scholarly journals Mutational Frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in Rifampicin Resistant patients at a tertiary care setting in Urban Sindh, Pakistan: Analysis from a Five-Year Period

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Muhammad Alamgir ◽  
Mehwish Sajjad ◽  
Mirza Saifullah Baig ◽  
Muhammad Yahya Noori
Keyword(s):  
Care Setting ◽  
Tertiary Care ◽  
Rpob Gene ◽  
Cross Sectional Study ◽  
Molecular Probes ◽  
Gene Probe ◽  
Single Mutation ◽  
Cross Sectional ◽  
Creative Commons ◽  
Tertiary Care Setting

Objectives: To assess the mutational frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in rifampicin resistant patients during 2013-2017 at a tertiary care setting in Urban Sindh, Pakistan. Methods: This Retrospective Descriptive Cross-Sectional Study was conducted at the TB laboratories, Ojha Institute of Chest Diseases, Dow University of Health Sciences. The record of 713 positive cases of Rifampicin Resistant Tuberculosis from January 2013 to December 2017 were analysed. These were diagnosed using GeneXpert® that detects mutations in the 81 base pair region of rpoB gene with the help of five molecular probes A, B, C, D and E. All invalid and extra pulmonary samples were excluded. Results: In total, 713 cases were found to be rifampicin resistant during the five-year period, among which 374 (52.45%) were males while 339 (47.55%) were females. Among the five standard probes A, B, C, D and E, 97.48% of the cases had a single mutation. Among these, mutations in Probe E (66.48%) were the most common, followed by Probe B (14.3%) and Probe D (11.08%). Only 13 cases (1.82%) of double mutations and five cases (0.7%) of triple mutations were detected. Conclusion: The rpoB gene Probe E region 529-533 appears the most potent site for a mutation and development of rifampicin resistance in the rpoB gene in Mycobacterium tuberculosis, that encodes the β-subunit of RNA polymerase. The most affected age-group in both males and females is 19-45 Years. doi: https://doi.org/10.12669/pjms.37.4.3875 How to cite this:Alamgir M, Sajjad M, Baig MS, Noori MY. Mutational Frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in Rifampicin Resistant patients at a tertiary care setting in Urban Sindh, Pakistan: Analysis from a Five-Year Period. Pak J Med Sci. 2021;37(4):1151-1154. doi: https://doi.org/10.12669/pjms.37.4.3875 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 Role of ultrasonography in childhood eye diseases in a tertiary care setting: indications and scope

2019 ◽  
Vol 50 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Ritika Mukhija ◽  
Amar Pujari ◽  
Rashmi Singh ◽  
Shreya Nayak ◽  
Vipul Singh ◽  
...  
Keyword(s):  
Care Setting ◽  
Ocular Trauma ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Congenital Glaucoma ◽  
Eye Disease ◽  
Cross Sectional ◽  
Diagnostic Potential ◽  
Tertiary Care Setting

We sought to evaluate the role and diagnostic potential of ocular B-scan ultrasonography in childhood eye disease in an observational cross-sectional study; 1091 patients with a total of 1445 eyes examined were studied. Cataract was the single most common indication for ultrasound followed by corneal pathology, ocular trauma, posterior segment pathology, primary congenital glaucoma, leukocoria, orbital pathology and other disease. Ultrasonography resulted in a change in diagnosis in 198 cases (18%). We conclude that B-scan ultrasonography plays an important adjunctive role in the management of childhood eye disease.

Qt Dispersion and Signal-Averaged Electrocardiogram in Hemodialysis and Capd Patients

2001 ◽  
Vol 21 (2) ◽  
pp. 186-194 ◽  
Author(s):  
Alaattin Yildiz ◽  
Vakur Akkaya ◽  
Sevgi Sahin ◽  
Tufan Tükek ◽  
Mine Besler ◽  
...  
Keyword(s):  
Care Setting ◽  
Tertiary Care ◽  
Qt Dispersion ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Lv Mass ◽  
Qrs Duration ◽  
Tertiary Care Setting

Objective The aim of this study was to compare QT dispersion (QTd) and signal-averaged electrocardiogram (SA-ECG) parameters that may predict risk of malignant arrhythmias in patients on hemodialysis (HD), on continuous ambulatory peritoneal dialysis (CAPD), and in controls. Setting Controlled cross-sectional study in a tertiary- care setting. Patients 28 HD (M/F 18/10; mean age 32 ± 9 years), 29 CAPD (M/F 17/12; mean age 34 ± 10 years), and 29 healthy controls (M/F 17/12; mean age 32 ± 8 years) were included. Interventions On ECG, minimum (QTmin) and maximum (QTmax) QT duration and their difference (QTd) were measured. In SA-ECG, duration of filtered QRS, HFLA signals less than 40 μV, and RMS voltage (40 ms) were also measured. Results Higher serum Ca2+ and lower K+ levels were found in CAPD compared to HD. All QT parameters were increased in HD and CAPD compared to controls. QT dispersion was significantly prolonged in HD compared to CAPD. In HD, QTd was correlated with left ventricular (LV) mass index ( r = 0.53, p = 0.004), but not in CAPD ( r = -0.09, p = 0.63). QT dispersion was significantly prolonged in patients with LV hypertrophy compared to patients without hypertrophy on HD (68 ± 18 ms vs 49 ± 18 ms, p = 0.008). In the analysis of SA-ECG, 3 of the 28 (11%) HD and 2 of the 29 (7%) CAPD patients had abnormal late potentials. Patients on HD and CAPD had significantly higher filtered-QRS duration compared to controls (105 ± 15 ms and 104 ± 12 ms vs 95 ± 5 ms, respectively, p = 0.04). Patients with LV hypertrophy had higher filtered-QRS duration compared to patients without hypertrophy (109 ± 12 ms vs 95 ± 8 ms, p < 0.001). Conclusion Dialysis patients had prolonged QTd and increased filtered-QRS duration in SA-ECG compared to controls. Patients on HD had longer QTd than patients on CAPD. QTd has been correlated to LV mass index in HD, but not in CAPD. This difference might be due to the effect of different dialysis modalities on electrolytes, especially the higher serum Ca2+ levels.

