scholarly journals Trends in trauma care before and after the introduction of ‘Mukhyamantri Santwana Harish Scheme’ in a tertiary care hospital at Kolar

2018 ◽  
Vol 5 (5) ◽  
pp. 2072
Author(s):  
Vikas Sankar Kottareddygari ◽  
Vishwas S. ◽  
Praveen G. P. ◽  
Amal Abraham ◽  
Sreeramulu P. N.
Keyword(s):  
Critical Care ◽  
Low Income ◽  
Life Support ◽  
Road Traffic ◽  
Tertiary Care ◽  
Advanced Life Support ◽  
Low Income Countries ◽  
Care Hospital ◽  
Number Of Patients ◽  
Before And After

Background: Road traffic injuries (RTI) are responsible for 1.2 million global deaths and rank 9th as cause of death in both the high and low income countries. Polytrauma cases make the bulk of emergencies in our centre and the victims were previously given only first aid and critical care before being referred to a government aided institute for further management due to monetary issues. After the introduction of Mukhyamantri Santwana - 'Harish' Scheme (MSHS), all the patients are entitled for cashless treatment for the first 48 hoursand this improved the quality of care they received.Methods: All the polytrauma cases brought to the emergency and critical care department for a period of 7months before the introduction of MSHS (October 2015- April 2016) and for a period of 7 months from the introduction of MSHS (May 2016- November 2016) were studied retrospectively. Data on the number of patients referred, admitted and underwent intervention during the time periods were collected and compared.Results: The number of cases that were admitted and given intervention in our centre increased considerably and number of cases referred to other centres decreased after the introduction of MSHS.Conclusions: Introduction of MSHS lead to patients receiving more advanced life support and interventions as necessary. However this cannot be generalised to all the centres as data is still lacking. Multicentric studies need to be done in this aspect.

scholarly journals Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Muhammad Aqil Soomro ◽  
Maryam Aftab ◽  
Maria Hasan ◽  
Hana Arbab
Keyword(s):  
Gastric Outlet Obstruction ◽  
Low Income ◽  
Tertiary Care ◽  
Outlet Obstruction ◽  
Low Income Countries ◽  
Care Hospital ◽  
Creative Commons ◽  
Pyloric Stricture ◽  
Special Supplement ◽  
Corrosive Ingestion

Corrosive ingestion in children is a common problem in low income countries. These agents cause injuries and later strictures of esophagus and stomach. Gastric outlet obstruction is known complication of acids and surgery is the mainstay of treatment. There are multitude of surgical options for these strictures depending on the involved segment of the stomach and experience of the surgeon. Here we present three cases of children who accidentally ingested acid stored in soda bottles and subsequently developed isolated pyloric strictures. These cases presented between August 2018 and April 2019 to our facility, a tertiary care hospital in Karachi, Pakistan. All three patients had an initial latent period of one to two weeks following corrosive ingestion, after which symptoms of gastric outlet obstruction appeared. Intraoperatively, all three had normal esophagus and antrum but scarred and strictured pylorus. Heineke-Mikulicz pyloroplasty was done in these cases without complications and the outcomes were satisfactory. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 How to cite this:Soomro MA, Aftab M, Hasan M, Arbab H. Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S87-S90.  doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Importance of Ground Critical Care Transport

2016 ◽  
Vol 32 (2) ◽  
pp. 163-169 ◽  
Author(s):  
Susan R. Wilcox ◽  
Michael Ries ◽  
Ted A. Bouthiller ◽  
E. Dean Berry ◽  
Travis L. Dowdy ◽  
...  
Keyword(s):  
Critical Care ◽  
Life Support ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Respiratory Acidosis ◽  
Advanced Life Support ◽  
Integrated Approach ◽  
Tertiary Care Center ◽  
Transport Services

Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team. In all 4 cases, the ground transport team enhanced the intensive care provided to these patients prior to arrival at the tertiary care center. In 2 of the cases, although limited by the profound hypoxemia, the team decreased the pressures and tidal volumes in an effort to approach evidence-based ventilator goals. In 3 cases, they stopped bicarbonate drips being used to treat mixed metabolic and respiratory acidosis, and in 1 case, they administered furosemide. In 1 case, they started cisatracurium, and in 3 others, they initiated inhaled epoprostenol. Existing literature supports the use of CCT teams over ALS teams for transport of the most critically ill patients, and helicopter CCT is not always available or practical. Therefore, offering comparable air and ground options, with similar staffing and resources, is a hallmark of a mature medical system with an integrated approach to CCT.

scholarly journals Preparedness for Internship: A Survey of New Interns at a Tertiary Care Hospital, Telangana

2021 ◽  
Vol 9 (2) ◽  
pp. 24-27
Author(s):  
Padmavathy V ◽  
Kranti Tekulapally
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Orientation Program ◽  
Cross Sectional ◽  
Hospital Practice ◽  
Before And After ◽  
Minor Injuries

