scholarly journals Expenses incurred by hospitalised patients in Era’s Lucknow Medical College, Lucknow

2021 ◽  
Vol 8 (11) ◽  
pp. 5451
Author(s):  
Digvijay Chaudhary ◽  
M. M. A. Faridi ◽  
Tarannum Fatima ◽  
Aysha Rahman
Keyword(s):  
Tertiary Care ◽  
General Medicine ◽  
Total Cost ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Hospitalised Patients ◽  
Private Teaching ◽  
Surgical Conditions ◽  
The Cost ◽  
Tertiary Care Hospitals

Background: Significant amount is spent by the patients when they attend tertiary care hospitals for treatment inspite of free services. The objective of this study was to account expenses on the medication, consumable items for patient care and food and transport.Methods: Fifty patients were recruited, 10 patients each from pediatrics, general medicine, obstetrics and gynaecology, general surgery and orthopaedics indoor wards. First two patients admitted on the day of admission were enrolled and followed for three days. The cost of patient’s expenses on investigations, medicines and consumables, travel to the hospital and food on self and relatives during hospitalization was estimated with the help of a questionnaire.Results: The expenditure was more on the patients suffering from surgical conditions. Total expenditure on the patients admitted in the orthopedics, surgery and surgical cases of obstetrics and gynaecology wards was INR 31985/, INR 11798/- and INR 14746/- for 3 days respectively. Out of the total expenses INR 1095/-, INR 1150/- and INR 1316/- were spent on food and travel of the patients and family members to the hospital for admission in orthopedics, surgery and surgical cases of obstetrics and gynaecology wards respectively. In patients with non-surgical conditions like medicine, pediatrics and non-operative cases of obstetrics and gynaecology the total cost per patient was INR 5610/-, INR 5037/- and INR 4416/- respectively.Conclusions: Patients treated in the private teaching hospital spent significant number of rupees. The expenditure by the patients undergoing surgical treatment spent two to three times more as compared to patients admitted in the general medicine and pediatric wards.

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

scholarly journals ANTIHYPERTENSIVE PHARMACOTHERAPY IN HYPERTENSIVE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL AND MEDICAL COLLEGE IN INDIA

2021 ◽  
pp. 30-36
Author(s):  
RANJODH JEET SINGH
Keyword(s):  
Heart Rate ◽  
Tertiary Care ◽  
General Medicine ◽  
Olmesartan Medoxomil ◽  
Joint National Committee ◽  
National Committee ◽  
Total Period ◽  
Medical College ◽  
Group B ◽  
Stage 1

Aim and Objectives: The aim of the study was to compare the efficacy of Atenolol and Olmesartan in Stage-1 hypertension (HTN), and the adverse effect profile of Atenolol and Olmesartan in Stage-1 HTN. Methods: A prospective, randomized, open, and parallel study was carried out in 100 patients attending the outpatient department of General Medicine Department MMIMSR, Mullana, Ambala, India with Stage -1 HTN according to joint national committee VII. The patients were randomly divided into two groups to receive Tab. Atenolol 50 mg od (Group A, n=50) and Tab. Olmesartan medoxomil 20 mg (Group B, n=50) od for a total period of 12 weeks with regular follow up every 2 weeks from the baseline. At each visit, blood pressure (BP), heart rate, and adverse effects were evaluated. Laboratory investigations were carried out at baseline and end of the study period. p<0.005 was considered statistically significant. Results: Atenolol and Olmesartan medoxomil both significantly reduce BP and heart rate (p<0.005). Olmesartan medoxomil is more efficacious in reducing BP. Conclusion: Olmesartan medoxomil is a better choice for Stage -1 HTN between the two drugs as it leads to a greater decrement in BP.

scholarly journals A Survey of Factors Influencing Drug Choice and the Prescribing Attitudes Among Junior Doctors of Two Major Tertiary Care Hospitals in Chittagong City

2018 ◽  
Vol 17 (1) ◽  
pp. 17-22
Author(s):  
Jannatul Ferdoush ◽  
Abhijit Chowdhury ◽  
Kohinoor Parveen ◽  
Maliha Ata ◽  
Sefa Sarwath Alam ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Complete Response ◽  
Continuous Medical Education ◽  
Junior Doctors ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Factors Influencing ◽  
Drug Choice ◽  
Tertiary Care Hospitals

