scholarly journals Cost Analysis of Haemodialysis Patients in Government Tertiary Care Centre – A Pharmacoeconomic Study

2021 ◽  
Vol 6 (2) ◽  
pp. 94
Author(s):  
Manjula MJ ◽  
Deepak P ◽  
Suresh R M ◽  
Raghu N
Keyword(s):  
Middle Class ◽  
Medical Cost ◽  
Low Income ◽  
Rural Areas ◽  
Low Cost ◽  
Treatment Options ◽  
Tertiary Care ◽  
Pharmacoeconomic Study ◽  
Tertiary Care Centre ◽  
Dialysis Unit

The progression of chronic kidney disease (CKD) to End-Stage Renal Disease (ESRD) in India is rapidly increasing. Over 25 million of people suffering from ESRD, especially in rural areas. Many of these patients are not undergoing dialysis due to the factors such as lack of awareness, fewer treatment options, unaffordability prices due to low income, and minor reimbursement for chronic illness. The cost of hemodialysis in private hospitals is around 12.000 INR (Indian Rupee) per person monthly and 140.000 INR per year, which seem too expensive for middle and lower-middle-class of patients. Hence our study was aimed to analyze the healthcare cost of hemodialysis in government tertiary health care centers by analyzing the direct and indirect cost from the patient perspective. Sixty patients who underwent dialysis in Hassan Institute of Medical Sciences Teaching Hospital were included in this study. The demographic details, past and present medical history, cost per session of dialysis, laboratory examination, money spent on travel, and the working days lost were calculated. Out of 60 patient (male: 47; female: 17), 53 patients aged 18-65 years old. They belonged to lower-middle (38.33%), middle (23.33%), lower (21.66%), and upper-middle-class (8%). The average direct medical cost of each patient in one session of dialysis was 481.5 INR and indirect medical costs were 557.33 INR. Based on our observation, we conclude that the patients are having satisfactory outcomes, comparatively at low cost in our government dialysis unit. Government should encourage and also cover the mobile dialysis centers under government health schemes, by which the indirect medical cost can be reduced. 

scholarly journals IV Paracetamol for closure of patent ductus arteriosus in preterm neonates admitted to a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 294 ◽  
Author(s):  
Sunil B. ◽  
Shruthi Patel ◽  
Girish N.
Keyword(s):  
Side Effects ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Tertiary Care ◽  
Current Treatment ◽  
Preterm Neonates ◽  
Tertiary Care Centre ◽  
Vascular Connection ◽  
Intravenous Paracetamol

Background: Ductus arteriosus is a vascular connection between the pulmonary artery and descending aorta. The incidence is inversely related to birth weight and gestational age (GA). In preterm infants it varies between 40% and 60% on the third day of life. At present, the choice of treatment of clinically significant PDA is with either ibuprofen or indomethacin, but they carry many contraindications and potential side effects. Hence it is important to consider that paracetamol may be used as an alternative to other non steroidal anti-inflammatory drugs and is effective in ductal closure with minimal side effects.Methods:Thirty six preterm infants with hemodynamically significant PDA(hs-PDA) were treated with intravenous paracetamol and subsequent closure was evaluated clinically and by follow-up 2D-Echo.Results: PDA closure following intravenous paracetamol was evident in 27 babies (75%). There were no significant side effects noted with paracetamol therapy.Conclusions: This study shows that paracetamol could offer favourable safety profile in comparison to current treatment options. Therefore, paracetamol may be accepted as a first-line drug treatment for PDA in preterm infants. 

scholarly journals CLINICOPATHOLOGICAL STUDY OF CARCINOMA ORAL CAVITY & PATTERN OF METASTASIS- EXPERIENCE IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 1-3
Author(s):  
Bijan Basak ◽  
Soutrik Kumar ◽  
Kaustuv Das Biswas ◽  
Sayan Hazra ◽  
Debarshi Jana
Keyword(s):  
Indian Subcontinent ◽  
Treatment Options ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Tertiary Care Centre ◽  
Major Health Problem ◽  
Node Metastases ◽  
Long Term Prognosis ◽  
Head Neck Surgery ◽  
Head Neck

