scholarly journals AN OBSERVATIONAL STUDY OF MEDICATION ERRORS AMONG PSYCHIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (11) ◽  
pp. 340
Author(s):  
Reenu Jose ◽  
Krishnaveni K ◽  
Jesna Maria ◽  
Shanmuga Sundaram R ◽  
Sambathkumar R
Keyword(s):  
Observational Study ◽  
Psychiatric Patients ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Male Patients ◽  
The Common ◽  
Psychiatric Department

Objective: The objective of this study is to evaluate the common medication error (ME), and its causes, category, and severity by using suitable questionnaire.Methods: A prospective observational study was carried out for 6 months in a psychiatric department. Demographic data, clinical history, and complete prescription were noted.Results: A total of 120 psychiatric cases were collected, among that 116 MEs were identified in which male patients were 64 (55%) and females 52 (44.8%). The number of MEs occurred due to physician was 67 (57.7%), due to nurses was 15 (12.9%), and combined was 38 (32.7%). Incomplete prescription was the main type of error that we found. About 43.1% of the error we identified was informed to the staff and and no specific action was needed for 37.1% of errors. In our study, we found that majority of 54 (46.5%) errors were categorized under category B, but there was no harm to the patient.Conclusion: The present study concluded that most of the patients admitted in the psychiatry department would experience MEs. Clinical pharmacist can play a major role in the early detection and prevention of MEs and thus can improve the quality of care to the patients.

scholarly journals Patient Perspectives on Telepsychiatry on the Inpatient Psychiatric Unit During the COVID-19 Pandemic

2020 ◽  
Vol 7 (5) ◽  
pp. 677-679
Author(s):  
Reuben Heyman-Kantor ◽  
Nathan Hardy ◽  
Amy R Corcoran
Keyword(s):  
Disease Transmission ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Patient Perspectives ◽  
Care Hospital ◽  
Effective Care ◽  
Psychiatric Units ◽  
Risk Of Disease ◽  
Inpatient Psychiatric Unit

Hospitals have eliminated many in-person interactions and established new protocols to stem the spread of COVID-19. Inpatient psychiatric units face unique challenges, as patients cannot be isolated in their rooms and are at times unable to practice social distancing measures. Many institutions have experimented with providing some psychiatric services remotely to reduce the number of people physically present on the wards and decrease the risk of disease transmission. This case report presents 2 patient perspectives on receiving psychiatric care via videoconferencing while on the inpatient unit of a large academic tertiary care hospital. One patient identified some benefits to virtual treatment while the second found the experience impersonal; both were satisfied with the overall quality of care they received and were stable 2 weeks after discharge. These cases demonstrate that effective care can be provided remotely even to severely ill psychiatric patients who require hospitalization.

scholarly journals Utility of pleural fluid adenosine deaminase in diagnosing tubercular pleural effusion: a prospective observational study in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1711
Author(s):  
Gayathri Devi H. J. ◽  
Sujith H.
Keyword(s):  
Pleural Effusion ◽  
Observational Study ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Diagnostic Methods ◽  
Care Hospital

Background: The diagnosis of Tubercular (TB) pleural effusion continues to be a challenge in clinical practice, as traditional diagnostic methods are useful but do not provide enough sensitivity and specificity.Methods: This was a prospective observational study carried out at Tertiary care Hospital with study population of 76 patients. Etiological diagnosis was based on clinical history with radiological imaging, biochemical and cytological examination of pleural fluid. Pleural fluid ADA was used as a biomarker for the diagnosis of tubercular pleural effusion.Results: The study included 76 patients with 69.7% (n=53) males and 30.3%(n=23) females. The mean age of patients was 48.97 17.03 years. Of 76 cases of pleural effusion, 62 were exudates and 14 transudates. Tuberculosis was the most common cause among exudates which accounted for 51.3% (n=39) of cases. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), Accuracy of pleural fluid ADA in diagnosing tubercular pleural effusion was 92.3%, 97.3%, 97%, 92% and 94.7% respectively.Conclusions: Pleural fluid ADA can be one of the most reliable biomarkers for the diagnosis of TB pleural effusion considering its high sensitivity and specificity.

scholarly journals Clinical profile and renal complications among cases of malaria in children attending a tertiary care hospital of South India

2019 ◽  
Vol 6 (4) ◽  
pp. 1445
Author(s):  
Tenali Ravi Kumar ◽  
Sai Lakshmi Ananya Tenali
Keyword(s):  
Renal Failure ◽  
Vivax Malaria ◽  
Statistical Significance ◽  
Demographic Data ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Clinical History ◽  
Clinical Profile ◽  
Care Hospital ◽  
Early Recovery

Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.

scholarly journals A prospective observational study to analyse clinical profile of varicose vein cases treated in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 769
Author(s):  
Maragadha Mani ◽  
Anand A.
Keyword(s):  
Observational Study ◽  
Clinical Presentation ◽  
Vascular System ◽  
Varicose Veins ◽  
Demographic Data ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Leg Pain ◽  
Care Hospital ◽  
Presenting Symptoms

Background: Varicose veins are common vascular disorder. The study was conducted to analyse the clinical presentation, treatment options and complications of varicose veins.Methods: This observational study was conducted in Thanjavur Medical College Hospital. Adults with clinically diagnosed unilateral or bilateral varicose veins of lower limbs were studied in surgical wards between August 2013 to July 2014. The demographic data and presenting symptoms, signs and previous treatment were collected using a structured proforma. Thorough clinical examination, duplex scan and abdominal and pelvic examination were done in all cases to find out the secondary causes. Peripheral vascular system was examined. All the patients were followed regularly for the period of one month to one year after treatment.Results: A total of 60 cases were included. Most participants belonged to 2nd and 3rd decade of life. 55 (91%) participants were male and5 (9%) participants were females. 45 (75%) participants were agriculturists. 10 (17%) participants had bilateral involvement. Most participants 30 (50%) participants had 1 to 5 years duration of disease, most common clinical presentation of the study participants was varicosity with 70.0%, followed by lipodermo sclerosis, leg pain, hyperpigmentation, pruritus as 63.0%, 56.0%, 15% and 11.6% respectively. 17 (28.33%) patients were present with a venous ulcer. 32 (53%) participants were managed surgically, and 28 (47%) participants were managed conservatively. Most participants were treated with multiple ligation 21.8% followed by trendelenburg operation+ stripping18.75%.Conclusions: Regarding the treatment, surgery is the treatment of choice for primary varicose veins and conservative treatment for secondary varicose veins.

scholarly journals DERMATOPHYTOSIS PROFILE IN A MADHUBANI MEDICAL COLLEGE AND TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Shahid Hassan
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Clinical History ◽  
Epidemiologic Studies ◽  
World Population ◽  
Care Hospital ◽  
Indirect Contact ◽  
Medical College ◽  
Number Of Patients ◽  
History Of

INTRODUCTION: The current perception among dermatologists based on their experience in the outpatient’s clinics is that there is a huge change in clinical profile, both qualitative and quantitative, in the patients presenting with dermatophytosis. The prevalence of superficial mycotic infection is about 20%–25% of the world population, and dermatophytes is the leading microorganism responsible. Now there is a changing trend in the dermatophytic infections, the cases are presenting as chronic, not responding to usual treatment and also there are recurrent cases. Dermatophytosis is a contagious disease that spreads by direct or indirect contact. Until a few years ago, it had been a disease treated with ease using antifungal agents. In the recent past, there has been a failure of treatment with conventional therapy and emergence of an epidemic of recurrent and chronic dermatophytosis in India. MATERIAL AND METHODS: Our study population included 112 patients who were clinically diagnosed as dematophytosis in the Outpatient department (OPD). Clinical history of all patients was taken. Demographic data such as age, sex, occupation, duration of disease, history of recurrence, habits and associated diseases was recorded. Culture were done in all suspected cases. Nail scrapings, clippings and sub-ungual debris were collected. RESULTS: In present study there were in all 112 patients among which maximum number of patients about 33% belonged to age group 11 to 20, majority of which were males 66.96% whereas 33.04% were females. 50% were culture positive among all patients and microscopy was positive in 58.93% of cases. Trichophytonrubrum species was isolated predominantly in 57.1% cases, Trichophytonmentagrophyte was found in 23.2% of patients followed by microscoporumgypsium isolated in 12.5% cases and E.floccosum was seen isolated in 7.1% among all clinical types. Percentage of tineacorporis, tineacapitis and tineacruris was 39.3%, 18.8% and 13.4% respectively. CONCLUSION: Dermatophytosis was found to be common in second decade of life and male were commonly affected. T. rubrum was most common isolate. The need of the hour is carry out multicentric large epidemiologic studies that can effectively establish the prevalence of fungal isolates and its antifungal resistance status.

scholarly journals Incidence and clinico-demographic characteristics of neonatal meningitis in clinically suspected sepsis: an observational study

2019 ◽  
Vol 6 (6) ◽  
pp. 2267
Author(s):  
Rupali Jadhav ◽  
Baraturam Bhaisara ◽  
Anjali B Bhatawdekar
Keyword(s):  
Observational Study ◽  
Tertiary Care Hospital ◽  
White Cell Count ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical Suspicion ◽  
Neonatal Meningitis ◽  
Care Hospital ◽  
Suspected Sepsis ◽  
Study Population

