Newborns presented within first 24 hours of life were 1478 (13.4%). Birth asphyxia 3518 (31.89%) was the most common cause of hospital admissions followed by prematurity 2907 (26.36%) and neonatal sepsis 1865 (16.91%). Out of 11030 babies, 7055 (64%) were discharged, 2805 (25.4%) left against medical advice and 1170 (10.6%) neonates expired. Highest number of deaths was because of prematurity 469 (39.32%) followed by asphyxia neonatorum 359 (30.68%) and neonatal sepsis 180 (15.38%). Conclusion: Birth asphyxia, prematurity and sepsis constitute three fourths of hospital admissions in our neonatal unit. Most common cause of mortality was prematurity followed by birth asphyxia and neonatal sepsis. (author)

  11. Analysis of functioning and efficiency of a code blue system in a tertiary care hospital.

    Science.gov (United States)

    Monangi, Srinivas; Setlur, Rangraj; Ramanathan, Ramprasad; Bhasin, Sidharth; Dhar, Mridul

    2018-01-01

    "Code blue" (CB) is a popular hospital emergency code, which is used by hospitals to alert their emergency response team of any cardiorespiratory arrest. The factors affecting the outcomes of emergencies are related to both the patient and the nature of the event. The primary objective was to analyze the survival rate and factors associated with survival and also practical problems related to functioning of a CB system (CBS). After the approval of hospital ethics committee, an analysis and audit was conducted of all patients on whom a CB had been called in our tertiary care hospital over 24 months. Data collected were demographic data, diagnosis, time of cardiac arrest and activation of CBS, time taken by CBS to reach the patient, presenting rhythm on arrival of CB team, details of cardiopulmonary resuscitation (CPR) such as duration and drugs given, and finally, events and outcomes. Chi-square test and logistic regression analysis were used to analyze the data. A total of 720 CB calls were initiated during the period. After excluding 24 patients, 694 calls were studied and analyzed. Six hundred and twenty were true calls and 74 were falls calls. Of the 620, 422 were cardiac arrests and 198 were medical emergencies. Overall survival was 26%. Survival in patients with cardiac arrests was 11.13%. Factors such as age, presenting rhythm, and duration of CPR were found to have a significant effect on survival. Problems encountered were personnel and equipment related. A CBS is effective in improving the resuscitation efforts and survival rates after inhospital cardiac arrests. Age, presenting rhythm at the time of arrest, and duration of CPR have significant effect on survival of the patient after a cardiac arrest. Technical and staff-related problems need to be considered and improved upon.

  12. Clinical and microbiological profile of a retrospective cohort of enteric fever in 2 Spanish tertiary hospitals.

    Science.gov (United States)

    Sánchez-Montalvá, Adrián; Martínez-Pérez, Ángela; Pérez-Molina, José Antonio; González-López, Juan José; Lopez-Vélez, Rogelio; Salvador, Fernando; Sánchez, Irene; Planes, Anna M; Molina, Israel

    2015-05-01

    Enteric fever in high-income countries is diagnosed mainly in patients returning from endemic countries. We assess the clinical, microbiological, and prognosis aspects of enteric fever in 2 Spanish tertiary hospitals. A retrospective observational study was conducted at Vall d'Hebron University Hospital and Ramón y Cajal University Hospital in Spain. We reviewed medical records of all patients who were diagnosed with enteric fever from January 2000 to January 2014 at these hospitals. We identified 47 patients with enteric fever episodes. According to their travel history, 35 (74.5%) patients had travelled to highly endemic countries. Imported enteric fever was acquired mainly in Asia (70.3%). Imported infections were implicated in travelers (48.6%), visiting friends and relatives (40%) and immigrants (11.4%). We found that 12 patients were diagnosed with enteric fever without a travel history (autochthonous infection). The resistance profile of the isolates showed decreased ciprofloxacin susceptibility in 66.7% of the imported group and 8.3% of the autochthonous group (P = 0.001). Salmonella strains from patients returning from Asia had an increased risk of having decreased ciprofloxacin susceptibility (odds ratio, 52.25; 95% confidence interval: 8.6-317.7). Patients with imported enteric fever are at higher risk for having a Salmonella strain with decreased ciprofloxacin susceptibility, especially in patients returning from Asia. Initial treatment with third-generation cephalosporin or azithromycin is strongly recommended until a drug-susceptibility test is available. Prevention strategies such as pretravel counseling and immunization before travel may be beneficial.

  13. A retrospective review of snake bite victims admitted in a tertiary ...

    African Journals Online (AJOL)

    Objective: Snake bite remains major public health problem worldwide. We present our experience with cases of snake bites managed in our tertiary care teaching center of South India. Materials and Methods: The details of all patients with snake bite admitted to a tertiary teaching care hospital from 2010 to 2012 were ...

  14. Evaluation of the appropriateness of imipenem/cilastatin prescription and dosing in a tertiary care hospital

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    Kabbara WK

    2015-03-01

    Full Text Available Wissam K Kabbara, George T Nawas, Wijdan H RamadanDepartment of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon Background: Imipenem/cilastatin is an antibacterial agent of the carbapenem class of β-lactams that is known to have an extremely wide spectrum of activity against Gram-positive, Gram-negative, aerobic, anaerobic, and even multidrug-resistant strains. The objective of this study was to evaluate the appropriate use of imipenem/cilastatin in a local tertiary care hospital. The study assessed the indication both empirically and after the culture results were available, the dose and dose adjustment in renal failure, as well as the incidence of seizure in hospitalized patients receiving imipenem/cilastatin. Methods: This observational study was conducted in a tertiary care hospital over a 3-month period. The treatment of 100 patients with imipenem/cilastatin was evaluated both empirically and after culture results were available. Analysis of the appropriateness of imipenem/cilastatin indication, dose, and monitoring of seizure frequency was based on the package insert, updated published guidelines, and clinical judgment. Results: Patients from internal medicine and intensive care units comprised approximately 50% of the population in the study. The patients received imipenem/cilastatin mainly for urinary tract infections (27% or for sepsis of an unknown focus (22%. The use of imipenem/cilastatin empirically was appropriate in 97.2% (n=69/71 of the cases, and its use postculture in 86% of the cases. There were 29% of the patients who were not started on imipenem/cilastatin empirically. Four patients out of the 29 patients (13.8% who were not started on imipenem/cilastatin empirically inappropriately received imipenem/cilastatin post-culture results. Thirty-three patients (33% were not dosed appropriately, 30 of whom had renal impairment and creatinine clearance fluctuations. Only one patient developed a

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital

    Directory of Open Access Journals (Sweden)

    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.

  18. An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa

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    Clare A. Surridge

    2017-03-01

    Objectives: To perform an audit of the UGCNB biopsies performed at the Grey’s Hospital Mammography Department and assess the accuracy of the radiologists’ use of the BI-RADS scoring system. Methods: Records of all patients who underwent UGCNB biopsy between 01 January 2014 and 31 October 2015 were reviewed. A retrospective study was performed. Results: A total of 304 UGCNB biopsies were performed on 291 patients. The mean age was 49.2 (s.d. = 15.9 years. Tissue samples from 303 lesions were adequate for histological assessment, and of these, 51% of the lesions were malignant whilst 49% were benign. The most common malignant and benign diagnoses were invasive ductal carcinoma and fibroadenoma respectively. The BI-RADS scoring of the radiologists demonstrated a positive predictive value of 61.6% for the identification of possible malignant lesions. Conclusion: This study describes the patient and lesion profile and unit practices in a tertiary hospital setting in South Africa. The radiologists’ application of the BI-RADS scoring largely conforms to the BI-RADS guidelines. The study highlights several challenges encountered by a breast imaging programme in an under-resourced setting as well as making recommendations in overcoming these challenges.

  19. Antibacterial susceptibility patterns of methicillin resistant staphylococcus spp. from a tertiary reference hospital

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    Çiğdem Karabıçak

    2012-03-01

    Full Text Available Objectives: Methicillin resistant Staphylococcus strainsstill remain as an important reason of hospital acquiredinfections. The aim of this study to see the antimicrobialsensitivity patterns of these strains for effective empiricaltherapyMaterial and methods: Antibiotic susceptibility resultsof staphylococcus strains were investigated retrospectivelyfrom tertiary reference hospital. 276 methicillin resistantstaphylococcus species, which were isolated fromKırıkkale University Faculty of Medicine Department of InfectiousDisease and Clinical Microbiology laboratory betweenNovember 2009-2010 were enrolled in this study.Identification and antibiotic susceptibilities of the strainswere evaluated by using Vitek automated systems (bioMerieux.Results: Most of these strains were isolated from blood(49% and wound (40 % samples. There was no glycopeptideresistance established from 276 strains. Susceptibilitypercents of these strains to linezolid and erythromycinwere 97% and 16% respectively.Conclusions: we believe that, informing physiciansabout antibiotic susceptibility patterns of methicillin resistantstaphylococcus species will be helpful for effectivetreatment and control the spread of these infections. JClin Exp Invest 2012; 3(1: 71-74

  20. Initiation of a medical toxicology consult service at a tertiary care children's hospital.

    Science.gov (United States)

    Wang, George Sam; Monte, Andrew; Hatten, Benjamin; Brent, Jeffrey; Buchanan, Jennie; Heard, Kennon J

    2015-05-01

    Currently, only 10% of board-certified medical toxicologists are pediatricians. Yet over half of poison center calls involve children toxicology consultation is not common at children's hospitals. In collaboration with executive staff from Department of Pediatrics and Emergency Medicine, regional poison center, and our toxicology fellowship, we established a toxicology consulting service at our tertiary-care children's hospital. There were 139 consultations, and the service generated 13 consultations in the first month; median of 11 consultations per month thereafter (range 8-16). The service increased pediatric cases seen by the fellowship program from 30 to 94. The transition to a consult service required a culture change. Historically, call center advice was the mainstay of consulting practice and the medical staff was not accustomed to the availability of bedside medical toxicology consultations. However, after promotion of the service and full attending and fellowship coverage, consultations increased. In collaboration with toxicologists from different departments, a consultation service can be rapidly established. The service filled a clinical need that was disproportionately utilized for high acuity patients, immediately utilized by the medical staff and provided a robust pediatric population for the toxicology fellowship.

  1. 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.

  2. Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital.

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    Pang, Feng; Jia, Xiu-Qin; Song, Zhen-Zhu; Li, Yan-Hua; Wang, Bin; Zhao, Qi-Gang; Wang, Chuan-Xin; Zhang, Yi; Wang, Le-Xin

    2016-03-01

    The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012. The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype. Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged. It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting.

  3. Patient Complaints Emphasize Non-Technical Aspects of Care at a Tertiary Referral Hospital

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    John King

    2017-03-01

    Full Text Available Background:Patient concerns represent opportunities for improvement in orthopaedic care. Thisstudy’s objectiveis to identify the nature and prevalence of unsolicited patient complaints regarding orthopaedic care ata tertiary referral hospital. The primary null hypothesis that there are no demographic factors associatedwith complaint types was tested. Secondarily we determined if the overall complaint number and typesdifferedby year.Methods:Complaints to the hospital ombudsperson by orthopaedic patients between January 1997 and June 2013 werereviewed. All 1118 complaints were categorized: access and availability, humaneness and disrespect, communication,expectations of care and treatment, distrust, billing and research.Results:Patients between 40 and 60 years of age filed the most complaints in all categories except distrust(more common in patients over age 80 and research. Women were slightly more likely to address access andavailability, humaneness, disrespect, and billing compared to men. The overall number of complaints peakedin 1999. The most common issue was access and availability followed by communication, and humaneness/disrespect.Conclusion:Half of concerns voiced by patients addressed interpersonal issues. The largest category was related toaccess and availability. Quality improvement efforts can address technology to improve access and availability as wellas empathy and communication strategies.

  4. Depression and anxiety in cancer patients in outpatient department of a tertiary care hospital in Pakistan

    International Nuclear Information System (INIS)

    Dogar, I.A.; Azeem, M.W.; Kiran, M.; Hussain, I.; Mehmood, K.; Hina, I.

    2010-01-01

    Objective: To examine the prevalence of depression and anxiety in patients with cancer in an outpatient department of a tertiary care hospital in Pakistan. Methodology: This study was conducted between May 2006 and January 2007. The sample consisted of 60 diagnosed cancer patients (30 males/30 females). DSM- IV criteria and Hospital Anxiety and Depression Scale (HADS) were used to diagnose and assess anxiety and depression. Results: Fifty two percent (31 patients, 10 males/21 females) of the subjects reported having symptoms of anxiety, depression or both according to DSM IV Criteria, (anxiety =14, males six / females eight, depression = 6, males two / females four , and depression + anxiety both = 11, males two / females nine). A total of 70% (21/30) of the entire female sample met the criteria for depression, anxiety or both. A total of 33% (10/30) of the entire male sample met the criteria for depression, anxiety or both. Conclusion: This study shows high prevalence rates of depression and anxiety in cancer patients in Pakistan. The oncologists and internists treating cancer patients should screen their patients for symptoms of depression and anxiety. (author)

  5. 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.

  6. An epidemiological study of road traffic accident cases admitted in a tertiary care hospital.

    Science.gov (United States)

    Pathak, S M; Jindal, A K; Verma, A K; Mahen, A

    2014-01-01

    Road traffic accidents are a leading cause of mortality and morbidity globally. In India, more than a million are injured annually and about a lakh are killed in road traffic accidents.(1) It causes the country to lose around 55,000 crores annually which is 2-3% of Gross Domestic Production (GDP).(2) This cross sectional study was conducted to elucidate the role of various factors involved in road traffic accidents. Road traffic accident cases admitted to a tertiary care hospital between 01 Oct 2009 and 28 Feb 2011 were included in the study. A total of 182 patients were studied. Information was collected through questionnaire, hospital records and on-site visit. OPD cases, comatose patients and deaths were excluded. Two-wheelers were the commonest vehicle involved in vehicular accidents. Most accidents happened at a speed of 40-60 km/h (37.9%). Most of the patients were aged between 20 and 30 years. Majority had a driving experience of less than 5 years. Monsoons witnessed 46.7% cases. Most cases occurred between 6 and 10 pm. Among severe injuries, the commonest was lower limb fractures (19.8%). There are multiple factors associated with road traffic accidents which due to the lack of road safety measures in the country are playing their role. It is the need of the hour to address this issue and formulate comprehensive, scientific and practical rules and regulations as well as evaluate its enforcement.

  7. Presentations and Outcome of Thyroiditis from a Tertiary Care Hospital of Karachi.

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    Mahar, Saeed Ahmed; Shahid, Muhammad; Sarfaraz, Aqiba; Shaikh, Zuhaib-u-Ddin; Shaikh, Shiraz; Shahid, Nadia

    2015-10-01

    To assess the clinical presentations and short-term outcomes of patients with thyroiditis presenting to a tertiary care hospital in Karachi, Pakistan. Case series. Department of Endocrinology, Liaquat National Hospital, Karachi, from June 2014 to February 2015. Patients between 18 and 70 years of age with acute onset of thyroiditis confirmed on thyroid scan or clinical judgment presenting to the outpatient services were included in the study. Pregnant females, psychiatric patients and patients having other chronic illnesses were excluded from the study. A total of 26 patients with thyroiditis attended the endocrine clinic. Mean age of patients was 41.2 ± 11.12 years. There were 18 (69.2%) females. Clinical presentations were fever (65.4%), tender neck (23.1%), goiter (19.2%), localized tenderness in neck and palpable lymph nodes (26.9%). Major symptoms reported were: sore throat (69.2%), weight loss (38.5%), upper respiratory tract infection, thyroid pain, tremor, sweating and fever of unknown origin in 26.9% cases. All the patients had raised Erythrocyte Sedimentation Rate (ESR). Low Thyroid Stimulating Hormone (TSH) 1.8 ng/dL. Complete recovery was seen in 88.5% patients while 11.5% had early hypothyroidism. Fever and sore throat were the main presenting features of thyroiditis patients. ESR was raised in all patients. A majority of patients had complete recovery with appropriate management; however, few cases developed hypothyroidism.

  8. PAEDIATRIC POSTERIOR FOSSA TUMORS: A CLIN ICO - PATHOLOGICAL STUDY I N A TERTIARY CARE HOSPITAL

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    Raja Sekhar Kennedy

    2015-09-01

    Full Text Available INTRODUCTION: Tumors of the Central Nervous S ystem , are the second commonest childhood tumors and are the most common solid paediatric tumors comprising 40% - 50% of all tumors . 1 2 Posterior fossa brain tumors are one of the most devastating forms of human illnesses wh ich are more common in children. AIMS AND OBJECTIVES : To study the incidence, clinicopathological features and management of paediatric posterior fossa tumors. MATERIALS AND METHOD S : This is a prospective study done in the Department of Neurosurgery, Ranga raya Medical College, Government General Hospital, Kakinada from 2012 to 2015. It is a Tertiary Care Hospital. A total of 25 paediatric patients ranging from infants to 15 years were included in the study. DISCUSSION AND CONCL USION: Posterior fossa tumors are the commonest solid brain tumors of children with a rate of 2.4 per lakh of children at risk per year. The predominant symptoms are headache and vomiting followed by cerebellar symptoms (gait disturbances. Posterior fossa tumors are predominantly seen in children with peak incidence in first decade. Commonest presenting symptoms are due to raised intracranial pressure with headache and vomiting followed by cerebellar symptoms. Meticulous microsurgical techniques are to be followed in removing these tum ors. The incidence of recurrence is very less after gross total excision. Prognosis is good in patients with total excision

  9. How Do Patients Perceive and Expect Quality of Surgery, Diagnostics, and Emergency Services in Tertiary Care Hospitals? An Evidence of Gap Analysis From Pakistan

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    Iram Fatima

    2017-07-01

    Full Text Available Objectives: Service quality is one of the important gears to appraise services and determine the gray areas that need improvement. In countries with a resource-poor health system, the first step of measuring quality is yet to be taken. This study seeks to inform policy makers in developing contextual service quality models by identifying service quality gaps in tertiary care teaching hospitals using patients’ perspective. Methods: A cross-sectional study was performed using multistage cluster sampling, and a modified version of the SERVQUAL (SERV-service, QUAL-quality instrument was administered to determine patient’s expectations and perceptions. A total of 817 completed questionnaires were obtained from patients and/or their attendants using convenience sampling. Results: Data analysis revealed statistically significant negative quality gaps between expectations and perceptions of tangibility, reliability, empathy, assurance, responsiveness, and communication. The difference in mean expectation and perception for responsiveness across the sexes was significant (p < 0.003; p < 0.037, respectively as well as in perception of communication (p < 0.026. Other dimensions and overall hospital expected and perceived quality were independent of sex. Educational status showed significant difference in expectation and perception in responsiveness (p < 0.005, but the perception of each dimension was significantly different in different educational categories (assurance: p < 0.001; empathy: p < 0.001; reliability: p < 0.001; tangibility: p < 0.001; responsiveness: p < 0.001; communication: p < 0.001; and for overall service quality: p < 0.001. Age and service departments showed no relationship with any of the perceived or expected dimension of service quality of hospitals. Conclusions: Tertiary care hospitals failed to meet patients’ expectations in all major areas of service quality, posing a question of how hospitals implement and evaluate their

  10. Spectrum Of Opportunistic Infections In Aids Cases In A Tertiary Care Hospital In Nepal

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    Hari Shanker Joshi

    2006-12-01

    Full Text Available A retrospective study was carried out, 404 clinically suspected cases attending AIDS clinic at Manipal Teaching Hospital, Pokhara, Nepal to assess an occurance of opportunistic infections in AIDS cases. Study reveals that Tuberculosis (60%, Cryptospridiosis (13.33% and candidasis (11.11% are the predominant opportunistic infection in HIV/AIDS patients in the Pokharo village. Next common pathogen was found an ubiquitous yeast. Candida obtained from skin, oral cavity, oesophagus, sputum and stool. The least common documented documented infection was pneumocystis carini pneumonia (2.22%.

  11. [Governance of tertiary referral hospitals in the Democratic Republic of the Congo: a critical interpretive synthesis of the literature].

    Science.gov (United States)

    Karemere, H; Kahindo, J B; Ribesse, N; Macq, J

    2013-01-01

    Because hospitals are complex enterprises requiring adaptive systems, it is appropriate to apply the theory and terminology of governance or even better adaptive governance to the interpretation of their management. This study focused on understanding hospital governance in Logo, Bunia, and Katana, three hospitals in two regions of the eastern DRC, which has been characterized by intermittent armed conflict since 1996. In such a context of war and continuous insecurity, how can governance be interpreted for hospitals required to adapt to a constantly changing environment to be able to continue to provide health care? A critical interpretive synthesis of the literature, identified by searching for keywords related to governance. The concepts of governance, adaptive governance, performance, leadership, and complex adaptive system concepts are defined. The interpretation of the concepts helps us to better understand (1) the hospital as a complex adaptive system, (2) the governance of tertiary referral hospitals, (3) analysis of hospital performance, and (4) leadership for good governance of these hospitals. The interpretation of these concepts raises several questions about their application to the eastern DRC. Conclusion. This critical interpretive synthesis opens the door to a new way of exploring tertiary hospitals and their governance in the eastern DRC.

  12. 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

  13. Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

    Science.gov (United States)

    Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

    2013-01-01

    Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain

  14. 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.

