scholarly journals IsHelicobacter pyloriBeing Treated Appropriately? A Study of Inpatients and Outpatients in a Tertiary Care Centre

2007 ◽  
Vol 21 (5) ◽  
pp. 285-288 ◽  
Author(s):  
Jose Nazareno ◽  
David K Driman ◽  
Paul Adams
Keyword(s):  
Tertiary Care ◽  
Gastric Biopsy ◽  
Pathology Report ◽  
Tertiary Care Centre ◽  
Delivery Of Care ◽  
Ulcer Disease ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
H Pylori

BACKGROUND:Helicobacter pyloriis causally associated with peptic ulcer disease and gastric cancer. Although effective treatment is available, studies have shown that patients withH pyloriare often not well managed. Recently, there has also been increasing awareness of patient safety concerns arising from missed follow-up of abnormal test results.OBJECTIVE: To examine whether inpatients and outpatients diagnosed withH pylorireceive appropriate treatment.PATIENTS AND METHODS: All patients who were diagnosed withH pyloriby gastric biopsy in London, Ontario between January 1, 2004, and December 31, 2004, were identified. The hospital charts of these patients were reviewed. Outpatient office charts, clinic notes, pathology reports and endoscopy reports were also reviewed.RESULTS: One hundred ninety-three patients were diagnosed withH pyloriby gastric biopsy in 2004. Of the 193 patients, 143 (74%) were outpatients and 50 (26%) were inpatients. Overall, 89% of patients received treatment forH pylori. Ninety-two per cent of outpatients were treated, while only 60% of inpatients received treatment (P<0.001). Among the inpatients, the pathology report was available in 40% of the cases before the patient was discharged from the hospital. After discharge from the hospital, 30% of inpatients received appropriate treatment and follow-up. There was no significant difference in treatment whether the patient was admitted to a medical or a nonmedical service.CONCLUSION:H pyloriis treated relatively poorly in inpatients compared with outpatients. Results of the present study reveal opportunities to improve delivery of care for inpatients on a number of different levels. More research is needed to ensure safety, effectiveness and timeliness in the test result management process.

Contact Dermatitis Mimickers: A Tertiary Care Center's Experience

2013 ◽  
Vol 17 (6) ◽  
pp. 429-432 ◽  
Author(s):  
Yuliya Velykoredko ◽  
Marie-Claude Houle ◽  
Sandy Skotnicki
Keyword(s):  
Contact Dermatitis ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Significant Delay ◽  
Tertiary Care Centre ◽  
Delay In Diagnosis ◽  
Pityriasis Rubra Pilaris ◽  
Appropriate Treatment ◽  
Specialized Program

Background: Contact dermatitis (CD) is very common but can be mimicked by numerous dermatologic conditions. Thus, a wide differential must be considered before a definitive diagnosis of CD is made to ensure the patient receives appropriate treatment and follow-up. Objective: To describe conditions that can present similarly to contact dermatitis. Methods: We retrospectively analyzed patients referred to the Occupational Disease Specialized Program at St. Michael's Hospital in Toronto between 2009 and 2011 for CD investigations but with a final diagnosis other than CD. Results: We report cases of 2 feet-1 hand syndrome, Dermatitis Herpetiformis, Sézary syndrome and two cases of Pityriasis Rubra Pilaris misdiagnosed as CD and referred for patch testing at our busy tertiary care centre. Failing to recognize these mimickers of CD resulted in a significant delay in diagnosis for the patients and resulting initiation of necessary intervention. Conclusions: It is important to consider numerous mimickers before making a diagnosis of CD to ensure optimal outcome for patients.

scholarly journals Risk Factors For Recurrence of Peptic Ulcer Disease: A Retrospective Study In Tertiary Care Referral Center

2022 ◽  
Author(s):  
Yaser Alsinnari ◽  
Mohammed S. Alqarni ◽  
Meshari Attar ◽  
Ziad M. Bukhari ◽  
Faisal Baabbad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Recurrence Rate ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Ulcer Disease ◽  
Significant Difference ◽  
Risk Factors For Recurrence ◽  
H Pylori

