Comprehensive study of insomnia and its association with specific burn characteristics: an experience from a tertiary care centre in North-West India

Background: Burn injuries are devastating, sudden and unpredictable forms of trauma which affect the victims both physically and psychologically. Recent advances in medical management have drastically decreased mortality rates of burn patients. There is a significant relationship between acute burn pain and sleep. Alteration in sleep patterns are commonly seen in post burn patients. The objectives of the study were to determine the prevalence of insomnia in burn patients compared with a group of adequately matched controls; to determine risk factors associated with insomnia; to study the quality of sleep in post burn patients compared with a group of adequately matched controls.Methods: Sleep quality in post burn patients was analyzed and measured with the help of Pittsburg sleep quality index questionnaire and compared with a group of adequately matched controls. Post burn patients experienced prolonged and long lasting pain which is assessed with visual analogue scale. Data were tabulated and analyzed statistically using univariate and multivariate analysis (chi square test, odds ratio, Binary logistic regression).Results: The relationship between post burn patients with changed sleep architecture and pain was found to be statistically significant. Other important parameters were also evaluated and discussed.Conclusions: Post burn patients are more prone for disturbed sleep patterns. Any variation in sleep patterns and quality is significantly related to pain experienced by the post burn patients, thus this problem should be evaluated and analyzed meticulously.

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Comparison of Clinical Outcomes With Drug Coated Balloons Versus Plain Balloon Angioplasty In Chronic Limb-Threatening Ischemia

Vascular and Endovascular Surgery ◽

10.1177/15385744211022598 ◽

2021 ◽

pp. 153857442110225

Author(s):

Joel Mathew John ◽

Vimalin Samuel ◽

Dheepak Selvaraj ◽

Prabhu Premkumar ◽

Albert A Kota ◽

...

Keyword(s):

Clinical Outcomes ◽

Interventional Procedure ◽

Tertiary Care ◽

Arterial Disease ◽

Multivariable Logistic Regression Analysis ◽

Tertiary Care Centre ◽

Chi Square ◽

Exact Test ◽

Institutional Review ◽

Chi Square Test

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.

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Frequency of Depression in Burn Patients at a Tertiary Care Hospital

Journal of Sheikh Zayed Medical College ◽

10.47883/jszmc.v11i03.59 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3-7

Keyword(s):

Tertiary Care ◽

Depression Scale ◽

Care Hospital ◽

Burn Patients ◽

Chi Square ◽

Cross Sectional ◽

Residential Status ◽

Duration Of Illness ◽

Chi Square Test ◽

Medical University

Background: Burns are physically, psychologically and economically challenging injuries and the factors leading to them are many and under studied. Different studies have associated burn injuries with psychiatric disorders from different parts of the world. Objective: To determine the frequency of depression among the burn patients. Methodology: This cross sectional study was conducted at the Pak Italian Modern Burn Unit, Nishtar Medical University, Multan and the Department of Psychiatry, Nishtar Medical University, Multan. Non probability consecutive sampling technique was used to collect the data from study subjects, which consisted of 150 patients of burn. All patients were assessed by a single psychiatrist on Hospital Anxiety and Depression scale (HADS) scale for screening of depression. Chi square test was applied to determine association between the socio demographic factors of burn patients and depression. Results; Of these 150 study cases, 91 (60.7 %) were male patients while 59 (39.3 %) were female patients. Mean age of our study cases was 33.94 ± 8.88 years. The frequency of depression was noted as 88 (58.7%). Post stratification Pearson chi square test revealed significant associations between age (p=0.001), residential status (p=0.038), occupation (p= 0.000), etiology of burn (p=0.044) and duration of illness (p=0.000) with depression. Conclusion: A high frequency of depression was noted among burn patients in our study. Depression was significantly associated with age, residential status, occupation, duration of illness and etiology of the burn. Healthcare professionals treating such patients should anticipate depressive symptoms in these patients and treat them accordingly.

