scholarly journals Hydroxychloroquine: does prophylaxis work?

2021 ◽  
Vol 8 (12) ◽  
pp. 5805
Author(s):  
Atul Jha ◽  
Manish Bhartiya ◽  
Vijay R. Kumar ◽  
Vimal Upreti ◽  
Parag Deshmukh ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Care Hospital ◽  
The North ◽  
Group I ◽  
Risk Mitigation Strategies ◽  
Front Line Workers ◽  
Group Ii ◽  
Exposure Prophylaxis

Background: Healthcare workers are front line workers in management of SARS-CoV-2 pandemic. The higher risk of acquiring the infection due to increased contact and exposures has prompted multiple risk mitigation strategies. To assess the role of hydroxychloroquine pre-exposure prophylaxis in prevention of SARS-CoV-2 infection amongst HCWs.Methods: This retrospective cohort study assessed the effect of HCQS prophylaxis amongst HCWs in a tertiary care hospital in the north-eastern part of India. All HCWs, involved in management of SARS-CoV-2 were enrolled. The subjects were retrospectively divided in two groups on HCQ prophylaxis. Group I (51.8%, n=116) taking HCQ prophylaxis and group II (48.2%, n=108) not taking the prophylaxis. The demographic characteristics, use of PPE, HCQ prophylaxis and side effect profile were noted. Results: Of the whole cohort, 22.8% (n=51) subjects tested positive. In group I (n=116), 24 subjects (20.7%) tested positive, whereas in Group II (n=108), 27 subjects (25.0%) tested positive. Further analysis of the incidence of SARS-CoV-2 infection amongst the two groups demonstrated that the although the rate of infection was lower (20.7% vs 25%) in Group I as compared to group II [X2 (1, N=224)=0.371, p=0.5] but it was statistically insignificant.Conclusions: Our study involving HCWs, does not show a statistically significant reduction in the incidence of infection with pre-exposure prophylaxis. Based on our findings and published literature, a prophylaxis of HCQS against the SARS-CoV-2 infection cannot be recommended.

scholarly journals An ethical approach to considering family presence during COVID-19

2020 ◽  
pp. 084047042098065
Author(s):  
Elizabeth Bardon
Keyword(s):  
Decision Making ◽  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Ethical Framework ◽  
Care Hospital ◽  
Healthcare Organizations ◽  
Family Presence ◽  
The Public ◽  
Risk Mitigation Strategies

The COVID-19 pandemic has required healthcare organizations to introduce risk mitigation strategies that challenge usual family presence (visitor) policies. Policies within healthcare must be viewed from an ethical lens, which includes ensuring that the patient voice helps guide decision-making. In considering pandemic-specific family presence policies, Kingston Health Sciences Centre, an academic tertiary care hospital in Southeastern Ontario, applied an ethical framework for decision-making. The various tensions between the values of duty to provide care, protection of the public from harm, transparency, proportionality, and patient-centred care are highlighted in a discussion of how patient partners contributed to decision-making about family presence in the first 9 months of the COVID-19 pandemic.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

scholarly journals A randomised trial of 5% minoxidil versus combination of 5% minoxidil and oral spironolactone in treatment of female pattern hair loss

2019 ◽  
Vol 5 (4) ◽  
pp. 668
Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu
Keyword(s):  
Combination Therapy ◽  
Hair Loss ◽  
Tertiary Care ◽  
Randomised Trial ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Female Pattern Hair Loss ◽  
Group I ◽  
Topical Minoxidil ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>

scholarly journals A comparative study of tapentadol versus tramadol in the treatment of low back pain

2020 ◽  
Vol 9 (7) ◽  
pp. 1064
Author(s):  
Laxman Verma ◽  
Pankaj Kumar Chaudhary ◽  
Chandresh Gupta ◽  
Umesh Saroj
Keyword(s):  
Pain Intensity ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Assessment ◽  
Group I ◽  
Parallel Group ◽  
Reduction Of Pain ◽  
The Mean ◽  
Group Ii ◽  
The Difference

Background: Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department with Rachialgia being the most common reason to request medical assessment among them. Methods: This was a prospective, randomized, parallel group open labelled study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients were randomized into two groups. Group I (63 patients) received tablet tramadol 50 mg twice daily orally and group II (63 patients) received tablet tapentadol 50 mg twice daily orally.Results: The mean age of the patients of group I was 40.6±9.6 years and in the group II was 42.7±10.6 years. A total of 61 males participated in the study of which 31 males were enrolled in group I and 30 in group II while 65 females participated in the study of which 32 females were enrolled in group I and 33 in group II. The mean reduction of pain intensity VAS score at the end of 4 weeks from baseline in group I and group II were 34.57 and 37.55 respectively. The difference in the mean reduction of pain intensity VAS between the two groups was not statistically significant.Conclusions: We conclude that both the drugs show significant reduction in the pain intensity in moderate to severe CLBP patients. Tapentadol is as efficacious as tramadol in moderate to severe CLBP. However, tapentadol is better tolerated than tramadol.

