A CLINICAL AUDIT ON ANALYSIS OF PATIENTS WITH PLEURAL EFFUSION IN A TERTIARY CARE HOSPITAL IN SRI LANKA

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.

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The High Burden of In-Hospital Diabetes Mellitus at A Tertiary Care Hospital in Sri Lanka; A Case Control Study

Journal of Diabetes & Metabolism ◽

10.4172/2155-6156.1000502 ◽

2015 ◽

Vol 06 (03) ◽

Author(s):

Arjuna B Medagama

Keyword(s):

Diabetes Mellitus ◽

Sri Lanka ◽

Case Control Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Control ◽

Care Hospital ◽

High Burden ◽

Control Study

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Teleradiological implementation as a decision support system at an accident service unit in a tertiary care hospital in Sri Lanka

Sri Lanka Journal of Bio-Medical Informatics ◽

10.4038/sljbmi.v10i3.8082 ◽

2019 ◽

Vol 10 (3) ◽

pp. 18

Author(s):

D. H. Jayakody ◽

R. B. Marasinghe

Keyword(s):

Decision Support ◽

Sri Lanka ◽

Decision Support System ◽

Support System ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Service Unit

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Endoscopic evaluation of patients with dyspepsia in a tertiary care hospital in Sri Lanka

Sri Lanka Journal of Surgery ◽

10.4038/sljs.v33i4.8201 ◽

2016 ◽

Vol 33 (4) ◽

pp. 23

Author(s):

R. T. Gamage ◽

J. R. Wijesekera ◽

A. L. A. M. C. Ambegoda ◽

D. T. Wijesinghe ◽

K. I. Panditharathne

Keyword(s):

Sri Lanka ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Endoscopic Evaluation

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Prevalence and associations of psychoactive substance use among male supportive staff members in a tertiary care hospital of Sri Lanka

BJPsych Open ◽

10.1192/bjo.2021.778 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S293-S293

Author(s):

Chathurie Suraweera ◽

Iresha Perera ◽

Priyanka Rupasinghe ◽

Janith Galhenage

Keyword(s):

Substance Use ◽

Sri Lanka ◽

Alcohol Use ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Psychoactive Substance ◽

Staff Members ◽

History Of ◽

Psychoactive Substance Use

AimsThe study describes the prevalence and associated socio-demographic variables of psychoactive substance use among male supportive staff members at a tertiary care hospital in Sri Lanka.MethodA cross-sectional descriptive study was carried out among male supportive staff members of a tertiary care hospital in Colombo District, Sri Lanka by using a self-administered anonymous questionnaire. Participants were recruited using stratified cluster sampling in thirteen overseer divisions of the hospital. Anonymous questionnaires were collected into a sealed box and analysed using Statistical Package for Social Sciences 20.ResultThe mean age of the 404 male staff members who participated in the study was 38.78(SD = 10.90) years and 71.5% were married. Among them 202 (49.1%) were educated up to grade 6-11 and 30 of them has had encounters with law in the past. Thirty of participants had history of psychoactive substance use in the family. Alcohol was used more than once a month by 127(30.9%) and more than once a week by 19(4.6%) individuals. Among other substances, tobacco, beetle and beedi were used by 104(25.3%), 78(19.0%) and 18(4.4%) respectively at least once a month. Further, 22(5.3%), 20(4.8%), 7(1.7%) and 7(1.7%) participants used Mava, Cannabis, Methamphetamine and Thool respectively at least less than once a month. Heroin, Tramadol and Morphine were used by two individuals at least less than once a month. Among substance using participants, 132 wished to cut down their habit. Most commonly identified (14.1%) adverse consequence was financial issues secondary to psychoactive substance use. Eleven (4.5%) staff members used the substance at hospital. Alcohol use was associated with age more than 35 years (p = 0.039) and history of forensic involvement (p = 0.038). Tobacco(p = 0.000), beetle (p = 0.056), Cannabis (p = 0.000) and mava (p = 0.015) use were significantly associated with positive forensic history. Supportive staff members’ alcohol and cannabis use was associated with tobacco (p = 0.000, p = 0.000) and beetle use (p = 0.001, p = 0.049). Mava use was associated with alcohol (p = 0.060) use in addition to tobacco (p = 0.020) and beetle use (p = 0.008).Binomial logistic regression revealed alcohol use and beetle use were associated with the number of children in family and above associations.ConclusionCommonest psychoactive substance consumed by supportive staff members were alcohol, tobacco, beetle, Cannabis and Mava in descending order of frequency. Forensic history was significantly associated with substance use. True prevalence of substance use can be higher than these values.

