scholarly journals Facility based retrospective infant death study in a tertiary care hospital of Tripura

2020 ◽  
Vol 7 (7) ◽  
pp. 2574
Author(s):  
Subrata Baidya ◽  
Sanjib Debbarma ◽  
Debosmita Paul ◽  
Purvita Chowdhury ◽  
Biraj Kumar Kalita ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Care Facility ◽  
Preterm Births ◽  
Healthcare Facility ◽  
Healthcare Services ◽  
Mortality Data ◽  
Care Hospital ◽  
Tertiary Care Facility

Background: Infant and neonatal mortality are important indicators of the overall physical health of a community. An increase is generally indicative of unmet human needs in healthcare, sanitation, nutrition and education. Objective: To estimate the different causes of death along with the geographic distribution of the reported death cases during the study period.Methods: Analysis of the retrospective mortality data of infant and neonates in the Pediatric Department of Agartala Government Medical College and Hospital, from 2014-2018, was conducted.Results: A total of 1525 infant deaths were recorded in the study facility, of which 878 (57.57%) were early-neonates, 120 (7.87%) late neonates and 527 (34.56%) post-neonatal infants. The most reported causes of neonatal mortality in Tripura were found to be preterm/low birth weight and perinatal asphyxia with OR of 1.45 (CI=1.137-1.857) and 1.41 (CI=1.10-1.81) respectively.Conclusions: The increasing burden of preterm births and neonatal sepsis needs attention towards ante-natal care along with holistic healthcare services. The need for intensive actions from both administration and healthcare facility to promote identification of red-flags at primary level, followed by proper referral from the periphery to tertiary care facility has been reiterated in this study.

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

scholarly journals Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study

2021 ◽  
Vol 8 (10) ◽  
pp. 4944
Author(s):  
Shyam V. Ashtekar ◽  
Aryaman Singh ◽  
Manasi S. Padhyegurjar ◽  
Sidrah M. Shaikh ◽  
Abhimanyu R. Kapse ◽  
...  
Keyword(s):  
Physical Activity ◽  
Tertiary Care ◽  
Care Facility ◽  
Cross Sectional Study ◽  
Diabetes Risk ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Waist Size ◽  
Tertiary Care Facility

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

P152590 DAY MORTALITY DATA OF PATIENTS INITIATING MAINTENANCE HEMODIALYSIS AT A TERTIARY CARE FACILITY IN PAKISTAN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonia Asif ◽  
Mohammad Saleem ◽  
Ahad Qayyum
Keyword(s):  
Mortality Rate ◽  
Vascular Access ◽  
Tertiary Care ◽  
Care Facility ◽  
High Rate ◽  
Maintenance Hemodialysis ◽  
Mortality Data ◽  
Tertiary Care Facility ◽  
Town Hospital ◽  
Dialysis Vintage

Abstract Background and Aims Mortality of end stage renal disease patients is 10 to 30 times higher than that of the general population. Timing of death related to dialysis vintage remains unclear. Mortality risk among hemodialysis patients may be highest soon after initiation of hemodialysis, the reason for which remains elusive. Additionally mortality on initiating hemodialysis is related to arteriovenous vascular access. Poor planning for dialysis initiation may contribute to hemodialysis catheter use and the associated high rate of infections. This study was carried out to determine the 90-day mortality in patients starting maintenance hemodialysis at a tertiary care facility in Pakistan. Method This is a cross sectional study which included all consecutive patients who initiated maintenance hemodialysis at Bahria Town Hospital Lahore. A total of 485 participants were included and the collected data was entered into the SPSS software and their mortality rate was calculated within 90 days after initiation of maintenance hemodialysis. Additionally 90-day mortality based on type of vascular access at initiation was also noted. Results The mean age of the participants included in the study was 44 with 50% of the patients were male. The 90-day mortality of patients initiating maintenance hemodialysis at our centre was found to be 37%. 90% of the patients initiating maintenance hemodialysis started through a double lumen temporary dialysis catheter. Amongst these patients the mortality rate was 39%. 10% of the patients initiating maintenance hemodialysis started through an arteriovenous fistula. Amongst these the mortality rate was 19%. Conclusion Our study showed that the mortality rate is high in patients undergoing hemodialysis with in first 90 days. Early planning for permanent vascular access may result in a reduction of mortality.

scholarly journals (A22) Impact of Karachi Terrorist Bombing on an Emergency Department of a Tertiary Care Hospital

