Adenoma detection rate as a quality indicator for colonoscopy: a descriptive cross-sectional study from a tertiary care hospital in Pakistan

Abstract Background and study aims Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan. Patients and methods This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018. Results Of 1985 patients, 59 % were male and 41 % female, with mean age of 47.8 ± 16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0 %) and overall PDR and ADR were 17.9 % and 9.9 %, respectively. There was no significant difference between genders for either PDR (P = 0.378) or ADR (P = 0.574). Significantly higher PDR and ADR were found for patients ≥ 50 years (P < 0.001), as well as for suboptimal bowel preparation [PDR (25.7 %; P = 0.007) and ADR (18.6 %; P = 0.014)]. Interestingly, endoscopists with < 500 colonoscopy-procedural-experience reported a higher PDR (21.6 %; P = 0.020) and ADR (14.4 %; P = 0.049), corresponding to a significantly higher PDR (20.6 %; P = 0.005) and ADR (11.7 %; P = 0.02) for endoscopists in practice for ≤ 10 years. Conclusions We have noticed low PDR and ADR, which require further investigation and research. In addition, we believe there should be a different baseline ADR and PDR as a quality indicator for colonoscopy in our region, where no internationally recommended colonoscopic screening programs have been implemented.

Download Full-text

Su1656 Adenoma Detection Rate in Screening Compared to Non-Screening Colonoscopies: A Cross-Sectional Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.970 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB381-AB382

Author(s):

Sherif Elhanafi ◽

David C. Metz ◽

Gregory G. Ginsberg ◽

Shivan J. Mehta ◽

Nuzhat A. Ahmad

Keyword(s):

Detection Rate ◽

Cross Sectional Study ◽

Adenoma Detection Rate ◽

Sectional Study ◽

Cross Sectional ◽

Adenoma Detection

Download Full-text

IDDF2020-ABS-0184 Differences of adenoma detection rate (ADR) between high definition colonoscopes – a retrospective cross-sectional study

10.1136/gutjnl-2020-iddf.109 ◽

2020 ◽

Author(s):

Marianne Linley Sy-Janairo ◽

Juliet Cervantes

Keyword(s):

Detection Rate ◽

Cross Sectional Study ◽

Adenoma Detection Rate ◽

Sectional Study ◽

High Definition ◽

Cross Sectional ◽

Adenoma Detection

Download Full-text

Superior versus Inferior Conjunctival Limbal Autograft with Sutures in the Management of Primary Pterygium in a Tertiary Care Hospital in Dakshina Kannada - A Cross Sectional Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/118 ◽

2021 ◽

Vol 8 (11) ◽

pp. 603-607

Author(s):

Madhuri Upadhyaya ◽

Sheetal Savur

Keyword(s):

Cross Sectional Study ◽

Bulbar Conjunctiva ◽

Care Hospital ◽

Sectional Study ◽

Surgical Time ◽

Cross Sectional ◽

Significant Difference ◽

The Mean ◽

Pterygium Excision ◽

Primary Pterygium

BACKGROUND Pterygium excision with conjunctival limbal autograft (CAU) is one of the most frequently used modalities in the treatment of pterygium. The graft has traditionally been harvested from the superior bulbar conjunctiva, but this may not be possible in all patients. The purpose of this study was to compare the intraoperative difficulties and early postoperative outcomes between superior and inferior CAU in the management of primary pterygium. METHODS This hospital based cross sectional study evaluated 58 eyes of 50 patients with primary pterygium who underwent pterygium excision with conjunctival limbal autograft secured with the help of sutures over a period of 2 years from March 2018 to March 2020. In 28 eyes, the superior bulbar conjunctiva was used for grafting whereas in 30 eyes, the inferior conjunctiva was used for the same. The outcome measured was in terms of the mean surgical time, clinical symptoms and signs in the early postoperative period and recurrence rate. RESULTS The mean age of the patients was 44.14 ± 12.71 years in the superior CAU group and 45.76 ± 14.51 years in the inferior CAU group. There was no statistically significant difference between the two groups in terms of the mean surgical time (68.39 ± 31.51 in superior group, 2.60 ± 0.79 in inferior group; P value 0.712). The duration of follow-up after surgery was significantly more (P = 0.048) in the inferior CAU group (42.60 ± 11.71 days) as compared to the superior CAU group (37.39 ± 7.52 days). Postoperative symptoms were comparable, and no recurrence was observed in either of the two groups. CONCLUSIONS Pterygium excision with inferior conjunctival limbal autograft is safe and effective in the management of primary pterygia and may be considered as an alternative to superior graft in cases where harvesting the superior conjunctiva is not possible or not advisable. KEYWORDS Primary Pterygium, Conjunctival Limbal Autograft, Inferior Graft

Download Full-text

PSYCHOLOGICAL IMPACT OF COVID ON HEALTH CARE WORKER DUE TO COVID 19 PANDEMIC IN A TERTIARY CARE HOSPITAL : A CROSS SECTIONAL STUDY

International Journal of Advanced Research ◽

10.21474/ijar01/13927 ◽

2021 ◽

Vol 9 (12) ◽

pp. 435-442

Author(s):

Anjana Kumari ◽

◽

Manish Kumar ◽

Arati Shivhare ◽

Vikash Chandra Mishra ◽

...