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FAKTOR-FAKTOR YANG MEMPENGARUHI POLA TIDUR PADA ANAK YANG MENJALANI HOSPITALISASI DI RUANG RAWAT INAP ANAK RSD. MAYJEND. HM. RYACUDU KOTABUMI TAHUN 2016

Jurnal Keperawatan Abdurrab ◽

10.36341/jka.v2i2.624 ◽

2019 ◽

Vol 2 (2) ◽

pp. 42-49

Author(s):

Rina Mariani

Keyword(s):

Emotional Stress ◽

Physical Illness ◽

Bivariate Analysis ◽

Sleep Patterns ◽

Chi Square ◽

Cross Sectional ◽

Inpatient Ward ◽

Disturbed Sleep ◽

Falling Asleep ◽

Chi Square Test

ABSTRACT Problems faced by children during home care is difficulty sleeping due to treatment and environmental conditions that are different from home conditions. Based on a survey conducted in February 2016, out of 12 treated children had difficulty falling asleep due to the disease 's illness and the uncomfortable environment. The purpose of this study was to determine the factors that influence the sleep patterns of children who underwent hospitalization at the inpatient ward of Mayor Jendral HM Ryacudu Kotabumi Regional Hospital. The research design uses quantitative analytic with cross sectional approach. Research sample is children aged 1-3 years amounted to 68 people. The research variables consist of independent and dependent variable. Independent variables are physical illness, environmental and emotional stress while dependent variable is sleep pattern. Data analysis using univariate and bivariate analysis through chi-square test with α = 0,05. The univariate result was obtained by 51 people (75.0%) of disturbed sleep patterns, 48 people (70.6%) had physical illness, 59 people (86.8%) felt the environment was disturbing, and 59 people (86.8%) experienced emotional stress. Bivariate results show there is a relationship between physical illness with sleep patterns in children, there is a relationship between the environment with sleep patterns of children and there is no relationship between emotional stress with sleep patterns in children. Keyword: sleep patterns, children, hospitalization, hospital, difficulty sleeping ABSTRAK Persoalan yang dihadapi anak selama di rawat di rumah adalah kesulitan tidur akibat pengobatan dan keadaan lingkungan yang berbeda dengan kondisi rumah. Berdasarkan presurvey yang dilakukan pada bulan Februari 2016, dari 12 anak yang dirawat mengalami sulit tidur karena`faktor penyakit yang diderita dan lingkungan yang kurang nyaman. Tujuan penelitian adalah untuk mengetahui faktor-faktor yang mempengaruhi pola tidur anak yang menjalani hospitalisasi di ruang rawat inap anak Rumah Sakit Daerah Mayor Jendral HM Ryacudu Kotabumi. Desain penelitian mengunakan analitik kuantitatif dengan pendekatan cross sectional. Sampel penelitian adalah anak usia 1-3 tahun berjumlah 68 orang. Variabel penelitian terdiri atas variabel independen dan dependen. Variabel independen adalah penyakit fisik, lingkungan dan stress emosional sedangkan variabel dependen adalah pola tidur. Analisa data menggunakan analisa univariat dan bivariat melalui uji chi-square dengan α = 0,05. Hasil univariat diperoleh 51 orang (75.0%) pola tidur anak terganggu, 48 orang (70.6%) mengalami penyakit fisik, 59 orang (86.8%) merasakan lingkungan menganggu, dan 59 orang (86.8%) mengalami stress emosional. Hasil bivariat menunjukkan ada hubungan antara penyakit fisik dengan pola tidur pada anak, ada hubungan antara lingkungan dengan pola tidur anak dan tidak ada hubungan antara stress emosional dengan pola tidur pada anak. Kata Kunci: pola tidur, anak, hospitalisasi, rumah sakit, sulit tidur

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Prevalence Of Post Partum Depression Among Postnatal Women At A Tertiary Care Centre Using Edinburgh Post Partum Depression Scale

