scholarly journals Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Daniel J. Oh ◽  
Levi N. Kanu ◽  
Judy L. Chen ◽  
Ahmad A. Aref ◽  
William F. Mieler ◽  
...  
Keyword(s):  
Emergency Room ◽  
Clinical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Field Evaluation ◽  
Consulting Services ◽  
Wide Range ◽  
A Prospective Study ◽  
The University

Background. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consulting ophthalmologist should be prepared. The purpose of this study was to profile the emergency room and inpatient ophthalmology consultations seen at an academic institution. Methods. A prospective study of 581 patients was conducted on inpatient and emergency room ophthalmology consultations at the University of Illinois at Chicago over twelve months. Characteristics such as the consulting service, type of and reason for consultation, subspecialty staffing service, diagnosis, and suitability for in-hospital evaluation were recorded. Results. Consultations were received from either inpatient wards (59.4%) or the Emergency Department (40.6%). The most common inpatient consulting services were internal medicine (22%), followed by neurosurgery (16%) and neurology (7%). All the consultations were categorized as acute (72.3%), chronic (6.0%), or screening (21.7%). Consultations categorized as screening included papilledema (31.0%), fungemia (20.6%), syndromic evaluation (19.8%), visual field evaluation (17.5%), and miscellaneous evaluation (11.1%). We classified the ophthalmic diagnoses into 63 unique diagnoses. Amongst the ophthalmic subspecialties, neuro-ophthalmologic diagnoses were the most common (32.0%), followed by retina (20.1%) and cornea (19.4%). Neuro-ophthalmology had the highest proportion of screening consultations (36.6%), while glaucoma had the least overall number of consultations (10.1%), and the least proportion of screening consultations (3.6%). A significant proportion of nonacute consultations (19.0%) was deemed to be more suitable for outpatient evaluation. Discussion. Consultation databases can be useful in preparing trainees for in-hospital clinical care. A wide range of ocular pathologies may present to the ophthalmology consultant, from acute trauma to screening for systemic syndromes. Some consultations may be more suitable for outpatient evaluation which may help optimize patient care.

scholarly journals Antiemetic prophylaxis with temozolomide: an audit from a tertiary care center

2019 ◽  
Vol 6 (6) ◽  
pp. 479-483 ◽  
Author(s):  
Vijay M Patil ◽  
Arun Chandrasekharan ◽  
Dilip Harindran Vallathol ◽  
Mridul Malhotra ◽  
Ram Abhinav ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Nausea And Vomiting ◽  
P Value ◽  
Antiemetic Prophylaxis ◽  
Retrospective Audit ◽  
Time Period ◽  
Chi Squared ◽  
A Prospective Study

Abstract Background In our previous experience, a significant proportion of patients who received 5-HT3 antagonist monotherapy with adjuvant temozolomide (150-200 mg/m2) had chemotherapy-induced nausea and vomiting (CINV). This is an audit comparing the multiple antiemetic therapies in the prevention of temozolomide-associated CINV. Methods This was a retrospective audit. Adult glioma patients treated with temozolomide at a dose of 150-200 mg/m2 between October 2017 and June 2018 were selected for this analysis. Three antiemetic prophylaxis were used in this time period: ondansetron (October 2017 to November 2017), ondansetron + domperidone (December 2017 to February 2018), and ondansetron + olanzapine (March 2018 to June 2018). The rates of nausea and vomiting were compared among the 3 cohorts using the chi-squared test with Bonferroni correction. A P value of less than .016 was considered significant. Results A total of 360 patients were selected for this analysis. There were 91 patients in the ondansetron prophylaxis group (25.3%), 113 (31.4%) in the ondansetron plus domperidone group, and 156 (43.3%) in the ondansetron plus olanzapine group. The overall incidence of nausea and vomiting was 25.0% (n = 90) and 7.2% (n = 26). Overall the rates of nausea (P = .052) and vomiting (P = .481) were similar in all 3 cohorts. However, the rates of grade 2 and above nausea (P = .012) and vomiting (P = .015) were significantly lower in the olanzapine group. Conclusion The combination of ondansetron with olanzapine leads to a statistically significant decrease in the rate of moderate-to-severe emesis and nausea and needs to be explored in a prospective study.

scholarly journals Profile of Patients Attending as Psychiatric Emergency at General Hospital

2015 ◽  
Vol 3 (2) ◽  
pp. 31-36
Author(s):  
P Tulachan ◽  
M Chapagain ◽  
S P Ojha ◽  
S Dhungana
Keyword(s):  
Emergency Room ◽  
Somatoform Disorders ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
University Teaching ◽  
Behavioral Disorder ◽  
Presenting Symptoms ◽  
Self Harm ◽  
A Prospective Study

Introduction: Scaling of services in any area requires knowledge of the pattern of illnesses and their various presentations. We therefore conducted this study aiming to see the pattern of neuropsychiatric illness in an emergency department of tertiary care center.  Methods: A prospective study was carried out to assess the pattern of psychiatric morbidity as well as pattern of presenting symptoms in the general emergency room services. Total 340 patients were sought for psychiatric consultation over a period of one and half years from Emergency Room of Tribhuvan University Teaching hospital, Kathmandu.Results: Out of these patients, 281 patients (82.7%) were found to have diagnosable psychiatric disorder. Most of the patients were in the age group of 31-40 years (25.6%), and from valley itself (56.2%).Males (55.9%) outnumbered females. Most common presenting symptoms were disturbed behavior and intentional self harm. Out of the patients who received the diagnosis of Category F- Mental and Behavioral disorders of the ICD-10 (82.7%), 26.8% were suffering from the Neurotic, stress-related and somatoform disorders and 26.5% were suffering from Mental and behavioral disorder due to psychoactive substance use. From the remaining 17.3% of patients, 14.1% of cases belonged to who attempted intentional self harm and rest were suffering from systemic disorder.Conclusion: Thus, this study emphasizes the importance of clinical and demographic characteristics of patients seeking psychiatric care in emergency service in order provide proper management.J Psychiatric Association of Nepal Vol .3, No.2, 2014, pp: 31-36DOI: http://dx.doi.org/10.3126/jpan.v3i2.12387  

scholarly journals Serum Concentration of Myelin Basic Protein as a Prognostic Marker in Mild-to-moderate Head Injury Patients: A Prospective Study in a Tertiary Care Center