Abstract Backgrounds: Peptic ulcer disease (PUD) is a common gastrointestinal tract disease characterized by mucosal damage secondary to pepsin and gastric acid secretion. The aim of this study was to evaluate the five-year recurrence rate for treated patients with PUD and risk factors contributing to PUD relapses.Methods: From 2016 through 2021, all patients with endoscopy-proved PUD were identified by reviewing medical records (Best-Care system). Possible risk factors including smoking, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, caffeine, and steroid were analyzed by univariate analysis. Treatment outcomes, 5-year recurrence rate, and mortality rate were assessed.Results: Among 223 patients, there were 187 (83.8%), who diagnosed endoscopy-proved PUD and 36 (16.2%), who diagnosed clinical PUD. Among them, 126 (56.5%) patients were males and the mean age was 62±2 years. The five years recurrence rate of PUD was 30.9%. There was no significant difference in the recurrence rate between the duodenal ulcer (33.3%) and the gastric ulcer (28.8%). By univariate analysis, the use of steroid and NSAID and H. pylori infection were potential risk factors for PUD (P < 0.005). The common complication of PUD was gastrointestinal bleeding (34.1%). Patients who had a complicated PUD were associated with a higher rate of recurrence (45.9%) compared to the uncomplicated PUD (19.2%) (P > 0.05). Conclusion: Our findings demonstrated that the five years recurrence rate of PUD was 30.9%. The use of steroid and NSAID and H. pylori infection were risk factors for recurrence of PUD. PUD places a significant burden on health care systems. Therefore, a multicenter prospective study is needed for effective management to prevent recurrence and complications of PUD.

scholarly journals Evaluation of the Anxiety Level of Mothers of Children with Epilepsy during the COVID-19 Pandemic Period

2021 ◽  
pp. 1-8
Author(s):  
Halil Celik ◽  
Sadettin Burak Acikel ◽  
Fatih Mehmet Akif Ozdemir ◽  
Erhan Aksoy ◽  
Ulkuhan Oztoprak ◽  
...  
Keyword(s):  
Neurological Disease ◽  
Chronic Conditions ◽  
Care Center ◽  
Tertiary Care ◽  
Anxiety Level ◽  
Childhood And Adolescence ◽  
Routine Examination ◽  
Significant Difference ◽  
Anxiety Levels

<b><i>Background and Aim:</i></b> Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. <b><i>Methods:</i></b> The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers’ anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. <b><i>Results:</i></b> There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. <b><i>Conclusion:</i></b> Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.

scholarly journals Limited adequacy of thyroid cancer patient follow-up at a Canadian tertiary care centre

2013 ◽  
Vol 56 (6) ◽  
pp. 385-392 ◽  
Author(s):  
Elaine Lam ◽  
Scott S. Strugnell ◽  
Chris Bajdik ◽  
Daniel Holmes ◽  
Sam M. Wiseman
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patient ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Thyroid Cancer Patient

scholarly journals PHARMACOINVASIVE VERSUS THROMBOLYSIS IN STEMI COHORT – OUTCOMES FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Richa Sharma ◽  
Ajeet Jain ◽  
Praveen Singh ◽  
Bhushan Shah
Keyword(s):  
Myocardial Ischemia ◽  
Tertiary Care ◽  
Myocardial Necrosis ◽  
North India ◽  
Registry Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Promising Strategy ◽  
Cardiology Department

STEMI is an event where transmural myocardial ischemia induces myocardial necrosis. PI strategy is a promising strategy in the management of STEMI. It is prospective registry study conducted in Cardiology Department, KGMU between January-June 2016 to know 30 day outcome of thrombolysis alone or thrombolysis followed by PCI in north India.At 30 day follow up, patients undergoing PI strategy,complained less of angina and dyspnea compared to thrombolysis arm.

scholarly journals Efficacy and Safety of Rituximab in Immunobullous Diseases: A Retrospective Study from a Tertiary Care Centre of Nepal

2020 ◽  
Author(s):  
Sudip Parajuli ◽  
Jyoti Vidhan ◽  
Dinesh Binod Pokhrel ◽  
Upama Paudel
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Data Entry ◽  
Pemphigus Vulgaris ◽  
University Teaching ◽  
Efficacy And Safety ◽  
Tertiary Care Centre ◽  
Cutaneous Lesions

Introduction: Rituximab is effective and safe treatment of immunobullous disorders. There are variations in doses of drugs used in different studies and uncertainties on when to use it along with use of adjuvant therapies. Efficacy and safety of this drug has not been described in Nepalese population till date. Dermatologists have hesitation in starting this drug in immunobullous diseases because of lack of data on efficacy and safety. Aim: To assess the efficacy and side effects of Rituximab therapy in treating immunobullous disorders in Nepalese patients. Materials and Methods: This was a retrospective study of patients with immunobullous diseases treated with Rituximab in Dermatological ward of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from May 2018 to August 2019. Data were analysed for duration of disease and treatment received before Rituximab therapy, duration of steroid used before Rituximab, adverse effects due to prolonged steroid use, time to remission from 1st Rituximab pulse, duration of remission, relapse, duration of steroid and adjuvant drug used post 1st pulse and adverse effects associated with Rituximab. SPSS version 20 was used for data entry and descriptive statistics was used for analysis of the data. Results: Nine patients (Pemphigus Vulgaris-8 (PV-8), Bullous Pemphigoid-1 (BP-1) were treated with Rituximab. Seven were treated for refractory disease not controlled by conventional therapy and two received Rituximab as first-line therapy. The patients were under follow-up for 15-60 weeks (mean 31.89±15.62 weeks). Out of these nine patients, eight were free of lesions in one to eight weeks (mean 5.125±2 weeks) of first pulse. One patient with Oral Pemphigus had persistence of old lesions, however there were no new cutaneous lesions after first pulse. Adverse effects were seen in four patients that included infusion reaction in one and infection in three. There was relapse in one patient at last follow-up. Conclusion: Rituximab is efficacious and is safe in treating immunobullous disorders in Nepalese Population.

