scholarly journals Evaluation of Patient-Initiated Direct Care Mobile Phone–Based Teledermatology During The COVID-19 Pandemic

Iproceedings ◽  
10.2196/35400 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35400
Author(s):  
Jasleen Kaur ◽  
Priyanka Sharma ◽  
G P Thami ◽  
Maninder Sethi ◽  
Shruti Kakar
Keyword(s):  
Patient Satisfaction ◽  
Mobile Phone ◽  
Conflicts Of Interest ◽  
Care Center ◽  
Tertiary Care ◽  
Confidence Score ◽  
Accurate Diagnosis ◽  
Direct Care ◽  
Patients Satisfaction ◽  
Assess Patient Satisfaction

Background With advances in telecommunication, especially smartphones, teledermatology services offered by specialists are now being directly requested by the patients themselves. This model is known as patient-initiated, direct care teledermatology. It has been pushed to the forefront due to the COVID-19 pandemic. Objective The objectives of this study were to determine patients’ satisfaction and dermatologists’ confidence when a diagnosis was made via direct care mobile phone–based teledermatology. Methods Patients availing direct care teledermatology services during the COVID-19 pandemic at a tertiary care center were subjected to a questionnaire within 5 days of the teleconsultation to assess patient satisfaction and opinions regarding using this model during and beyond the current COVID-19 pandemic. The dermatologists rated their confidence in making the clinical diagnosis on a scale from 1-10 for every case. Results Of 437 participants, 419 (95.9%) were satisfied with this mode of teledermatology. An overwhelming majority (n=428, 97.9%) felt safe consulting the dermatologist via teleconsultation and not having to visit the hospital during the COVID-19 pandemic. In addition, 269 (61.6%) patients agreed that they would be happy to use a teledermatology service beyond the COVID-19 pandemic. The dermatologists’ confidence score in making an accurate diagnosis ranged from 3 to 10, with a mean of 9.20 (SD 1.12). Conclusions The high levels of patient satisfaction and dermatologists’ confidence scores indicate that direct care mobile phone–based teledermatology may be a useful tool in providing dermatological services in appropriate settings and its use should continue to be explored beyond the COVID-19 pandemic. Conflicts of Interest None declared.

scholarly journals Evaluation of Patient-Initiated Direct Care Mobile Phone–Based Teledermatology During The COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Jasleen Kaur ◽  
Priyanka Sharma ◽  
G P Thami ◽  
Maninder Sethi ◽  
Shruti Kakar
Keyword(s):  
Patient Satisfaction ◽  
Mobile Phone ◽  
Care Center ◽  
Tertiary Care ◽  
Confidence Score ◽  
Accurate Diagnosis ◽  
Direct Care ◽  
Tertiary Care Center ◽  
Patients Satisfaction ◽  
Assess Patient Satisfaction

BACKGROUND With advances in telecommunication, especially smartphones, teledermatology services offered by specialists are now being directly requested by the patients themselves. This model is known as patient-initiated, direct care teledermatology. It has been pushed to the forefront due to the COVID-19 pandemic. OBJECTIVE The objectives of this study were to determine patients’ satisfaction and dermatologists’ confidence when a diagnosis was made via direct care mobile phone–based teledermatology. METHODS Patients availing direct care teledermatology services during the COVID-19 pandemic at a tertiary care center were subjected to a questionnaire within 5 days of the teleconsultation to assess patient satisfaction and opinions regarding using this model during and beyond the current COVID-19 pandemic. The dermatologists rated their confidence in making the clinical diagnosis on a scale from 1-10 for every case. RESULTS Of 437 participants, 419 (95.9%) were satisfied with this mode of teledermatology. An overwhelming majority (n=428, 97.9%) felt safe consulting the dermatologist via teleconsultation and not having to visit the hospital during the COVID-19 pandemic. In addition, 269 (61.6%) patients agreed that they would be happy to use a teledermatology service beyond the COVID-19 pandemic. The dermatologists’ confidence score in making an accurate diagnosis ranged from 3 to 10, with a mean of 9.20 (SD 1.12). CONCLUSIONS The high levels of patient satisfaction and dermatologists’ confidence scores indicate that direct care mobile phone–based teledermatology may be a useful tool in providing dermatological services in appropriate settings and its use should continue to be explored beyond the COVID-19 pandemic.

