scholarly journals Maternity handover in Kerala: a cross sectional study

2018 ◽  
Vol 5 (9) ◽  
pp. 3760 ◽  
Author(s):  
Aadil Sheikh ◽  
Jessica Dunphy ◽  
Claire Humphries ◽  
Christina MacArthur ◽  
Semira Manaseki-Holland
Keyword(s):  
Healthcare Provider ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Community Health Services ◽  
High Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Background: The objective of the study was to explore the referral system from the community to hospital obstetric care in Kerala, India.Methods: Cross-sectional study. A total of 206 obstetric inpatients in 3 hospitals in Kerala, India completed an orally-administered questionnaire regarding referral and attitudes towards healthcare information.Results: Among 206 respondents, 19 (9%) had been referred from another healthcare provider.  In multivariate analysis, referral was independently associated with being in a tertiary hospital (p<0.001). At total of 17 referred women received a document containing hand-written notes from their previous healthcare provider. Just 3 of the documents available to view were formal referral documents; others were test results and/or hospital notes. A total of 170 (86%) of the 206 women thought that receiving documents such as referral letters was important; mostly because it helped them understand their condition and explain it to others (91%).Conclusions: A high rate of self-referral (91%) was reported by obstetric inpatients. It appears that some women who are referred do not receive a formal referral document. Participants thought that receiving referral documents was important. A strong health system requires transfer of information between primary and secondary/tertiary care services, which India is seeking to develop. Further research is needed into why women are not accessing community health services and the impact of the content of referral documents on patient care. 

CROSS SECTIONAL STUDY OF CAUSES AND DETERMINANTS OF STILLBIRTHS AT TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 41-43
Author(s):  
Chavan L. G ◽  
Bangal V. B. ◽  
Poorna M. N.
Keyword(s):  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Cross Sectional Study ◽  
High Rate ◽  
Child Health Services ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Common Causes

Introduction- Stillbirth rates are unacceptably high in developing countries. It reects the suboptimum quality of maternal and child health services. Material And Methods- Prospective observational cross sectional study, carried out for one year duration at tertiary care referral hospital in central India. Results-There were 9165 deliveries and 9318 babies born in the hospital.There were 318 stillbirths of which 245(77%) were antepartum stillbirths and 73(23%) were intra-partum stillbirths. The stillbirth rate in the present study was 34/1000 births. Ante-partum haemorrhage (36%) and pregnancy induced hypertension (21%) were most common causes of ante-partum stillbirths where as extreme prematurity with very low birth weight (41%), birth asphyxia, meconium aspiration (21%) and intra-partum haemorrhage (15%) were common causes of intra-partum stillbirths. Conclusion- There is high rate of stillbirths in the present study. Health education, improvement of maternal nutrition, regular antenatal check-ups, high risk pregnancy identication and timely referral and institutional deliveries will help in preventing large number of stillbirths.

scholarly journals 458. Diagnostic Accuracy and Management of Suspected Moderate to Severe Cellulitis Referred to an Infectious Diseases Outpatient Parenteral Antibiotic Clinic: A Prospective Cross-Sectional Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S225-S225
Author(s):  
Jolanta Piszczek ◽  
Eric Partlow ◽  
Shay-Anne Daniels ◽  
Milena Semproni ◽  
Wayne Ghesquiere
Keyword(s):  
Emergency Department ◽  
Infectious Diseases ◽  
Diagnostic Accuracy ◽  
Cross Sectional Study ◽  
High Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Parenteral Antibiotic ◽  
Intravenous Antibiotics ◽  
The Impact

