scholarly journals ALLERGIC RHINITIS

2011 ◽  
Vol 18 (02) ◽  
pp. 289-294
Author(s):  
MUHAMMAD ZAHID RAFIQ GILL ◽  
SALAHUDDIN AYUBI
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Mucociliary Clearance ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Topical Steroids ◽  
Care Hospital ◽  
India Ink ◽  
Significant Difference ◽  
Before And After

Introduction: Allergic rhinitis is one of the most common ENT diseases in Faisalabad. The affects of topical steroids on nasal mucosal environment has not been studied reliably. Objectives: To see the affects of topical steroids on symptom score and mucociliary clearance in Allergic Rhinitis. Rationale: To see whether symptom score change with change in mucociliary clearance after topical application of steroids. Study design: A quasi-experimental study. Setting: ENT Unit, Madina Teaching Hospital, Faisalabad ( a tertiary care hospital). Subjects: (sample, sampling technique): Non-probability convenience sampling. Fifty patients in total. Intervention: Saccharine with dye: india ink (Indigocarmine) application on anterior end of inferior turbinate to check mucociliary clearance. Methods (Main outcome measures): To assess change in mucociliary clearance time and symptom score (total as well as individual) before and after application of steroid at one, three and six months in patients having allergic rhinitis. Each nasal symptom was scored as zero to 3 on a severity scale (absent-mild-moderatesevere). Results: Patients were tested for nasal mucociliary clearance and symptom score before and after application of steroid. The results showed statistically significant difference in these groups. Conclusions: 1.Topical steroids modify the nasal mucosal environment in terms of mucociliary clearance and thus affects the patients quality of life in terms of allergic rhinitis symptom score 2. More long term follow up and wider studies are required to study the definite affects of steroids on nasal mucosa.

scholarly journals Prevalence of Aeroallergens in Allergic Rhinitis in a Tertiary Care Hospital

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Monika Pokharel ◽  
Bikash Lal Shrestha ◽  
Dharmendra Karn ◽  
Ashish Dhakal ◽  
Abha Kiran K.C. ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Data Entry ◽  
Sampling Technique ◽  
House Dust Mites ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prick Test

Introduction: The prevalence of allergic rhinitis has increased significantly globally over the last two decades. Detection of sensitizing aeroallergens plays a crucial role in the diagnosis and management of this troublesome disease. This study aims to investigate the spectrum of aeroallergens sensitization in patients with allergic rhinitis in a tertiary care hospital. Methods: A descriptive cross-sectional study conducted in the Department of Otorhinolaryngology of our hospital between January 2016 to December 2019. Ethical approval was taken from the Institutional Review Committee (No: 210/19). Patients diagnosed with allergic rhinitis were enrolled using the convenience sampling technique. Data entry and analysis was done using IBM Statistical Package for Social Sciences version 20.0. Results: Among 170 patients, altogether 103 (60.6%) patients yielded positive responses on the skin prick test. The most prevalent aeroallergens were Lepidoglyphus 86 (50.60%), Dermatophagoides pteronyssinus 85 (50%), Dermatophagoides farina 82 (48.20%), Thyrophagus 50 (29.40%), Blomia 46 (27.10%), Acarus 43 (25.30%), cat dander 26 (15.30%), dog dander 24 (14.10%), cow and buffalo dander 20 (11.8%), ragweed 20 (11.8%), grass pollen 18 (10.60%) and mugwort 17 (10%). Conclusions: This study highlights that the frequency of aeroallergens based on skin prick test in patients presenting to a tertiary care hospital which showed the dominance of house dust mites, dog and cat hair, pollen, and grasses. Reduced exposure and training of patients about protection against these agents will possibly help in controlling the severity of allergic rhinitis in this region.

The Impact of Hospital Accreditation on the Patients Satisfaction of Haemodialysis Department Services

2018 ◽  
Vol 6 (8) ◽  
pp. 384
Author(s):  
Zuber Mujeeb Shaikh
Keyword(s):  
Patient Satisfaction ◽  
Health Care Quality ◽  
Tertiary Care ◽  
Care Quality ◽  
Care Hospital ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Survey Questionnaires

The quality of hospital Haemodialysis Department Service is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on Haemodialysis Department Service patient satisfaction. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital at Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower patient satisfaction rate of the hospital Haemodialysis Department Services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (Ho) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question in the questionnaire. Study Design: The closed ended questionnaire was developed considering the Haemodialysis Department Services and incorporated the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients' families for completion upon using the Haemodialysis Department Services two months before and two months after the accreditation. The data were collected in order to cover all three shifts of the Haemodialysis Department Services. Study Population: Simple random sampling method was selected, the researcher had involved all conscious patients (clinical conditions) from all age groups. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: At the 5 % level of significance, the t-test results indicate that there is a significant difference in the responses between before (M=51.11, SD=21.89) and after accreditation (M=58.56, SD=17.28) with p-value <0.001. The mean satisfaction score has improved from before accreditation compared to after accreditation.