scholarly journals Association of toll-like receptor 4, 5 and 10 polymorphisms with Helicobacter pylori -positive peptic ulcer disease in a center in Jordan

2021 ◽  
Vol 41 (4) ◽  
pp. 206-215
Author(s):  
Laith AL-Eitan ◽  
Fouad Abdelaziz Almomani ◽  
Sohaib Mahmoud Al-Khatib ◽  
Hanan Abdulraheem Aljamal ◽  
Mohammed Nayef Al-Qusami ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Conflicts Of Interest ◽  
Care Center ◽  
Treatment Success ◽  
Tertiary Care ◽  
Genotype Distribution ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
H Pylori

BACKGROUND: Helicobacter pylori infection is widespread, affecting about 50% of the global population. Polymorphisms in host genes such as the toll-like receptor 4 ( TLR4 ) might affect the susceptibility and severity of infection and treatment success. OBJECTIVE: Investigate the susceptibility and severity of H pylori infection with host TLR4 (rs11536889, rs4986790, rs200109652, rs10759932), TLR5 (rs5744174, rs2072493, rs746250566), TLR10 (rs559182335, rs10004195) polymorphisms. DESIGN: Analytical, cross-sectional. SETTING: Endoscopy clinic at tertiary care center. PATIENTS AND METHODS: Genomic DNA was extracted from formalin-fixed paraffin-embedded tissues collected from H pylori -infected patients and healthy individuals. The single nucleotide polymorphisms (SNPs) within the targeted TLR genes were genotyped to assess the genetic association of various SNPs with disease severity. MAIN OUTCOME MEASURES: Effect of genotype distribution on H pylori infection. SAMPLE SIZE: 250 peptic ulcer patients and 217 controls. RESULTS: The TLR10 genotype showed no significant association with H pylori infection except for rs10004195 (T>A) ( P =.002). The genotype frequency of Rs5744174 in TLR5 had a significant association with the presence of H pylori infection ( P =.046, OR=0.52). Except for gender (P=.022), there were no significant associations between clinical and demographic variables and SNPs relating to the severity of the H pylori infections. CONCLUSIONS: Our findings are consistent with differences in severity of H pylori infection due to TLR SNPs in different ethnic groups. Understanding differences in genetic susceptibility could help in classifying patients and matching patients with various treatment options on a genetic basis. LIMITATIONS: Lack of H pylori pathogenicity features assessment. CONFLICTS OF INTEREST: None.

PS01.054: GASTROESOPHAGEAL REFLUX DISEASE PHENOTYPES IN THE MODERN ERA: CLINICAL, ENDOSCOPIC, MANOMETRIC AND PH TESTING PROPERTIES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 65-65
Author(s):  
Patrick Hoversten ◽  
David Katzka ◽  
Magnus Halland
Keyword(s):  
Conflicts Of Interest ◽  
Ph Monitoring ◽  
Care Center ◽  
Tertiary Care ◽  
Acid Group ◽  
Esophageal Physiology ◽  
Patient Groups ◽  
Endoscopic Characteristics ◽  
One Year ◽  
Modern Era