Abstract Background Moderate to severe cellulitis is a common reason for presentation to the emergency department and administration of intravenous antibiotics. Misdiagnosis of cellulitis occurs frequently as the disease can masquerade as a wide variety of noninfectious and infectious problems. There are currently no studies evaluating the impact of infectious diseases physicians on the diagnostic accuracy and management of cellulitis referred to an outpatient parenteral antibiotic clinic from the emergency department. The objective of this study was to quantify the prevalence of misdiagnosed moderate to severe cellulitis through an evaluation by an infectious diseases specialist, characterize the alternative diagnoses, and assess variables associated with misdiagnosis. Methods A prospective cross-sectional study of adults referred from emergency departments with presumed moderate to severe cellulitis to an outpatient parenteral antibiotic clinic staffed by infectious diseases specialists. Results 301 consecutive patients with presumed cellulitis were evaluated over a 6-month period. A concurring diagnosis of cellulitis was found in 170 patients (56.5%), for a misdiagnosis rate of 43.5% (131/301). Table 1 summarizes the alternative diagnoses. Infectious conditions other than cellulitis were the most common (63/301; 20.9%), with abscess being present in 23 (7.6%) of patients. Fifty-two of 301 (17.3%) of the diagnoses were noninfectious and 16/301 (5.3%) patients had a dual diagnosis where minor cellulitis was present, but secondary to another, predomintating condition. The presence of stasis dermatitis (OR 6.62, P = 0.013) and a history of physical trauma (OR 1.76, P = 0.046) were associated with a misdiagnosis. 31.9% (107/335) of antibiotic regimens prescribed by emergency physicians were inappropriate or sub-optimal compared with 7.9% (22/280) of those ordered by infectious disease doctors. Conclusion Moderate to severe cellulitis was incorrectly diagnosed in nearly half of the patients referred for intravenous antibiotics and resulted in a high rate of unstewardly antimicrobial use. Infectious diseases physicians at an outpatient antibiotic clinic improved the diagnostic accuracy and management of this complicated condition. Disclosures All authors: No reported disclosures.

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

2020 ◽  
pp. archdischild-2020-319173
Author(s):  
Rasha D Sawaya ◽  
Cynthia Wakil ◽  
Sami Shayya ◽  
Moustafa Al Hariri ◽  
Alik Dakessian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Peak Time ◽  
Work Efficiency ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Impact

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

scholarly journals Fetomaternal outcome of eclamptic parturient in a tertiary care center: A descriptive cross-sectional study

2021 ◽  
Vol 12 (7) ◽  
pp. 94-99
Author(s):  
Aashika Shrestha ◽  
Junu Shrestha ◽  
Sangeeta Gurung ◽  
Anjali Subedi Adhikari
Keyword(s):  
Developing Countries ◽  
Perinatal Outcome ◽  
Early Recognition ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nicu Admission

Background: Eclampsia is still a leading cause of maternal death second to postpartum hemorrhage in developing countries. It is also associated with poor perinatal outcome. Aims and Objective: The objective of this study was to find the incidence, maternal and perinatal outcome of patients admitted in a tertiary hospital, Pokhara with diagnosis of eclampsia. Materials and Methods: A descriptive cross sectional study was conducted in department of obstetrics and gynecology, MTH, Pokhara for duration of 1 year from 1st January 2020 to 30th December 2020. A total of 22 patients were enrolled in the study irrespective of timing of occurrence of fits, age, parity, gestational age and status of booking on admission. Results: During the study period the incidence of eclampsia at our center was 0.85% .Majority of the patients 17(77.27%) were primigravida and 16(72.68%) delivered at less than 37 weeks of gestation. Only 4 patients had her antenatal checkup done in MTH. According to timing of occurrence of fits Antepartum and postpartum eclampsia comprise 50% each with no cases of intrapartum eclampsia. Caesarean section was done in 17(77%) cases. Among the cases 10, (45.45%) patients required ICU admission and 6(27.27%) required ventilator support. HELLP, acute renal failures, PRES, PPH were causes of maternal morbidity. Three (13.63%) babieswere born stillbirth. Sixteen (72.72%) babies were born preterm and 13(59.09%) had birth weight less than 2.5kg. Six (27.27%) babies needed NICU admission. Conclusion: Eclampsia continues to be one of the prime etiological factors for maternal and perinatal morbidity and mortality in developing countries like ours. This is mostly due to the delay in seeking and reaching the care. Regular antenatal checkup, early recognition, its prevention and proper management of eclamptic cases are vital to tackle this challenge.

scholarly journals Wastage of rarest blood and blood components can be stopped: 9 years retrospective and cross-sectional study at tertiary hospital

2018 ◽  
Vol 6 (11) ◽  
pp. 3678
Author(s):  
Balkrishna H. Namdhari ◽  
Tapasya V. Bharati ◽  
Ashish P. Shinde
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Red Cells ◽  
Care Hospital ◽  
Blood Components ◽  
Sectional Study ◽  
Cross Sectional