scholarly journals Compliance with Updated Sepsis Bundles to Meet New Sepsis Core Measure in a Tertiary Care Hospital

2017 ◽  
Vol 52 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Taylor H. Ramsdell ◽  
April N. Smith ◽  
Eric Kerkhove
Keyword(s):  
Hospital Mortality ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Bundles ◽  
Sepsis Bundles ◽  
Improved Outcomes ◽  
Significant Difference ◽  
Before And After ◽  
Core Measure ◽  
Bundle Compliance

Background The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016. The before group ( n = 48) consisted of sequential patients discharged from April 1, 2015 to September 30, 2015 (prior to core measure implementation), and the after group ( n = 110) consisted of sequential patients discharged from October 1, 2015 to February 29, 2016 (after core measure implementation). Results Significant improvement was seen in the after group compared to the before group for bundle compliance with the 3-hour (66.4% vs 31.3%; p < 0.01) and 6-hour (75.5% vs 41.7%; p < 0.01) components and the overall core measure (51.8% vs 16.7%; p < 0.01). In-hospital mortality was lower in the after group compared to the before group (14.5% vs 27.1%; p = 0.05), but this difference was not statistically significant. There was no significant difference in LOS. Conclusions The study found a significant increase in compliance with the sepsis care bundles since the implementation of this core measure. Increased adherence to the care bundles may improve in-hospital survival.

Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis

2021 ◽  
pp. 000348942110254
Author(s):  
Yavuz Atar ◽  
Semih Karaketir ◽  
Imran Aydogdu ◽  
Hüseyin Sari ◽  
Hasan Sami Bircan ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Clearance Time ◽  
Liquid Extract ◽  
Alternative Treatment Option ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Nasal Mucociliary Clearance

Objective: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. Methods: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. Results: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant ( P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times ( P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant ( P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant ( P = .010; P = .001, respectively). Conclusion: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

scholarly journals Comparison of Antibiotic Dosing Before and After Implementation of an Electronic Order Set

2019 ◽  
Vol 10 (02) ◽  
pp. 229-236 ◽  
Author(s):  
Kristen Nichols ◽  
Allison Petschke ◽  
Emily Webber ◽  
Chad Knoderer
Keyword(s):  
Health System ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stewardship Program ◽  
Significant Difference ◽  
Before And After ◽  
Implementation Period ◽  
Antibiotic Dosing ◽  
Electronic Order ◽  
Order Set

Background To maximize resources, the antimicrobial stewardship program at a pediatric tertiary care hospital made pediatric dosing specific guidance within the electronic health record available to all hospitals within the health system. Objective The objective of this study was to compare the appropriateness of antibiotic dosing before and after the implementation of an electronic intravenous (IV) antibiotic order set. Methods This was a retrospective cohort study evaluating orders from patients younger than 18 years who received cefepime, piperacillin–tazobactam, tobramycin, or gentamicin at 12 health-system hospitals. Antibiotic dosing regimens and order set use were evaluated in patients who received the specified antibiotics during the 6-month time frame prior to and following electronic order set availability at each hospital. Results In the before and after implementation periods, 360 and 387 total antibiotic orders were included, respectively. Most orders were gentamicin (55.8% in the before implementation period and 54.5% in the after implementation period) followed by piperacillin-tazobactam (22.5% in the before period and 22.2% in the after period). Overall, 663 orders were classified as appropriate (88.8%). Appropriateness was similar in the before or after implementation periods (87.8 vs. 89.7%, p = 0.415). There was a significant difference in appropriateness if a blank order versus the electronic IV antibiotic order set was used (82.8 vs. 90.5%; p = 0.024). Conclusion No difference in antibiotic appropriateness overall was found in the before and after implementation periods. However, when specifically compared with the appropriateness of dosing when blank order forms were used, dosing was more appropriate when electronic antibiotic order sets were used.

