scholarly journals Suction diathermy adenoidectomy: audit of current practice in a tertiary care hospital

2019 ◽  
Vol 5 (6) ◽  
pp. 1611
Author(s):  
Nithya Venkataramani ◽  
Ravi Sachidananda ◽  
Sandeep Dachuri ◽  
Srividya Rao Vasishta
Keyword(s):  
Current Practice ◽  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Records ◽  
Hospital Database ◽  
Adenoid Tissue ◽  
Minimal Rate ◽  
Feasible Alternative

<p class="abstract"><strong>Background:</strong> Adenoidectomy is conventionally performed using adenoid curette as a blind procedure. Suction diathermy adenoidectomy is a technique of ablating the adenoid tissue using thermal energy and removing it by suction. This audit aims to study the efficacy and complications of this technique in a tertiary care center.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of hospital database was conducted. Twenty-seven patients who underwent suction diathermy adenoidectomy were identified and hospital records studied. Parents were contacted and enquired regarding improvement in child's symptoms.</p><p class="abstract"><strong>Results:</strong> No instances of postoperative complications identified. All except 2 parents were completely satisfied with the improvement in their child's symptoms. Two children had occasional mouth breathing.</p><p class="Standard"><strong>Conclusions:</strong> Suction diathermy adenoidectomy is a feasible alternative to conventional adenoidectomy with few complications and minimal rate of recurrence.</p>

scholarly journals A retrospective analysis of mid trimester termination of pregnancies for fetal congenital malformations at tertiary care hospital

2021 ◽  
Vol 10 (11) ◽  
pp. 4254
Author(s):  
Geethalakshmi Suriyanarayanan ◽  
Vijayalakshmi Kandasamy ◽  
Anuradha Coimbatore Ramachandran
Keyword(s):  
Congenital Malformations ◽  
Tertiary Care Hospital ◽  
Pregnancy Termination ◽  
Care Center ◽  
Tertiary Care ◽  
Termination Of Pregnancy ◽  
Care Hospital ◽  
Fetal Anomalies ◽  
Hospital Records ◽  
Musculoskeletal Abnormalities

Background: This study was conducted to analyse the spectrum of fetal anomalies as a cause of pregnancy termination in a tertiary care hospital.Methods: This retrospective study includes antenatal women with fetal anomalies diagnosed by an ultrasound (USG) and admitted in Chettinad Hospital and Research Institute, Kelambakkam from January 2018 to January 2020 for termination of pregnancy. Data was collected from hospital records and analysed.Results: Gestational age of women with fetal congenital anomalies ranged from 13 to 21 weeks. Pregnancy termination, was performed between 17-19 weeks of gestation in 41% of patients, between 13-15 weeks and 19-21 weeks in 23% of women respectively. Congenital fetal anomalies resulting in termination of pregnancy were CNS, musculoskeletal, cardiovascular, renal and multiple anomalies. CNS abnormalities was a major cause of termination of pregnancy which includes meningomyelocele, spina bifida, acrania, anencephaly.Conclusions: In our study conducted at our tertiary care center, CNS abnormalities were the major cause of mid trimester termination of pregnancies, followed by musculoskeletal abnormalities being second most common cause.

scholarly journals Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki
Keyword(s):  
Tertiary Care Hospital ◽  
Organophosphorus Compounds ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
History Of ◽  
One Year

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

Vancomycin Control Measures at a Tertiary-Care Hospital: Impact of Interventions on Volume and Patterns of use

1998 ◽  
Vol 19 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Mary V. Singer ◽  
Rachel Haft ◽  
Tamar Barlam ◽  
Mark Aronson ◽  
Amy Shafer ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Hospital Information Systems ◽  
Control Measures ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Patterns Of Use ◽  
Before And After ◽  
Aggressive Interventions

