scholarly journals Cost effectiveness of tunneled double lumen to non-tunnel double lumen dialysis catheters.

2019 ◽  
Vol 26 (12) ◽  
pp. 2192-2195
Author(s):  
Taleah Tahir ◽  
Muhammad Afzal ◽  
Malik Nadeem Azam Khan ◽  
Khalid Mehmood Raja ◽  
Wahaj ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Study Design ◽  
Care Hospital ◽  
Dialysis Patients ◽  
Double Lumen ◽  
First Choice ◽  
Catheter Malfunction ◽  
Group A ◽  
Group B ◽  
The Cost

Objectives: To ascertain the cost-effectiveness of tunneled catheters to non-tunneled catheter in dialysis patients of a tertiary care hospital. Study Design: Retrospective cross-sectional study. Study Design: Department of Nephrology, Pak Emirates Military Hospital Rawalpindi. Period: Jan 2016 to Jan 2019. Material & Methods: The sample population comprised of 500 patients, being divided into two groups and followed over a period of 03 yrs. Group A had tunneled double lumen and group B had non tunneled double lumen. Dialysis was started on the same day in both groups. Both groups were compared in terms of cost effectiveness. Cost effectiveness included price of catheter, procedure cost, treatment of infection (if any), and change of catheter in case of catheter malfunction. The amount spent on each patient was added and then an average was calculated. Results: Out of 600 patients, 300 were in group A and 300 patients were in group B. The two groups were analogous in gender (male: 52.8% vs 57.8%, p=0.35)age (41 years vs 49 yrs, p=0.71) hypertension and diabetes as the main causes of ESRD  (51% vs 39%, p=0.08 and 32% vs 34%, p=0.38, respectively). Total incurred cost of tunneled double lumen was Rs.19000.00, with average infection free patency time being three months during which Arteriovenous fistula formed. In comparison, non-tunneled double lumen in 300 patients, average cost incurred was Rs.30000.00 including cost incurred on treating sepsis and in two –three insertions in few cases . There was no procedure related mortality. Conclusion: The cost-effectiveness of Tunneled double lumen catheters and clinical benefit of reduction in patency failures and also access related infections make them the first choice for dialysis patients in majority of dialysis centers of our country but large randomized control trials needed as the sample size quite less to detect a difference from the newer agents.

scholarly journals A Comparative Study of Diclofenac with Paracetamol versus Diclofenac with Serratiopeptidase in Pain Associated with Soft Tissue Injury

2021 ◽  
Vol 9 (8) ◽  
pp. 2740-2744
Author(s):  
Dr. S. E. Gowtham
Keyword(s):  
Soft Tissue ◽  
Pain Intensity ◽  
Proteolytic Enzyme ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Cost Effective ◽  
Care Hospital ◽  
Group A ◽  
Group B ◽  
The Cost

Abstract: The point of the executives is to ease the pain rapidly and improve practical capacity. NSAIDs are the primary line treatment. Serratiopeptidase is the proteolytic enzyme. The challenge lies in deciding whether only NSAIDs or NSAIDs with proteolytic enzyme will give more prominent indicative help, while additionally being savvy. the primary goal is to think about the adequacy of diclofenac with paracetamol and diclofenac with serratiopeptidase in the administration of delicate tisssue injury. This prospective, open label, observational study was conducted at a tertiary care hospital. Patients over 18 years of age and presenting with soft tissue injury pain (elbow pain, knee pain, general pain, back pain ) of less than 6 weeks duration were enrolled in the study. Forty patients with soft tissue injury pain were randomized into two groups: Group A got diclofenac with paracetamol (50mg/325mg) double a day and Group B got diclofenac with serratiopeptidase (50mg/10mg) double a day for 1 week. The Numerical Rating Scale (NRS) determined the clinically significant results. The decrease in pain intensity in Group B was (MEAN= 3.76), while in Group A it was (MEAN= 3.93). The average cost-effectiveness ratio indicated that diclofenac wit paracetamol was the dominant treatment over diclofenac with serratiopeptidase. Therefore, diclofenacc with paracetamol was found to be the cost-effective option for soft tissue injury pain relief in for 1 week. Both diclofenac wit paracetamol and diclofenac with serratiopeptidase. were clinically effective in reducing the pain intensity and in improving functional ability. H owever, diclofenac wit paracetamol was found to be the cost-effective intervention. Keywords: Paracetamol, diclofenac, Serratiopeptidase, soft tissue injury, pain.

