scholarly journals Mortality prediction in chronic interstitial lung diseases (ILDs): ILD-GAP (gender age physiology) and (the new modified classification) TNMC-ILD-GAP

Pneumologia ◽  
2021 ◽  
Vol 69 (4) ◽  
pp. 218-226
Author(s):  
Sameer Bansal ◽  
Unnati D. Desai ◽  
Jyotsna M. Joshi
Keyword(s):  
Tertiary Care ◽  
Interstitial Lung Diseases ◽  
Mortality Prediction ◽  
Gap Model ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Resource Limited ◽  
The Difference ◽  
Gap Models

Abstract Introduction: The interstitial lung disease-gender age physiology (ILD-GAP) model has been proposed on the lines of GAP-idiopathic pulmonary fibrosis (IPF) to predict mortality in chronic ILDs, other than IPF. We replaced diffusion capacity of lung for carbon monoxide (DLCO) with the easy to perform 6-minute walk distance (6 MWD) in the ILD-GAP and proposed the new modified classification (TNMC)-ILD-GAP model. Our aim was to demonstrate the usefulness of the TNMC-ILD-GAP as a predictor of mortality in all chronic ILDs and compare the results with the ILD-GAP. Methods: It was a retrospective observational study conducted at a tertiary care centre. Baseline characteristics of the patients among different ILD groups were analysed. A 3-year follow-up was recorded. The results were compared with the original ILDGAP model. Chi-square and paired t-test was used for comparison of qualitative and quantitative data, respectively. Results: Mean ages were 62.34 (±9.85), 57.9 (±11.6), 46.1 (±14.6) and 55.5 (±14.7) in IPF, non-specific interstitial pneumonitis (NSIP), connective tissue disease (CTD) and unclassifiable groups, respectively. There were 50%, 18%, 26% and 55% males in the four categories respectively. Mean 6 MWD was 227 m, 302 m, 342 m, and 332 m. Mean PaO2 was 64 mmHg, 70 mmHg, 75 mmHg, 69 mmHg. Mean forced vital capacity (FVC) (percentage predicted) was 52, 49, 51 and 54. Most of the patients had comorbidities, among which pulmonary hypertension was the most common. Mortality with ILD-GAP model and TNMC-ILD-GAP showed concordant results as the difference in mortality predicted by ILD-GAP and the TNMC-ILD-GAP models was statistically insignificant (P > 0.050). Conclusion: 6 MWD can serve as a reliable replacement for DLCO in the ILD-GAP model, especially in resource limited settings.

scholarly journals Psycho sexual profile of perimenopausal and post-menopausal women visiting a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4613
Author(s):  
Smita Sharma ◽  
Poonam Mani ◽  
Shashi Prateek ◽  
Lalita Yadav ◽  
Jasneet Dhingra
Keyword(s):  
Psychological Symptoms ◽  
Tertiary Care ◽  
Sexual Life ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Medical College ◽  
Sexual Symptoms ◽  
Care And Support ◽  
The Difference ◽  
Post Menopausal

Background: The objective was to study the psychosexual profile of perimenopausal and postmenopausal females visiting a tertiary care centre.Methods: The present study was carried out in the Obstetrics and Gynecological Department of Subharti Medical College and Hospital from July 2013 to June 2015.A questionnaire was made including the questions regarding the various symptoms and problems encountered by both peri and postmenopausal females. A detailed interaction in the form of history and examination was done on a total of 220 patients which included both type of females. They were then given a questionnaire which they filled it by themselves or with assistance from our side. The females in both the groups were then analysed on the presence or absence of a particular symptom and whether the difference was statistically significant or not and the data was analysed using Chi square test.Results: The study showed varied symptoms in both the type of females be it Perimenopausal or post-menopausal. The vasomotor and the psychological symptoms were more common in the perimenopausal females whereas the physical and sexual symptoms were more common in post-menopausal females. Variations from this pattern were also found. The mean age of menopause was found to be 48.3 years with only 1.81% females above 70 years.Conclusions: The perimenopausal and postmenopausal females do undergo many physiological as well as psychological changes that surely affects their social, personal as well as sexual life. Thus they require a lot of care and support and adequate evaluation so that they can be treated well. 

scholarly journals Efficacy of Influenza Like Illness (ILI) Screening OPD for COVID-19 at a High-Volume Centre: Unlocking Routine OPD

