scholarly journals Impact of the Novel Coronavirus 2019 (COVID-19) Pandemic on Head and Neck Cancer Care

2021 ◽  
pp. 019459982110045
Author(s):  
Joshua Adam Thompson ◽  
Joshua E. Lubek ◽  
Neha Amin ◽  
Reju Joy ◽  
Donita Dyalram ◽  
...  
Keyword(s):  
Head And Neck ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Tumor Board ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Tertiary Care Facility ◽  
Procedural Volume ◽  
The Impact

Objective The study aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on head and neck oncologic care at a tertiary care facility. Study Design This was a cross-sectional study conducted between March 18, 2020, and May 20, 2020. The primary planned outcome was the rate of treatment modifications during the study period. Secondary outcome measures were tumor conference volume, operative volume, and outpatient patient procedure and clinic volumes. Setting This single-center study was conducted at a tertiary care academic hospital in a large metropolitan area. Methods The study included a consecutive sample of adult subjects who were presented at a head and neck interdepartmental tumor conference during the study period. Patients were compared to historical controls based on review of operative data, outpatient procedures, and clinic volumes. Results In total, 117 patients were presented during the review period in 2020, compared to 69 in 2019. There was an 8.4% treatment modification rate among cases presented at the tumor conference. There was a 61.3% (347 from 898) reduction in outpatient clinic visits and a 63.4% (84 from 230) reduction in procedural volume compared to the prior year. Similarly, the operative volume decreased by 27.0% (224 from 307) compared to the previous year. Conclusion Restrictions related to the COVID-19 pandemic resulted in limited treatment modifications. Transition to virtual tumor board format observed an increase in case presentations. While there were reductions in operative volume, there was a larger proportion of surgical cases for malignancy, reflecting the prioritization of oncologic care during the pandemic.

scholarly journals Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 4944
Author(s):  
Shyam V. Ashtekar ◽  
Aryaman Singh ◽  
Manasi S. Padhyegurjar ◽  
Sidrah M. Shaikh ◽  
Abhimanyu R. Kapse ◽  
...  
Keyword(s):  
Physical Activity ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Diabetes Risk ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Waist Size ◽  
Tertiary Care Facility

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

scholarly journals Legal, Social, and Occupational Problems in Persons with Alcohol Use Disorder: An Exploratory Study

2020 ◽  
pp. 025371762095646
Author(s):  
Barikar C Malathesh ◽  
Channaveerachari Naveen Kumar ◽  
Arun Kandasamy ◽  
Sydney Moirangthem ◽  
Suresh Bada Math ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Driving Under The Influence ◽  
Chi Square ◽  
Cross Sectional ◽  
Work Absenteeism ◽  
Targeted Interventions ◽  
Tertiary Care Facility

Background: Very few studies have examined the extent and nature of legal, social, and occupational problems among persons who have SUDs. This study was aimed at studying the prevalence and patterns of the aforementioned problems among individuals with alcohol use disorders (AUDs) and their relationship with the quantity of alcohol consumed and other variables. Methods: We conducted a cross-sectional study of adult patients with a diagnosis of AUDs admitted to the deaddiction unit of a tertiary care facility in India, using a semistructured questionnaire prepared for this study. Results: The mean age (SD) of the 91 subjects (95.6% males) was 40.3 years (8.5). Majority of them (92.3%) had started alcohol consumption before the age of 25 years. Common problems reported were work absenteeism (83.5%), a major altercation with spouse (69.3%), assaulting someone while intoxicated (53.8%), and driving under the influence of alcohol (59.3%). Significant association was found between being unemployed and having a police complaint lodged against them (chi-square = 5.7, P = 0.01). Quantity of alcohol consumed per day was significantly more among those who had a history of work absenteeism ( Z = 2.27, P = 0.01), major altercation with spouse ( Z = 2.25, P = 0.02) and assaulted someone under intoxication ( Z = 2.33, P = 0.02). Conclusion: The quantity of alcohol consumed is significantly more in those who had several legal, social, and occupational problems when compared to those who did not have, highlighting the need for routine assessment of the aforementioned problems among patients of AUDs. Treatment of AUDs should be multidisciplinary, with targeted interventions tailored to the aforementioned problems. Doing so will go a long way in reducing the harm to patients and the community at large.

scholarly journals Transient Impact of Dysglycemia on Sputum Conversion among Smear-Positive Tuberculosis Patients in a Tertiary Care Facility in Ghana

2021 ◽  
Vol 15 ◽  
pp. 117954842110398
Author(s):  
Ernest Yorke ◽  
Vincent Boima ◽  
Ida Dzifa Dey ◽  
Maame-Boatemaa Amissah-Arthur ◽  
Vincent Ganu ◽  
...  
Keyword(s):  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Tertiary Care Facility ◽  
Conversion Rates ◽  
Sputum Conversion ◽  
Negative Sputum