2011 ◽  
Vol 26 (S1) ◽  
pp. s6-s7
Author(s):  
H. Waseem ◽  
S. Shahbaz ◽  
J. Razzak
Keyword(s):  
Emergency Department ◽  
Tertiary Care Hospital ◽  
Wound Care ◽  
Tertiary Care ◽  
Care Facility ◽  
Care Hospital ◽  
Disaster Plan ◽  
Tertiary Care Facility ◽  
Number Of Patients ◽  
The Government

ObjectivesThe objective of this study was to collect epidemiological injury data on patients presenting to the emergency department of a tertiary care hospital after the bombing on 29 December 2009.MethodsThis was a retrospective review of the medical records of the victims that were brought to a tertiary care hospital. Bombing victims were described as requiring acute care due to the direct effect of the bombing.ResultsThe results are derived from a sample size of 198 bomb blast victims, most of which were first transported to government hospitals by private cars rather than ambulances. After the government announced free treatment, there was a wave of patients, among which, most were stable and already had received some form of treatment. Approximately 5–6 patients who had life-threatening injuries were brought directly to the tertiary care facility and needed surgical intervention. The lack of security in the emergency department could have lead to another terrorist activity. There were no procedures done in the field as there is lack of emergency medical services training in Pakistan, but in the hospital most of the interventions included intravenous (IV) lines, wound care, and laceration repair. The most common treatments included the administration of IV fluids, antibiotics, and analgesia. Radiographs of specific sites and trauma series were used to rule out bone injuries. There was lack of documentation in most of the medical charts.ConclusionsThe emergency department was overwhelmed with the number of patients that it received. Therefore, an updated disaster plan and regular disaster drills are required. Rapid and accurate triage could minimize mortality among bombing survivors significantly. The majority of patients were discharged home.

Emergency General Surgery Regionalization: Retrospective Cohort Study of Emergency General Surgery Patients at a Tertiary Care Center

2021 ◽  
pp. 000313482110385
Author(s):  
Sullivan A. Ayuso ◽  
Sharbel A. Elhage ◽  
Kyle W. Cunningham ◽  
A. Britton Christmas ◽  
Ronald F. Sing ◽  
...  
Keyword(s):  
General Surgery ◽  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Geographic Origin ◽  
Care Facility ◽  
Care Hospital ◽  
Emergency General Surgery ◽  
Tertiary Care Facility ◽  
Tertiary Care Hospitals

Background Emergency general surgery (EGS) patients presenting at tertiary care hospitals may bypass local hospitals with adequate resources. However, many tertiary care hospitals frequently operate at capacity. We hypothesized that understanding patient geographic origin could identify opportunities for enhanced system triage and optimization and be an important first step for EGS regionalization and care coordination that could potentially lead to improved utilization of resources. Methods We analyzed patient zip code and categorized EGS patients who were cared for at our tertiary care hospital as potentially divertible if the southern region hospital was geographically closer to their home, regional hospital admission (RHA) patients, or local admission (LA) patients if the tertiary care facility was closer. Baseline characteristics and outcomes were compared for RHA and LA patients. Results Of 14 714 EGS patients presenting to the tertiary care hospital, 30.2% were categorized as RHA patients. Overall, 1526 (10.4%) patients required an operation including 527 (34.5%) patients who were potentially divertible. Appendectomy and cholecystectomy comprised 66% of the operations for potentially divertible patients. Length of stay was not significantly different ( P = .06) for RHA patients, but they did have lower measured short-term and long-term mortality when compared to their LA counterparts ( P < .05). Conclusions EGS diagnoses and patient geocode analysis can identify opportunities to optimize regional operating room and bed utilization. Understanding where EGS patients are cared for and factors that influenced care facility will be critical for next steps in developing EGS regionalization within our system.

Mortality in Patients with Primary Unipolar Depression, Secondary Unipolar Depression, and Bipolar Affective Disorder: A Comparison with General Population Mortality

1988 ◽  
Vol 17 (4) ◽  
pp. 351-360 ◽  
Author(s):  
Donald W. Black ◽  
George Winokur ◽  
Amelia Nasrallah
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Geographical Area ◽  
Care Facility ◽  
Unipolar Depression ◽  
Mortality Data ◽  
Initial Portion ◽  
Tertiary Care Facility

Mortality data are presented from a two to fourteen year follow-up of 705 primary unipolar depressives, 302 secondary unipolar depressives, and 586 patients with bipolar affective disorder (BAD) hospitalized at a tertiary care facility. Death ascertainment was made through a record-linkage process. Using sex- and age-standardized mortality ratios (SMRs), the mortality experience of the study population was compared with that of Iowa, the geographical area served by the admitting medical facility for this study group. Results show that risk for all-cause mortality was most pronounced during the first two years following hospital discharge, although secondary unipolar depressives continued to show a significant excess of deaths throughout the entire follow-up period. Deaths occurring from natural causes were significantly excessive only during the initial portion of the follow-up. Deaths from unnatural causes were significantly excessive throughout follow-up except for patients with bipolar affective disorder.

scholarly journals Intrauterine fetal death: Five years’ experience in a secondary care hospital.

