scholarly journals Profile of COVID-19 Patients at Zero Delay COVID-19 Ward, Tertiary Care Hospital in South India

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Theranirajan Etherajan ◽  
S. Zahir Hussain ◽  
Karthick Rajendran ◽  
Arunkumar Ramachandran ◽  
Murugan Natrajan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Late Presentation ◽  
Multivariable Logistic Regression Analysis ◽  
Care Hospital ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Poor Patient ◽  
High Risk Factor ◽  
Set Up ◽  
Time Of Admission

Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health crisis. During huge surge in COVID-19 cases, most of the patient arrived at Rajiv Gandhi Government General Hospital, Chennai were severe due to late presentation and also available evidence demonstrating that the delay in treatment is directly associated with increased mortality or poor patient outcome. As an innovative concept of Zero Delay COVID-19 Ward were set up to provide the required critical care for all severe COVID-19 cases. The experience of setting up of such Zero Delay COVID-19 Ward and profile of admitted COVID-19 patients were described in this paper. Methods: A total of 4515 laboratory-confirmed COVID-19 patients admitted at Zero Delay COVID-19 Ward was analyzed retrospectively from 7th July to 31st December 2020. Results: At the time of admission the frequency of dyspnea were 85.6% among them 99.1% recovered from dyspnea after the oxygen therapy and other management at Zero Delay COVID-19 Ward. Of the 4515 COVID-19 individuals, about 1829 (40.5%) had comorbidity, 227 (5%) had died. Multivariable logistic regression analysis, COVID-19 death was more likely to be associated with comorbidity (OR: 18.687; 95% CI: 11.229-31.1) than other variables. Conclusions: Comorbidity is an independent high risk factor for mortality of COVID-19 patients. From our observation, it is strongly recommended that effective zero delay covid-19 ward model will help for the prevention of mortality in current/expected waves of COVID-19.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

scholarly journals MICROORGANISMS VARIANTS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN A SELECTED TERTIARY CARE HOSPITAL

2021 ◽  
pp. 22-25
Author(s):  
SARALA KS ◽  
NANDAKUMAR BS ◽  
NARENDRANATH V
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Secondary Data ◽  
Blood Stream ◽  
Microbial Flora ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Set Up ◽  
Healthcare Associated

Objective: Microorganisms are minute and can be only in microscope and these are not visible to naked eyes. Various types of microbe include bacteria, virus, fungi, and protozoa. These microorganisms are subclassified and these are disease causing leading to mortality and morbidity. Healthcare-associated infections (HAIs) arise from different variants of microbes and knowing the category of microbes for treating the diseases with specific antibiotics is important for better patient outcome. Methods: Using secondary data, all the patients who had HAI for 3 years were taken into consideration by considering the different variants of microorganisms. Results: Retrospective data collected for the period of 3 years the inpatients who got admitted for more than 48 h of duration, the data collected included the parameters for various microorganisms such as Bacilli, cocci, Klebsiella, Acinetobacter, and Aures, other micro-organisms such as Escherichia coli, Citrobacter, and Pseudomonas microorganisms. Bacilli group of microorganisms was more common for urinary tract infection, blood stream infection, and ventilator-associated pneumonia. Aures was more common among surgical site infection infections. Conclusions: Most of the patients who had an HAI had two or more different kind of microorganisms which are responsible for spreading infection. There is a need to control microbial flora in the hospital set up as the rate of HAI increases with microbial flora.

scholarly journals Evaluation of rational drug use pattern using WHO prescribing indicators in a medical intensive care unit of a tertiary teaching hospital in Kerala, India

2017 ◽  
Vol 6 (6) ◽  
pp. 1328
Author(s):  
Shobha P. ◽  
Messaline Sunitha
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Essential Drug ◽  
Prescribing Pattern ◽  
Respiratory Problems ◽  
Essential Drug List ◽  
Drug List ◽  
Tertiary Teaching ◽  
Set Up

Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.

scholarly journals Zero Healthcare-Associated COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s73-s73
Author(s):  
Moi Lin Ling ◽  
Molly How ◽  
Kwee Yuen Tan ◽  
Elaine Wee ◽  
Phoon Poh Choo ◽  
...  
Keyword(s):  
Migrant Workers ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Personal Hygiene ◽  
Care Hospital ◽  
Service Staff ◽  
Medical Teams ◽  
Set Up ◽  
Healthcare Associated

Background: The ongoing COVID-19 pandemic tests the healthcare system in many ways. The scarcity of resources poses challenges to infection prevention (IP) practices. We describe our experience in managing such scarcity in our care of COVID-19 patients in the hospital as well as community settings. Methods: The hospital pandemic plan traditionally included only plans for healthcare delivery management within the hospital. However, on March 25, 2020, a decision was made by the Ministry of Health to set up swab isolation (SIFs) and community care facilities (CCFs) to meet the growing demand for isolation beds for migrant workers infected by COVID-19. The CCFs were located in convention halls and resort centers and the SIFs were located in facilities previously functioning as hotels. Mobile medical teams were activated to run clinics at the dormitories housing 200,000 migrant workers. The IP team of an acute- and tertiary-care hospital in Singapore was activated to oversee IP measures at facilities managed by medical teams from the hospital, with the goal of zero healthcare-associated COVID-19 cases among staff. Two IP leaders were set up to oversee the IP program at 8 dormitories, 4 SIFs, and 2 CCFs. In total, 12 IP staff and 15 infection prevention liaison officers (IPLOs) were deployed from 2 acute-care hospitals and 3 specialty centers to conduct training in hand hygiene and the use of personal protective equipment, and to conduct daily audits of compliance to practice guidelines. Education on personal hygiene was also given to patients in these facilities in at least 7 languages. In the SIFs and dormitories, IPLOs were recruited to perform daily audits and feedback to the IP team on issues related to IP at the sites. Results: Since our first COVID-19 patient on January 23, 2020, there has been no report of healthcare-associated COVID-19 within the hospital nor among the medical, administrative, and support service staff working in the external operation facilities. Daily audits showed an average of 99.4% compliance to IP guidelines. Conclusions: IPLOs or IP champions play a significant role in ensuring compliance to IP guidelines. This compliance allows the IP professional to focus on the evaluation of the IP program, managing IP consultations, and planning and implementation of the IP program in nontraditional healthcare settings. The key success factors of the program included the ability to contextualize the planning and implementation of IP programs in various settings, strong leadership support, cohesive teamwork, and effective communication at various levels.Funding: NoDisclosures: None

Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India

2021 ◽  
Vol 17 ◽  
Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Set Up

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.

scholarly journals 2019 Novel Coronavirus Infection: Gastrointestinal Manifestations

2020 ◽  
Vol 11 (01) ◽  
pp. 13-18 ◽  
Author(s):  
Jayanta Samanta ◽  
Jahnvi Dhar ◽  
Abdul Khaliq ◽  
Rakesh Kochhar
Keyword(s):  
Patient Outcomes ◽  
Respiratory Pathogen ◽  
Health Crisis ◽  
Oral Transmission ◽  
Public Health Crisis ◽  
The Third ◽  
Poor Patient ◽  
Inflammatory Bowel ◽  
Coronavirus Infection ◽  
Novel Coronavirus

AbstractThe world is witnessing a major public health crisis in the wake of the third coronavirus strain pandemic, a novel coronavirus (severe acute respiratory syndrome coronavirus 2). Although initially thought to be a pure respiratory pathogen, recent reports have highlighted not only the extrapulmonary effects of the virus but also, importantly, the gastrointestinal tract (GIT) effects. Various studies have looked into the effects of this novel coronavirus infection (coronavirus-19 disease [COVID-19]) on GIT involvement with reports of more frequent involvement than previously expected. With feco-oral transmission, debate being conclusively proven with fecal samples testing positive for COVID-19 and longer shedding time, it only underlines the importance of GIT involvement. Moreover, the presence of other GI diseases, such as inflammatory bowel disease, with COVID-19 infection might wreak havoc leading to poor patient outcomes.