  15. Distribution and predictors of emergency department charges: the case of a tertiary hospital in Lebanon.

    Science.gov (United States)

    Saleh, Shadi; Mourad, Yara; Dimassi, Hani; Hitti, Eveline

    2016-03-18

    As health care costs continue to increase worldwide, health care systems, and more specifically hospitals are facing continuous pressure to operate more efficiently. One service within the hospital sector whose cost structure has been modestly investigated is the Emergency Department (ED). The study aims to report on the distribution of ED resource use, as expressed in charges, and to determine predictors of/contributors to total ED charges at a major tertiary hospital in Lebanon. The study used data extracted from the ED discharge database for visits between July 31, 2012 and July 31, 2014. Patient visit bills were reported under six major categories: solutions, pharmacy, laboratory, physicians, facility, and radiology. Characteristics of ED visits were summarized according to patient gender, age, acuity score, and disposition. Univariate and multivariate analyses were conducted with total charges as the dependent variable. Findings revealed that the professional fee (40.9 %) followed by facility fee (26.1 %) accounted for the majority of the ED charges. While greater than 80 % of visit charges went to physician and facility fee for low acuity cases, these contributed to only 52 and 54 % of the high acuity presentations where ancillary services and solutions' contribution to the total charges increased. The total charges for males were $14 higher than females; age was a predictor of higher charges with total charges of patients greater than 60 years of age being around $113 higher than ages 0-18 after controlling for all other variables. Understanding the components and determinants of ED charges is essential to developing cost-containment interventions. Institutional modeling of charging patterns can be used to offer price estimates to ED patients who request this information and ultimately help create market competition to drive down costs.

  16. Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

    Science.gov (United States)

    Iu, L Pl; Lai, C Hy; Fan, M Cy; Wong, I Yh; Lai, J Sm

    2017-02-01

    Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong. This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied. The mean (± standard deviation) gestational age at birth was 30 +2 weeks ± 16.5 days (range, 24 +1 to 35 +5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (Pprematurity, all regressed successfully after one laser treatment. Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

  17. Frequecy of different causes of upper gastrointestinal bleeding using endoscopic procedure at a tertiary care hospital

    International Nuclear Information System (INIS)

    Sher, F.; Ullah, R.S.; Khan, J.

    2014-01-01

    To assess the outcome of early endoscopy in terms of frequency of different causes of upper Gastrointestinal bleeding at a tertiary care hospital.Study Design: Cross sectional descriptive study. Place and Duration of Study: Outpatients / indoor patients, Department of Medicine Military Hospital Rawalpindi from 1st Jan 2010 to 30th June 2010. Patients and Methods: Study was carried out in department of medicine Military Hospital Rawalpindi. Two hundred and forty four after cosen. Patients of upper gastrointestinal bleeding fulfilling the inclusion criteria were included in the study. Haemodynamically stable patients were kept empty stomach for at least 6 -8 hours before procedure. A detailed history and thorough physical examination was carried out. Protocols for endoscopic examination were followed. Mandatory baseline investigations were obtained. Endoscopic findings were documented on a proforma. pvalue of less than 0.05 was considered statistically significant. Results: There were 174 males (71.3%) and 70 females (28.7%). The age of the patients ranged from 15 years to 75 years, mean age was 52.23 years (SD = 14.78). The most common cause of upper GI bleed was varices in 176 (72.1%) patients; followed by gastric ulcer in 24 (9.8%) patients. Other causes in order of decreasing frequency included gastritis 16(6.55%), duodenal ulcer 14(5.73%), esophagitis 6(2.45%), Mallory Weiss tear 2(0.81%) and miscellaneous 6(2.45%). Conclusion: Esophageal varices is the most common cause of upper GI bleed in our set up reflecting high prevalence of liver cirrhosis secondary to chronic HBV and HCV infection. (author)

  18. 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.

  19. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    Science.gov (United States)

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  20. Beta-Lactam Antibiotic Sensitization and Its Relationship to Allergic Diseases in Tertiary Hospital Nurses

    Science.gov (United States)

    Han, Eui-Ryoung; Lim, Seong-Wook; Lim, Seong-Ryoon; Kim, Ji-Na; Park, Sin-Young; Chae, Su-Kyoung; Lim, Hye-Hyeun; Seol, Young-Ae; Bae, You-In; Won, Young-Ho

    2010-01-01

    Purpose Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics. Methods All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded, 427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the β-lactam antibiotics cefotiam, cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G. Results A positive response to at least one of the antibiotics occurred in 8 (2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427 nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, χ2=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4 versus 7.4%, χ2=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, χ2=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00, OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy. Conclusions Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy. PMID:20358025

  1. 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

  2. PROFILE OF POISONING CASES IN A TERTIARY CARE HOSPITAL , TELANGANA , INDIA

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    Naresh

    2015-05-01

    Full Text Available BACKGROUND : Poisoning with various substances is an important cause of death and disability worldwide . The types of poisons that are encountered in the emergency medicine departments encompass a wide range of substances . Apparently , geographic location , socio - demographic factors , ease of availability of poisons and many other cryptic factors contribute to the wide spectrum of substances that cause poisoning . Pesticides , drugs and chemicals are reported to be the most commo nly used poisons in India . Management of poisoning is quite challenging for the health care professionals globally . Factors such as the uncertainty in the identification of allegedly consumed poison , varied clinical features and the need for timely access to specific information for treatment , complicates poisoning management . This study was therefore conducted to explore the clinical features , management and outcomes of poisoning cases reporting to a tertiary care centre in south India . OBJECTIVE : To ident ify the spectrum of poisons and evaluate their clinical manifestations , medical management and clinical outcomes . METHODOLOGY : All cases of poisoning that were reported at a tertiary care hospital in South India for a period of 18 months from January 1 , 20 13 to June 30 , 2014 were included in this study . A data abstraction sheet was designed to document demographic details ( age and gender , poison consumed , duration of stay in the hospital , clinical features , treatment administered , need for life support and patient outcomes . RESULTS : A total of 145 poisoning cases were reported during the study period . Among them , 58 . 5% were males and 41 . 3% were females . Majority of victims were in the age group of 21 - 30 years . Intentional poisoning was observed in 86 . 2% , whereas the rest were accidental poisonings . Organophosphorus ( OP poisoning was the most common poisoning encountered in this study . It accounted for 25 . 5% of the total

  3. Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals

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    Nahid Sherbini

    2014-01-01

    Full Text Available Background : Idiopathic pulmonary fibrosis (IPF is rare and can be challenging to diagnose. Limited data is available from the Middle Eastern region, especially Saudi Arabia. Methods: This was a retrospective study that looked at all the patients diagnosed with IPF between 2007 and 2012 at two tertiary care hospitals in Saudi Arabia. We collected the demographical, clinical, laboratory and radiological data from the patients′ medical records. Medications administered and 1 year survival was also assessed. Results : Between 2007and 2012, 134 IPF patients were identified. Their baseline characteristics (Mean ± SD included: age 64 ± 13 years, body mass index 29 ± 8 kg/m 2 , FEV 1 56 ± 15 percent of predicted, FVC 53 ± 13 percent of predicted, FEV 1 /FVC 0.81 ± 0.09, total lung capacity 75 ± 13 percent of predicted, diffusing capacity of the lung for carbon monoxide 57 ± 15 percent of predicted, on home oxygen at presentation 71 (53%, mean ejection fraction 0.50 ± 0.07, mean pulmonary artery systolic pressure (via echocardiogram 40 + 22 mmHg, presentation mean S pO2 92 ± 7%, presentation 6-min walk distance 338 ± 64 m and lowest S pO2 during 6-min walk test 88 ± 5%. Patients were predominantly female (56%, and 42% of patients had diabetes and were active smokers. The IPF patients′ frequency of hospital admission (n = 99 was 2.4 ± 1.7 per year and duration of hospital stay (n = 99 was 17.4 ± 23.8 days. Overall 1 year survival in all IPF patients was good, 93% (124 patients remained alive after 1 year. Conclusions : In Saudi Arabia, IPF patients tended to be slightly older and the disease progression was somewhat slower than reported IPF cohorts in other populations. They had frequent hospital admissions and a long hospital length of stay. The influence of genetics and co-morbid diseases on the incidence and outcome of IPF should be explored further.

  4. Service quality of diagnostic fine needle aspiration cytology in a tertiary care hospital of lahore

    International Nuclear Information System (INIS)

    Rizvi, Z.; Usmani, R.A.; Zahra, T.; Rasool, H.; Rizvi, A.

    2017-01-01

    Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. Methods: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely procedure, sterilization, conduct and competency of doctor was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was =60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05) Results: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05) Conclusion: The study suggests that service quality of

  5. 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

  6. Prevalence and characterization of rotaviruses in children hospitalized for diarrheal disease in a tertiary care hospital, Pune

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    Sae Satish Pol

    2017-01-01

    Full Text Available Background: Diarrhoea remains the second most common cause of death among children below 5 years globally. Among various enteric pathogens, rotavirus appears to be the most important aetiological agent of acute gastroenteritis in infants and young children. Increased understanding of epidemiology of rotavirus infections is needed to improve the vaccine efficacy. Aim: This study aims to determine prevalence rotavirus infection and prevalent circulating strains of rotavirus in and around Pune. Setting and Design: Prospective hospital-based study. The study was approved by Institutional Ethical Committee. Materials and Methods: Stool samples (n = 100 were collected from children aged <5 years, hospitalised for acute diarrhoea in paediatric ward at a tertiary care hospital. Samples were subjected for rotavirus antigen capture ELISA. The viral RNA was subjected to multiplex reverse transcription polymerase chain reaction to amplify VP7 genotypes G1–G4, G8–G10 and G12 and VP4 genotypes P[4], P[6], P[8], P[9], P[10] and P[11]. Nontypable rotavirus strains were sequenced. Results: About 35% stool samples were positive for rotavirus antigen by ELISA. G9P[4] (28.6% was found to be the most prevalent rotavirus strain. The detection of emerging strain G12P[6] (14.3% and rare reassortant strain G9P[4] was the significant finding. Conclusion: Genotypes found in circulation are not present in the currently used vaccine. Thus, an emergence of newer genotypes over a period calls for the continued surveillance and genomic characterisation of rotaviruses to improve the vaccine efficacy.

  7. The impact of parental alcohol dependence on the development and behavior outcome of children in a tertiary care hospital

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    Jasmeet Sidhu

    2016-01-01

    Full Text Available Parents play a pivotal role in upbringing a child and shaping their future. However, children of alcoholics (COAs suffer due to their parent′s dependence pattern. The various domains affected encompass cognitive, behavioural, psychological, emotional and social spheres. This study was designed to assess the impact of alcohol dependence in the parent on the development and behavior of their children, so that further steps could be taken to minimize the negative influences. Aims: To study the impact of parental alcohol dependence on the development and behaviour outcome of children in various domains, alongwith the effect of the family environment. Materials and Methods: The study was a cross-sectional observational study conducted at a tertiary care teaching hospital on 25 children between 6 and 18 years of age, whose atleast one parent was diagnosed as alcohol dependant. The other parent was assessed using a general health questionnaire-28. Child behaviour checklist and family evaluation scale (FES were then applied. Statistical Analysis Used: The analysis was done according the manuals provided with the respective scales to calculate the score. Results: Both male and female COAs had high externalizing and internalizing scores. The girls have higher internalizing scores while the boys of such parents have higher externalizing scores. The FES showed dysfunction in all the three dimensions, namely the relationship, personal growth and the system maintenance. Conclusions: Our study corroborates the findings of the studies done in the past on COAs. The COAs face various affective, anxiety, somatic, attention deficit/hyperactivity, oppositional defiant conduct problems.

  8. Knowledge and perception of human papilloma virus vaccine among the antenatal women in a Nigerian tertiary hospital.

    Science.gov (United States)

    Agida, Teddy E; Akaba, Godwin O; Isah, Aliyu Y; Ekele, Bissalla

    2015-01-01

    Cervical cancer is a major health problem globally, especially in sub-Saharan Africa, Nigeria inclusive. One of the preventive measures is the vaccination of teenagers against oncogenic human papilloma virus. The aim of this study was to find out the level of knowledge mothers possess about these vaccines and their willingness to administer vaccination to their teenage girls. This was a cross-sectional descriptive study of 255 consecutive women attending antenatal clinic at the University of Abuja Teaching Hospital, Abuja. They were given either a self-administered questionnaire or interviewer-administered questionnaire containing both closed and open-ended questions. Information recorded includes socio-demographic variables, knowledge of cervical cancer, knowledge of HPV/HPV vaccines and acceptance of these vaccines for their adolescent girls. The data was analysed using descriptive statistics. The mean age of the respondents was 26.9 years. Over 90% had at least secondary education. A total of 102 (40%) had the knowledge of cancer of the cervix while 153 (60%) had never heard about it. Overall, 236 (92.5%) of them had no idea about the predisposing factors. The study showed that only 23 (9.0%) out of the total respondents had heard about human papilloma virus (HPV) infection. In the same vein, 20 (7.8%) had knowledge about HPV vaccine. Among the respondents, who had the knowledge of HPV and vaccination, 18.2% and 23.4% of them had secondary and tertiary levels of education respectively. Overall, 160 (62.8%) accepted that the vaccines could be administered to their teenage girls. Awareness of cervical cancer, HPV infections, and HPV vaccines is low among antenatal clinic attendees in Gwagwalada, Abuja. However, majority of them would want their girls vaccinated against HPV infections. There is a need for all stakeholders to step up awareness creation for improved HPV vaccination project in Nigeria.

  9. Unlicensed and off-label use of drugs in pediatric surgical units at tertiary care hospitals of Pakistan.

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    Aamir, Muhammad; Khan, Jamshaid Ali; Shakeel, Faisal; Asim, Syed Muhammad

    2017-08-01

    Background Unlicensed and off-label prescribing practice is global dilemma around the world. This pioneering study was designed to determine unlicensed and off-label use of drug in surgical wards of tertiary care hospitals of Pakistan. Objective To assess unlicensed and off-label use of drugs in pediatric surgical unit at three tertiary care hospitals in Peshawar, Pakistan. Setting Two government and one private tertiary care hospitals in Pakistan. Method Drug profiles of 895 patients from three different clinical settings were evaluated for unlicensed and off-label use of drugs using Micromedex DRUGDEX. Main outcome measure Characteristics of the unlicensed and off-label drug prescriptions. Result Total of 3168 prescribed drugs were analyzed in this study. Indication (38.7%) and dose (34.8%) were the most frequent off-label categories. In comparison with the corresponding reference categories, infants and children, male patients and having less than five prescribed drugs were significant predictors of unlicensed prescriptions. In comparison with the corresponding reference categories, significant predictors of off-label drug prescribing were children younger than two year, children between 2-12 years, patient staying at hospital less than 5 days and patients having less than five prescribed drugs. Conclusion The prevalence of unlicensed and off-label drug prescriptions are high at pediatric surgical ward of tertiary care hospitals. More awareness of the efficacy and safety of drugs are required in pediatrics. In addition, new formulations with advanced dosing for children are also required to minimize the risk of adverse outcomes.

  10. Psychosocial Factors in End-Stage Kidney Disease Patients at a Tertiary Hospital in Australia

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    Charan Bale

    2016-01-01

    Full Text Available Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD from a tertiary hospital in Australia. Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database. Results. Of the 244 patients referred, the majority were >60 years (58.6%, male (60.7%, born in Australia (62.3%, on haemodialysis (51.6%, and reliant on government financial assistance (88%. Adjustment issues (41%, financial concerns (38.5%, domestic assistance (35.2%, and treatment nonadherence (21.3% were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p=0.004, <0.001, and =0.018, resp.. Independent risk factors for treatment nonadherence included age and financial and employment status (p=0.041, 0.052, and 0.008, resp.. Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.

  11. Study of Pancytopenia in a Tertiary Care Hospital in North Karnataka

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    Kulkarni Naveen S

    2017-03-01

    Full Text Available Introduction: Pancytopenia refers to the combination of anaemia, leukopenia and thrombocytopenia. Causes may be due to bone marrow failure, bone marrow infiltration, ineffective haematopoiesis or peripheral pooling/ destruction. A bone marrow aspirate is usually required to establish the diagnosis. Aetiologies of pancytopenia vary from one geographical region to other. Aim: Study of pancytopenia in patients admitted to a tertiary care hospital in north Karnataka. Methods: This study was conducted at SNMC and HSK, Bagalkot. This study was prospective, observational undertaken for 6-month period between July 2016-January 2017. History, physical examination, and primary blood investigations were done in all patients. Selected patients were evaluated with bone marrow examination. Materials: A total of 69 human subjects were enrolled. A thorough history, clinical examination and blood investigations were carried out. Results: Dimorphic anaemia is common than megaloblastic anaemia. Among those subjected for bone marrow megaloblastic anaemia was commoner than dual deficiency bone marrow. Other causes of pancytopenia were malaria, dengue, enteric fever, and less common causes included sepsis, MDS, TB, HIV, SLE. Conclusion: Nutritional anaemia is commonest cause for pancytopenia. This may be due to megaloblastic anaemia or deficiency of iron/vitamin B12/folate combined

  12. Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, Kolkata

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    Abhik Sinha

    2012-01-01

    Full Text Available Introduction : Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. Aims and Objectives: The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants. Materials and Methods: Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predesigned, pretested, semi-structured proforma. Results and Conclusion: More than 90% sought healthcare just after the onset of a seizure. The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A significant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2.98 ± 10.49 months and the chief motivators were mostly the family members. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas. District care model of epilepsy was proposed in the recommendation.

  13. Maternal and foetal outcome in hellp syndrome at tertiary care hospital

    International Nuclear Information System (INIS)

    Sadaf, N.; Haq, G.; Din, S.S.U.

    2013-01-01

    Objective: To determine maternal and foetal outcome in patients of Haemolysis, Elevated Liver enzyme and Low Platelet Cont syndrome. Methods: The descriptive case series was conducted at the Gynae Unit II of Civil Hospital, Karachi, over a period of 12 months in two episodes; first from December 28, 2006, to February 28, 2007, and then from September 1, 2007, to June 30, 2008. It comprised 40 consecutive women with pre-ecampsia and eclampsia along with altered platelet count who met the syndrome criteria. A pre-designed proforma was administered for data collection. Maternal and foetal outcomes were noted. SPSS 10 was used for statistical analysis. Result: Among the 40 mothers, cesarean section was the most common outcome (n=24; 60%). Pulmonary oedema was found in 2 (5%) cases, acute renal failure in 10 (25%), disseminated intravascular coagulation in 6 (15%), and abruptio placenta in 5 (12.5%). Intrauterine growth restriction as a foetal outcome was observed in 18 (45%) cases. Pre-term birth was the result in 20 (50%) cases, and perinatal mortality was high (n=23; 57.5%). Conclusion: Management and delivery of HELLP syndrome patients should be performed at tertiary care centres, where highly trained obstetrician, neonatal intensive care unit personnel and Multi-disciplinary facilities are available. Correct diagnosis and timely intervention can decrease the risk of maternal and perinatal mortality. (author)

  14. Evaluation of bone marrow in cases of pancytopenia in a tertiary care hospital

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    S Vaidya

    2015-03-01

    Full Text Available Background: A spectrum of primary and secondary disorders that affect the bone marrow may manifestwith pancytopenia. This study was carried out to identify the various causes of pancytopenia in patients attending a tertiary care hospital in Lalitpur, Nepal.Materials and Methods: A descriptive study of 83 cases of pancytopenia was carried out in the Department of Pathology, Patan Academy of Health Sciences, Lalitpur, Nepal over a two year period from August 2010 to July 2012.Results: Eighty three patients underwent bone marrow examination. Mean age of the patients was 34 years (range: 4 to 75 years. Maximum number of patients (31.33% was seen in the age group of 16 - 30 years. The commonest cause of pancytopenia was megaloblastic anemia which was seen in 34.94% (29/83 cases followed by aplastic anemia and hematological malignancies in 31.32% (26/83 and 14.46% (12/83 cases, respectively.Conclusion: This study concluded that megaloblastic anemia and aplastic anemia were the two most common causes of pancytopenia. Bone marrow aspiration is an established diagnostic modality in the evaluation of pancytopenia.Journal of Pathology of Nepal (2015 Vol. 5, 691 - 695

  15. CLINICAL PROFILE AND COMMON CAUSES OF HAEMOLYTIC ANAEMIA IN A TERTIARY CARE HOSPITAL, NORTHERN KERALA

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    Jog Antony

    2016-09-01

    Full Text Available BACKGROUND Haemolytic anaemia is a well-recognised clinical problem. This study looks into the clinical profile of haemolytic anaemia and also attempts to find out the common underlying causative disease. It also tries to group the patients according to the clinical manifestations and underlying causes. MATERIALS AND METHODS This is a hospital-based observational study conducted in a tertiary care centre in Northern Kerala. Forty-four adult patients with clinical manifestations and laboratory evidence of haemolytic anaemia were identified and studied for a period of one year. RESULTS Maximum number of cases were seen in the age group of 20-40 years. The overall male-female ratio was 1.1:1. The most common presenting symptoms were features of anaemia like breathlessness, easy fatigability, headache and tiredness. Family history of anaemia was present in 34.1%. The most common signs observed were pallor and jaundice. The most common causes were autoimmune haemolytic anaemia and sickle cell anaemia. CONCLUSION Haemolytic anaemia mostly affects individuals in their 3rd and 4th decade. There is no significant difference in gender distribution of haemolytic anaemia. Haemolytic anaemia most commonly presents with symptoms of anaemia and jaundice. Commonest causes of haemolytic anaemia are autoimmune haemolytic anaemia and sickle cell anaemia.

  16. Maternal and Fetal Outcomes of Triplet Gestation in a Tertiary Hospital in Oman

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    Maryam Al-Shukri

    2014-05-01

    Full Text Available Objectives: The aim of this study was to describe the fetal and maternal outcomes of triplet gestation and to report on the maternal characteristics of those pregnancies in a tertiary care centre in Oman. Methods: A retrospective study was undertaken of all triplet pregnancies delivered at Sultan Qaboos University Hospital, Muscat, Oman, between January 2009 and December 2011. Results: Over the three-year study period, there were 9,140 deliveries. Of these, there were 18 triplet pregnancies, giving a frequency of 0.2%. The mean gestational age at delivery was 31.0 ± 3.0 weeks, and the mean birth weight was 1,594 ± 460 g. The most common maternal complications were preterm labour in 13 pregnancies (72.2%, gestational diabetes in 7 (39% and gestational hypertension in 5 (28%. Of the total deliveries, there were 54 neonates. Neonatal complications among these included hyaline membrane disease in 25 neonates (46%, hyperbilirubinaemia in 24 (43%, sepsis in 18 (33% and anaemia in 8 (15%. The perinatal mortality rate was 55 per 1,000 births. Conclusion: The maternal and neonatal outcomes of triplet pregnancies were similar to those reported in other studies.

