scholarly journals A case series of cyclic vomiting syndrome in paediatric patients at a tertiary care hospital in Chennai, Tamil Nadu, India

2018 ◽  
Vol 6 (1) ◽  
pp. 118
Author(s):  
Ruchi R. Mittal ◽  
Latha Ravichandran ◽  
Elayaraja Elayaraja
Keyword(s):  
Tamil Nadu ◽  
Tertiary Care ◽  
Case Series ◽  
Cyclic Vomiting Syndrome ◽  
Care Hospital ◽  
Severe Nausea ◽  
Paediatric Patients ◽  
The Mean ◽  
Cyclic Vomiting

Background: Cyclic vomiting syndrome is an increasingly recognized disorder with sudden, repeated episodes of severe nausea, vomiting, and physical exhaustion that occur with no apparent cause. It is more common in children than adults. However, we don’t often see a diagnosis of cyclic vomiting syndrome being made. Hereby we report 7 cases of cyclical vomiting.Methods: This is a retrospective study. Medical records of 5 years were review and consecutive paediatric patients discharged with a diagnosis of cyclic vomiting syndrome were identified, data collected and analysed.Results: Total of 7 cases were found, all of which were adolescents. The mean age was 13.28. 57.14% (4) were females and 42.86% (3) were boys. 42.86% (3) presented with complications. 14.28% (1) had an association with menstrual cycles and 14.28% (1) had an association with psychological stress.Conclusions: Cyclic vomiting syndrome should be kept in mind when a child presents with multiple episodes of vomiting, especially when repeated admissions have been made for the same. Early diagnosis and treatment can improve the quality of life.

Spinal Surgery During COVID-19 Pandemic in Saudi Arabia

2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Tertiary Care ◽  
Case Series ◽  
Medical Intervention ◽  
Care Hospital ◽  
Hospital Data ◽  
Chi Square ◽  
Chi Square Test ◽  
The Mean ◽  
American Society

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.

Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

2020 ◽  
pp. 1-8
Author(s):  
Saima Kanwal ◽  
Sara Sajid ◽  
Noreen Nasir ◽  
Syed Ahsan ◽  
Aysha Almas
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Heat Stroke ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Related Factors ◽  
Hospital Perspective ◽  
The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...  

scholarly journals A comparative study to determine intermittent versus continuous phototherapy for reducing neonatal hyperbilirubinemia at tertiary care hospital in Chennai, Tamil Nadu, India

2019 ◽  
Vol 6 (6) ◽  
pp. 2287
Author(s):  
Diksha Suri ◽  
Krithika A. P. ◽  
R. Somasekar
Keyword(s):  
Tamil Nadu ◽  
Tertiary Care ◽  
Mean Difference ◽  
Neonatal Hyperbilirubinemia ◽  
Serum Total Bilirubin ◽  
Care Hospital ◽  
The Mean ◽  
The Difference ◽  
Sensory Neural

Background: Phototherapy is safe and effective in neonatal hyperbilirubinemia. Despite its worldwide application, questions regarding methods of optimizing efficacy remain unanswered, turning the infant is believed to be one of the methods to improve. Severe neonatal hyperbilirubinemia is associated with kernicterus, condition characterized by athetoid spasticity, gaze and visual abnormalities, and sensory-neural hearing loss. It may also be associated with mental retardation. Aim of this study was conducted to compare the efficacy of intermittent with continuous phototherapy.Methods: Study was conducted in 100 neonates from February 2018 to July 2018 in Sree Balaji medical college and hospital. Inclusion criteria were weight >2000 grams, absence of other concomitant diseases, and hyperbilirubinemia not requiring exchange transfusion. The neonates were randomly divided into two groups. Continuous phototherapy group received phototherapy on and off for 2 hours and half an hour respectively and the intermittent phototherapy group on and then off for one hour. Serum total bilirubin levels were measured in every 36 hours.Results: Mean age of the patients was 3.89±1.83(p=.91) days, mean baseline bilirubin was 17.56mg/dl±1.42 (p=0.36), while the mean follow-up bilirubin was 12.85mg/dl±1.65 (p=.95), and the mean difference between the baseline and follow-up bilirubin was 4.7 mg/dl±1.19 (p=.32). For group A and B babies, the mean difference between the baseline and follow-up bilirubin was 4.78 mg/dl±1.20 (p=.32) and 4.63mg/dl±1.18(p=0.32) respectively. The difference between the mean age, mean baseline bilirubin, mean follow-up bilirubin, and the mean decrease in bilirubin for both the groups was statistically not significant.Conclusions: Intermittent and continuous phototherapies were found to be equally effective for reducing neonatal hyperbilirubinemia.

