scholarly journals Clinical Profile and Outcome of COVID Positive Hematology Patients during the COVID-19 Pandemic - an Analytical Cross Sectional Study from a Tertiary Care Centre in India

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4996-4996
Author(s):  
Faisal Kassim ◽  
Chirag Sunil Lalwani ◽  
Hamsini Movva ◽  
Sani Kodathumuriyil Sunny ◽  
Merlin Moni ◽  
...  
Keyword(s):  
Active Treatment ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Outcome Variable ◽  
Categorical Variables ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hematological Diseases ◽  
Significant Difference ◽  
D Dimer

Abstract Introduction: The COVID-19 pandemic is a global public health challenge that has affected more than 30 million people and taken more than 4 lakh lives in India. The first and second COVID waves have greatly impacted the lives of a vast majority and vaccination of the masses remains a struggle. Although SARS -CoV-2 infections in patients with hematological diseases are expected to have an adverse outcomes, only limited reports are available from India. Hence, our study aims to identify the outcome in terms of severity and mortality in this group and the risk factors involved in developing severe COVID-19 and death. Methodology: This is a cross sectional analytical study done in a tertiary care hospital in Southern India for a period of 11 months. All hematological patients irrespective of age, who were infected with SARS-CoV-2 during the first wave (June -December 2020) and second wave (March - June 2021) were consecutively enrolled for the study after IRB approval. The patients were then categorized as neoplastic (acute and chronic leukemia, lymphoma, myeloma, MPN and MDS ) and non-neoplastic (ITP, aplastic anemia, hemolytic anemia, MGUS and TTP ) diseases. The clinical data was collected retrospectively from the electronic medical records and by direct telephonic contact. Patients were categorized as having mild (spO2 > 94 % symptomatic /asymptomatic), moderate (spO2 90 - 94 %) and severe (spO2 < 90 %) disease based on their severity of infection, each category of patients received appropriate clinical management. Treatment details, mortality and other outcomes were recorded for 30 days. The continuous variables were represented as mean (± SD)/median (IQR) and categorical variables as frequency and percentage. The association of the outcome variable with selected variables were calculated using Chi-square tests and kaplan meier survival analysis. The data sets were analyzed (SPSS version 21) and a p value of < 0.05 was considered statistically significant. Results: The study was conducted with 70 patients (n=70). Demographic details of patients are summarized in Table 1.Seventeen (24.3%) out of 49 (70%) hospitalized patients required ICU care. There were 13 (18.6%)deaths. in the patients who survived, prolonged antigen positivity of COVID on testing after 21 days was seen in 9 patients (16.1%). In 35 patients (50%)hematological treatment was restarted with a mean delay of 9.2 +/- 10.72 days. Predictors of severity of the disease is summarized in Table 2. Age more than 50 years (P=0.002)(Figure 1a), severe COVID (P=<0.001) and D dimer value of >2 times normal (P=0.047) were associated with a 30-day mortality. Additionally, patients on active treatment for hematological disease were at greater risk of severe COVID (P=0.012). There was no significant difference in severity (P=0.197) or mortality (P=0.556)in patients with neoplastic vs. non-neoplastic disorders Conclusion: COVID-19 patients with malignant and non-malignant hematological diseases showed an increased mortality. Age > 50 years and high D dimer values (>2N) were identified as predictors of mortality. Active treatment for haematological disease predisposed to severe disease.The study needs to be validated further on a larger cohort of patients . Preventive strategies including vaccination is warranted in patients with hematological disorders. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

Does Teaching Clinical Ethics to Medical Students Improve Knowledge, Attitude, and Practice of Medical Ethics Among Clinicians? An Observational Study in a Tertiary Care Hospital in Nepal.