  17. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

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    Mosam Phirke

    2015-01-01

    Full Text Available Background: Electroconvulsive therapy (ECT is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014, and it was observed that 23 elderly patients (aged ≥60 years had received ECT. Results: The patients received modified bitemporal ECT using a brief pulse ECT machine and had no major complications. A total of 184 ECT treatments were administered at an average of 8 treatments per case. The major diagnoses of patients were schizophrenia and major depression. The main indications of ECT were intolerance to medication, suicidal behavior and aggression. Out of the 23 elderly patients, 18 (78.26% showed a good response to ECT. The only complication noted was memory loss and confusion in 3 cases. Patients with medical illnesses like hypertension, diabetes and both together received ECT without any complications. Conclusions: This study adds to the scarce database on the use of ECT in elderly patients in India and adds evidence to the fact that ECT is a safe and effective treatment in the elderly.

  18. Clinical and electroencephalographic characteristics of benign occipital epilepsy of childhood in two tertiary Brazilian hospitals

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    Soniza Vieira Alves-Leon

    2011-08-01

    Full Text Available This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92% patients; 4 (33.3% with criteria for early BOEC; 6 (50% for late form and 2 (16.7% with superimposed early and late onset forms. After new investigation, 2 (16.7% had normal EEG; 4 (33.3% had paroxysms over the occipital region; 3 (25% over the temporal posterior regions and 3 (25% over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6%; spike and slow wave complexes in 1 (8.3% and sharp and slow wave complexes in 1 (8.3%. Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100% of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.

  19. The patterns and causes of neonatal mortality at a tertiary hospital in oman.

    Science.gov (United States)

    Abdellatif, Mohamed; Ahmed, Masood; Bataclan, Maria Flordeliz; Khan, Ashfaq Ahmed; Al Battashi, Abeer; Al Maniri, Abdullah

    2013-11-01

    To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years. This is a retrospective cohort study where four years data (January 2006 - December 2009) of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification. The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal) at the neonatal intensive care unit was 73 (63 inborn and 10 out born). Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58), 34 (59%) were males and 24 (41%) were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30). Lethal congenital malformations lead to 17 (29%) newborn deaths, specific diagnosis in 7 newborns (12%), and birth asphyxia in four (7%) of cases. There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

  20. Socio-demographic study of hepatitis c patients visiting tertiary care hospital

    International Nuclear Information System (INIS)

    Mukhtar, O.; Malik, M.F.; Khan, J.S.; Zaheer, F.; Ijaz, T.

    2015-01-01

    Background: Hepatitis C is a very common blood-borne disease of liver caused by Hepatitis C Virus and about two third of these patients will ultimately end up having liver cirrhosis or hepatocellular carcinoma. This study was carried out to determine the sociodemographic status of the hepatitis C infected patients visiting tertiary care hospitals in Lahore, Pakistan. Method: This study was conducted during the months of October and November 2009. In this cross sectional study, 154 volunteer patients of HCV were included. They were investigated for sociodemographic variables and were statistically analysed by SPSS-15. Results: Of these 154 patients, a high percentage of patients were females (70.1 percentage). Majority of the patients belonged to the families of labour occupation (39.4 percentage) of which 71.4 percentage were illiterate. Gender was found significantly associated with categories of sleep disturbance (p<0.05) and tension (p<0.05) among HCV patients. Married patients were significantly associated with tension (p<0.05) and a significant emotional and behavioural change in their attitude was also found (p<0.05). Patients with shorter interval after first diagnosis of the disease felt more emotional and had greater behavioural changes in their attitude (p<0.05). Conclusion: Incidence of Hepatitis C was higher in females and married females with shorter interval after first diagnosis of the disease were more depressed. (author)

  1. The Burden of Hand Injuries at a Tertiary Hospital in Sub-Saharan Africa

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    P. Makobore

    2015-01-01

    Full Text Available Background. Hand injuries are common worldwide and lead to heavy financial losses in terms of treatment, job loss, and time off duty. There is paucity of data on hand injuries in sub-Saharan Africa. The aim of this study was to determine the burden and early outcomes of hand injuries at a tertiary hospital. Method. A descriptive prospective study. Eligible patients were recruited over 5 months and followed up for four weeks. Pain, nerve function, and gross functions of the hand were assessed. Results. In total 138 patients were enrolled out of 2940 trauma patients. Of these, 122 patients returned for follow-up. The majority of the patients were males (83%. Mean age was 26.7 years (SD 12.8. The commonest places of injury occurrence were the workplace (36%, home (28%, and on the road (traffic crushes (23%. Machines (21.3% were the commonest agent of injuries; others were knives (10% and broken glass (10%. Sixty-three (51% patients still had pain at one month. Conclusions. Hand injuries accounted for 4.7% of all trauma patients. Road traffic crushes and machines were the commonest causes of hand injuries. Men in their 20s were mostly involved. Sensitization for prevention strategies at the workplace may be helpful.

  2. Factors Affecting Compliance to Antihypertensive Treatment among Adults in a Tertiary Care Hospital in Mumbai.

    Science.gov (United States)

    Shah, Ayushi Jayesh; Singh, Vijaykumar; Patil, Subita P; Gadkari, Mithila R; Ramchandani, Varun; Doshi, Karan Janak

    2018-01-01

    Compliance to antihypertensive therapy reduces the risk of complications. It is important to understand the factors affecting compliance in patients so that the goal of successful treatment is not jeopardized. To determine the proportion of participants' compliant to treatment and various factors associated with compliance of antihypertensive treatment. A cross-sectional study of 330 hypertensive patients on treatment attending the outpatient department of a tertiary care hospital in Mumbai. It was conducted over 8 weeks using a validated, pretested questionnaire including information on the individual's sociodemographic profile, compliance to antihypertensive therapy and lifestyle advice assessed using a 4-point Likert scale. Data were entered into MS Excel 2007 and analyzed using SPSS 20. Participants' mean age was 55.2 ± 12.6 years. 39.4% were compliant to their treatment. Common reasons for frequently skipping the dose - forgetfulness (41.2%) and discontinued the medication when feeling well (30.3%). Factors positively associated with compliance were gender and illiteracy. The proportion of noncompliance among smokers and alcoholics was statistically significant. Forgetfulness and subjective feeling of wellness were the prevalent reasons for noncompliance. Controlling habits such as smoking and alcohol may prove as key factors for compliance.

  3. An outbreak of Burkholderia cepacia complex in the paediatric unit of a tertiary care hospital

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    Swapna Mali

    2017-01-01

    Full Text Available Introduction: Burkholderia cepacia complex (Bcc has emerged as a serious nosocomial pathogen worldwide especially in patients with indwelling catheters and cystic fibrosis. Bcc is a common contaminant of pharmaceutical products. We describe an outbreak of Bcc bacteraemia amongst children admitted in Paediatric Intensive Care Unit (PICU and paediatric ward at a tertiary care hospital, Mumbai, in Western India. Materials and Methods: Blood culture samples from paediatric patients yielded growth of non-fermenting, oxidase positive, motile, Gram negative bacilli (NFGNB (76/909 over a period of 8 months. Based on conventional biochemical tests and antimicrobial susceptibility testing, these isolates were provisionally identified as Bcc. The increased, repeated and continued isolation of Bcc alerted the possibility of an outbreak confined to PICU and paediatric ward. Active surveillance was undertaken to trace the source and contain the outbreak. Isolates were subjected to recA polymerase chain reaction (PCR and Expanded multilocus sequence typing (EMLST. Results: Surveillance revealed the presence of Bcc on the upper surface of rubber stopper of sealed multidose amikacin vials. Isolates from blood culture and rubber stoppers were confirmed as Bcc by recA PCR. EMLST revealed that these isolates shared an identical novel sequence type 824 proving clonality. Timely interventions instituted led to control of the outbreak. Conclusion: This study highlights the importance of identification and molecular characterization of Bcc to establish its role in infection and outbreak.

  4. 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.

  5. An outbreak of Burkholderia cepacia complex in the paediatric unit of a tertiary care hospital.

    Science.gov (United States)

    Mali, Swapna; Dash, Lona; Gautam, Vikas; Shastri, Jayanthi; Kumar, Sunil

    2017-01-01

    Burkholderia cepacia complex (Bcc) has emerged as a serious nosocomial pathogen worldwide especially in patients with indwelling catheters and cystic fibrosis. Bcc is a common contaminant of pharmaceutical products. We describe an outbreak of Bcc bacteraemia amongst children admitted in Paediatric Intensive Care Unit (PICU) and paediatric ward at a tertiary care hospital, Mumbai, in Western India. Blood culture samples from paediatric patients yielded growth of non-fermenting, oxidase positive, motile, Gram negative bacilli (NFGNB) (76/909) over a period of 8 months. Based on conventional biochemical tests and antimicrobial susceptibility testing, these isolates were provisionally identified as Bcc. The increased, repeated and continued isolation of Bcc alerted the possibility of an outbreak confined to PICU and paediatric ward. Active surveillance was undertaken to trace the source and contain the outbreak. Isolates were subjected to recA polymerase chain reaction (PCR) and Expanded multilocus sequence typing (EMLST). Surveillance revealed the presence of Bcc on the upper surface of rubber stopper of sealed multidose amikacin vials. Isolates from blood culture and rubber stoppers were confirmed as Bcc by recA PCR. EMLST revealed that these isolates shared an identical novel sequence type 824 proving clonality. Timely interventions instituted led to control of the outbreak. This study highlights the importance of identification and molecular characterization of Bcc to establish its role in infection and outbreak.

  6. [Triage evaluation making in a pediatric emergency department of a tertiary hospital].

    Science.gov (United States)

    Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

    2014-03-01

    Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

  7. STUDY OF CLINICAL PROFILE OF PATIENTS WITH SHORT STATURE VISITING A TERTIARY CARE HOSPITAL

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    Arun Kumar Choudhury

    2016-07-01

    Full Text Available BACKGROUND Short stature is one of the common causes of referral of children to endocrine unit. It may result due to various causes and elucidating the exact cause is necessary to formulate the right therapy. OBJECTIVE To study the various aetiologies and clinical presentation of patients presenting with short to a tertiary care hospital. DESIGN Cross sectional study MATERIAL AND METHODS We collected and analysed the clinical, biochemical, radiological and hormonal data of 104 consecutive patients who presented to our department from January 2015 to March 2016 for evaluation of short stature. RESULTS Majority of the subjects studied belonged to 10-15 years group (44.23% followed by 5-10 years age group (31.73%. The most common cause in our population was due to familial short stature (29.80%. The next common causes included chronic medical illness (23.08% followed by hypothyroidism (13.46%. Majority of patients presenting for evaluation of short stature were males (60.58%. CONCLUSIONS Short stature is caused due to a multitude of causes. In our population, familial short stature was the most common aetiology

  8. Causes and pattern of death in a tertiary hospital in south eastern Nigeria

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    C C Nwafor Chukwuemeka Charles

    2014-01-01

    Full Text Available Background: Morbidity and mortality pattern is a reflection of disease burden. The aim of this study is to provide a comprehensive report of the causes of death in a tertiary hospital in Nigeria, a developing tropical nation. Methods and Material: We carried out a retrospective descriptive cross-sectional study of all records of deaths from January 2004 to December 2008 in Federal Medical Centre Umuahia, Abia, State in Southeast Nigeria. Results: Of a total of 18,107 patients were admitted during the study period, 2;172 deaths representing 12% mortality rate and comprising 1;230 (56.6% males and 942 (43.4% females were recorded. The age of patients ranged from birth to 100 years with a mean of 41.41 ± 26.30 years and 25-44 years age group being the most affected (n = 587, 27.1%. The overall leading cause of death was the infections group, which accounted for 837 (37.6% deaths. Other major causes were cardiovascular system -related deaths 534 (24.7%, neonatal causes 173 (8.0%, trauma 155 (7.1%, diabetes mellitus complications 144 (6.6% and neoplasia 76 (3.5%. Conclusion: Majority of the leading causes of mortality in this study are preventable. Our data reflects the effects of double disease burden of infections and non- communicable communicable diseases in a developing nation.

  9. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

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    Manisha Bisht

    2008-01-01

    Full Text Available Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. The data obtained from the patients included symptoms reported by the patients, currently prescribed treatments and the site of cancer. Results: The average number of symptoms reported per patient was 5.33 ± 0.67 (mean ± SE. The most common symptoms were pain, weakness/fatigue, anorexia, insomnia, nausea/vomiting, dyspnea, constipation and cough. Polypharmacy was frequent. Patients consumed approximately 8.7 ± 0.38 (mean ± SE drugs on average during the 2-month period of follow-up. Conclusion: The result gives insight into the varied symptomatology of patients with advanced cancer. Polypharmacy was quite common in patients with advanced cancer, predisposing them to complicated drug interactions and adverse drug reactions.

  10. The pattern of the discovery of medication errors in a tertiary hospital in Hong Kong.

    Science.gov (United States)

    Samaranayake, N R; Cheung, S T D; Chui, W C M; Cheung, B M Y

    2013-06-01

    The primary goal of reducing medication errors is to eliminate those that reach the patient. We aimed to study the pattern of interceptions to tackle medication errors along the medication use processes. Tertiary care hospital in Hong Kong. The 'Swiss Cheese Model' was used to explain the interceptions targeting medication error reporting over 5 years (2006-2010). Proportions of prescribing, dispensing and drug administration errors intercepted by pharmacists and nurses; proportions of prescribing, dispensing and drug administration errors that reached the patient. Our analysis included 1,268 in-patient medication errors, of which 53.4% were related to prescribing, 29.0% to administration and 17.6% to dispensing. 34.1% of all medication errors (4.9% prescribing, 26.8% drug administration and 2.4% dispensing) were not intercepted. Pharmacy staff intercepted 85.4% of the prescribing errors. Nurses detected 83.0% of dispensing and 5.0% of prescribing errors. However, 92.4% of all drug administration errors reached the patient. Having a preventive measure at each stage of the medication use process helps to prevent most errors. Most drug administration errors reach the patient as there is no defense against these. Therefore, more interventions to prevent drug administration errors are warranted.

  11. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India

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    Pikee Saxena

    2011-01-01

    Full Text Available Background: Women with gestational diabetes mellitus (GDM pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objectives: The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies. Materials and Methods: This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies. Results: Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all. Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001 among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05 in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

  12. 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.

  13. 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.

  14. [Occupational exposure investigation and protective measures in a tertiary infectious disease hospital].

    Science.gov (United States)

    Ding, H M; Zhou, X P; Huang, J Z

    2018-02-20

    Objective: To investigate the cause of occupational exposure among 136 nurses in a tertiary infectious disease hospital, and puts forward the prevention strategy. Methods: A total of 136 nurses exposed to occupational exposure between 2014 and 2016 were included in the study. Analysis was conducted from the years of work of nurses, exposure routes, and the pathogens. Results: The nurses suffer from the highest risk of occupational exposures (73.91%) .Nurses working for less than 5 years and interns are most likely to suffer occupational exposure (45.59% and 35.29% respectively) . Occupational exposure was mainly caused by needle injuries, in which infusion was the main route of occupational exposure (36.76%) . The improper treatment of needle pulling after infusion is the main link of needle puncture (36.76%) . Occupational exposure pathogens were mainly HBV (63.24%) . Conclusion: Nursing staff is the high-risk group of occupational exposure. Irregular operation, lack of awareness of protection, improper disposal after the needle withdrawal and poor safety assessment of the operating environment are the main causes of occupational exposure. It is suggested to strengthen the training of occupational safety and protection, enhance clinical nurses occupational safety protection consciousness, standardize medical operation, so as to prevent the occurrence of occupational exposure.

  15. STUDY OF CLINICAL PRESENTATIONS OF PATIENTS WITH HYPERPROLACTINAEMIA VISITING A TERTIARY CARE HOSPITAL

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    Binoy Kumar Mohanty

    2016-06-01

    Full Text Available BACKGROUND Hyperprolactinaemia is one of the common endocrine disorders seen in clinical practice. It may result due to various causes and elucidating the exact cause is necessary to formulate the right therapy. OBJECTIVE To study the various aetiologies and clinical presentation of patients presenting with hyperprolactinaemia to a tertiary care hospital. DESIGN Cross-sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 74 consecutive patients who presented to our department from June 2015 to May 2016 for evaluation of hyperprolactinaemia. RESULTS Majority of the subjects studied belonged to 20-29 years group (47.29% followed by 30-39 years age group (24.32%. The most common cause in our population was due to drug-induced causes (35.13%. The next common causes included idiopathic group (20.4% followed by pituitary adenomas (16.21%. There was significant female predominance (83.78% among total cases. Among women who presented with hyperprolactinaemia, menstrual irregularity (69.35% followed by galactorrhoea (35.48% were the most common presentations. CONCLUSIONS Hyperprolactinaemia is frequently seen among women who presented with either menstrual irregularity or galactorrhoea or both. Drug-induced hyperprolactinaemia is the most common cause seen in our study population.

  16. Intensity of interprofessional collaboration among intensive care nurses at a tertiary hospital.

    Science.gov (United States)

    Serrano-Gemes, G; Rich-Ruiz, M

    To measure the intensity of interprofessional collaboration (IPC) in nurses of an intensive care unit (ICU) at a tertiary hospital, to check differences between the dimensions of the Intensity of Interprofessional Collaboration Questionnaire, and to identify the influence of personal variables. A cross-sectional descriptive study was conducted with 63 intensive care nurses selected by simple random sampling. Explanatory variables: age, sex, years of experience in nursing, years of experience in critical care, workday type and work shift type; variable of outcome: IPC. The IPC was measured by: Intensity of Interprofessional Collaboration Questionnaire. Descriptive and bivariate statistical analysis (IPC and its dimensions with explanatory variables). 73.8% were women, with a mean age of 46.54 (±6.076) years. The average years experience in nursing and critical care was 23.03 (±6.24) and 14.25 (±8.532), respectively. 77% had a full time and 95.1% had a rotating shift. 62.3% obtained average IPC values. Statistically significant differences were found (P<.05) between IPC (overall score) and overall assessment with years of experience in critical care. This study shows average levels of IPC; the nurses with less experience in critical care obtained higher IPC and overall assessment scores. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Complications associated with blood donations in a blood bank at an Indian tertiary care hospital.

    Science.gov (United States)

    Meena, Monika; Jindal, Tarun

    2014-09-01

    Blood donation, though safe, has a few potentially avoidable complications associated with it. They are important reasons for the failure of the donors to return for repeat donations. The aim of this study was to assess the frequency and identify the possible factors associated with increased risk of blood donation related complications so that they can be minimized. A prospective study was done over a period of four months in the blood bank of an Indian tertiary care hospital to record the donation related complications. Out of 7450 blood donations, total donation associated complications were 74, of which majority were vasovagal reactions (VVRs) (n=48), followed by venous hematomas (n=24) and arterial punctures (n=2). The incidence of VVRs was more, though not statistically significant, in females, replacement/repeat donors, donors between 21-30 y of age and who had a body-mass-index (BMI) of 18.5-24.9. VVRs were more common in April (p=0.002) and in those who donated 450ml of blood (pdonated 350ml of blood, statistically significant association was seen only in repeat donors (pdonation in our country has a complication rate of nearly 1%.

  18. Triple approach for diagnosing breast lesions-experience at a Tertiary Care Hospital

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    Ritu Mehta

    2017-01-01

    Full Text Available Background: Breast lesions are always a diagnostic challenge and range from benign to malignant. Fine-Needle Aspiration Cytology (FNAC is done in patients with breast lesions. However, to get an accurate and diagnostic yield is difficult at times. Aims: The aim of this study is to highlight the role of triple approach in diagnosing breast lesions. Design and Setting: This is an observational prospective study carried out in the Department of Pathology at a tertiary care hospital over 2 years. Materials and Methods: One hundred and fifty cases of breast lump were studied. Clinical findings, imaging findings, and cytology along with histopathological findings were correlated. Results: Cytological findings were benign in 102 out of 107 patients, who were otherwise clinically and radiologically benign. In rest five patients, Breast Imaging Reporting and Data Systems (BIRADS BIRADS II category was given on mammography. In four of these five patients, there was cytological atypia. Biopsy in these four patients showed features of fibroadenoma with mild cytological atypia and one patient showed infiltrating duct carcinoma. Mammography was suggestive of malignant breast lump in 43 patients. In three patients, breast lump was diagnosed as benign on cytological examination. However, histopathological examination confirmed the mammography findings of malignancy. Conclusion: FNAC is a well-established procedure for diagnosing breast lesion but has got many pitfalls. Hence for diagnosis a breast lesion, the triple approach consisting of histopathological examination in addition to mammography and FNAC, should be considered.

  19. Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

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    Uttam Kumar Sarkar

    2017-10-01

    Full Text Available Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically suspected to have heart disease from January 2015 to September 2016 at Dr.B.C.Roy P.G.I.P.S. Kolkata and echocardiographically categorized.Results:A VSD was the commonest acyanotic heart disease (17. 08%.Tetralogy of Fallot (TOF was commonest complex cyanotic heart disease (10.64%, VSD +ASD was the commonest combined lesion (8.12%. Simple heart lesions (63.1% were commoner than complex (36.9% congenital heart diseases.Conclusion:Health policy makers should give due care to manage Congenital Heart Disease either catheter based or surgically keeping in mind about 63.1% of the lesions are simple cardiac lesions and 36.9% lesions are complex cardiac lesion where complex surgery is required. 

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

    Science.gov (United States)

    Vahora, Roshni; Thakkar, Sejal; Marfatia, Yogesh

    2013-07-01

    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. To study the pattern of mucocutaneous manifestations in diabetics and role of it in diagnosing diabetes mellitus and its complications. 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. 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. The data was analyzed by using Epi info software. 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%). 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.

