Nurse-Led Neonatal Follow-Up Clinic: A New Emerging Concept in a Developing Country

2020 ◽  
Vol 34 (1-2) ◽  
pp. 19-23
Author(s):  
Poonam Joshi ◽  
Bindu Sarojini ◽  
Meena Joshi ◽  
Anu Thukral
Keyword(s):  
Developing Countries ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Newborn Care ◽  
Care Facility ◽  
Essential Newborn Care ◽  
Tertiary Care Facility ◽  
Neonatal Assessment ◽  
The Mean

Objective: To investigate the feasibility and acceptance of nurse-led neonatal follow-up clinic (NLNFC) in a tertiary care facility. Materials and Methods: In a prospective observational study, total 105 stable mother-neonate dyads were independently followed up in both nurse led and neonatologist run follow-up clinics. The outcome was measured in terms of agreement between the nurse and neonatologist in the domains of neonatal assessment, counselling mothers on essential newborn care (ENC) and giving advice ( P < 0.05) and mothers’ acceptability for NLNFC. Results: Agreement between the trained neonatal nurse and neonatologist varied between 87 and 100%. The most unanimity was observed in neonatal assessment and counselling on ENC (93.3%-100%) followed by prescribing treatment (87%). The mean acceptability scores of the mothers for NLNFC was 33.13 ± 2.6 (25-35, maximum possible score 35). Conclusion: Establishing NLNFCs in developing countries is feasible. Nurses can be entrusted with the responsibility of following up stable neonates here and mothers will surely be satisfied with this type of clinic.

scholarly journals Accidental childhood poisoning in Paediatrics department of a tertiary care facility: A retrospective review

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
D.C. Obu ◽  
M.C. Orji ◽  
U.V. Muoneke ◽  
U.V. Asiegbu ◽  
G.O. Ezegbe
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
The Public ◽  
Tertiary Care Facility ◽  
Childhood Poisoning ◽  
The Mean ◽  
The Relationship ◽  
Male To Female

Background: Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This studywas aimed at determining the prevalence, pattern, and outcome of childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed usingSPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most  vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home. Keywords: Accidental poisoning, Childhood, Kerosene

What is the Long-Term Follow-Up of Nonoperatively Treated Patients with Appendicitis?

2019 ◽  
Vol 85 (5) ◽  
pp. 462-465
Author(s):  
Andrew Felber ◽  
Deven Catalano ◽  
Caitlin Stafford ◽  
Todd D. Francone ◽  
Patricia L. Roberts ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Nonoperative Treatment ◽  
Interval Appendectomy ◽  
Tertiary Care Facility ◽  
Long Term Follow Up ◽  
Mean Time ◽  
Emergent Surgery

In this study, we determine outcomes after nonoperative treatment of appendicitis. First, we abstracted data for patients discharged with a diagnosis of appendicitis from a tertiary care facility from August 1, 2007, through June 30, 2017. For patients treated nonoperatively, we collected additional medical treatment for appendicitis, future surgical treatment, and date of last follow-up. In our study, we identified 487 patients treated for appendicitis. From this group, 66 patients were successfully treated nonoperatively. Eight patients (12%) had an interval appendectomy at a mean follow-up time of two months. Of the 58 remaining patients, 20 (34%) did not have any further appendicitis-related issues over a mean follow-up period of 25 months. A total of 38 (66%) had recurring or additional concerns requiring further treatment or emergent surgery within a mean time of four months. A large proportion, 76 per cent (n = 29), required unscheduled or emergent appendectomy. There were more patients diagnosed with an abscess (55%) in the group that had further appendicitis issues. In conclusion, nonoperative treatment of appendicitis is associated with significant likelihood of future appendicitis-related treatment or emergency surgery (66%). In addition, patients diagnosed with an abscess are at particularly high risk of future appendicitis-related issues.

Clinical Outcomes of Endoscopic and Endoscopic-Assisted Resection of Inverted Papillomas: A 15-Year Experience

2007 ◽  
Vol 21 (5) ◽  
pp. 591-600 ◽  
Author(s):  
Bradford A. Woodworth ◽  
Geeta A. Bhargave ◽  
James N. Palmer ◽  
Alexander G. Chiu ◽  
Noam A. Cohen ◽  
...  
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
Care Facility ◽  
Recurrence Rates ◽  
Time To Recurrence ◽  
Tertiary Care Facility ◽  
Inverted Papillomas

Background The endoscopic resection of sinonasal inverted papillomas (IPs) has been well described. However, the majority of published reports in the literature are small case series with limited clinical follow-up. The aim of this retrospective study was to review the experience with the endoscopic and endoscopic-assisted resection of IPs at a major academic tertiary care facility and assess long-term outcomes. Methods A retrospective review of endoscopic and endoscopic-assisted resections of IP was performed. Charts were reviewed for standard demographic data, operative technique, adjuvant approaches, complications, and postoperative follow-up times. Results One hundred fourteen patients (average age, 56 years) underwent endoscopic or endoscopic-assisted resection for IPs with a mean disease-free follow-up of 40 months (7–135 months). Seventeen patients developed disease after endoscopic or endoscopic-assisted resection for a recurrence rate of 15%. Average time to recurrence was 23 months. Combined approaches were used when indicated in 34% (39/114) of patients, including adjuvant osteoplastic flap, midface degloving, trephine, or Caldwell-Luc approaches. Four patients (4%) had cerebrospinal fluid leaks that were successfully repaired endoscopically. Conclusion In this large series of endoscopically resected IPs with extensive clinical follow-up, recurrences occurred an average of 23 months after the procedure. This emphasizes the importance of long-term endoscopic follow-up to detect recurrences in all patients. Endoscopic or endoscopic-assisted resection of IPs is a valid technique in this series with recurrence rates comparable with open approaches.