scholarly journals Acute appendicetomy is better choice for appendicular mass

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Muhammad Imran ◽  
Mahmood Ayyaz ◽  
Hamid Majeed ◽  
Tariq Ghafoor
Keyword(s):  
Cost Effectiveness ◽  
Hospital Stay ◽  
P Value ◽  
Oral Fluids ◽  
Surgical Ward ◽  
Group A ◽  
Group B ◽  
The Cost ◽  
Early Surgical Intervention ◽  
Appendicular Mass

Objective: To compare the cost effectiveness, hospital stay and morbidity in each type of management of appendicular mass i.e. early surgical intervention and conservative management. Design: A randomized comparative study. Place and duration: South Surgical Ward, Mayo Hospital Lahore from July, 1999 to January, 2001. Patients and Methods: 40 patients were included dividing in two equal groups. Group A patients were explored early and group B patients were managed conservatively. Cost effectiveness, hospital stay and morbidity were determined in each group. Results: Mean hospital stay was 2.85 days (2-4 days) in group A and 6.25 days (5-8 days) in group B (p value< 0.001). Mean expenditure in group A was Rs.1255 and Rs. 2183.75 in group B (p value < 0.001). 100% patients in group A got complete pain relief within three days while it took 7 days for 90% of patients in group B (p value<0.001). Oral fluids were started earlier in group A as compared to group B (p value<0.05).

In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

2019 ◽  
Vol 21 (2) ◽  
pp. 154-160
Author(s):  
Gianluca Villa ◽  
Rosa Giua ◽  
Timothy Amass ◽  
Lorenzo Tofani ◽  
Cosimo Chelazzi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vascular Access ◽  
Cost Effective ◽  
Causative Factor ◽  
Control Group ◽  
Previous Trial ◽  
Venous Cannulation ◽  
Group A ◽  
The Cost ◽  
And Control

Background: In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration. Methods: We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access. Results: In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay. Conclusion: In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals Ultrasound evaluation of intima media thickness of carotid arteries in dialysis patients and correlation with proposed risk factors

2003 ◽  
Vol 131 (9-10) ◽  
pp. 382-388 ◽  
Author(s):  
Tatjana Damjanovic ◽  
Nada Dimkovic
Keyword(s):  
Risk Factors ◽  
Carotid Arteries ◽  
Intima Media Thickness ◽  
Cardiovascular Morbidity ◽  
Dialysis Patients ◽  
Media Thickness ◽  
Ultrasound Evaluation ◽  
Cardiovascular Morbidity And Mortality ◽  
Group A ◽  
Group B

Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis), in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I,30 on hemodialysis, group II) and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0,720 mm) and group B (intima media thickness higher then 0,720mm). Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.

scholarly journals Dyslipidemia in End Stage Renal Disease: A Study on Dialysis Patients in Bangabandhu Sheikh Mujib Medical University Bangladesh

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hdl Cholesterol ◽  
Dialysis Patients ◽  
Ckd Stage ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
Medical University

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Antibiotic usage rates in bacterial versus nonbacterial diseases: a new way to monitor hospital-acquired infections in children: a retrospective case analysis

2020 ◽  
Vol 7 (11) ◽  
pp. 2176
Author(s):  
Jayendra R. Gohil ◽  
Chintu C. Chaudary ◽  
Sheena D. Sivanandan
Keyword(s):  
Antibiotic Usage ◽  
Retrospective Case ◽  
Hospital Acquired Infections ◽  
Group A ◽  
Added Benefit ◽  
Reduction Of Mortality ◽  
Group B ◽  
The Cost ◽  
Hospital Acquired ◽  
Selection Of