Background: Inventory of blood/blood components suffer due to outdating of Rh Negative units. Rationale of this article is strategy of transfusion of O Rh Negative red cells to all. A Rh Negative red cells can be given to A Rh Positive, AB Rh Positive. B Rh Negative red cells can be given to B Rh Positive, AB Rh Positive. AB Rh Negative red cells to AB Rh Positive recipients. AB Rh Negative FFP/PRP can be given to all. Objective was to avoid out dating of Rh Negatives by studying the percentage of outdated Rh Negative units amongst the all outdated.Methods: This was 9 years observational, retrospective, cross sectional and descriptive study conducted at tertiary care hospital. Outdated units of Rh Negative blood and components were analysed from the year wise discard registers of blood bank. Percentage of Rh Negative units within all outdated units were calculated.Results: 198 Rh Negative units of whole blood and blood components within all outdated units was 29.11%. Out of 198 the 20 Rh Negative blood components were discarded.Conclusions: Adopt type and screen protocol to prevent outdating. Avoid to bleed the rare blood groups. Audit by hospital transfusion committee and implementation of MSBOS. Track O Rh Negative red cells transfusion to Rh Positive as quality indicator. Track/review transfusion of O Rh negative red cells to Non O Rh negative recipients. Track AB Rh Negative FFP/PRP transfusions to all.

scholarly journals Correlation between sonological and clinical profile of mesenteric lymphadenitis among children in a tertiary care hospital of central Kerala

2021 ◽  
Author(s):  
Vinod Joseph ◽  
Danny Jose Titus ◽  
Aby Dany Varghese ◽  
Jijo Joseph John ◽  
Girija Mohan ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mesenteric Lymphadenitis ◽  
Younger Age

Background: For abdominal pain in children, imaging is routinely applied to make a possible diagnosis both in the outpatient and in the emergency department. Though the diagnosis of mesenteric lymphadenitis is made often these days, the significance of the size and number is still ambiguous and most studies consider mesenteric lymphadenitis is defined as three or more lymph nodes that are each 5 mm or greater in the short axis.Methods: Cross-sectional study was conducted in a tertiary hospital in central Kerala and the study tool included a detailed structured questionnaire.Results: Our study included 115 children with pain in the abdomen. 69 were found to have mesenteric lymphadenitis. Younger age group, fever as a symptom and acute infective gastroenteritis are statistically significantly associated with mesenteric lymphadenitis.Conclusions: In our study, acute infective gastroenteritis was the most common cause to be associated with mesenteric lymphadenitis which was. The incidence of mesenteric lymphadenitis was found to be more in children below 5 years.

scholarly journals The impact of the Covid-19 pandemic on emergency surgery in a tertiary hospital in Jordan. A cross sectional study

2021 ◽  
pp. 102339
Author(s):  
Mohammad Rashdan ◽  
Raed Al-Taher ◽  
Mohammad Qaisi ◽  
Ibrahim Khrais ◽  
Mohammad Salameh ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

scholarly journals Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Bishal Raj Joshi ◽  
Shikha Rizal ◽  
Shanti Subedi
Keyword(s):  
Confidence Interval ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Thyroid hormone is known to affect reproductive biology. Abnormal uterine bleeding is one of the common presentations in gynaecology outpatient departments and thyroid dysfunction is known to affect its progression. This study aims to find the prevalence of thyroid dysfunction in diagnosed cases of abnormal uterine bleeding in patients in a tertiary hospital of eastern Nepal. Methods: A descriptive cross-sectional study was conducted in patients diagnosed with abnormal uterine bleeding in a tertiary care hospital of eastern Nepal from April 2019-March 2020 after taking ethical clearance from the Institutional Review Committee. On basis of inclusion and exclusion criteria, 95 cases of abnormal uterine bleeding were included in the study. A blood sample was taken and a thyroid function test was done by chemiluminescence assay on an automated analyzer. Convenient sampling method was used for sample collection. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the total cases of abnormal uterine bleeding, 15 (15.79%) (8.46-23.12 at 95% Confidence Interval) had thyroid dysfunction. Among total cases, 80 (84.21%) were euthyroid. The mean age of the patients was 33±8 years. Among thyroid dysfunction, 9 (60.0%) were hypothyroid, 4 (26.66 %) were subclinical hypothyroid, and 2 (13.33 %) were hyperthyroid. Conclusions: Thyroid dysfunction was common among patients with abnormal uterine bleeding, with hypothyroidism being the most common type.

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