ABSTRACTOBJECTIVE: Evaluate vancomycin prescribing patterns in a tertiary-care hospital before and after interventions to decrease vancomycin utilization.DESIGN: Before/after analysis of interventions to limit vancomycin use.SETTING: 420-bed academic tertiary-care center.INTERVENTIONS: Educational efforts began August 10, 1994, and involved lectures to medical house staff followed by mailings to all physicians and posting of guidelines for vancomycin use on hospital information systems. Active interventions began November 15, 1994, and included automatic stop orders for vancomycin at 72 hours, alerts attached to the medical record, and, for 2 weeks only, computer alerts to physicians following each vancomycin order. Parenteral vancomycin use was estimated from the hospital pharmacy database of all medication orders. Records of a random sample of 344 patients receiving van-comycin between May 1, 1994, and April 30, 1995, were reviewed for an indication meeting published guidelines.RESULTS: Vancomycin prescribing decreased by 22% following interventions, from 8.5 to 6.8 courses per 100 discharges (P<.05). The estimated proportion of van-comycin ordered for an indication meeting published guidelines was 36.6% overall, with no significant change following interventions. However, during the 2 weeks that computer alerts were in place, 60% of vancomycin use was for an approved indication.CONCLUSIONS: Parenteral vancomycin prescribing decreased significantly following interventions, but the majority of orders still were not for an indication meeting published guidelines. Further improvement in the appropriateness of vancomycin prescribing potentially could be accomplished by more aggressive interventions, such as computer alerts, or by targeting specific aspects of prescribing patterns.

scholarly journals Clinico-etiological profile of childhood stroke in a Tertiary Care Hospital in Eastern India

2015 ◽  
Vol 06 (04) ◽  
pp. 515-519 ◽  
Author(s):  
Chaitali Patra ◽  
Shatanik Sarkar ◽  
Debasree Guha ◽  
Malay K. Dasgupta
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Geographical Location ◽  
Care Hospital ◽  
Childhood Stroke ◽  
Intracranial Infection ◽  
Radio Imaging ◽  
Common Etiology ◽  
Neurological Insult

ABSTRACT Background: The clinical pattern and etiology of stroke may vary over time or with geographical location. In Asian countries, specific etiology and outcome of childhood stroke have been rarely reported. Objective: To determine the clinical and etiological pattern of childhood stroke and their outcome in a Tertiary Care Center. Materials and Methods: This study was conducted in a Tertiary Care Hospital of Kolkata over a period of 3 years. All children from 6 months to 12 years, diagnosed as childhood stroke by radio-imaging were included in our study. Children presenting with paraplegia/paraparesis were excluded. Etiologies were determined on the basis of clinical examination, related blood investigations and radio-imaging findings. Data gathered from the stroke patients were entered into a preformed proforma and appropriate statistical analyses were done. Result: Most commonly found clinical presentation was hemiparesis (70.6%). Next in place was a seizure (61.8%) and alteration of consciousness (58.8%). The most common etiology of childhood stroke in our hospital was found to be an intracranial infection (41.2%), followed by vascular etiology. Stroke was ischemic in nature in 91.2% of cases. Among the clinical features, vomiting, alteration of sensorium, and fever were significantly (P < 0.01) more in infectious cases of stroke, but hemiparesis was significantly (P < 0.05) more common in noninfectious etiology. Most of the cases of noninfectious etiology (95%) completely recovered without any persistent neurodeficit or mortality. Conclusion: Intracranial infection is the commonest etiology of stroke in pediatric patients presenting at our hospital. Commonest type is an ischemic stroke. The most of the patients completely recovered from the acute neurological insult after proper and timely management.

scholarly journals Outcome of NIV in Critical Care Setting: Experience from a Tertiary Care Center

2013 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Md Motiul Islam ◽  
Mirza Nazim Uddin ◽  
ARM Nooruzzaman ◽  
Rahan Rabbani ◽  
Ahmad Mursel Anam ◽  
...  
Keyword(s):  
Care Setting ◽  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Positive Outcome ◽  
Care Hospital ◽  
Positive Outcomes ◽  
Mechanical Ventilatory Support ◽  
Report Data

NIV is a method of ventilatory support which is delivered to the patient without using an invasive airway. For the last two decades it is increasingly used as an accepted method of mechanical ventilatory support as it is proved to have many positive outcomes as it can prevent invasive ventilation & its complication. In a tertiary care hospital of Bangladesh we are using this method in all patients meeting the NIV criteria & not having absolute contraindication irrespective of diagnosis. Our study aimed to access the out come of the NIV trial using our local resource & to compare it with others. This is an ongoing prospective study and till this report data from 82 patients were analyzed here of which 50% patient ended with positive outcome & 50% ended as negative outcome. As the result of this method varies significantly by diagnosis & severity of disease we are generating specific recommendations according to the likely outcome according to the diagnosis. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14358 Bangladesh Crit Care J March 2013; 1: 3-7

scholarly journals Management of extra hepatic biliary obstruction, in a rural tertiary care hospital India