Oral cancer (code 145.9, ICD 9) encompasses all malignancies originating in oral tissues & it is a major health problem in many parts of the world. Although incidence is relatively low in the western countries, in the Indian subcontinent & other parts of Asia it remains one of the commonest cancers. The study was conducted on the patients attending the ENT & HEAD-NECK SURGERY OPD at the INSTITUTE OF OTORHINOLARYNGOLOGY & HEAD-NECK SURGERY, IPGME&R, Kolkata during a period of 1 year from 1st March 2019 to 29th February 2020. Buccal mucosa was the commonest site & most cases presented in late stage with cervical lymph node metastases entailing poorer prognosis. People should be made aware of the warning symptoms, need for early diagnosis & treatment options available through IEC (information, education & communication programmes) in order to provide better treatment outcomes, improved long term prognosis & thereby reducing the morbidity & mortality of people at large.

scholarly journals Clinical study of multiple myeloma and treatment responses in a tertiary care centre

2021 ◽  
Vol 9 (11) ◽  
pp. 3356
Author(s):  
Immanni S. M. Giridhar ◽  
C. Deepak Yadlapalli ◽  
Muralidhar Gullipalli ◽  
Venkatesh Mushini ◽  
Yerraguntla S. Sarma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Staging System ◽  
Stage Iiib ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Incurable Disease ◽  
Unknown Significance

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden.

scholarly journals Region wise referrals to a tertiary care centre: a retrospective analysis

2019 ◽  
Vol 8 (12) ◽  
pp. 4678
Author(s):  
Sirisha Paidi ◽  
Aashritha Thonangi
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Urban Rural ◽  
King George Hospital ◽  
Tribal Areas

Background: Emergency obstetric care in health care requires a linked referral system to be effective in reducing maternal morbidity and mortality. This review is aimed at summarizing the proportion of referrals from urban, rural and tribal areas of surrounding districts to tertiary care centre, King George Hospital, Visakhapatnam for a 6 month period; from May 2018 to October 2018.Methods: Retrospective study done at a tertiary care teaching hospital, including 3157 cases referred from the surrounding urban, rural and tribal areas.Results: Out of the 3157 referred cases, most of them (1658) were from rural areas, 1030 from urban and 469 from tribal areas. Referrals done in view of post caesarean pregnancies were more in urban and rural areas whereas more preeclampsia and anaemia cases were referred from tribal areas. Various indications of referral are documented. Majority of them were unbooked cases.Conclusions: Specific guidelines regarding whom to refer, how to refer and when to refer would be helpful in making timely referral. These would also help to decrease the burden on the tertiary care centers which deal with a huge caseloads in spite of limited infrastructure and manpower. Adequate attention and better care can be given to complicated cases if the total case load is reduced. Stringent documentation in referral slip and better co-ordination are required for a strong health care system.

scholarly journals Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

2019 ◽  
Vol 8 (2) ◽  
pp. 425
Author(s):  
Shruti Uniyal ◽  
Ritika Agarwal ◽  
Nupur Nandi ◽  
Pulkit Jain
Keyword(s):  
Observational Study ◽  
Low Socioeconomic Status ◽  
Treatment Options ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Skin Lesions ◽  
Personal Hygiene ◽  
Tertiary Care Centre ◽  
Palmar Erythema ◽  
In Pregnancy

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.

scholarly journals P042: Use of technology to create economically sustainable supplemented triage: a feasibility study at an urban tertiary care centre

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S92-S92
Author(s):  
C.H. Filipowska ◽  
L. Mazurik
Keyword(s):  
Patient Flow ◽  
Low Cost ◽  
Tertiary Care ◽  
Physician Assistants ◽  
Process Chain ◽  
Tertiary Care Centre ◽  
Use Of Technology ◽  
Average Patient ◽  
Patient Arrival ◽  
Test Ordering