Background: The magnitude of rational prescribing is well known but the irrationalities and errors in prescriptions are seen worldwide as the training of future doctors is still not up to the mark. This study aimed to find out the factors influencing drug choice and the prescribing attitudes among junior doctors of two major tertiary care hospitals in Chittagong city. Methods: A cross-sectional questionnaire survey was conducted among the junior doctors of Chittagong Medical College Hospital (CMCH) and Chattagram Maa -O- Shishu Hospital Medical College (CMOSHMC) to assess the factors influencing drug choice and the prescribing attitudes among junior doctors during August 2016. Results: The questionnaires were provided to 220 participants of whom 162 (73.63%) participants provided a complete response to the survey. The response rate was 75.89% in CMOSHMCH and 71.29% in CMCH. The majority (87.03%) of junior doctors mentioned that they are highly influenced by their supervising senior doctors’ patterns of prescriptions. About 79.01% of them took the cost of drugs into consideration while prescribing. 58.64% of the prescribers reported their confidence while prescribing without supervision. On the otherhand, 33.33% doctors mentioned that side effects of the drug changed their patterns of prescriptions. Only one-third (33.95%) of the junior doctors opined that the pharmaceutical promotional offers never influence them. Conclusion: Junior doctors decide their drug of choice mainly by copying their supervising senior doctors’ prescriptions without knowing how to choose, and they feel less confident while prescribing. Issues of drug cost, adverse drug reactions concerned the majority of the participants, but they do not have the clear ideas on how to deal with these practice behaviours. Moreover, pharmaceutical promotional offers significantly persuaded the junior doctors’ prescription patterns. So, there is a need for the continuous medical education programs in hospital settings to train the junior doctors for building capacities and competencies while prescribing. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 17-22

Pharmacoeconomic Analysis of Using Sinemet CR over Standard Sinemet in Parkinsonian Patients with Motor Fluctuations

1998 ◽  
Vol 32 (9) ◽  
pp. 878-883 ◽  
Author(s):  
Alan G Hempel ◽  
Mary L Wagner ◽  
Mohamed A Maaty ◽  
Jacob I Sage
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Pharmacoeconomic Analysis ◽  
Tertiary Care ◽  
Motor Fluctuations ◽  
University Teaching ◽  
Total Cost ◽  
Medication Costs ◽  
The Cost

OBJECTIVE: To compare the costs of pharmacotherapy in patients with Parkinson's disease before and after converting from standard Sinemet to extended-release Sinemet CR. DESIGN: Investigators retrospectively reviewed records of patients converting from Sinemet to Sinemet CR for efficacy and total drug costs. Cost-effectiveness was evaluated retrospectively from data collected in prospective Sinemet CR efficacy trials. SETTING: Parkinson's disease clinic at a tertiary care university teaching hospital. PATIENTS: 100 patients with motor fluctuations who had undergone an initial 6-month course of Sinemet therapy, followed by a 6-month course of Sinemet CR. MAIN OUTCOME MEASURES: Total cost was measured as the cost of Sinemet formulations plus the costs of other antiparkinson medications. Differences in pre- and postconversion costs were compared by using the paired, two-tailed Student's t-test. A substudy of 39 patients on the cost-effectiveness of conversion measured the ratio of daily medication costs to the daily hours “on” without chorea. RESULTS: While total daily medication costs after conversion increased by 21%, patients experienced either a comparable or an improved degree of disease control with Sinemet CR. Patients who were also taking selegiline were able to decrease selegiline expense by 20%. The costs of other adjunctive medications did not differ significantly after conversion. The cost-effectiveness analysis revealed an increase in postconversion on time by 2.2 hours (p = 0.0001), accompanied by a $2.85 decrease in total cost per hour on without chorea (p = 0.11). CONCLUSIONS: Although Sinemet CR is more costly, it may be more cost-effective in patients with motor fluctuations. Some patients may be able to reduce adjunctive medications.

scholarly journals Study of pattern of congenital anomalies at tertiary center in Maharashtra, India

2018 ◽  
Vol 7 (7) ◽  
pp. 2802
Author(s):  
B. B. Yadav ◽  
S. B. Yadav ◽  
P. K. Damase
Keyword(s):  
Congenital Anomalies ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Second Trimester ◽  
Community Based ◽  
Common Pattern ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Tertiary Center

Background: To highlight common pattern of congenital malformation seen at hospital population of tertiary care center in Maharashtra.Methods: The study was a descriptive prospective study and conducted in the department of obstetrics and gynaecology of government medical college Latur, Maharashtra for a period of six months. Study includes all womens coming for 2nd trimester MTP due to congenital anomalies in foetus and women’s admitted in labour having anomalous foetus. Details of maternal age, parity, type of anomaly present and sex of fetus were noted.Results: Total babies born in the study period were 3482 (including the second trimester abortions). Total babies with congenital abnormality were 75, making the prevalence 2.15%. 10 cases (13.33) had multiple anomalies involving more than one system. The predominant system involved was central nervous system 40 (53.33%) followed by gastrointestinal system 15 (20%). In this study male babies affected more than females.Conclusions: Prevalence of the congenital anomalies will be definitely higher at tertiary care center and to know prevalence in community, more community based studies are required. Increased awareness about preventable risk factors may help in reducing the incidence of congenital anomalies.

