Extended Sick Neonate Score (ESNS) for Clinical Assessment and Mortality Prediction in Sick Newborns referred to Tertiary Care

2019 ◽  
Vol 56 (2) ◽  
pp. 130-133 ◽  
Author(s):  
Somosri Ray ◽  
Rakesh Mondal ◽  
Kaushani Chatterjee ◽  
Moumita Samanta ◽  
Avijit Hazra ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Tertiary Care ◽  
Mortality Prediction ◽  
Sick Neonate

scholarly journals Improving Communication Between Health Care Professionals and Parents: A Quality Improvement Initiative

2017 ◽  
Vol 4 (1) ◽  
pp. 1-9
Author(s):  
Poonam Joshi ◽  
Meena Joshi ◽  
Aakansha Sharma ◽  
Anu Sachdeva ◽  
Rajesh Sagar ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Parental Satisfaction ◽  
Satisfaction Score ◽  
Quality Improvement Initiative ◽  
Base Line ◽  
Team Members ◽  
Sick Neonate

This quality improvement initiative was undertaken in a tertiary care neonatal intensive care unit (NICU) to improve communication between the HCP and parents related to the sick neonates admitted in NICU as measured by increase in parental satisfaction score from base line (34.5%) to 80% in 3 months time. A team was formulated to evaluate the reasons for low parental satisfaction resulting from communication between HCP and the parents of sick neonates and to further plan strategies for improving the same. Multiple PDSA cycles were implemented. The results of the all PDSA cycles were discussed amongst team members. Satisfaction of parents related to communication with HCP increased to more than 80% in 3 months time followed by increase up to 90% in sustenance phase. Multiple simple feasible interventions led to improvement in communication between the HCP and parents as evident by increase in satisfaction score (40.8 ± 4.3 vs. 40.8 ± 4.3 vs. 91.3 ± 4.8, p < 0.001). There was significant improvement in the satisfaction scores of the mothers on communication related to sick neonate in NICU at the end of intervention phase as well as in the sustenance phase. Multiple simple doable and feasible interventions had led to the improvement in communication between the HCP and parents hence improving the satisfaction of parents related to their communication with HCP.

Risk factors and outcomes of patients colonized with carbapenemase-producing and non–carbapenemase-producing carbapenem-resistant Enterobacteriaceae

2020 ◽  
Vol 41 (10) ◽  
pp. 1154-1161
Author(s):  
Amal Kassem ◽  
Aman Raed ◽  
Tal Michael ◽  
Orli Sagi ◽  
Orly Shimoni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Rectal Swab ◽  
Tertiary Care ◽  
Mortality Prediction ◽  
Charlson Index ◽  
University Hospital ◽  
Historical Study ◽  
Carbapenem Resistant

AbstractObjective:To compare risk factors and outcome of patients colonized with carbapenemase-producing (CP) carbapenem-resistant Enterobactereaceae (CRE) and non–CP-CRE.Design:A comparative historical study.Setting:A 1,000-bed tertiary-care university hospital.Patients:Adults with CP-CRE positive rectal swab cultures, non–CP-CRE positive rectal swab cultures, and negative rectal swab cultures (non-CRE).Methods:CP-CRE and non–CP-CRE colonized adult patients versus patients not colonized with CRE hospitalized during 24 months were included. We identified patients retrospectively through the microbiology laboratory, and we reviewed their files for demographics, underlying diseases, Charlson Index, treatment, and outcome.Results:This study included 447 patients for whom a rectal swab for CRE was obtained: 147 positive for CP-CRE, 147 positive for non–CP-CRE, and 147 negative for both. Patients with CP-CRE and non–CP-CRE versus no CRE more frequently resided in nursing homes (P<0.001), received antibiotics 3 months prior to admission (P < .001), and received glucocorticosteroids 3 months prior to admission (P = .047 and P < .001, respectively). Risk factors unique for non–CP-CRE versus CP-CRE colonization included mechanical ventilation and patient movement between hospital departments. Non–CP-CRE was a predictor for mechanical ventilation 2.5 that of CP-CRE colonization. In-hospital mortality was highest among non–CP-CRE–colonized patients. On COX multivariate regression for mortality prediction age, Charlson index and steroid treatment 3 months before admission influenced mortality (P = .027, P = .023, and P = .013, respectively).Conclusions:Overlapping and unique risk factors are associated with CP-CRE and non–CP-CRE colonization. Non–CP-CRE colonized patients had a higher in-hospital mortality rate.