Keyword(s):

Health Care ◽

Health Care Worker ◽

Cross Sectional Study ◽

Administrative Staff ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Health Crisis ◽

Significant Difference ◽

Care Worker

Background: Corona virus disease 2019 (COVID-19) pandemic caused health crisis. It is important to assess the status of stress, depression and anxiety among medical health care worker (HCWs). Material and Methods: A cross sectional study based on online questionnaire wherein sample size was 160, and HAMD, HAMA and PSS questionnaire was applied and also a self made questionnaire was applied to assess the strategies to cope with covid stress, it consists of 3 items. Data analysed using SPSS software variables compared by using Chi-square/Fishers exact test. Students t-test was used to compare mean values in the two independent groups, and one-way ANOVA was used for more than two groups. The variables with P < 0.05 were considered as statistically significant. Result: A total of 160 sample included, in which 94 (58.1%) were medical staff and 66 (41.25%) were administrative staff. Significant difference was noted in sex(p= 0.004), educational status(p= 0.000), monthly income(p= 0.000), high risk exposure(p= 0.000) and contact with COVID positive suspect or case(p=0.000).There were significant difference noted in depression, anxiety and stress scale as compared to the administrative staff group (p = 0.004, p= 0.004 and p= 0.007) respectively. Conclusions: During this COVID-19 pandemic, HCWs reported a high prevalence of depression, anxiety and stress than the administrative staff.

Download Full-text

PROXIMAL SERRATED POLYP DETECTION RATE: A COMPLEMENTARY QUALITY INDICATOR FOR ADENOMA DETECTION RATE?

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202000000-81 ◽

2020 ◽

Vol 57 (4) ◽

pp. 466-470

Author(s):

Fernando Antônio Vieira LEITE ◽

Luiz Cláudio Miranda ROCHA ◽

Rodrigo Roda Rodrigues SILVA ◽

Eduardo Garcia VILELA ◽

Luiz Ronaldo ALBERTI ◽

...

Keyword(s):

Quality Indicator ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

Polyp Detection ◽

Historical Cohort ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Significant Difference

ABSTRACT BACKGROUND: The effectiveness of colonoscopy for colorectal cancer (CRC) screening depends on quality indicators, which adenoma detection rate (ADR) being the most important. Proximal serrated polyp detection rate (pSPDR) has been studied as a potential quality indicator for colonoscopy. OBJECTIVE: The aim is to analyze and compare the difference in ADR and pSPDR between patients undergoing screening colonoscopy and an unselected population with other indications for colonoscopy, including surveillance and diagnosis. METHODS: This is a historical cohort of patients who underwent colonoscopy in the digestive endoscopy service of a tertiary hospital. Out of 1554 colonoscopies performed, 573 patients were excluded. The remaining 981 patients were divided into two groups: patients undergoing screening colonoscopy (n=428; 43.6%); patients with other indications including surveillance and diagnosis (n=553; 56.4%). RESULTS: Adenoma detection rate of the group with other indications (50.6%) was higher than that of the screening group (44.6%; P=0.03). In regarding pSPDR, there was no difference between pSPDR in both groups (screening 13.6%; other indications 13.7%; P=0.931). There was no significant difference in the mean age (P=0.259) or in the proportion of men and women (P=0.211) between both groups. CONCLUSION: Proximal serrated polyp detection rate showed an insignificant difference between groups with different indications and could be used as a complementary indicator to adenoma detection rate. This could benefit colonoscopists with low colonoscopy volume or low volume of screening colonoscopies.

Download Full-text

Rational and irrational use of intra-venous infusions: a cross-sectional study among patients of a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193287 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1286

Author(s):