2021 ◽  
Author(s):  
Bhawna Mattoo ◽  
Radhika Sarda ◽  
Arvind Kumar ◽  
Kaleem Fatima ◽  
Ravneet Kaur ◽  
...  
Keyword(s):  
Tertiary Care ◽  
High Volume ◽  
Confirmatory Test ◽  
Care Centre ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Influenza Like Illness ◽  
Resource Limited ◽  
The Impact

Abstract Background: The Impact of COVID-19 pandemic over non-essential health services has been massive. We initiated Influenza Like Illness (ILI) screening for resumption of out-patient services at a tertiary care centre and this study attempted to gauge its efficacy in effectively pruning out COVID-19. Methods: We included all the patients who had visited for an OPD appointment during the study period. Patient details and ILI symptoms were noted. Patients were then followed up telephonically after 2 weeks. The telephonic follow up was to ensure RT-PCR status and complaints of any newly developed ILI post OPD visit (within the last 14 days). Results: Out of the 957 patients who were enrolled, 929 patients were successfully followed up telephonically after 14 days. Only 13 who were screened out as ‘possible ILI’, were either RT-PCR negative or did not follow up with a confirmatory test. The telephonic follow up to ensure RT-PCR status and complaints of any newly developed ILI post OPD visit (within the last 14 days) was noted in the rest of the patients. Only 1 participant out of 957 screened, tested positive for COVID-19. Conclusion:The period in which the study was held the national positivity rate was low (around 3%). Therefore, in a resource limited country such as India it is astute to restart the OPD services in the pre-existing setup using basic precautions and a verbal questionnaire during the slope of the pandemic.

Neonatal sacrococcygeal teratoma: Our 20-year experience from a tertiary care centre in North India

2020 ◽  
pp. 004947552097361
Author(s):  
Kamal N Rattan ◽  
Jasbir Singh
Keyword(s):  
Mature Teratoma ◽  
Tertiary Care ◽  
Therapeutic Interventions ◽  
North India ◽  
Sacrococcygeal Teratoma ◽  
Type I ◽  
Tertiary Care Centre ◽  
Type Iv ◽  
Resource Limited

Advances in diagnostic and therapeutic interventions have improved the survival of neonates with sacrococcygeal teratoma in richer countries. These changes have not yet taken place in resource-limited settings. A retrospective analysis of neonates with sacrococcygeal teratoma operated at our centre during 1997–2016 was performed. Among 44 neonates enrolled, prenatal diagnosis of sacrococcygeal teratoma was available in 25% of pregnancies. All babies except one were born vaginally. Associated congenital malformations were seen in 20% (9/44). Types of sacrococcygeal teratoma were classified as Altman type I in 12 (27.3%), 24 (54.5%) as type II, 6 (13.6%) as type III and 2 (4.5%) as type IV. Morphologically, 77% (34/44) neonates had cystic lesions. All patients were managed successfully by total excision. Histopathology confirmed mature teratoma in 43 (97.7%). After a 12-month follow-up, no recurrence was observed. An uneventful pregnancy, absence of associated congenital anomalies, cystic morphology and a mature histology are good prognostic factors.

Comparison of Clinical Outcomes With Drug Coated Balloons Versus Plain Balloon Angioplasty In Chronic Limb-Threatening Ischemia

2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Arterial Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Exact Test ◽  
Institutional Review ◽  
Chi Square Test

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.

scholarly journals IsHelicobacter pyloriBeing Treated Appropriately? A Study of Inpatients and Outpatients in a Tertiary Care Centre

2007 ◽  
Vol 21 (5) ◽  
pp. 285-288 ◽  
Author(s):  
Jose Nazareno ◽  
David K Driman ◽  
Paul Adams
Keyword(s):  
Tertiary Care ◽  
Gastric Biopsy ◽  
Pathology Report ◽  
Tertiary Care Centre ◽  
Delivery Of Care ◽  
Ulcer Disease ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
H Pylori