Background: Authors objective was to study the incidence and risk factors for meningitis in neonates with clinical suspicion of sepsis in Neonatal Intensive Care Unit (NICU) of tertiary care hospital of Mumbai, India.Methods: This descriptive observational study enrolled Consecutive 92 patients of either sex with suspected neonatal sepsis admitted in NICU of Tertiary Care Hospital. All neonates admitted to NICU with clinical suspicion of sepsis or developing signs of sepsis during NICU stay were included in study. Exclusion criteria were 1.Neonates with hemodynamic instability 2.major congenital malformations 3.contraindication or no willingness for Lumber puncture (LP ) 4.neonates who have received intravenous antibiotics for more than 24 hours elsewhere.Standard data collection form was used to collect all demographic data and clinical characteristics of neonates.Results: Incidence of meningitis in study population was 7.6%. Cases of meningitis in study population had mean birth weight 1.91 kg, 71.43% were preterm, 57.14% vaginaly delivered, 42.86% by LSCS, Premature rupture of membrane (PROM) observed in 28.57% cases. Meconium stained liquor in 42.86% cases and foul smelling liquor in 28.57% cases observed. 42.86% cases required resuscitation and 28.57% received surfactant therapy. Poor feeding (100%), lethargy (85.71%), weak cry (85.71%) and tachypnea (50.58%). Retractions (85.71%), Grunting (57.14%) and Nasal flaring (42.86%) were clinical presentation. Lab findings in a case of meningitis: mean Hemoglobin (Hb) 15.22 gm%, Leukopenia (28.57%), Leukocytosis 28.57%, Absolute Neutrophil count (ANC) <1800 (28.57%), Thrombocytopenia 42.85%, blood culture positive (28.57%) hypoglycemia (28.57%), CSF white cell count (124.57cells/ml.), mean CSF protein level (60 mg/dl.) Mean CSF glucose level (40.86 mg/dl.) CSF culture was positive in two cases of meningitis.Conclusions: Authors study highlights the diagnostic utility of routine lumbar puncture in neonates with clinically suspected sepsis.

scholarly journals Outcome of primary repair in typhoid ileal perforation at Tertiary Care Hospital.

2020 ◽  
Vol 27 (06) ◽  
pp. 1128-1132
Author(s):  
Gulshan Ali Memon ◽  
Abdul Hakeem Jamali ◽  
Sajjad Hussain Qureshi ◽  
Altaf Hussain Ghumro ◽  
Mashooq Ali Khowaja ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Tertiary Care Hospital ◽  
Primary Repair ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Ileal Perforation ◽  
Surgical Department ◽  
Male Patients ◽  
The Common

Typhoid ileal perforation is the common complication of typhoid fever in third week of its phase of progression. It is the most common cause of mortality in developing countries. Small perforations are dealt with primary repair and the more complicated disease is treated by multiple other options. Prognosis is good with primary repair with least postoperative complications. Objectives: To detect the outcome of typhoid ileal perforation treated by primary repair at tertiary care hospital. Study Design: Cross sectional study. Setting: Surgical Department of PMC Hospital Nawabshah. Period: From August 2017 to December 2018. Material & Methods: This study included total 70 patients. All patients were admitted from surgical OPD and emergency department of PMCH Nawabshah. Out of 70, 45 (64.28%) were females and 25 (35.71%) were male patients. Age ranged from 27 to 52 and 24 to 47 in females and males respectively. The common presentation was pain in whole abdomen along with distention and fever, vomiting. Plain X ray chest/ Abdomen and ultra sonography showed gas under diaphragm. Primary repair was done and also other surgical options but our study included only the postoperative outcomes of primary repair of typhoid ileal perforation. A few complications were detected after primary repair of the gut perforation. Results: Total 70 patients were included in this study. 45 (64.28%) were females and 25 (35.71%) were male patients. In females, 25 (55%) were found single perforations of less than 1cm whereas 7 (15.5%) had size of perforation less than 1.5 cm. In 25 males, 11 (44%) had single perforations of less than 1cm in size. 2 (8%) had < 1.5 cm size perforations and 12 (48%). Over all complication rate in this study was 26%. Conclusion: Primary repair is the best surgical option to treat typhoid ileal perforation in selected patients with least postoperative complications.

scholarly journals Interdisciplinary handover between obstetric nursing and neonatal physician teams: an observational study