Postoperative Hemorrhage after Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P80-P80
Author(s):  
Troy D. Woodard ◽  
James A Stankiewicz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Care Facility ◽  
Postoperative Hemorrhage ◽  
Sinus Surgery ◽  
Complication Rates ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
Extent Of Surgery ◽  
The Mean

Objective 1) Identify complication rates of patients that underwent endoscopic sinus surgery and developed postoperative hemorrhage. 2) Determine if there is a correlation of preoperative variables with the development of this complication. Methods Retrospectively review patients who had functional endoscopic sinus surgery and developed postoperative hemorrhage from 1987 to 2007 in an university tertiary care facility. Analyze baseline characteristics and preoperative clinical variables for significant correlations. Results 29 of 5000 endoscopic cases resulted in postoperative hemorrhage (.58% complication rate). The mean age of the patients was 50 years old and there were equal proportions of male and female patients. While the extent of surgery demonstrated no significant difference among the patients, hemorrhage was most likely to occur in patients with previous surgery. An overwhelming majority of patients required a surgical procedure to control the bleeding. Hemorrhage was primarily isolated on the patient's right side and involved the sphenopalatine or posterior septal arteries. Conclusions Endoscopic sinus surgery has vastly increased in popularity. However, there still is a paucity of information in the literature on complications associated with endoscopic sinus surgery, particularly postoperative hemorrhage. The results from this study provide identifying characteristics that predispose patients to develop this complication and what methods can be successfully utilized to treat this complication.

Mortality in Patients with Primary Unipolar Depression, Secondary Unipolar Depression, and Bipolar Affective Disorder: A Comparison with General Population Mortality

1988 ◽  
Vol 17 (4) ◽  
pp. 351-360 ◽  
Author(s):  
Donald W. Black ◽  
George Winokur ◽  
Amelia Nasrallah
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Geographical Area ◽  
Care Facility ◽  
Unipolar Depression ◽  
Mortality Data ◽  
Initial Portion ◽  
Tertiary Care Facility

Mortality data are presented from a two to fourteen year follow-up of 705 primary unipolar depressives, 302 secondary unipolar depressives, and 586 patients with bipolar affective disorder (BAD) hospitalized at a tertiary care facility. Death ascertainment was made through a record-linkage process. Using sex- and age-standardized mortality ratios (SMRs), the mortality experience of the study population was compared with that of Iowa, the geographical area served by the admitting medical facility for this study group. Results show that risk for all-cause mortality was most pronounced during the first two years following hospital discharge, although secondary unipolar depressives continued to show a significant excess of deaths throughout the entire follow-up period. Deaths occurring from natural causes were significantly excessive only during the initial portion of the follow-up. Deaths from unnatural causes were significantly excessive throughout follow-up except for patients with bipolar affective disorder.

scholarly journals Long-Term Follow-Up After Fat Graft Myringoplasty: Do Size and Location Matter?

2020 ◽  
pp. 014556132097355
Author(s):  
Alfonso Rodriguez Diaz ◽  
Carlos O’Connor Reina ◽  
Guillermo Plaza ◽  
Elena Rodriguez Posadas ◽  
Francisco Valdeon Arevalo ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Care Facility ◽  
Clinical Results ◽  
Fat Graft ◽  
Closure Rate ◽  
Tertiary Care Facility ◽  
Long Term Follow Up ◽  
Prospective Case Series

Objective: To assess clinical and functional outcomes of a fat graft myringoplasty under local in an office setting. Study Design: Prospective case series. Setting: Tertiary care facility. Patients: Patients with a tympanic membrane (TM) perforation presenting between December 2005 and June 2019. Inclusion criteria included perforation size >25% of the surface of the pars tensa of the TM, entire perforation margins visualized through a transcanal view, and lack of spontaneous closure at the 6-month follow-up. The exclusion criteria were the presence of cholesteatoma, wet appearance of the mucosa in the tympanic cavity, ear discharge in the 3 months before surgery, or signs of ossicular inconsistency. Intervention: In-office fat graft myringoplasty technique under local anesthesia. Main outcome Measures: Complete perforation closure rate and audiometric outcomes. Results: A total of 121 patients underwent the procedure, of whom 21 had bilateral sequential procedures (total 142 ears). Average age was 51.1 ± 18.4 years (range, 3-78 years). The size of perforation was <25% of TM in 39 (27.5%) ears, 25% to 50% of TM in 49 (34.55%) ears, 50% to 75% of TM in 34 (23.91%) ears, and 75% to 100% of TM in 20 (14.10%) ears. Complete perforation closure was evident in 130 (91.55%) of the 142 ears. Preoperative mean air conduction threshold was 59.3 dB (17-95 dB) and significantly improved into 35.6 dB (10-85 dB; P < .0004) after surgery. Preoperative air–bone gap was 30.2 dB (5-70 dB) and also significantly improved into 10.2 dB (5-65 dB; P < .0001) after surgery. Conclusion: In office fat graft myringoplasty, in adult and pediatric patients with variable perforation sizes, is a well-tolerated procedure with very satisfactory clinical results.