  1. Clinical neurophysiology referral patterns to a tertiary hospital--a prospective audit.

    LENUS (Irish Health Repository)

    Renganathan, R

    2012-02-03

    BACKGROUND: Cork University Hospital (CUH) provides a tertiary service for all neurophysiology referrals in the Southern Health Board region. AIM: To ascertain the number, source, symptoms and diagnosis of neurophysiology referrals at CUH. METHODS: We did a prospective audit of the referral patterns to the neurophysiology department over a 12 -week period. RESULTS: Of 635 referrals, 254 had electromyograms (EMG), 359 had electro-encephalograms (EEG), 18 had visual evoked potentials (VEP), three had somato-sensory evoked potentials (SSEP) and one had multiple sleep latency tests (MSLT). We analysed the demographic pattern, reason for referrals, the average waiting time for neurophysiology tests and the patterns of diagnosis in this audit. CONCLUSIONS: Patients from County Cork are making more use of the neurophysiology services than patients from other counties within the Southern Health Board. The average waiting time for an EEG was 32 days and for an EMG was 74 days. However, more than 35% of those patients waiting for an EEG or an EMG had their tests done within four weeks of referral. The appointments of EEG and EMG were assigned on the basis of clinical need.

  2. Early Detection of Hearing Impairment Among High Risk Neonates in a Tertiary Care Hospital

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    Gurudutt Joshi

    2014-07-01

    Full Text Available Background: Hearing impairment has a devastating, detrimental and an invariably adverse impact on the development of the newborns and the psychological well-being of their families. It also adversely affects development of the central auditory nervous system, and can affect speech perception that interferes with growth in social, emotional, behavioural and cognitive spheres, academic achievement, vocational options, employment opportunities and economic selfsufficiency. Objectives: To find out incidence of hearing impairment in high risk neonates in Neonatal Intensive Care Unit (NICU, prevalence of hearing impairment with and without high risk factors in newborns and to correlate the risk factors with hearing impairment. Material and Methods: A cohort study was carried out at a tertiary care hospital of Surat, Gujarat, India consisting of 190 normal newborns and 163 newborns with high risk factors. These newborns underwent a systematized Transient Otoacoustic Emissions Examination (TOAE and Brain Stem Evoked Audiometry (BERA examination according to designed protocol and were followed up with repeated ear examinations. Data were recorded and analyzed statistically. Results: The incidence of hearing impairment in NICU, newborns were 3.6% and the prevalence of hearing impairment was 13%. Hearing impairment was statistically significant in newborns with high risk factors such as low birth weight, preterms 5 days when compared to normal newborns. Conclusion: Presence of risk factors in newborns predisposes them to hearing impairment more as compared to normal newborns and the more the number of risk factors they are exposed to, the more will be the chances of hearing impairment.

  3. Frequency and Antibiogram of Vancomycin Resistant Enterococcus in a Tertiary Care Hospital

    International Nuclear Information System (INIS)

    Babar, N.; Usman, J.; Munir, T.; Gill, M. M.; Anjum, R.; Gilani, M.; Latif, M.

    2014-01-01

    Objective: To determine the frequency of Vancomycin Resistant Enterococcus (VRE) in a tertiary care hospital of Rawalpindi, Pakistan. Study Design: Observational, cross-sectional study. Place and Duration of Study: Department of Microbiology, Army Medical College, Rawalpindi, from May 2011 to May 2012. Methodology: Vancomycin resistant Enterococcus isolated from the clinical specimens including blood, pus, double lumen tip, ascitic fluid, tracheal aspirate, non-directed bronchial lavage (NBL), cerebrospinal fluid (CSF), high vaginal swab (HVS) and catheter tips were cultured on blood agar and MacConkey agar, while the urine samples were grown on cystine lactose electrolyte deficient agar. Later the antimicrobial susceptibility testing of the isolates was carried out using the modified Kirby-Bauer disc diffusion method on Mueller Hinton agar. Results: A total of 190 enterococci were isolated. Of these, 22 (11.57%) were found to be resistant to vancomycin. The antimicrobial sensitivity pattern revealed maximum resistance against ampicillin (86.36%) followed by erythromycin (81.81%) and gentamicin (68.18%) while all the isolates were 100% susceptible to chloramphenicol and linezolid. Conclusion: The frequency of VRE was 11.57% with the highest susceptibility to linezolid and chloramphenicol. (author)

  4. Healthcare waste management: qualitative and quantitative appraisal of nurses in a tertiary care hospital of India.

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    Shivalli, Siddharudha; Sanklapur, Vasudha

    2014-01-01

    The nurse's role in healthcare waste management is crucial. (1) To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2) to elicit the determinants of knowledge and attitudes of healthcare waste management. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and "nonparticipatory observation" were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses' knowledge was categorized as excellent (>70%), good (50-70%), and poor (70% score). Most (86%) expressed the need of refresher training. No study variable displayed significant association (P > 0.05) with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Nurses' knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.

  5. Healthcare Waste Management: Qualitative and Quantitative Appraisal of Nurses in a Tertiary Care Hospital of India

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    Siddharudha Shivalli

    2014-01-01

    Full Text Available Background. The nurse’s role in healthcare waste management is crucial. Objectives. (1 To appraise nurses quantitatively and qualitatively regarding healthcare waste management; (2 to elicit the determinants of knowledge and attitudes of healthcare waste management. Method. A cross-sectional study was undertaken at a tertiary care hospital of Mangalore, India. Self-administered pretested questionnaire and “nonparticipatory observation” were used for quantitative and qualitative appraisals. Percentage knowledge score was calculated based on their total knowledge score. Nurses’ knowledge was categorized as excellent (>70%, good (50–70%, and poor (70% score. Most (86% expressed the need of refresher training. No study variable displayed significant association (P>0.05 with knowledge. Apt segregation practices were followed except in casualty. Patients and entourages misinterpreted the colored containers. Conclusion. Nurses’ knowledge and healthcare waste management practices were not satisfactory. There is a need of refresher trainings at optimum intervals to ensure sustainability and further improvement. Educating patients and their entourages and display of segregation information board in local language are recommended.

  6. Factors affecting compliance to antihypertensive treatment among adults in a tertiary care hospital in Mumbai

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    Ayushi Jayesh Shah

    2018-01-01

    Full Text Available Background: Compliance to antihypertensive therapy reduces the risk of complications. It is important to understand the factors affecting compliance in patients so that the goal of successful treatment is not jeopardized. Objectives: To determine the proportion of participants' compliant to treatment and various factors associated with compliance of antihypertensive treatment. Settings and Design: A cross-sectional study of 330 hypertensive patients on treatment attending the outpatient department of a tertiary care hospital in Mumbai. Subjects and Methods: It was conducted over 8 weeks using a validated, pretested questionnaire including information on the individual's sociodemographic profile, compliance to antihypertensive therapy and lifestyle advice assessed using a 4-point Likert scale. Statistical Analysis: Data were entered into MS Excel 2007 and analyzed using SPSS 20. Results: Participants' mean age was 55.2 ± 12.6 years. 39.4% were compliant to their treatment. Common reasons for frequently skipping the dose – forgetfulness (41.2% and discontinued the medication when feeling well (30.3%. Factors positively associated with compliance were gender and illiteracy. The proportion of noncompliance among smokers and alcoholics was statistically significant. Conclusion: Forgetfulness and subjective feeling of wellness were the prevalent reasons for noncompliance. Controlling habits such as smoking and alcohol may prove as key factors for compliance.

  7. Physician job satisfaction in Saudi Arabia: insights from a tertiary hospital survey.

    Science.gov (United States)

    Aldrees, Turki; Al-Eissa, Sami; Badri, Motasim; Aljuhayman, Ahmed; Zamakhshary, Mohammed

    2015-01-01

    Job satisfaction refers to the extent to which people like or dislike their job. Job satisfaction varies across professions. Few studies have explored this issue among physicians in Saudi Arabia. The objective of this study is to determine the level and factors associated with job satisfaction among Saudi and non-Saudi physicians. In this cross-sectional study conducted in a major tertiary hospital in Riyadh, a 5-point Likert scale structured questionnaire was used to collect data on a wide range of socio-demographic, practice environment characteristics and level and consequences of job satisfaction from practicing physicians (consultants or residents) across different medical specialties. Logistic regression models were fitted to determine factors associated with job satisfaction. Of 344 participants, 300 (87.2%) were Saudis, 252 (73%) males, 255 (74%) married, 188 (54.7%) consultants and age [median (IQR)] was 32 (27-42.7) years. Overall, 104 (30%) respondents were dissatisfied with their jobs. Intensive care physicians were the most dissatisfied physicians (50%). In a multiple logistic regression model, income satisfaction (odds ratio [OR]=0.448 95% CI 0.278-0.723, P job satisfaction identified in this study should be addressed in governmental strategic planning aimed at improving the healthcare system and patient care.

  8. Dengue fever in patients admitted in tertiary care hospitals in Pakistan

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    Munir, M. A.; Saqib, M. A. N.; Qureshi, H.; Alam, S. E.; Arif, A.; Khan, Z. U.; Saeed, Q.; Iqbal, R.

    2014-01-01

    Objectives: To assess the gaps in the diagnosis and management of dengue fever cases. Methods: The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Results: Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3+-14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Conclusions: Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed. (author)

  9. FACTORS PREDICTING MORBIDITY IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL

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    Muhammad Imran Hasan Khan

    2013-02-01

    Full Text Available Introduction: Dengue virus (DENV affects over half the world’s population in 112 countries, and dengue fever (DF is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF and Dengue Shock Syndrome (DSS accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9, deranged liver function test OR 1.9 (CI 0.97-0.99, platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19, presence of urinary red blood cells OR 1.4 (CI 0.179-0.900 and presence of urinary protein OR 1.1 (CI 0.191-0.974 were related to development of DHF and DSS.

  10. Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India

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    Shazia Qayum

    2018-04-01

    Full Text Available Purpose: Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India. Methods: A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed. Results: Of total 357 patients, 271 (76% were below the age of 12 years; 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9:1. Out of total patients, 242 (67.8% presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball (15.7% and finger nail trauma (13.2%. Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury (47.8%, followed by streets (17.9% and playground (14.9%. Conclusion: Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children. Keywords: Ocular trauma, Open globe injuries, Closed globe injuries, Birmingham eye trauma terminology system, Adnexal injuries, Pediatric ocular trauma

  11. Quality of Care of Hospitalized Infective Endocarditis Patients: Report from a Tertiary Medical Center.

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    Kashef, Mohammad Amin; Friderici, Jennifer; Hernandez-Montfort, Jaime; Atreya, Auras R; Lindenauer, Peter; Lagu, Tara

    2017-06-01

    There have been no recent studies describing the management and outcomes of patients with infective endocarditis (IE). We conducted a retrospective cohort study of adult patients admitted to a tertiary medical center from 2007 to 2011 with a Duke criteria consistent discharge diagnosis of IE. We examined concordance with guideline recommendations. Outcomes included embolic events, inhospital and 1-year mortality, length of stay (LOS) and cardiac surgery. We used descriptive statistics to describe the cohort and Fisher exact and unpaired t tests to compare native valve endocarditis (NVE) with prosthetic valve endocarditis (PVE). Of 170 patients, definite IE was present in 135 (79.4%) and possible IE in 35 (20.6%); 74.7% had NVE, and 25.3% had PVE. Mean ± standard deviation age was 60.0 ± 17.9 years. Comparing PVE to NVE, patients with PVE were less likely to have embolic events (14.0% vs. 32.3%; P = 0.03), had shorter LOS (median 12.0 days vs. 14.0 days; P = 0.047), but they did not show a statistically significant difference in inhospital mortality (20.9% vs. 12.6%; P = 0.21). Of 170, patients 27.6% (n = 47) underwent valve surgery. Most patients received timely blood cultures and antibiotics. Guideline-recommended consults were underused, with 86.5%, 54.1%, and 47.1% of patients receiving infectious disease, cardiac surgery, and cardiology consultation, respectively. As the number of consultations increased (from 0 to 3), we observed a nonsignificant trend toward reduction in 6-month readmission and 12-month mortality. IE remains a disease with significant morbidity and mortality. There are gaps in the care of IE patients, most notably underuse of specialty consultation. Journal of Hospital Medicine 2017;12:414-420. © 2017 Society of Hospital Medicine

  12. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India

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    M Dash

    2013-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV counseling and testing (HCT conducted at integrated counseling and testing centers (ICTCs is an entry point, cost-effective intervention in preventing transmission of HIV. Objectives: To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. Materials and Methods: It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. Results: A total of 1732 (7.5% out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7% were males, while 594 (34.3% were females. Majority (88.3% of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1% was more seropositive compared to provider-initiated (2.9%. Among discordant couples, majority (95.5% were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001. Risk factors included heterosexual promiscuous (89.3%, parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%. Conclusions: There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

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

    Science.gov (United States)

    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.

  14. Genotypic and Phenotypic Characterization of Stenotrophomonas maltophilia Strains from a Pediatric Tertiary Care Hospital in Serbia.

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    Haowa Madi

    Full Text Available Stenotrophomonas maltophilia is an environmental bacterium and an opportunistic pathogen usually associated with healthcare-associated infections, which has recently been recognized as a globally multi-drug resistant organism. The aim of this study was genotyping and physiological characterization of Stenotrophomonas maltophilia isolated in a large, tertiary care pediatric hospital in Belgrade, Serbia, hosting the national reference cystic fibrosis (CF center for pediatric and adult patients.We characterized 42 strains of cystic fibrosis (CF and 46 strains of non-cystic fibrosis (non-CF origin isolated from 2013 to 2015 in order to investigate their genetic relatedness and phenotypic traits. Genotyping was performed using sequencing of 16S rRNA gene, Pulse Field Gel Electrophoresis (PFGE and Multi locus sequencing typing (MLST analysis. Sensitivity to five relevant antimicrobial agents was determined, namely trimethoprim/sulfamethoxazole (TMP/SMX, chloramphenicol, ciprofloxacin, levofloxacin and tetracycline. Surface characteristics, motility, biofilm formation and adhesion to mucin were tested in all strains. Statistical approach was used to determine correlations between obtained results.Most of the isolates were not genetically related. Six new sequence types were determined. Strains were uniformly sensitive to all tested antimicrobial agents. The majority of isolates (89.8% were able to form biofilm with almost equal representation in both CF and non-CF strains. Swimming motility was observed in all strains, while none of them exhibited swarming motility. Among strains able to adhere to mucin, no differences between CF and non-CF isolates were observed.High genetic diversity among isolates implies the absence of clonal spread within the hospital. Positive correlation between motility, biofilm formation and adhesion to mucin was demonstrated. Biofilm formation and motility were more pronounced among non-CF than CF isolates.

  15. Ocular knowledge and practice among type 2 diabetic patients in a tertiary care hospital in Bangladesh.

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    Ahmed, Kazi Rumana; Jebunessa, Fatema; Hossain, Sharmin; Chowdhury, Hasina Akhter

    2017-09-19

    Diabetes mellitus is likely to have a major effect on vision, and adequate knowledge of its ocular manifestations is of substantial importance to diabetic patients. The study aimed to assess the ocular knowledge and practices among Type 2 diabetic patients of Bangladesh. This cross-sectional study included 122 diabetic patients from the outpatient department (OPD) of the apex diabetic healthcare hospital of the country under the sponsorship of the Diabetic Association of Bangladesh (BIRDEM). A questionnaire was used for collecting data on knowledge on and practices relating to diabetes mellitus with particular emphasis on ocular issues. A predefined score was used for categorizing levels of knowledge and practices as poor, average, and good. Of the 122 respondents, 63%, 55%, 40%, 44%, and 30% reported, blindness, retinopathy, cataracts, glaucoma, and double vision respectively, as complications of diabetes mellitus. About 50% were aware of the need for eye screening for people with the complications. Only 8% monitored their blood glucose levels daily, 15% monitored weekly, and 10% reported checking their blood pressure daily and 43% took their medications as prescribed. The level of diabetic knowledge was poor, moderate and good, respectively, among 24%, 56%, and 20% of the respondents, whereas the practice standards showed that 47%, 31%, and 22% had poor, average, and good levels respectively. The knowledge score was significantly associated with the practice score (r = 0.460, p = 0.001). The results indicate that the ocular knowledge and practices among diabetic patients attending a tertiary-care hospital in Bangladesh is average. Health and eye-care practitioners need to expand diabetic health education and promotion among diabetic patients.

  16. Pediatric retinal detachment in the Eastern Province of Saudi Arabia: experience of a tertiary care hospital.

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    Cheema, Rizwan A; Al-Khars, Wajeeha; Al-Askar, Essam; Amin, Yasir M

    2009-01-01

    Because no previous studies have addressed the issue, we describe clinical characteristics and surgical outcome of patients with rhegmatogenous retinal detachment (RRD) in a pediatric population of the Eastern province of Saudi Arabia. We conducted a retrospective review of all consecutive cases of pediatric RRD (0-18 years) patients presenting at Dhahran Eye Specialist Hospital, a tertiary care hospital, in the Eastern Province of Saudi Arabia over a period of 3 years. Twenty patients were included in the study, accounting for 9.4% of all retinal detachment surgery cases performed over a period of 3 years (January 2006 to December 2008). The median age was 11.0 years, (range, birth to 18 years). Trauma, (45%) myopia/vitreoretinal degeneration (10%) and prior ocular surgery (25%) were significant risk factors for RRD. Proliferative vitreoretinopathy (PVR) more than grade C was present in 14/20 (70%) of cases. Most patients (15/20, 75%) were treated with pars plana vitrectomy and placement of an encircling buckle, while silicone oil or gas was used as tamponade in 13/20 (65%) patients. Surgery was successful in 17/20 (85%) cases in achieving retinal re-attachment. Visual acuity improved significantly following surgery (Mean preop 2.146 LogMAR, Mean postop 1.497 LogMAR) ( P= .014). Longer duration of RRD ( P =.007) and macular involvement ( P =.05) were associated with worse anatomical outcomes following surgery. Pediatric RRD in the Eastern province is often associated with predisposing pathology. Surgery is successful in achieving anatomical reattachment of the retina in a majority of cases with improvement of visual acuity.

  17. HBV and HIV co-infection: Prevalence and clinical outcomes in tertiary care hospital Malaysia.

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    Akhtar, Ali; Khan, Amer Hayat; Sulaiman, Syed Azhar Syed; Soo, Chow Ting; Khan, Kashifullah

    2016-03-01

    According to WHO, Malaysia has been classified as a concentrated epidemic country due to progression of HIV infection in the population of injecting drug users. The main objectives of current study are to determine the prevalence of HBV among HIV-positive individuals in a tertiary care hospital of Malaysia and to assess the predictors involved in the outcomes of HIV-HBV co-infected patients. A retrospective, cross-sectional study is conducted at Hospital Palau Pinang, Malaysia. The collection of socio-demographic data as well as clinical data is done with the help of data collection form. Data were analyzed after putting the collected values of required data by using statistical software SPSS version 20.0 and P > 0.05 is considered as significant. Results show that the overall prevalence of HBV was 86 (13%) including 495 (74.5%) males and 169 (25.5%) females among a total of 664 HIV-infected patients. It was observed that there is a high prevalence of HIV-HBV co-infection in males 76 (11.4%) as compared to females 10 (1.5%) (P = 0.002). The median age of the study population was 39 years. The statistical significant risk factors involved in the outcomes of HIV-HBV co-infected patients were observed in the variables of gender, age groups, and injecting drug users. The findings of the present study shows that the prevalence of HBV infection among HIV-positive patients was 13% and the risk factors involved in the outcomes of HIV-HBV co-infected patients were gender, age, and intravenous drug users. © 2015 Wiley Periodicals, Inc.

  18. Patient knowledge and intention to use the intrauterine contraceptive device IUCD at a tertiary level hospital

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    Nadia van der Westhuizen

    2016-12-01

    Full Text Available Background:  The intrauterine device (IUCD is a highly effective and safe method of contraception.  Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries.Despite numerous advantages and suitability the uptake of the IUCD is poor. Patients in South Africa seem to lack knowledge regarding this contraceptive.Objectives:  The aim of this study was to determine the quantity and quality of knowledge of the IUCD, and to evaluate its acceptability for future use.Methods:  A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital.  201 consecutive patients were interviewed using structured questionnaires.Results:  Awareness of the IUCD was found in almost half (49%, n=95 of our patients. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those that were aware of the IUCD. There was a significant association between level of education and knowledge, with patients having passed Grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (RR 1.57, 95% CI 1.18-2.08. Forty-five percent (n=86 of patients indicated a desire for future IUCD use.Conclusion:  Despite the availability of the IUCD in South African clinics and hospitals, its uptake is still poor. Awareness of this method seemed to have improved over the past few years, but the qualitative knowledge still lacks considerably.  Education plays a major role in the knowledge of contraception and better educational aids in all facilities will increase its use and reduce unwanted pregnancies. 

  19. Surgical therapies for corneal perforations: 10 years of cases in a tertiary referral hospital

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    Yokogawa H

    2014-10-01

    Full Text Available Hideaki Yokogawa, Akira Kobayashi, Natsuko Yamazaki, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanPurpose: To report surgical therapies for corneal perforations in a tertiary referral hospital.Methods: Thirty-one eyes of 31 patients (aged 62.4±18.3 years with surgically treated corneal perforations from January 2002 to July 2013 were included in this study. Demographic data such as cause of corneal perforation, surgical procedures, and visual outcomes were retrospectively analyzed.Results: The causes of corneal perforation (n=31 were divided into infectious (n=8, 26% and noninfectious (n=23, 74% categories. Infectious causes included fungal ulcer, herpetic stromal necrotizing keratitis, and bacterial ulcer. The causes of noninfectious keratopathy included corneal melting after removal of a metal foreign body, severe dry eye, lagophthalmos, canaliculitis, the oral anticancer drug S-1, keratoconus, rheumatoid arthritis, neurotrophic ulcer, atopic keratoconjunctivitis, and unknown causes. Initial surgical procedures included central large corneal graft (n=17, small corneal graft (n=7, and amniotic membrane transplantation (n=7. In two cases the perforation could not be sealed during the first surgical treatment and required subsequent procedures. All infectious keratitis required central large penetrating keratoplasty to obtain anatomical cure. In contrast, several surgical options were used for the treatment of noninfectious keratitis. After surgical treatment, anatomical cure was obtained in all cases. Mean postoperative best corrected visual acuity was better at 6 months (logMAR 1.3 than preoperatively (logMAR 1.8.Conclusion: Surgical therapies for corneal perforations in our hospital included central large lamellar/penetrating keratoplasty, small peripheral patch graft, and amniotic membrane transplantation. All treatments were effective. Corneal

  20. Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital.

