scholarly journals Impact of Amending the Acetylcysteine Marketing Authorisation on Treatment of Paracetamol Overdose

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
G. Thompson ◽  
S. B. Fatima ◽  
N. Shah ◽  
G. Kitching ◽  
W. S. Waring
Keyword(s):  
Cost Effectiveness ◽  
Hospital Stay ◽  
Regulatory Agency ◽  
Marketing Authorisation ◽  
Paracetamol Overdose ◽  
Extensive Review ◽  
Entire Study ◽  
Duration Of Hospital Stay ◽  
Study Population ◽  
The Impact

In September 2012, the Medicines and Healthcare products Regulatory Agency (MHRA) substantially amended the Marketing Authorisation for acetylcysteine following an extensive review. The present study examined the impact of this license change on patterns of acetylcysteine use in patients presenting to hospital after paracetamol (acetaminophen) overdose. Between September 2011 and April 2013, 785 consecutive patients presented to York Hospital due to paracetamol overdose, and a before-after analysis was used to compare outcomes. There were 483 patients before and 302 patients after the license amendment, and age, gender, acute or staggered overdose pattern, and dose were similar in both groups. In the patients with paracetamol concentrations between the “100-line” and “200-line,” a significantly higher proportion received acetylcysteine treatment (51% before versus 98% after, ), as expected. A modest increase was also observed in relation to late or staggered overdose or cases where the time of ingestion was uncertain (53% versus 74%, ). The median duration of hospital stay increased across the entire study population, from 15 to 24 hours () due to the increased proportion of patients requiring acetylcysteine treatment. The findings indicate that the MHRA amendment is a financially costly intervention, and further studies are needed to examine clinical outcomes so that its cost effectiveness might be addressed.

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

The Influence of Preoperative Hematocrit Levels on Early Outcomes in Patients undergoing Cardiac Surgery

2021 ◽  
Vol 15 (10) ◽  
pp. 2817-2819
Author(s):  
Ajwad Farogh ◽  
Asma Hassan ◽  
Saira Gull ◽  
Muhammad Irfan Khan ◽  
Gohar Bashir ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Common Risk Factor ◽  
Duration Of Hospital Stay ◽  
Increased Risk ◽  
The Impact ◽  
Written Informed Consent ◽  
Preoperative Anaemia

Background: Anemia is a common risk factor for cardiovascular disease. The impact of preoperative anaemia is unclear in cardiac surgery. Preoperative anaemia affects early findings in patients undergoing cardiac surgery. Aim and Objective: The main objective of current research was to investigate the impact of preoperative anaemia on early outcomes in heart surgery patients. Material and Methods: A prospective randomized clinical research was undertaken after obtaining written informed consent from patients for cardiac surgery at the PIC, Lahore between Apr 2020 and Feb 2021. A total of 120 individuals between the ages of 20 and 60 were chosen for the research. Preoperative anaemia was described as Hb levels of <13 g/dl for males and <12 g/dl in female patients undergoing cardiac surgery. Results: Total 120 patients were enrolled and stratified into two groups (60 patients each) with average age 5 ± 5.75 years. Early outcomes after surgery such as postoperative stroke (6.67 % versus 1.6 %), AF (37 % versus32 %), and duration of hospital stay > 7 days (50 % vs 41.67 %) were found to be different between anaemic and normal Hb groups. Conclusion: Preoperative anaemia can be increased risk of morbidity and mortality in patients after surgery. Low preoperative Hb found as advanced risk factor for death, renal impairment, stroke, AF and long hospital stay in our research. Keywords: Anemia, CABG, AF, MI, IABP, CPB

Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair

2020 ◽  
pp. 105566562094911
Author(s):  
Iva Burianova ◽  
Milos Cerny ◽  
Jiri Borsky ◽  
Kristyna Zilinska ◽  
Jana Dornakova ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Artificial Ventilation ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Ventilation Support ◽  
Cleft Lip Repair ◽  
The Impact