2021 ◽  
Vol 28 (08) ◽  
pp. 1076-1082
Author(s):  
Erum Saleem Khan ◽  
◽  
Mahwash Jamil ◽  
Reeta Chanderparkash ◽  
Sheikh Irfan ◽  
...  
Keyword(s):  
Fetal Death ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Intrauterine Fetal Death ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Fetal Demise ◽  
Intrauterine Fetal Demise ◽  
Tertiary Care Facility

Objectives: The objectives of this study were to estimate the prevalence, preoperative, and operative risk factors associated with the higher risk of SSI in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Study Design: Retrospective Study. Setting: Obstetrics and Gynecology Department, Agha Khan Hospital for Women Garden Karachi, Pakistan. Period: Jan 2012 to Dec 2016. Material & Methods: Retrospective review of medical records of patients over a period of five years from Jan 2012 to Dec 2016 was done. Results: The study consisted of 56 cases of intrauterine fetal demise out of 4813 number of deliveries which occurred during the study duration. Overall estimated rate of intrauterine fetal demise was 11.6 %( 56/4813). Approximately 33.9% of cases did not have a clear cause of fetal death identified and hence were un-explained. In 56 cases, 28.6% had some form of congenital abnormality identified on ultrasound, 7.1% (n=4) had anemia, 23.2% (n=13) IUGR, 5.4% (n=3) placental abruption and 1.8% (n=1) of gestational diabetes and around 83.9% (n=47) had normal vaginal delivery and 8 were delivered by LSCS and only 1 patient had instrumental delivery. Fetal characteristics identified 50% (n=28) were males and 50% (n=28) were females. 4 fetuses were born with tight cord around their neck 58.1% were macerated stillbirths (n=25) while 32.6% were fresh stillbirth. Conclusion: Antepartum intrauterine fetal death or stillbirths in the third trimester, affect the entire family. We conclude from our study that quality antenatal care with health education and timely interventions can reduce the number of intrauterine fetal deaths thus reducing the psychological sequelae.

scholarly journals Managing dyspnea in pregnancy-an errand uphill: an experience from the critical care obstetric unit of a tertiary care facility in India

2017 ◽  
Vol 7 (1) ◽  
pp. 152
Author(s):  
Sheeba Marwah ◽  
Jyotsana Suri ◽  
Pratima Mittal
Keyword(s):  
Critical Care ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Care Facility ◽  
Fetal Outcome ◽  
Mortality Data ◽  
Third Trimester ◽  
Maternal Risk ◽  
Tertiary Care Facility ◽  
In Pregnancy

Background: The occurrence of dyspnea in a gravid woman induces the query in the treating obstetrician regarding its root cause being either underlying or new cardiac or pulmonary disease, or due to the pregnancy itself. Attainment to this conclusion requires grasp of the cardiopulmonary changes befalling during normal pregnancy, as well as detection of the ailment of dyspnea during antenatal period. Objective of present study was to find out the incidence and feto-maternal outcome of patients presenting with dyspnea in pregnancy and puerperium.Methods: This study was conducted in Department of Obstetrics and Gynaecology in Vardhaman Mahavir Medical College and Safdarjung hospital over a period of one year, wherein review of all women who had presented with a diagnosis of dyspnea in pregnancy and puerperium, and admitted and treated in the Critical care obstetric unit of the department was done. Thorough evaluation was done and case files were exhaustively reviewed, data was anonymously extracted, and outcomes analyzed. All causes of mortality were also recorded. The primary outcome was incidence of dyspnea in pregnancy. Secondary outcomes measured were socio-demographic variables, timing of presentation-antepartum=first trimester, second trimester, third trimester/postpartum<48 hours, 3-7 days,>7 days, causative factors for dyspnea, any other obstetric complications, mode of delivery, fetal outcome (fetus weight, Apgar score, need for NICU admission), need for ICU/HDU admission, duration and course in the hospital, mortality, and cause of death in case of mortality. Data recording was done on a predesigned proforma and deciphered at the end of study and analyzed.Results: Incidence of dyspnea was 1.97% of all admissions. Pulmonary edema following hypertensive disorders of pregnancy, was the leading cause. 28.5 % women succumbed to their illness. Majority were preterm births (88/112), requiring NICU admission.Conclusions: The clinician should be able to determine the underlying cause of dyspnea, differentiating it from physiologic progesterone-induced hyperventilation. Strategy of expeditious delivery during the third trimester is often warranted after weighing fetal outcome and maternal risk in such women.

