scholarly journals An observational study on usage of insulin and self-injection practises among patients with diabetes attending to Diabetic Centre and Medical outpatient clinics of a tertiary care hospital of Northern Sri Lanka

2020 ◽  
Author(s):  
Sathyasagaran Narayanapillai ◽  
Peranantharajah Thambipillai ◽  
Aravinthan Mahalingam ◽  
Rajeshkannan Nadarajah
Keyword(s):  
Sri Lanka ◽  
Injection Site ◽  
Low Income ◽  
Tertiary Care ◽  
Insulin Injection ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Care Hospital ◽  
Premixed Insulin ◽  
Cross Sectional

Abstract Background: Prevalence of diabetes increasing world-wide particularly in low income countries. Management of diabetes sometimes requires insulin injection due to various reasons. Proper usage of insulin and injection techniques are important for diabetes control among who requires insulin. This study was aimed to assess current insulin practices and associated complications.Methods and material: This was a cross sectional study conducted among diabetes patients attended all medical clinics and Diabetic Centre in Jaffna teaching Hospital which is the only tertiary hospital in the Northern Sri Lanka in May 2020.Insulin practices retrieved by using interviewer administered questionnaire. Data was analyses by using SPSS 26.Results: Out of 360 patients 64.2% were female and mean age was 58.19 (12-89).Majority (61.9%) of them belongs to low income category and most (73.3%) of them using insulin more than 1 year. Main reason for the insulin initiation was oral hypoglycaemic failure (81.7%) and majority of them (80.0%) were using twice daily premixed insulin regime followed by daily basal insulin (11.4%) and basal bolus insulin (5.6%) regime. Most of the participants (81.4%) reported they do cleaning of the injection site before injection and 89.7% usually rotate the injection site. Approximately half of them (50.8%) inject themselves and majority use syringes (91.4%). Common injection site complications reported were skin changes (25%), followed by 15.3% persistent swelling (15.3%) and thinning of skin(7.8%). Angle of injection (P-0.039) and insulin regime (P<0.001) showed statistically significant association with skin changes.High proportion of participants 68.6% (95%CI: 63.7%-73.2%) experienced hypoglycaemia, using syringes 2.21 times (95%CI-1.05-4.64) more risk of compare to pen users and missing meals 2.22 times more risk of hypoglycaemic events (95%CI: 1.18-4.17). Majority of them reported reusing the needles for injection (83.6%) and 35% were disposing needle into common garbage pin.Conclusion: This study revealed significant gaps in current insulin practices from expected norm and hypoglycaemic events alarmingly high among participants. Exploring Continuous Glucose Monitoring Devices or flash monitoring can be a mitigation strategy and urgent attention from health professionals needed to improve the safe insulin practices.

scholarly journals Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 325-330
Author(s):  
Santosh Pathak ◽  
Nagendra Chaudhary ◽  
Prativa Dhakal ◽  
Shyam Kumar Mahato ◽  
Sandeep Shrestha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Economic Status ◽  
Tertiary Care ◽  
Growth Curves ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods:  This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

scholarly journals Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Muhammad Aqil Soomro ◽  
Maryam Aftab ◽  
Maria Hasan ◽  
Hana Arbab
Keyword(s):  
Gastric Outlet Obstruction ◽  
Low Income ◽  
Tertiary Care ◽  
Outlet Obstruction ◽  
Low Income Countries ◽  
Care Hospital ◽  
Creative Commons ◽  
Pyloric Stricture ◽  
Special Supplement ◽  
Corrosive Ingestion

Corrosive ingestion in children is a common problem in low income countries. These agents cause injuries and later strictures of esophagus and stomach. Gastric outlet obstruction is known complication of acids and surgery is the mainstay of treatment. There are multitude of surgical options for these strictures depending on the involved segment of the stomach and experience of the surgeon. Here we present three cases of children who accidentally ingested acid stored in soda bottles and subsequently developed isolated pyloric strictures. These cases presented between August 2018 and April 2019 to our facility, a tertiary care hospital in Karachi, Pakistan. All three patients had an initial latent period of one to two weeks following corrosive ingestion, after which symptoms of gastric outlet obstruction appeared. Intraoperatively, all three had normal esophagus and antrum but scarred and strictured pylorus. Heineke-Mikulicz pyloroplasty was done in these cases without complications and the outcomes were satisfactory. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 How to cite this:Soomro MA, Aftab M, Hasan M, Arbab H. Heineke-Mikulicz pyloroplasty for isolated pyloric stricture caused by corrosive ingestion in children. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S87-S90.  doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1714 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A CROSS-SECTIONAL STUDY TO ASSESS VACCINATION COVERAGE OF CHILDREN OF AGE GROUP 12 - 23 MONTH RESIDING IN THE FIELD PRACTICE AREA OF TERTIARY HOSPITAL.