BACKGROUND Apart from increasing the risk of tuberculosis (TB), diabetes may be associated with more severe disease and lower rates of sputum conversion among TB patients. METHODS We conducted a baseline cross-sectional study with a longitudinal follow-up of newly diagnosed smear-positive TB patients for 6 months. Sputum conversion rates between those with dysglycemia and those without were compared at 2 months (end of the intensive phase) and 6 months (end of the treatment). Descriptive statistics and logistic regression were computed to assess factors associated with dysglycemia as well as sputum conversion. RESULTS A significantly higher proportion of normoglycemic patients had negative sputum compared with those with dysglycemia (83% vs 67%, P-value < .05) at 2 months but not at 6 months (87% vs 77%, P-value > .05). After controlling for age group and adjusting for other covariates, patients with dysglycemia were 66% less likely to convert sputum than those with normoglycemia. Females were at least 7 times more likely than males and those with high waist-to-hip ratio (WHR) of 88% were less likely compared with those with low WHR for sputum conversion at 2 months, respectively. At 6 months, females (compared with males) and those with high WHR (compared with those with normal WHR) were at over 9 times increased odds and 89% less likely for sputum conversion, respectively. CONCLUSION A significantly lower proportion of smear-positive TB patients with dysglycemia converted to smear negative after 2 months of treatment but not at the end of the treatment, thus suggesting a transient impact of dysglycemia on sputum conversion.

scholarly journals An Assessment of Emergency Department Throughput and Provider Satisfaction after the Implementation of a Scribe Program

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Brandon Allen ◽  
Ben Banapoor ◽  
Emily C. Weeks ◽  
Thomas Payton
Keyword(s):  
Emergency Department ◽  
Program Implementation ◽  
Tertiary Care ◽  
Care Facility ◽  
Workplace Satisfaction ◽  
Electronic Survey ◽  
Left Without Being Seen ◽  
Tertiary Care Facility ◽  
Discharged Patients ◽  
The Impact

Objectives. To assess the impact of a scribe program on an academic, tertiary care facility. Methods. A retrospective analysis of emergency department (ED) data, prior to and after scribe program implementation, was used to quantitatively assess the impact of the scribe program on measures of ED throughput. An electronic survey was distributed to all emergency medicine residents and advanced practice providers to qualitatively assess the impact of the scribe program on providers. Results. Several throughput time measures were significantly lower in the postscribe group, compared to prescribe implementation, including time to disposition. The left without being seen (LWBS) decrease was not statistically significant. A total of 30 providers responded to the survey. 100% of providers indicated scribes are a valuable addition to the department and they enjoy working with scribes. 90% of providers indicated scribes increase their workplace satisfaction and quality of life. Conclusions. Through evaluation of prescribe and postscribe implementation, the postscribe time period reflects many throughput improvements not present before scribes began. Scribe Program implementation led to improved ED throughput for discharged patients with further system-wide challenges needing to be addressed for admitted patients.

scholarly journals Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study (Preprint)

2017 ◽  
Author(s):  
Sami Omar Amawi ◽  
Ahmed Hussein Subki ◽  
Hazim Abdulkarim Khatib ◽  
Omer Sameer Alkhateeb ◽  
Rida Hashim Fida ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Behavioral Problems ◽  
Electronic Devices ◽  
Care Facility ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Communication Devices ◽  
The Impact

BACKGROUND Excessive use of various electronic entertainment and communication devices, particularly among children, has been associated with increased behavioral problems. Despite children’s escalating use of these devices, parents’ awareness about the impact thereof is still lacking. OBJECTIVE The objective of this study was to assess the use of electronic entertainment and communication devices among children attending a health care facility in Jeddah, Saudi Arabia, as well as the parental impression regarding the impact of electronic devices use on the behavior of their child. METHODS A focused 15-item questionnaire was designed for this cross-sectional study involving mothers of children attending the Well Baby Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from July 1, 2016 to November 30, 2016. RESULTS This study included 190 mothers. The mean ages of the children, mothers, and fathers were 7.3 (SD 3.5), 35 (SD 6.5), and 43 (SD 8.3) years, respectively. Most children were of Saudi Arabian nationality (106/190, 55.8%). The most used device in this study was television (154/190, 81.0%), followed by mobile phones (134/190, 70.5%), and tablets (116/190, 61.0%). Computers were the least used device in this study (59/190, 31.0%). In total, 24.7% (47/190) of children in this study used electronic entertainment and communication devices for more than 4 hours per day. Most mothers (129/190, 67.9%) felt that their child spends too much time on electronic devices. Hyperactivity or behavioral problems were reported by 20.0% (38/190) of mothers in this study. Children spending longer hours on electronic devices were much more likely to be perceived to suffer from hyperactivity or behavioral problems (P=.01). CONCLUSIONS Parental awareness is necessary to counteract the harmful effects of using electronic devices for a prolonged period. Parents require help to cope with this problem effectively.

