scholarly journals Heart Rate Monitoring of Anaesthesiology Residents during the Airway Management of COVID 19 Suspect Patients: An Observational Study

2021 ◽  
Author(s):  
Bhavna Gupta ◽  
Vijay Adabala ◽  
Pratik Tuppad ◽  
Unni Kannan
Keyword(s):  
Heart Rate ◽  
Tertiary Care ◽  
Perioperative Period ◽  
Smart Devices ◽  
P Value ◽  
Heart Rate Monitoring ◽  
Indirect Measure ◽  
Percentage Points ◽  
Observational Cohort ◽  
The Difference

Background: Anaesthesiologists undergo shear stress during the perioperative period, which was further increased during the COVID 19 pandemic. Many observational studies were done to find out the stress levels of the residents. Methods: This was a prospective observational cohort study of Anaesthesiology residents in a tertiary care academic institution. We have measured the minute to minute heart rate variability which can be an indirect measure of stress level with the help of wrist band MI 4 which works on the principle of PPG. Results: The difference between baseline HR and resting HR was observed to be substantial (p value 0.115 and 0.000 respectively). The percentage rise in heart rate during intubation from resting heart rate was 42.79 ± 25.54 percentage points. Conclusion: Users can use this type of ongoing information as a feedback option to increase their work efficacy. Understanding how to use these smart devices will assist us in balancing our stress-free day-to-day activities.

scholarly journals Transition to oral antibiotic therapy for pyelonephritis in children under 60 days of age: An observational retrospective cohort study

2020 ◽  
Author(s):  
David-Alexandre Lessard ◽  
Thelma Huard-Girard ◽  
Arnaud Tremblay ◽  
Jean-Francois Turcotte
Keyword(s):  
Cohort Study ◽  
Antibiotic Therapy ◽  
Tertiary Care ◽  
P Value ◽  
Oral Antibiotic ◽  
Tertiary Care Centre ◽  
Oral Antibiotic Therapy ◽  
Observational Cohort ◽  
Systemic Symptoms ◽  
Retrospective Observational Cohort Study

Abstract Objectives To describe the use of antibiotics and assess if an early transition from intravenous to oral antibiotic therapy is generally safe in infants less than 60 days of age with a diagnosis of pyelonephritis. Methods This retrospective observational cohort study included hospitalized infants less than 60 days with a diagnosis of pyelonephritis based on fever or systemic symptoms and a positive urine culture between January 1, 2015 and July 30, 2017 at a Canadian paediatric tertiary care centre. Results A total of 108 infants were included. Forty-eight of them were under 1 month of age. The median intravenous (IV) antibiotic therapy duration was 3.5 days, with a longer duration of 4 days in infants less than 1 month of age. The total antibiotic therapy was almost equally divided between a shorter (10 days) and longer (14 days) duration. The recurrence of pyelonephritis within the 2 months following the initial urinary infection was 9 % in the group with IV antibiotic therapy duration of <4 days, compared to 11% in the group treated ≥4 days IV (P-value 0.75). There was a recurrence of pyelonephritis of 10.2% in the group treated for 10 days, compared to 11.5% of recurrence in the group treated for 14 days (P-value 1.0). Conclusions Our study provides limited retrospective data regarding the management of pyelonephritis in infants less than 60 days of age. Prospective research is needed to confirm those findings.

scholarly journals Poststroke Cognitive Decline: A Longitudinal Study from a Tertiary Care Center

2019 ◽  
Vol 10 (03) ◽  
pp. 459-464 ◽  
Author(s):  
Rameshwar Nath Chaurasia ◽  
Jitendra Sharma ◽  
Abhishek Pathak ◽  
Vijay Nath Mishra ◽  
Deepika Joshi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Care Center ◽  
Tertiary Care ◽  
Rank Test ◽  
P Value ◽  
Stroke Patients ◽  
Stroke Registry ◽  
Chi Squared ◽  
The Difference

Abstract Objectives Poststroke cognitive decline (PSCD) is a serious disabling consequence of stroke. The purpose of this study is to find the prevalence of PSCD and sociodemographic and clinical determinants of risk factors of PSCD. Materials and Methods This study was a prospective, hospital-based study conducted on 200 stroke patients from stroke registry during October 2015 to April 2017. Detailed clinical evaluation was done. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were used to determine PSCD after 3 and 6 months as per the Diagnostic and Statistical Manual of Mental Disorders V. Chi-squared test was used to find the association between two variables. The Wilcoxon signed-rank test was used to compare the difference in cognitive impairment between two follow-ups at 3 and 6 months, respectively. A p-value < 0.05 was considered statistically significant. Results The prevalence of PSCD measured by MoCA scale at 3 and 6 months was 67 and 31.6%, respectively. By MMSE scale, cognitive decline prevalence at 3 months was found to be 87 (46.3%), which reduced to 22 (17.1%) at 6 months. The association between MMSE scale and type of stroke was significant at 3 months. Conclusion One-third of the stroke patients developed PSCD within 3 months of onset of stroke, with different levels of severity. The major predictors of new-onset poststroke cognitive impairment were diabetes and hypertension. The prevalence of PSCD reduced significantly at 6 months of stroke on follow-up.