Abstract Background Reflux phenotypes have classically been divided into supine, upright, and bipositional predominant reflux. Recent data on clinical, endoscopic, and manometric features in these patient groups are scant and most prior reports occurred prior to the advent of high resolution impedance manometry and prolonged wireless pH monitoring. We aimed to evaluate the distribution, demographic, manometric, and endoscopic characteristics of the reflux phenotypes in this modern era of testing. Methods Patients who had esophageal physiology testing at a single tertiary care center over a one year period were retrospectively reviewed for demographic, clinical, endoscopic, manometric and pH impedance data. We included consecutive patients who had undergone pH-impedance or wireless pH testing with an EGD within 6 months. Results 139 patients were included and 91 (65.5%) patients were women was mean age of 51.9 + /- 15.2 years and mean BMI of 29.1 + /- 6.4. The most common reflux pattern was bipositional (46% of patients), followed by supine (25%). Baseline characteristics, endoscopic and manometric data across groups are included in Table 1. Barrett's esophagus was most common in the non-acid group. Endoscopically, esophagitis was most common in the supine and bipositional groups. Manometric findings were similar across groups. Conclusion The epidemiology of GERD patients appears to be changing as evidenced by a higher mean BMI than in the largest prior study from 1999. Despite demographic changes in GERD and more widespread use of advanced esophageal physiology testing, the manometric and endoscopic characteristics of GERD phenotypes remains fairly similar. Disclosure All authors have declared no conflicts of interest.

scholarly journals Clinicopathological correlation in the diagnosis of granulomatous cutaneous disorders: a retrospective study

2021 ◽  
Vol 7 (4) ◽  
pp. 538
Author(s):  
Manisha Nijhawan ◽  
Divya Yadav ◽  
Shivi Nijhawan ◽  
Damini Shaktawat
Keyword(s):  
Retrospective Study ◽  
Care Center ◽  
Tertiary Care ◽  
Common Type ◽  
Accurate Diagnosis ◽  
Tertiary Care Center ◽  
Clinicopathological Correlation ◽  
Cutaneous Tuberculosis ◽  
Skin Biopsies ◽  
Granulomatous Disorder

<p class="abstract"><strong>Background:</strong> To ascertain the various cutaneous granulomatous disorders and clinicopathological concordance in skin biopsies.</p><p class="abstract"><strong>Methods: </strong>The study included the patients with skin biopsy showing granulomatous infiltrate in a tertiary care center. The cases were categorized according to level of concordance into consistent, corroborative and inconsistent based on the concurrence between clinical and histological diagnosis.</p><p class="abstract"><strong>Results: </strong>Of the total 155 granulomatous disorder, 75.48% showed clinicopathological concordance, 19.35% showed corroborative diagnosis while 5.16% were inconsistent. The maximum number of biopsies performed were in the group of young adult (19-49 years, 57.41%). The most common type of granuloma found was of tuberculoid type and disorders were Hansen’s disease, fungal infection and cutaneous tuberculosis.</p><p class="abstract"><strong>Conclusions:</strong> Our study showed that the coordination of dermatologist and pathologist plays a pivotal role in making accurate diagnosis of granulomatous cutaneous dermatoses.</p>

scholarly journals Significant Variability in the Initial Workup of Thrombocytopenia in the Hematology Clinic - What Is the "Optimal" Workup?

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5966-5966
Author(s):  
Aishwarya Ravindran ◽  
Ronald S. Go ◽  
Kaaren K. Reichard ◽  
Ariela L. Marshall
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Large Scale ◽  
Hepatitis A Virus ◽  
Conflicts Of Interest ◽  
Medical Condition ◽  
Care Center ◽  
Laboratory Finding ◽  
Tertiary Care ◽  
Target Cells

