scholarly journals Acute exacerbations of asthma occurring frequently time to check your techniques

2019 ◽  
Vol 6 (6) ◽  
pp. 1755
Author(s):  
Vijaysagar Reddy Bonapelli ◽  
Sujay D. J. ◽  
Prakruthi J. ◽  
Sathiqali A. S.
Keyword(s):  
Tertiary Care ◽  
Severity Index ◽  
Inhalation Therapy ◽  
Lower Grade ◽  
Care Hospital ◽  
Strong Negative Correlation ◽  
Inhalational Technique ◽  
Set Up ◽  
A Prospective Study ◽  
Inhalational Therapy

Background: Asthmatics form a predominant section of patients in OPD. If poorly controlled the frequency of attacks requiring an emergency department visit adds to the burden. It was noticed that the patients who were on inhalational therapy had poor control despite the absence of other factors which could lead to exacerbations. Hence author evaluated the inhalational techniques.Methods: A prospective study undertaken in the department of medicine  in tertiary care hospital in Dakshina Kannada District, Karnataka enlisting 25 patients admitted with acute exacerbation of bronchial asthma. The patients were assessed for their symptoms, signs and recurrent attacks along with their cough severity index and inhaler scores and the observations were tabulated.Results: Of the twenty-five, 15 were on inhalation therapy with various modes of deliveries. There were 15 males and 10 females from ages 20 to 50years. The number of attacks of asthma was higher in those not on inhalation therapies than those using inhalation therapies. Also, the level/severity of cough, measured as Cough Severity Index, was assessed among the two groups. Those on inhalation therapy had a lower grade of cough than those not on therapy . Mean AEC was 94 among those on inhalation therapy and 209 among those not on therapy. Inhalational score was calculated for each patient. There is a strong negative correlation of -0.709 between inhalation score and recurrent attacks, which is statistically significant (p=0.003). Lower inhalation scores were associated with recurrent attacks.Conclusions: Recurrent exacerbations in an asthmatic patient on inhalation therapy are due to improper inhalational technique. It was suggested that it is wise to spend time with the patients in authors OPD set up and teach them the correct techniques of using inhalational therapy hence reducing frequency of attacks and cost of health care in such patients.

scholarly journals A two-year study on postmenopausal bleeding at a tertiary institute

2021 ◽  
Author(s):  
Sowmyanarayanan Lavanya ◽  
Swetha Munivenkatappa ◽  
Anthata Jyothsna Sravanthi
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Developed Countries ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Postmenopausal Bleeding ◽  
Medical Problems ◽  
Set Up ◽  
A Prospective Study

Background: The life expectancy of women shows an increase as a result of which women experience a long postmenopausal phase. Postmenopausal bleeding is a worrisome symptom occurring in 10 % of the women, making them seek a gynaecology opinion at the earliest. Women in developed countries have a predilection for developing endometrial cancer whereas cancer cervix still dominates in the developing countries. This prospective study was carried out on 75 women presenting with postmenopausal bleeding to the gynaecology clinic at a tertiary hospital set up. The study aimed to find the incidence of postmenopausal bleeding, age distribution, causes and different evaluation methods to confirm the diagnosis.Methods: The present study is a prospective study conducted on 75 postmenopausal women reporting with postmenopausal bleeding at the gynaecology clinic at a tertiary care hospital.              Results: Menopause was noted above 45 years in 84% of the patients and 16% were in 40-45 years age. Postmenopausal bleeding was observed in 50-60 years in 56% of women and 30% above 60 years. The medical problems associated were hypertension (20%), diabetes (11%), obesity (22%), hypothyroidism (4%). 53 women had benign causes while 22 had malignancy.Conclusions: Benign lesions of the genital tract are common causes of postmenopausal bleeding. Carcinoma cervix and endometrium classically present with postmenopausal bleed. Strong suspicion, thorough evaluation and early diagnosis improve the quality of life and reduce the morbidity and mortality.

scholarly journals Nontraumatic Headache in Adult Emergency Patients: Prevalence, Etiologies, and Radiological Findings

2020 ◽  
Vol 9 (8) ◽  
pp. 2621
Author(s):  
Nadja Handschin ◽  
Maria Oppliger ◽  
Alex Brehm ◽  
Marios Psychogios ◽  
Leo Bonati ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Severity Index ◽  
Care Hospital ◽  
Radiological Findings ◽  
Acute Therapy ◽  
Term Outcome ◽  
New Finding ◽  
History Of ◽  
A Prospective Study ◽  
Headache Patients