BACKGROUND:Helicobacter pyloriis causally associated with peptic ulcer disease and gastric cancer. Although effective treatment is available, studies have shown that patients withH pyloriare often not well managed. Recently, there has also been increasing awareness of patient safety concerns arising from missed follow-up of abnormal test results.OBJECTIVE: To examine whether inpatients and outpatients diagnosed withH pylorireceive appropriate treatment.PATIENTS AND METHODS: All patients who were diagnosed withH pyloriby gastric biopsy in London, Ontario between January 1, 2004, and December 31, 2004, were identified. The hospital charts of these patients were reviewed. Outpatient office charts, clinic notes, pathology reports and endoscopy reports were also reviewed.RESULTS: One hundred ninety-three patients were diagnosed withH pyloriby gastric biopsy in 2004. Of the 193 patients, 143 (74%) were outpatients and 50 (26%) were inpatients. Overall, 89% of patients received treatment forH pylori. Ninety-two per cent of outpatients were treated, while only 60% of inpatients received treatment (P<0.001). Among the inpatients, the pathology report was available in 40% of the cases before the patient was discharged from the hospital. After discharge from the hospital, 30% of inpatients received appropriate treatment and follow-up. There was no significant difference in treatment whether the patient was admitted to a medical or a nonmedical service.CONCLUSION:H pyloriis treated relatively poorly in inpatients compared with outpatients. Results of the present study reveal opportunities to improve delivery of care for inpatients on a number of different levels. More research is needed to ensure safety, effectiveness and timeliness in the test result management process.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

SPECTRUM OF HISTOPATHOLOGICAL LESIONS OF FEMALE GENITAL TRACT - STUDY IN A TERTIARY CARE CENTRE

2021 ◽  
pp. 19-21
Author(s):  
Naik Viraj R ◽  
Manjusha Jindal ◽  
Siddhi D. Naik
Keyword(s):  
Genital Tract ◽  
Malignant Tumors ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Screening Methods ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Histopathological Lesions ◽  
Female Genital

Introduction: (1) The female genital tract is constituted by the ovaries, fallopian tubes, uterus (body/corpus and cervix), vagina, and vulva. Female genital tract lesions can be benign or malignant. Our study was carried out to nd out the frequency of various histopathological lesions including neoplasms of female genital tract. Materials and Methods: Our study is retrospective conducted over 2 years period. Data was collected from case records of patients presenting to Goa Medical College and histopathology reports obtained from Dept of pathology. Data was represented in form of charts and tables. The analysis of statistical data of variables was done using SPSS software version 22. Signicance was calculated using chi square test. Value of p <0.05 was considered signicant. Results: Out of total 270 subjects studied, 229 were having benign lesions and 41 had malignant lesions.The mean age was 49.5 years. Leiomyoma was diagnosed in (40.58%) cases. In abnormalities of endometrium proliferative endometrium was seen in 37.6%. Chronic cervicitis was seen 78.74% cases. Among the ovarian lesions, 67.74% cases were simple follicular cysts. Cervical cancer was found in 73.17% cases followed by ovarian malignancies in 19.51 % cases, endometrial carcinoma in 4.87% cases and vulvar cancer in 2.44% cases. Among the malignant tumors (58.54%) cases were postmenopausal women. Conclusion: Microscopic assessment and clinico-pathological correlation of lesions is necessary as grossly identiable benign lesion may harbour a focus of malignancy. It aids to appropriate management in the postoperative period. A concerted effort should be done towards prevention of cancers, by creating awareness through health education in addition to implementation of screening methods.

scholarly journals Limited adequacy of thyroid cancer patient follow-up at a Canadian tertiary care centre

2013 ◽  
Vol 56 (6) ◽  
pp. 385-392 ◽  
Author(s):  
Elaine Lam ◽  
Scott S. Strugnell ◽  
Chris Bajdik ◽  
Daniel Holmes ◽  
Sam M. Wiseman
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patient ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Thyroid Cancer Patient

scholarly journals PHARMACOINVASIVE VERSUS THROMBOLYSIS IN STEMI COHORT – OUTCOMES FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Richa Sharma ◽  
Ajeet Jain ◽  
Praveen Singh ◽  
Bhushan Shah
Keyword(s):  
Myocardial Ischemia ◽  
Tertiary Care ◽  
Myocardial Necrosis ◽  
North India ◽  
Registry Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Promising Strategy ◽  
Cardiology Department

STEMI is an event where transmural myocardial ischemia induces myocardial necrosis. PI strategy is a promising strategy in the management of STEMI. It is prospective registry study conducted in Cardiology Department, KGMU between January-June 2016 to know 30 day outcome of thrombolysis alone or thrombolysis followed by PCI in north India.At 30 day follow up, patients undergoing PI strategy,complained less of angina and dyspnea compared to thrombolysis arm.

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