scholarly journals Adherence to recommended intra-partum guidelines of high risk pregnancies: a study in North Bengal Medical College, Darjeeling district, West Bengal, India

2019 ◽  
Vol 6 (8) ◽  
pp. 3490
Author(s):  
Sumanta Chakraborty ◽  
Sunamika Banerjee
Keyword(s):  
High Risk ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Health Service Delivery ◽  
Near Miss ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Standard Treatment Guidelines ◽  
North Bengal

Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya.Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique.Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis.Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures. 

scholarly journals A survey of prescription pattern of antibiotic drugs on patients suffering from ENT infection within Dhaka metropolis

2017 ◽  
Vol 6 (2) ◽  
pp. 257 ◽  
Author(s):  
Rubaba Karim ◽  
Md. Sahab Uddin ◽  
M. Sohanur Rahman ◽  
Most. Akhlatun Nure ◽  
Rita Rani Saha ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Brand Names ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Medical College ◽  
Antibiotic Drugs ◽  
Antibiotic Drug ◽  
Antibiotics Use ◽  
Standard Treatment Guidelines ◽  
Almost All

Background: This survey was designed to assess and evaluate the prescription pattern of antibiotic drugs on patients suffering from ENT infection within Dhaka metropolis.Methods: A cross sectional, observational and prospective study was conducted from January to June 2015 in the out-patients (OPD) and in-patients (IPD) of ENT department at different general and specialized government and private hospitals (Dhaka Medical College and Hospital, Sir Solimullah Medical College Mitford Hospital, Holy Family Red Crescent Medical College and Hospital, Dhaka Community Medical College and Hospital) within Dhaka city.300 prescriptions were collected and randomly evaluated for this present study.Results: Out of 300 patients, 220 (73.33%) were male and 80 (26.67%) were female (including children and adults) where most of the patients were outpatients 262 (87.33%). In the patients information section it was observed that approximately 93.33%  prescription contained antibiotic drugs and almost all prescription (100%) contained antibiotic drugs along with other drugs such as 80.67%PPI (proton pump inhibitors), 76.67% analgesic and 51.33% vitamin / iron supplements. From this analysis we found that 19.33% prescription contained single antibiotic drug, 80.67% contained two antibiotic drugs and no prescription contained more than two antibiotic drugs. Most of the prescribed drugs were administered orally (12% capsule, 80% tablet form). Out of 473 prescribed antibiotic drugs majority of them lie underβ-Lactam (54%) class followed by cephalosporin (46.33%) class in which maximum drugs (92%) were prescribed by their brand names.Conclusions: Prescribing more than one antibiotics was commonly encountered in this study indicating the occurrence of polypharmacy. Interventions to rectify over prescription of antibiotics, use of brand names, inadequate labelling of drugs is necessary to improve rational drug use. Standard treatment guidelines, hospital formulary, and educational intervention become essential to modify this behaviour to benefit the patient.

scholarly journals Major Depressive Disorder Among Patients Suffering From Myocardial Infarction

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 39-42
Author(s):  
Md Shamshul Alom ◽  
Md Sultan E Monzur ◽  
Md Mofazzal Sharif ◽  
Md Zillur Rahman
Keyword(s):  
Depressive Disorder ◽  
Cross Sectional Study ◽  
Major Depressive ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Postmyocardial Infarction ◽  
Prevalence Of Depression ◽  
Artery Disease ◽  
North Bengal

Background: Depression is now a recognized independent risk factor of coronary artery disease. Postmyocardial infarction (MI) patients with a clinician-diagnosed depressive disorder or self-reported depressive symptoms carry a 2.0- to 2.5-fold increased relative risk of new cardiovascular events and cardiac mortality. Objective: The objective of this study was to determine the prevalence of depression among patients suffering from MI. Materials and Methods: This was a cross sectional study carried out in the department of Cardiology in collaboration with department of Psychiatry at North Bengal Medical College Hospital (NBMCH) Sirajganj, Bangladesh, during the period of July 2016 to December 2017 among purposively selected 50 patients attended the Cardiology in-patient department of NBMCH. Results: The heighest number of respondents (30%) were from 41-50 years of age group. Among the respondents, 68% were male and 32% were female. Most of them were married (80%), muslim (78%), completed higher secondary level of education (26%), businessmen (38%) and of rural background (60%). Total numbers of depression were 28 (56%), among them, 17 were males and 11 were females. Conclusion: This study reflects that post MI patients experienced significantly higher rate of depression. So we should pay attention for their cardiac management as well as to evaluate depression KYAMC Journal Vol. 10, No.-1, April 2019, Page 39-42

scholarly journals Adherence to standard treatment guidelines among prescribers in primary healthcare facilities in the Dodoma region of Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources that impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions. Methods A cross-sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five broadly defined main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 cases (30.9%) and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria. Conclusion Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted and focused attention, directed at improving prescribing and pharmacotherapy, is required with a view of improving patient care and health outcomes.

scholarly journals Adherence to Standard Treatment Guidelines Among Prescribers in Primary Healthcare Facilities in the Dodoma Region of Tanzania

2021 ◽  
Author(s):  
Karin Anne Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background: Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources which impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions.Methods: A cross sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public, primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five, broadly defined, main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results: Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 (30.9%) cases and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria.Conclusion: Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted, and focused attention directed at improving prescribing and pharmacotherapy is required with a view of improving patient care and health outcomes.

SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang
Keyword(s):  
Preterm Birth ◽  
Comparative Study ◽  
Pregnancy Outcome ◽  
Neonatal Morbidity ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Chorionic Villi ◽  
Term Birth ◽  
Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

Rapid detection of Rotavirus antigen in stool sample of acute diarrheic children

2012 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Sushmita Roy ◽  
S.M. Shamsuzzaman ◽  
K.Z. Mamun
Keyword(s):  
Stool Sample ◽  
Rapid Detection ◽  
Cross Sectional Study ◽  
Rapid Diagnosis ◽  
Age Group ◽  
College Hospital ◽  
Cross Sectional ◽  
Rotavirus Infection ◽  
Medical College ◽  
Stool Samples

Rotavirus is one of the leading causes of pediatric diarrhea globally. Accurate and rapid diagnosis of Rotavirus diarrhea should reduce unnecessary use of antibiotics and ultimately reduce drug resistance. Study was designed for rapid diagnosis of Rotavirus antigen in stool sample by ICT (Immunochromatographic test) as well as to observe the seasonal variation of rotavirus infection. This cross sectional study was carried out in the department of Microbiology, Dhaka Medical College from January 2011 to December 2011. Eighty stool samples were collected from Dhaka Shishu Hospital and Dhaka Medical College Hospital. All samples were tested for rotavirus antigen by ICT. Among 80 patients, 42 (52.5%) samples were positive for rotavirus antigen. Among these 42 positive samples, 30 (71.43%) were from 0-12 months of age group, 10 (23.81%) from 13 to 24 months of age group and rest 2 (4.76%) from 25 to 36 months of age group. Rotavirus Ag was detected in stool samples from January to April and another peak episode from October to December. Considering the importance of Rotavirus associated diarrhea, rapid detection of Rotavirus infection in human is substantially needed and should be routinely practiced.DOI: http://dx.doi.org/10.3329/bjmm.v6i1.19354 Bangladesh J Med Microbiol 2012; 06(01): 11-13

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