Amber G. ◽

Muhammad J. Khan ◽

Amina K. ◽

Warda G. ◽

Murtaza G. ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Age Groups ◽

Female Gender ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Adult Age ◽

Significant Difference

Background: Intravenous infusions (IV) are a rapid mean of administering drugs. Hospitals are commonplace for their use, but at the same time they have many serious potential complications. This study aims to know the justified use of intravenous infusion among patients of a tertiary care hospital and awareness about its use.Methods: It was a cross-sectional study in which 249 subjects were conveniently studied. Nil per oral, severity of dehydration, vomiting, and diarrhoea was used as confirmatory criteria for using IV Infusions. Questionnaire with verbal consent was used to collect the data. Descriptive statistical analysis was applied to analyse the data and presented as means, frequencies and percentages in the form of tables and figure.Results: Total n249 (100%) subjects, n68 (27.3%) males and n181 (72.7%) females with average age was 24.05±14.21 years participated. Among n116 (46.6%) irrational users, females n76 (30.5%) were more then males n40 (16.1) with significant difference, p= 0.018. However, no significant difference was found among other variables (age groups, profession, education, awareness and rational or irrational use of IV infusion). Majority n249, n204 (81.9%) were not aware of the IV infusion medication error and doctors were most common unjustified prescribers of IV infusion, n105 (90.5%).Conclusions: The study concluded with the more prevalent irrational IV infusion use in our setup. Doctors appeared the dominant prescriber of irrational IV infusion. This statement is astonishing and must not be overlooked. Female gender, adult age, under-grade patients and students are more exposed to irrational IV infusion.

Download Full-text

Prevalence of metabolic syndrome in psoriasis vulgaris: a cross sectional study from a tertiary care hospital of South-East Rajasthan

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20162832 ◽

2016 ◽

Vol 2 (2) ◽

pp. 30

Author(s):

Manjaree Morgaonkar ◽

Ramesh Kushwaha ◽

Savera Gupta ◽

Suresh Kumar Jain ◽

Dattatray V. Kulkarni ◽

...

Keyword(s):

Metabolic Syndrome ◽

Psoriasis Vulgaris ◽

Tertiary Care ◽

Cross Sectional Study ◽

P Value ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Systemic Inflammatory Disease ◽

Significant Difference

Background: Psoriasis, a common skin disorder is now considered as systemic inflammatory disease. Its chronic inflammatory state is thought to predispose patients to metabolic syndrome (MetS), which is a significant predictor of cardiovascular events. The objective of the study is to investigate the prevalence of metabolic syndrome in psoriatic patients with only cutaneous involvement and to evaluate the correlation between presence of MetS and psoriasis severityMethods: We performed hospital based, cross-sectional study on 100 adult patients with psoriasis vulgaris and equi-numbered age and sex matched controls. MetS was diagnosed by revised National Cholesterol Education Program’s Adult Panel III criteria.Results: A higher prevalence of metabolic syndrome was found in psoriasis patients as compared to controls [28 (28%) vs 9 (9%), P value=0.0005].Impaired fasting glucose level, hypertension, hypertriglyceridemia and abdominal obesity were more prevalent in psoriasis group. No statistically significant difference was found between prevalence of low levels of HDL and presence of metabolic syndrome. Presence of metabolic syndrome was not associated with severity and duration of psoriasis. Female patients with psoriasis were more frequently having metabolic syndrome.Conclusions: Prevalence of metabolic syndrome is higher in patients with psoriasis irrespective of its duration and severity. This stresses on the need of regular evaluation for the presence of MetS or any of its components in psoriasis patients so as to allow early detection and management.

Download Full-text

Viral clearance in COVID-19 patients admitted in designated COVID hospital in Western India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213528 ◽

2021 ◽

Vol 8 (9) ◽

pp. 4303

Author(s):

Harpreet Singh ◽

Kanwaljit Kaur ◽

S. K. Ghai ◽

Pranaya Gurmeet ◽

Raju Agarwal ◽

...

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Viral Clearance ◽

Care Hospital ◽

Sectional Study ◽

Rt Pcr ◽

Chi Square ◽

Cross Sectional ◽

Significant Difference ◽

Chi Square Test

Background: COVID-19 pandemic is one of the greatest challenges faced worldwide and has not only posed health crisis but also had social, economic and political devastating effects. The speedy transmission risk enforced bygone practices of quarantine of healthy persons and isolation of all positive patients. The basis of all key policy making is the understanding of virus clearance from the body so that transmission can be ceased. The aim of the study was to understand the viral clearance and its’ co-relates for guiding infection control and transmission practices in COVID-19.Methods: Cross sectional study in a tertiary care hospital. A cross-sectional study of total 398 patients admitted for COVID-19 between June 2020 and November 2020 at a tertiary care centre. Statistical analysis used: frequency, percentage, and chi square test Chi square test for linear trend and was used to find association.Results: 88.19% were males and 11.81% were female patients, mean age of study participants was 34.84 years. 61.56% were symptomatic and among them 1.64% presented with severe symptoms. Mean duration to turn RT-PCR negative was 11.83 days. No significant difference in time taken to turn RT-PCR negative among asymptomatic and symptomatic cases is suggestive of no difference in viral load and its clearance in symptomatic vs asymptomatic cases.Conclusions: The disease profile of COVID-19 in our setup was alike the national disease profile and the recovery rate being 98.76%. Presence of co-morbidities affects viral clearance in COVID-19.

Download Full-text