scholarly journals FACTORS INFLUENCING COMPLIANCE TO THERAPEUTIC REGIMEN AMONG PATIENTS WITH HYPERTENSION

Author(s):  
Dhanya R Dharan ◽  
Moly Kt

Objectives: The objectives of the study were to identify the level of compliance to therapeutic regimen, assess the factors promoting and interfering compliance, and to find the association between level of compliance and factors influencing it in patients with hypertension in a Tertiary Care Hospital, Kochi, with a view to develop an information booklet.Methods: Nonprobability convenience sampling technique was used to collect data from 150 individuals attending outpatient departments. Data on compliance were assessed through interview using standardized Hill And Bone High Blood Pressure Compliance. Scale and factors promoting and interfering compliance were assessed using self-developed semi-structured questionnaire.Results: Only 55 (36.7%) had good compliance, while 52 (34.7%) had average and 43 (28.7%) had poor compliance to anti-hypertensive therapeutic regimen. The major factors promoting compliance were found as patient-prescriber relationship 146 (97.3%), family support 133 (88.7%), motivation 125 (83.3%), communication with healthcare providers 122 (81.3%), health literacy 104 (69.3%), and patient satisfaction 75 (50%). The factors interfering with compliance were lack of self-esteem 136 (90.7%), long-term adherence 129 (86%), misconceptions and erroneous beliefs 122 (81.3%), cost of therapy and income 100 (80%), forgetfulness 107 (71.3%), difficulty in adjustment to dietary change 82 (54.7%), and fear of side effects 70 (50%). A significant association between the level of compliance and factors promoting and interfering with compliance to therapeutic regimen (p<0.01) was noted. Level of compliance with therapeutic regimen was found to be lower in patients with associated comorbidities such as diabetes mellitus (c2=9.52, p<0.01) and coronary artery disease (c2=6.737, p<0.05).Conclusion: The study concludes the significance of developing systems to tack and ensure compliance to therapy among hypertensives with a focus on factors promoting compliance not only from the patient perspective but also from the perspective of family and society.

2022 ◽  
Vol 7 (1) ◽  
pp. 1-10
Author(s):  
Azam Khan ◽  
Khalil Ahmed Orakzai ◽  
Allah Noor ◽  
Usman Khan ◽  
Sohail Khan ◽  
...  

Introduction: Tympanoplasty refers to any operation involving reconstruction of the tympanic membrane and /or the ossicular chain. Myringoplasty is a tympanoplasty without ossicular reconstruction. Over the years many methods have been used for closing perforations. Myringoplasty was introduced by Berthold in 1878 but the modern era began only in 1950s with the work of Wullstein and Zoellner. The study aims to analyse the common factors which are predictive of success of myringoplasty in adult patients and to construct and validate a prognostic index that could be used as tool to predict the success of myringoplasty in adults. Objectives: To determine the frequency of common factors influencing the graft uptake in myringoplasty. Materials and Method: In this study, a total sample size was 376, using 4.08% proportion of fourth degree perineal tear, 95% confidence level and 2% margin of error under WHO software for sample size determination. Moreover, consecutive non probability sampling technique was used. Results: The mean age was 40 years with standard deviation of ± 2.63.  Sixty two percent of the patients were male while thirty eight percent patients were female. The success rate of myringoplasty was 90% while the failure rate was 15(10%) patients in which 4(25%) patients had medium perforation, 5(33%) patients had large perforation while 6(42%) patients had subtotal perforation. Regarding the causes of perforation among 15(10%) patients, 13(85%) patients had infection while only 2 patients had trauma. Conclusion: The study concludes that infection (85%) was the most common cause of perforation followed by trauma (15%) in the graft uptake in myringoplasty.