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i4.4875 ◽

2021 ◽

Vol 12 (4) ◽

pp. 2395-2399

Author(s):

Sivasundari Maharajan ◽

Dhanvarsha Sumaldha Subbiah Ramkumar ◽

Nimrah Amthul ◽

Shrutiravali

Keyword(s):

Postpartum Depression ◽

Negative Impact ◽

Post Partum ◽

Tertiary Care ◽

Depression Scale ◽

Medical Intervention ◽

Tertiary Care Centre ◽

Chi Square ◽

Post Partum Depression ◽

Chi Square Test

Postpartum depression is a grave mental health problem, which is more prevalent than society realizes and poses great risk. It has been associated with lack of breastfeeding, aversion towards the baby and negative impact on the development of the child. A total of 300 women who delivered between January 14 to March 31 of 2020 at Saveetha Medical College and Hospital were chosen following ethical clearance. After explaining the aspects of the Edinburgh Postpartum Depression Scale in their native language, the questionnaire was provided. A score of 10 and above were considered positive. Data were evaluated using SPSS and Chi square test. The prevalence of PPD was seen in 14% of women. It was higher with vaginal delivery, in women who had multiple births, lack of financial and social support, with domestic violence and alcoholic partner. Medical help was advised to women who scored 10 and above; only 5% sought medical intervention. Others did not recognize depression as a health issue. This shows the lack of awareness among the population. Medical health professionals should spread awareness, conduct more studies to evaluate the prevalence, the predisposing factors, methods for early diagnosis and ways to help women overcome “THE OTHER SIDE OF MOTHERHOOD”.

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Assessment of breastfeeding position and attachment (ABPA) in a tertiary care centre in Chennai, India: an observational descriptive cross-sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184282 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2209

Author(s):

Nalini Aswathaman ◽

Mohamed Sajjid ◽

C. N. Kamalarathnam ◽

A. T. Arasar Seeralar

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Tertiary Care Centre ◽

Correct Position ◽

Chi Square ◽

Cross Sectional ◽

Key Points ◽

Chi Square Test ◽

Correct Technique

Background: Effective breastfeeding becomes an art with experience. Correct position and attachment is the first step necessary for exclusive breast feeding. However, studies assessing correct position and attachment for breastfeeding in South India are sparse. Hence our study aimed to assess the percentage of mother infant dyads with correct breastfeeding position and attachment along with factors influencing them in a Tertiary care Hospital.Methods: A descriptive cross-sectional study was conducted among the stable dyads in Institute of Obstetrics and Gynaecology using quasi random sampling. 101 dyads were observed for correct position, attachment and effective suckling using WHO B-R-E-A-S-T feed observation form and were scored. Data was analyzed using SPSS software with chi square test, univariate logistic regression and spearman correlation test.Results: Among the 101 dyads, only 30.7% of them had good or average position, 52.47% had good or average attachment and 62.3% had effective suckling at breast. There was significant correlation between breast problem in mother with incorrect position and poor attachment. NICU stay and breast problems were significantly associated with poor attachment. Effective suckling improved significantly as gestational age matured and in infants who had no NICU stay.Conclusions: Practical demonstration on how to hold infants in correct breastfeeding position and drilling with key points for correct position and attachment as soon as possible after delivery will go a long way for promoting exclusive and effective breastfeeding by learning correct technique. Rechecking after counselling will reinforce this learned art.

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Frequency of Depression in Burn Patients at a Tertiary Care Hospital

Journal of Sheikh Zayed Medical College ◽

10.47883/jszmc.113.259.35 ◽

2020 ◽

Vol 11 (03) ◽

Author(s):

Muhammad Asif ◽

◽

Owais Kareem ◽

Bushra Ijaz ◽

Naeem Ullah Leghari ◽

...

