Factors associated with prolonged length of stay in patients admitted with severe hypoglycaemia to a tertiary care hospital

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia. Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P<0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively. Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P<0.05) post-AMS reduction of the LOS and the RR.

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Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32624 ◽

2020 ◽

Vol 22 (3) ◽

pp. 106-110

Author(s):

Supri Raj Shrestha ◽

B Shakya ◽

R Oli

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

College Teaching ◽

Sampling Technique ◽

Cost Effective ◽

Dropout Rate ◽

Care Hospital ◽

Vaccine Preventable Diseases ◽

Factors Associated ◽

Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

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Study of clinical profile and certain modifiable risk factors associated with acute respiratory infection cases admitted in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20160144 ◽

2016 ◽

pp. 129-133 ◽

Cited By ~ 1

Author(s):

Jayashree Naik ◽

Swapnil Jain ◽

Madhuri Mathurkar ◽

Sandeep Suryawanshi ◽

Sandesh Kamble ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Profile ◽

Modifiable Risk Factors ◽

Care Hospital ◽

Factors Associated

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Psychological status of healthcare workers during COVID-19 pandemic: a single center observational study from Peshawar

Journal of Rehman Medical Institute ◽

10.52442/jrmi.v6i4.166 ◽

2020 ◽

Vol 6 (4) ◽

pp. 03-06

Author(s):

Wajeeha Qayyum ◽

Asad Khalil ◽

Mohammad Jawad ◽

Seema Ashraf

Keyword(s):

Health Care ◽

Health Care Workers ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Psychological Status ◽

Anxiety And Depression ◽

Medical Institute ◽

Care Hospital ◽

Factors Associated ◽

Care Workers

Introduction: Infectious pandemics are a significant health risk to the general population, but much more so for the frontline health care workers tending patients at different locations. The increased workload, stress, fear, and anxiety are the burdens to be coped with by health professionals through resort to resiliency and other mechanisms.Objective: To determine the magnitude of depression / anxiety and factors associated with it in health care workers of a tertiary care hospital during the COVID-19 pandemic in Peshawar, Khyber Pakhtunkhwa, Pakistan.Materials & Methods: This cross sectional study was conducted at Rehman Medical Institute, Peshawar after approval from Rehman Medical Institute Research Ethics Committee. A structured questionnaire consisting of two sections was distributed by convenience sampling to health care workers in the hospital, the first part containing demographic information, and the second part consisting of Hospital Anxiety and Depression Scale (HADS) comprised of 14 scales to assess anxiety and depression. Scoring for Normal, Borderline Abnormal, and Definitive Disorder was done as per standard criteria. Data were analyzed for descriptive statistics by SPSS 22. Results: Total 327 participants were included in the study, having mean age of 30.19 ± 7.82 years, of which 230(70.3%) were males. The majority of health care workers 226(69.1%) were suffering from disturbed mental status either in the form of Anxiety (19.9%), Depression (8%) or Mixed Disorder (41.3%). Factors associated with high disease frequency were female gender, age group 21-30 years, nursing staff, workers of ICU and Hostel residence (p value <0.05). Conclusion: COVID-19 related psychological disturbances significantly affected healthcare staff of a tertiary care hospital of Peshawar, being more evident in females, younger age groups, nurses, and ICU staff on duty.

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

PLoS ONE ◽

10.1371/journal.pone.0139883 ◽

2015 ◽

Vol 10 (10) ◽

pp. e0139883 ◽

Cited By ~ 36

Author(s):

Pedro Torres-Gonzalez ◽

Miguel Enrique Cervera-Hernandez ◽

María Dolores Niembro-Ortega ◽

Francisco Leal-Vega ◽

Luis Pablo Cruz-Hervert ◽

...

Keyword(s):

Cohort Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Factors Associated ◽

Carbapenem Resistant ◽

Fecal Carriage ◽

Carbapenem Resistant Enterobacteriaceae

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Pattern and Factors Associated With the Utilization of Herbs As Medications Among Patients in a Tertiary Care Hospital in Western Saudi Arabia

Cureus ◽

10.7759/cureus.19502 ◽

2021 ◽

Author(s):

Ahmad Alamoudi ◽

Yazeid Alrefaey ◽

Yazeed Asiri ◽

Eyad Farrash ◽

Fayssal Farahat ◽

...

Keyword(s):

Saudi Arabia ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Factors Associated

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Incidence, Etiology and Risk Factors Associated with Mortality of Nosocomial Candidemia in a Tertiary Care Hospital in Istanbul, Turkey

Medical Principles and Practice ◽

10.1159/000320305 ◽

2010 ◽

Vol 19 (6) ◽

pp. 463-467 ◽

Cited By ~ 7

Author(s):

Ilknur Erdem ◽

Naz Oguzoglu ◽

Derya Ozturk Engin ◽

Asu Ozgultekin ◽

Asuma Sengoz Inan ◽

...

Keyword(s):

Risk Factors ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Factors Associated ◽

Nosocomial Candidemia

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FACTORS ASSOCIATED WITH SEVERITY OF ILLNESS IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL IN SOUTHERN INDIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i3.23496 ◽

2018 ◽

Vol 11 (3) ◽

pp. 272

Author(s):

Melissa Sherrel Pereira ◽

Chandrashekar Udyavara Kudru ◽

Sreedharan Nair ◽

Girish Thunga ◽

Vijayanarayana Kunhikatta ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Univariate Analysis ◽

Tertiary Care ◽

Elevated Serum ◽

Hospital Setting ◽

Severity Of Illness ◽

Southern India ◽

Severe Dengue ◽

Care Hospital ◽

Factors Associated

Objective: Denguefeveris one of the important tropical disease of public health significance caused by flavivirus. It is a major cause of morbidity and mortality worldwide. Identification of factors associated with severity of dengue can improve the prognosis of the disease.This study tried toassess the factors associated with severity of dengue.Methods: A record based study was conducted in a tertiary care hospital setting in southern India. A total of 550 case files were reviewed to ascertain demographic, clinical and laboratory parameters among confirmed cases of dengue. The severity of dengue was categorized using WHO 2009 classification.Results: Of 550 records reviewed, 449 (81.6%) were classified as non-severe dengue and 101 (18.4%) as severe dengue. Factors associated with severe dengue on univariate analysis were: gender, backache, skin rash, nausea and vomiting, abdominal distension, haemorrhage, breathlessness, oliguria, hepatomegaly, splenomegaly, ascites, leukopenia, hypoproteinemia, and elevated serum alanine transaminase (ALT) >63 IU/L.On multivariate analysis,haemorrhage (OR=11.75, 95%; CI=6.38-21.62), oliguria (OR=4.01, 95%; CI=1.32-12.15), ascites (OR=2.68, 95%; CI=1.19-6.01), ALT>63 IU/L (OR=1.77, 95%; CI=1.01-3.1) and hypoproteinemia (OR=5.57, 95%; CI=2.82-10.98) were found to have significant association with the development of severe dengue.Conclusion: This study indicates thatwhen dengue patients present with bleeding episodes, ascites, oliguria,raised ALT and low serum protein levels, clinicians should be alert to the appearance of severe complications. Early identification of these factors will help clinicians to recognise the severity of dengue illness and enable them to implement appropriate interventions.

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