INTRODUCTION An internship orientation program is conducted in most of the medical colleges before the beginning of internship program to facilitate the transition between medical student and intern. The present study was initiated to assess the preparedness of interns for the internship program and identifying the areas that require additional training and education. MATERIALS AND METHODS A cross sectional study was carried out among 2014 batch interns of Malla Reddy Medical College for Women, Suraram, Hyderabad. Hard copies of the study questionnaire prepared and validated by expert panel was administered to the interns before and after the two-day internship orientation program. The outcomes were measured on 5-point quantitative scale. The raw scores obtained by each student were converted to percentages.The scores less than or equal to 49% were considered low, the scores between 50% to 70% were considered as average and scores above 71% were considered high with respect to level of preparedness for internship. Two open ended questions were asked – additional topics to be included in the program and other suggestions. RESULTS A total of 110 students completed the study. Only 2% of the interns were highly prepared for hospital practice before the orientation program while this number increased to 78% after the program. Interns expressed their desire to learn new topics like basic first aid to minor injuries, management of trauma cases and Road Traffic Accidents and handling of medical emergencies during the orientation program. They also suggested that there should more focus on practical demonstrations and hands on training in skill lab during this program. CONCLUSION here is significant improvement in the preparedness of interns after the orientation program indicated the program helped to boost the confidence of the interns for hospital practice.

scholarly journals An observational study on usage of insulin and self-injection practises among patients with diabetes attending to Diabetic Centre and Medical outpatient clinics of a tertiary care hospital of Northern Sri Lanka

2020 ◽  
Author(s):  
Sathyasagaran Narayanapillai ◽  
Peranantharajah Thambipillai ◽  
Aravinthan Mahalingam ◽  
Rajeshkannan Nadarajah
Keyword(s):  
Sri Lanka ◽  
Injection Site ◽  
Low Income ◽  
Tertiary Care ◽  
Insulin Injection ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Care Hospital ◽  
Premixed Insulin ◽  
Cross Sectional

Abstract Background: Prevalence of diabetes increasing world-wide particularly in low income countries. Management of diabetes sometimes requires insulin injection due to various reasons. Proper usage of insulin and injection techniques are important for diabetes control among who requires insulin. This study was aimed to assess current insulin practices and associated complications.Methods and material: This was a cross sectional study conducted among diabetes patients attended all medical clinics and Diabetic Centre in Jaffna teaching Hospital which is the only tertiary hospital in the Northern Sri Lanka in May 2020.Insulin practices retrieved by using interviewer administered questionnaire. Data was analyses by using SPSS 26.Results: Out of 360 patients 64.2% were female and mean age was 58.19 (12-89).Majority (61.9%) of them belongs to low income category and most (73.3%) of them using insulin more than 1 year. Main reason for the insulin initiation was oral hypoglycaemic failure (81.7%) and majority of them (80.0%) were using twice daily premixed insulin regime followed by daily basal insulin (11.4%) and basal bolus insulin (5.6%) regime. Most of the participants (81.4%) reported they do cleaning of the injection site before injection and 89.7% usually rotate the injection site. Approximately half of them (50.8%) inject themselves and majority use syringes (91.4%). Common injection site complications reported were skin changes (25%), followed by 15.3% persistent swelling (15.3%) and thinning of skin(7.8%). Angle of injection (P-0.039) and insulin regime (P<0.001) showed statistically significant association with skin changes.High proportion of participants 68.6% (95%CI: 63.7%-73.2%) experienced hypoglycaemia, using syringes 2.21 times (95%CI-1.05-4.64) more risk of compare to pen users and missing meals 2.22 times more risk of hypoglycaemic events (95%CI: 1.18-4.17). Majority of them reported reusing the needles for injection (83.6%) and 35% were disposing needle into common garbage pin.Conclusion: This study revealed significant gaps in current insulin practices from expected norm and hypoglycaemic events alarmingly high among participants. Exploring Continuous Glucose Monitoring Devices or flash monitoring can be a mitigation strategy and urgent attention from health professionals needed to improve the safe insulin practices.

scholarly journals The epidemiology of drowning among Saudi children: results from a large trauma center

2021 ◽  
Vol 41 (3) ◽  
pp. 157-164
Author(s):  
Hamad Alkhalaf ◽  
Meshal Zuraie ◽  
Ryan Nasser Alqahtani ◽  
Mashael Alghamdi ◽  
Abdulrahman Bin Afif ◽  
...  
Keyword(s):  
Low Income ◽  
Life Support ◽  
Public Awareness ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Low Income Countries ◽  
Swimming Pools ◽  
Neurological Damage ◽  
Tertiary Center ◽  
Epidemiological Characteristics

BACKGROUND: Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies. OBJECTIVE: Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children. DESIGN: Retrospective chart review. SETTING: Patients admitted to the tertiary care unit of a hospital in Riyadh. PATIENTS AND METHODS: Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed. MAIN OUTCOME MEASURE: Drowning mortality and morbidity. SAMPLE SIZE: 99. RESULTS: Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome ( P <.01). A high Glasgow Coma Scale score upon admission was a predictor of normal recovery ( P <.01). CONCLUSION: These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes. LIMITATIONS: The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable. CONFLICT OF INTEREST: None.

scholarly journals A study on the knowledge and attitudes on advanced life support among medical students and medical officers in a tertiary care hospital in Sri Lanka

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Dissanayake Mudiyanselage Priyantha Ralapanawa ◽  
Kushalee Poornima Jayawickreme ◽  
Ekanayake Mudiyanselage Madhushanka Ekanayake ◽  
Pallegoda Vithanage Ranjith Kumarasiri
Keyword(s):  
Medical Students ◽  
Sri Lanka ◽  
Life Support ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Advanced Life Support ◽  
Care Hospital ◽  
Knowledge And Attitudes

scholarly journals Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

2021 ◽  
Author(s):  
Sukriti Das ◽  
Bipin Chaurasia ◽  
Dipankar Ghosh ◽  
Asit Chandra Sarker
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Head Injuries ◽  
Skull Fracture ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Care Hospital ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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