A STUDY OF THE IMPACT OF DIETARY HABITS ON TYPE II DIABETIC RETINOPATHY CORRELATING WITH HBA1C LEVELS, AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL ATTACHED TO ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM, ANDHRAPRADESH.

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

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THE IMPACT OF ANTIMICROBIAL STEWARDSHIP ON THE PATTERNS OF ANTIBIOTICS’ PRESCRIPTION AND CLINICAL OUTCOMES IN THE MEDICAL WARD OF A MALAYSIAN TERTIARY CARE HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2021v13i3.40460 ◽

2021 ◽

pp. 20-25

Author(s):

OVAIS ULLAH SHIRAZI ◽

NORNY SYAFINAZ AB RAHMAN ◽

CHE SURAYA ZIN ◽

HANNAH MD MAHIR ◽

SYAMHANIN ADNAN

Keyword(s):

Length Of Stay ◽

Clinical Outcomes ◽

Antimicrobial Stewardship ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Medical Ward ◽

Prescribing Patterns ◽

Care Hospital ◽

Slope Change ◽

The Impact

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia. Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P<0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively. Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P<0.05) post-AMS reduction of the LOS and the RR.

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SOCIODEMOGRAPHIC AND ANTHROPOMETRIC PROFILE OF DIABETIC PATIENTS ATTENDING IN A DIABETIC CLINIC IN A TERTIARY MEDICAL COLLEGE AND HOSPITAL, WEST BENGAL

10.36106/9100420 ◽

2021 ◽

pp. 12-15

Author(s):

Smarajit Banik ◽

Sandip Saha ◽

Sudipan Mitra ◽

Ujjwal Pattanayak ◽

Rajib Sikder ◽

...

Keyword(s):

West Bengal ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Care Hospital ◽

Diabetes Clinic ◽

Cross Sectional ◽

Medical College ◽

Study Participants

Background: Diabetes mellitus is one of the important causes of morbidity and mortality. With a rise in non communicable diseases in India, diabetes has become a modern epidemic showing a rising trend in West Bengal also. A large number of diabetes patients come to the diabetes clinic of our tertiary care hospital in North Bengal Medical College and Hospital, Darjeeling, West Bengal. The large proportion of patients presenting with this condition prompted us to study the Sociodemographic and Anthropometric Prole of such patients. Methods: This was a descriptive hospital based cross sectional study involving a total of 344 diabetic patients enrolled in the diabetes clinic of a tertiary care teaching hospital from December 2019 to February 2020. A self-administered questionnaire was used to collect data and was analyzed in Microsoft excel sheet and using SPSS 20.0 software. Results: Among the 344 study participants, we found that 220 (63.95%) were males and 124 (36.05%) were females. Diabetes was more common among those aged 51-60 years 108 (31.40%). Family history was present among 188 (54.65%) of the diabetic patients. Almost 160 (46.51%) patients have diabetes 1.1 – 5 years. Hypertension was present among 216 (62.79%) patients. Almost 218 (63.37%) of the patients were overweight and 84 (24.42%) were obese. Conclusions: The diabetic patients presenting to this tertiary care hospital belong lower socioeconomic strata and having limited education in their age group. There is high proportion of obesity and hypertension among them.

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Cerebral malaria in children : an update

Northern International Medical College Journal ◽

10.3329/nimcj.v6i2.23168 ◽

2015 ◽

Vol 6 (2) ◽

pp. 45-47

Author(s):

Mirza Md Ziaul Islam ◽

M Mizanur Rahman

Keyword(s):

Cerebral Malaria ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Medical Emergency ◽

Care Hospital ◽

Medical College ◽

Antimalarial Therapy ◽

Neurological Presentation ◽

Supportive Management ◽

Prompt Diagnosis

Cerebral malaria (CM) is the most severe neurological presentation of acute falciparum malaria. It is a medical emergency, the hallmark of which is the presence of coma probably due to diffuse encephalopathy. A compromised microcirculation with sequestration of parasitized erythrocytes is central to the pathogenesis of cerebral malaria. The death is unacceptably high even with effective antimalarials in tertiary care hospital. The mainstay of treatment of cerebral malaria include prompt diagnosis and early institution of effective antimalarial therapy, recognition of complications, and appropriate supportive management in an ICU. Neurological sequlae are increasingly recognized, but further research on the pathogenesis of coma and neurological damage is required to develop other ancillary treatmentsNorthern International Medical College Journal Vol.6(2) 2015: 45-47

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A Study of Prevalence of Microalbuminuria and Diabetic Retinopathy in Rural Patients Presenting to a Tertiary Care Hospital in North India

International Journal of Contemporary Medical Research [IJCMR] ◽

10.21276/ijcmr.2019.6.8.30 ◽

2019 ◽

Vol 6 (8) ◽

Author(s):

Udit Narang ◽

Vipin Jagadhami ◽

Mohit Singla ◽

Kiran Kumar Singal ◽

Rajat Agarwal ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

Rural Patients

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Characteristics of Lichen Planus in Patients Attending a Tertiary Care Hospital in Bangladesh

Journal of Dhaka Medical College ◽

10.3329/jdmc.v21i2.15338 ◽

2013 ◽

Vol 21 (2) ◽

pp. 156-159

Author(s):

Md. Mostaque Mahmud ◽

Lubna Khandker ◽

Md. Shahadat Hossain ◽

Md. Mostafizur Rahman ◽

Mohammad Zaid Hossain

Keyword(s):

Lichen Planus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Medical College

J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 156-159 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15338

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Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191592 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1007

Author(s):

Vijoy S. Kairi ◽

Pinaki Chakravarty ◽

Arun Kumar Sipani

Keyword(s):

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Early Recognition ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Case Record ◽

Medical College ◽

Disease Modifying ◽

Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

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