scholarly journals Feasibility of the home isolation programme for adults and children with COVID-19

2020 ◽  
Vol 7 (11) ◽  
pp. 1647
Author(s):  
Purwa Doke ◽  
Jitendra S. Oswal ◽  
Disha A. Padalkar ◽  
Mohit P. Jain
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Morbid Condition ◽  
Resource Limited Settings ◽  
Once Daily ◽  
Use Of Resources ◽  
Resource Limited ◽  
Hospital Beds ◽  
Adults And Children

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused an upsurge of cases in many countries leading to inadequate quarantine facilities and hospital beds. Studies on the feasibility of home isolation for COVID-19 patients are the need of the hour. This is the first study from India on the feasibility of home isolation to the best of the author's knowledge.Methods: This methodical study was conducted at a designated COVID-19 tertiary care hospital in India, which included all patients enrolled for the home isolation programme from the 4 July to 3 August 2020. Laboratory confirmed COVID-19 patients were assessed during the enrolment for their eligibility for home isolation. The enrolled patients were followed up once daily over a telephonic call with objective parameters like temperature, pulse and oxygen saturation.Results: There were a total of 447 adults and 67 children. Amongst adults, hypertension was the most common co-morbid condition seen in 23 (5.15%) followed by diabetes in 18 (4.03%) patients. Only 24 (5.37%) patients were hospitalised during the duration of home isolation due to reasons like persistent fever, decreased SpO2, and non-medical ones like anxiety regarding the disease. Age and the presence of co-morbidities were directly related to the requirement of hospitalisation. No children required hospitalisation. There were no deaths.Conclusions: Home isolation is effective for COVID-19 patients in resource limited settings. We provide strong evidence for adapting it for asymptomatic and mild symptomatic cases with judicious use of resources and without compromising the risk to patients.

scholarly journals Prevalence and Specificity of RBC Alloantibodies in Indian Patients Attending a Tertiary Care Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shamsuz Zaman ◽  
Rahul Chaurasia ◽  
Kabita Chatterjee ◽  
Rakesh Mohan Thapliyal
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Patient Population ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Antibody Screening ◽  
Resource Limited ◽  
Transfusion Requirements

Background.Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. Data about alloimmunization rate in general patient population is scarce especially from resource limited countries. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients admitted in various clinical specialties at a tertiary care hospital in North India.Methods.Antibody screening was carried out in 11,235 patients on automated QWALYS 3 platform (Diagast, Loos, France). Antibody identification was carried out with an 11-cell identification panel (ID-Diapanel, Diamed GmbH, Switzerland).Results.The overall incidence of RBC alloimmunization in transfused patients was 1.4% (157/11235), with anti-E being the most common specificity (36.3%), followed by anti-D (16%), anti-c (6.4%), anti-c + E (6.4%), anti-C + D (5.1%), and anti-K (4.5%). The highest incidence of alloimmunization was observed in hematology/oncology patients (1.9%), whereas in other specialties the range was 0.7–1%.Conclusion.As alloimmunization complicates the transfusion outcomes, authors recommend pretransfusion antibody screening and issue of Rh and Kell matched blood to patients who warrant high transfusion requirements in future.

scholarly journals Etiologies of Neonatal Mortality in a Tertiary Care Hospital in a Resource-Limited Setting

2021 ◽  
Vol 11 (02) ◽  
pp. 268-280
Author(s):  
Calixte Ida Penda ◽  
Ritha Mbono Betoko ◽  
Danielle Kedy Koum ◽  
Essome Henri ◽  
Patricia Epée Eboumbou ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resource Limited Setting ◽  
Care Hospital ◽  
Resource Limited ◽  
Limited Setting

scholarly journals Periodic evaluation of drug utilization in intensive coronary care unit patients in a tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 292
Author(s):  
Sangeeta Nath Sharma ◽  
Rajendra Holla ◽  
Subramanyam K. ◽  
Mangala Srinivas
Keyword(s):  
Prospective Study ◽  
Drug Utilization ◽  
Tertiary Care Hospital ◽  
Beta Blockers ◽  
Tertiary Care ◽  
Antiplatelet Agents ◽  
Care Hospital ◽  
Drug Of Choice ◽  
Use Of Resources ◽  
Periodic Evaluation

Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class.