The aim of this study was to measure prevalence, to describe underlying etiologies, and to assess radiological findings, focusing on significant intracranial abnormality (sICA). This was a prospective study of unselected adult patients admitted to the emergency department (ED) in a tertiary care hospital where all presenters were systematically interviewed about their symptoms. We attributed nontraumatic headache with neuroimaging to four groups: Normal or no new finding, extracranial abnormality, insignificant intracranial abnormality, or significant intracranial abnormality. sICA was defined as “needing acute therapy”, “needing follow-up neuroimaging”, or “clinically important neurological disorder”. Among 11,269 screened ED presentations, the prevalence of nontraumatic headache was 10.1% (1132 patients). Neuroimaging (cCT and/or cMRI) was performed in 303 patients. Seventy (23.1% of scanned; 6.2% of all headache patients) patients had sICA. Etiologies were cerebrovascular disease (56%), intracranial bleeding (17%), tumors (14%), infection (9%), and others (6%). Short-term outcome was excellent, with 99.3% in-hospital survival in patients with and 99.4% in patients without neuroimaging, and 97.1% in sICA; 1-year survival in outpatients with neuroimaging was 99.2%, 99.0% in outpatients without, and 88.6% in patients with sICA. Factors associated with sICA were age, emergency severity index (ESI) of 1 or 2, Glasgow coma score (GCS) under 14, focal neurological signs, and a history of malignancy. Prevalence of headache and incidence of sICA were high, but survival after work-up for nontraumatic headache was excellent in the 94% patients without sICA. Due to the incidence of sICA, extensive indication for neuroimaging in headache patients is further warranted, particularly in patients with risk factors.

scholarly journals Strategies to cope claustrophobia during magnetic resonance imaging examination

2019 ◽  
Vol 7 (4) ◽  
pp. 1166
Author(s):  
Syed Amir Raza Zaidi ◽  
Kamran Masood ◽  
Usman Khanzada ◽  
Syed Omair Adil ◽  
Munawar Hussain
Keyword(s):  
Tertiary Care ◽  
Magnetic Resonance Imaging Examination ◽  
P Value ◽  
Care Hospital ◽  
Diagnostic Modality ◽  
Effective Strategies ◽  
Education Status ◽  
Set Up ◽  
A Prospective Study ◽  
Short Intervention

Background: Claustrophobia associated with MRI scan is a well-recognized problem all over the world. The unpleasant psychological experience during MRI can lead to premature cancellation of the study resulting in non-interpretable data. In addition, performing future studies on the claustrophobic patient may not be possible leading to non-utilization of an important diagnostic modality. This study was conducted with the aim to determine a cheap and short intervention which can be applicable to small radiology set up as well.Methods: A prospective study was conducted at a tertiary care hospital from October 2016 to December 2016. Accompanying someone was the first strategy used to coped MR imaging claustrophobia followed by placebo (multivitamin), listening Quran and closed eye (blindfold). All those patients who failed to respond in these strategies were finally labeled as an unsuccessful candidate. Listening of Quran was selected as one of the tools as all the patients were Muslims in present study.Results: Among 84 claustrophobic patients, a closed eye was the most successful strategy found effective in (13) 81.2%, followed by placebo 66.7% patients, listening Quran (7) 30.4%, accompanying someone (15) 17.85% while 4% patients remained claustrophobic after application of all strategies. Significant association of accompanying someone and placebo was observed with education (p-value 0.037) and age of the patients (0.016) respectively.Conclusions: In general, placebo, being accompanied by someone and blindfold were found to be the most effective strategies to cope with MRI related claustrophobia. However, the success of these strategies is also dependent on certain factors like age, education status and socioeconomic status of the patients.

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

Enhancing the empiric antibiotic selection by introducing an antibiogram toolkit in a tertiary care hospital in Southern India – A prospective study

2021 ◽  
Author(s):  
Sadagoban G. Krishnamoorthy ◽  
Vyshak Raj ◽  
Balasubramaniam Viswanathan ◽  
Ganga Priyadharshini Dhanasekaran ◽  
Dhivyaprasath Palaniappan ◽  
...  
Keyword(s):  
Prospective Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Southern India ◽  
Care Hospital ◽  
Antibiotic Selection ◽  
Empiric Antibiotic ◽  
A Prospective Study
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