2021 ◽  
Author(s):  
Ashvamedh Singh ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
R. S. Prasad ◽  
N. Pandey ◽  
...  
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Myelin Basic Protein ◽  
Prognostic Marker ◽  
Outcome Prediction ◽  
Basic Protein ◽  
Care Center ◽  
Tertiary Care ◽  
Gcs Score ◽  
A Prospective Study

Abstract Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and specificity 72%, that is, patients with good outcome have lower mean MBP levels. Conclusion MBP as per our analysis can be used as a prognostic marker in patients with head injury. It is not the absolute value rather a trend showing rise in serum MBP levels, which carries a significant value in outcome prediction.

scholarly journals Health-related quality of life using QOLIE-31: Before and after epilepsy surgery a prospective study at a tertiary care center

2007 ◽  
Vol 55 (4) ◽  
pp. 343 ◽  
Author(s):  
PoodipediSarat Chandra ◽  
FaizUddin Ahmad ◽  
Manjari Tripathi ◽  
MV Padma ◽  
Shailesh Gaikwad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Health Related Quality ◽  
Before And After ◽  
Related Quality ◽  
Health Related ◽  
A Prospective Study

scholarly journals COVID-19 Conversion after Exposure in a Semiprivate Room at a Tertiary Care Center in Iowa, July–December 2020

2021 ◽  
Vol 1 (S1) ◽  
pp. s20-s21
Author(s):  
Alexandra Trannel ◽  
Takaaki Kobayashi ◽  
Oluchi Abosi ◽  
Kyle Jenn ◽  
Holly Meacham ◽  
...  
Keyword(s):  
Exposure Time ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
University Of Iowa ◽  
Subsequent Conversion ◽  
Risk Of Exposure ◽  
Polymerase Chain ◽  
The University

Background: Hospital semiprivate rooms may lead to coronavirus disease 2019 (COVID-19) patient exposures. We investigated the risk of COVID-19 patient-to-patient exposure in semiprivate rooms and the subsequent risk of acquiring COVID-19. Methods: The University of Iowa Hospitals & Clinics is an 811-bed tertiary care center. Overall, 16% of patient days are spent in semiprivate rooms. Most patients do not wear masks while in semiprivate rooms. Active COVID-19 surveillance included admission and every 5 days nasopharyngeal SARS-CoV-2 polymerase chain reaction (PCR) testing. We identified inpatients with COVID-19 who were in semiprivate rooms during their infectious periods during July–December 2020. Testing was repeated 24 hours after the first positive test. Cycle threshold (Ct) values of the two tests (average Ct <30), SARS-CoV-2 serology results, clinical assessment, and COVID-19 history were used to determine patient infectiousness. Roommates were considered exposed if in the same semiprivate room with an infectious patient. Exposed patients were notified, quarantined (private room), and follow-up testing was arranged (median seven days). Conversion was defined as having a negative test followed by a subsequent positive within 14 days after exposure. We calculated the risk of exposure: number of infectious patients in semiprivate rooms/number of semiprivate patient-days (hospitalization days in semiprivate rooms). Results: There were 16,427 semiprivate patient days during July–December 2020. We identified 43 COVID-19 inpatients who roommates during their infectious periods. Most infectious patients (77%) were male; the median age was 67 years; and 22 (51%) were symptomatic. Most were detected during active surveillance: admission testing (51%) and serial testing (28%). There were 57 exposed roommates. The risk of exposure was 3 of 1,000 semiprivate patient days. In total, 16 roommates (28%) did not complete follow-up testing. Of 41 exposed patients with follow-up data, 8 (20%) converted following their exposure. Median time to conversion was 5 days. The risk of exposure and subsequent conversion was 0.7 of 1,000 semiprivate patient days. Median Ct value of the source patient was 20 for those who converted and 23 for those who did not convert. Median exposure time was 45 hours (range, 3–73) for those who converted and 12 hours (range, 1–75) for those who did not convert. Conclusions: The overall risk of exposure in semiprivate rooms was low. The conversion rate was comparable to that reported for household exposures. Lower Ct values and lengthier exposures may be associated with conversion. Active COVID-19 surveillance helps early detection and decreases exposure time.Funding: NoDisclosures: None

A prospective study to validate various clinical criteria used in classification of leprosy: a study from a tertiary care center in India

2018 ◽  
Vol 57 (9) ◽  
pp. 1107-1113 ◽  
Author(s):  
Manisha Thapa ◽  
Muthu Sendhil Kumaran ◽  
Tarun Narang ◽  
Uma N. Saikia ◽  
Gitesh U. Sawatkar ◽  
...  
Keyword(s):  
Prospective Study ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Clinical Criteria ◽  
A Prospective Study
Sign in / Sign up

Export Citation Format

Share Document