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    Judith Rodríguez-García

    Full Text Available Controversy exists as to whether obesity constitutes a risk-factor or a protective-factor for the development of nosocomial Infection (NI. According to the obesity-paradox, there is evidence that moderate obesity is a protective-factor. In Mexico few studies have focused on the nutritional status (NS distribution in the hospital setting.The aim of this study was to estimate the distribution of NS and the prevalence of nosocomial infection NI among adult elective surgery (ES patients and to compare the clinical and anthropometric characteristics and length of stays (LOS between obese and non-obese patients and between patients with and without NI.We conducted a cross-sectional study with a sample (n = 82 adult ES patients (21-59 years old who were recruited from a tertiary-care hospital. The prevalences of each NS category and NI were estimated, the assessments were compared between groups (Mann-Whitney, Chi-squared or the Fisher's-exact-test, and the association between preoperative risk-factors and NI was evaluated using odds ratios.The distribution of subjects by NS category was: underweight (3.66%, normal-weight (28.05%, overweight (35.36%, and obese (32.93%. The prevalence of NI was 14.63%. The LOS was longer (p<0.001 for the patients who developed NI. The percentages of NI were: 33.3% in underweight, 18.52% in obese, 17.39% in normal-weight, and 6.90% in overweight patients.The prevalence of overweight and obesity in adult ES patients is high. The highest prevalence of NI occurred in the underweight and obese patients. The presence of NI considerably increased the LOS, resulting in higher medical care costs.

  1. Clinico-microbiological study of dermatophytosis in a tertiary-care hospital in North Karnataka

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    Tonita M Noronha

    2016-01-01

    Full Text Available Context: The dermatophytoses constitute a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The distribution and frequency of dermatophytosis and their etiologic agents vary according to the geographic region studied, the socio-economic level of the population, the time of study, the climatic variations, the presence of domestic animals, and age. Aims: The present study was undertaken to assess the clinical profile of dermatophytic infections and to identify the causative fungal species in the various clinical presentations. Settings and Design: This was a hospital-based observational study. Materials and Methods: One hundred and fifty clinically suspected cases of dermatophytosis attending the outpatient department of a tertiary care hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Statistical Analysis Used: Statistical analysis was done using SPSS 17.0 software. Chi-square test and contingency coefficient test were used as significant tests for analysis. Results: Out of 150 patients studied, majority belonged to the age group of 21–30 years (22.7%. Male-to-female ratio was 1.63:1. Tinea corporis (24.7% was the most common clinical type observed. The overall positivity by culture was 40% and by direct microscopy was 59.3%. Trichophyton mentagrophytes was the predominant species isolated (48.3%. Conclusions: The present study reveals the changing trend in the prevalence of dermatophyte species in this part of Karnataka.

  2. [Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital].

    Science.gov (United States)

    López-Picazo Ferrer, J J; Tomás García, N; Cubillana Herrero, J D; Gómez Company, J A; de Dios Cánovas García, J

    2014-01-01

    To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level («A» to «D») increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. There were 22.4±6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. AEP is useful to assess the admission appropriateness and may be included in the «Emergencies» process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  3. Frequency of Group B Streptococci in Pregnant Women in a Tertiary Care Hospital

    International Nuclear Information System (INIS)

    Munir, S. I.; Waheed, K.; Khanum, A.; Iqbal, R.; Eusaph, A. Z.; Hanif, A.

    2016-01-01

    Objective: To determine the frequency and risk factors of Group B Streptococci (GBS) in pregnant patients in third trimester in a tertiary care hospital in Lahore. Study Design: Cross-sectional, prospective study. Place and Duration of Study: Lady Willingdon Hospital, Lahore, from October 2014 to March 2015. Methodology: Sterile lower vaginal swabs were taken from 200 women aged 20 years and over, in third trimester, with no history of vaginal bleeding, ruptured membrane, recent intake of antibiotics or chronic illness. These swabs were cultured for detection of GBS. The risk factors of GBS and its frequency were noted in the pregnant population. Quantitative and qualitative data was analyzed by SPSS version 20. Chi-square test was applied to see association between diagnosis of GBS and other categorical variables. P-value 0.05 was considered as statistically significant. Results: In this study, the mean age of all the females was 26.36 ±4.32 years and mean duration of pregnancy was 35.54 ±2.65 weeks. Frequency of GBS in pregnant women was found as 14 percentage. We observed significant association of GBS with parity and previous history of miscarriage (p-value = 0.033 and 0.010 respectively). Moreover, significant association between vaginal discharge and GBS was also found (p = 0.027). Conclusion: GBS is present in a small but significant number of pregnant women in our setting and it has association with multiparity, vaginal discharge during pregnancy, and previous history of miscarriage. (author)

  4. Effectiveness and acceptability of ready to use therapeutic foods among malnourished children in tertiary care hospital

    International Nuclear Information System (INIS)

    Bashir, A.

    2016-01-01

    Ready-to-use-therapeutic foods (RUTF) are an important component of the effective outpatient treatment of severe wasting because most of the child deaths in the world especially in developing countries is due to malnutrition. The objective of the study was to evaluate the effectiveness and acceptability of ready to use therapeutic food among malnourished children in a tertiary care hospital. Methods: An observational exploratory study based on sixty subjects with 3-120 months of age, malnourished children were chosen by universal sampling from Children Hospital Lahore, Pakistan, during the time period 1st September 2012 to 30th November 2012 with the approval of ethical committee. The study tool for investigation was a well-structured questionnaire. Results: The highest proportion of malnourished children belonged to urban areas (71.67%) and age group <24 months (65%). The effect of RUTF on weight for height and weight for age Z score from baseline to the end of follow-up was statistically significant (Paired sample t-test) (p=0.000, 0.000) but there was no significant effect of RUTF on height for age (p-value=0.14).The acceptance of food among patients was good, the proportion of patient was higher who consumed ready to use therapeutic food easily (70%), percentage of vomiting (16.7%) and complaints of diarrhoea (46.7%) after taking RUTF was less in patients. All mothers were satisfied from ready to use therapeutic foods (100%). Conclusion: Malnourished children gained weight after the short term supplementation of ready to use therapeutic food but had no significant effect on height of the patients. Its acceptability in term of taste, amount consumes and demand was good. Mother's perception was also satisfactory regarding these foods. (author)

  5. Frequency Of Hyperthermia In Acute Ischemic Stroke Patients Visiting A Tertiary Care Hospital

    International Nuclear Information System (INIS)

    Maheshwari, A. K.; Kumar, P.; Alam, M. T.; Aurangzeb, M.; Imran, K.; Masroor, M.; Parkash, J.

    2016-01-01

    Objective: To determine the frequency of hyperthermia in acute ischemic stroke patients visiting a tertiary care hospital in a developing country. Study Design: Cross-sectional, observational study. Place and Duration of Study: Medical Wards of Civil Hospital, Karachi, from January to June 2013. Methodology: Patients aged = 18 years of either gender with acute ischemic stroke presenting within 24 hours of onset of symptoms were included. Written informed consent was obtained from all participants as well as approval of ethical review committee of the institute. Axillary temperature by mercury thermometer was monitored at the time of admission and after every 6 hours for 3 days. The data was analyzed using SPSS version 17.0 (SPSS Inc., IL, Chicago, USA). Result: A total of 106 patients of ischemic stroke were included. The mean age of enrolled participants was 60.1 ±9.5 years. Among these, 61 (57.5 percentage) were males and 45 (42.5 percentage) females. Among all patients, 51.9 percentage presented with loss of consciousness, 30.2 percentage with slurred speech, 77.4 percentage with limb weakness, and 9.4 percentage with decrease vision. A total of 17 (16 percentage) patients with ischemic stroke developed hyperthermia. When the prevalence of hyperthermia was stratified according to age, among patients of < 60 years of age, 26 percentage developed hyperthermia compared to 7.1 percentage in patients of = 60 years of age (p=0.008). On gender stratification, among male patients, 14.8 percentage developed hyperthermia compared to 17.8 percentage in female patients (p=0.43). Conclusion: It is concluded from this study that the frequency of hyperthermia in ischemic stroke was 16 percentage and it should be looked for as it has significant impact on the outcome. The hyperthermia was significantly more common in younger adults as compared to older adults. However, gender had no influence on the prevalence rate of hyperthermia. (author)

  6. HIV counseling and testing in a tertiary care hospital in Ganjam district, Odisha, India.

    Science.gov (United States)

    Dash, M; Padhi, S; Sahu, S; Mohanty, I; Panda, P; Parida, B; Sahoo, M K

    2013-01-01

    Human immunodeficiency virus (HIV) counseling and testing (HCT) conducted at integrated counseling and testing centers (ICTCs) is an entry point, cost-effective intervention in preventing transmission of HIV. To study the prevalence of HIV among ICTC attendees, sociodemographic characteristics, and risk behaviors of HIV-seropositive clients. It was hospital record-based cross-sectional study of 26,518 registered ICTC clients at a tertiary care hospital in Ganjam district, Odisha, India over a 4-year period from January 2009 to September 2012. A total of 1732 (7.5%) out of 22,897 who were tested for HIV were seropositive. Among HIV-seropositives, 1138 (65.7%) were males, while 594 (34.3%) were females. Majority (88.3%) of seropositives were between the age group of 15-49 years. Client-initiated HIV testing (12.1%) was more seropositive compared to provider-initiated (2.9%). Among discordant couples, majority (95.5%) were male partner/husband positive and female partner/wife negative. Positives were more amongst married, less educated, low socioeconomic status, and outmigrants (P<0.0001). Risk factors included heterosexual promiscuous (89.3%), parent-to-child transmission 5.8%, unknown 3.1%, infected blood transfusion 0.8%, homosexual 0.5%, and infected needles (0.5%). There is need to encourage activities that promote HCT in all health facilities. This will increase the diagnosis of new HIV cases. The data generated in ICTC provide an important clue to understand the epidemiology in a particular geographic region and local planning for care and treatment of those infected with HIV and preventive strategies for those at risk especially married, young adults, and outmigrants to reduce new infections.

  7. Compliance to topical anti-glaucoma medications among patients at a tertiary hospital in North India

    Directory of Open Access Journals (Sweden)

    Ketaki Rajurkar

    2018-06-01

    Full Text Available Purpose: The present study aims to estimate the prevalence of non-compliance and improper drop administration technique among glaucoma patients and describe common obstacles to medication compliance. Methods: A hospital-based cross-sectional study, using standardized questionnaire and direct observation by study personnel was conducted among glaucoma patients aged 18 years and above at a tertiary care charitable eye hospital in North India. 151 consecutive glaucoma patients on medical therapy following up at the glaucoma clinics for at least 6 months were recruited. Non-compliance was defined as missing at-least one drop of medication per week and (or the inability to accurately describe the medication regimen. Study personnel also assessed drop administration technique during application of eye drops by patients treating ophthalmologist-provided information, including measures of disease stability. Factors such as socioeconomic status, presence of caregiver, and number of medications with their effect on compliance were studied using chi-square statistics. Results: Among 151 patients interviewed, around 49% of patients reported problems in using glaucoma medications, with 16% of them reporting total non-compliance. 35% of patients demonstrated improper drop administration technique. Forgetfulness was cited as the main reason for being non-compliant and had a significant association with non-compliance (P = 0.00. Paying patients were more compliant as compared to subsidized patients (P = 0.05. Disease was more stable in compliant patients compared to non-compliant patients (P = 0.05. No other factor had significant association with compliance (P > 0.05. Conclusions: Over 50% of the patients surveyed were non-compliant, and 35% demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and aids that minimize forgetfulness, and delivery systems facilitating the delivery of

  8. Retinopathy risk factors among diabetics in a tertiary care military hospital

    International Nuclear Information System (INIS)

    Nizi, M.K.; Ameen, S.S.; Saeed, K.; Yaqub, M.A.; Khan, M.D.; Arain, M.A.

    2011-01-01

    Objective: To determine the frequency and risk factors for severity of retinopathy in diabetic patients referred to a tertiary military hospital. Study Design: Cross-sectional study. Place and duration of study: Armed Forces Institute of Ophthalmology, Rawalpindi from Jun 2008 to Dec 2009. Patients and Methods: Diabetic patients aged 40 to 79, referred for suspected diabetic retinopathy (DR) on fundoscopy from medical outpatient clinic of Military Hospital Rawalpindi were randomly included in the study. Participants underwent a standardized interview and examination. Retinopathy was assessed through dilated pupils, and graded into absent retinopathy, mild to moderate, or advanced. Presence of clinically significant macular edema (CSME) was also recorded. To evaluate the simultaneous effect of significant risk factors on the different stages of DR, multivariate regression analysis was carried out. Results: Out of five hundred and ten patients, DR was confirmed in 63% cases with advanced retinopathy in 21.3%. In univariate analysis, duration of diabetes, fasting blood glucose, and presence of macular oedema were significantly associated with retinopathy (P<0.005). On multivariate analysis, however, only duration of diabetes (Odds Ratio 6.15 for 5 to 10 years and 38.29 for more than 10 years) and macular oedema (OR 6.617 95% CI 3.95-11.07) remained significant. CSME was present in 173 (33%) patients and its frequency increased with the severity of DR (P <0.001). Conclusion: The frequency of DR among military personnel and their dependants was high with strong association to duration of diabetes. This underscores the importance of regular retinal examination to detect DR in the early stages and timely intervention to prevent diabetes related blindness. (author)

  9. Impact assessment of an automated drug-dispensing system in a tertiary hospital

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    Débora de-Carvalho

    Full Text Available OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013 and post- (October 2013-October 2014 intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy. Costs were evaluated based on a 5-year analytical horizon and are reported in Brazilian Reals (R$ and US dollars (USD. RESULTS: The observed decrease in the mean number of events reported with regard to the automated drug-dispensing system between pre- and post-implementation periods was not significant. Importantly, the numbers are small, which limits the power of the mean comparative analysis between the two periods. A reduction in work time was observed among the nurses and administrative assistants, whereas pharmacist assistants showed an increased work load that resulted in an overall 6.5 hours of work saved/day and a reduction of R$ 33,598 (USD 14,444 during the first year. The initial investment (R$ 206,065; USD 88,592 would have been paid off in 5 years considering only personnel savings. Other findings included significant reductions of audit adjustments to patient hospital bills and urgent requests and returns of medications to the central pharmacy. CONCLUSIONS: Evidence of the positive impact of this technology on personnel time and costs and on other outcomes of interest is important for decision making by health managers.

  10. Control of multidrug resistant bacteria in a tertiary care hospital in India

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    Jaggi Namita

    2012-06-01

    Full Text Available Abstract Background The objective of this study was to assess the impact of antimicrobial stewardship programs on the multidrug resistance patterns of bacterial isolates. The study comprised an initial retrospective analysis of multidrug resistance in bacterial isolates for one year (July 2007-June 2008 followed by prospective evaluation of the impact of Antimicrobial Stewardship programs on resistance for two years and nine months (July 2008-March 2011. Setting A 300-bed tertiary care private hospital in Gurgaon, Haryana (India Findings Methods Study Design • July 2007 to June 2008: Resistance patterns of bacterial isolates were studied. • July 2008: Phase I intervention programme Implementation of an antibiotic policy in the hospital. • July 2008 to June 2010: Assessment of the impact of the Phase I intervention programme. • July 2010 to March 2011: Phase II intervention programme: Formation and effective functioning of the antimicrobial stewardship committee. Statistical correlation of the Defined daily dose (DDD for prescribed drugs with the antimicrobial resistance of Gram negatives. Results Phase I intervention programme (July 2008 resulted in a decrease of 4.47% in ESBLs (E.coli and Klebsiella and a significant decrease of 40.8% in carbapenem-resistant Pseudomonas. Phase II intervention (July 2010 brought a significant reduction (24.7% in carbapenem-resistant Pseudomonas. However, the resistance in the other Gram negatives (E.coli, Klebsiella, and Acinetobacter rose and then stabilized. A positive correlation was observed in Pseudomonas and Acinetobacter with carbapenems and cefoperazone-sulbactam. Piperacillin-tazobactam showed a positive correlation with Acinetobacter only. E.coli and Klebsiella showed positive correlation with cefoparazone-sulbactam and piperacillin-tazobactam. Conclusion An antimicrobial stewardship programme with sustained and multifaceted efforts is essential to promote the judicious use of antibiotics.

  11. A descriptive study of hyponatremia in a tertiary care hospital of Eastern India

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    Nandini Chatterjee

    2012-01-01

    Full Text Available Background: Hyponatremia is one of the commonest electrolyte disturbances encountered in medical wards and contributes to substantial morbidity and mortality. However, early recognition and management drastically alters prognosis. Therefore, this observational study was taken up to explore the clinical profile of hyponatremia. Aim: To assess the incidence and clinical profile of hyponatremia in medically ill patients. Materials and Methods: This observational study was conducted in the medical ward of a tertiary care hospital from March 2010 to April 2011. All patients underwent routine hemogram, blood biochemistry, serum electrolytes, thyroid function tests, and morning serum cortisol estimation. This was followed by a plasma and urinary osmolality determination (osmometer 800 CL as well as urinary sodium estimation. Patients were diagnosed to have syndrome of inappropriate antidiuretic hormone secretion (SIADH if they satisfied the Bartter and Schwartz criteria. Results: 201 patients (16.4% had a serum Na < 135 meq/l. There were 126 (62.69% male patients and 75 (37.31% female patients. Severe hyponatremia (Na < 120 meq/l was detected in 30 patients (2.4%. The largest group of hyponatremic patients were euvolemic [102 (50.74%], followed by hypervolemic [54 (26.86%] and hypovolemic [45 (22.4%]. Sixty-six patients fulfilled the criteria for SIADH. The most common underlying predisposing factor for hyponatremia in our case series was fluid loss by vomiting/diarrhea. During the hospital stay, 13.5% (15/201 hyponatremic patients died, while the corresponding figure in normonatremic patients was 8.5% (87/1020. Conclusion: The incidence of hyponatremia in our series was higher than values mostly reported in western literature. Euvolemic hyponatremia was the most common type, a significant fraction of which is SIADH.

  12. The financial burden of cancer: Estimates from patients undergoing cancer care in a tertiary care hospital

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    Zaidi Adnan A

    2012-10-01

    Full Text Available Abstract Introduction The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private tertiary care hospital. Methods This cross-sectional study was conducted at day care and radiotherapy unit of Aga Khan University, Hospital (AKUH Karachi, Pakistan. All adult patients with breast and head & neck cancers diagnosed for 3 months or more were included. Data was collected using a structured questionnaire and analysed using SPSS. Results Sixty seven patients were interviewed during the study period. The mean and median monthly income of these patients was 996.4 USD and 562.5 USD respectively. Comparatively the mean and median monthly cost of cancer care was 1093.13 USD and 946.42 USD respectively. The cost of the treatment either fully or partially was borne by the family in most cases (94%. The financial burden of cancer was perceived as significant by 28 (42% patients and unmanageable by 18 (27% patients. This perceived level of burden was associated significantly with average monthly income (p = Conclusion Our study indicates that the financial burden of cancer care is substantial and can be overwhelming. There is a desperate need for treatment support programs either by the government or other welfare organisations to support individuals and families who are already facing a difficult and challenging situation.

  13. [A case-series analysis of tuberculosis in pediatric patients treated in a tertiary level hospital].

    Science.gov (United States)

    Vázquez Rosales, José Guillermo; Acosta Gallegos, Cynthia; Miranda Novales, María Guadalupe; Fuentes Pacheco, Yazmín Del Carmen; Labra Zamora, María Guadalupe; Pacheco Rosas, Daniel Octavio; Solórzano Santos, Fortino

    Tuberculosis (TB) remains a challenge because severe forms occur most frequently in children under 5 years of age and the diagnosis is complex. The objective of this paper was to describe the clinical presentation, frequency, diagnostic methods used and response to treatment in children with TB treated at a tertiary level hospital. The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2010 to December 2013. Ninety-three medical records of children diagnosed with TB according to the definition of the NOM-006-SSA2-2013 were reviewed. Descriptive statistics were used for the analysis. From 93 children, 58% were male (mean age of 7 years), 97% with a history of BCG vaccination, and 6% had contact with a TB case. The most frequent clinical forms were pulmonary (30.1%), lymph node (24.7%), miliary/disseminated (16.1%), meningeal (13%), and osteal TB (7.5%). The most common symptoms were fever and weight loss (50% and 40%, respectively). BAAR and culture were positive in 26% and 7% of all cases, respectively. The histopathological study was conclusive in 90% of the cases. The treatment was successful in 94.6%, with not associated mortality. The association of clinical symptoms with alterations in chest radiography and positive PPD are useful in establishing the presumptive diagnosis and an early and appropriate treatment. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  14. NICU OUTCOME IN A LOW RESOURCE TEACHING HOSPITAL SETTING

    OpenAIRE

    Sunil; Adarsh; Sahana; Prema; Tamil; Purushotham; Rajanish; Sebastain

    2013-01-01

    OBJECTIVE : To study the mortality pattern in a level III neonatal intensive care unit (NICU)in a low resource teaching hospital. METHODS : A retrospective study was conducted over a period of three years from January 2011 to December 2013. The medical records of all babies who died after being admitte d to the NICU were reviewed. Survival was defined as the discharge of a live infant from the hospital. Data regarding...