2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Adil Hazara ◽  
Victoria Allgar ◽  
Maureen Twiddy ◽  
Sunil Bhandari

Abstract Background and Aims Mortality rates are high in patients starting haemodialysis/haemodiafiltration (HD) therapy. Incremental HD may help reduce this risk by reducing the burden of early treatment whilst patients are still adapting to long-term HD therapy. A feasibility study (ENDURE study – Clinical trials ID: NCT04268264) is being conducted with the primary objectives of evaluating the acceptability and tolerance of a new incremental HD regime. Its secondary aims are to evaluate the impact of this form of incremental HD on indicators of patient safety and wellbeing. These indicators include blood pressure (BP) control and interdialytic weight gains (IDWG) which are independently associated with adverse cardiovascular outcomes in patients on long-term HD. We present preliminary findings from the study related to systolic BP and IDWG. Method The ENDURE study is being carried out at a tertiary care hospital in the United Kingdom. Patients aged &gt; 18 years known to renal services for at least 90 days, referred for start of HD, were eligible for participation. Following approved consenting procedures, they are started on a new regime of incremental HD starting dialysis twice weekly with progressive increases in the duration and frequency of sessions over 15 weeks. This period is split in to four phases; phase 1 representing the first two days of dialysis (baseline) whereas phases 2 – 4 representing the pre-specified incremental steps. Propensity scores were calculated to match each participant (incremental HD group) with two controls from a database of patients who previously started HD at our centres using the standard protocol of 3 times weekly, 4hr long sessions. The matching criteria accounted for 14 key demographic, clinical and laboratory characteristics. Results were analysed as intention to treat. In comparing BP and IDWG between the two groups, only readings taken pre-dialysis at the first session of the week was considered. This study has been approved by the West of Scotland Research Ethics committee-4 (Ref: 19/WS/0019). Results Baseline characteristics of the first 15 participants (target 20) and their matched controls are presented in table 1. The proportion of females and duration of previous specialist input was higher in the incremental HD group. Conclusion The ENDURE study tests the feasibility of starting patients on a novel incremental HD regime. Early data suggest that control of systolic BP and IDWG are comparable to patients who start dialysis at 3 times weekly. Further work is needed to understand the impact of reducing dialysis frequency on BP control correlating the findings with changes residual renal function and objective measures of fluid overload.


1969 ◽  
Vol 2 (1) ◽  
pp. 105-110
Author(s):  
Bushra Iftikhar ◽  
Muhammad Jan ◽  
Khurshid Ahmad ◽  
Satea Arif

Objectives: The study was designed to find out the type and quantity of different type of wastes generated inthe two wings of Saidu Group of teaching Hospitals. The study also aimed at finding that whether facilitiesare available in different units for the segregation, storage, disinfection of infectious waste at the onset andmethods of disposal of waste within and outside the hospital. Also, types of items reused and their methodsof sterilization and the fate of used syringes was found out.Study Design: ObservationalMethodology: The study focus was Saidu Teaching Hospital (STH), a tertiary care hospital providingservices to the people of Swat, Malakand, Dir, Kohistan and areas far up to Chitral. Situated 1.5 Km apartSTH consists of two administrative units,Saidu Wing and Central Wing.A qualitative analysis of various aspects of waste management was done by reviewing the availableauthentic record and discussion with the sanitary and administrative staff of the hospital. All the data wascollected according to, and filled in a pre-designed questionnaire.Results: It was found that Saidu Teaching Hospital generates more than 550 Kg of solid waste and 1295liters of liquid waste per day, which makes 1.2 Kg/bed/day. As a whole 80% of the waste generated wasordinary garbage, 12% was infectious, 4% was Pharmacological, 3% pathological and 0.8% consisted ofsharps.The provision of facilities for the segregation of waste at outpatient departments, Wards, Operation theatreand Laboratories/Blood Banks were 7.5%, 7%, 20% and 28.5% respectively and for storage of waste beforedisposal at outpatient departments, Wards, Operation theatre and Laboratories / Blood Banks were 22%,8%, 0% and 28.5% respectively.Disinfection of infectious waste at outpatient departments, wards, operation theatre and laboratories / bloodbanks was 10%, 12%, 0% and 17% respectively. Methods used were treatment with phenyl and burning inopen air.About the removal of waste from hospital premises, 78% mentioned sweepers, 17% said rig pickers while5% said that there is no one to take away the waste.54% admitted that they threw the syringes as such in thebins.The study found that 80% of the waste went to the municipal corporation land fills, the rest was either burntor thrown as such into the water channel passing through the hospital (12% & 8% respectively). 67% blamedthe administration, 25 % held the doctors responsible, 37% charged the nursing staff and 67% blamed thesweepers for the faulty management of hospital waste.Conclusion: It is thus concluded that Saidu Teaching Hospital generates huge amount of solid and liquidwaste, which is not properly disposed off currently, therefore it needs modern and scientific waste disposalsystems.Keywords: Waste Management, hospital waste management, waste disposal