scholarly journals Early debridement with physiotherapy for prevention of postburn contracture of neck: a case series

2020 ◽  
Vol 7 (5) ◽  
pp. 1618
Author(s):  
Girish D. Bakhshi ◽  
Aditya B. Marathe ◽  
Chirag Kamat ◽  
Khadeija Hussain
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Neck Region ◽  
Late Presentation ◽  
Favourable Outcome ◽  
High Morbidity ◽  
Care Hospital ◽  
Thermal Burns ◽  
Early Return ◽  
Early Debridement

Hypertrophic scars and contractures are well known sequelae after burns. They result in high morbidity in severely burned patients who are surviving. Present case study was done to establish the usefulness of early debridement and physiotherapy in preventing these sequelae. Present study was conducted on patients admitted in a tertiary care hospital on patients with alleged history of thermal burns to neck and upper chest over a period of 6 months. These patients were subjected to early debridement, daily dressings and early neck physiotherapy. They were assessed for neck mobility and development of neck contracture. Three patients were studied, two had a favourable outcome due to adherence to above measures while one developed contracture due to her late presentation and non-compliance to early physiotherapy. Post burn contractures are common sequelae of thermal burns involving the neck region. Early Debridement, daily dressing of the raw areas with starting of early neck physiotherapy are important and prove beneficial in preventing neck contractures with early return to normal daily activity.

scholarly journals A two-year study on postmenopausal bleeding at a tertiary institute

2021 ◽  
Author(s):  
Sowmyanarayanan Lavanya ◽  
Swetha Munivenkatappa ◽  
Anthata Jyothsna Sravanthi
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Developed Countries ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Postmenopausal Bleeding ◽  
Medical Problems ◽  
Set Up ◽  
A Prospective Study

Background: The life expectancy of women shows an increase as a result of which women experience a long postmenopausal phase. Postmenopausal bleeding is a worrisome symptom occurring in 10 % of the women, making them seek a gynaecology opinion at the earliest. Women in developed countries have a predilection for developing endometrial cancer whereas cancer cervix still dominates in the developing countries. This prospective study was carried out on 75 women presenting with postmenopausal bleeding to the gynaecology clinic at a tertiary hospital set up. The study aimed to find the incidence of postmenopausal bleeding, age distribution, causes and different evaluation methods to confirm the diagnosis.Methods: The present study is a prospective study conducted on 75 postmenopausal women reporting with postmenopausal bleeding at the gynaecology clinic at a tertiary care hospital.              Results: Menopause was noted above 45 years in 84% of the patients and 16% were in 40-45 years age. Postmenopausal bleeding was observed in 50-60 years in 56% of women and 30% above 60 years. The medical problems associated were hypertension (20%), diabetes (11%), obesity (22%), hypothyroidism (4%). 53 women had benign causes while 22 had malignancy.Conclusions: Benign lesions of the genital tract are common causes of postmenopausal bleeding. Carcinoma cervix and endometrium classically present with postmenopausal bleed. Strong suspicion, thorough evaluation and early diagnosis improve the quality of life and reduce the morbidity and mortality.

scholarly journals Study of Maternal and Foetal Outcome in Abruptio Placentae

2021 ◽  
Vol 8 (01) ◽  
pp. 5208-5213
Author(s):  
Vikram Lokhande ◽  
Kunal Jadhav ◽  
Minal Kadam ◽  
Suresh Rawte
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Abruptio Placentae ◽  
Foetal Outcome ◽  
Obstetrical Emergency ◽  
Time Of Admission