  15. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

    Science.gov (United States)

    Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

    2015-01-01

    Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  16. Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

    Directory of Open Access Journals (Sweden)

    Wei Tian

    Full Text Available Universal Zero-Markup Drug Policy (UZMDP mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST.This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively.In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively, while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4% and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%.Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

  17. Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

    Science.gov (United States)

    Tian, Wei; Yuan, Jiangfan; Yang, Dong; Zhang, Lanjing

    2016-01-01

    Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

  18. Prevalence of Clostridium difficile infection and colonization in a tertiary hospital and elderly community of North-Eastern Peninsular Malaysia.

    Science.gov (United States)

    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 difficile colonization is 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.

  19. Are medical students accepted by patients in teaching hospitals?

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    Yousef Marwan

    2012-04-01

    Full Text Available Background: Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients’ acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. Methods: Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%. A self-administered questionnaire was used to collect data. Results: In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients’ files, presenting in outpatient clinic, observing doctors performing examination or procedures compared to other situations (e.g., performing physical examination or procedures. Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8% believed that the presence of medical students in hospitals improves the quality of health care. Conclusion: Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate.

  20. Grandmultiparity: outcome of delivery in a tertiary hospital in southern Nigeria.

    Science.gov (United States)

    Abasiattai, Aniekan M; Utuk, Ntiense M; Udoma, Edem J; Umoh, Augustine V

    2011-01-01

    Grandmultiparity is traditionally associated with increased risk of complications during pregnancy and delivery. Reports from developed countries where obstetric facilities are excellent and the standard ofperinatal care is high indicate that currently, obstetric complications among grandmultipara are now independently associated with progressive maternal age. In Nigeria and other developing nations however, grandmultiparity still contributes a significant proportion of the obstetric population. The aim of this study is to evaluate the outcome of delivery of grandmultiparous patients at the University of Uyo Teaching Hospital. The case records of all grandmultiparous patients who delivered at the University of Uyo Teaching Hospital, Uyo over a six-year period were studied. Grandmultiparous women constituted 6.4% of the parturients who delivered in the hospital during the study period. Their ages ranged from 20-45 years with majority (71.5%) being 30-39 years. Majority (77.9%) were para 5 and 6 and 326 (80.1%) of the patients booked and received antenatal care in the hospital. Majority of the booked patients (79.8%) initiated antenatal care after 32 weeks of gestation while all the unbooked patients 68 (16.7%) and the antenatal clinic defaulters 8 (2.0%) were brought from unorthodox health facilities when they developed obstetric complications. Two hundred and forty three patients (59.7%) had spontaneous vaginal delivery, 15 (3.7%) of the patients had laparotomy for ruptured uterus and out of these ten of them (66.7%) had a subtotal abdominal hysterectomy while five (33.4%) had uterine repair and bilateral tubal ligation. The perinatal mortality rate was 128/1000 births. There were three maternal deaths, two from eclampsia while one followed postpartum haemorrhage resulting in a maternal mortality rate of 7.4/1000. The prevalence of grandmultiparity in our centre is relatively low. It is, however, associated with high perinatal and maternal morbidity and mortality

  1. Burkholderia cepacia infection at A university Teaching Hospital in ...

    African Journals Online (AJOL)

    Twenty five isolates of B. cepacia, representing 1.4% of all isolates, were obtained at the Microbiology Laboratory of a University Teaching Hospital in Lagos between January 1996 and December 1997. Identification of isolates was done using analytical profile index systems (Biomerieux, France) and sensitivity testing was ...

  2. Endometrial pathology in a teaching hospital in North Central ...

    African Journals Online (AJOL)

    The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

  3. Childhood Nephrotic Syndrome in Aminu Kano Teaching Hospital ...

    African Journals Online (AJOL)

    Methods: A prospective study spanning two years (July 2002 – August 2004). Twenty two children with nephrotic syndrome were seen ate the Aminu Kano Teaching Hospital, Kano. The demographic, clinical and laboratory features and response to treatment were documented. Results: Nephritic syndrome made up of 1.2% ...

  4. Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

    African Journals Online (AJOL)

    Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

  5. Audit of day case surgery in LAUTECH teaching hospital, Osogbo ...

    African Journals Online (AJOL)

    Background/ method: A retrospective study of all patients operated as day-case at the Ladoke Akintola University Teaching Hospital Osogbo over a period of 14 months (October 2000 to November 2001) was carried out. Results: Seventy-six patients were operated as day-cases within the study period, but 74 case notes ...

  6. Medical Audit: A Nigerian Teaching Hospital's Preliminary Experience

    African Journals Online (AJOL)

    The definition, historical background, aims dimensions and the characteristics of medical audit as well as the indices to be measured in a medical audit exercise are highlighted. The preliminary experience of the University of Ilorin Teaching Hospital (UITH) in the planning, implementation and monitoring of a viable medical ...

  7. Ectopic Pregnancy in Lagos State University Teaching Hospital ...

    African Journals Online (AJOL)

    We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the ...

  8. Uniocular blindness in Delta State Teaching Hospital, Oghara, Nigeria

    African Journals Online (AJOL)

    Background: Uniocular blindness causes loss of binocular single vision. People with uniocular blindness are potentially at risk of developing binocular blindness. Aim: To determine the prevalence rate, causes and risk factors for uniocular blindness in a teaching hospital in southern Nigeria over a one-year period. Methods: ...

  9. Epidemiology of open tibial fractures in a teaching hospital ...

    African Journals Online (AJOL)

    Methods: This is a prospective observational study of all open tibial fractures seen at the Accident and Emergency department of the University of Port Harcourt Teaching Hospital (UPTH) over a twelve- month period (July 2002- June 2003). Data from a pre-designed proforma for the study was analyzed and descriptive ...

  10. Anaemia in Pregnancy in Abia State University Teaching Hospital, Aba

    African Journals Online (AJOL)

    A prospective study of incidence of anaemia in pregnancy at Abia state University Teaching Hospital, Aba was conducted over a six-month period spanning from 31st January 2000 to 31st July 2000. The incidence of anaemia in pregnancy was 29%. The vast majority (97.6%) had mild anaemia. The result showed that most ...

  11. Introduction of bubble CPAP in a teaching hospital in Malawi

    NARCIS (Netherlands)

    Van den Heuvel, M.; Blencowe, H.; Mittermayer, K.; Rylance, S.; Couperus, A.; Heikens, G. T.; Bandsma, R. H. J.

    Background: Continuous positive airway pressure (CPAP) is relatively inexpensive and can be easily taught; it therefore has the potential to be the optimal respiratory support device for neonates in developing countries. Objective: The possibility of implementing bubble CPAP in a teaching hospital

  12. Health workers' ICT literacy in a Nigerian University Teaching Hospital

    African Journals Online (AJOL)

    This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...

  13. Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

    African Journals Online (AJOL)

    Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

  14. Outpatient waiting time in Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

  15. Neonatal outcomes of Syrian refugees delivered in a tertiary hospital in Ankara, Turkey.

    Science.gov (United States)

    Büyüktiryaki, Mehmet; Canpolat, Fuat Emre; Alyamaç Dizdar, Evrim; Okur, Nilüfer; Kadıoğlu Şimşek, Gülsüm

    2015-01-01

    We retrospectively reviewed the medical records of all Syrian immigrants from the TurkishSyrian border who delivered the Zekai Tahir Burak Maternity and Teaching Hospital Neonatal Intensive Care Unit (NICU) in Ankara, Turkey. Between January 2013 and December 2014 a total of 36,346 women gave birth at this center. Of these, 457 women were Syrian immigrants, comprising 1.2 % (457/36,346) of all deliveries. The number of births among Syrian refugees in Turkey appears to be increasing. Further research is needed to understand the relative morbidity of babies born to Syrian refugees compared to the local population, as well as the economic impact on facilities treating these cases.

  16. 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...

  17. Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

    OpenAIRE

    Kang, Byung Ju; Jo, Kyung-Wook; Park, Tai Sun; Yoo, Jung-Wan; Lee, Sei Won; Choi, Chang-Min; Oh, Yeon-Mok; Lee, Sang-Do; Kim, Woo Sung; Kim, Dong Soon; Shim, Tae Sun

    2013-01-01

    Background The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified ...

  18. Analysis of doctor-patient relationship status and its influencing factors of the tertiary hospital in Suzhou

    OpenAIRE

    Bing-yi WANG; Teng XIA; Xiao-tian YAN; Yi-cheng SHEN; Jia-ning WANG; Ya-na MA

    2014-01-01

    Objective: To investigate the relationship between doctors and patients in Suzhou, we focused on exploring the factors of doctor-patient communication, and strived to deepen the doctor-patient communication skills and knowledge. Method: Questionnaire survey was carried out in comprehensive tertiary-class hospitals in Suzhou , adopting the method of random sampling, respectively on patients and doctors. Results: 593 valid questionnaires were from both doctors and patients. The doctors thought ...

  19. PREVALENCE OF ANEMIA AND ITS SOCIO - DEMOGRAPHIC DETERMINANTS IN PREGNANT WOMEN AT A TERTIARY CARE HOSPITAL IN JAIPUR, RAJASTHAN

    OpenAIRE

    Prabhjot Singh; Swati; Rajat; Urvahi; Karnika; Isha; Navsangeet; Arihant

    2015-01-01

    AIM: Prevalence of anemia and its socio - demographic determinants in pregnant women at a tertiary care hospital in Jaipur, Rajasthan . MATERIALS AND METHODS: All the pregnant women aged 25 to 35 years , registered at antenatal clinic at Department of Obstetrics an d Gynaecology , Mahatma Gandhi Medical College , Jaipur were included. A predesigned and pre tested questionnaire was used to elicit the information. Various possible causes of anaemi...

  20. PRESCRIBING TRENDS OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS IN A TERTIARY CARE HOSPITAL IN THE MIDDLE ANATOLIA

    OpenAIRE

    Elif Borekci

    2017-01-01

    Background: Non-steroidal anti-inflammatory (NSAI) drugs are widely used for their analgesic, antipyretic and antiinflammatory effects. The aim of this study is to evaluate the prescribing trends of NSAI drugs among the doctors working the outpatients clinics in our hospital. Materials and methods: Questionnaires consisting of 10 questions related to analgesic and NSAI drug preferences were applied to the doctors working the medical and surgery outpatient clinics in a tertiary care hospita...

  1. Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania.

    Science.gov (United States)

    Sawe, Hendry R; Mfinanga, Juma A; Lidenge, Salum J; Mpondo, Boniventura C T; Msangi, Silas; Lugazia, Edwin; Mwafongo, Victor; Runyon, Michael S; Reynolds, Teri A

    2014-09-23

    In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania. This was a retrospective analysis of ICU patient records, for three years (2009 to 2011) from all tertiary referral hospitals of Tanzania, namely Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Mbeya Referral Hospital (MRH) and Bugando Medical Centre (BMC). MNH is the largest of the four referral hospitals with 1300 beds, and MRH is the smallest with 480 beds. The ratio of hospital beds to ICU beds is 217:1 at MNH, 54:1 at BMC, 39:1 at KCMC, and 80:1 at MRH. KCMC had no infusion pumps. None of the ICUs had a point-of-care (POC) arterial blood gas (ABG) analyzer. None of the ICUs had an Intensive Care specialist or a nutritionist. A masters-trained critical care nurse was available only at MNH. From 2009-2011, the total number of patients admitted to the four ICUs was 5627, male to female ratio 1.4:1, median age of 34 years. Overall, Trauma (22.2%) was the main disease category followed by infectious disease (19.7%). Intracranial injury (12.5%) was the leading diagnosis in all age groups, while pneumonia (11.7%) was the leading diagnosis in pediatric patients (<18 years). Patients with tetanus (2.4%) had the longest median length ICU stay: 8 (5,13) days. The overall in-ICU mortality rate was 41.4%. The ICUs in tertiary referral hospitals of Tanzania are severely limited in infrastructure, personnel, and resources, making it difficult or impossible to provide optimum care

  2. Candidemia in a major regional tertiary referral hospital – epidemiology, practice patterns and outcomes

    Directory of Open Access Journals (Sweden)

    Jocelyn Qi-Min Teo

    2017-03-01

    Full Text Available Abstract Background Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. Methods A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. Results In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%, C. tropicalis (29.9%, and C. albicans (23.8% were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0–0.007, p = 0.04. Fluconazole resistance was detected primarily in C. tropicalis (16.7% and C. glabrata (7.2%. fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01, neutropenia (p < 0.001 and higher SAPS II scores (p = 0.02, while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001. Echinocandins (73.3% were most commonly prescribed as initial treatment. The median (range time to initial treatment was 1 (0–9 days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05–1.11 and renal replacement therapy (OR 5.54; CI 2.80–10.97 were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19–0.99 was protective. Conclusions Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility

  3. Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

    Directory of Open Access Journals (Sweden)

    Suriya C

    2011-12-01

    Full Text Available Chutikarn Suriya1, Nongyao Kasatpibal2, Wipada Kunaviktikul2, Toranee Kayee31Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, 2Faculty of Nursing, Chiang Mai University, 3Department of Surgery, Nakornping Hospital, Chiang Mai, ThailandIntroduction: Limited data currently exists regarding the diagnostic indicators of peptic ulcer perforation for early detection among patients in Thailand. Delayed diagnosis and treatment for an ulcer can be life-threatening, resulting in shock or death.Objective: To determine the diagnostic indicators of peptic ulcer perforation.Material and methods: A cohort study was conducted in a tertiary care hospital in Thailand from 2005 to 2009. Peptic ulcer patients aged 15 years and over admitted to the surgical department were included. The diagnostic indicators used criteria of the patients' final diagnoses and operations, coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, which included patient profiles, gender, age, coexisting illnesses, personal habits, signs and symptoms, laboratory investigations, radiological finding, and treatment role. Exponential risk regression analyses to obtain relative risk (RR estimates for diagnostic indicators were analyzed using Stata® statistical software package, version 11 (StataCorp LP, College Station, TX.Results: The study included 1290 patients. Of these, 57% reported perforated peptic ulcer. Multivariate analysis showed five diagnostic indicators: signs and symptoms including intense abdominal pain (RR = 1.53, 95% confidence interval [CI] 1.14–2.06, tenderness (RR = 1.94, 95% CI 1.17–3.21, and guarding (RR = 1.52, 95% CI 1.05–2.20; X-ray with free air (RR = 2.80, 95% CI 2.08–3.77; and referral from other hospitals (RR = 1.37, 95% CI 1.03–1.82.Conclusion: Five diagnostic indicators for peptic ulcer perforation monitoring were suggested from this study. Improving diagnostic

  4. Prevalence and genotypic relatedness of methicillin resistant Staphylococcus aureus in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    B A Fomda

    2014-01-01

    Full Text Available Background: Methicillin-resistant Staphylococcus aureus (MRSA is the most common multidrug-resistant pathogen causing nosocomial infections across the world. MRSA is not only associated with significant mortality and morbidity but also places a large economic strain on our health care system. MRSA isolates are also typically resistant to multiple, non-β-lactam antibiotics. We conducted a prospective study in a tertiary care hospital, to determine the prevalence of MRSA and to establish the clonal distribution of MRSA isolates recovered from various clinical specimens. Materials and Methods: Clinical samples were cultured and S. aureus was identified as per standard microbiological procedures. Susceptibility testing was done by agar disk diffusion and minimum inhibitory concentration (MIC method as recommended by CLSI. Methicillin resistance was detected by phenotypic methods namely, oxacillin disc diffusion (ODD, minimum inhibitory concentration (MIC of oxacillin, cefoxitin disk diffusion (CDD, and MIC of cefoxitin. Amplification of mecA gene by PCR was used as gold standard for detection of methicillin resistance. Pulsed field gel electrophoresis (PFGE typing was performed for MRSA isolates. Results: Out of 390 S. aureus isolates, 154 (39.48% isolates were MRSA and 236 (60.51% isolates were MSSA. Penicillin was the least effective antibacterial drug against the hospital associated S. aureus isolates with 85.64% resistance rate. All the isolates were susceptible to vancomycin. The MRSA showed a high level of resistance to all antimicrobials in general in comparison to the MSSA and the difference was statistically significant (P < 0.05. Multiplex PCR performed for all strains showed amplification of both the mecA and nucA genes in MRSA strains whereas MSSA strains showed amplification of only nucA gene. PFGE of these isolates showed 10 different patterns. Conclusion: Prevalence of MRSA in our hospital was 39.48%. Most of these isolates were

  5. Incidence of Hydronephrosis in Cervical Cancer Patients in A Tertiary Hospital Lagog, Nigeria.

    Science.gov (United States)

    Sowunmi, A C; Ajekigbe, A T; Alabi, A O; Popoola, A O; Fatiregun, O A; Akinyanju, A M

    2015-01-01

    Cervical cancer is still a global health challenge that affects women of reproductive age group and consequently causes a drawback on the social and economic stability of nations. Developing countries suffer a greater burden of the disease because of several factors such as poverty, multiple sexual partners, unbalanced diet, poor knowledge and attitude to prevention of diseases and late-presentation. The aim of this study is to evaluate the incidence of hydronephrosis in cervical cancer patients in Lagos University Teaching Hospital (LUTH), Lagos, Nigeria for the period of 3 years (2010-2012). This study is a cross sectional study carried out among cervical cancer patients seeking treatment in the Radiotherapy department of the Lagos University Teaching Hospital (LUTH), between the year 2010 and 2012, to find out the incidence of hydronephrosis using abdominopelvic ultrasonography. The incidence of hydronephrosis during the 3years period studied was 43.7%. A rise in the incidence of hydronephrosis of 5.4% in 2011 and 13.3% in 2012 was noted. The mean age of the patients was 55.5 years. 122 (56.7%) were grand multiparous and 123 (57.2%) had multiple sexual partners. An increase of 8.3% in 2011 and 9.3% in 2012 was noted in the incidence of cervical cancer cases studied. 107 (49.8%) presented at stages III and IV. Late presentation of patients is still a major challenge affecting treatment outcomes. The presence of hydronephrosis was noticed at staging, during or after treatment, resulting in the need to separate this population from current Stage IIIB classification. The presence of hydronephrosis may or may not be related to the disease and so adequate staging is important.

  6. Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

    Science.gov (United States)

    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. Clinical Presentation and Outcomes among Children with Sepsis Presenting to a Public Tertiary Hospital in Tanzania

    Directory of Open Access Journals (Sweden)

    Teresa Bleakly Kortz

    2017-12-01

    Full Text Available BackgroundPediatric sepsis causes significant global morbidity and mortality and low- and middle-income countries (LMICs bear the bulk of the burden. International sepsis guidelines may not be relevant in LMICs, especially in sub-Saharan Africa (SSA, due to resource constraints and population differences. There is a critical lack of pediatric sepsis data from SSA, without which accurate risk stratification tools and context-appropriate, evidence-based protocols cannot be developed. The study’s objectives were to characterize pediatric sepsis presentations, interventions, and outcomes in a public Emergency Medicine Department (EMD in Tanzania.MethodsProspective descriptive study of children (28 days to 14 years with sepsis [suspected infection with ≥2 clinical systemic inflammatory response syndrome (SIRS criteria] presenting to a tertiary EMD in Dar es Salaam, Tanzania (July 1 to September 30, 2016. Outcomes included: in-hospital mortality (primary, EMD mortality, and hospital length of stay. We report descriptive statistics using means and SDs, medians and interquartile ranges, and counts and percentages as appropriate. Predictive abilities of SIRS criteria, the Alert-Verbal-Painful-Unresponsive (AVPU score and the Lambaréné Organ Dysfunction Score (LODS for in-hospital, early and late mortality were tested.ResultsOf the 2,232 children screened, 433 (19.4% met inclusion criteria, and 405 were enrolled. There were 247 (61% subjects referred from an outside facility. Approximately half (54.1% received antibiotics in the EMD, and some form of microbiologic culture was collected in 35.8% (n = 145 of subjects. In-hospital and EMD mortality were 14.2 and 1.5%, respectively, median time to death was 3 days (IQR 1–6, and median length of stay was 6 days (IQR 1–12. SIRS criteria, the AVPU score, and the LODS had low positive (17–27.1, 33.3–43.9, 18.3–55.6%, respectively and high negative predictive values (88.6–89.8, 86.5

  8. [Association between occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China].

    Science.gov (United States)

    Dai, Junming; Hua, Yujie; Zhang, Hao; Huang, Li; Fu, Hua

    2015-10-01

    To investigate the current status of occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China, and to analyze the association between occupational stress and presenteeism. A total of 2356 healthcare workers from eight grade A tertiary hospitals in Shanghai were investigated by stratified random sampling. All the subjects were asked to complete self-administered questionnaires with informed consent. The occupational stress was assessed by the occupational stress core questionnaire. The presenteeism was evaluated by the Stanford Presenteeism Scale. In all subjects, the average score of presenteeism was 15.23 ± 3.89, and 72.5% felt occupational stress in self-evaluation. There were significant differences in the score of presenteeism between subjects with different ages, education levels, occupations, lengths of service, job titles, and shifts (all Poccupational stress, including job demand, control, social support, and demand-control ratio (Poccupational stress in medical staff from grade A tertiary hospitals is positively correlated with the level of presenteeism. It is important to promote social support to reduce the loss of work efficiency due to presenteeism.

  9. Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

    Science.gov (United States)

    Latta, Linda C; Dick, Ronald; Parry, Carol; Tamura, Glen S

    2008-03-01

    In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital. A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis. Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as "comfortable" with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred. Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

  10. Three-year follow-up of implementation of evidence-based transfusion practice in a tertiary hospital

    DEFF Research Database (Denmark)

    Norgaard, A.; Stensballe, J.; de Lichtenberg, T. H.