Abstract BACKGROUND: Thrombocytopenia is a common hematologic condition associated with multiple etiologies ranging from benign to malignant to potentially life-threatening disorders. Given the heterogeneity of clinical presentations, available clinical information, and pertinent clinical history, there are inter-physician variations in the approach to the workup of thrombocytopenia in the hematology clinic. While a limited test repertoire may be adequate for many cases, more extensive testing may be warranted in others. We were interested in analyzing the various tests performed and testing approaches in the initial workup of thrombocytopenia. METHODS: We reviewed the records of 69 patients who were referred to our center between 2010 and 2015 for an initial workup of thrombocytopenia. We collected epidemiologic data, laboratory testing results, and pathologic findings. Pathologic results were classified as "normal" or "abnormal" and further subcategorized on the basis of review by two clinicians. Quantitative data were analyzed using JMP Pro 10.0.2 software. RESULTS: At the time of thrombocytopenia diagnosis, the median age was 59 years (range: 17-90) and majority were males (65%). The median platelet count was 91,000/µL (range: 3,000-146,000). Isolated thrombocytopenia was present in 51 cases (74%). Forty-four patients (64%) had a peripheral blood smear review and 4 (9%) contained abnormalities including hypogranular neutrophils, rouleaux formation, and target cells. Autoimmune workup included anti-platelet antibody (APA) in 34 (49%), anti-nuclear antibody (ANA) in 21 (30%), lupus anticoagulant (LA) in 4 (6%) and rheumatoid factor (RF) in 13 (19%) of cases. Autoimmune testing was positive for APA in 2 (5.9%), ANA in 4 (19%), LA in 0 (0%), and RF in 1 (8%) of patients who underwent testing, respectively. Common infectious workups included human immunodeficiency virus in 23 (33%), hepatitis A virus in 2 (3%), hepatitis B virus in 11 (16%), hepatitis C virus in 22 (32%), Epstein-Barr virus in 5 (EBV, 7%), cytomegalovirus in 7 (10%) and Helicobacter pylori in 5 (7%) of patients, and were negative in all cases except for one patient with evidence of active EBV infection. Sixteen patients (23%) underwent bone marrow biopsy, and 2 (12.5%) were diagnosed with hematologic malignancies including myelodysplastic syndrome and hairy cell leukemia. Based on results of these tests, 28 (41%) patients were diagnosed with primary immune thrombocytopenia, 19 (27%) with thrombocytopenia secondary to another medical condition, and 22 (32%) with thrombocytopenia of undefined etiology. CONCLUSION: Thrombocytopenia is a common laboratory finding, and workup involves significant inter-clinician variation, often involving multiple laboratory tests and in some cases invasive tests such as bone marrow biopsy. We found that autoimmune causes of thrombocytopenia were moderately common and infectious and malignant causes were rare. Our findings were based on a small cohort of patients but are likely to be representative of the clinical practice in a large tertiary care center. Large scale studies may be warranted to devise a protocol for a thorough yet cost-effective and stepwise initial workup of thrombocytopenia and to minimize unwarranted inter-clinician variation in such investigations. Disclosures No relevant conflicts of interest to declare.

scholarly journals PATIENT SATISFACTION;

2013 ◽  
Vol 20 (06) ◽  
pp. 973-980
Author(s):  
FATIMA MUKHTAR ◽  
AFTAB ANJUM ◽  
MUHAMMAD ASLAM BAJWA ◽  
Shahzana Shahzad ◽  
Shahzeb Hamid ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Health Facilities ◽  
Care Hospital ◽  
Registration Desk ◽  
Assess Patient Satisfaction ◽  
Primary Care Health ◽  
Care Health ◽  
Waiting Area

Introduction: Patient satisfaction is a relative phenomenon, which embodies the patients perceived need, his expectationsfrom the health system, and experience of health care. Objective: To determine the level of patient satisfaction towards OPD services withreference to doctor-patient interaction, registration desk, waiting area, and overall health facilities. Study Design: Descriptive crosssectional study. Setting: Tertiary care hospital of Lahore. Study Period: April 2013. Material & Methods: A sample of 250 patients wasselected by employing systematic random sampling technique. The patients were interviewed and data was collected using a pretestedquestionnaire. Data was analyzed using the statistical package for social sciences (SPSS) version 16.00. Data was presented in figuresand tables. It was described using frequencies, percentages and mean. Results: Majority of the patients i.e 232 (94%) reported beingsatisfied with the doctor. A vast majority agreed that hospital was clean 233 (94%) and adequately ventilated 224 (90%). The hospital staffin the waiting area was found to be respectful 220 (89%) and fair 198 (80%) towards the patients. The patients had no difficulty locatingthe reception desk of the health facility 235 (95%). A large proportion of patients i.e.220 (89%) said they would re-visit the hospital.Conclusions: The patients were highly satisfied with their doctors and were ready to re-visit the hospital. It is recommended that furtherstudies should be conducted to assess patient satisfaction in the secondary and primary care health facilities and efforts should be madeto get regular feedback from the patients.