2021 ◽  
Vol 8 (9) ◽  
pp. 2711
Author(s):  
Divyanshu Joshi ◽  
Y. P. Monga ◽  
Shashank Mishra ◽  
Rani Bansal ◽  
Sachin Agrawal
Keyword(s):  
Biliary Obstruction ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Rural Setting ◽  
Care Hospital ◽  
Tube Drainage ◽  
T Tube

Background: Extra hepatic biliary obstruction (EHBO) is not a rare surgical problem; our experience in managing 36 patients over a period of two years at a tertiary care hospital in a rural setting in India. The objective was to study the etiology and clinical presentation of patients with EHBO, role of various investigative modalities and management strategies in these patients and their outcome.Methods: This was a prospective study conducted between September 2018 to August 2020 in the department of surgery in tertiary care center Subharti medical college (SMC) Meerut. Data was taken in a pre-formed performa and the results were tabulated and analyzed (descriptive analysis).Results: Out of 36 patients, 2 (5.5%) patients underwent choledochoduodenostomy, 1 (2.7%) exploratory laparotomy with CBD exploration with t tube drainage, 1 (2.7%) ERCP with pigtail drainage; 17(47.2%) ERCP (endoscopic retrograde cholangiopancreatography) followed by cholecystectomy, 1 (2.7%) open cholecystectomy with t tube drainage, 4 (11.1%) ERCP alone, 2 (5.5%) hepaticojejunostomy, 1 (2.7%) ERCP followed by diverticulectomy, 2 (5.5%) PTBD (percutaneous transhepatic biliary drainage) followed by a triple bypass surgery, 2 (5.5%) PTBD, 1 (2.7%) pylorus preserving pancreaticoduodenectomy, 1 (2.7%) ERCP with sphincterotomy, 1 (2.7%) PTBD followed by whipples procedure. Patients were followed up and 5 (13.8%) patients had recurrence of the disease.Conclusions: EHBO is a hepatobiliary surgical condition caused by both neoplastic and non-neoplastic etiology. Benign pathologies common in younger patients whereas neoplastic conditions in older age. Ultrasonography is the most common investigative modality followed by ERCP with PTBD/ENBD playing an important role in decompression of biliary obstruction as a palliative measure in advanced malignancies.

scholarly journals Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

2021 ◽  
Author(s):  
Harsha Prasada Lashkari ◽  
Manisha Madkaikar ◽  
Aparna Dalvi ◽  
Maya Gupta ◽  
Jacinta Bustamante ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Southern India ◽  
Care Hospital ◽  
Optimal Care ◽  
Inborn Errors ◽  
Inborn Errors Of Immunity

Abstract Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and offered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodeficiencies (ESID) criteria (working definition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody deficiencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classification. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and efforts to provide optimal care for children with possible IEI in this center.

scholarly journals Determinants of Inpatient Satisfaction on Hospital Services in a Government Tertiary Care Center

Healthline ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 5-12
Author(s):  
Smita Kumari Panda ◽  
Sushree Priyadarsini Satapathy ◽  
Prakash Chandra Panda ◽  
Kulwant Lakra ◽  
Shilpa Karir ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
Care Hospital ◽  
Hospital Services ◽  
Cross Sectional ◽  
Economic Class

Introduction: Patient satisfaction is a psychological concept which is considered as a judgment of individuals regarding any object or event after gathering some experiences over time. It is one of the established yardsticks to measure the success of the services. Objectives: 1. To assess the level of inpatient satisfaction on hospital services. 2. To find out the determinants of inpatient satisfaction on hospital services. Method: It was a cross-sectional study conducted over a period of four months at VIMSAR, a tertiary care hospital in Odisha in eastern India. A total of 164 patients were enrolled in the study from the five most occupied indoor departments who were administered a pre-tested semi-structured standardised questionnaire by face to face interview method. Results: Majority (77.44%) of respondents were in the age group of 21-60 years. The sample consisted of 65.24 % males and 43.9% were from lower socio-economic class. Patient satisfaction level was found to be relatively low (~80%) for the service domains like housekeeping, general services and ancillary services. Fields like front desk services, medical care, nursing care and laboratory services enjoyed a better satisfaction score (~90%). Binary logistic regression analysis reflected age and socio-economic class to be the negative determinants of the level of satisfaction. Conclusion: About two thirds of the inpatients were satisfied with the services availed at the tertiary care hospital in the five specialities. There is scope of improvement in the areas like housekeeping, ancillary care and general care. Socio-demographic characteristics like age and socioeconomic class inversely related to inpatient satisfaction on hospital services.

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