scholarly journals The comparison of apache II and apache IV score to predict mortality in intensive care unit in a tertiary care hospital

2019 ◽  
Vol 7 (5) ◽  
pp. 1598
Author(s):  
Vidya S. Nagar ◽  
Basavaraj Sajjan ◽  
Rudrarpan Chatterjee ◽  
Nitesh M. Parab
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Mortality Rates ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Youden Index ◽  
Apache Ii Score ◽  
Care Hospital ◽  
Apache Iv

Background: The prognostication of critically ill patients, in a systematic way, based on definite objective data is an integral part of the quality of care in Intensive Care Unit (ICU). Acute physiology and chronic health evaluation (APACHE) scoring systems provide an objective means of mortality prediction in Intensive Care Unit (ICU). The aims of this study were to compare the performance of APACHE II and APACHE IV in predicting mortality in our intensive care unit (ICU).Methods: A prospective observational study was conducted in a 13 bedded intensive care unit (ICU) of a tertiary level teaching hospital. All the patients above the age of 12 years, irrespective of diagnosis managed in ICU for >24hours were enrolled. APACHE II and APACHE IV scores were calculated based on the worst values in the first 24hours of admission. All enrolled patients were followed up, and outcome was recorded as survivors or non survivors. Observed mortality rates were compared with predicted mortality rates for both the APACHE II and APACHE IV. Receiver operator characteristic curves (ROC) were used to compare accuracy of the two scores.Results: APACHE II score of the patients ranged from 1 to 32 and APACHE IV score of the patients ranged from 25 to 142. There was good correlation between APACHE II and APACHE IV scores with the spearman’s rho value of 0.776 (P<0.01). Discrimination for APACHE II and APACHE IV models were good with area under ROC curve of 0.805 and 0.832 respectively. APACHE IV was more accurate than APACHE II in this regard. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV were 72 respectively for predicting mortality.Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in present study. There was good correlation between the two models observed in present study.

scholarly journals CLINICAL ASSESSMENT OF COMPLICATIONS & TYPE OF DELIVERY IN PREGNANT FEMALES DIAGNOSED WITH FIBROID UTERUS

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Aakarsh Sinha ◽  
Kumar Amit
Keyword(s):  
Clinical Assessment ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Successful Outcome ◽  
Benign Tumors ◽  
Obstructed Labor ◽  
Pregnant Females ◽  
Fibroid Uterus ◽  
Increased Risk ◽  
Type Of Delivery

Fibroid (myoma) is the most common benign tumors of the uterus. Effect of pregnancy on myoma may be stimulatory and it can lead to unpredictable and impressive growth during pregnancy. These tumors respond differently in different women. Fibroids may grow, regress or remain unchanged in size during pregnancy. Though in some cases it does not affect the outcome of pregnancy but they are associated with complications like preterm labor, IUGR, abortion, PROM, uterine dysfunction, placental abruption, and obstructed labor, increased risk of cesarean delivery, breech presentation, malposition. Hence based on above findings the present study was planned for Clinical Assessment of Complications & Type of Delivery in Pregnant Females Diagnosed with Fibroid Uterus. The present study was planned in Department of Obstetrics and Gynaecology, Madhubani Medical College and Hospital, Madhubani, Bihar. In the present study 15 females diagnosed with the fibroid undergone the delivery were enrolled in the present study. Though many of the fibroids are asymptomatic, but may adversely affect the course of pregnancy and labor depending on their location and size. The data generated from the present study concludes that pregnancy with Fibroids is considered High-Risk. Timely diagnosis and tertiary care referral and Management of Antepartum, Intrapartum, Postpartum complications with good neonatal care leads to successful outcome. Caesarean Myomectomy in selected cases can prove beneficial. Keywords: Complications, Type of Delivery, Pregnant Females, Fibroid Uterus, etc.