2020 ◽  
Author(s):  
Carmina Shrestha ◽  
Jasmin Joshi ◽  
Ashma Shrestha ◽  
Shuvechchha Karki ◽  
Sajan Acharya ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Ethics ◽  
Clinical Ethics ◽  
Core Curriculum ◽  
Tertiary Care ◽  
Medical Schools ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background: The importance of doctors being aware of medical ethics has been highlighted in a number of studies. Our first study (Study-1) aims to assess the knowledge, attitude, and practices of medical ethics among clinicians at Patan Academy of Health Sciences (PAHS). We then follow up with the effect of teaching clinical ethics to medical students (Study-2). The purpose of this study is to assess the awareness regarding appropriate ethical principles, application of medical ethics and the effect of teaching medical ethics to students. Methods: There are two studies presented: Study-1 is a cross-sectional questionnaire-based study. A total of 72 participants, selected by simple random sampling, included doctors working as interns, medical officers and consultants in six departments of PAHS. Study-2 was a follow-up, cross-sectional online questionnaire-based comparative study conducted at PAHS to compare KAP of medical ethics among medical officers with and without formal medical ethics training. We used the validated questionnaire from our previous study. All graduates of PAHS 2016 and all medical officers employed at PAHS at the time of study who had graduated from other medical schools that did not include Medical Ethics in their core curriculum were included. Results: Study-1: A positive correlation between Knowledge(p = 0.088), Attitude (p = 0.002), Practice of medical ethics(p = 0.000), and years of practice was found. No significant difference in KAP of medical ethics between MBBS graduates from Nepal and abroad (p = 0.190) was found. The majority scored poorly in issues concerning autonomy. The follow-up study found a statistically significant difference (p = 0.000) in the knowledge between the doctors who were taught medical ethics and those who were not. Conclusions: Doctors find it easier to discuss ethical dilemmas with their colleagues rather than department heads. The KAP of the consultants were found to be better than that of the interns and medical officers. Autonomy is the least understood ethical principle. ‘Medical Ethics’ as a part of the core curriculum in medical schools would improve ethical practice.

scholarly journals Pattern of Chemotherapy-Related Adverse Effects Among Adult Patients With Cancer Treated at Gondar University Referral Hospital, Ethiopia: A Cross-Sectional Study

2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 15s-15s
Author(s):  
Sewunet Admasu Belachew ◽  
Daniel Asfaw Erku ◽  
Abebe Basazn Mekuria ◽  
Begashaw Melaku Gebresillassie
Keyword(s):  
Health Care Professionals ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Chemotherapeutic Agents ◽  
Referral Hospital ◽  
Categorical Variables ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients With Cancer

Abstract 32 Purpose Adverse drug reactions (ADRs) are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the current study was to assess the pattern of ADRs that occur in patients with cancer who were treated with chemotherapy in a tertiary care teaching hospital in Ethiopia. Methods A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted in patients with cancer who underwent chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. Reported ADRs were assessed for causality using the WHO causality assessment scale and Naranjo’s algorithm. Severities of the reported reactions were also assessed using National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0). Pearson’s χ2 test was used to examine the association between two categorical variables. Results A total of 815 ADRs were identified from 203 patients who were included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%), infections (16.7%), neutropenia (14.7%), fever and/or chills (11.3%), and anemia (9.3%). Platinum compounds (31.4%) were the most common group of drugs that caused ADRs. Of reported ADRs, 65.8% were grades 3 to 4 (severe level), 29.9% were grades 1 to 2 (mild level), and 4.3% were grade 5 (toxic level). Significant association was found between age, number of chemotherapeutic agents, and dose of chemotherapy with the occurrence of grades 3 to 5 toxicity. Conclusion The high incidence of chemotherapy-related ADRs among patients with cancer is of concern. Establishing an effective ADR monitoring and reporting system—oncopharmacovigilance—and creating awareness among health care professionals of the importance of ADR reporting may help prevent the problem. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

scholarly journals Estimation of Serum Copper in Post-menopausal Women Attending in a Tertiary Care Hospital, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Serum Copper ◽  
Copper Level ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113

scholarly journals Need for teleconsultation among the emergency medicine and critical care personnel during pre-hospital transport in a tertiary care unit

2017 ◽  
Vol 4 (1) ◽  
pp. 176
Author(s):  
V. Karunai Kadhir ◽  
T. Hemalatha ◽  
V. P. Chandrasekaran
Keyword(s):  
Emergency Medicine ◽  
Treatment Guidelines ◽  
Improve Patient Safety ◽  
Prehospital Care ◽  
Tertiary Care ◽  
Minimum Time ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Time Required

Background: Time being the most crucial factors in emergency medicine, teleconsultation enables patient assessment by specialists, immediate reception of appropriate treatment guidelines until the patient's arrival at hospital.Methods: Our study evaluated the need for teleconsultation among the emergency physicians (EP) and emergency technicians (ET) in a tertiary care hospital. Cross-sectional study conducted in Department of Emergency Medicine, a tertiary care setting. Pretested semi-structured questionnaire was given to EP and ET. Various parameters like the need for teleconsultation, the minimum time required for EMS (emergency medical services) to arrive at the scene and to the hospital, effectiveness of teleconsultation in prehospital care were evaluated.Results: SPSS version 18.0 was used. 24 EP and 36 ET participated in the study. The minimum time required for the EMS to arrive at the scene and then to hospital was calculated indirectly to be > 30 min. There was a significant difference among the EP an ET in interpreting common emergency condition p = 0.029 and criticality assessment p=0.035.The training of EMS staffs was adequate. Both EP and ET were able to adhere recent guidelines during prehospital transport. All the study participants (100%) felt the need for teleconsultation which would improve the patient management during the prehospital period.Conclusions: Teleconsultation has the potential to improve patient safety and quality of treatment in a prehospital setting and should be further evaluated.  

