scholarly journals Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Creative Commons ◽  
Oral Medications ◽  
Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals DIABETIC RETINOPATHY;

2018 ◽  
Vol 25 (08) ◽  
pp. 1256-1260
Author(s):  
Nasir Ahmad Chaudhary ◽  
Samreen Hameed ◽  
Muhammad Sultan Ul Moazzam ◽  
Sarmad Zahoor ◽  
Sidrah Latif ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Retinal Disease ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Retinal Examination ◽  
Tertiary Care Hospitals ◽  
Hba1c Levels

Background: Diabetic retinopathy is one of the most common complications ofdiabetes affecting more than 1/4th of the diabetics and is also the leading cause of blindness inmany parts of the globe. Regular fundoscopic examination for screening is a routine practicein tertiary care hospitals but is not available in the primary care centers. This necessitatesthe development of a reliable screening tool which will allow for early referral of those withcomplications to the specialist centers. Objective: To determine the predictive value of HbA1clevels for the presence of diabetic retinopathy. Study Design: A cross-sectional study. Setting:Diabetic Clinic of Mayo Hospital, Lahore. Period: 04 months, January to April 2017. Method:75 diabetic patients who presented in Diabetic clinic were investigated for HbA1c levels andfundoscopic evaluation was done to detect retinal changes. Results: Out of 75 patients, 35(46.7%) were female, 40 (53.3%) were male. Median age of the patients was 51 years. All patientshad HbA1c levels more than 6.0% and 62% patients had detectable changes on fundi while therest had no detectable retinal disease despite elevated HbA1c levels. Positive predictive value(PPV) of elevated HbA1c levels for the presence of diabetic retinal changes was calculated tobe 62.66%. Conclusion: All the patients who had retinal disease on fundoscopy had HbA1clevels of more than 6.0% (PPV = 62.66) which means that elevated HbA1c levels warrant afundoscopic retinal examination to rule out diabetic retinopathy.

scholarly journals A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

2009 ◽  
Vol 34 (4) ◽  
pp. 346 ◽  
Author(s):  
Yogesh Gautam ◽  
AK Sharma ◽  
AK Agarwal ◽  
MK Bhatnagar ◽  
RoochikaRanjan Trehan
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tertiary Care Hospitals

scholarly journals Anxiety among Doctors during COVID-19 Pandemic in Secondary and Tertiary Care Hospitals

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Syed Riazul Hasan ◽  
Zeeshan Hamid ◽  
Muhammad Talha Jawaid ◽  
Rashida Kaizar Ali
Keyword(s):  
Risk Factors ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Significant Difference ◽  
Scale Scores ◽  
Associated Risk Factors ◽  
Tertiary Care Hospitals

Objective: To assess the level of anxiety among doctors during COVID-19 pandemic and the associated risk factors. Methods: This cross-sectional study was conducted from 30th April to 16th May, 2020 in Karachi, Pakistan. The data was collected via an online web-based questionnaire. Questionnaire was used to assess anxiety level using GAD-7 scale among health-care professionals and the risk factors playing role in it. Results: One hundred and fifty-one doctors participated in our study. Out of these 151 participants, 69 (45.7%) had mild, 22 (14.6%) had moderate, and 5 (3.3%) had severe symptoms of anxiety, whereas the remaining 55 (36.4%) had no anxiety according to GAD-7 scale. The median [interquartile range (IQR)] GAD-7 scale scores are 6.0 [3.00-9.00]. Females showed more severe degrees of measurement of anxiety symptoms than males. Doctors dealing with COVID-19 patients showed higher level of anxiety as compared to the doctors who were not dealing with COVID-19 patients, having a significant difference (U = 9.697, p = 0.008). One hundred and forty-one (93.4%) participants were concerned about being exposed to COVID-19 at work and 112 (74.2 %) thought they have inadequate protective equipment for safety. Conclusions: During COVID-19 pandemic, doctors exhibited different grades of anxiety. In order for healthcare workers to perform to the best of their capability, certain guidelines and interventions are needed. doi: https://doi.org/10.12669/pjms.36.6.3113 How to cite this:Hasan SR, Hamid Z, Jawaid MT, Ali RK. Anxiety among Doctors during COVID-19 Pandemic in Secondary and Tertiary Care Hospitals. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.3113 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of Retinal Sensitivity by Automated Perimetry in Middle Aged Type 2 Diabetic Patients with and without Diabetic Retinopathy - A Cross-Sectional Study in a Tertiary Care Centre in West Bengal

2021 ◽  
Vol 8 (13) ◽  
pp. 835-839
Author(s):  
Abhinav Marlapati ◽  
Sambuddha Ghosh ◽  
Swati Majumdar
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Automated Perimetry ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Group 2