scholarly journals COMPARISON OF HAEMODYNAMIC STABILITY WITH 0.5% AND 0.75% HYPERBARIC BUPIVACAINE DURING SPINAL ANAESTHESIA IN WOMEN UNDERGOING CAESAREAN SECTION

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
The Mean ◽  
The Difference

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.

scholarly journals COVID-19 Pandemic: A Speed Breaker for Routine Immunisation

2021 ◽  
Author(s):  
Sumit Singh Bhadoria ◽  
Durgesh Shukla ◽  
Ashutosh Joshi
Keyword(s):  
Vaccination Coverage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Secondary Data ◽  
Study Data ◽  
P Value ◽  
Care Hospital ◽  
Routine Immunisation ◽  
Vaccine Preventable Diseases ◽  
The Difference

Introduction: Immunisation services are affected by Coronavirus Disease 2019 (COVID-19) pandemic due to lockdown and fear of COVID among public along with problems of workforce management and vaccine supply. All these factors have led to decrease in vaccination coverage. It may further lead to increase in risk of vaccine preventable diseases. Aim: To assess the overall trend and evaluate the vaccination coverage during COVID-19 pandemic in a tertiary care hospital in Gwalior district. Materials and Methods: Record based secondary data from the immunisation OPD of the tertiary care hospital Gwalior, Madhya Pradesh, India, for the period of 01 February 2020 to 31 August 2020 was utilised in current study. Data were entered into Microsoft Excel version-2007 and analysed. Frequency, percentage, mean, and standard deviation were calculated as a descriptive measures and graphical presentation to show time trends. The p-value was calculated at 5% level of significance. Results: In the study, 817 children were included, with mean age of 7.46 ±13.59 months. Total 61.1% (499) children were male and 38.9% (318) were female. During the study period, all the children were vaccinated for Bacille Calmette-Guerin (BCG) (10.6%) Pentavalent-1 series (36.4%), Pentavalent-2 series (17.4%), Pentavalent-3 series (12.2%), Measles-Rubella (MR-1) (6.5%), Booster-I (11.8%) and Booster-II (5.1%). Delayed vaccination was seen in 51(6.20%) children. The delay was observed for Pentavalent-2 series (43.1%), pentavalent-3 series (51.0%) and MR-1 (5.9%) and the difference is significant at p-value <0.05. Conclusion: Immunisation services were severely interrupted and completely suspended in April 2020. Certain amount of delay in various doses was also observed. Maintaining routine immunisation is essential in preventing an outbreak of vaccine preventable diseases.

scholarly journals Decreased fetal movement: Is it an alarm to Obstetrician and Pregnant Lady?

2018 ◽  
Vol 1 (2) ◽  
pp. 92-97
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala
Keyword(s):  
Heart Rate ◽  
Fetal Movement ◽  
Maternal Outcome ◽  
P Value ◽  
Indirect Measure ◽  
System Integrity ◽  
Significant Difference ◽  
Fetal Wellbeing ◽  
Movement Group ◽  
And Function

Introduction: Fetal activity serves as an indirect measure of the fetus central nervous system integrity and function. Regular fetal movement can be regarded as an expression of fetal wellbeing. Maternal perception of decreased fetal movement is associated with poor feto-maternal outcome. This study is to find out feto-maternal outcome in cases of decreased fetal movement, done by assessing fetal heart rate (FHR) correlating with cardiotocography (CTG) and USG (ultrasonography) findings, Apgar score and meconium in amniotic fluid. Materials and method: This was a hospital based, prospective comparative study done in Patan Academy of Health Sciences, Lalitpur, Nepal. The sample size was 200; 100 cases of decreased fetal movement versus 100 cases of good fetal movement at same gestational age in weeks. Data processing was done in SPSS version 20.0 (SPSS, Chicago, IL, USA) and calculated by chisquare test. P value less than 0.05 was considered significant. Results: Significant difference was found in fetal kick chart counting. In the decreased fetal movement group, 16% had oligohydraminos, 3% had polyhydraminos and 5% had non reassuring CTG and 4% had abnormal heart rate detected clinically. There was statistically significant difference observed between the two groups in labor induction, cesarean section, meconium stain liquor, cord around the neck and different neonatal morbidities. Conclusion: Decreased fetal movement is associated with poor fetomaternal outcome. Improved vigilance, early identification, further evaluation with CTG, USG and proper management of these pregnancies have favourable pregnancy outcome.

scholarly journals 570. Prioritized Access to COVID-19 Vaccines Among Vulnerable Communities Increases Vaccination Rates