scholarly journals Functional status of COVID-19 patients at discharge from acute care

2021 ◽  
Vol 8 (1) ◽  
pp. 38
Author(s):  
Geete Dipti B. ◽  
Jaimala Shetye V. ◽  
Gawade Krutika D.
Keyword(s):  
Quality Of Life ◽  
Functional Status ◽  
Acute Care ◽  
Gait Speed ◽  
Tertiary Care ◽  
Case Series ◽  
Breath Holding ◽  
Care Hospital ◽  
Speed Test

<p class="abstract">Coronavirus disease 2019 (COVID-19) is a multisystem illness that can affect a person's mental and physical health exhibiting various physiological and behavioural symptoms. The long-term consequence of COVID -19 affects the quality of life of these patients. The quality of life depends on the status of the physical function. Hence the need to focus on post-COVID rehabilitation in addition to already existing acute care Physiotherapy. This case series, describes functional status of 5 patients at the time of discharge from the Tertiary Care Hospital. The evaluation is done on the day of discharge of each patient using six outcomes, namely Breath Holding Time, 1 Minute Sit to Stand Test, 6 Minute Walk test, Heel Raise Test, 4 Meter Gait Speed Test and muscle strength, to study the functional status. All the patients showed impairment in musculoskeletal capacity (one MSTS, manual muscle test, Heel raise test), functional capacity (6 MWT), lung capacity (BHT) and gait speed as compared to their normal values.This case series brings out the reduced functional status of COVID-19 patients in all domains of fitness at discharge. Thus, there is a dire need for Physiotherapy based holistic pulmonary rehabilitation even after discharge to prevent or delay the possible late manifestation of the disease.</p>

End-of-life symptoms and interventions among women with gynecologic cancers in a tertiary-care hospital in Thailand

2019 ◽  
Vol 29 (5) ◽  
pp. 951-955
Author(s):  
Thanchanok Sompratthana ◽  
Natacha Phoolcharoen ◽  
Kathleen M Schmeler ◽  
Ruangsak Lertkhachonsuk
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Medical Records ◽  
Uterine Cancer ◽  
Tertiary Care ◽  
Care Hospital ◽  
Do Not Resuscitate ◽  
Gynecologic Cancers ◽  
The Mean

ObjectivesStudies have shown improved patient quality of life with supportive care rather than aggressive treatment at the end of life. This study evaluated the symptoms that patients in Thailand with gynecologic cancers experienced and the interventions that they received at the end of life.MethodsThe medical records of patients admitted to a tertiary cancer center in Thailand who died in the hospital from gynecologic malignancies between January 1, 2011 and December 31, 2016 were reviewed. Inclusion criteria were patients who had been been diagnosed with gynecologic cancers (ovarian, endometrial, cervical, vulvar, or peritoneal cancers or uterine sarcomas) and had died in the hospital during that period. Patients whose medical records were incomplete or unavailable were excluded from the study. Data on demographics, symptoms, interventions, and end-of-life care were collected.ResultsA total of 159 patients were included in this analysis. The mean age at death was 54.3 (range 15–91) years. Over half (54.7%) of the patients were diagnosed with ovarian or peritoneal cancer, 26.4% with uterine cancer or sarcoma, 16.4% with cervical cancer, and 1.3% with dual primary cancers. Symptoms at time of admission were poor oral intake (68.6%), abdominal distention or discomfort (63.5%), pain (42.8%), nausea or vomiting (35.2%), and fever or signs of infection (27.0%). The mean number of hospitalizations during the last 6 months was 3.6. Thirty-six patients (22.6%) had major surgery during the last 6 months of life, with 14 patients (8.8%) having it performed during their last admission before death. The mean length of the last hospital stay was 22.3 (range 6–31) days, and 61 patients (38.4%) were admitted to the intensive care unit. Eleven patients (6.9%) had chemotherapy in their last 14 days of life and 10 (6.3%) received cardiopulmonary resuscitation. Almost all patients (153, 96.2%) had do-not-resuscitate (DNR) consents. The mean time between the DNR consent and death was 6.3±9.7 days.ConclusionMultiple hospital admissions, aggressive treatments, and invasive procedures were common among patients with gynecologic cancer at the end of life. Better symptom management, end-of-life preparation, and communication are needed to enhance patients’ quality of life in Thailand.

