scholarly journals The evaluation of effectiveness of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital: a before and after study

2019 ◽  
Vol 6 (3) ◽  
pp. 1239
Author(s):  
Bhowmik A. ◽  
Gargi G. ◽  
Nandy M.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Newborn Care ◽  
Kangaroo Mother Care ◽  
Care Practice ◽  
P Value ◽  
Care Hospital ◽  
New Born ◽  
Before And After ◽  
Care Ward

Background: Kangaroo mother care (KMC) is a standard of care for preterm and low birth weight babies. To implement KMC in institutional care it was often practiced inside intensive care unit and also in separate ward. In present study authors have tried to evaluate effect of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital.Methods: Uncontrolled study before and after establishment of separate kangaroo mother care ward comparing kangaroo mother care in sick new-born care unit versus kangaroo mother care in separate ward.Results: In separate ward, as compared to kangaroo mother care practice in sick newborn care unit, mean (SD) duration of kangaroo mother care increased from 5.3 (1.6) to 11.4 (7.4) hours/day (95%CI 5.0-7.1, p value <0.0001). Mean (SD) weight gain increased from 10.7 (7.0) g/day to 13.7 (11.1) g/day (95% CI 1.0-4.8, p value <0.0024). Incidence of sepsis diminished from 14.0% to 28.9% (95% CI 6.4-23, p value <0.0006). Exclusive breast-feeding rate at discharge (42.3% vs. 57.3%) (95% CI 4.8- 24.9, p value <0.0041) and follow up (49.4% vs. 65.0%) (95% CI 1-29.4, p value <0.0378) increased. Mortality also decreased in this group of patients (8.6% vs.2.3%) (95% CI-1.6-11.4, p value <0.0082).Conclusions: Kangaroo mother care ward is better place than sick new born care unit for providing kangaroo mother care in tertiary care hospital.

scholarly journals Knowledge on essential newborn care among antenatal mothers attending tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 1236
Author(s):  
Aravindan J. ◽  
Indira N. C. ◽  
Mithun Kumar A.
Keyword(s):  
Neonatal Period ◽  
Tertiary Care ◽  
Newborn Care ◽  
P Value ◽  
Care Hospital ◽  
Maternal Knowledge ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
New Born ◽  
Danger Signs

Background: Globally 4 million newborn die every year before they reach the age of one month. To achieve the millennium developmental goals newborn survival is essential. Aim of the study was to assess the level of knowledge of antenatal women on essential new born care and danger signs during neonatal period, to find the association of sociodemographic and obstetric characteristics with maternal knowledge level. Settings and design included descriptive cross-sectional study was conducted in a tertiary care hospital.Methods: The study enrolled 439 antenatal women by convenient sampling technique. A pretested semi structured questionnaire was used to assess the knowledge. Statistical package for the social sciences (SPSS) 21 version was used to analysis the data. Chi square was calculated to find the association. P value of <0.05 was considered statistically significant.Results: The study shows that 16.7% respondents had adequate knowledge about danger signs during neonatal period. The maternal age, parity, socioeconomic status, parity had significantly associated with the maternal knowledge regarding new-born care (p<0.05).Conclusions: Majority of the ante natal mother had poor knowledge on new born care.

scholarly journals Pattern of Drug Utilisation in the Management of Hyperpigmentary Disorders in a Tertiary Care Hospital- An Observational Study

2021 ◽  
Author(s):  
Vijayamathy Arunnair ◽  
Girish Kumaraswamy ◽  
M Ramesh
Keyword(s):  
Observational Study ◽  
American Indians ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Calcineurin Inhibitors ◽  
P Value ◽  
Care Hospital ◽  
Prescription Pattern ◽  
Acneiform Eruption ◽  
Before And After

Introduction: Hyperpigmentary disorders, a common skin disorder affecting individuals with darker skin especially Asians, Blacks, Hispanics and American Indians, has a great impact on patient’s Quality of Life (QOL) with physical distress and psychological impact, and studies have shown that there is an improvement in QOL after treatment. The topical medications include sunscreens, demelanising agents, immunomodulators like tacrolimus, retinoids and Glucocorticoids (GCs). Systemic therapy includes GCs and antioxidants. Physical therapy includes chemical peels, microderma abrasion, Laser and light therapies and mesotherapy. Aim: To determine the pattern of drug use in hyperpigmentary disorders, to assess the tolerability of therapy and to analyse the effect of hyperpigmentary disorders of skin to the prescribed medications on the QOL before and after treatment. Materials and Methods: This was a prospective, observational study conducted on 102 newly diagnosed and untreated participants with hyperpigmentary disorders, who attended Dermatology Outpatient Department of a tertiary care hospital, Bangalore, India. The pattern of drug therapy, route of administration and Adverse Events (AEs) to the therapy was documented and analysed using descriptive statistics. The QOL using Dermatology Life Quality Index (DLQI) was assessed before and after treatment using Analysis of Variance (ANOVA). The patients were monitored every 30 days for three months to study the appropriateness, changing trends in prescription pattern, tolerability and QOL. Results: A total of 102 participants were enrolled for the study. The mean age was 33.71±10.68 years in males and 34.07±10.27 years in females. The different classes of drugs used were demelanising agents, sunscreens, antifibrinolytics, calcineurin inhibitors, keratolytics, glucocorticoids. The number ranged from 2-4 drugs per participant with a mean of 3.01±1.01. A significant improvement in the QOL was observed after treatment (p-value <0.01). Most of the AEs were self limiting except a few (acneiform eruption, rosacea) which were topical GCs induced. Conclusion: The individualised prescription pattern by treating physician was in concurrence with the standard line of therapy as they fulfilled the desired objectives. Hydroquinone (HQ), tranexamic acid and triple formula were the mainstay of treatment. The QOL improved after treatment.