scholarly journals Knowledge of sleep disorders among physicians at a tertiary care hospital in Qatar: A cross-sectional study. (Preprint)

2020 ◽  
Author(s):  
Irfan Ul Haq ◽  
Mansoor Ali Hameed ◽  
Merlin Marry Thomas ◽  
Khezar Shahzada Syed ◽  
Ahmad Mohammad Mahmoud Othman ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Medical Training ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Sleep Medicine ◽  
Care Hospital ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Significant Difference

BACKGROUND Sleep disorders (SD) constitute a major health problem because of their relatively high and rising prevalence. Several studies have analyzed the knowledge of SD among healthcare providers worldwide. We aimed to assess the knowledge of SD among physicians in Qatar OBJECTIVE To assess the knowledge of sleep medicine among physicians working in a tertiary care hospital. METHODS Total of 250 physicians were surveyed regarding their knowledge in sleep medicine using a validated 30 item “ASKME Survey”. The participants included residents, fellows and consultants in medicine and allied subspecialties. A score ≥60% was considered a high score implying adequate knowledge of SD. RESULTS Response was received from 158 physicians with a responder rate of 63.2%. We analyzed the data from 34 residents, 74 clinical fellows and 50 consultants. The overall mean score was 15.53± 4.42 out of 30. Only 57 (36%) respondents were able to answer ≥60% of the questions correctly. There was no statistically significant difference in the scores of the participants with regard to their ranks (residents, fellows, consultants) or years of training CONCLUSIONS This study demonstrates that healthcare providers in Qatar have decreased awareness and knowledge about sleep medicine which may reflect a lesser emphasis during medical school and medical training on SD. Increasing awareness regarding sleep medicine among non-specialist physicians will allow early detection and treatment of SD, improving the morbidity attached with these disorders CLINICALTRIAL The research was approved by the Institutional review board MRC-01-18-022

scholarly journals Vitamin Cobalamin deficiency in macrocytic anemia reporting at a Tertiary Care Hospital.

2021 ◽  
Vol 28 (04) ◽  
pp. 527-532
Author(s):  
Kashif Rasheed Shaikh ◽  
Shumaila Shaikh ◽  
Sadia Tabassum ◽  
Shagufta Memon ◽  
Umair Ali Soomro ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Macrocytic Anemia ◽  
Cobalamin Deficiency ◽  
Categorical Variables ◽  
Care Hospital ◽  
Female Ratio ◽  
Male And Female ◽  
Significant Difference

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.

scholarly journals A cross sectional study of clinical profile and evaluation of pulmonary hypertension in Chronic Obstructive Pulmonary Disease patients in a tertiary care hospital of Mangalore, India

2019 ◽  
Vol 6 (2) ◽  
pp. 330
Author(s):  
Kshama S. Ramesh ◽  
Devdas B. Rai ◽  
Shayma Sheikh Abdulla ◽  
Jyothsna B. K.
Keyword(s):  
Pulmonary Hypertension ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Cardiac Complications ◽  
Chronic Obstructive ◽  
Close Monitoring ◽  
Care Hospital ◽  
Cross Sectional ◽  
Copd Patients ◽  
Significant Difference

Background: The objectives was to study the clinical profile of COPD patients and to evaluate pulmonary hypertension in COPD patients by non-invasive methods.Methods: A prospective observational study of patients who satisfy all inclusion and exclusion criteria in OPD or admitted in medical wards of AJIMS Mangalore. The study was conducted from October 2017 to October 2018 with the sample size of 90 subjectsResults: Out of 90 subjects 53 (58.8%) of them had pulmonary hypertension. Among the subjects who had pulmonary hypertension 29 (54.72%) of them had moderate pulmonary hypertension, 17 (32.08%) of them had severe pulmonary hypertension and 7 (13.20%) of them had mild pulmonary hypertension. Mean age among the subjects who had pulmonary hypertension was 64.24+7.62yrs and mean age among the subjects who didn’t had pulmonary hypertension was 51.87+8.97yrs. There was a statistically significant difference found between mean age and pulmonary hypertension. Mean duration of diseases among the subjects who had pulmonary hypertension was 8.13+1.74yrs and Mean duration of diseases among the subjects who didn’t had pulmonary hypertension was 5.36+1.98yrs. There was a statistically significant difference found between mean duration of disease and pulmonary hypertension.Conclusions: Due to high prevalence of pulmonary hypertension we suggest screening for the all COPD patients for cardiac complications. This will help in identifying the individual who requires close monitoring and also in reducing the mortality.

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