scholarly journals Escalation and de-escalation of the radiology response to COVID-19 in a tertiary hospital in South London: The King’s College Hospital experience

2020 ◽  
Vol 93 (1116) ◽  
pp. 20201034
Author(s):  
Andreas Panayiotou ◽  
Vasileios Rafailidis ◽  
Thomas Puttick ◽  
Keshthra Satchithananda ◽  
Adam Gray ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Major Incident ◽  
Radiology Department ◽  
College Hospital ◽  
Treatment Regimens ◽  
Imaging Tool ◽  
Imaging Service ◽  
Diagnostic Modalities ◽  
Modern Medical Practice ◽  
Prevention Of Nosocomial Infection

The pandemic of COVID-19 presented an enormous challenge to the medical world in terms of diagnosis, treatment and health-care management as well as service organisation and provision. This novel virus and its spread affected every aspect of modern medical practice, ranging from investigating transmission of this new pathogen, antigen testing of symptomatic patients, imaging, assessing different treatment regimens and the production of a new vaccine. Imaging played a crucial role in the diagnosis of COVID-19-related lung disease, with plain radiography and CT being the main diagnostic modalities, with ultrasound a useful bedside imaging tool. The accurate and early diagnosis of the disease was not the only issue faced by Radiology Departments across the world; prevention of nosocomial infection, creating capacity with elective imaging suspension, management and protection of the workforce being few of the numerous challenges. The purpose of this manuscript is to present the steps that the Radiology Department of a large urban tertiary facility with a local vulnerable population, undertook to adapt the imaging service and structure, both initially escalating and then de-escalating a response to the COVID-19 pandemic. A step-by-step management strategy, effective and sustained staff deployment, imaging management are presented and discussed, to provide a guide for managing a major incident in a radiology department.

scholarly journals Use of Cephalosporin Type Antimicrobials in Infection Wards in Tertiary Hospital in West India

2021 ◽  
pp. 510-517
Author(s):  
Revati D. Kothari ◽  
Anita Barde ◽  
Harshavardhan Bhide ◽  
Teja Deshpande ◽  
Nimish S. Narkar ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Tertiary Hospital ◽  
Research Centre ◽  
Third Generation ◽  
College Hospital ◽  
Treatment Regimens ◽  
Culture Sensitivity

Background: Antibiotic resistance is exponentially increasing worldwide. Irrational prescription of antibiotic treatment contributes to the development of antibiotic resistance. Appropriate antibiotic use is vital in reducing the mortality caused by bacterial infections. Third generation cephalosporins are now considered as the backbone of antibiotic therapy for treatment of serious infections including those in hospitalized patients. These drugs are the commonly prescribed ꞵ-lactam antibiotics even before culture sensitivity reports arrive. Generation of resistance has been a growing concern for all clinicians and must be avoided at all costs. This drug utilization study was undertaken to understand the growing resistance acquired by the organisms against cephalosporins caused due to the superfluous and unrestrained use of cephalosporins in the medical wards of our institution. Objective: The study objectives were to assess: The cephalosporins generation which was most commonly prescribed The relevance of cephalosporins generations used in various diseases The shift or addition of other antimicrobials upon failure of cephalosporins treatment Methods: This was an observational study done amongst 350 patients admitted in infection wards of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of one year between January 2019 to December 2019 after obtaining institutional ethical clearance. Data was analyzed and values were presented descriptively in number and percentage form. Results: Maximum usage of third generation cephalosporin was seen with ceftriaxone being the most commonly prescribed third generation cephalosporin in parenteral form (59.43%). Gender analysis revealed that males (60.28%) were prescribed more cephalosporins as compared to females (39.71%), whereas, frequent usage was seen in the age group 61 – 70 years. Bacteriological investigations were done in only 103 (29.42%) cases following which shift or addition of other antimicrobials was seen in 13 (3.71%) cases. Metronidazole was the most frequently co-prescribed with cephalosporins. Conclusion: Our study revealed extensive usage of third generation cephalosporin and the treatment regimens implemented in majority of the cases were without prior culture sensitivity test leading to irrational prescribing. Our study, along with the various other studies, would help in taking the corrective measures to curb the unnecessary use of antibiotics, and framing the guidelines for the doctors prescribing them.

