scholarly journals A study on drug therapy issues in the department of medicine of a tertiary care teaching hospital-prospective observational study

2021 ◽  
Vol 10 (12) ◽  
pp. 1405
Author(s):  
Revathi J. ◽  
Venkatesh A. P. ◽  
Aswin C. ◽  
Guru Prasad Mohanta ◽  
Senthilvelan M.
Keyword(s):  
Drug Therapy ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Prolonged Length ◽  
Medical Indication ◽  
Medical College ◽  
Undesirable Event ◽  
Increased Risk ◽  
Improper Use

Background: A drug therapy problem (DTP) is any undesirable event experienced by a patient that involves or is suspected to involve, drug therapy, and that interferes with achieving the desired goals of therapy. The improper use of drugs can lead to patient morbidity and even mortality. DTP s are the clinical territory of the pharmaceutical care practitioner and the resolution of identifying the DTPs help patients to achieve their goals of therapy. Identifying DTPs enables risk quantification and determination of the potential impact of prevention strategies.  DTPs are associated with prolonged length of stay and increased economic burden and results in increased risk of death.Methods: A hospital based, prospective observational study was conducted at department of medicine in Rajah Muthiah medical college and hospital, 80 patients were enrolled in this study based on the inclusion-exclusion criteria. The DTPs were identified using the Cipolle’s method of classification of DTP.Results: The study has shown that 80 of the patients involved in the study had a total of 136 DTPs. An average of 1.7 DTPs were recorded per patient during the study. The most common DTP identified was unnecessary drug therapy accounting to 47%. The absence of valid medical indication was (30%) and (16%) were due to the duplication of therapy. The second most common DTP was unsafe drug for patients, accounting to 45% were due to patient non-compliance and drug interaction which was minor. Need for additional drug therapy was the third most identified accounting 13% were due to medical indication indicate the need of drug therapy.Conclusions: The foremost commonly observed DTP is unnecessary therapy and patient non-compliance to the drugs. The study suggests that DTPs are significantly occurring in hospital can cause the patient for comorbidity, prolonged hospitalization. The study suggests that clinical pharmacist and general practitioners can work together to spot and resolve the DTPs.

A PROSPECTIVE OBSERVATIONAL STUDY ON SURGICAL INDICATIONS FOR SPLENECTOMY IN A TERTIARY CARE CENTER.

2021 ◽  
pp. 18-19
Author(s):  
Vijaya Bhaskara Reddy. M. G ◽  
Salman Ahmed. F ◽  
Santosh Kumar Rajput ◽  
Ganashyam. K. R
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Recent Trend ◽  
Care Center ◽  
Tertiary Care ◽  
Splenic Abscess ◽  
Surgical Indications ◽  
Spleen Preservation ◽  
Medical College ◽  
Operative Outcomes

Background: Spleen mediates important immunologic, storage and hematologic functions. A person can undergo a splenectomy for various causes which includes both surgical and non surgical. The recent trend being towards spleen preservation, it is necessary to critically analyse the indications for splenectomy and assess if the desired post operative outcomes are achieved by splenectomy. Materials and Methods: This prospective observational study was carried out on patients of Department of General Surgery, Mysore Medical College and Research Institute, Mysore, from august 2017 to November 2019. 45 adult subjects (both male and females) aged ≥ 18 years, who underwent elective or emergency splenectomy for various indications were studied. Results: The most common indication for splenectomy was trauma in 27 patients(60%) followed by splenic abscess(15.6%). Most of the patients underwent emergency splenectomy i.e., 25 cases(55%) . In our study the majority received blood transfusion, 15.5% developed wound infection and 2 cases(4.4%) needed reexploration due to rebleeding.

scholarly journals AN OBSERVATIONAL STUDY OF CESAREAN TRENDS AT A TEACHING HOSPITAL IN PUNJAB

2021 ◽  
pp. 109-113
Author(s):  
SUPARNA GROVER ◽  
SUNITA MEENA ◽  
AJAY CHHABRA
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Caesarean Delivery ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Medical College ◽  
Government Hospitals ◽  
Patient Groups ◽  
Group 5