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

scholarly journals Maternity handover in Kerala: a cross sectional study

2018 ◽  
Vol 5 (9) ◽  
pp. 3760 ◽  
Author(s):  
Aadil Sheikh ◽  
Jessica Dunphy ◽  
Claire Humphries ◽  
Christina MacArthur ◽  
Semira Manaseki-Holland
Keyword(s):  
Healthcare Provider ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Community Health Services ◽  
High Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Background: The objective of the study was to explore the referral system from the community to hospital obstetric care in Kerala, India.Methods: Cross-sectional study. A total of 206 obstetric inpatients in 3 hospitals in Kerala, India completed an orally-administered questionnaire regarding referral and attitudes towards healthcare information.Results: Among 206 respondents, 19 (9%) had been referred from another healthcare provider.  In multivariate analysis, referral was independently associated with being in a tertiary hospital (p<0.001). At total of 17 referred women received a document containing hand-written notes from their previous healthcare provider. Just 3 of the documents available to view were formal referral documents; others were test results and/or hospital notes. A total of 170 (86%) of the 206 women thought that receiving documents such as referral letters was important; mostly because it helped them understand their condition and explain it to others (91%).Conclusions: A high rate of self-referral (91%) was reported by obstetric inpatients. It appears that some women who are referred do not receive a formal referral document. Participants thought that receiving referral documents was important. A strong health system requires transfer of information between primary and secondary/tertiary care services, which India is seeking to develop. Further research is needed into why women are not accessing community health services and the impact of the content of referral documents on patient care. 

scholarly journals A study of metabolic syndrome in patients of HIV on ART in India

2021 ◽  
Author(s):  
V K Sashindran ◽  
Anchit Raj Singh
Keyword(s):  
Metabolic Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Noncommunicable Diseases ◽  
Care Hospital ◽  
Cross Sectional ◽  
High Prevalence ◽  
Hiv Morbidity ◽  
The Impact

AbstractMetabolic syndrome is a risk factor for cardiovascular disease. With improvement in therapy for HIV, morbidity related to metabolic syndrome becomes a focus of interest. Change in nutritional status and introduction of newer regimens of ART are changing the impact of metabolic syndrome on patients of HIV. Few studies in recent times from developing countries have addressed this question. This is a cross sectional study to study the prevalence of Metabolic Syndrome in patients of HIV on ART from clinics in a tertiary care hospital in India. Data from 1208 patients of HIV on ART was analyzed and metabolic syndrome was seen in 257(21.3%) patients.The high prevalence of metabolic syndrome in patients of HIV in India found in this study gives an insight on the morbidity of noncommunicable diseases in patients with HIV in India in recent times.

scholarly journals DEMOGRAPHICS AND CORRELATION OF RISK FACTORS FOR HEPATOCELLULAR CARCINOMA IN PATIENTS PRESENTING TO A TERTIARY CARE FACILITY IN PAKISTAN

2021 ◽  
Vol 71 (2) ◽  
pp. 614-18
Author(s):  
Hafsa Rashid ◽  
Laima Alam ◽  
Muhammad Asif Farooq ◽  
Muhammad Zafar Ali
Keyword(s):  
Risk Factors ◽  
Tumor Staging ◽  
Tertiary Care ◽  
Care Facility ◽  
Decompensated Cirrhosis ◽  
Military Hospital ◽  
Continuous Variables ◽  
Male Population ◽  
Cross Sectional ◽  
Tertiary Care Facility

Objective: Demographics of HCC in Pakistan. Correlation of HCC with its possible etiology. Correlation of tumoraggressiveness with PCR status and anti-viral treatment. Study Design: Cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi from Jul 2017 to Jun 2018. Methodology: Patients with age >18 years presenting with space occupying lesion(s) of liver were confirmed to be HCC according to standard guidelines. The variables such as age, gender, presence of cirrhosis, etiology of cirrhosis, tumor staging, viral status through PCR study and the treatment offered were documented. Baseline descriptive data was reported as mean with SD for continuous variables. Chi square test was used to compare qualitative data. Results: A total of 195 patients were enrolled for one year. Male population with HCC was in predominance (75.9%). Sixty one percent of the afflicted population was having liver cirrhosis, 34.9% had decompensated cirrhosis and 3.8% had no cirrhosis. HCV accounted for the bulk of patients with cirrhosis (82%) followed by HBV (9.2%), HBV and HCV co-infection (3.1%), NASH and cryptogenic cirrhosis (1.5% each). Majority got diagnosed with triphasic CECT scan Abdomen, only 3.6% needed liver biopsy for diagnosis. Majority (43.6%) belonged to BCLC B. Viral PCR was positive for 58.5% and 73.8% of the patients were treatment naïve. Conclusion: HCC shows highest rates seen in male patients presenting in old age. Gender, classes of cirrhosis, number of lesions, portal vein thrombosis and extrahepatic metastasis correlated with possible risk factors of HCC. Tumor aggressiveness correlated with PCR status..............

Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

2020 ◽  
pp. archdischild-2020-319173
Author(s):  
Rasha D Sawaya ◽  
Cynthia Wakil ◽  
Sami Shayya ◽  
Moustafa Al Hariri ◽  
Alik Dakessian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Peak Time ◽  
Work Efficiency ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Impact

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

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