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Experience of lodopovidone Pleurodesis at A Tertiary Care Hospital in Peshawar

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2021.11.3.644 ◽

1969 ◽

Vol 11 (3) ◽

pp. 123-127

Author(s):

Muhammad Umar ◽

Zia Ul Haq ◽

Imtiaz Khan ◽

Anila Basit ◽

Amin Ul Haq ◽

...

Keyword(s):

Pleural Effusion ◽

Malignant Pleural Effusion ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Efficacy And Safety ◽

Chemical Pleurodesis ◽

Effective Agent ◽

Age Range ◽

Recurrent Pleural Effusion

Background: Chemical pleurodesis is used for the management of malignant /recurrent pleural effusion and pneumothorax.Malignant pleural effusion is diagnosed on histopathology or malignant cells in pleural fluid. Pneumothorax is diagnosed by chestradiograph. Pleurodesis can be performed surgically or by using medical agents. Various pleurodesis agents have been used e.g.Tetracycline.Bleomycin. Talc and lodopovidone with different success and complications rates.Objective: This study was conducted to know the efficacy and safety of lodopovidone as pleurodesis agent in themanagement of pleural effusion (malignant/recurrent) and recurrent pneumothorax.Material and Methods: This was a descriptive study conducted at department of Pulmonology Lady Reading HospitalPeshawar from February 2018 to May 2019.Results:A Total of 213 patients were included in the study, among which 120 (56.3%) were males and 93 (43.6%) werefemales. Age range was from 20 to 83 years. One hundred and thirty eight patients (74.8%) had malignant pleural effusion and75 (35.2%) had recurrent pneumothorax. The success rate with lodopovidone pleurodesis was 85 % (181) as a whole with afailure rate of 13 %( 28) in pleural effusion and 2 %( 4) in pneumothorax. Chest pain (65.7%) was the most common side effectfollowed by fever (24.4%) and dyspnea (12.2%).No serious side effects were observed in this study.Conclusion: lodopovidone is easily available, safer, cheaper and effective agent for chemical pleurodesis in pneumothorax,malignant/recurrent pleural effusion.Keywords: Pleurodesis, lodopovidone. Malignant, Pleural Effusion, Pneumothorax.

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A Descriptive Study on Sepsis: Causes, Outcomes, and Adherence to Guidelines on Patients with Sepsis at a Tertiary Care Hospital in Sri Lanka

BioMed Research International ◽

10.1155/2020/7971387 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Anne Thushara Matthias ◽

J. Indrakumar ◽

Tharushi Ranasinghe ◽

Shalini Wijekoon ◽

Charuni Yashodara

Keyword(s):

Sri Lanka ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Bundle ◽

Common Source ◽

Care Hospital ◽

Poor Countries ◽

Arterial Blood ◽

Resource Poor ◽

Sepsis Care

The global incidence of sepsis is increasing, and mortality remains high. The mortality is even higher in resource-poor countries where facilities and equipment are limited. The Surviving Sepsis Campaign (SSC) recommends an updated hour-1 bundle based on the evidence from the International Guidelines for Management of Sepsis and Septic Shock 2018. To reduce mortality from sepsis, compliance with the “bundle” is essential. Data from developing countries like Sri Lanka on the management of sepsis according to the SSC guidelines are not available. Hence, this study looks at the patient characteristics and management of septic patients at a tertiary care hospital in Sri Lanka. Patients admitted to the University Medical Unit of Colombo South Teaching Hospital from January to August 2019 fulfilling the inclusion criteria were included. The hour-1 sepsis bundle adherence, demographic data, and management were recorded. There were 387 patients: 163 males and 224 females. The age range was 15-95 with a mean age of 63. 83.7% were direct admissions while 16.3% were transfers from a peripheral hospital. The most common source of infection was urine (82 (21.2%)) followed by blood stream (105 (27.1%)) and skin and soft tissue (114 (29.5%)). One-hour SSC bundle compliance is as follows: administration of intravenous fluids: 42 (10.9%), blood cultures before antibiotics: 225 (58.1%), first dose antibiotic: 15 (3.9%), and arterial blood gas: 60 (15.5%). Staffing capacity did not make a difference to adherence to the bundle. The study mortality rate was 37 (9.6%). Binary logistic regression indicates that quick sequential organ failure assessment (qSOFA) score is a significant predictor of mortality (chi‐square=35.08, df=3, and p=0.001 (<0.05)) with an odds ratio (OR) of 7.529 (95% CI 3.597-14.323). The other predictors, age, sex, adherence to sepsis care bundle, and comorbidities, were not significant. In conclusion, mortality of sepsis is high and adherence to sepsis care bundle is poor in Sri Lanka even at a tertiary care hospital. Education and training of staff are needed to boost adherence. This will in turn improve quality of care and outcomes of septic patients in resource-poor countries.

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