Objectives: The objective of the study was to study the indications and risk factors for caesarean section (CS) and to study the caesarean rates in various patient groups as per Robson’s classification. Methods: This prospective observational study was conducted at Government Medical College Amritsar over a period of six months. All the patients admitted for delivery beyond 22 weeks were allotted to Robson groups on admission and the indications of all CS were recorded. The data collected were tabulated and analyzed statistically. Results: There were 553 deliveries in the study period, of which there were 241 CS amounting to a caesarean rate of 43.6%. Nulliparity, previous caesarean delivery and malpresentation were significant risk factors for CS but induction of labor was not associated with increased probability of caesarean delivery. Previous caesarean delivery was the most common indication of CS followed by foetal distress. Among Robson groups, group 10 had the biggest group size and biggest contribution to cesarean rates followed by group 5. Conclusion: Tertiary care government hospitals have a higher cesarean rates due to referral of high-risk pregnancies. Increasing the rates of trial of labour after caesarean is one of the interventions that may serve to decrease the caesarean rates in such institutions.

scholarly journals Prevalence and pattern of PCOS in women presenting with acne, a hospital based prospective observational study

2018 ◽  
Vol 6 (3) ◽  
pp. 899
Author(s):  
Raja Shareef A. ◽  
P. V. S. Prasad ◽  
P. K. Kaviarasan
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Polycystic Ovarian Syndrome ◽  
Acne Vulgaris ◽  
Strong Association ◽  
Tertiary Care ◽  
Final Analysis ◽  
Endocrine Disorders ◽  
Medical College ◽  
Ovarian Syndrome

Background: Acne is one of the most common dermatological conditions encountered in day to day practice. Many recent studies have reported a strong association between acne and underlying systemic endocrine disorders, more particularly Poly cystic ovarian syndrome. But there is scarcity of literature on the subjects in Indian population. Hence the present study was conducted with an objective of studying the association between acne and polycystic ovarian syndrome, in women presenting with adult onset acne to a tertiary care teaching hospital.Methods: A prospective observational study was carried out in department of dermatology, Dhananalakshmi Srinivasan medical college and hospital, Permabalur from January 2016 to August 2017. The study population included women above 18 years of age clinically diagnosed with acne vulgaris. The presence of polycystic ovarian syndrome was assessed using Rotterdam criteria.Results: The final analysis had included 100 women with acne. The most common type of lesion observed was comedone in 91% of women. The other most common lesions were papule seen in 73%, pustule in 35% of women. The proportion with grade I, Grade II and grade III acne was 58%, 29% and 13% respectively. The prevalence of PCOS was 30% (95% CI 21.89% to 39.58%). PCOS had shown no statistically significant association with age, marital status and regularity of menstrual cycle. The factors which have shown statistically significant association were higher BMI, presence of Hirsutism and higher waist circumference.Conclusions: PCOS is highly prevalent among women with acne. Presence of hirsutism, obesity are strong risk factors for PCOS.

scholarly journals A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia

2017 ◽  
Vol 5 (5) ◽  
pp. 1785 ◽  
Author(s):  
Santosh Kumar Dora ◽  
Lalmohan Nayak ◽  
Benudhar Pande ◽  
Atal Bihari Dandapat
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Medical College ◽  
Labour Room

Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication. 

scholarly journals Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Functional Health ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Post Stroke ◽  
Self Rated Health ◽  
Modifying Factors ◽  
Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

A STUDY OF THE CLINICAL PROFILE OF PATIENTS WITH HYPOSPADIAS AT A TERTIARY CARE CENTRE AT KANPUR, INDIA

2021 ◽  
pp. 65-66
Author(s):  
R. K. Maurya ◽  
Shraddha Verma ◽  
R. K. Tripathi ◽  
Amit Yadav
Keyword(s):  
Prospective Observational Study ◽  
Undescended Testis ◽  
Tertiary Care ◽  
Care Centre ◽  
Common Site ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Treatment History ◽  
Congenital Hernia ◽  
Distal Hypospadias