2019 ◽  
Vol 3 (1) ◽  
pp. e000432
Author(s):  
Anshul Arora ◽  
Thomas Kannampallil ◽  
Joanna Abraham
Keyword(s):  
Adverse Events ◽  
Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Obstetric Nurses ◽  
Handover Process ◽  
Delivery Unit ◽  
Clinical Content

ObjectiveWe investigated the content and quality of communication of interservice interprofessional handover between obstetric nurses and neonatal physicians for high-risk deliveries.DesignObservational study.SettingLabour and delivery unit at a tertiary care hospital.MethodWe audio-recorded handovers between obstetric and neonatal teams (n=50) and conducted clinician interviews (n=29). A handover content framework was developed and used to qualitatively code missing core and ancillary content and their potential for adverse events.Results26 (52%) handovers missed one or more clinical content elements; a third of the handovers missed at least one core clinical content element. Increase in the number of missed clinical content elements increased the odds of potential adverse events by 2.39 (95% CI1.18 to 5.37). Both residents and nurses perceived handovers to be of low quality and inconsistent and attributed it to the lack of a structured handover process.ConclusionStreamlining handover processes by instituting standardisation approaches for both information organisation and communication can improve the quality of neonatal handovers.

scholarly journals Data Quality of Request Forms for Lumbar Spine Radiography in a Tertiary Care Hospital in Sri Lanka

2019 ◽  
Author(s):  
Mihiri Chami Wettasinghe ◽  
Shanthini Rosairo ◽  
Nuwan Darshana Wickramasinghe
Keyword(s):  
Lumbar Spine ◽  
Sri Lanka ◽  
Data Quality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
X Rays ◽  
X Ray

Abstract Objective: To assess the data quality of request forms for lumbar spine X-ray received by a tertiary care hospital in the Central Province, Sri Lanka. Results: A total number of 185 lumbar spine X-ray request forms received by the Department of Radiology were analysed. Data quality was assessed on the aspects of completeness, accuracy and legibility. Completeness was assessed for different sections separately and altogether eight sections in the request forms were analyzed. Out of the 185 request forms, 138 (74.5%) had complete entries for all the eight sections. Thirteen (7.0%) requests failed to provide the clinical history. Five request forms (2.7%) failed to provide the sex and the age of the patient. Thirty two (17.3%) did not provide details on the region of examination. Accuracy was assessed in relation to the clinical history and region of examination. In the 172 requests, which gave a clinical history, 167 (97.1%) provided relevant clinical histories for requesting lumbar spine X-rays. Five requests (2.9%) provided irrelevant history and five (2.9%) requests contained non-standard abbreviations. Five (2.7%) referrals were not readable by the radiologists. Hence, the data quality of lumbar spine X-ray request forms received by the Department of Radiology needs further improvement.

Physical examination of psychiatric patients who presented at emergency department in a tertiary care hospital in Sultanate of Oman

2017 ◽  
Vol 41 (S1) ◽  
pp. S335-S335
Author(s):  
S. Alhuseini
Keyword(s):  
Emergency Department ◽  
Physical Examination ◽  
Psychiatric Patients ◽  
Demographic Data ◽  
Tertiary Care ◽  
Vital Signs ◽  
University Hospital ◽  
Psychiatric History ◽  
Care Hospital ◽  
Physical Assessment

ObjectiveTo examine the completeness of physical assessment of patients presenting with psychiatric problems to the emergency department (ED).MethodsThis was observational study based on a retrospective review of the medical records of patients who attended the ED of Sultan Qaboos university hospital and referred to the on-duty psychiatrist for assessment over a 12-month period. All patients aged 16 years and above, who presented to the ED with a psychiatric complaint were included in the study. A data collection sheet was designed to gather each patient's demographic data such as age and gender, past psychiatric history, nature of the presenting complaints, thoroughness of physical assessment, medications prescribed by the ED doctor prior to psychiatric assessment, and whether the patient was discharged, admitted to a psychiatry.ResultsA total of 202 patients met the inclusion criteria. The mean age of the patients was 34.2 years. Females represented 56% of the sample. The majority of the study group (60.4%) were patients with a documented past psychiatric history. Physical examination was conducted in the ED for 61.4% of the patients, while vital signs were recorded for 68.8% of them. Approximately, 31% of the patients required injectable psychotropic medications as tranquillizers in the ED. Patients with an isolated psychiatric complaint coupled with a documented past psychiatric history were more likely to be referred to the on-call psychiatrist without a physical examination by the ED doctors.ConclusionIn our institution, not all patients with psychiatric presentations had a complete physical examination by the ED doctors.Disclosure of interestThe author has not supplied his declaration of competing interest.

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