Introduction: Decreasing patient Length of Stay (LOS) in the Emergency Department (ED) improves patient safety. Numerous studies have taken differing approaches to supplementing care at triage in order to decrease LOS, however, have not proven to be financially sustainable. The goal of this study was to explore financially viable options to expedite care in a safe way and reduce patient LOS. Methods: The ED process chain was identified. Two reviewers observed triage for a 4-hour period following patients. Times from patient arrival to: completion of triage, completion of registration, test ordering, physician assessment and final disposition were measured. Results were presented at departmental rounds. Nursing staff, Physician Assistants, Residents and Physician staff were paired in interdisciplinary groups to brainstorm and trial approaches to expedited test ordering and use of technology to carry out orders. Results: Triage interruptions increased time to triage a patient up to 3 times baseline, and 33% of triage interactions were interrupted. A bottleneck occurred at registration, increasing time to be registered by up to 30 minutes. Also, registration is using antiquated technology, significantly increasing registration time. Average patient LOS was 249 min, but was only 120 min if there was no delay in test ordering for patients. Average time for MD disposition was 129 min, but was only 47 minutes if there was no delay in ordering tests. Brainstorming lead to the following ideas: 1) use of companion phones to access already-working ED MD for test ordering and ECG interpretation 2) the use of the computer system to flag new orders or ECG for triage patients 3) use of a dedicated iPad in zones 4) increased standing orders for RNs to order diagnostic imaging. Conclusion: Patient LOS was reduced by lack of delay in test ordering, in keeping with previous studies. Numerous points in the process chain were identified for creating an economically sustainable supplemented triage to improve patient flow. These were: interruptions to triage, registration bottleneck, technology at registration, test ordering at triage. Ways in which to effectively order tests at triage include: MD-companion phones, pre-existing computer program, dedicated iPad in zones. The next step in this study is to trial each of these low-cost technologies.

scholarly journals Pediatric Interstitial Lung Disease Masquerading as Difficult Asthma: Management Dilemmas for Rare Lung Disease in Children

2005 ◽  
Vol 12 (6) ◽  
pp. 317-320 ◽  
Author(s):  
EY Chan ◽  
Sharon D Dell
Keyword(s):  
Lung Disease ◽  
Bronchiolitis Obliterans ◽  
Treatment Options ◽  
Tertiary Care ◽  
Asthma Management ◽  
Open Lung Biopsy ◽  
Tertiary Care Centre ◽  
Exertional Dyspnea ◽  
Syncytial Virus ◽  
Difficult Asthma

Idiopathic nontransplant-related childhood bronchiolitis obliterans is an uncommon disease. Most patients present with chronic recurrent dyspnea, cough and wheezing, which are also features of asthma, by far a much more common condition. The present case study reports on a six-year-old girl who presented to a tertiary care centre with recurrent episodes of respiratory distress on a background of baseline tachypnea, chronic hypoxemia and exertional dyspnea. Her past medical history revealed significant lung disease in infancy, including respiratory syncytial virus bronchiolitis and repaired gastroesophageal reflux. She was treated for 'asthma exacerbations' throughout her early childhood years. Bronchiolitis obliterans was subsequently diagnosed with an open lung biopsy. She did not have sustained improvement with systemic corticosteroids, hydroxychloroquine or clarithromycin. Cardiac catheterization confirmed the presence of secondary pulmonary hypertension. Treatment options remain a dilemma for this patient because there is no known effective treatment for this condition, and the natural history is not well understood. The present case demonstrates the need for careful workup in 'atypical asthma', and the urgent need for further research into the rare lung diseases of childhood.

scholarly journals Potential of ceramic and biosand water filters as low-cost point-of-use water treatment options for household use in Nigeria

2020 ◽  
Author(s):  
Ebele Erhuanga ◽  
Maingaila Moono Banda ◽  
Doutimiye Kiakubu ◽  
Isah Bolaji Kashim ◽  
Bioye Ogunjobi ◽  
...  
Keyword(s):  
Drinking Water ◽  
Water Treatment ◽  
Rural Areas ◽  
Filter Design ◽  
Low Cost ◽  
Treatment Options ◽  
Household Water Treatment ◽  
Sustainable Solutions ◽  
Household Water ◽  
Water Filters