BACKGROUND We wanted to measure and compare retinal sensitivity in central 30 degree in diabetic patients, with and without diabetic retinopathy in different stages, evaluate changes in retinal sensitivity in relation to change in HbA1c values, measure and compare GCL thickness in various stages of DR with the help of optical coherence tomography (OCT). METHODS This observational, cross-sectional study involving 100 eyes of 100 middle aged (45 - 64 years) type 2 diabetes mellitus patients (50 eyes without DR - group 1 & 50 eyes with DR - group 2) without any other ocular abnormalities was conducted in the outpatient and in-patient departments of department of ophthalmology in a tertiary care centre in West Bengal. Non-randomised sequential sampling was performed with corrected visual acuity better than or equal to 6 / 12. Fasting and postprandial blood glucose and HbA1c were estimated. Detailed ocular examination was performed using direct and indirect ophthalmoscope with + 20 D lens and slit lamp bio-microscope using + 90D lens. Retinal sensitivity was assessed by Humphrey visual field analyser by Swedish Interactive Thresholding Algorithm (SITA) standard strategy (30 - 2 programme). Spectral domain optical coherence tomography (SD OCT) was performed in all patients. SPSS version 20 has been used for the analysis. RESULTS Among DR patients, 33 had mild non-proliferative diabetic retinopathy (NPDR) (male = 15, female = 18) and 17 had moderate NPDR (male = 7, female = 10). Mean age in DR (Gr. 2) and no DR (Gr. 1) group were 52.62 and 50.74 years respectively. Mean foveal sensitivity and mean retinal sensitivity decreased significantly (P-value 0.001 and 0.002 respectively) in group 2 patients. It further decreased with increased severity of DR. Mean ganglion cell + inner plexiform layer (GC + IPL) thickness in temporal quadrant decreased in DR group compared to no DR group with significant difference between the two (P-value < 0.001). Mean retinal nerve fibre layer (RNFL) thickness was significantly reduced in DR group (P-value < 0.001). HbA1c mean in no DR (6.7 %) and DR group (8.07 %) and in mild (7.5 %) and moderate NPDR (9.17 %) shows significant association of poor control of blood sugar with severity of DR. CONCLUSIONS Retinal sensitivity decreased significantly in diabetes even without retinopathy as detected by automated perimetry. Significant decrease in retinal thickness as detected by OCT suggested that neurodegeneration occurs in diabetes even without retinopathy. So automated perimetry and OCT could be helpful in identifying persons at an early stage who are at risk of future vision loss due to diabetes. KEYWORDS Diabetic Retinopathy, Retinal Neurodegeneration, Retinal Sensitivity, Automated Perimetry, GCL + IPL Thickness, RNFL Thickness

scholarly journals HYPERTENSION;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Hafiz Muhammad Bilal ◽  
Neelam Iqbal ◽  
Muhammad Kamran Raza
Keyword(s):  
Health Status ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Morbidity Rate ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Outpatient Departments ◽  
Tertiary Care Hospitals

Background and Objectives:Asymptomatic nature of hypertension (HTN) has made it a silent killer. The better understanding of the underlying causes or factors can be beneficial in reducing the mortality and morbidity rate. Thus, the present study aims to determine the risk factors associated with HTN among adults and elderly patients visiting outpatient departments (OPDs) and the knowledge of patients about their health status. Study Design: Cross-sectional study. Setting: Outpatient departments (OPDs) of four tertiary care hospitals (Nishtar hospital, Khawaja Farid Social Security hospital, Railway hospital and Bakhtawar Amin Memorial hospital) of Multan, Pakistan. Period:1st May 2017 and 31st October 2017. Patients and Methods:364 patients (≥18 years−≥60 years of age) in OPDs of four tertiary care hospitals of Multan, Pakistan. Data regarding demographic details, medical history and blood pressure measurements were collected on a structured questionnaire. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and Microsoft Excel (MS Office 2010).Result: Overall 38.7% of the participants were suffering from HTN. Most of them were 40-59 years of age and had body mass index (BMI) >23 kg/m2. Bivariate analysis (p-value <0.005) showed a significant association of age, marital status, gender, weight, and physical activity with HTN. Conclusion: The major determinants of HTN include increase in age, obesity, sedentary lifestyle, genetics, diabetes mellitus (DM) and lack of health concerns. Although patients are knowledgeable of their poor health status but make little or no efforts in controlling and preventing HTN.

scholarly journals A study of serum C peptide levels in newly detected diabetic patients in tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 679
Author(s):  
Balakrishna Teli ◽  
Prabhu S. ◽  
Sneha Biradar
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Study Data ◽  
P Value ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
C Peptide ◽  
Medical College ◽  
Endogenous Insulin

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.

scholarly journals Lipid profile pattern in controlled and uncontrolled diabetic patients in a tertiary care centre

2020 ◽  
Vol 8 (4) ◽  
pp. 1528
Author(s):  
Smita Gupta ◽  
Rajat Mangal ◽  
Ankit Grover
Keyword(s):  
Glycemic Control ◽  
Total Cholesterol ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Lipid Panel