Appropriate utilization of hospital beds in internal medicine: evaluation in a tertiary care hospital

2007 ◽  
Vol 13 (3) ◽  
pp. 408-411 ◽  
Author(s):  
Ömer Dizdar ◽  
Ömer Karadağ ◽  
Umut Kalyoncu ◽  
Mevlüt Kurt ◽  
Zekeriya Ülger ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Beds

scholarly journals Bomb blast in a tertiary care hospital, the challenges faced during management of victims in a resource limited country

Trauma ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 25-29
Author(s):  
Rizwan Sultan ◽  
Hasnain Zafar ◽  
Umar Bhatti ◽  
Rozina Khimani ◽  
Khabir Ahmed
Keyword(s):  
Health Care ◽  
Medical Records ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fold Increase ◽  
University Hospital ◽  
Care Hospital ◽  
Trauma Centers ◽  
Resource Limited ◽  
The City

Introduction A bomb blast in a hospital results in a many fold increase in the casualties. The affected health care in the region is the next challenge faced by the administration of the city. We discuss the challenges faced after a bomb blast in the civil hospital of Quetta, Pakistan on 8 August 2016. Methods A retrospective review of the medical records of patients who were transferred by air to the Aga Khan University Hospital Karachi over a period of 86 h after the blast in Quetta. Results Seventy-five patients were received in three separate waves; those received in the first wave were sicker than the following waves. Errors in triage and communication which could have been prevented were identified. Conclusion Security of hospitals needs to be improved to avoid such incidents in future. The teams involved in the management of these incidents should be trained about triage and communication and its importance. There is need for designated trauma centers to take care of these incidents.

Development of an Efficient, Non-Invasive Method for Cardiovascular Disease Risk Stratification in a Resource-Limited Setting

2019 ◽  
Vol 12 (2) ◽  
pp. 91-99
Author(s):  
Biswarup Pramanik ◽  
Amit Ghosh
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Tertiary Care ◽  
Care Hospital ◽  
Resource Limited Settings ◽  
Non Invasive ◽  
Resource Limited ◽  
Increasing Risk ◽  
Risk Categories

Background: Augmentation Index (AIx) is considered as an important predictor of cardiovascular disease. So, quantification of AIx may provide a rapid cost-effective and non-invasive means of cardiovascular risk stratification. At present, WHO/ISH risk prediction charts are used to predict 10-year risk of a fatal or nonfatal major cardiovascular event, an assessment which requires laboratory support for blood chemistry and thus making it ill-suited for resource-limited settings. Objectives: In this study, we examined the association of AIx with cardiovascular risk as determined by the WHO/ISH chart and identified AIx cut-offs to stratify patients into different risk categories. Methods: A case-control study with 162 cases and 61 controls was conducted in a tertiary care hospital in eastern India. Data were obtained for demographic, anthropometric, cardiovascular, and biochemical parameters. Cardiovascular risk assessment was carried out by WHO/ISH risk model in R. Statistical analysis was done for examining the association of AIx with WHO/ISH cardiovascular risk and for identifying AIx cut-offs to stratify patients into different risk categories. Results: Box and whisker plots for assessing the correlation between AIx and WHO/ISH cardiovascular risk showed an increase in the median value of AIx with increasing risk in both cases and controls. Heart rate corrected AIx showed a steady increase with increasing risk in males. AIx cutoffs showed good sensitivity and specificity for each risk category. Conclusions: AIx is remarkably associated with cardiovascular risk as assessed by the WHO/ISH chart and the AIx cut-offs obtained in the study can be used as an efficient, non-invasive surrogate biomarker of cardiovascular risk even in resource-limited settings.

scholarly journals Clinical Characteristics of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in North Indian Population of HIV/AIDS Patients Receiving HAART

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Suman Karmakar ◽  
Surendra K. Sharma ◽  
Richa Vashishtha ◽  
Abhishek Sharma ◽  
Sanjay Ranjan ◽  
...  
Keyword(s):  
Indian Population ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Case Definitions ◽  
Minimum Period ◽  
Important Complication ◽  
Resource Limited ◽  
Inflammatory Syndrome

Background & Objective. IRIS is an important complication that occurs during management of HIV-TB coinfection and it poses difficulty in diagnosis. Previous studies have reported variable incidence of IRIS. The present study was undertaken to describe the pattern of TB-associated IRIS using recently proposed consensus case-definitions for TB-IRIS for its use in resource-limited settings.Methods. A prospective analysis of ART-naïve adults started on HAART from November, 2008 to May, 2010 was done in a tertiary care hospital in north India. A total 224 patients divided into two groups, one with HIV-TB and the other with HIV alone, were followedup for a minimum period of 3 months. The diagnosis of TB was categorised as ‘‘definitive’’ and ‘‘probable’’.Results. Out of a total of 224 patients, 203 completed followup. Paradoxical TB-IRIS occurred in 5 of 123 (4%) HIV-TB patients while 6 of 80 (7.5%) HIV patients developed ART-associated TB. A reduction in plasma viral load was significantly (P=.016) associated with paradoxical TB-IRIS. No identifiable risk factors were associated with the development of ART-associated TB.Conclusion. The consensus case-definitions are useful tools in the diagnosis of TB-associated IRIS. High index of clinical suspicion is required for an early diagnosis.

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