scholarly journals Effect of waiting time estimates on patients satisfaction in the emergency department in a tertiary care center

2020 ◽  
Vol 41 (8) ◽  
pp. 883-886
Author(s):  
Khaled Alrajhi ◽  
Nawfal Aljerian ◽  
Rand Alazaz ◽  
Lama Araier ◽  
Lujane Alqahtani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Waiting Time ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Patients Satisfaction ◽  
Time Estimates

scholarly journals Outpatient Fractionated ICE Protocol in Relapsed/Refractory Lymphomas: Efficacy and Safety

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5357-5357
Author(s):  
Reyad Dada ◽  
Azhar Nawaz ◽  
Ehab Mosaad Abdelghany ◽  
Tarek Boubakra
Keyword(s):  
Stem Cells ◽  
Survival Rate ◽  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Care Center ◽  
Tertiary Care ◽  
Young Patients ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Serious Adverse Events

Abstract Objectives: The diagnosis of cancer significantly affects quality of life (QoL) of patients. Admission on wards and spending several days far from home to receive chemotherapy, especially in young patients with Hodgkin lymphoma (HL), might negatively affect the QoL. Therefore, we are offering our patients with relapsed and refractory lymphomas receiving the so-called outpatient fractionated regimen of ifosfamide, carboplatin and etoposide (ICE) as salvage treatment prior to high dose chemotherapy and autologous stem cell transplantation (ASCT). Methods: We retrospectively collected the data of patients who received outpatient fractionated ICE between 2011-2017 at a tertiary care center. The ICE protocol consisted of: ifosfamide 1500 mg/m2 infused over 2 h daily on days 1-3, carboplatin (mg dose = 5 · AUC) i.v. on day 1, and etoposide 100 mg/m2 i.v. daily on days 1-3, plus filgrastim 5 ug/kg/day s.c. for 5 days. Rituximab 375 mg/m2 on day 1 was added for patients with CD20 positive B cell Non-Hodgkin lymphoma. The Cycles of outpatient ICE were given every 21 days. Results: 89 patients (44% female and 56% male) with median age of 34 years (17-72) fulfilled the inclusion criteria. Majority of patients had HL (64%). 88% had stage III and IV with 60% having B symptoms and 38% extranodal disease prior to ICE. 5% had transformed lymphoma. Mean of received ICE was 2.5 cycles. The complete remission and partial remission rates for primary refractory (63%) and non-primary refractory (37%) disease were 7% and 25% versus 19% and 38% respectively. Of patients who achieved a response qualifying for ASCT, stem cells were successfully collected with filgrastim alone and plerixafor plus filgrastim in 77.1% and 22.9% respectively. The median of collected stem cells was 6.13 106/kg with mean apheresis of two days. 75% of eligible patients proceeded to ASCT. The relapse free survival rate was 45 months (95% CI 10-80) and overall survival rate 58 months (95% CI 32-84). Mean follow-up time was 33.1 months (range 8-92). The rate of hematological toxicities grade 3 were documented in 15% with 10% neutropenia and 9% thrombocytopenia. Febrile neutropenia rate was 5.6%. Non-hematological toxicities included oral mucositis 3%, vomiting and diarrhea each 1%. No grade 4 or serious adverse events were observed. Conclusions: Our institutional experience is, to our knowledge, the largest of it is kind, which showed the outpatient fractionated ICE as an interesting alternative to the classic ICE regimen with favorable safety profile. However, for patients with primary refractory lymphomas more effective regimens are urgently needed. Disclosures No relevant conflicts of interest to declare.

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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