scholarly journals A study of clinical profile of renal involvement in diabetic patients in correlation with diabetes complication at tertiary care center, Gujarat, India

2020 ◽  
Vol 7 (4) ◽  
pp. 630
Author(s):  
Virendra Kosamiya ◽  
Niyati Gosai
Keyword(s):  
Diabetic Patient ◽  
Microvascular Complications ◽  
Care Center ◽  
Renal Involvement ◽  
Tertiary Care ◽  
General Medicine ◽  
Diabetic Patients ◽  
Female Ratio ◽  
Medical College ◽  
Male Female Ratio

Background: The chronic complications of diabetes are broadly divided into microvascular and macrovascular, with the former having much higher prevalence than latter. Microvascular complications include neuropathy, nephropathy and retinopathy. Objectives of the study was to assess the clinical and biochemical profile of renal involvement in diabetic patient and complications due to diabetes mellites.Methods: This was a hospital based prospective study done in which total of 250 cases attended and admitted at general medicine department, Government Medical College, Sir. T. Hospital, Bhavnagar. Study included Diabetic patient having age - >12 years, Both Gender and Patient who gives consent for study.Results: Almost 54.8% having age between 41-60 years, Male: female ratio 0.87:1 and 44.0% were to ‘obese 2’ Body mass index (BMI) category. Around 22.4% participants have retinopathy, 30.0% have anemia, 62.4% have HTN and 26.8% have Ischemic Heart Disease (IHD). Almost 59.6% participants have S. creatinine level was 1.3 to 4 mg/dL and 43.6% have stage 5 of Chronic Kidney Disease (CKD).Conclusions: Incidence of DM Nephropathy increase with age. With increasing numbers of years of diagnosed DM, the chances of DM Nephropathy are increased and as the duration of DM as well as duration of uncontrolled glycemia increases GFR decreases and DM Nephropathy progresses. HbA1c is a useful marker to account for the glycemic control over the past months, and hence the better indicator to the development as well as progression of DM Nephropathy.

scholarly journals Antibiotic prescribing among inpatients with infectious and non-infectious indications in obstetrics and gynaecology departments at two tertiary care hospitals in Central India

2020 ◽  
Author(s):  
Anna Machowska ◽  
Kristoffer Landstedt ◽  
Cecilia Stålsby Lundborg ◽  
Megha Sharma
Keyword(s):  
Hospital Stay ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Central India ◽  
Fixed Dose ◽  
Antibiotic Prescribing ◽  
Prescription Data ◽  
Surgical Indications ◽  
Obstetrics And Gynaecology ◽  
Tertiary Care Hospitals

Abstract Background: Patients in obstetrics and gynaecology (OBGY) departments are at high risk of life-threatening infection, thus prescribed antibiotics extensively. The use of antibiotics leads to increasing antibiotic resistance (ABR). Antibiotic surveillance is one of the cornerstones to combat ABR. However, surveillance of, department specific antibiotic prescription data is rarely performed, especially in low- and middle-income countries. Aim: To describe and compare antibiotic prescription patterns among the inpatients at OBGY departments of two tertiary care hospitals, one teaching (TH) and one non-teaching (NTH), in Central India. Methods: A prospective study was conducted for three years using. Demographics, length of hospital stay, diagnoses and prescribed antibiotics including dose, duration and frequency were recorded for all inpatients during their hospital stay. The patients were divided into, infectious and non-infectious diagnosis categories and further into surgical, non-surgical and possible surgical indications using the International Classification of Disease system version-10. Results: A total of 5558 patients were included in the study; 2044 (81%) in the TH and 2567 (85%) in the NTH received antibiotics (p<0.001). A majority of the patients with surgical indications were prescribed antibiotics (TH-87%, NTH-100%). Prescribing of the fixed-dose combinations (FDCs) of antibiotics and use of trade names were more common at the NTH. Most of the inpatients who had neither surgery nor any confirmed bacterial infection received antibiotics (TH-71% and NTH-75%). Overall, higher DDD/1000 patients were prescribed in the TH in both categories. Conclusions: High antibiotic prescribing for the inpatients having no infection indications in both hospitals, as well as frequent prescribing of trade-name, broad-spectrum antibiotics, including the FDCs in the NTH than the TH, are points of concern. Investigation of the underlying reasons for prescribing antibiotics for unindicated diagnoses and the development and implementation of antibiotic stewardship programs are recommended measures to improve the antibiotic prescribing practice.

scholarly journals Study of the clinical spectrum of AUB (FIGO AUB Systems) and women’s attitude towards its management at Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India

2020 ◽  
Vol 10 (1) ◽  
pp. 178
Author(s):  
Ruby Kumari ◽  
Lata Shukla Dwivedy ◽  
Sweta Gupta ◽  
Surabhi . ◽  
Madhuri Choudhary ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Clinical Spectrum ◽  
Cross Sectional ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Ovulatory Dysfunction