2021 ◽  
pp. 28-29
Author(s):  
Jayesh Dhananjay Gosavi ◽  
Deppa H Velankar ◽  
Sumedha M Joshi ◽  
Sumit G Wasnik ◽  
Sudarshan Ramaswamy
Keyword(s):  
Vaccination Coverage ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
Tertiary Hospital ◽  
Cluster Sampling ◽  
Care Hospital ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 12

Background:It is estimated that annually more than 89 lakh children in the country do not receive all vaccines that are available under the UIP– the highest number compared with any other country in the world. Objective: This study was carried out to assess vaccination coverage of children of age group 12 - 23 month residing in the eld practice area of tertiary hospital. Material & methods: This was sectional study conducted at eld practice area of tertiary care hospital during January 2017 to July 2018. Study population was children in the age group 12-23 month. As per WHO norm for identication of sample size for vaccination coverage in study area 30 cluster sampling method is preferred. Results: In the study 188 (89.52%) children were Fully Immunized. 22 (10.48%) children were partially immunized and none of the child was non immunized. overall coverage of BCG was 98.5, for PENTA3 was 96.3%, OPV3 was 96.3% and Measles was 89.8%. Conclusion: Overall immunization coverage in the area is good and higher than the national coverage level. There is no signicant difference in the immunization status of Male and Female children.

scholarly journals Knowledge and Acceptance of Labour Analgesia in Pregnant Women

2018 ◽  
Vol 16 (3) ◽  
pp. 302-306 ◽  
Author(s):  
Mona Sharma ◽  
Saurya Dhungel ◽  
Sujata Niroula ◽  
Manan Karki
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Acceptance Rate ◽  
Labour Analgesia ◽  
Low Income Countries ◽  
Cross Sectional

Background: Labour analgesia, though practiced worldwide, is not very popular in low-income countries. The aim of the study was to assess the awareness, attitude, acceptance, and reasons for hindrance of labour analgesia among patients visiting a tertiary care center in the capital cityMethods: It was a cross sectional study conducted in Obstetrics and Gynecology outpatient department of Kathmandu Medical College Teaching Hospital in the month of August 2017. All pregnant patients presenting for antenatal checkup was included. Data was collected based on a questionnaire after informed consent. Statistical analysis was done in SPSS version 20 and results were expressed in frequencies and percentage.Results: Total of 270 pregnant women participated in the study. Out of these forty-four (16.3%) patients were aware about labour analgesia. The acceptance rate was high (72.2%). Majority (84.6%) had no problem with expenditure associated with labour analgesia.Conclusions: Despite low awareness about painless delivery among the antenatal women, the acceptance rate is high.

scholarly journals Susceptibility for varicella and factors associated with immunity among pregnant women in a tertiary care hospital in Sri Lanka- a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ishara P. Premathilake ◽  
Praveena Aluthbaduge ◽  
Channa P. Senanayake ◽  
Renuka Jayalatharachchi ◽  
Sirithilak Gamage ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals An Audit of Rational Use of Antibiotics in a Tertiary Hospital

2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Number Of Patients ◽  
Rational Use Of Antibiotics

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67

scholarly journals A Research Project to Improve Human Resource Record Management System of Nurses In A Teaching Hospital, Sri Lanka

2020 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Pamila Adikari ◽  
Shanti Dalpatadu
Keyword(s):  
Sri Lanka ◽  
Human Resource ◽  
Stakeholder Participation ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Record Management ◽  
Care Hospital ◽  
Annual Increment ◽  
Research Project

<p>Background: Poor quality records management in Sri Lankan Hospital offices is a major dissatisfaction and demotivation for healthcare staff. An intervention research project to improve the record management of selected Human Resource (HR) records of nurses in an Office of a Tertiary Care Hospital in Sri Lanka was carried out to identify the gaps, implement improvements and to test the outcome.<br />Methods: Grade promotion and annual increment HR processes considered for the improvements. Qualitative and quantitative techniques used for gap identification, planning of interventions and assessment of the effectiveness. A package of quality improvements initiatives implemented following literature review and stakeholder participation.<br />Results: Absence of instructions/sample filled-forms and issues in the document flow were the inconsistencies noted. The record processing time was 30.83 days with an SD of ±4.84 for completion of annual increments and 24.33 days with an SD of ±4.21 for authorisation of grade promotions. The package of interventions included e-based/ paper-based guides and specimen request forms and a document movement register to track the records. Increased accessibility, accuracy, improved quality, timeliness and improved traceability of submitted forms and improvements in the average time spent for annual increments and grade promotions noted; 17.52 days (SD ±3.39) and 12.13 days (SD ±2.33) respectively, a statistically significant reduction (p&lt;0.05). <br />Conclusion: Implementation of quality improvement interventions using computer based initiatives with stakeholder participation can improve office management issues in the tertiary hospital setting.</p>

scholarly journals Prevalence of iron deficiency and thalassemia in patients presenting Tertiary Care Hospital.

2020 ◽  
Vol 27 (12) ◽  
pp. 2618-2621
Author(s):  
Nadia Taj ◽  
Saba Javed ◽  
Munazza Munir ◽  
Anam Naz ◽  
Asma Sajid ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Gestational Age ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Iron Deficient ◽  
Tertiary Care Hospitals

Objectives: To find the frequency of iron deficient anemia and thalassemia in anemic patient reporting in tertiary hospital in Multan. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology in Nishtar Hospital, Multan. Period: 20th October 2018 to 20th April 2019. Material & Method: In this study total 260 females with anemia HB<10.5g/dl were incorporated. Blood of all the patients were collected following the septic measures in CBC vial for counting of hemoglobin and blood investigation serum ferritin [<11ng/ml] and HB electrophoresis HBA [>6]. Gestational age was predicted depending upon last period of menstruation. Results: Age of patients in this study was between 24 to 34 year with the average age of 29.9±2.3 year, average gestational age 33.2±2.11 week, average parity 1.46±1.3. Iron deficient anemia was observed in 88.4 percent patient. Thalassemia was observed in 5.7 percent patient. Conclusion: The results of our study revealed that iron deficiency and thalassemia are significant contributing factors of anemia in patients reporting tertiary care hospitals Multan. General screening for carriers of thalassemia should be provided to all pregnant females attending prenatal care.

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