scholarly journals The dilemma of using physical restraint in delirium tremens: a case report

2019 ◽  
Vol 7 (8) ◽  
pp. 3172
Author(s):  
Yogender Kumar Malik ◽  
Debasish Basu ◽  
Chandrima Naskar
Keyword(s):  
Case Report ◽  
Clinical Setting ◽  
Tertiary Care ◽  
Delirium Tremens ◽  
Physical Restraint ◽  
Common Presentation ◽  
Usual Dose ◽  
High Level ◽  
Tertiary Care Hospitals ◽  
Higher Doses

Delirium tremens (DT) is a common presentation in tertiary care hospitals. Refractory DT, though not very common, is a dreaded presentation in any clinical setting. Usually, patients with DT respond to standard doses of benzodiazepines, but sometimes we encounter patients requiring higher than the usual dose. Also, due to the high level of agitation, confusion and hallucinatory behaviour, physical restraint is frequently used in these patients. We hereby report a case of refractory DT in whom the dilemma of using physical restraint and need for higher doses of Benzodiazepine has been highlighted.

scholarly journals Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature

2016 ◽  
Vol 8 (1) ◽  
pp. 66-68
Author(s):  
Thankam Varma ◽  
Shashidhar Boraiah
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Review Of The Literature ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Scar ◽  
Maternal Morbidity And Mortality ◽  
Tertiary Care Hospitals

ABSTRACT Cesarean scar ectopic pregnancy is becoming increasingly common in tertiary care hospitals. Cesarean scar pregnancy is a rare type of ectopic pregnancy associated with complications, such as uterine rupture, uncontrollable bleeding which may lead to hysterectomy and increased maternal morbidity and mortality and subsequent infertility. Options available for treatment, such as dilatation and curettage, excision of trophoblastic tissues using laparotomy or laparoscopy, systemically administered methotrexate, and more recently uterine artery embolization. We report two such cases between 2012 and 2013 managed conservatively. How to cite this article Boraiah S, Varma T, Shankar K. Cesarean Scar Ectopic Pregnancy: Case Report and Review of the Literature. J South Asian Feder Obst Gynae 2016;8(1):66-68.

scholarly journals Acute pancreatitis in pregnancy: A 10-year, multi-center, retrospective study in Beijing

2021 ◽  
Author(s):  
Tingting Zhang ◽  
Guoxing Wang ◽  
Zheng Cao ◽  
Wenyang Huang ◽  
Hongli Xiao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Common Causes ◽  
High Level ◽  
Tertiary Care Hospitals ◽  
Beijing China ◽  
In Pregnancy

Abstract Objective Acute pancreatitis in pregnancy (APIP) is a rare and serious complication during pregnancy. It has acute onset and is difficult to diagnose and treat. The aim of the present study was to describe the etiology, clinical manifestations, and maternofetal outcomes of APIP. Methods We retrospectively reviewed 32 pregnant women who were treated at three tertiary care hospitals in Beijing, China. The correlation between the causes of APIP, severity, laboratory indices, and outcomes was analyzed. Results The most common causes of APIP were hypertriglyceridemia (56.2%,18/32) and gallstones (28.1%, 9/32). Hypertriglyceridemia-induced APIP was associated with a higher rate of severe acute pancreatitis (P = 0.025). Serum level of triglycerides showed a positive correlation with the severity of APIP (P = 0.039). The most frequent presentation of APIP was abdominal pain (93.7%, 30/32). There were no maternal or fetal deaths in our study. Neonatal asphyxia was correlated with the severity of APIP (P = 0.039). Conclusion High level of triglycerides may serve as a useful marker of the severity of APIP. The severity of APIP was associated with higher risk of neonate asphyxia. Appropriate timing of termination of pregnancy is a key imperative for APIP patients.

CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Infectious Diseases ◽  
East Asia ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
South East Asia ◽  
Immunization Status ◽  
Tertiary Care Hospitals ◽  
Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

Study of Mortality Patterns among Hospitalized Patients in Public Sector Tertiary Care Hospitals Faisalabad, Pakistan

2017 ◽  
Vol 11 (3) ◽  
pp. 238-242
Author(s):  
Muhammad Arif Ali ◽  
Ayesha Arif ◽  
Tehreem Fatima ◽  
Muhammad Moaaz Arif
Keyword(s):  
Public Sector ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Tertiary Care Hospitals

scholarly journals Interhospital referral of colorectal cancer patients: a Dutch population-based study

2021 ◽  
Author(s):  
A. K. Warps ◽  
◽  
M. P. M. de Neree tot Babberich ◽  
E. Dekker ◽  
M. W. J. M. Wouters ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Waiting Time ◽  
Secondary Care ◽  
Advanced Disease ◽  
Waiting Times ◽  
Tertiary Care ◽  
Disease Stage ◽  
Colorectal Cancer Patients ◽  
Tertiary Care Hospitals

Abstract Purpose Interhospital referral is a consequence of centralization of complex oncological care but might negatively impact waiting time, a quality indicator in the Netherlands. This study aims to evaluate characteristics and waiting times of patients with primary colorectal cancer who are referred between hospitals. Methods Data were extracted from the Dutch ColoRectal Audit (2015-2019). Waiting time between first tumor-positive biopsy until first treatment was compared between subgroups stratified for referral status, disease stage, and type of hospital. Results In total, 46,561 patients were included. Patients treated for colon or rectal cancer in secondary care hospitals were referred in 12.2% and 14.7%, respectively. In tertiary care hospitals, corresponding referral rates were 43.8% and 66.4%. Referred patients in tertiary care hospitals were younger, but had a more advanced disease stage, and underwent more often multivisceral resection and simultaneous metastasectomy than non-referred patients in secondary care hospitals (p<0.001). Referred patients were more often treated within national quality standards for waiting time compared to non-referred patients (p<0.001). For referred patients, longer waiting times prior to MDT were observed compared to non-referred patients within each hospital type, although most time was spent post-MDT. Conclusion A large proportion of colorectal cancer patients that are treated in tertiary care hospitals are referred from another hospital but mostly treated within standards for waiting time. These patients are younger but often have a more advanced disease. This suggests that these patients are willing to travel more but also reflects successful centralization of complex oncological patients in the Netherlands.

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