scholarly journals Rising Trend of Caesarean Section in a Tertiary Hospital Over a Decade

1970 ◽  
Vol 29 (3) ◽  
pp. 126-132 ◽  
Author(s):  
R Nazneen ◽  
RA Begum ◽  
K Sultana
Keyword(s):  
Caesarean Section ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Background Information ◽  
P Value ◽  
Demographic And Health Surveys ◽  
College Hospital ◽  
Medical College ◽  
Foetal Movement

Background information: Since the early 1990s, emergency obstetric care (EmOC) in Bangladesh has played important role to reduce the maternal mortality rate. Along with other indicators of improved maternal care, there is a trend of rising caesarean section rates over the last decade affecting the economy of the country. According to demographic and Health Surveys conducted between 1993 and 2004, rate of caesarean section has risen from 2% to 6% which is more pronounced in urban area. Objective: To assess the indications and the trends of caesarean sections done over a 10-year period from 1995- 2004. Study Design: A retrospective observational study of the cases of caesarean sections over a decade. Study setting: Holy Family Red Crescent Medical College Hospital. Results: 23748 women were admitted in department of Obstetrics and Gynacology. Total deliveries were 21149(89.05% of total admission). The caesarean birth rate increased from 45.85% to 70.55%. The indications varied a little in cases of malpresentation and eclampsia. APH and IUGR has risen a little (from 2.56 to 2.6 to 1.83 to 2.34%) respectively. But proportion of repeat caesarean section and that of presumed foetal distress (or less foetal movement) increased (from 25.99 to 31.45% and from 8 to 15%), recently the indication, as maternal choice is also coming up (from .43 to .8%). The proportion has fallen in prolonged labour for cervical dystocia (from 17 to 2.6%) and obstructed labour (from 4.6% to .36%). The data were compared and analyzed by Z Test and corresponding P value was calculated which was not significant. Conclusion: Though caesarean section is a very safe intervention in obstetrics at present, crucial evaluation of the indications is advocated to reduce the rates of caesarean secion. Keywords: Caesarean section rates; Indications DOI: http://dx.doi.org/10.3329/jbcps.v29i3.9432 JBCPS 2011; 29(3): 126-132

scholarly journals Relationship between Stature and Length of Tendo Achilles in Adult Male and Female of Bangladesh

2020 ◽  
Vol 7 (2) ◽  
pp. 80-83
Author(s):  
Sanjida Amin ◽  
Shamim Ara ◽  
Rawshon Naznin ◽  
Umma Marium ◽  
Farah Diba ◽  
...  
Keyword(s):  
Medical Science ◽  
Age Groups ◽  
Medical College Hospital ◽  
Radiology Department ◽  
College Hospital ◽  
Cross Sectional ◽  
Male And Female ◽  
Medical College ◽  
Tendon Thickness ◽  
Ankle Flexibility

Background: Tendo Achilles injuries are usually related to poor ankle flexibility and strength and to overuse. Morphology of tendo Achilles is an important tool for its assessment which can be done by measuring tendon thickness, cross-sectional area and length of tendon. Objective: The aim of the study was to correlate length of tendo Achilles with stature in several age groups of sedentary people as measured by ultrasonography. Materials and method: This cross sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2013 to June 2014. The present study was performed on 200 tendo Achilles of 100 people (50 male and 50 female) randomly selected from the patients who came to the Radiology department of Dhaka Medical College Hospital for ultrasonography of any region of their body other than leg. Results: In this study length of tendo Achilles was measured in both legs of adult people and was correlated with stature. Highly significant correlation was found between length of tendo Achilles with stature (p<0.001). Conclusion: The data of length of tendo Achilles obtained from the present study may provide valuable information in different aspects of medical science as a guide line for physiotherapists, radiologists, sports professionals and ortho-surgeons in early detection and monitoring of rehabilitation especially of professional athletes. Delta Med Col J. Jul 2019 7(2): 80-83

Patient arrival pattern and waiting time analysis for a tertiary hospital radiology department