scholarly journals Effect of Povidone Iodine Versus Chlorhexidine Mouthwash on Oral Mucositis among Cancer Patients

2021 ◽  
Author(s):  
. Jyothi ◽  
S Latha ◽  
K Pavithra ◽  
M Nalini ◽  
Sowmya J Rao ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Oral Mucositis ◽  
Povidone Iodine ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Group I ◽  
Grading Scale ◽  
Group Ii

Introduction: Radiation therapy and chemotherapy are the standard treatment given for cancer, which leads to the variety of adverse effects of which Oral Mucositis (OM) is one of the common side-effects. It is responsible for patient discomfort and decreases their level of functioning. Both Chlorhexidine and Povidone Iodine have got antimicrobial and antifungal activity which decreases the severity of mucositis. Aim: To compare the effectiveness of Povidone Iodine and Chlorhexidine mouthwash on OM among cancer patients undergoing radiation therapy or chemotherapy. Materials and Methods: A prospective observational study was conducted in the tertiary care hospital of Mangaluru, Karnataka, India for the duration of one year and three months from December 2015-March 2017. Fifty cancer subjects aged between 25 to 65 years and who developed OM after radiation therapy or chemotherapy were selected by purposive sampling technique. Data were collected using the demographic profile, clinical proforma and World Health Organisation (WHO) OM grading scale (2004) from 19.09.2016 to 17.12.2016. Experimental group I received 10 mL of diluted Povidone Iodine mouthwash and group II received 10 mL of diluted chlorhexidine mouthwash. Level of OM in the group I and group II were assessed on the 1st, 3rd, 5th and 7th day using WHO OM grading scale (2004). The data were analysed by descriptive and inferential statistics (Wilcoxon signed- rank test, Mann-Whitney U test, Repeated measures ANOVA) using SPSS version 16.0. Results: Among the 50 cancer subjects, majority 30 (60%) were in the age group between 55-64 years and majority 35 (70%) were receiving radiation therapy. On day seven, in the group I (Povidone Iodine) majority 14 (56%) subjects had mild level of mucositis whereas in the group II (Chlorhexidine) majority 14 (56%) subjects had moderate mucositis. Comparison of the effect of Povidone Iodine and Chlorhexidine mouthwash using Friedman’s ANOVA showed that there was a difference in the level of mucositis (p<0.05) at 5% level of significance among two groups. The study findings also revealed a difference in the level of mucositis between day 1 to day 3, 5 and 7 (Mann-Whitney U test) (p<0.05) in both the groups. Conclusion: Povidone Iodine mouth wash was more effective than Chlorhexidine mouthwashes in reducing OM, and the patients were more comfortable after the use of the mouthwash.

scholarly journals Experiential account of risk mitigation strategies in a tertiary care psychiatric setting during COVID-19 pandemic

2021 ◽  
Vol 56 ◽  
pp. 102556
Author(s):  
Sundarnag Ganjekar ◽  
Guru S. Gowda ◽  
Damodharan Dinakaran ◽  
Sharad Philip ◽  
Nellai K. Chithra ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Tertiary Care ◽  
Mitigation Strategies ◽  
Psychiatric Setting ◽  
Risk Mitigation Strategies

scholarly journals Telluric and Climate-Related Risk Awareness, and Risk Mitigation Strategies in the Azores Archipelago: First Steps for Building Societal Resilience

2021 ◽  
Vol 13 (15) ◽  
pp. 8653
Author(s):  
Ante Ivčević ◽  
Isabel Estrela Rego ◽  
Rui Gaspar ◽  
Vania Statzu
Keyword(s):  
Natural Hazards ◽  
Risk Mitigation ◽  
Research Question ◽  
Local Population ◽  
Relevant Information ◽  
Mitigation Strategies ◽  
Risk Awareness ◽  
Azores Archipelago ◽  
The North ◽  
Risk Mitigation Strategies

Islands are often considered excellent socio-ecological laboratories for testing the rapidity of global change since they experience the climate effects of sea-level rise faster than other areas. The Azores are a Portuguese volcanic archipelago located on the junction of the three tectonic plates: the Eurasian, the African and the North American plates. São Miguel, the main island of the Azores archipelago, hosts three active volcanoes, but the last significant volcanic eruption was the Capelinhos volcano on the island of Faial in 1957. Hence, the Azores offers the opportunity to assess insular risk awareness, facing both telluric and climate-related hazards. The key research question emerges from their natural situation: how does the local population perceive the threat of the natural hazards that occur in Azores? Because risks are socially constructed and depend on the uniqueness of territories, risk mitigation strategies must focus on the individual experiences of local dwellers, as a relationship between risk awareness and such strategies may be expected. To analyze this relationship, a web-based survey with a questionnaire including these variables was administered to a sample of Azoreans. The study aimed to assess risk awareness of the Azorean population and find a relationship between this and reported mitigation strategies. The results gave a preliminary insight into Azorean risk awareness of natural hazards and showed a significant positive relationship between risk awareness-raising activities and reported mitigation strategies. This is relevant information for municipalities and regional governments of areas with similar risk exposures, showing that, although risk awareness alone is not enough for measures to be implemented, it may be an important motivational first step for this to occur.