scholarly journals First Bite Syndrome After Parotidectomy: A Case Series and Review of Literature

2020 ◽  
pp. 014556132098017
Author(s):  
Vivian Xu ◽  
Kurren S. Gill ◽  
Jared Goldfarb ◽  
Cory Bovenzi ◽  
Roxana Moayer ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Care Facility ◽  
Cervical Region ◽  
Parotid Region ◽  
Tertiary Care Facility ◽  
Upper Cervical ◽  
Potential Risk Factors ◽  
First Bite Syndrome

Introduction: First bite syndrome (FBS) is a rare but potentially debilitating complication observed after surgery involving the upper cervical region. Patients classically complain of severe facial pain in the ipsilateral parotid region with the first few bites of a meal. Objective: The aim of this study is to shed light on the incidence and potential risk factors of FBS, including a series of cases depicting FBS observed after parotidectomy. Methods: Retrospective review of 419 patients who underwent parotidectomy at a single tertiary care facility between December 2016 and June 2020. Results: With a mean follow-up time of 16.5 months, 8 (2%) patients were documented to have symptoms of FBS after parotid gland surgery. Six of these patients underwent partial parotidectomy by dissection of the deep lobe of the parotid (DLP). Conclusion: Patients undergoing dissection of the DLP are particularly at risk for the development of FBS. All patients should be appropriately counseled during informed consent discussions, especially in high-risk cases.

The Use of ECMO for the Treatment of Refractory Cardiac Arrest or Postarrest Cardiogenic Shock Following In-Hospital Cardiac Arrest: A 10-Year Experience

2018 ◽  
Vol 34 (8) ◽  
pp. 615-621 ◽  
Author(s):  
Meshe Chonde ◽  
Penny Sappington ◽  
Robert Kormos ◽  
Andrew Althouse ◽  
Arthur Boujoukos
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Tertiary Care ◽  
Care Facility ◽  
Primary Objective ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Tertiary Care Facility ◽  
Social Security Death Index ◽  
Refractory Cardiac Arrest

Objectives: Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR. Methods: We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS. Between January 2004 and December 2013, patients were prospectively entered into an institutional registry. One-year follow-up was assessed by electronic medical record or social security death index if clinical follow-up was unavailable. Results: Fifty-one patients were treated with ECMO during the study period. The mean age was 54.0 ± 10.9 years; the majority of patients were men (80.4%). The most common etiology of arrest was acute myocardial infarction (51.0%). Overall, 13 (25.4%) patients survived for at least 1 year. Preexisting coronary artery disease, hypertension, and hyperlipidemia were associated with reduced likelihood of survival. We observed a significant improvement in 1-year mortality in patients treated for PACS when compared to ECPR, 46.7% versus 16.7%, respectively. Conclusion: The use of ECMO for treatment of refractory cardiac arrest or cardiogenic shock may be a suitable treatment in a very select cohort of patients. Our results support a significantly higher 1-year survival in patients with PACS compared to refractory cardiac arrest.

scholarly journals Imaging and cytopathological correlation of space occupying lesions in liver: a prospective observational study

2017 ◽  
Vol 4 (5) ◽  
pp. 1687
Author(s):  
Sachinkumar Patel ◽  
P. B. Nichkaode ◽  
Prasad Y. Bansod ◽  
Murtaza Akhtar
Keyword(s):  
Longitudinal Study ◽  
Observational Study ◽  
Selection Criteria ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Liver Pathology ◽  
Common Site ◽  
Short Term ◽  
The Mean

Background: Liver is a common site for Space occupying lesions. It is difficult to distinguish these entities with imaging criteria alone. Development in liver surgery and liver pathology have led to many new types of primary hepatic space-occupying lesions (PHSOLS) being surgically resected and pathologically diagnosed, which has greatly increased the surgicopathological spectrum of PHSOLS.Methods: A 2-year tertiary care teaching hospital based longitudinal study with 77 participants was done. Selection criteria was defined and a prestructured proforma was made to assess and note the findings.Results: The mean age of occurrence of space occupying lesions of liver was 45.49±13.45 years with a range of 24 to 70 years. Space occupying lesions of liver was commonly observed in 4th Decade of life. 64.93% pathology of Space Occupying Lesions of Liver occur in males. 76.62% patients of space occupying lesions of liver present with pain in right upper quadrant.Conclusions: Majority of space occupying lesions were surgically managed with a short-term follow-up of 1 month in which no complications were noted.

Sign in / Sign up

Export Citation Format

Share Document