Objective: There are minimal data available on nutrition after early repair of cleft lip and the factors influencing initiation of breastfeeding. This study assessed the impact of the length of surgery, length of ventilation support, and duration of hospital stay on breastfeeding rates after early cleft lip surgery. Design: This is a prospective observational cohort study comparing 2 hospitals providing early surgical repair of facial clefts from January 2014 to December 2016. Both hospitals are designated as Baby-Friendly Hospitals. Demographic and anthropometric data from mothers and newborns were recorded. Setting: Tertiary neonatal and pediatric surgery center. Patients: Hospital A: 61 newborns, Hospital B: 157 newborns. Interventions: Early (day 5 to 14) cheiloplasty in newborns with cleft lip or cleft lip and palate. Main Outcome Measures: Influence of duration of hospital stay, length of operation, and artificial ventilation on the rate of breastfeeding. Results: Significantly, more newborns were breastfed following early surgical repair of an isolated cleft lip compared to those with both cleft lip and palate, in both hospitals (hospital A 82% vs 0%, P = .0001, hospital B 66% vs 5%, P = .0001). Duration of hospital stay, length of operation, and duration of artificial ventilation did not significantly affect the rate of breastfeeding. Conclusions: The factors associated with early cleft lip repair (length of operation, length of ventilation support, and duration of hospital stay) do not affect breastfeeding rate.

scholarly journals An Analysis of Drug-Drug Interactions in a Tertiary Care Hospital in Kerala: A Retrospective Study

2021 ◽  
Author(s):  
Jihana Shajahan
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Positive Correlation ◽  
Duration Of Hospital Stay ◽  
The Impact

Introduction: Concomitant use of several drugs for a patient is often necessary for achieving therapeutic response. Understanding the profile of Drug-Drug Interactions (DDI) will help health care providers to optimise therapy for better patient outcomes, reinforcing the concept of rational drug use. Aim: To analyse the frequency, mechanisms and severity of DDIs in a tertiary care hospital at Kerala. Materials and Methods: A retrospective cross-sectional study among 350 inpatients of a tertiary care hospital in Kerala from August 2020 to September 2020. Prescriptions containing ≥3 drugs were collected from inpatient medical records. A drug interaction check was performed using the Lexicomp drug interaction checker software. Results: DDIs were present in 74.6% of prescriptions and the average number of interactions was found to be 2.78. Most number for interactions was in the age group 61-80. Average number of DDI was significantly high among patients >60 years. Percentage of prescriptions with DDI and average number of DDI was found to be increasing with increase in number of drugs. Average number of interactions were maximum (5.01) in the group >10. Drug groups most commonly involved in interactions were antiplatelets, oral hypoglycaemic agents, bronchodilators, antibiotics, diuretics, insulin, statins, beta blockers, Proton Pump Inhibitors (PPI) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The most common interventions for minimising the impact of DDIs were changing the timing of drug administration, monitoring for symptoms/signs/lab values/drug levels or both. There was a significant positive correlation between duration of hospital stay and number of DDI. Conclusion: This study threw light upon the pattern and profile of DDIs among inpatients of a tertiary care hospital in Kerala. Elderly people (>60 years) were most prone for DDIs. Percentage of prescriptions with DDI and average number of DDIs was found to be increasing with increase in number of drugs. There was a positive correlation between duration of hospital stay and number of DDI.

scholarly journals The Impact of the First Wave of Covid 19 on Orthopaedic Surgeries in a Tertiary Care Teaching Hospital

2021 ◽  
pp. 95-100
Author(s):  
B. Jagadeesh ◽  
N. Adhishwar Kumaran ◽  
K. Gunalan ◽  
K. Midhuna ◽  
S. Natarajan
Keyword(s):  
Hospital Stay ◽  
Health Care Services ◽  
Tertiary Care ◽  
Healthcare Personnel ◽  
Orthopaedic Department ◽  
Duration Of Hospital Stay ◽  
Care Services ◽  
Global Pandemic ◽  
The Cost ◽  
The Impact

Background: The Covid 19 was declared a global pandemic that had a sizeable impact on the health care services in the surgical field including the orthopaedic department. There was additionally a decreased accessibility to healthcare personnel and facilities reallocated to manage the Covid patients. The study was mainly conducted to find out the impact of the first wave of COVID-19 on the orthopaedic surgeries. Aim: The main aim of the study is to find out the alteration in the number, type of surgeries, financial implications, duration of hospital stay, delay in surgery during the first wave of the COVID-19 pandemic. Study Design: Retrospective crossectional study. Methods: All the surgeries conducted in the orthopaedic department in the year 2019 and 2020 following first peak in March including pre-op and post-op COVID cases are included in the study. The procedure conducted, date of admission, date of surgery, date of discharge, investigations done and the cost expenses are the various parameters that are taken into consideration. The results are analysed for each year and comparisons are made using statistical methods. Results: The comparative analysis of the data collected from the years 2019 and 2020 showed an increase in the duration of hospital stay, delay in surgery, additional expenditure, back log in the number of elective surgeries done during the Pandemic.