2019 ◽  
Vol 25 (3) ◽  
pp. 136-143
Author(s):  
Felicitas Ugochinyere Idigo ◽  
Kenneth Kalu Agwu ◽  
Obinna Emmanuel Onwujekwe ◽  
Mark Chukwudi Okeji ◽  
Angel-Mary Chukwunyelu Anakwue
Keyword(s):  
Waiting Time ◽  
Tertiary Hospital ◽  
Radiology Department ◽  
Time Analysis ◽  
Patient Arrival ◽  
Arrival Pattern

scholarly journals Identifying the effects of an upgraded ‘fever clinic’ on COVID-19 control and the workload of emergency department: retrospective study in a tertiary hospital in China

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039177
Author(s):  
Jiangshan Wang ◽  
Liang Zong ◽  
Jinghong Zhang ◽  
Han Sun ◽  
Joseph Harold Walline ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Disease Transmission ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
College Hospital ◽  
Upper Respiratory Infection ◽  
Number Of Patients ◽  
Screening And Prevention

ObjectiveCOVID-19 started spreading widely in China in January 2020. Outpatient fever clinics (FCs), instituted during the SARS epidemic in 2003, were upgraded to serve for COVID-19 screening and prevention of disease transmission in large tertiary hospitals in China. FCs were hoped to relieve some of the healthcare burden from emergency departments (EDs). We aimed to evaluate the effect of upgrading the FC system on rates of nosocomial COVID-19 infection and ED patient attendance at Peking Union Medical College Hospital (PUMCH).DesignA retrospective cohort study.ParticipantsA total of 6365 patients were screened in the FC.MethodsThe FC of PUMCH was upgraded on 20 January 2020. We performed a retrospective study of patients presenting to the FC between 12 December 2019 and 29 February 2020. The date when COVID-19 was declared an outbreak in Beijing was 20 January 2020. Two groups of data were collected and subsequently compared with each other: the first group of data was collected within 40 days before 20 January 2020; the second group of data was collected within 40 days after 20 January 2020. All necessary data, including patient baseline information, diagnosis, follow-up conditions and the transfer records between the FC and ED, were collected and analysed.Results6365 patients were screened in the FC, among whom 2912 patients were screened before 21 January 2020, while 3453 were screened afterward. Screening results showed that upper respiratory infection was the major disease associated with fever. After the outbreak of COVID-19, the number of patients who were transferred from the FC to the ED decreased significantly (39.21% vs 15.75%, p<0.001), and patients generally spent more time in the FC (55 vs 203 min, p<0.001), compared with before the outbreak. For critically ill patients waiting for their screening results, the total length of stay in the FC was 22 min before the outbreak, compared with 442 min after the outbreak (p<0.001). The number of in-hospital deaths of critically ill patients in the FC was 9 out of 29 patients before the outbreak and 21 out of 38 after the outbreak (p<0.05). Nineteen cases of COVID-19 were confirmed in the FC during the period of this study. However, no other patients nor any healthcare providers were cross-infected.ConclusionThe workload of the FC increased significantly after the COVID-19 outbreak. New protocols regarding the use of FC likely helped prevent the spread of COVID-19 within the hospital. The upgraded FC also reduced the burden on the ED.

scholarly journals Pattern of Adverse Drug Reactions Due to Cancer Chemotherapy in Tertiary Care Teaching Hospital in Bangladesh

1970 ◽  
Vol 8 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Sneegdha Poddar ◽  
Razia Sultana ◽  
Rebeka Sultana ◽  
Maruf Mohammad Akbor ◽  
Mohammad Abul Kalam Azad ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Cancer Chemotherapy ◽  
Economic Status ◽  
Alkylating Agents ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Drug Reactions ◽  
College Hospital ◽  
Medical College

The objective of the present study was to evaluate the pattern of adverse drug reactions (ADRs)occurring in cancer patients treated with chemotherapy in tertiary care hospitals in Bangladesh. A prospectivehospital based study over a period of six month was carried out in the Department of oncology, Bangabandhu SheikhMujib Medical University and Dhaka Medical College Hospital. The data were subjected to descriptive analysis. Atotal of 50 patients having ADRs due to cancer chemotherapy were randomly selected. Adverse drug reactions weremostly occurred in the age group between 41-50 years (26%). Considering socio-economic status of cancer patientsmarried persons (82%) have significantly higher risk than unmarried (18%). Prevalence of breast cancer (20%),cervical cancer (14%) and leukemia (16%) were higher and they were treated mostly by adjuvant chemotherapy(46%) and secondly by chemotherapy (38%) alone. In most cases ADRs were developed in patients receivingalkylating agents (40%) and antimetabolites (40%) as anticancer therapy. The five certain ADRs observed in thecurrent study were nausea, stomatitis, alopecia, myelosuppression and increased ESR level in both male and femalepatients. Moreover, hematological system was affected severely by alkylating agents and antimetabolites. Similarstudies covering more patients from different regions are needed to validate our findings.Key words: ADRs; Cancer; Chemotherapy; Tertiary hospital; Bangladesh.DOI: 10.3329/dujps.v8i1.5330Dhaka Univ. J. Pharm. Sci. 8(1): 11-16, 2009 (June)