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 Burnout among clinicians in tertiary care setting

2018 ◽  
Vol 5 (3) ◽  
pp. 1157 ◽  
Author(s):  
Rajya Lakshmi Chepuru ◽  
Siva Kumar Lotheti ◽  
Devi Madhavi Bhimarasetty
Keyword(s):  
Emotional Exhaustion ◽  
Work Experience ◽  
Care Setting ◽  
Tertiary Care ◽  
Working Hours ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
Three Dimensions ◽  
Cross Sectional

Background: “Burnout” is defined as a state of physical, emotional and mental exhaustion, or a coping mechanism to working conditions that are stressful, demanding and lack of recognition. Effects of burnout are many and can eventually threaten one’s job satisfaction, relationship and also health. High patient load, long working hours, poor logistics and infrastructure support and unreasonable demands from patients make clinicians vulnerable for stress and burnout. Objective was to study the prevalence of burn out in clinicians and factors associated with burnout.Methods: The study was an observational descriptive cross-sectional study conducted among Doctors in clinical departments of a Tertiary Medical care setting in October-November 2015. Sample size was 97. Study was conducted using Maslach Burnout Inventory with additional questions on demographic factors, work experience, hours of work and speciality. The inventory comprised 22 items on a seven-point Likert scale. Frequency of symptoms (ranging from ‘0=never’ to ‘6=every day’). Burnout was measured in three dimensions - emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). The data was collected after taking Institutional ethics committee approval and verbal consent from participants. Data was analyzed using MS Excel 2007.Results: About 15% 0f clinicians showed high emotional exhaustion, 9% high depersonalization, and 18% low Personal accomplishment. More Females showed burnout than males and more clinicians from surgical branches showed burnout when compared to medical branches.Conclusions: Burnout exists among healthcare professionals and measures should be taken to identify causes and take remedial actions.

scholarly journals Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Ayesha Muneer ◽  
Attia Bari ◽  
Arslan Haider ◽  
Agha Shabbir Ali
Keyword(s):  
Health Care Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Job Descriptions ◽  
Cross Sectional ◽  
Creative Commons ◽  
Postgraduate Qualification

Objective: To analyze the knowledge of the doctors dealing with pediatric patients about neonatal resuscitation. Methods: This was a cross sectional study conducted at The Lahore General Hospital over one year. Total 137 doctors related to pediatrics with different job descriptions were enrolled and requested to fill a questionnaire proforma regarding their knowledge about basic equipment required and about neonatal resuscitation steps. Data was entered and analyzed using SPSS 20. Results: Out of 137 participants, majority (71%) had >2 years of experience in pediatrics and 52.5% had higher postgraduate qualification. Neonatal resuscitation workshop was attended by 57% doctors. In resuscitation of newborns at the time of delivery, resuscitating doctors were assisted by nurse in 50%, by junior doctor in 35%, paramedic staff 11% and it was done by single doctor in 4% cases. Oxygen (central or O2 cylinder) and warmer facilities were available in 90% and 82% of health facilities respectively. Majority (86%) of participants were of view that every neonate must be attended at birth. Not a single doctor followed all the standard steps of neonatal resuscitation although 90% had knowledge about resuscitation equipment and common resuscitation drugs. Conclusion: Pediatric health care professionals had knowledge about neonatal resuscitation but there are gaps in the practical application. There is a strong need of frequent neonatal resuscitation workshops for improving neonatal outcomes. doi: https://doi.org/10.12669/pjms.35.3.987 How to cite this:Muneer A, Bari A, Haider A, Ali AS. Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.987 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 Evaluation and Treatment of Perioperative Corneal Abrasions

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kira L. Segal ◽  
Peter M. Fleischut ◽  
Charles Kim ◽  
Ben Levine ◽  
Susan L. Faggiani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Care Setting ◽  
Tertiary Care ◽  
Significant Risk ◽  
Anesthesia Care ◽  
Artificial Tears ◽  
Cross Sectional ◽  
Corneal Abrasion ◽  
Estimated Blood Loss ◽  
Tertiary Care Setting

Purpose.To evaluate perioperative risk factors for corneal abrasion (CA) and to determine current care for perioperative CA in a tertiary care setting.Methods.Hospital-based, cross-sectional study. In Operating Room and Post-Anesthesia Care Units patients, a comparison of cases and controls was evaluated to elucidate risk factors, time to treatment, and most common treatments prescribed for corneal abrasions.Results.86 cases of corneal abrasion and 89 controls were identified from the 78,542 surgical procedures performed over 2 years. Statistically significant risk factors were age (P=0.0037), general anesthesia (P<0.001), greater average estimated blood loss (P<0.001), eyes taped during surgery (P<0.001), prone position (P<0.001), trendelenburg position (P<0.001), and supplemental oxygen en route to and in the Post-Anesthesia Care Units (P<0.001). Average time to complaint was 129 minutes. 94% of cases had an inpatient ophthalmology consult, with an average time to consult of 164 minutes. The most common treatment was artificial tears alone (40%), followed by combination treatment of antibiotic ointment and artificial tears (35.3%).Conclusions.Trendelenburg positioning is a novel risk factor for CA. Diagnosis and treatment of perioperative corneal abrasions by an ophthalmologist typically require three hours in the tertiary care setting.

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.

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