Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Instrumental delivery: a comparative study in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1079
Author(s):  
Bhanu B. T. ◽  
Anitha G. S.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Care Hospital ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Maternal And Neonatal Outcomes ◽  
Vertex Presentation

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions.

scholarly journals EARLIEST SYMPTOMS OF PRESENTATION IN COVID-19 PATIENTS IN TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S500-03
Author(s):  
Maqbool Raza ◽  
Muhammad Ali Raza ◽  
De Emmal Asjad Cheema ◽  
Maham Asjad Cheema ◽  
Atif Rafique ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Sampling Technique ◽  
Military Hospital ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Chi Square Test

Objective: To determine the frequency of earliest symptoms of COVID-19 infection among patients with confirmed SARSCOVID-19 infection. Study Design: Cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Multan, from Jun to Dec 2021. Methodology: Data from 299 patients admitted in tertiary care settings was collected on a questionnaire. Patients regardless of gender and age who had confirmed COVID-19 infection through Real Time Polymerase Chain Reaction (RT-PCR) were included in the study. A nonprobability consecutive sampling technique was used to select samples. Data was entered and analyzed through SPSS version 22. Frequencies and percentages of various presenting symptoms were calculated. Sample size calculated at 95% level of confidence, 1% required precision, and 27% anticipated population proportion were 299. The overall difference in frequencies of symptoms in various groups was compared by using chi-square test. p-value <0.05 was taken as significant. Results: A total of 299 participants were included in this analysis. The median age for participants (interquartile range [IQR]) was 46 (36-54) years. Among 299 adults the reported symptoms were cough 238 (79.6%), fever 176 (58.7%) and, dyspnea 113 (37.8%). Only 78 (26.1%) of participants with confirmed infection reported having all three symptoms of cough, fever, and dyspnea. Other reported symptoms in patients were diarrhea 54 (18.1%), fatigue 128 (42.8%), myalgia 113 (37.8%), and anosmia 98 (32.8%). There was no significant difference in the frequency of symptoms across both genders. Conclusion: The most frequent symptoms of COVID-19 are cough, fever, and dyspnea.

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

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.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

Oral paracetamol versus zolmitriptan to treat acute migraine attack in the emergency department

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Rescue Therapy ◽  
Tertiary Care ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Care Hospital ◽  
Acute Migraine ◽  
Pain Scores ◽  
Significant Difference

Background: Treatment provided in an emergency department is aimed at alleviating pain immediately with minimized adverse effects as well as warding off further migraine attacks. The primary aim of this article is to compare the effectiveness of oral paracetamol versus zolmitriptan in treating acute migraine attacks. Methods: This prospective, randomized, and controlled study was carried out at a tertiary care hospital visited by 95,000 patients annually. The study recruited 200 participants who were randomized into two groups. One group received 1000 mg paracetamol while the other group received 2.5 mg zolmitriptan orally. Baseline pain scores were recorded using the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 15, 30 and at 60 min following administration of the study drugs. Patients requiring further treatment were provided fentanyl at a dosage of 1 µg/kg as a rescue therapy. Results: A significant decrease was evident in VAS and NRS scores following the administration of the study drugs in both groups (P < 0.001). The change in VAS pain scores after 15, 30 and 60 min was calculated as 17.0 ± 13.9, 41.2 ± 16.3 and 61.2 ± 17.5 mm, respectively, in the paracetamol group and 14.2 ± 11.7, 39.2 ± 17.9 and 59.2± 19.3 mm, respectively, in the zolmitriptan group, which did not indicate significant differences (P = 0.103, P = 0.425, P = 0.483, respectively). Likewise, NRS pain scores showed a downward trend in line with VAS pain scores and did not yield a significant difference (P = 0.422). No significant difference concerning rescue therapy was noted between the two groups (P = 0.596). Conclusion: Oral paracetamol and zolmitriptan prove to be similarly effective and have low incidence of acute side effects in treating acute migraine cases without aura.

scholarly journals Frequency of Depression in Burn Patients at a Tertiary Care Hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 3-7
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Care Hospital ◽  
Burn Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Residential Status ◽  
Duration Of Illness ◽  
Chi Square Test ◽  
Medical University

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.

scholarly journals Trends of caesarean section: an analytical overview of indications