scholarly journals Assessment of Diabetic Patients in a Tertiary Hospital on Knowledge, Practice of and Attitude to Lifestyle Modifications

2020 ◽  
Vol 8 (1) ◽  
pp. 7-13
Author(s):  
Stella Folajole Usifoh ◽  
Bose Ademola
Keyword(s):  
Lifestyle Modification ◽  
Tertiary Education ◽  
Good Practice ◽  
Tertiary Hospital ◽  
Good Knowledge ◽  
Diabetic Patients ◽  
Lifestyle Modifications ◽  
College Hospital ◽  
Cross Sectional ◽  
Knowledge Practice

Objective: To assessed the types 2 diabetic patient’s knowledge, the practice of, and attitude to lifestyle modification at University College Hospital (UCH), Ibadan. Methods: A cross-sectional descriptive study of types- 2 diabetic patients at the Medical outpatient clinic in UCH was done with a validated structured 48 item self-administered questionnaire that measured the socio-demographics, knowledge, practice of and attitude to lifestyle modifications. A purposive sampling of 99 consenting patients out of 103 determined with Yaro Tamane formulae was done.  Data were entered into SPSS v. 21 for descriptive and inferential analysis. Results: About 59.6% of respondents were within ≥60 years age range, and 68.7% of them were females. Many (51.5%) of them had tertiary education qualifications. On knowledge of symptoms, the majority 78 (78.8%) had good knowledge and 21(21.2%) had poor knowledge of diabetes mellitus. While 64 (64.6%) respondents had a good attitude and 35(35.4%) had a poor attitude towards lifestyle modification. Besides, a vast majority (94.9%) reported that lifestyle modification helps attain normal blood glucose levels, preserves life, assuage symptoms, and avert extended complications. The respondents tend to strongly agree to have a good practice of lifestyle modification with a weighted mean of 3.76 to 4.69 on a 5point scale. Conclusion: The majority of the respondents had good knowledge, the practice of and attitude to lifestyle modification which can help patients in altering long-term habits, eating or physical activity, and maintaining these practices as part of the management of the disorder.

scholarly journals Review of the Guidelines For Radiology Practice During COVID -19 Pandemic by Nepal Radiologists’ Association

2020 ◽  
Vol 10 (1) ◽  
pp. 38-45
Author(s):  
Anamika Jha ◽  
Sundar Suwal ◽  
Dan Bahadur Karki ◽  
Ram Kumar Ghimire
Keyword(s):  
Computed Tomography ◽  
Virus Disease ◽  
Clinical History ◽  
Radiology Department ◽  
Medical Council ◽  
X Ray ◽  
Safety Issues ◽  
Chest X Ray ◽  
Diagnostic Modalities

Nepal is also affected by Corona Virus Disease (COVID-19) pandemic which is likely to last for several months. The Reverse Transcriptase-Polymerase Chain Reaction is the current gold standard diagnostic test. Chest X-ray or Computed Tomography scan is considered inappropriate according to most society recommendations for screening though are emerging as frontline diagnostic modalities in conjunction with clinical history and laboratory parameters.Multiple guidelines have been released by prominent radiological societies worldwide to facilitate preparedness of radiology department in the war against COVID-19. Based on these, the Nepal Radiologists’ Association has proposed its guidelines, endorsed by the Nepal Medical Council, practical in our context, with the aim to limit exposure to the infection while ensuring best use of imaging, protection of health care personnel and other patients and maintenance of uninterrupted radiology department operations.This review article aims to summarize the highlights from various guidelines focusing on role of chest X-ray and Computed Tomography including the indications, specific findings, reporting format and important differentials and also addresses the safety issues.

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