    2017-01-01

    of the implementation of evidence-based transfusion practice. Materials and Methods: Red blood cell transfusion quality indicators were compared with the evidence-based guideline at hospital and department level. Based on this evaluation, wards were selected for interventions targeting doctors and nurses......Background and Objectives: Traditionally, Denmark has had a high rate of allogeneic red blood cell transfusion caused by a liberal transfusion practice despite the existence of restrictive guidelines. We established a Patient Blood Management programme in a tertiary hospital and report the results...... procedures and 28% in admissions (P blood cell transfusion for non-bleeding patients, and led to significantly fewer patients being exposed to transfusion....

  11. Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Zynal Karaca

    2013-09-01

    Full Text Available Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.Results: The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.Conclusion: There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups. [West J Emerg Med. 2013;14(5:529–541.

  12. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. Profile of catering staff at a tertiary care hospital in Mumbai.

    Science.gov (United States)

    Bobhate, Prateek S; R Shrivastava, Saurabh; Gupta, Pankaj

    2011-01-01

    Food borne illnesses, even today, continue to be a major public health problem in both developing and developed nations. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation.Health of food handlers is of great importance for maintaining hygienic quality of food prepared and served by them. Thus, the present study was conducted to study socio-demographic characteristics, morbidity pattern and immunization status of catering staff at a tertiary care hospital in Mumbai A cross sectional study was conducted from August 2010 to November 2010. Out of the total of 162 food handlers working in 11 food service establishments, 137 were interviewed face to face using a semi-structured questionnaire, while remaining 25 food handlers were excluded because of either their absence or not giving consent. The food handlers were assessed clinically for personal hygiene and investigated for hemoglobin, stool routine and sputum AFB examination. 82 (59.8%) food handlers were from the age group 10 - 29 years, 113 (82.5%) male, 95 (69%) married, 59 (43.1%) educated up to primary level. Only 7 (5.1%) had ever received a dose of typhoid vaccine. 103 (75.2%) had an addiction, majority consuming gutkha 59 (57.3%). Dental caries 32 (23.4%) was the most common morbidity identified. Entamoeba histolytica was isolated in 13 (9.5%) subjects. This study has confirmed an association between educational status and personal hygiene suggesting the need for greater personal hygiene in this group. Preemployment and periodical medical examination should be encouraged.

  14. Fast Track Extubation In Adult Patients On Pump Open Heart Surgery At A Tertiary Care Hospital.

    Science.gov (United States)

    Akhtar, Mohammad Irfan; Sharif, Hasanat; Hamid, Mohammad; Samad, Khalid; Khan, Fazal Hameed

    2016-01-01

    Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined as extubation within 6 hours of arrival in CICU. A total of 290 patients were recruited. The average age of the patients was 56.3±10.5 years. There were 77.6% male and 22.4% female patients. Overall success rate was 51.9% and failure rate was 48.1%. The peri-operative renal insufficiency, cross clamp time and CICU stay (hours) were significantly lower in success group. Re-intubation rate was 0.74%. The perioperative parameters were significantly better in success group and the safety was also demonstrated in the patients who were fast tracked successfully. To implement the practice in its full capacity and benefit, a fast track protocol needs to be devised to standardize the current practices and to disseminate the strategy among junior anaesthesiologists, perfusionists and nursing staff.

  15. Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

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    Raju Prasad Shakya

    2016-12-01

    Full Text Available Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7% than in male (n=21, 32.3% with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%. Most of the cases were students (37% followed by farmers (26%. The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99% route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.

  16. The Patterns and Causes of Neonatal Mortality at a Tertiary Hospital in Oman

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    Mohamed Abdellatif

    2013-11-01

    Full Text Available Objective: To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years.Methods: This is a retrospective cohort study where four years data (January 2006 - December 2009 of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification.Results: The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal at the neonatal intensive care unit was 73 (63 inborn and 10 out born. Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58, 34 (59% were males and 24 (41% were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30. Lethal congenital malformations lead to 17 (29% newborn deaths, specific diagnosis in 7 newborns (12%, and birth asphyxia in four (7% of cases.Conclusion: There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

  17. Uterine rupture: A seven year review at a tertiary care hospital in New Delhi, India

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    Maruti Sinha

    2016-01-01

    Full Text Available Objective: To identify the obstetric risk factors, incidence, and causes of uterine rupture, management modalities, and the associated maternal and perinatal morbidity and mortality in one of the largest tertiary level women care hospital in Delhi. Materials and Methods: A 7-year retrospective analysis of 47 cases of uterine rupture was done. The charts of these patients were analyzed and the data regarding demographic characteristics, clinical presentation, risk factors, management, operative findings, maternal and fetal outcomes, and postoperative complications was studied. Results: The incidence of rupture was one in 1,633 deliveries (0.061%. The vast majority of patients had prior low transverse cesarean section (84.8%. The clinical presentation of the patients with rupture of the unscarred uterus was more dramatic with extensive tears compared to rupture with scarred uterus. The estimated blood loss ranged from 1,200 to 1,500 cc. Hemoperitoneum was identified in 95.7% of the patient and 83% of the patient underwent repair of rent with or without simultaneous tubal ligation. Subtotal hysterectomy was performed in five cases. There were no maternal deaths in our series. However, there were 32 cases of intrauterine fetal demise and five cases of stillbirths. Conclusions: Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors including history of prior cesarean section, grand multiparity, obstructed labor, and fetal malpresentations constitute 90% of cases of uterine rupture. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse fetomaternal complications.

  18. 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.

  19. Workplace violence against resident doctors in a tertiary care hospital in Delhi.

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    Anand, Tanu; Grover, Shekhar; Kumar, Rajesh; Kumar, Madhan; Ingle, Gopal Krishna

    2016-01-01

    Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. This study was done among doctors working in a tertiary care hospital in Delhi. Data were collected by using a self-administered questionnaire containing items for assessment of workplace violence against doctors, its consequences among those who were assaulted, reporting mechanisms and perceived risk factors. Of the 169 respondents, 104 (61.4%) were men. The mean (SD) age of the study group was 28.6 (4.2) years. Sixty-nine doctors (40.8%) reported being exposed to violence at their workplace in the past 12 months. However, there was no gender-wise difference in the exposure to violence (p=0.86). The point of delivery of emergency services was reported as the most common place for experiencing violence. Verbal abuse was the most common form of violence reported (n=52; 75.4%). Anger, frustration and irritability were the most common symptoms experienced by the doctors who were subjected to violence at the workplace. Only 44.2% of doctors reported the event to the authorities. 'Poor communication skills' was considered to be the most common physician factor responsible for workplace violence against doctors. A large proportion of doctors are victims of violence by their patients or relatives. Violence is being under-reported. There is a need to encourage reporting of violence and prepare healthcare facilities to tackle this emerging issue for the safety of physicians.

  20. PREVALENCE OF INCIDENTAL GALLBLADDER CANCER IN A TERTIARY-CARE HOSPITAL FROM PERNAMBUCO, BRAZIL

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    Euclides Dias MARTINS-FILHO

    2015-09-01

    Full Text Available BackgroundGallbladder cancer is sometimes incidentally uncovered following cholecystectomy for gallstones diseases. The supposed highly variable prevalence of incidental gallbladder cancer through our country is unknown.ObjectiveTo explore the prevalence of incidental gallbladder cancer in our tertiary-care hospital.MethodsA cross-sectional study was carried out on patients who consecutively underwent cholecystectomy due to gallstones disease at Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira - FPS/IMIP, from January, 2007 to December, 2010. Data on incidental gallbladder cancer patients were explored for prevalence estimation and description of our experience with the management of this malignancy.ResultsOur analysis involved 2018 patients with a marked predominance of women (n=1.697; 84.1% over men (n=321; 15.9%. The 3-year prevalence estimate of 0.34% was recorded for incidental gallbladder cancer in our sample. Regarding tumor staging, there were 1 T1a, 1 T1b, and 5 T2 adenocarcinoma tumors. Laparoscopic cholecystectomy alone was performed for the T1a tumor, and additional radical surgery was performed in five others. One patient presented metastatic disease at the time of repeat surgery. The final pathology revealed residual/additional disease in all T2 tumors after radical surgery whereas the T1b patient underwent a salvage Whipple’s procedure due to a secondary distal cholangiocarcinoma. The patient with T1a tumor is alive after 3-year follow-up but all of the others died because of disease recurrence/progression up to 12 months.ConclusionThis study confirms the poor prognosis of Gallbladder cancer even when incidentally diagnosed following cholecystectomy and supposes a 3-year prevalence estimate of 0.34% for incidental gallbladder cancer in our Center from Pernambuco State, Brazil.

  1. Seroprevalence of HIV in pregnant women in North India: a tertiary care hospital based study

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    Singh Sarman

    2007-11-01

    Full Text Available Abstract Background Estimating the seroprevalence of HIV in a low risk population such as pregnant women provides essential information for an effective implementation of AIDS control programmes, and also for the monitoring of HIV spread within a country. Very few studies are available from north India showing the current trend in HIV prevalence in the antenatal population;which led us to carry outthis study at a tertiary care hospital in north India Methods Blood samples from pregnant women attending antenatal clinics at the All India Institute of Medical Sciences, New Delhi were collected after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the WHO guidelines, over a period of four years from January 2003 to December 2006. Results Of the 3529 pregnant women tested in four years, 0.88% (CI 0.5 – 1.24 women were found to be HIV seroreactive. Majority of the seroreactive pregnant women (41.9% were in the age group of 20–24 years followed by the 30–34 yrs (25.8% and 25–29 years (22.6% age group. The mean age of the HIV positive women was 24.9 years (SD ± 1.49 yrs. The HIV seroprevalence rates showed an increasing trend from 0.7% (CI 0.14 – 2.04 in 2003–2004 to 0.9% (CI 0.49 – 1.5 in 2005–2006. This prevalence rate indicates concern, as Delhi and its adjoining states are otherwise considered as 'low prevalence states'. Conclusion Seroprevalence of HIV infection was found to be increasing in the last four years amongst pregnant women of North India. These findings are in contrast to the national projections.

  2. Awareness of Breast Cancer among Female Care Givers in Tertiary Cancer Hospital, China

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    Dinegde, Negalign Getahun; Xuying, Li

    2017-01-01

    Objective: Breast cancer is a worldwide public health issue and most common cancer diagnosed among women including China, where advanced stages at diagnosis appears to be increasing and an ever-rising incidence twice as fast as global rates. The study was conducted to describe the awareness of breast cancer and associated factors among care giver women in tertiary Cancer Hospital, China. Methods: Institutional based cross-sectional study was conducted among 261 women selected by systematic random sampling. Information provided by the participants was converted into awareness scores for analysis using SPSS version 23. Awareness scores were dichotomized in to ‘good awareness and ‘poor awareness’ taking median score=11 as the cut-off point. Data analysis was performed using the binary logistic regression. A p-value of awareness. Breast lump was the most commonly known symptom of cancer by 61.7% of the respondents. Slightly more than half of the study participants acknowledged having a past history of breast cancer, drinking alcohol and having close relative with breast cancer as potential risk factors for breast cancer (63.6%, 58.6%, and 55.6% respectively). Nevertheless, a vast majority of the study participants were unable to appreciate modifiable risk factors of the disease. More than half of the participants had never/rarely checked their breasts and all of the participants wrongly answered breast cancer knowledge age related risk. Awareness level was significantly associated with entertainment preference (OR=3.57; 95%CI=1.71, 7.44) and residence setting areas (OR=2.4; 95%CI=1.04, 5.69). Conclusion: The study indicated suboptimal awareness while entertainment preference and residence setting were significantly associated with awareness level. Public awareness campaigns should be made by dissemination of information about breast cancer through health education and printed Medias with great emphases on women living in rural areas. PMID:28749635

  3. Etiological profile of noncompressive myelopathies in a tertiary care hospital of Northeast India

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    Ashok Kumar Kayal

    2017-01-01

    Full Text Available Background: The discovery of antibodies against aquaporin-4 and evolving concepts of noncompressive myelopathies in the 21st century have made a major impact on the etiological profile of these diseases, with few cases turning out to be idiopathic. Objective: To find causes of noncompressive myelopathy in a tertiary care hospital of Northeast India. Materials and Methods: An observational study was carried out in the Neurology Department of Gauhati Medical College, Guwahati, from September 2013 to February 2016. Patients of noncompressive myelopathies who underwent magnetic resonance imaging (MRI of the spine were segregated into two categories: acute-to-subacute myelopathy (ASM and chronic myelopathy (CM. In addition to routine blood tests, chest X-ray, urinalysis, and visual evoked potentials, investigations included MRI of the brain, cerebrospinal fluid analysis, and immunological, infectious, and metabolic profile based on the pattern of involvement. Results: The study had 151 patients (96 ASM and 55 CM with a median age of 35 years and male: female ratio 1.4:1. The causes of ASM were neuromyelitis optica spectrum disorder (23, multiple sclerosis (MS (8, systemic lupus erythematosus (1, Hashimoto's disease (1, postinfectious acute disseminated encephalomyelitis (6, postinfectious myelitis (8, infections (9, spinal cord infarct (5, and electrocution (1. The causes of CM were MS (1, probable or possible sarcoidosis (7, mixed connective tissue disease (1, Hashimoto's disease (2, infections (9, Vitamin B12deficiency (4, folate deficiency (2, hepatic myelopathy (2, radiation (11, and paraneoplastic (1. No etiology could be found in 48 (31.8% patients (34 ASM and 14 CM. In 21/96 (21.9% patients of ASM, acute transverse myelitis was idiopathic based on current diagnostic criteria. Conclusion: Underlying etiology (demyelinating, autoimmune, infectious, vascular, metabolic disorder, or physical agent was found in 68% patients of noncompressive

  4. Pattern of seizure cases in tertiary care hospitals in Karnataka state of India

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    Nitin Joseph

    2013-01-01

    Full Text Available Background: The prevalence and incidence of epilepsy is higher in developing countries than in developed countries. Understanding pattern and risk factors of seizure cases will help in suggesting appropriate preventive measures. Objectives: This study was carried out to assess the pattern of seizure, its management and compliance with treatment. Materials and Methods: Data from medical records of seizure cases in three tertiary care hospitals of Mangalore city in south India admitted from January 2006 to December 2011 were collected and analyzed. Results: Nearly half (44.4% of the 196 cases belonged to productive age group (15-45 years and 2/3 rd (60.7% were males. Majority (>80% cases were unskilled workers and of low socio-economic status groups. Family history of seizures was present in 8.4% cases. Mean age of onset of seizure was found to be 19.9 years. Proportion of generalized tonic clonic seizure cases was 78.1%. Secondary seizures were seen in 66 (33.7% cases with the most common cause being trauma to the head (24.2%. Refractory seizures were present in 2.7% cases. Monotherapy was the most commonly followed treatment regimen and phenytoin was the most popular anti-epileptic drug (AED used. Non-compliance with AEDs was seen in 18.1% cases and was more among patients on polytherapy (P = 0.032. Conclusion: Seizure manifestations and treatment compliance vary widely in the studied population. In depth analysis of each seizure type will give more information about the factors associated with it.

  5. 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.

  6. MICROBIAL PROFILE AND ANTIBIOTIC RESISTANCE PATTERN OF THE BACTERIAL ISOLATES IN A TERTIARY CARE PSYCHIATRY HOSPITAL

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    Jyoti

    2015-11-01

    Full Text Available BACKGROUND: Antibiotic resistance is a challenge for effective management of infections as it increases the morbidity, mortality and costs of treating infectious diseases. AIMS: This study was aimed to obtain the profile of the bacterial isolates and their antibiotic resistance pattern. SETTINGS AND DESIGN: It is a cross sectional study carried out in a tertiary care psychiatry hospital in India. MATERIALS AND METHODS: Isolation and identification of the isolates were done by standard methods. Susceptibility patterns were checked by Kirby Bauer disc diffusion method. STATISTICAL ANALYSIS USED: Statistical analysis was done by using SPSS 16.0 version to calculate the frequencies as well as for cross tabulation. RESULTS: Significant bacterial growth observed in 43(25.6% samples, of which 39(90.7% showed resistant to at least one of the antibiotics used and 36(83.7% were multi-drug resistant. Gram negative organism accounted for the 25(58.14% of total significant isolates, Escherichia coli being the highest (76% in this group. Among multi-drug resistant (MDR isolates E.coli was the highest (44.4% and imipenem resistance was also observed in 1(5.3% of 19 E.coli isolates. Among the 43 isolates 18(41.86% were Gram positive with Streptococcus spp. showing incidence of 41.7% among the total MDR isolates. CONCLUSION: Increasing incidence of MDR strains seen in the population requires continuous monitoring and a restricted use of antibiotics to keep a check on resistance pattern, for effective treatment plan.

  7. Chikungunya fever among patients with acute febrile illness attending a Tertiary Care Hospital in Mumbai

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    Lata Baswanna Galate

    2016-01-01

    Full Text Available Background: Chikungunya fever (CHIK is an arboviral disease. Dengue fever (DENG and CHIK are indistinguishable clinically and need to be differentiated by laboratory investigations. Purpose: This study aimed at estimating the seroprevalence of CHIK mono-infection and CHIK and DENG dual infection in suspected patients. We also analyzed the age, sex distribution, joint involvement, and relation of joint movement restriction with visual analog scale (VAS. Materials and Methods: Two hundred patients clinically suspected with DENG and CHIK were enrolled from a Tertiary Care Hospital in Mumbai from April 2012 to October 2013. The detailed history and examination findings were recorded. Serum samples were subjected to DENG and CHIK immunoglobulin G (IgM enzyme-linked immunosorbent assay (ELISA. Results: The seroprevalence of CHIK was 12.5%. Mono-infection of CHIK was 3%, and CHIK and DENG dual infection was 9.5%. Most affected age group in CHIK cases was 46-60 years wherein female preponderance was seen. All 6 patients with CHIK mono-infection had fever and joint involvement; knee and elbow were the most commonly affected joints. All CHIK patients had VAS score of 6-10 with restricted joint movement. Of the patients with dual infection, the majorities were from 31 to 45 years with male preponderance; all had fever and joint pain mainly affecting knee and elbow. Of patients who had VAS score 6-10 in patients with dual infection, only 5.26% had restricted joint movement. Conclusion: IgM ELISA for Chikungunya infection should be included in the routine laboratory tests for acute febrile illness.

  8. Prevalence of HIV in pregnant women identified with a risk factor at a tertiary care hospital.

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    Mahmud, Ghazala; Abbas, Shazra

    2009-01-01

    HIV is an epidemic quite unlike any other, combining the problems of a lifelong medical disease with immense social, psychological, economic and public health consequences. Since we are living in a global village where human interactions has become fast and frequent, diseases like HIV are no more alien to us. HIV/AIDS in Pakistan is slowly gaining recognition as a public health issue of great importance. Objectives of this study were to determine the prevalence of HIV in pregnant women identified with a high risk factor/behaviour at a tertiary care hospital. It is a Descriptive study. All pregnant women attending antenatal booking clinic were assessed via a pre-designed 'Risk assessment questionnaire'. Women identified with a risk factor were offered HIV Rapid screening test (Capillus HIV1/2). Positive (reactive) results on screening test were confirmed with ELISA. During the study period (March 2007-May 2008), out of 5263 antenatal bookings 785 (14%) women were identified with a risk factor. HIV screening test was done in 779 (99%), and 6 women refused testing. Three women (0.3%) were found positive (reactive) on screening. Two out of 3 women were confirmed positive (0.2%) on ELISA. Husbands of both women were tested and one found positive (migrant from Dubai). Second women had history of blood transfusion. Her husband was HIV negative. During the study period, in addition to 2 pregnant women diagnosed as HIV positive through ANC risk screening, 6 confirmed HIV positive women, found pregnant were referred from 'HIV Treatment Centre', Pakistan Institute of Medical Sciences (PIMS) to Prevention of Parent to Child Transmission (PPTCT) centre for obstetric care. Spouses of 5 out of 6 had history of working abroad and extramarital sexual relationships. All positive (8) women were referred to PPTCT centre for further management. A simple 'Risk Assessment Questionnaire' can help us in identifying women who need HIV screening. Sexual transmission still remains the

  9. 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.

  10. Changing Trends of Skin Cancer: A Tertiary Care Hospital Study in Malwa Region of Punjab.

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    Lal, Sonal Tina; Banipal, Raja Paramjeet Singh; Bhatti, Deepak John; Yadav, Hanuman Prasad

    2016-06-01

    Skin cancer constitutes a small but significant proportion of patients with cancer. Although the presence of eumelanin in dark skin is protective against the development of skin cancer, it is increasingly being diagnosed in the Indian population. To study the profile of skin cancer patients presenting to a tertiary hospital in Malwa area of Punjab, India. Retrospective study was done to analyse the profile of skin cancer patients who attended the institution over one year from 1(st) December 2013 to 30(th) November 2014. A comprehensive review of aetiology and related risk factors was done to correlate the environmental factors with high skin cancer prevalence in this region. Skin cancer constituted (3.18%) 84 out of 2638 patients registered with cancer of all types. The age of the patients was 62±14.2 years and ranged from 27 to 92 yrs. Basal cell carcinoma (BCC) was the most common histological type(46/84, 54.76%) followed by squamous cell carcinoma (SCC) (31/84, 36.91%) and malignant melanoma (MM) (7/84, 8.33%). Male: female ratio was found to be 0.79:1. BCC showed higher female preponderance (phistory of prolonged exposure to sunlight. Skin cancer constitutes a small but significant proportion of patients with cancers. This study highlights a paradoxically increasing trend of BCC and female preponderance. Head and neck is the most common site involved. Exposure to Ultra Violet B (UVB) radiation and higher levels of arsenic in drinking water has been reported to be associated with skin cancers. Limited studies show that levels of arsenic and pesticides were higher in the samples of drinking water in Malwa area of Punjab. Therefore a multipronged strategy to provide safe drinking water supply and discouraging the indiscriminate use of pesticides is recommended.