Background: While treating children, the selection of antibiotics, when indicated, should be from the point of its effectiveness, safety, suitability, and cost. However, this flow of action does not take place in all cases. Aim of the study was to assess the antibiotic usage in admitted children and mortality.Methods: The case records between January to July 2012 in children wards was evaluated for the use of antibiotics. Patients were grouped into; group A- ‘must use' antibiotic in all, and group B- where antibiotics are not indicated.Results: There were 1852 admissions, including 719 Thalassemia cases. Antibiotic usage was 63% in 1133 cases after excluding thalassemia. Out of 1133 cases, 423 were in group A and 710 cases were in group B. In group B the antibiotic usage was 41%. The mortality was 6.6% and 4.8% in group A and B. Inside group B, mortality was 5.9% versus 4.0% in those administered versus not administered, antibiotics.Conclusions: There was no increase in mortality in patients in whom antibiotics were not prescribed, and no added benefit of prescribing antibiotics was observed in nonbacterial group B disease patients. The mortality was similar in both the groups. In nonbacterial group B, the antibiotics did not offer any advantage in the reduction of mortality, but increased the cost of the treatment, and possibly the chance of development of drug resistance and adverse events. When analysing the hospital antibiotic usage, only the nonbacterial diseases should be considered to get a true picture of the inappropriate prescription of antibiotics.

scholarly journals Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

2020 ◽  
Vol 6 (10) ◽  
pp. 1804
Author(s):  
Priyanka Aggarwal ◽  
Barjinder Singh Sohal ◽  
J. P. Goyal
Keyword(s):  
Success Rate ◽  
Cost Effective ◽  
Patient Comfort ◽  
Hearing Improvement ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
The Cost ◽  
Results Of Surgery ◽  
Endoscopic Tympanoplasty

<p><strong>Background:</strong> To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.</p><p><strong>Methods: </strong>Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.</p><p><strong>Results: </strong>The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.</p><p><strong>Conclusions: </strong>Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.<strong></strong></p>

scholarly journals “A Comparative Study of Efficacy of Atorvastatin Alone and Atorvastatin with Omega-3 Fatty Acids Combination in Patients with Hyperlipidaemia Attending Tertiary Care Hospital”

2021 ◽  
pp. 482-490
Author(s):  
C. Srinivasa ◽  
K. La Kshminarayan ◽  
V. Srinivas ◽  
B. V. S. Chandrasekhar
Keyword(s):  
Fatty Acids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Low Density ◽  
Care Hospital ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Group A ◽  
Group B

Background: Current treatment with statins has become an integral part of vascular diseases but monotherapy has a significant residual event rate. Due to particularly one of the factor associated with atherogenic lipid phenotype that is characterized by a low high-density lipoprotein (HDL) cholesterol and increase in non-HDL cholesterol like Low-Density Lipoprotein (LDL). Omega-3 Fatty acids have demonstrated a preventiverole in primary and, particularly secondary cardiovascular diseases.  Hence this study was planned to compare the efficacy of Atorvastatin alone with Atorvastatin and Omega-3 fatty acids in treatment in hyperlipidaemia patients. Methods: The study was comparative, randomized, and prospective and open labeled conducted in MI patients. A total of 100 patients were selected based on inclusion and exclusion criteria. They were divided randomly into two Groups (Group–A and Group-B). Group-A was given Atorvastatin 10mg/day and Group-B was given Atorvastatin 10mg/day and Omega-3 fatty acids 600mg/day for 6 months. Follow up was done every month and efficacy was measured by assessing the lipoprotein levels in serum. Results: The results were compared before treatment and after 6 months treatment.The levels were significantly decreased Total Cholesterol (TC), LDL, Low-Density Lipoprotein (VLDL), Triglycerides (TG) and HDL levels were increased in Group–A and Group-B. When these results compared between two Groups the HDL levels were increased also it shown high significance (<0.001) but there were no significance changes in other cholesterol levels. Conclusion: The present study results showed that Atorvastatin and Omega-3 fatty acids treatment was more effective than Atorvastatin alone treatment in improving HDL-C levels from base line and it may have a additive effect in major coronary artery diseases.

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