2019 ◽  
Vol 9 (1) ◽  
pp. 288
Author(s):  
Shruti A. Gavhane ◽  
Shilpa N. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Graphical Representation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Chi Square Test ◽  
Evidenced Based

Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.

scholarly journals Incidence and Pattern of Adverse Events in Pentavalent Vaccine Recipients in Pune, India

2017 ◽  
Vol 16 (1) ◽  
pp. 8-13
Author(s):  
Barun Bhai Patel ◽  
Kapil Harish Pandya ◽  
Bikal Shrestha ◽  
Raj Kumar ◽  
Atul Kotwal
Keyword(s):  
Institutional Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Safety Monitoring ◽  
Exposed Group ◽  
Care Hospital ◽  
Chi Square ◽  
Pentavalent Vaccine ◽  
Chi Square Test ◽  
Hep B

Introduction: Safety monitoring of vaccines used in routine programmes on immunization is important in all settings. There is a lot of debate in the country about the relevance of the pentavalent vaccine in general and the Hib component in particular, in view of reports of deaths in children following immunization. This study was conducted to evaluate the incidence and profile of AEFI in children receiving pentavalent vaccine. Methods: A cohort study was conducted between May to Oct 2012, in a tertiary care hospital, Pune. Exposed groups received pentavalent vaccine, while the control received DPT or DPT + Hep B. Both the groups were followed up telephonically after 24 hr, 48 hr, 72 hr and 7 days following vaccination. 175 children in both groups were studied. Convenient sampling was done recruiting consecutive vaccinees till the sample size was achieved. Frequency, percentage, mean difference (T test) and chi square test was used to find associationResults: 100 % children were institutional delivery. In controls, 80 % received DPT and Hep B, rest received only DPT. Fever was present in 76.2 % among exposed and 26.7% among non-exposed. Presence of fever after 1 day following immunization was significantly associated with exposed group (P=0.003). In 19 % exposed group fever continued for 2nd day. Other side effects included swelling (4.8 %) and reduced appetite (4.8 %) among exposed.Conclusion: Pentavalent vaccine does not increase the probability of deaths among the vaccines vis-a-vis nor receivers. The profile of AEFI among both the groups, except fever, is similar as far as frequency and severity is concerned. 

scholarly journals Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: a tertiary care hospital based observational study

2018 ◽  
Vol 15 (1) ◽  
pp. 39-41 ◽  
Author(s):  
Navaraj Paudel ◽  
Vijay Madhav Alurkar ◽  
Ramchandra Kafle ◽  
Abhishek Maskey ◽  
Subash Sapkota
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hormonal Changes ◽  
Poor Prognostic Factor ◽  
Coronary Syndrome ◽  
St Segment ◽  
Significant Difference

Background and aims: Serum thyroid hormonal changes can occur in acute or chronic non-thyroidal systemic illness including acute coronary syndrome in otherwise euthyroid individuals. In this study we aimed to assess thyroid hormonal profile in patients presenting with acute coronary syndromes (ACS) and compare between ST segment elevated myocardial infarction and unstable angina/Non ST segment elevated myocardial infarction.Methods: A hospital based, retrospective, observational comparative study was designed. Data of all patients with acute coronary syndrome presenting to hospital were collected from July 2015 through June 2017 in a pre-structured proforma and analyzed.Results: A total of 200 ACS patients between 23 years to 88 years with mean age of 61.33 ± 12.30 years were studied. One hundred and twenty seven (63.5%) were males. Among them 116 (58%) was ST segment elevated myocardial infarction (STEMI) patients while 84 (42%) were unstable angina/ non-ST elevated myocardial infarction (UA/ NSTEMI) patients. Total 47 (23.5%) patients had abnormal TFT of which 28(59.5%) had Euthyroid Sick Syndrome, 12(25.5%) had subclinical hypothyroidism, 5(10.6%) had subclinical hyperthyroidism and 2(4.25%) had low fT4 with normal fT3 and normal TSH. There was significant difference in TFT in patients with STEMI and UA/NSTEMI (P=0.006).There were higher rates of heart failure (p= 0.001 & 0.003 in STEMI & UA/NSTEMI respectively), longer length of hospital stay (3+0.17 days) and high mortality (more than 4 fold) in all types of ACS patients with abnormal TFT than ACS patients with normal TFT.Conclusion: There is higher prevalence of abnormal thyroid hormonal findings in ACS causing significant morbidity and mortality.

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