Keyword(s):

Tertiary Care ◽

Depression Scale ◽

Care Hospital ◽

Burn Patients ◽

Chi Square ◽

Cross Sectional ◽

Residential Status ◽

Duration Of Illness ◽

Chi Square Test ◽

Medical University

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Study of expression of PTEN and Cyclin D1 in endometrium at a tertiary care centre

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20191165 ◽

2019 ◽

Vol 6 (2) ◽

pp. 495

Author(s):

Shaffy Thukral ◽

Shuaeb Bhat ◽

Nusrat Bashir

Keyword(s):

Cyclin D1 ◽

Tertiary Care ◽

Inverse Correlation ◽

Premalignant Lesions ◽

P Value ◽

Nuclear Staining ◽

Tertiary Care Centre ◽

Chi Square ◽

Normal Endometrium ◽

Chi Square Test

Background: To study the expression of PTEN (Phosphatase and Tensin homologue) and Cyclin D1 in normal, hyperplastic and neoplastic endometrium by immunohistochemistry and to corroborate the interrelationship between PTEN and Cyclin D1 in normal to neoplastic endometrial disorders including endometrial carcinoma.Methods: Formalin fixed paraffin embedded (FFPE) sections of spectrum of endometrium in fifty different cases were taken from secretory phase to endometrial carcinoma and subjected to Immunohistochemistry using PTEN and Cyclin D1 .Results: Immunoreactivity was regarded as positive when brown staining was localized in the nuclei or cytoplasm. The intensity of nuclear staining was graded from 0 to 3+ and the extent was semi quantitatively estimated. If less than 10% of cells were positive a score of 0 was given, 11 % to 30% cell positivity was scored as 1+, 31% to 60 % positivity was scored as 2+ and more than 60% positive cells was labelled as 3+. Statistical analysis was performed with Chi-Square test and significant differences were noted between these 3 groups (p value < 0.05).Conclusions: The present study supports that an inverse correlation exists in the expression of PTEN and Cyclin D1 in normal, hyperplastic and neoplastic endometrium. The decreased PTEN expression is a marker of the earliest endometrial premalignant lesions, and we propose that use of PTEN immunostaining may be informative in identifying premalignant lesions that are likely to progress to carcinoma. Cyclin D1 expression in endometrial glands increases progressively in intensity and extent from normal endometrium to hyperplasia to carcinoma.

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Proportion of ophthalmia neonatorum following prophylaxis with azithromycin eye ointment in newborns at a tertiary care centre in Central Kerala

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213737 ◽

2021 ◽

Vol 8 (10) ◽

pp. 1720

Author(s):

Najeeba Chamban Mammooty ◽

Madhu George ◽

Jino Joseph ◽

Abdul Tawab

Keyword(s):

Tertiary Care ◽

Newborn Care ◽

Causative Organism ◽

Care Centre ◽

Tertiary Care Centre ◽

Chi Square ◽

Ophthalmia Neonatorum ◽

Chi Square Test ◽

Culture And Sensitivity ◽

Neonatal Conjunctivitis

Background: The objective was to evaluate the proportion of ophthalmia neonatorum among 425 hospital born newborns who had received antibiotic eye prophylaxis within one hour of birth at a tertiary care centre in Central Kerala and to detect their causative organisms.Methods: The study design was an observational study done for a period of 10 months. A total of 425 term well newborn babies were included in the study. At delivery after the normal routine newborn care, babies were received azithromycin 1% eye ointment as prophylaxis for neonatal conjunctivitis in both eyes within one hour of birth. Babies were observed routinely during every vital monitoring for developing signs of neonatal conjunctivitis for the first 72 hours of life at hospital. During outpatient follow ups, 7 to 14 days and 14 to 28 days, these babies were examined for the presence of neonatal conjunctivitis. Babies having neonatal conjunctivitis were treated empirically with the same topical 1% azithromycin eye ointment after taking eye swab for culture and sensitivity in both eyes. The treatment has been modified based on the culture reports. Proportions were compared using Chi-square test with significance at p<0.05.Results: A total 15 (3.5%) of the 425 babies developed ophthalmia neonatorum. The most common isolate was Staphylococcus aureus which was 4 (26.7%) of all positive cultures followed by Escherichia coli 13.3%, Klebsiella pneumoniae 6.7%, Serracia marcescens 6.7%. None of the risk factors were found to be having association with conjunctivitis.Conclusions: This study concludes that a high proportion of neonatal conjunctivitis present despite eye antibiotic prophylaxis, though a greater reduction in cases has been shown when compared with no prophylaxis at our centre during the previous year. S. aureus was the most common causative organism isolated.