Abstract Many households in Nigeria lack access to safe drinking water. Sixty-three percent (63%) of the nation's population live in rural areas where only 3% of households have access to safely managed drinking water. This suggests an urgent need for intervention to offer sustainable solutions to drinking water needs at household levels. An operational research was commissioned by the United Nations Children's Fund (UNICEF) Nigeria to generate evidence to inform and guide Water, Sanitation and Hygiene (WASH) programming on household water quality. This involved an assessment of local manufacturing of household water filters; factors influencing social acceptability and market opportunities for clay and biosand water filters in Nigeria. Implementation of the research recommendations by the filter factories resulted in improved bacterial removal efficiency (>97%) in filters. Factors such as filter design and efficiency were shown to influence acceptability of filters, which influenced the price at which users were willing to pay for the filters in the study areas. The market research indicated low popularity of the filters due to lack of promotion and marketing of the water filters. The research outcomes show great potential for sustainability and marketability of clay and biosand water filters for household water treatment in Nigeria.

scholarly journals Study of social and demographic determinants of severe acute malnutrition in children aged 6-59 months in a tertiary care centre of Odisha, India

2018 ◽  
Vol 6 (1) ◽  
pp. 46
Author(s):  
Pravati Jena ◽  
Soumini Rath ◽  
Manas Kumar Nayak ◽  
Diptirekha Satapathy
Keyword(s):  
Low Socioeconomic Status ◽  
Rural Areas ◽  
Health Care Services ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Study Population

Background: The objective is to study the various social and demographic determinants of severe acute malnutrition in children aged 6 months to 59 months in a tertiary care centre of Odisha, India.Methods: This is a hospital based prospective observational study done in a tertiary care centre of Odisha during the period of Nov 2015 to Oct 2017 in which all children with severe acute malnutrition as per WHO criteria in the age group 6 months to 59 months were enrolled and their socioeconomic and demographic details were evaluated.Results: Present study revealed a prevalence of severe acute malnutrition as 2.8%. Males (54.2%) were more affected than females (45.8%). Most common age group affected was 6-12 months (37.4%). Most of the children were from low socioeconomic status (96.4%) and from rural areas (84.8%).63.7% of the study population were unimmunised. Only 12.6% of the participants were exclusively  breast fed.100% of the children in the study population received top feeding with cow’s milk.Conclusions: The prevalence of malnutrition is high in Odisha but most of the causative factors are preventable. Adequate education regarding exclusive breastfeeding, complementary feeding, immunisation, promotion of proper referral and health care services can help to improve nutritional status in the state of Odisha.

scholarly journals IndoorCare: Low-Cost Elderly Activity Monitoring System through Image Processing

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6051
Author(s):  
Daniel Fuentes ◽  
Luís Correia ◽  
Nuno Costa ◽  
Arsénio Reis ◽  
José Ribeiro ◽  
...  
Keyword(s):  
Low Income ◽  
Assisted Living ◽  
Rural Areas ◽  
Low Cost ◽  
Elderly Care ◽  
Ambient Assisted Living ◽  
The Elderly ◽  
Case Scenario ◽  
Care Services ◽  
Socially Excluded

The Portuguese population is aging at an increasing rate, which introduces new problems, particularly in rural areas, where the population is small and widely spread throughout the territory. These people, mostly elderly, have low income and are often isolated and socially excluded. This work researches and proposes an affordable Ambient Assisted Living (AAL)-based solution to monitor the activities of elderly individuals, inside their homes, in a pervasive and non-intrusive way, while preserving their privacy. The solution uses a set of low-cost IoT sensor devices, computer vision algorithms and reasoning rules, to acquire data and recognize the activities performed by a subject inside a home. A conceptual architecture and a functional prototype were developed, the prototype being successfully tested in an environment similar to a real case scenario. The system and the underlying concept can be used as a building block for remote and distributed elderly care services, in which the elderly live autonomously in their homes, but have the attention of a caregiver when needed.

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