Background: Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia with disturbances of carbohydrate, lipid as well as protein metabolism virtually affecting every organ in the human body. Dyslipidemia is a group of biochemical disorders, which is frequently seen in diabetic individuals. Dyslipidemia associated with diabetes has a major role in atherosclerosis and cardiovascular complications.Methods: This cross-sectional study was conducted in diabetic patients visiting OPD of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly over a period of 6 months. A total of 320 patients were randomly selected for the study and divided into 2 groups depending on HbA1c levels.Results: BMI of controlled diabetics was 26.2±1.91 kg/m2 and of uncontrolled was 27.56±4.36 kg/m2 respectively with a statistically significant p value. Total Cholesterol levels in controlled group was 185.63±52.32 mg% and 217.83±61.33 mg% in uncontrolled group with a p value of 0.0005 which is highly significant. Same was seen in triglyceride and VLDL levels in controlled group which was 173.88±101.77 mg% and 31.5±12 mg% respectively and 203.33±83.7 mg% and 40.67±17.66 mg% in uncontrolled group respectively.Conclusions: The diabetic patients with poor glycemic control had statistically significant high values of Total Cholesterol, Triglycerides, VLDL levels and significant low HDL Levels. Good glycemic control can result in improvement in the lipid panel and the patients can be prevented from the high cardiovascular and neurological risk.

scholarly journals Do you really get what you are looking for? Exploring the medical call writing trend in tertiary care hospitals

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Abdul Rahim Khan ◽  
Usman Mahboob ◽  
Najma Baseer
Keyword(s):  
Content Validity ◽  
Tertiary Care ◽  
Great Majority ◽  
Cross Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Creative Commons ◽  
Kappa Value ◽  
Quantitative Descriptive ◽  
Tertiary Care Hospitals

Objective: To explore the trend of medical call writing by doctors working in tertiary care hospitals. Methods: A quantitative descriptive cross-sectional study was carried out to evaluate the quality of medical calls written by the doctors at three tertiary care hospitals of Peshawar, Khyber Pakhtunkhwa between June 2016 to June 2017. An instrument was developed following AMEE Guide 87. Its content validity and reliability were established by 33 consultants from twenty specialties. A total of 198 medical calls (66 each) were collected from medicine, surgery and allied specialties and evaluated on the basis of validated instrument. Results: During instrument development, six items with content Validity Ratio of 0.78 & Kappa value of 0.70 were deemed most significant in every medical call written. Among all the calls, the great majority (96% and 84.34%) mentioned the reason for referral (item 1) and history of presenting problem (item 2), respectively, while item 6 (explicit mention of the doctor who will receive the call) was addressed the least (17.6%). Item 3 (Result of physical examination) and 4 (what tests have been done/arranged by the referring doctor and a summary of the main findings) were stated in < 30% of the calls whereas item 5 (diagnosis/provisional diagnosis) was specified in less than half of the calls. Conclusion: In this study, the written medical calls of different specialties were evaluated using specifically designed six items instrument. Unfortunately, the content of medical calls assessed was found to be inadequate probably because medical call writing is not explicitly taught at under and postgraduate levels. doi: https://doi.org/10.12669/pjms.36.4.1642 How to cite this:Khan AR, Mahboob U, Baseer N. Do you really get what you are looking for? Exploring the medical call writing trend in tertiary care hospitals. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1642 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Raja - ◽  
Badil - ◽  
Sajid Ali ◽  
Shaheen Sherali
Keyword(s):  
Public Sector ◽  
Tertiary Care ◽  
Medication Administration ◽  
Cross Sectional Study ◽  
University Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Phone Calls ◽  
Medication Administration Errors ◽  
Tertiary Care Hospitals

Objectives: To determine the association of medication administration errors with interruption among nurses working at public sector tertiary care hospitals in Karachi, Pakistan. Methods: An analytical cross-sectional study was accomplished at two public sector healthcare facilities Civil Hospital, and Dow University Hospital, Karachi. The study was carried out from October 2017 to July 2018 over a period of 10 months. The sample was calculated by using OpenEpi version 3.0. By taking 56.4% of medication administration errors, 5% margin of error and 95% confidence level. The calculated sample size was 204 of both genders. The subjects both male and female nurses having a valid license from Pakistan Nursing Council and one year of clinical experience were enrolled in the study. The subjects were approached by using non-probability purposive sampling method. Validated and adapted questionnaire utilized to gather the data. Data was entered and analyzed by using SPSS version 21.0. Results: In this study, total 204 nurses were included, almost half (52%) of them were male. Majority of (82.3%) study participants had age between 25-35 years old. There were total 716 medications given by 204 nurses. Out of these, 295 (41.2%) were antibiotics, other common medications were acid-suppressive, analgesic and antiemetic 14.5%, 15.9% and 11.2% respectively. Among all 716 medications, 644 (89.9%) were given intravenously whereas only 6.7% drugs given orally. A significant association has been found between medication administration errors and interruption like talking with other health care personnel, patients or attendant queries, phone calls (p-value=<0.001). Nearly 91% of the study nurses who were interrupted during medication committed medication errors. Conclusion: It is concluded that there is a significant association between medication administration errors with interruption among nurses. doi: https://doi.org/10.12669/pjms.35.5.287 How to cite this:Raja, Badil, Ali S, Sherali S. Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.287 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sign in / Sign up

Export Citation Format

Share Document