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Histopathological Findings of Cystic Endometrial Morphology Based on Ultrasonographic Imaging in Premenopausal Women

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.773 ◽

2018 ◽

pp. 1

Author(s):

Tugba Kinay ◽

Metin Kaplan ◽

Fulya Kayikcioglu ◽

Jale Karakaya

Keyword(s):

Endometrial Hyperplasia ◽

Care Center ◽

Tertiary Care ◽

Premenopausal Women ◽

Binary Logistic Regression ◽

Endometrial Biopsy ◽

Binary Logistic Regression Analysis ◽

Chi Square ◽

Histopathological Findings ◽

Chi Square Test

Objective: To evaluate the histopathological findings of cystic endometrial morphology based on ultrasonographic imaging in premenopausal women.Study Design: The medical records of 3607 premenopausal women that underwent ultrasonographic examination at a tertiary care center were reviewed, as were endometrial biopsy findings in 816 of the women. These 816 women were divided in 2 groups according to ultrasonographic endometrial findings: the cystic group and the non-cystic group. Clinical and histopathological findings in the 2 groups were compared. Statistical analysis was performed using independent samples t test, chi-square test, and binary logistic regression analysis.Results: Three hundred and eighty one (46.7%) of the women that underwent endometrial biopsy had cystic endometrium, whereas 435 (53.3%) had non-cystic endometrium. The most common histopathological finding in the cystic group was endometrial hyperplasia without atypia (44.6%). Cystic morphology was nearly 8-fold more common in the women with endometrial hyperplasia without atypia (95% CI: 5.43-11.67). The premalignant and malignant pathology rates in the cystic group and non-cystic group were similar (1.1% vs. 0.5% [p=0.426] and 0.8% vs. 0.5% [p=0.669], respectively). Secretory endometrium was less common in the cystic group than in the non-cystic group (5.0% vs. 37.9% [p< 0.001])Conclusion: Cystic endometrial morphology based on ultrasonographic imaging was more common in women with endometrial hyperplasia without atypia. There wasn’t an association between cystic endometrium and other endometrial pathologies or functional endometrium. Keywords: Cystic endometrium, Endometrium, Endometrial hyperplasia, Premenopausal, Ultrasonography

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Neonatal Candidemia: Clinical Presentation, Laboratory Profile, Risk Factors and Immediate Outcome in a Tertiary Hospital in Kerala- A Case-Control Study

Global Journal of Medical Research ◽

10.34257/gjmrfvol20is6pg33 ◽

2020 ◽

pp. 33-38

Author(s):

Dr. Jayaram Sankar. KR ◽

Dr. Sunil Daniel ◽

Dr. Rekha Rachel Philip

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Tertiary Care ◽

Binary Logistic Regression ◽

Tertiary Hospital ◽

Case Control ◽

Chi Square ◽

Chi Square Test ◽

Laboratory Profile ◽

Control Study

Objective: To identify the clinical and laboratory profile and risk factors of bloodstream candida infection in newborns and to assess the immediate outcome of candidemia in newborns. Design: Case -control study. Setting: Tertiary care NICU of Govt. T.D. Medical College, Alappuzha, Kerala from 1st January 2010 to 31st December 2014. Methods: Through consecutive sampling, we got 94 cases and 188 controls. For comparison, chi-square test was used, and for strength association Odds ratio was used. Analysis was done using SPSS V18. Binary logistic regression has been used to identify independent risk factors.

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