Background: AUB has significant impact on quality of life of women related to health specially in developing countries including India. FIGO AUB systems are universally accepted. Aim was to study the clinical spectrum of AUB according to the FIGO AUB systems and women’s attitude towards its management.Methods: Cross sectional prospective study was carried out in the department of Obstetrics and Gynaecology, ANMMCH, Gaya, a tertiary care center, among women of 15-55 years age groups having complain related to abnormal uterine bleeding, for 1 year from 1st May 2019 to 30th April 2020 on 1000 patients. Data was collected and analyzed by percentage and proportions.Results: Prevalence of AUB was maximum among 15-30 years age group of patients (46.80%). Most of the patients belong to lower (62.5%) class, rural area (68%) and were anaemic (62.5%). Ovulatory dysfunction (55%) was most common cause for AUB, maximum patients choose surgical management (hysterectomy) but after counselling, most of them shifted to medical management.Conclusions: This study suggests more conservative approach for management of AUB and emphasizes the importance of awareness for clinical spectrum of AUB among women so that they can be self-motivated for early treatment and unnecessary hysterectomy can be avoided.

scholarly journals A study of clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center

2019 ◽  
Vol 6 (3) ◽  
pp. 574
Author(s):  
Rahul Gandhi G. ◽  
Taha Mahboob Ali Khalid
Keyword(s):  
Ct Scan ◽  
Care Center ◽  
Tertiary Care ◽  
General Medicine ◽  
Clonic Seizure ◽  
Clinical Profile ◽  
Medical College ◽  
Common Presentation ◽  
Common Etiology ◽  
The Brain

Background: Confusion lies over the diagnosis when the patients show ring enhancing lesions of the brain on CT scan. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center.Methods: This study was conducted in the Department of General Medicine, SVS Medical College, Mahabubnagar district which is a tertiary care referral hospital in the state of Telangana. This study was done during the period from July 2006 to October 2008. A total of 50 cases were taken up for this study. After selecting the patients for the study, already prepared protocol was followed strictly for each patient. The protocol contained identification data, detailed history and examination of central nervous system and peripheral signs for tuberculosis and cysticercosis.Results: The males were more than the females and 14-24 years age group was most affected. The most common presentation of ring enhancing lesions was seizures alone in 72% of the cases. Out of these cases the most common presentation was generalized tonic-clonic seizure in 40% of the cases. Majority i.e. 45 had single ring enhancing lesion on CT scan of the brain. The most common etiology of the ring enhancing lesion was found out to be neurocysticercosis in 54% of the cases of ring enhancing lesions.Conclusions: Ring enhancing lesions should be considered in differential diagnosis of those who present with seizures in endemic areas like India. 

scholarly journals The nature of language problem in Bangladeshi children with cerebral palsy: an observation using neurolinguistic approach

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 22-27
Author(s):  
F Ferdous ◽  
MF Alam ◽  
MMR Chisty ◽  
JI Ali ◽  
NMW Rahman
Keyword(s):  
Cerebral Palsy ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Childhood Disability ◽  
Medical College ◽  
Complex Sentences ◽  
History Of ◽  
Children Development ◽  
Tertiary Care Hospitals

Cerebral palsy (CP) is the leading cause of childhood disability affecting function and development. The objective of the study was to look into the language problems in Bangladeshi children with CP on the basis of neurolinguistic approach and was conducted during the period of April 2014 to December 2014 at the Department of Linguistics, University of Dhaka among children aged between 3 to 18 years. In the study, a total of 10 children with CP were enrolled purposively from two tertiary care hospitals in Dhaka (Children Development Centre of Sir Salimullah Medical College and Mitford Hospital and National Institute of Mental Health). The mean±SD age was 8.9±4.8 years. Male was predominant (60.0%). History of prolonged labour was 100%, and home attended by untrained birth attendants in 70.0%. The 90.0% of the children understood simple meaningful sentences using two words. The children were unable to understand complex sentences. The 80.0% children did not want to play or make friendship with other children; 40.0% did not understand others’ speech, 50.0% did not express their own speech, and 10.0% did not understand & express their own speech. All the children had deep thong articulation changed to mono thong in case of semi vowel articulation. In case of history of delayed crying at birth, phoneme omission occurred when the children tried to articulate any word. To the best of knowledge, this was the first study done on the neurolinguistic approach in Bengali children, but the limitation of the study were that it was with small sample size, city based and short duration. Therefore, generalization of the results would be difficult. Further studies using larger sample would be better to visualize the extent of the issue in order to insert the children with CP in their social context and to give them quality of life.Mediscope Vol. 5, No. 1: Jan 2018, Page 22-27

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