  11. Radiological tests versus pathological diagnostics: Complimentary or antagonistic relationship? The experience of a tertiary hospital

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    Maria A Arafah

    2017-01-01

    Full Text Available Introduction: Early detection of breast cancer plays a pivotal role in the outcome of the disease. Diagnostic modalities encompass radiological and pathological findings. The aim of this study is to evaluate the correlation between the results of these two modalities in a tertiary hospital. Materials and Methods: From a total of 180 patients, 203 ultrasound-guided breast core needle biopsies (US-CNBs were included in this study over a period of a year (May 2015 - May 2016. All clinical parameters, the site of the biopsy, the size of the needle, the radiological findings, the pathological diagnoses as well as all available follow-up data were reviewed. The concordance between the radiological and pathological results was studied and a statistical analysis conforms to the Pearson Chi-square test was applied. Results: The majority of our patients were above 40 years of age. A strong and statistically significant association was noted between radiological findings and histopathological results (Pearson's Chi-square test = 186.28, P ≤ 0.0001 with only four discordant cases (1.97%. This discrepancy was not statistically associated with age, site of biopsy, needle size, or number of cores obtained (P = 0.621, P = 0.584, P = 0.786, and P = 0.478, respectively. Conclusions: US-CNB is an accurate method in the diagnosis of breast lesions. Radiological and pathological correlation is of utmost importance in relation to patient's care and to reduce false rates. Follow-up of concordant benign lesions is essential. In addition, the importance of a multidisciplinary breast conference during which input from all teams caring for the patient is strongly emphasized.

  12. Prevalence of Recognised and Unrecognised Depression among Medical and Surgical Patients in a Tertiary Care Hospital

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    Rahman, A. S.; Jamal, Q.; Riaz, M.

    2015-01-01

    Objective: To observe the prevalence of recognised and unrecognised depression among in-patients. Methods: The cross-sectional study was conducted from June 2012 to May 2013 at a tertiary care hospital in Karachi, and comprised patients admitted in the Medicine and Surgical departments at the time. Patients with known history of depression or on anti-depressants or on anti-psychotics, or with suicidal attempt were excluded. The prevalence of unrecognised depression was then perceived using Patient Health Qurstionnaire-9. Statistical analysis was performed using SPSS 20. Results: Of the 1180 patients, 432(36.6 percent) either had history of depression or on were on anti-depressants. The study sample, as such, comprised 748(65 percent), and of them 399(53 percent) were from the Medicine and 349(47 percent) patients were from Surgery department. Prevalence of recognised depression was 36.6 percent; 48 percent in Medical and 14 percent in Surgical patients. Unrecognised depression was 51.2 percent; 45.3 percent in Medical and 53.6 in Surgical patients. Overall prevalence was 87.9 percent; 93.4 percent in Medical and 53 percent in Surgical patients. Gender was not found to be significantly associated with depression in Medical (p= 0.367) and Surgical (p=0.606) patients. No depression was found in 48(12 percent) Medical patients and 131(37.5 percent) Surgical patients. Conclusion: More than one-third of in-patients had co-morbid depression diagnoses, mostly unrecognised by their clinicians. (author)

  13. Pattern of anti-diabetic drugs prescribed in a tertiary care hospital of Bangladesh.

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    Ahmed, Zuhayer; Hafez, M A; Bari, M A; Akhter, Jesmin

    2016-01-01

    Globally, diabetes mellitus is a common endocrine disorder. This study was conducted for collecting the demographic details of diabetic patients and determining the pattern of drugs prescribed among them in outpatient department of a tertiary healthcare center. A descriptive type of cross-sectional study was carried out at the outpatient department of Endocrinology, Dhaka Medical College Hospital, Bangladesh from 1 May to 31 July, 2015. Diabetic patients receiving the management for at least 6 months were enrolled and interviewed by the researchers after getting informed written consent. Structured case record form was used for demographic data & prescription details. Data were analysed using computer in SPSS 22 and Microsoft Excel 2010. Altogether 105 patients, 40 males (38.1%) and 65 females (61.9%) were enrolled with urban predominance (69.5%) where 51 (48.6%) were in the age group 47-61 years with a mean of 53.4 (SD±10.6) years. 70 (66.7%) had diabetic history of less than 5 years and 66 (62.9%) had at least one concurrent illness. Hypertension accounted for majority (34.3%) of complications. On an average, 5.62 (SD±3.16) drugs were advised per prescription for diabetes as well as associated co-morbidities and majority (23.8%) had 4 drugs. The majority of drugs (74.3%) were from local manufacturers. Most patients (62.9%) were prescribed with oral drugs singly. Metformin alone predominated in 41% prescriptions followed by the combination of Metformin and Sitagliptin (31.4%). The findings can serve as a guide to choose the formulation and combination of anti-diabetic drugs in this part of the world before developing & marketing any new drug.

  14. Demographic and clinical characteristics of patients referred to psychiatric unit in a tertiary care hospital

    International Nuclear Information System (INIS)

    Yousafzai, A.W.; Kazim, M.; Jehangiri, A.U.R.

    2015-01-01

    Very few studies from Pakistan have examined the profile of patients seen by psychiatrists in general hospital. The aim of this research is to describe the clinical and demographic characteristics of patients referred to the psychiatric unit of a general hospital over a one year period. Methods: This cross-sectional study was conducted at the Ayub Teaching Hospital, Abbottabad, from January 1st to December 31st 2012. All patients being referred to psychiatry were included in the study over one year period. The information was recorded on a structured questionnaire and analysed the data using SPSS-19.0. Results: Out of the 105 patients referred to the psychiatric unit, 74 (72.3%) were females. A total of 69 (68.5%) patients were married. More than half were uneducated and only number 4 (3%) patients had university qualification. Housewives made up 64.4% of the patient population followed by students (11%). Majority 55 (53%) had less than Rs. 5000/ monthly income. About 30% patients were shifted to psychiatry ward while, nearly one tenth were discharged. In 35% cases the psychiatrist was asked to help in the management, while in 50% cases only opinion was sought. Aggressive and threatening behaviour was source of concern in majority of patients for the primary team while 34% exhibited suicidal behaviour. Depression was most frequent diagnosis in 45 43% patients, followed by conversion disorder 19 (17%) and delirium 16 (14%). Conclusion: The rate of psychiatric referrals is dismal with only one third of the patients being transferred to the psychiatric ward. The major psychiatric diagnosis was depression. Patients with aggressive and threatening behaviour were more frequently referred. (author)

  15. Preparation and Response to the 2014 Ebola Virus Disease Epidemic in Nigeria-The Experience of a Tertiary Hospital in Nigeria.

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    Dimie Ogoina

    Full Text Available The 2014 Ebola Virus Disease (EVD outbreak elicited global attention and challenged health systems around the world, Nigeria inclusive. We hereby report the preparation and response to the outbreak by a tertiary teaching hospital in Bayelsa State, Nigeria.Between 4th August and 31st October 2014, we conducted a mixed cross sectional and qualitative study to ascertain the EVD-related fear, myths and misconceptions among healthcare workers (HCWs, and to evaluate the plans, activities and challenges faced by the hospital during the outbreak. Data was collected using a self-administered questionnaire as well as by documented observations during the outbreak. HCWs were asked to rate their fear of EVD from 1 (no fear to 10 (highest fear.Out of 189 respondents, majority (>75% reported uncertainty about the myth that EVD can be prevented by drinking salt water or eating Garcinia kola, while 82% of respondents believed that EVD can be prevented by avoiding crowded places. About 40% of respondents expressed fear ratings of EVD of ≥ 7 out of 10. In response to the outbreak, the hospital established an EVD response team, organised EVD-sensitization and training programmes and commenced routine EVD surveillance activities. An EVD-isolation ward was constructed from an existing ward, a field incinerator was designed, hand sanitizers were produced locally and personal protective equipment were procured. No case of EVD was reported in the hospital, although three false alarms caused panic. Some HCWs adopted overly protective and avoidance behaviours, but these behaviours were abandoned after the outbreak was declared over.Our results suggest that the fear, myth and misconceptions were common among HCW during the outbreak. The EVD outbreak, however, helped to strengthen gaps in infection control and emergency preparedness in the hospital. Strategies to allay fear are required to contain future outbreaks of EVD in Nigeria hospitals.

  16. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... teaching hospitals. 415.190 Section 415.190 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching hospitals. (a...

  17. Difference between Japanese Secondary and Tertiary Medical Facilities Regarding Changes in the Hospitalization of Children for Pneumonia after the Introduction of the Pneumococcal Conjugate Vaccine.

    Science.gov (United States)

    Haro, Kaoru; Ogawa, Masato; Hoshina, Takayuki; Kojiro, Masumi; Kusuhara, Koichi

    2017-05-24

    This study aimed to compare hospitalization of children for pneumonia between secondary and tertiary medical facilities, which hospitalize many children without and with underlying diseases, respectively, after the introduction of the pneumococcal conjugate vaccine (PCV). Our retrospective study included children admitted to the Department of Pediatrics at Kitakyushu General Hospital, a secondary medical facility, and the Hospital of the University of Occupational and Environment Health, Japan, a tertiary medical facility, from 2009 to 2013 for pneumonia. We compared the change in the rate of hospitalization for pneumonia after the introduction of the 7-valent PCV between the secondary and tertiary medical facilities. Hospitalization of patients with pneumonia declined by 28.8% in our secondary medical facility. In particular, hospitalization for pneumonia other than confirmed mycoplasmal or viral pneumonia was significantly reduced by 49.2%. In contrast, hospitalization of patients with pneumonia did not decline in our tertiary medical facility. After the introduction of PCV, hospitalization of children for pneumonia was not reduced at the tertiary medical facility. Various other pathogens besides pneumococcus may be associated with the development of pneumonia in children with underlying diseases.

  18. Patterns of infections, aetiological agents and antimicrobial resistance at a tertiary care hospital in northern Tanzania.

    Science.gov (United States)

    Kumburu, Happiness Houka; Sonda, Tolbert; Mmbaga, Blandina Theophil; Alifrangis, Michael; Lund, Ole; Kibiki, Gibson; Aarestrup, Frank M

    2017-04-01

    To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods, and disc diffusion was used to determine the antimicrobial susceptibility pattern of the bacterial isolates. A total of 249 (42.2%) specimens were culture-positive yielding a total of 377 isolates. A wide range of bacteria was isolated, the most predominant being Gram-negative bacteria: Proteus spp. (n = 48, 12.7%), Escherichia coli (n = 44, 11.7%), Pseudomonas spp. (n = 40, 10.6%) and Klebsiella spp (n = 38, 10.1%). Wound infections were characterised by multiple isolates (n = 293, 77.7%), with the most frequent being Proteus spp. (n = 44, 15%), Pseudomonas (n = 37, 12.6%), Staphylococcus (n = 29, 9.9%) and Klebsiella spp. (n = 28, 9.6%). All Staphylococcus aureus tested were resistant to penicillin (n = 22, 100%) and susceptible to vancomycin. Significant resistance to cephalosporins such as cefazolin (n = 62, 72.9%), ceftriaxone (n = 44, 51.8%) and ceftazidime (n = 40, 37.4%) was observed in Gram-negative bacteria, as well as resistance to cefoxitin (n = 6, 27.3%) in S. aureus. The study has revealed a wide range of causative agents, with an alarming rate of resistance to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic settings. The key steps would be to ensure the diagnostic capacity at a sufficient number of sites and implement structures to routinely exchange, compare, analyse and report data. Sentinel sites

  19. Spectrum of Congenital Heart Diseases in Eastern Nepal: A tertiary care hospital experience

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    Prashant Shah

    2017-01-01

    Full Text Available Background & Objectives: Congenital heart diseases are neglected especially in world’s poorest nations and appear to be ignored and unexplored dimension of health. The exact prevalence and spectrum of congenital heart diseases in Nepal is largely unknown. The aim of this study was to describe the local experience on the magnitude and the pattern of congenital heart disease in order to increase the awareness of the public and health policy makers on its burden in Nepal.Materials & Methods: This is an observational hospital based study carried out in a tertiary care hospital in Eastern Nepal. The duration of this study was from April 2015 to July 2016. The echocardiography reports of all patients clinically suspected of having congenital heart disease were retrieved, and their diagnostic details were extracted. Only patients of day one of life to 14 years of age were included. Congenital heart diseases like bicuspid aortic valve, mitral valve prolapse and various inherited cardiomyopathies were excluded.Results: A total of 330 echocardiograms were performed for clinically suspected congenital heart disease.  The mean age of study population was 22.31±34.08 months with male to female ratio of 1.2:1. 23% of clinically suspected congenital heart disease cases turned out to have normal echocardiography. Acyanotic congenital heart disease was most common (81.5% followed by cyanotic congenital heart disease (14.2% and obstructive congenital heart disease (4.3%. Atrial septal defect was found to be the most common form of acyanotic congenital heart disease (52% which was followed by ventricular septal defect (28.8% and patent ductus arteriosus (14.8%. Tetralogy of Fallot and double outlet right ventricle were the most common form of cyanotic CHD representing 44.4% of all cyanotic patients. Pulmonary stenosis was the most common obstructive congenital heart disease observed in this study population (63.6%. Rarer entities, like d-transposition of great

  20. Surgical Indications and Clinical Results of Patients with Exchanged Intraocular Lenses in a Tertiary Eye Hospital.

    Science.gov (United States)

    Kavuncu, Sevim; Omay, Aslıhan Esra; Tırhış, Mehmet Hakan; Yılmazbaş, Pelin

    2016-08-01

    To evaluate the demographics, surgical indications and clinical results of patients with repositioned or explanted intraocular lens (IOL) in a tertiary referral eye hospital. Forty-eight eyes of 48 patients that underwent surgery to exchange or reposition the IOL at Ulucanlar Eye Training and Research Hospital between 2009 and 2013 were included in the study. Medical records of patients were evaluated for surgical indications, time elapsed since initial operation, preoperative and postoperative best corrected distance visual acuity and the presence of ocular disease. The mean age of the 31 male and 17 female patients was 64.91±14.26 years. Median time between the initial and final operations was 36.0 months. Pseudoexfoliation syndrome (PEX) was present in 25% of the patients. There was history of previous vitreoretinal surgery in 18.8% of patients, ocular trauma in 6.3%, high myopia and refractive surgery in 4% of patients. In the first operation the IOL was implanted in the sulcus in 50%, in the bag in 27.1%, and in the anterior chamber in 20.8%; following the final surgery the IOL was in the sulcus in 27.1%, in the anterior chamber in 22.9%, and fixated to the sclera in 10.4% of the patients, while the remaining 29.1% remained aphakic. Indication for the secondary surgery was IOL dislocation in 58%, corneal decompensation in 20.8% and IOL degeneration in 6.3%. In the final surgery, IOL was exchanged in 54.2% of the cases, removed in 31.3% of cases, and repositioned in 14.6%. Visual acuity improved by 1-3 lines in 52.3% and remained stable in 13.6% of the patients postoperatively. IOL exchange may be necessary at any time following cataract surgery due to surgical complications, IOL dislocation, biometric measurement errors and corneal decompensation. Factors such as vitreoretinal surgery and the existence of PEX increase the risk of IOL exchange surgery.

  1. Surgical Indications and Clinical Results of Patients with Exchanged Intraocular Lenses in a Tertiary Eye Hospital

    Directory of Open Access Journals (Sweden)

    Sevim Kavuncu

    2016-08-01

    Full Text Available Objectives: To evaluate the demographics, surgical indications and clinical results of patients with repositioned or explanted intraocular lens (IOL in a tertiary referral eye hospital. Materials and Methods: Forty-eight eyes of 48 patients that underwent surgery to exchange or reposition the IOL at Ulucanlar Eye Training and Research Hospital between 2009 and 2013 were included in the study. Medical records of patients were evaluated for surgical indications, time elapsed since initial operation, preoperative and postoperative best corrected distance visual acuity and the presence of ocular disease. Results: The mean age of the 31 male and 17 female patients was 64.91±14.26 years. Median time between the initial and final operations was 36.0 months. Pseudoexfoliation syndrome (PEX was present in 25% of the patients. There was history of previous vitreoretinal surgery in 18.8% of patients, ocular trauma in 6.3%, high myopia and refractive surgery in 4% of patients. In the first operation the IOL was implanted in the sulcus in 50%, in the bag in 27.1%, and in the anterior chamber in 20.8%; following the final surgery the IOL was in the sulcus in 27.1%, in the anterior chamber in 22.9%, and fixated to the sclera in 10.4% of the patients, while the remaining 29.1% remained aphakic. Indication for the secondary surgery was IOL dislocation in 58%, corneal decompensation in 20.8% and IOL degeneration in 6.3%. In the final surgery, IOL was exchanged in 54.2% of the cases, removed in 31.3% of cases, and repositioned in 14.6%. Visual acuity improved by 1-3 lines in 52.3% and remained stable in 13.6% of the patients postoperatively. Conclusion: IOL exchange may be necessary at any time following cataract surgery due to surgical complications, IOL dislocation, biometric measurement errors and corneal decompensation. Factors such as vitreoretinal surgery and the existence of PEX increase the risk of IOL exchange surgery.

  2. Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

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    Benjamin Louis Moresco

    2018-04-01

    Full Text Available ObjectivesThis study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER of a tertiary care children’s hospital.MethodsThis was a retrospective, observational study of children (0–18 years old in The Children’s Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9 diagnostic codes for “severe sepsis” and “shocks.” Patients in the adherent group were those who met all three elements of adherence: (1 rapid vascular access with at most one IV attempt before seeking alternate access (unless already in place, (2 fluids administered within 15 min from sepsis recognition, and (3 antibiotic administration started within 1 h of sepsis recognition. Comparisons between groups with and without sepsis guideline adherence were performed using Student’s t-test (the measurements expressed as median values. The proportions were compared using chi-square test. p-Value ≤0.05 was considered significant.ResultsA total of 43 patients who visited the ER from July 2014 to July 2015 had clinically proven severe sepsis or SS ICD-9 codes. The median age was 5 years. The median triage time, times from triage to vascular access, fluid administration and antibiotic administration were 26, 48.5, 76, and 135 min, respectively. Adherence to vascular access, fluid, and antibiotic administration guidelines was 21, 26, and 34%, respectively. Appropriate fluid bolus (20 ml/kg over 15–20 min was only seen in 6% of patients in the non-adherent group versus 38% in the adherent group (p = 0.01. All of the patients in the non-adherent group used an infusion pump for fluid resuscitation. Hypotension and ≥3 organ dysfunction were more commonly observed in patients in adherent group as compared to patients in non-adherent group (38 vs. 14% p = 0.24; 63 vs. 23% p = 0.03.Conclusion

  3. Frequency of anti hepatitis C virus antibodies amongst sanitary workers in a tertiary care hospital in Pakistan

    International Nuclear Information System (INIS)

    Khan, A.Z.; Razzaq, K.; Ansari, J.K.; Niazzi, S.K.

    2011-01-01

    Objective: To determine the frequency of anti Hepatitis C Virus antibodies in sanitary workers at Military Hospital Rawalpindi and to identify additional risk factors in them for hepatitis C infection. Cross sectional study Place and Duration of Study: Department of medicine, Military Hospital (M.H.), Rawalpindi, Pakistan over six months. Patients and Methods: All sanitary workers working at Military Hospital Rawalpindi were tested for anti HCV antibodies by third generation ELISA. Results: Six percent of the study population was found to be positive for anti HCV antibodies. Conclusion: The frequency of anti HCV antibodies is fairly high in sanitary workers, working in this tertiary care hospital studied. HCV infection is more frequent in those sanitary workers who have longer duration of service. (author)

  4. [Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities].

    Science.gov (United States)

    Li, Guo; Jiang, Ronghuan; Guo, Chengjun; Liu, Meiyan; Zhang, Lijun

    2014-12-01

    To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities. A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up. A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123). There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.

  5. Text-Selection for Teaching Reading to ESL Tertiary Students: A Study on Genre and Content Preferences

    Directory of Open Access Journals (Sweden)

    Razanawati Nordin

    2017-01-01

    Full Text Available Most learners studying English language feel that their educators use irrelevant, uninteresting, and culturally unfamiliar reading materials for teaching reading. As a result, most of them struggle to comprehend the English language texts used by the teachers. Therefore, the aim of this research is to investigate the genre and content preferences of ESL tertiary learners in UiTM Kedah, Malaysia. A two-part questionnaire was administered to 132 respondents aged 20 to 23 years old who are presently furthering their undergraduate studies in Accountancy, Administrative Science and Policy Studies, Business Management, Industrial Design, and Information Management. The results of the study show that these ESL tertiary learners prefer texts from the websites and blogs; and their preferred reading contents are dealing with Business Management, watching movies and listening to music. This article offers guidance to ESL teachers to select L2 reading texts based on the students’ preferred genre and content.

  6. Drug-food interaction counseling programs in teaching hospitals.

    Science.gov (United States)

    Wix, A R; Doering, P L; Hatton, R C

    1992-04-01

    The results of a survey to characterize drug-food interaction counseling programs in teaching hospitals and solicit opinions on these programs from pharmacists and dietitians are reported. A questionnaire was mailed to the pharmacy director and the director of dietary services at teaching hospitals nationwide. The questionnaire contained 33 questions relating to hospital characteristics, drug-food interaction counseling programs, and the standard calling for such programs issued by the Joint Commission on Accreditation of Healthcare Organizations. Of 792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of the pharmacists and dietitians (51.2%) did not consider their drug-food interaction counseling program to be formal; some had no program. The pharmacy department was involved more in program development than in the daily operation of such programs. The most frequent methods of identifying patients for counseling were using lists of patients' drugs and using physicians' orders. A mean of only five drugs were targeted per program. Slightly over half the respondents rated the Joint Commission standard less effective than other standards in its ability to improve patient care. A majority of teaching hospitals did not have formal drug-food interaction counseling programs. Pharmacists and dietitians did not view these programs as greatly beneficial and did not believe that the Joint Commission has clearly delineated the requirements for meeting its standard.

  7. [Impact of the funding reform of teaching hospitals in Brazil].

    Science.gov (United States)

    Lobo, M S C; Silva, A C M; Lins, M P E; Fiszman, R