The Impact of Hospital Accreditation on the Patient Satisfaction of In-Patient Department Services

2018 ◽  
Vol 6 (8) ◽  
pp. 368
Author(s):  
Zuber Mujeeb Shaikh
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Care Delivery ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Survey Questionnaires ◽  
Patient Department

Patient satisfaction is as important as other clinical health measures and is a chief means of assessing the strength of health care delivery. The current competitive environment has driven health care organisations to concentrate on patient satisfaction as a means to acquire and keep market share. If you don’t recognise what your strengths and weaknesses are, you can’t compete effectively. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on the patient satisfaction of In-Patient Department Services. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital in Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower satisfaction rate in in-patient department services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (H0) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question of the questionnaire. Study Design: The closed ended questionnaire was developed considering the in-patient services process by incorporating the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients for completion upon discharge two months before and two months after the accreditation. Study Population: Simple random sampling method was selected, and the researcher had involved conscious patients of all age groups and gender. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: It is very evident from this research that at the 5 % level of significance, the chi-square test indicates that there is a significant difference in the satisfaction with respect to the overall experience in the hospital between before the accreditation group and after accreditation group with p-value <0.001.The responses of satisfaction has improved from N=421 (Satisfied=245, Highly satisfied= 176) from N=241 (Satisfied = 124, Highly satisfied= 117).

scholarly journals The impact of a computerized physician order entry system implementation on 20 different criteria of medication documentation—a before-and-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Viktoria Jungreithmayr ◽  
Andreas D. Meid ◽  
Janina Bittmann ◽  
Markus Fabian ◽  
Ulrike Klein ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multivariable Analysis ◽  
Computerized Physician Order Entry ◽  
Care Hospital ◽  
Order Entry ◽  
Significant Difference ◽  
Before And After ◽  
Physician Order Entry ◽  
The Impact

Abstract Background The medication process is complex and error-prone. To avoid medication errors, a medication order should fulfil certain criteria, such as good readability and comprehensiveness. In this context, a computerized physician order entry (CPOE) system can be helpful. This study aims to investigate the distinct effects on the quality of prescription documentation of a CPOE system implemented on general wards in a large tertiary care hospital. Methods In a retrospective analysis, the prescriptions of two groups of 160 patients each were evaluated, with data collected before and after the introduction of a CPOE system. According to nationally available recommendations on prescription documentation, it was assessed whether each prescription fulfilled the established 20 criteria for a safe, complete, and actionable prescription. The resulting fulfilment scores (prescription-Fscores) were compared between the pre-implementation and the post-implementation group and a multivariable analysis was performed to identify the effects of further covariates, i.e., the prescription category, the ward, and the number of concurrently prescribed drugs. Additionally, the fulfilment of the 20 criteria was assessed at an individual criterion-level (denoted criteria-Fscores). Results The overall mean prescription-Fscore increased from 57.4% ± 12.0% (n = 1850 prescriptions) before to 89.8% ± 7.2% (n = 1592 prescriptions) after the implementation (p < 0.001). At the level of individual criteria, criteria-Fscores significantly improved in most criteria (n = 14), with 6 criteria reaching a total score of 100% after CPOE implementation. Four criteria showed no statistically significant difference and in two criteria, criteria-Fscores deteriorated significantly. A multivariable analysis confirmed the large impact of the CPOE implementation on prescription-Fscores which was consistent when adjusting for the confounding potential of further covariates. Conclusions While the quality of prescription documentation generally increases with implementation of a CPOE system, certain criteria are difficult to fulfil even with the help of a CPOE system. This highlights the need to accompany a CPOE implementation with a thorough evaluation that can provide important information on possible improvements of the software, training needs of prescribers, or the necessity of modifying the underlying clinical processes.

scholarly journals EARLIEST SYMPTOMS OF PRESENTATION IN COVID-19 PATIENTS IN TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S500-03
Author(s):  
Maqbool Raza ◽  
Muhammad Ali Raza ◽  
De Emmal Asjad Cheema ◽  
Maham Asjad Cheema ◽  
Atif Rafique ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Sampling Technique ◽  
Military Hospital ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Chi Square Test

Objective: To determine the frequency of earliest symptoms of COVID-19 infection among patients with confirmed SARSCOVID-19 infection. Study Design: Cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Multan, from Jun to Dec 2021. Methodology: Data from 299 patients admitted in tertiary care settings was collected on a questionnaire. Patients regardless of gender and age who had confirmed COVID-19 infection through Real Time Polymerase Chain Reaction (RT-PCR) were included in the study. A nonprobability consecutive sampling technique was used to select samples. Data was entered and analyzed through SPSS version 22. Frequencies and percentages of various presenting symptoms were calculated. Sample size calculated at 95% level of confidence, 1% required precision, and 27% anticipated population proportion were 299. The overall difference in frequencies of symptoms in various groups was compared by using chi-square test. p-value <0.05 was taken as significant. Results: A total of 299 participants were included in this analysis. The median age for participants (interquartile range [IQR]) was 46 (36-54) years. Among 299 adults the reported symptoms were cough 238 (79.6%), fever 176 (58.7%) and, dyspnea 113 (37.8%). Only 78 (26.1%) of participants with confirmed infection reported having all three symptoms of cough, fever, and dyspnea. Other reported symptoms in patients were diarrhea 54 (18.1%), fatigue 128 (42.8%), myalgia 113 (37.8%), and anosmia 98 (32.8%). There was no significant difference in the frequency of symptoms across both genders. Conclusion: The most frequent symptoms of COVID-19 are cough, fever, and dyspnea.