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study the clinical prole of hypospadias. Settings and Design:This was a prospective, observational study. Methods: This prospective study was conducted at Department of General Surgery, LLR & Associated Hospitals, GSVM Medical College, Kanpur, India, from January 2019 to October 2020, on 72 patients of hypospadias, after taking clearance from the Institutional Ethical Committee, and taking proper informed consent for participation. Data collected for each patient included age, sex, demography, symptoms with duration, and relevant past and treatment history. Results: The most common age of presentation was between 1-5years of age (48.61%, n=35). Distal hypospadias (DH) was the most common site. (47.22%, n=34). 4.16% (n=3) patients presented with urethrocutaneous stula. Chordee was more commonly seen in patients with mid & proximal penile hypospadias (64.70%, n=33). In the present study, 4.1% (n=3) had associated undescended testis, 4.1% (n=3) had an associated bid scrotum and 1.3% (n=1) had an associated congenital hernia. Conclusions: Most cases of hypospadias present before 10 years of age. Distal hypospadias is the most common type. Chordee is associated most commonly with proximal penile and mid penile hypospadias. It may also be associated with other congenital anomalies like, undescended testis, bid scrotum or congenital hernias

Aetiological Outcome of Mesenteric Lymphadenopathy and Pain Abdomen in Paediatric Population at a Tertiary Care Hospital (MRIMSHyderabad) - A Hospital Based Prospective Observational Study

2021 ◽  
Vol 8 (29) ◽  
pp. 2601-2608
Author(s):  
Dileep Kumar Allagadda ◽  
Harikrishna Appana ◽  
Ramu Pedada ◽  
Deepika Gurram ◽  
Ditin Joseph
Keyword(s):  
Abdominal Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Etiological Agent ◽  
Parasitic Infections ◽  
Care Hospital ◽  
Age Group ◽  
Mesenteric Lymphadenitis

BACKGROUND Abdominal pain is a common disorder in children and adolescents worldwide with prevalence rate ranging from 20 - 25 % in school-going children in India. It is a frustrating concern to the child, parents and the physician. Even though abdominal pain is one of the most common complaints in children, it poses a diagnostic challenge owing to the variety of underlying causes. The purpose of this study was to evaluate the aetiology of abdominal pain associated with significant mesenteric lymphadenopathy in a paediatric population. METHODS This is a hospital based prospective, observational study done in Department of Paediatrics, Malla Reddy Institute of Medical Sciences (MRIMS), Hyderabad. RESULTS Out of the 65 children studied, 30.8 % were of 5 - 8 years age group, 36.9 % were 9 - 12 years age group and 32.3 % were 13 - 15 years age group. In our study, we found 50.8 % were boys and 49.2 % were girls. 20 % of them were having fever, 16.9 % were having cough, 16.9 % were having diarrhoea, 13.8 % were having sore throat, 16.9 % dysuria, and 15.4 % were having constipation. All patients in our study group underwent ultrasound of abdomen. All cases were having significant mesenteric lymphadenopathy (more than 5 mm in short axis with three or more number of lymph nodes). In 53.8 % cases, etiological agent for the mesenteric lymphadenopathy was not proved with our investigations. In the remaining 46.2 % of children, cause of mesenteric lymphadenopathy was proved and 38.5 % were bacterial infections, 6.2 % were viral infections and 1.5 % were parasitic infections. CONCLUSIONS It is important to recognise mesenteric lymphadenitis as a clinical entity in paediatric cases presenting with abdominal pain. They should be evaluated for an etiological agent and if no proven source of infection and etiological agent is found, it can be considered as functional abdominal pain. If we are able to get a proper etiological diagnosis in these cases, we could treat them and we could make huge difference in terms of quality of life. KEYWORDS Abdominal Pain, Mesenteric Lymphadenitis, Ultrasound, Significant Mesenteric Lymphadenopathy

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