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S386-S387
Author(s):  
Leonor Fernandez ◽  
Ashley O'Donoghue ◽  
Peter Shorett ◽  
Jonathan Blair ◽  
Lawrence Markson ◽  
...  
Keyword(s):  
Health System ◽  
Urban Communities ◽  
P Value ◽  
Vaccination Rates ◽  
Vulnerable Communities ◽  
Early Access ◽  
Percentage Points ◽  
The Difference ◽  
National Trends ◽  
The Impact

Abstract Background Based on national recommendations,1 Beth Israel Lahey Health (BILH) in Eastern Massachusetts (MA) prioritized vulnerable communities in our distribution of COVID-19 vaccines. We hypothesized that creating prioritized access to appointments for patients in these communities would increase the likelihood vaccination. Methods The BILH health system sent vaccine invitations first to patients of two clinics in vulnerable neighborhoods in Boston (Wave 1), followed by other patients from vulnerable communities (Wave 2) up to 1 day later, and then by all other patients (Wave 3) after up to 1 more day later. To identify whether early access/prioritization increased the likelihood of receipt of vaccine at any site or a vaccine at a BILH clinic, we compared patients in Wave 1 in a single community with high cumulative incidence of COVID-19 (Dorchester) to patients in Wave 2 during a period of limited vaccine access, 1/27/21-2/24/21. Each wave was modeled using logistic regression, adjusted for language and race. By taking the difference between these two differences, we are left with the impact of early vaccination invitation in Wave 1 for a subset of our most vulnerable patients (termed difference-in-differences; Stata SE 16.0). Results In our study of Waves 1 and 2, we offered vaccinations to 24,410 patients. Of those, 6,712 (27.5%) scheduled the vaccine at BILH (Table 1). Patients in Wave 1 were much more likely to be vaccinated at BILH than patients in Wave 2. Patients offered the vaccine in Wave 1 and living in Dorchester were 1.7 percentage points more likely to be vaccinated at all (p=0.445) and 9.4 percentage points more likely to be vaccinated at BILH than another site in MA (p-value = 0.001), relative to patients living outside of Dorchester and offered the vaccine in Wave 2 (Table 2). The coefficient of interest is on Wave1*Dorchester, 0.094. This indicates that residents of Dorchester who were offered the vaccine in Wave 1 were 9.4 percentage points more likely to receive the vaccine at BILH, given that they were vaccinated, relative to patients living outside of Dorchester and offered the vaccine in Wave 2. Conclusion Patients residing in an urban community given prioritized access to vaccination had a higher likelihood of vaccination at our health system, given that they were vaccinated, than patients in other urban communities without prioritized access. We provide an example of a successful effort to move towards equity in access to COVID-19- vaccines, in contrast to larger national trends.2,3 Health systems can use a prioritization approach to improve vaccination equity. Disclosures All Authors: No reported disclosures

scholarly journals Application and Clinical Analysis of Remote Fetal Heart Rate Monitoring Platform in Continuous Fetal Heart Rate Monitoring Images

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Xuan Yang ◽  
Ke Zhang ◽  
Jianhu He
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Heart Sound ◽  
Fetal Heart ◽  
The United States ◽  
Heart Rate Monitoring ◽  
Fetal Heart Rate Monitoring ◽  
Significant Difference ◽  
Diagnostic Standards ◽  
The Difference

Fetal heart sound is an important part of fetal monitoring and has attracted extensive research and attention from scholars at home and abroad in recent years. The fetal heart rate, extracted from the fetal heart sound signal, is one of the important indicators that reflect the health of the fetus in the womb. In this study, a maternal-fetal Holter monitor based on f ECG technology was used to collect maternal heart rate, fetal heart rate, and uterine contractions signals, isolate the fetal heart rate, and design an algorithm to extract the fetal heart rate baseline, acceleration, variation, wake-up cycle, and nonlinear parameters. Using statistical methods to analyze the average value and range of various characteristic parameters of fetal heart rate under continuous long-term monitoring, the results show that the baseline has a downward trend from 10 o’clock in the night to 4 o’clock in the morning and is the lowest around 2 o’clock in the morning. The area and acceleration time were significantly higher than those in the suspicious group. However, there was no significant difference in the number of acceleration values between the two groups; the proportion of small mutations in the normal group was lower than that of the suspicious group and the proportion of medium mutations was higher than that of the suspicious group. There is no statistically significant difference in maternal age, gestational age at childbirth, pregnancy comorbidities, and complication rates in the five-level interpretation system of ACOG (2009), RCOG (2007), SOGC (2007), and the United States (2007). The difference of pregnancy and parity in various images was statistically significant, P  < 0.05. The second type of fetal heart rate monitoring images appeared in the highest among the diagnostic standards, and the difference in the second type of fetal heart rate monitoring images between the various diagnostic standards was statistically significant, P  ≤ 0.001.

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