scholarly journals Major Septal Defects: Comparative Study of Down Syndrome and Non-Down Syndrome Infants, Before and After Surgery

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Saleha Aziz ◽  
Maaha Ayub ◽  
Laiba Masood ◽  
Muneer Amanullah ◽  
Rukhsana Hameed ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Comparative Study ◽  
Septal Defect ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Atrioventricular Septal Defect ◽  
Care Hospital ◽  
Septal Defects ◽  
Significant Difference ◽  
Before And After

Objective: To compare pre-operative, intra-operative, and post-operative parameters in Down syndrome (DS) and non-DS patients with atrioventricular septal defects (AVSD) and inlet ventricular septal defects (VSD) in a tertiary care hospital in Pakistan. Methods: We conducted a retrospective study at Aga Khan University, Pakistan. All complete atrioventricular septal defect (CAVSD), partial atrioventricular septal defect (PAVSD), and VSD with inlet extension surgical cases from January 2007 to January 2019 were included. Patients with congenital heart diseases other than those listed above were excluded. Results: In 61 cases, 18 had DS. Median age, mean body surface area (BSA), and height were lower in DS patients compared to non-DS patients: 7.0 vs 23.0 months, 0.311 vs 0.487 m2, and 63 vs 82 cm, respectively. Bypass duration, aortic cross clamp time, post-operative ventilator hours, dose of inotropes, CICU stay, and total hospital stay were all significantly higher in the DS group. The odds ratio (95% CI) for mortality in DS babies was 6.2 (1.4, 27.1), p=0.015, after adjusting for age, weight, and height. The overall morbidity was comparable between the two groups, demonstrating no significant difference after adjusting for confounders. Conclusion: DS babies with AVSD and inlet VSD are at a greater risk of mortality compared to non-DS babies, particularly those with CAVSD. Furthermore, DS babies undergo surgery at a younger age and require more aggressive post-operative therapy and monitoring due to the development of complications. doi: https://doi.org/10.12669/pjms.36.5.1743 How to cite this:Aziz S, Ayub M, Masood L, Amanullah M, Hameed R, Hashmi S, et al. Major Septal Defects: Comparative study of Down Syndrome and Non-Down Syndrome Infants, before and after surgery. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1743 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals EFFECTS OF BUTEYKO BREATHING TECHNIQUE AND CONVENTIONAL PHYSICAL THERAPY IN ADULT BRONCHIAL ASTHMA: A RANDOMIZED CONTROL TRAIL

2017 ◽  
Vol 6 (1) ◽  
pp. 36-44
Author(s):  
Qurat ul Ain Ausaf ◽  
Ghazala Noor Nizami ◽  
Amna Aamir Khan
Keyword(s):  
Physical Therapy ◽  
Bronchial Asthma ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Treatment Session ◽  
Care Hospital ◽  
Significant Difference ◽  
Related Quality ◽  
Randomized Control

OBJECTIVE To assess the effectiveness of Buteyko Breathing Technique (BBT) and Conventional Physical Therapy (Conventional PT) for improving pulmonary functions and Health Related Quality of Life (HRQoL) in the management of chronic bronchial asthma. STUDY DESIGN & SAMPLING TECHNIQUE It is a Randomized Control Trial. Patients were selected through Simple Random Sampling. STUDY SETTING & PARTICIPANTS 24 patients diagnosed as chronic bronchial asthma were recruited from the outpatient department, pulmonary clinics of tertiary care hospital. INTERVENTION Subjects were randomly assigned into two groups, BBT (n=12) and conventional PT (n=12). FEV1, FVC and FEV1/FVC ratio were measured at the start and end of the treatment through MIR Spirolab-III. HRQoL was also measured using St George Respiratory Questionnaire (SGRQ) at start and end of treatment session. RESULTS No statistically significant changes were observed in FVC, FEV1 and FEV1/FVC ratio in BBT as well as in Conventional PT whereas significant changes in HRQoL through SGRQ is revealed in BBT (p <0.05). CONCLUSION BBT is found to be more effective in assessing HRQoL through SGRQ, whereas a larger sample size is required in patients with chronic bronchial asthma to evaluate the effectiveness of BBT as no significant difference was shown in the study.

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