scholarly journals To study the correlation between various levels of cord blood albumin & serum bilirubin at 48 hrs of age in term healthy newborns

2021 ◽  
Vol 8 (3) ◽  
pp. 146-153
Author(s):  
Sunil Arya ◽  
◽  
Chetan Panwar ◽  
Jyoti Prajapati ◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Albumin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Care Hospital ◽  
Group I ◽  
Blood Albumin ◽  
Group Ii

Introduction: Neonatal Hyperbilirubinemia is the most common abnormal physical finding and themajor cause of neonatal morbidity during the early neonatal period. Early identification of infants atrisk might help in providing preventative therapy and follow-up. We aimed to assess whether arterialumbilical cord albumin level at birth predicts the development of neonatal hyperbilirubinemia in termnewborns at 48 hrs of life. Methods: This prospective observational cohort study was conducted ina tertiary care hospital over 1 year in 200 term healthy neonates. Cord blood albumin was estimatedat birth followed by serum bilirubin level on the 3rd postnatal day(48 hrs of age). Results: Total of200 neonates were divided into three groups based on cord blood albumin level of <2.8 g/dl(groupI), 2.8-3.4 g/dl(group II) and >3.4 g/dl(groupIII) with 32, 100 and 68 in three respective groups.19 newborns (59.4%) in group I,14 in group II, and 7 newborns (10.3%) in group III developedserum bilirubin levels above an intermediate high-risk zone in Bhutani nomogram at 48 hrs of age.newborn with low cord albumin (<2.8g/dl) were significantly associated with higher bilirubin levelsat 48 hrs of age. Conclusion: Neonates with cord blood albumin <2.8 gm/dl had a significantassociation of the development of hyperbilirubinemia at or above intermediate high-risk zoneaccording to Bhutani nomogram at 48 hrs of life.

scholarly journals Frequency and pattern of thyroid dysfunction in diabetic and non-diabetic women with primary infertility: experience in a tertiary care hospital in Dhaka, Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 92-96
Author(s):  
Farzana Islam Bithi ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Farhana Sharmin Emu
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Primary Hypothyroidism ◽  
Care Hospital ◽  
Infertile Women ◽  
Primary Infertility ◽  
Group I ◽  
Low T3 ◽  
Group Ii

Background: Thyroid hormones have profound effects on reproduction and pregnancy. A relationship betweenthe thyroid gland and the gonads is suggested by the far more frequent occurrence of thyroid disorders inwomen. Hormonal disorders of female reproductive system are comprised of a number of problems resultingfrom dysfunction of hypo-thalamic-pituitary ovarian axis. These relatively common disorders often lead toinfertility. Concomitant Diabetes and other metabolic abnormalities or endocrinopathy flare up the condition.This study was conducted to find out any difference in thyroid function among diabetic and non-diabeticpatient presenting with primary infertility. Methods: In this study total 174 patients were included and allocated into two groups, 87 in each group.Group I were diabetic infertile women and group II were non diabetic infertile women. Thyroid hormoneprofile were done and compared between groups. The data were based on the answers came from interviewsand medical records registered in the OPD follow up, investigation report, treatment paper and notes inhospital file sheet. Data processing work was consisted of registration schedules, editing computerization,preparation of dummy table, analyzing and matching of data. Results: No difference was observed in respect of demographic profile. It was observed that, majority ofpatients 73(41.9%) belonged to age 26-33 years, mean age was found 26.3±10.9 years in Group-I and 26.7±11.6years in Group-II. Low T3 was found in 15(17.2%) patients and in 9(10.3%) patients group I and group IIrespectively. Mean FT4 was found 8.25±1.5 pmol/L in group I and 10.57±1.82 pmol/L in group II. Raised TSHwas found in 23(26.4%) patients and 13(14.9%) patients in group I and group II respectively. On interpretationof thyroid function test, 71.8% (125/174) patients had normal finding or in euthyroid status (64.3% in group Iand 79.3% in group II). Present study shows that, frequency of thyroid dysfunction was common in group-Ipatients than group-II (35.6% vs. 20.6%). primary hypothyroidism was predominant abnormality, noted15(17.2%) patients in group I and 9(10.3%) patients in group II patients. Conclusion: Hypothyroidism is the most common thyroid dysfunction found in infertile females and it ispredominant in diabetic infertile group. Hence assessment of thyroid function should be considered as animportant component in infertility work up of women. Birdem Med J 2020; 10(2): 92-96

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