A PROSPECTIVE STUDY OF THE IMPACT OF MICROBIOLOGICAL CULTURES ON ANTIBIOTIC PRESCRIBING PATTERN IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 26-29
Author(s):  
PARTH VACHHANI ◽  
ANIL SINGH
Keyword(s):  
Antibiotic Therapy ◽  
Hospital Stay ◽  
Antibiotic Prescribing ◽  
Microbiological Analysis ◽  
Empirical Antibiotic Therapy ◽  
Prescribing Pattern ◽  
Duration Of Hospital Stay ◽  
Microbiological Culture ◽  
Tract Infections ◽  
The Impact

Objective: Antibiotics are frequently prescribed because of clinical suspicion of infection, while the results of the microbiological analysis are still awaited. This study was undertaken to assess the impact of microbiological culture results on the antibiotic prescribing pattern. Methods: This prospective observational study was conducted on 400 patients of either sex and any age with positive microbiological culture results. Empirical antibiotic therapy details were recorded and change in empirical antibiotic therapy after positive culture results was also recorded. Assessment of sensitivity resistance pattern of microorganisms was also performed. Results: In the study, male: female ratio was 1.01:1. The majority of patients i.e. 94 (24.50%) were in the 46 y to 60 y of age group. Definitive antibiotic therapy was initiated in 103 patients (25.75%) out of 400 patients. The highest number of changes in antibiotic therapy was done in urinary tract infections (63.95%) and septicemia (32.61%) cases. Klebsiella (34.25%), E. coli (32%) and Staphylococcus aureus (14.75%) were commonly isolated microorganisms. Cephalosporins (77.75%) and aminoglycosides (47%) were commonly used in empirical antibiotic therapy, while nitrofurantoin (47.57%) and penicillins (22.33%) were commonly used in definitive antibiotic therapy. Definitive antibiotic therapy was associated with a reduced duration of hospital stay as compared to empirical antibiotic therapy (p<0.0001). Conclusion: Antibiotic prescribing is infrequently influenced by microbiological culture results. Adjustment of the antimicrobial therapy according to microbiological culture results can decrease the duration of hospital stay as well as can decrease the spread of antimicrobial resistance.

scholarly journals Effects of Early Development of Hyponatremia on In-hospital Outcomes in Acute ST- Elevation Myocardial Infarction

2017 ◽  
Vol 32 (1) ◽  
pp. 29-35
Author(s):  
Mirza Md Nazrul Islam ◽  
Md Abdul Kader ◽  
HI Lutfor Rahman Khan ◽  
Mahmood Hasan Khan
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Hospital Stay ◽  
Sodium Level ◽  
Duration Of Hospital Stay ◽  
Group I ◽  
Study Population ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction

Background: Coronary heart disease is a major cause of death and is a global health problem and reaching epidemic in both developed and as well as in developing countries. In patients with acute myocardial infarction baroreceptor mediated hormonal activation has a prognostic value. Clinical importance of hyponatraemia in ST-elevation acute myocardial infarction has not been fully understood. Hyponatremia which developed in early phase of AMI has been recently advocated as an important prognostic factor in several studies.Objectives: The aim of the study was to investigate the impact of hyponatremia on in-hospital outcomes in patients with ST-elevation acute myocardial Infarction treated by thrombolysis.Methods: Hyponartaemia was defined as a sodium concentration <135 mmol/L. Hyponatremia which developed at 72 hours after admission was defined as early developed hyponatraemia. This study is a prospective observational study. A purposive sampling technique was used to select the sample. In this study data on 100 patients with ST-elevation acute myocardial infarction were analyzed. This study was done in the department of Cardiology Mymensingh Medical College Hospital from July 2014 to June 2015. Patients admitted in the department of Cardiology MMCH with acute STelevation myocardial infarction and treated with thrombolysis were evaluated for serum sodium level at admission and at 72 hours after admission. Total 100 patients were studied. Fifty patients with hyponatraemia were Group-I and fifty patients with normal sodium level were Group-II. Then the in-hospital outcome variables were analyzed.Results: Among the study population 85% were male and 15% were female. Age range was 25 years to 74 years. Mean age was 52.88±11.88. Risk factors such as smoking, hypertension, diabetes mellitus, dyslipidemia and F/H of CAD were evaluated. Highest percentage of study population had hypertension (52%) followed by dyslipidemia (49%), smoker (46%), diabetes mellitus (39%) and F/H of CAD had (24%) of study population. There were five outcome variables such as heart failure, cardiogenic shock, arrhythmia, duration of hospital stay and death. Total 12 patients died. 10 patients died in Group-I and 2 patients died in Group-II. Among the outcome variables death, heart failure and hospital stay was more in Group-I and was statistically significant.Conclusion: Early developed hyponatremia in patients with ST-elevation acute myocardial infarction was an independent predictor of prognosis. Heart failure, duration of hospital stay and death was more in hyponatraemic patients and Prognosis worsen with increasing severity of hyponatremia. Plasma sodium level may serve as a simple marker to identify patient at high risk.Bangladesh Heart Journal 2017; 32(1) : 29-35