scholarly journals A Study of Cost incurred in providing Emergency Care Services in an Apex Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 45-50
Author(s):  
Neeraj Garg ◽  
Amit Lathwal ◽  
Shakti K Gupta ◽  
Ruchi Garg
Keyword(s):  
Emergency Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Facility ◽  
Care Hospital ◽  
Total Cost ◽  
Care Services ◽  
Tertiary Care Facility ◽  
The Cost ◽  
Emergency Care Services

ABSTRACT Introduction An emergency department (ED), also known as accident and emergency (A8E), emergency room (ER), or casualty department, is a medical treatment facility specializing for acute care of patients who present without prior appointment, either by their own means or by ambulance. In spite of the emergency beds forming only a fraction of the hospital beds, they consume a relatively large proportion of the hospitals resources. There is a requirement to ascertain the cost incurred in providing emergency care treatment to the patients coming to an apex tertiary care center, whose principal mandate is to provide tertiary care treatment. The study will not only help in allocating funds to the ED in an apex tertiary care facility but will also be useful if the hospital authorities decide to outsource the emergency services to a third party. Aims and objectives To study the cost incurred in providing emergency care services in an apex tertiary care hospital. To identify the various cost centers pertaining to patient care in the emergency care department and to estimate the cost of rendering patient care in ED and the cost of running the emergency per day. Materials and methods Six months’ retrospective data were collected from the ED, accounts section, engineering section, stores department, radiology department, emergency lab, computer facility, etc. The cost was apportioned to per patient as well per hour in rendering emergency care services. Observations The total cost incurred in providing emergency care services in the hospital under study was Rs 2034 per patient, while Rs 31,000 are spent per hour in running the emergency care facility. Discussion Almost 40 to 50% of the total cost incurred on providing emergency care services goes to the salary head of the staff working in the ED. The next major sources of expenditure are the radiology and lab investigations. Conclusion The study suggests that a considerable amount of hospital funds are spent on providing emergency care services in the apex tertiary care facility, whose primary mandate is to provide tertiary care services. The possibility of complete outsourcing or partial outsourcing in the form of radiology investigations and hiring humanpower on a contract basis can be a viable solution, to reduce the cost on providing emergency care, which can better be utilized in providing high-end tertiary care facilities. How to cite this article Garg N, Gupta SK, Lathwal A, Garg R. A Study of Cost incurred in providing Emergency Care Services in an Apex Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2016;4(1):45-50.

scholarly journals Awareness of Mammographic Screening Amongst Females Visiting Breast Clinic at a Tertiary Care Hospital of Karachi

2020 ◽  
Vol 10 (3) ◽  
pp. 197-199
Author(s):  
Summayyah Shawana ◽  
Sehrish Shafique ◽  
Sarah Rabbani ◽  
Sobia Hassan ◽  
Santosh Sidhwani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Care Facility ◽  
Mammographic Screening ◽  
Breast Lesions ◽  
Care Hospital ◽  
Breast Clinic ◽  
Tertiary Care Facility ◽  
Malignant Breast

Objective: To assess the awareness of mammographic screening among women visiting the breast clinic at a tertiary care facility in Karachi. Study Design and Setting: This cross-sectional study was conducted at Jinnah Post Graduate Medical Centre Karachi over one month period from 1-10-2019 to 31-10-2019. Methodology: After receiving ethical approval, relevant information from patients coming to the breast clinic over the study period, regarding age, level of education, family history, diagnosis and awareness regarding mammographic screening was recorded on specially designed proformas and was statistically analyzed on SPSS 23. P value </= to 0.05 was considered as statistically significant. Results: Out of the 100 participants included in the study 68 patients had malignant lesions, 18 had a benign diagnosis while 14 patients were undiagnosed. Only 42 had at least some knowledge of mammographic screening of breast cancers and only 15 patients actually had a screening mammogram performed. Of those aware of the screening majority were informed regarding the procedure by health care professionals or through media sources. Only 4 out of 17 participants with a positive history of breast cancer in the family had the screening done. 12 patients diagnosed with malignant breast lesions were under the age of 40 years. Conclusion: Awareness of mammographic screening for breast cancer among females in our setup is still unsatisfactory and calls for improvements in the awareness programs for breast cancer screening. An early age at diagnosis for malignant breast lesions should prompt the concerned to revise the recommended lower age limit for commencing mammographic screening

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