scholarly journals A study on perception of clinicians regarding use of electronic medical record for patients attending outpatient departments in a tertiary care teaching hospital in northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 237
Author(s):  
Samarpita Dutta ◽  
Nirupam Madaam ◽  
Parmeshwar Kumar
Keyword(s):  
Quality Of Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Tertiary Care ◽  
Background Information ◽  
Care Hospital ◽  
Outpatient Departments ◽  
Computer Based ◽  
The Mean

Background: Information technology is increasingly being recognized as an important tool for improving patient safety and quality of care. Use of electronic medical record has the greatest potential for improving quality in healthcare. Use of technology in a highly interactive environment such as the OPD has to be user friendly and acceptable. Therefore a study was carried out to assess the perception of clinicians regarding use of computer modules in clinical care in the outpatient departments of a tertiary care hospital in northern India.Methods: A cross sectional study was carried out over a period of two months in which 70 clinicians in the selected hospital were administered pre-designed questionnaire format for self reporting. It required them to rate their preferences regarding adoption of a computer based module for their OPDs and how this would affect their time and quality of patient care.Results: For a given computer based module in OPD, 81.4% of the clinicians supported its adoption. The mean scores suggested that most clinicians perceive that use of electronic medical record would improve quality of care. The mean scores for any of the parameters did not differ significantly amongst supporters and non-supporters of adoption of the module except on one parameter that it would be easier to follow a patient seen earlier by another clinician (p<0.05).Conclusions: Although there might be an initial resistance to change, overall clinicians perceive that introduction of electronic medical records on outpatient department would lead to improved quality of medical information management.

Functional Outcome of Syndactyly Repair in Children

2021 ◽  
Vol 15 (10) ◽  
pp. 3375-3377
Author(s):  
Rizwana Fazlani ◽  
Kashan Qayoom Shaikh ◽  
Zuhera Khan ◽  
Yasir Arfat Memon ◽  
Sadia Rasheed ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Effective Technique ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean ◽  
Practical Implications ◽  
Prevalent Form

Background: As the most prevalent form of congenital hand malformation, syndactyly carries significant aesthetic and practical implications. For the vast majority of situations, surgery is the best option. Congenital syndactyly can be repaired with skin grafts and local flaps, however the results are often less functional and cosmetic than anticipated and often leave scars and residual syndactyly. So we set out to find out how children's syndactyly healing went in this study.1 Objective: To analyze the functional outcome of syndactyly repair in children presenting in a tertiary care hospital. Methodology: This Descriptive case series was conducted at Department of Plastic and Reconstructive Surgery, LUMHS Jamshoro / Hyderabad for 6 months. Sample size of 180 cases was recruited through Non-probability consecutive sampling. Then all patients underwent surgery under general anesthesia. In all cases, procedure was performed depends upon the type / extent of syndactyly. Then patients were discharged after recovery and were followed up on 1st, 2nd and 3rd months post operatively for assessment of functional outcome of syndactyly repair i.e. no supination and no pronation was noted. All this information was noted on proforma. Data was entered and analyzed using SPSS 22.0. Results: The mean age of children was 6.30+3.55. There were 66 (37%) females and 114 (63%) male in the sample. There were 128 (71%) cases of simple syndactyly and 52 (29%) cases of complex syndactyly. There were 127 (71%) cases who had no-supination, 162 (90%) cases who had no-pronation. There was significant difference observed between both type of syndactyly (P<0.05) for supination while insignificant for pronation. Conclusion: Thus we have found that syndactyly repair is effective technique through which we can attain success in maximum number of patients which can help in achieving normal angulation of fingers after surgery. Key words: Syndactyly, Pronation, Supination, Angulation, Children