scholarly journals Retrospective analysis of paediatric tracheostomy in Indian tertiary care centre

2020 ◽  
Vol 6 (3) ◽  
pp. 533
Author(s):  
Digant Patni ◽  
Vishal R. Munjal
Keyword(s):  
Retrospective Analysis ◽  
Tertiary Care ◽  
Care Facility ◽  
Tertiary Care Centre ◽  
Prolonged Intubation ◽  
Changing Trend ◽  
Lost To Follow Up ◽  
Neurological Infection ◽  
Related Mortality

<p class="abstract"><strong>Background:</strong> Tracheostomy is frequently performed surgical procedure. The present study was carried out to assess data on various indications, surgical issues if any, complications and outcomes of paediatric tracheostomy.</p><p class="abstract"><strong>Methods:</strong> This study is a retrospective analysis of 32 paediatric patients between 1 to 12 years of age, who underwent tracheostomy at SAIMS, Indore between June 2015 to June 2019. Data was analysed in terms of patient age, sex, emergency or planned procedure, any surgical challenge, complications and post-operative follow up.  </p><p class="abstract"><strong>Results:</strong> Majority of patients were of prolonged intubation due to respiratory and laryngotracheobronchitis (15.6%) each, neuromuscular disease (15.6%), seizure disorder (9.4%), metabolic disease (9.4%) and neurological infection (6.3%). Obstructive causes included head injury (9.4%), sub-glottic stenosis (6.3%), malignancy (6.3%) and craniofacial anomaly (3.1%). Common complication encountered were partial blockage of tube, peri-stomal granulation and accidental decannulation. There was no tracheostomy related mortality in this study. Out of 32 patients, 16 were successfully decannulated, 6 were lost to follow up, 6 could not be decannulated and 4 expired due to worsening of primary disease.</p><p class="abstract"><strong>Conclusions:</strong> There is a changing trend in indications of tracheostomy and overall complications have reduced due to trained team and better care facility.</p>

scholarly journals ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang
Keyword(s):  
Early Diagnosis ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

scholarly journals A Randomized Trial Comparing Seven-Day Ranitidine Bismuth Citrate and Clarithromycin Dual Therapy to Seven-Day Omeprazole, Clarithromycin and Amoxicillin Triple Therapy for the Eradication ofHelicobacter pylori

2003 ◽  
Vol 17 (9) ◽  
pp. 533-538 ◽  
Author(s):  
Sander Veldhuyzen van Zanten ◽  
Naoki Chiba ◽  
Alan Barkun ◽  
Carlo Fallone ◽  
Alain Farley ◽  
...  
Keyword(s):  
Dual Therapy ◽  
Success Rates ◽  
Open Label ◽  
Treatment Allocation ◽  
Ulcer Disease ◽  
Intention To Treat ◽  
Bismuth Citrate ◽  
The Difference ◽  
H Pylori

OBJECTIVE: To assessHelicobacter pylorieradication after one week dual ranitidine bismuth citrate-clarithromycin (RBC-C) or triple omeprazole, clarithromycin and amoxicillin (OCA) therapy.METHODS: In this multicentre Canadian trial,H pylori-positive patients with functional dyspepsia or inactive peptic ulcer disease were randomized to open-label treatment with RBC-C (ranitidine bismuth citrate 400 mg plus clarithromycin 500 mg) or OCA (omezaprole 20 mg, clarithromycin 500 mg and amoxicillin 1000 mg), given twice a day for seven days. Treatment allocation was randomly assigned.H pyloriinfection was confirmed by positive13C-urea breath test (13C-UBT).H pyloristatus was reassessed by UBT at least four and 12 weeks after treatment (negative: δ13CO2below 3.5 per mil). Intention-to-treat (ITT) eradication rates were determined for all patients with confirmedH pyloriinfection. Per protocol (PP) rate was determined for all patients treated with at least two evaluable follow-up visits.RESULTS: Three hundred five patients were included in the ITT and 222 in the PP analysis. The ITT eradication rates were 66% for RBC-C and 78% for OCA. The PP success rates were 84% for RBC-C and 96% for OCA. The difference for both ITT 12% (95% CI 2 to 22) and PP 12% (95% CI 4 to 19) were statistically significant, P=0.030 and P=0.007, respectively. Treatment was generally well tolerated.CONCLUSION: The eradication rate for the seven-day dual RBC-C regimen was lower than that for OCA.

Sign in / Sign up

Export Citation Format

Share Document