Epidemiological changes in hepatitis A in Korea: increasing age and its effect on clinical outcomes

2012 ◽  
Vol 140 (12) ◽  
pp. 2182-2189 ◽  
Author(s):  
J. J. SHIM ◽  
S. O. CHIN ◽  
C. K. LEE ◽  
J. Y. JANG ◽  
B. H. KIM
Keyword(s):  
Acute Hepatitis ◽  
Hospital Stay ◽  
Prothrombin Time ◽  
Clinical Outcomes ◽  
Hepatitis A ◽  
Duration Of Hospital Stay ◽  
Acute Hepatitis A ◽  
Epidemiological Changes ◽  
The Mean ◽  
The Impact

SUMMARYKorea has recently experienced an increasing number of acute hepatitis A cases. We investigated the dynamics of hepatitis A and changes in the mean age of patients in a hospital in Seoul, Korea. Mean age increased consistently from 19 years in 1996 to 30 years in 2009 (P < 0·0001). Between two acute hepatitis A outbreaks in 1998–1999 and in 2008–2009, mean age increased from 23 to 30 years (P < 0·001). However, the hepatitis A clinical outcomes were similar between the outbreaks. Duration of hospital stay, creatinine level and prothrombin time did not differ. Throughout the study period, individuals born in the 1970s and 1980s comprised the largest proportion (84%) of patients. As this susceptible generation ages, the mean age of hepatitis A patients in Korea will increase consistently. However, at present, the impact of increasing age on clinical outcomes is not apparent.

scholarly journals The effects of nosocomial rotavirus gastroenteritis on the length of hospital stay and cost

2016 ◽  
Vol 10 (02) ◽  
pp. 163-167 ◽  
Author(s):  
Özlem O Gundeslioglu ◽  
Recep Tekin ◽  
Saliha Cevik ◽  
Yılmaz Palancı ◽  
Atilla Yazıcıoglu
Keyword(s):  
Hospital Stay ◽  
Direct Cost ◽  
Length Of Hospital Stay ◽  
Prevention Measures ◽  
Duration Of Hospital Stay ◽  
Rotavirus Gastroenteritis ◽  
Organ Systems ◽  
The Social ◽  
The Cost ◽  
The Impact

Introduction: In this study, the goal was to evaluate the impact of nosocomial rotavirus gastroenteritis in pediatric patients by determining the incidence of nosocomial rotavirus gastroenteritis, the resulting duration of hospital stay, and direct cost. To our knowledge, this is the first study in Turkey that evaluates the impact of pediatric nosocomial rotavirus gastroenteritis on duration of hospital stay and calculates the direct cost. Methodology: Forty-nine patients who were diagnosed with nosocomial rotavirus gastroenteritis and hospitalized were included in the study. Nosocomial infection rates, organ systems affected by the nosocomial infections, and patients who had nosocomial rotavirus gastroenteritis were identified. A direct cost analysis of patients who were diagnosed with nosocomial rotavirus gastroenteritis was performed using copies of the invoices for the hospital bills. Results: During the study period, there were 49 cases of nosocomial rotavirus gastroenteritis. The length of hospitalization was extended, on average, by more than 6.3 days in cases of nosocomial rotavirus gastroenteritis. The cost of hospitalization for patients with nosocomial rotavirus gastroenteritis was on average 1,554 ± 2,067 US dollars, compared to a cost of only 244 ± 103 US dollars for patients who did not have nosocomial rotavirus gastroenteritis. This difference in cost was statistically significant (p < 0.05). Conclusions: Nosocomial rotavirus gastroenteritis is important because it significantly prolongs hospital stay and increases the social and economic burden of the hospitalization. Nosocomial rotavirus gastroenteritis can be reduced with prevention measures such as handwashing, isolation, and cohorting.

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