scholarly journals Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic

Esculapio ◽  
2021 ◽  
Vol 17 (2) ◽  
pp. 195-199
Author(s):  
Aysha Rashid ◽  
◽  
Umair Mudassar ◽  
Ismail Tariq ◽  
Adil Zaheer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Tertiary Care ◽  
Depression Score ◽  
Care Hospital ◽  
Cross Sectional ◽  
Quality Of Life Scale ◽  
The Mean ◽  
The Impact

Due to Covid-19 pandemic the psychological health of individuals is disturbed globally. There is a dire need of looking into details about the effects of mental health issues on quality of life (QOL). Objectives: To determine correlation between depression, anxiety, stress, and quality of life among adults in Covid-19 and evaluate the impact of demographics on quality of life. Methods: It was a cross-sectional study carried out at a tertiary care hospital. Patients presenting in the psychiatry outdoor of age 18 to 60 years, of both genders and scoring ≥21 on Depression, Anxiety, and Stress Scale (DASS) were enrolled in the study and depression, anxiety and stress severity was assessed and Quality of Life Scale (QOLS) was applied on all to assess their quality of life. All findings were then subjected to statistical analysis. Results: The mean age of the patients was 21.78±3.204, mean depression score on DASS was 8.58±4.510, mean anxiety score on DASS was 11.68±4.160 and the mean stress score on DASS was 14.84±3.192. There were 63.5% males and 36.5% females. Depression, anxiety and stress had a negative correlation with quality of life. Depression and stress were significantly correlated negatively with quality of life (p=0.000). No demographical factor was significantly associated with poor quality of life. Conclusion: Depression, anxiety and stress were negatively correlated with poorer QOL and depression and stress had significant association with poor QOL. Key words: Anxiety, Depression, Covid-19, Quality of life How to cite: Rashid A., Mudassar U., Tariq I., Zaheer A., Iftikhar M., Mazhar N. Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic. Esculapio 2021;17(02):195-199.

scholarly journals PATIENTS’ SATISFACTION WITH THE QUALITY OF DERMATOLOGY CONSULTATION OF A TERTIARY CARE HOSPITAL OF PAKISTAN

2021 ◽  
Vol 71 (3) ◽  
pp. 904-09
Author(s):  
Atiya Rahman ◽  
Tehseen Naveed ◽  
Sumeera Zulfiqar ◽  
Aisha Akhtar ◽  
Andaleeb Hamid ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Study Participant ◽  
Correlation Coefficients ◽  
Military Hospital ◽  
Care Hospital ◽  
Senior Registrar ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
The Mean

Objective: To determine the satisfaction rate of dermatology patients, after purposefully improving the consultation skills of residents. Study Design: Mix-method study. Place and Duration of Study: Department of Dermatology, Combined Military Hospital Lahore, from Jan to Sep 2020, Methodology: Empathy informed curriculum was delivered by the consultants and senior registrar prior to the conduction of study as well as an ongoing process to the post-graduate trainees in the department. Patients’ satisfaction with the quality of dermatological consultation was assessed by consultation and relational empathy (CARE) measure. One hundred and seventy six patients were recruited during the study period. Descriptive statistics such as frequencies, means, standard deviations and percentages were determined from the data. Advanced level analysis was done by Pearson’s correlation coefficients to analyse relationships between variables. Results: The mean age of study participant was 39.01 ± SD 19.81 year, with a minimum of 3 years and maximum of 91 years. Ninety two (52.3%) patients were male and 84 (47.7%) were female. The mean consultation and relational empathy score was 40.34 ± SD 8.56 with 16 minimum score and 50 maximum. One hundred and sixty six (94.3%) patients were overall satisfied with the consultation whereas 10 (5.7%) were not. Conclusion: We found high satisfaction rate amongst patients attending dermatology outpatient department. Empathy informed curricula should be emphasized upon to provide holistic patient care.

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