Study of Maternal and Foetal outcome in Abruptio Placentae Introduction: Abruptio placentae (AP) is a significant obstetrical emergency and as per WHO 2009 maternal mortality rates reported due to AP worldwide was 2.1% and fetal perinatal mortality rate was 15%. AP cannot be prevented but maternal and perinatal morbidity and mortality due to AP can be reduced significantly by aggressive management.   Methods: The present prospective study was conducted to evaluate the outcome of treatment on the perinatal and maternal outcome in Abruptio Placentae patients in a tertiary care hospital from January 2015 to January 2016 amongst 54 pregnant women diagnosed to have abruptio placentae from 28 weeks of gestation and above and all babies delivered. Face-to-face interviews was conducted. Results: Maximum no. of abruptio placentae were unbooked - 37 (69%) and 85% of patients belonged to the less than 30 years of age group. An abruptio placenta was more common in multipara. Anaemia was seen in 21 patients (38%). Anaemia and PIH was seen in 12 patients (23%). 7 patients had fetal distress at the time of admission (13%). Regarding mode of delivery, 50% of patients delivered vaginally by artificial rupture of membrane (ARM) and oxytocin augmentation and 50% underwent caesarean section. Conclusion:  It was concluded that abruptio placentae is still a leading cause of maternal morbidity and mortality that can be reduced with modern management of abruptio placentae, but timely diagnosis and intervention is necessary. Key Words: Abruptio placentae, maternal mortality, fetal distress, anaemia

scholarly journals Clinical profile and outcome of neonates admitted in sick newborn care unit with hypernatremic dehydration and association with breastfeeding in a tertiary care hospital in Northern India

2021 ◽  
Vol 8 (6) ◽  
pp. 1074
Author(s):  
Mohit Bajaj ◽  
Chiranth R. ◽  
Swati Mahajan ◽  
Pancham Chauhan
Keyword(s):  
Sodium Level ◽  
Tertiary Care ◽  
Newborn Care ◽  
Main Step ◽  
Care Hospital ◽  
Sick Newborn ◽  
Hilly Region ◽  
The Mean ◽  
Time Of Admission ◽  
Hypernatremic Dehydration

Background: Neonatal hypernatremic dehydration is a very commonly seen potentially devastating condition. Inadequate breastfeeding, gastrointestinal losses, warm weather and improperly diluted mixed feeding are the main etiologies linked with neonatal hypernatremic dehydration. We conducted this study to evaluate the etiology, risk factors, clinical symptoms and outcomes of neonates admitted with hypernatremic dehydration and its association with breastfeeding from hilly region in northern India.Methods: The authors retrospectively studied records from extramural sick newborn care unit (SNCU) from April 2018 to June 2019. Inclusion criteria for the study included admitted neonates with documented hypernatremia (serum sodium level >145 mmol/L). Results: Nine hundred and twenty-two neonates were admitted in sick newborn care unit during this study period. One hundred and three (13.39%) newborns were admitted with hypernatremic dehydration at the time of admission. All newborns had deranged kidney function tests at time of admission. Most commonly found presenting complaints were poor feeding (85.71%), fever (45.71%), loose stools (42.8%) and decreased urine output (8%). The mean (SD) sodium on admission was 154.04 (7.41) meq/L. The mean (SD) time taken to correct hypernatremia was 35.6 (14.6) hours. Six of total admitted newborn developed neurological complications (2 had developed cerebral venous thrombosis and 4 had developed seizures). Mortality rate was 4.4%. Top fed neonates (50.41%) had higher percentage of mean sodium level and acute kidney injury at time of admission.Conclusions: Hypernatremic dehydration is preventable and treatable condition. Looking in to and addressing etiology in a timely manner is main step in management. All mothers should be taught correct breastfeeding technique. More breast examination during prenatal and postnatal periods and careful neonatal weight record postnatally could decrease the incidence of neonatal hypernatremic dehydration. Top feeding should be discouraged and only exclusive breastfeeding for 6 months. 

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