scholarly journals Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review

2021 ◽  
pp. 104990912110304
Author(s):  
Amy Nolen ◽  
Rawaa Olwi ◽  
Selby Debbie
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Palliative Sedation ◽  
Palliative Care Unit ◽  
Care Hospital ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Before And After

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals EVALUATION OF RATIONAL USE OF ANTIBIOTIC DRUGS IN SURGERY DEPARTMENT AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 145-149
Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Rational Use ◽  
Post Surgery ◽  
Antibiotic Drugs ◽  
Before And After ◽  
Hospital Patients ◽  
Surgery Department

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

Vancomycin Control Measures at a Tertiary-Care Hospital: Impact of Interventions on Volume and Patterns of use

1998 ◽  
Vol 19 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Mary V. Singer ◽  
Rachel Haft ◽  
Tamar Barlam ◽  
Mark Aronson ◽  
Amy Shafer ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Hospital Information Systems ◽  
Control Measures ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Patterns Of Use ◽  
Before And After ◽  
Aggressive Interventions

ABSTRACTOBJECTIVE: Evaluate vancomycin prescribing patterns in a tertiary-care hospital before and after interventions to decrease vancomycin utilization.DESIGN: Before/after analysis of interventions to limit vancomycin use.SETTING: 420-bed academic tertiary-care center.INTERVENTIONS: Educational efforts began August 10, 1994, and involved lectures to medical house staff followed by mailings to all physicians and posting of guidelines for vancomycin use on hospital information systems. Active interventions began November 15, 1994, and included automatic stop orders for vancomycin at 72 hours, alerts attached to the medical record, and, for 2 weeks only, computer alerts to physicians following each vancomycin order. Parenteral vancomycin use was estimated from the hospital pharmacy database of all medication orders. Records of a random sample of 344 patients receiving van-comycin between May 1, 1994, and April 30, 1995, were reviewed for an indication meeting published guidelines.RESULTS: Vancomycin prescribing decreased by 22% following interventions, from 8.5 to 6.8 courses per 100 discharges (P<.05). The estimated proportion of van-comycin ordered for an indication meeting published guidelines was 36.6% overall, with no significant change following interventions. However, during the 2 weeks that computer alerts were in place, 60% of vancomycin use was for an approved indication.CONCLUSIONS: Parenteral vancomycin prescribing decreased significantly following interventions, but the majority of orders still were not for an indication meeting published guidelines. Further improvement in the appropriateness of vancomycin prescribing potentially could be accomplished by more aggressive interventions, such as computer alerts, or by targeting specific aspects of prescribing patterns.

Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

2019 ◽  
Vol 30 (2) ◽  
pp. 163-171
Author(s):  
Amod Tilak ◽  
Smita Shenoy ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Amruta Tripathy ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Opportunistic Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
P Value ◽  
Care Hospital ◽  
Long Term Treatment ◽  
Immunological Recovery

AbstractIntroductionThere is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital.MethodsAfter approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant.ResultsART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+cell count was 65 (39, 98) cells/mm3and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+count <50 cells/mm3were associated with poor immunological recovery.ConclusionsWith long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

A minimalist electronic health record-based intervention to reduce standing lab utilisation

2020 ◽  
pp. postgradmedj-2019-136992
Author(s):  
Kuo-Kai Chin ◽  
Amrita Krishnamurthy ◽  
Talhah Zubair ◽  
Tara Ramaswamy ◽  
Jason Hom ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Complete Blood Count ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Health Record ◽  
Care Hospital ◽  
Before And After ◽  
Electronic Health ◽  
One Year

BackgroundRepetitive laboratory testing in stable patients is low-value care. Electronic health record (EHR)-based interventions are easy to disseminate but can be restrictive.ObjectiveTo evaluate the effect of a minimally restrictive EHR-based intervention on utilisation.SettingOne year before and after intervention at a 600-bed tertiary care hospital. 18 000 patients admitted to General Medicine, General Surgery and the Intensive Care Unit (ICU).InterventionProviders were required to specify the number of times each test should occur instead of being able to order them indefinitely.MeasurementsFor eight tests, utilisation (number of labs performed per patient day) and number of associated orders were measured.ResultsUtilisation decreased for some tests on all services. Notably, complete blood count with differential decreased 9% (p<0.001) on General Medicine and 21% (p<0.001) in the ICU.ConclusionsRequiring providers to specify the number of occurrences of labs changes significantly reduces utilisation in some cases.

Sign in / Sign up

Export Citation Format

Share Document