COMPARISON OF PARKIN SCORE AND NEW BALLARDS SCORE FOR GESTATIONALAGE ESTIMATION- PROSPECTIVE ANALYTICAL STUDY

2021 ◽  
pp. 30-31
Author(s):  
Akshatha S ◽  
P. Bhanuchand ◽  
Chinthana BS
Keyword(s):  
Gestational Age ◽  
Analytical Study ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Age Assessment ◽  
Mortality And Morbidity ◽  
Sick Neonate

In an infant it is important to know correct gestational age , to evaluate the risk , line of management and mortality and morbidity. Most common used method for gestational age assessment is Ballard's score which includes various parameters and neurologic parameters and difcult to assess in sick neonate where parkin score only uses 4 criteria for assessment of gestational age. This prospective analytical study was conducted to compare new Ballard's score and parkin's score between healthy and sick neonates in tertiary care center

scholarly journals Encountering Dapsone Poisoning In a Child at the Emergency Department of a Tertiary Care Hospital in Eastern Nepal

2015 ◽  
Vol 12 (1) ◽  
pp. 52-54
Author(s):  
Gyanendra Malla ◽  
B Gauchan ◽  
S Chaudhary ◽  
R Bhandari ◽  
P P Gupta
Keyword(s):  
Emergency Department ◽  
Methylene Blue ◽  
Clinical Assessment ◽  
Tertiary Care Hospital ◽  
Chemotherapeutic Agent ◽  
Tertiary Care ◽  
Care Hospital ◽  
Accidental Ingestion ◽  
Sulfonamide Derivative ◽  
Important Drug

Dapsone (4, 4’-diaminophenylsulfone), a sulfonamide derivative, was introduced in 1943 as an effective chemotherapeutic agent for leprosy and still is an important drug for the treatment of this disease. Because of its use in various conditions, its toxicity is commonly seen in adults but rare in children. Rapid clinical assessment, measurement of methemoglobin and institution of methylene blue where indicated decreases the morbidity and mortality of dapsone poisoning. We report a case of 2 year old female with accidental ingestion of 20 tablets (20gm) of dapsone.DOI: http://dx.doi.org/10.3126/hren.v12i1.11988Health Renaissance 2014;12(1):52-54

scholarly journals Mortality prediction in chronic interstitial lung diseases (ILDs): ILD-GAP (gender age physiology) and (the new modified classification) TNMC-ILD-GAP

Pneumologia ◽  
2021 ◽  
Vol 69 (4) ◽  
pp. 218-226
Author(s):  
Sameer Bansal ◽  
Unnati D. Desai ◽  
Jyotsna M. Joshi
Keyword(s):  
Tertiary Care ◽  
Interstitial Lung Diseases ◽  
Mortality Prediction ◽  
Gap Model ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Resource Limited ◽  
The Difference ◽  
Gap Models

Abstract Introduction: The interstitial lung disease-gender age physiology (ILD-GAP) model has been proposed on the lines of GAP-idiopathic pulmonary fibrosis (IPF) to predict mortality in chronic ILDs, other than IPF. We replaced diffusion capacity of lung for carbon monoxide (DLCO) with the easy to perform 6-minute walk distance (6 MWD) in the ILD-GAP and proposed the new modified classification (TNMC)-ILD-GAP model. Our aim was to demonstrate the usefulness of the TNMC-ILD-GAP as a predictor of mortality in all chronic ILDs and compare the results with the ILD-GAP. Methods: It was a retrospective observational study conducted at a tertiary care centre. Baseline characteristics of the patients among different ILD groups were analysed. A 3-year follow-up was recorded. The results were compared with the original ILDGAP model. Chi-square and paired t-test was used for comparison of qualitative and quantitative data, respectively. Results: Mean ages were 62.34 (±9.85), 57.9 (±11.6), 46.1 (±14.6) and 55.5 (±14.7) in IPF, non-specific interstitial pneumonitis (NSIP), connective tissue disease (CTD) and unclassifiable groups, respectively. There were 50%, 18%, 26% and 55% males in the four categories respectively. Mean 6 MWD was 227 m, 302 m, 342 m, and 332 m. Mean PaO2 was 64 mmHg, 70 mmHg, 75 mmHg, 69 mmHg. Mean forced vital capacity (FVC) (percentage predicted) was 52, 49, 51 and 54. Most of the patients had comorbidities, among which pulmonary hypertension was the most common. Mortality with ILD-GAP model and TNMC-ILD-GAP showed concordant results as the difference in mortality predicted by ILD-GAP and the TNMC-ILD-GAP models was statistically insignificant (P > 0.050). Conclusion: 6 MWD can serve as a reliable replacement for DLCO in the ILD-GAP model, especially in resource limited settings.

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