2003 ◽  
Vol 121 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Jaime Natan Eisig ◽  
Fernando Marcuz Silva ◽  
Cláudio Hashimoto ◽  
Ethel Zimberg Chehter ◽  
Antonio Atilio Laudanna

CONTEXT: The curative treatment of peptic ulcer is made available nowadays through the eradication of the bacterium Helicobacter pylori, which is associated with it, but the best therapeutic regimen is yet to be determined. OBJECTIVE: To assess the efficacy of a therapeutic regimen with 400 mg ranitidine bismuth citrate associated with 500 mg clarithromycin given twice a day for seven days in a cohort of Brazilian patients with peptic ulcer. TYPE OF STUDY: Cross-sectional study. SETTING: Tertiary-care hospital. PATIENTS: One hundred and twenty nine outpatients, with active or healed peptic ulcers infected by Helicobacter pylori, diagnosed via endoscopy with confirmation via the urease test and histological examination, who had never undergone a regimen for the eradication of the bacterium. PROCEDURE: Administration of 400 mg ranitidine-bismuth and 500 mg clarithromycin twice a day, for seven days. MAIN MEASUREMENTS: Efficacy of the treatment, with a check on the cure done via another endoscopy eight weeks after drug administration. The eradication of the bacterium was determined via the urease test and histological examination. Patients who were negative for both were considered to be cured. RESULTS: Eight patients failed to complete the study. The eradication rate according to intention to treat was 81% (104/129) and per protocol was 86% (104/121). CONCLUSION: The bismuth ranitidine compound associated with clarithromycin used for one week was shown to be a simple, effective and well-tolerated therapeutic regimen for the eradication of Helicobacter pylori.


2020 ◽  
Vol 27 (12) ◽  
pp. 2744-2748
Author(s):  
Muhammad Ibrahim ◽  
Zeeshan Khan ◽  
Muhammad Saeed ◽  
Israr Ahmad ◽  
Salik Kashif ◽  
...  

Objectives: The aim of this study is to assess the commonest mode of presentation at our sarcoma unit and the duration from onset of symptoms till presentation. Study Design: Retrospectively study. Setting: Sarcoma Unit of Hayatabad Medical Complex, Peshawar. Period: June 2016 to December 2019. Material & Methods: Two hundred and eighty two patients were included in this study of which 172 patients were male and 110 were female. Sample size was calculated through non-probability consecutive sampling technique. Results: Average age of patients presenting to us was 30.2years (±18.5) ranging from 3years to 83years. Highest numbers of patients fell into the age group category of 11-20years i.e. 94 (33.33%). The average duration of symptoms among our patients was 19.6 months (±26.09) ranging from 0.1months (3 days) to 168 months (14years). Highest number of patients fell into the 7months-12months category i.e. 86 patients (30.5%). The commonest mode of presentation among our patients was painful lump i.e. 128(45.3%) while patients presenting with painless lump were 57(20.2%) and those presenting with only pain were 28(9.9%). Conclusion: The study concluded that there is a need of greater awareness amount general population and health care professionals regarding red flag signs and symptoms in order to avoid the delays in diagnosis which may leads to poor prognosis.


Author(s):  
V Aggarwal ◽  
Shakti Kumar Gupta ◽  
DK Sharma ◽  
S Arya ◽  
S Singh

ABSTRACT Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality and contribute to the incidence of adverse events, resulting in increased healthcare costs. Healthcare providers need to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs. The purpose of this study is to provide guidelines regarding the procedure of reporting ADRs to hospital authority. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from one public and two private hospitals. Interaction was done with study population against the back drop of the checklist and ADR policy was formulated. How to cite this article Singh S, Gupta SK, Arya S, Sharma DK, Aggarwal V. Adverse Drug Reaction Policy in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):41-47.


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