scholarly journals To explore the impact of following the pre-operative fasting guidelines by ASA (American society of anesthesiologists), in improving patient outcome.

2021 ◽  
Vol 28 (7) ◽  
pp. 1018-1021
Author(s):  
Maqsood Ahmed Siddiqui ◽  
◽  
Ashok Perchani ◽  
Hamid Raza ◽  
Ahmeduddin Soomro ◽  
...  

Objective: To analyze the occurrence and consequences of a prolonged preoperative-fasting. Study Design: Cross-sectional study. Setting: Large tertiary care hospital in Pakistan. Period: October 2018 to October 2019. Material & Methods: We collected data for all the procedures that occurred during the study period and divided the cases into emergency procedures, add-on procedures and elective cases. We excluded the first cases of the day and excluded the emergency and add-on cases. We studied the patients NPO duration and their scheduled start time of the procedure and compared with their actual start time of the procedure. Results: The study population was n= 434 cases. Of these 434 cases n= 164 cases were performed on time and n= 270 cases were delayed by 60 minutes or more from their scheduled time. The most frequent reason was a previous cases running longer than expected in 59.25% of the cases, the second most common reason was a change in sequence and order of the procedures which was the case for delay in 14.44% of the cases. The overall mean time of NPO for the patients was found to be 770.1 +/- 130.6 minutes, for the delayed cases the mean time duration of NPO was 812.3 +/- 105.3 minutes. The mean time of case delay was 155.2 +/- 102.7 minutes for overall cases and for the significantly delayed case the mean time period of delay was 190.2 +/- 92.1 cases. Conclusion: Our results showed that 60% of the cases have a prolonged NPO status due to delays in start of their surgical procedure as compared to the scheduled times.

2021 ◽  
Author(s):  
V K Sashindran ◽  
Anchit Raj Singh

AbstractMetabolic syndrome is a risk factor for cardiovascular disease. With improvement in therapy for HIV, morbidity related to metabolic syndrome becomes a focus of interest. Change in nutritional status and introduction of newer regimens of ART are changing the impact of metabolic syndrome on patients of HIV. Few studies in recent times from developing countries have addressed this question. This is a cross sectional study to study the prevalence of Metabolic Syndrome in patients of HIV on ART from clinics in a tertiary care hospital in India. Data from 1208 patients of HIV on ART was analyzed and metabolic syndrome was seen in 257(21.3%) patients.The high prevalence of metabolic syndrome in patients of HIV in India found in this study gives an insight on the morbidity of noncommunicable diseases in patients with HIV in India in recent times.


2020 ◽  
Vol 27 (10) ◽  
pp. 2187-2192
Author(s):  
Muhammad Ali ◽  
Vinod Kumar ◽  
Shafique Ahmed ◽  
Hina Iram ◽  
Sagheer Ahmed ◽  
...  

This study is designed to assess the mortality in OPP patients with low GCS scores. Study Design: Cross Sectional study. Setting: Jinnah Postgraduate Medical Center. Period: From 1st February 2018 to 31st August 2018. Material & Methods: Included patients with low GCS, both genders and age of 18-60 years diagnosed with OPP. Their GCS was calculated and the outcome was determined in terms of mortality. Results: Out of 70 patients, the mean age was 35.2+16.5 years with the majority (62.9%) <30 years. 62.9% of these were males. Most (57.1%) of them presented after ingestion of <15mL of OP, 60% had the poisoning for >60 minutes, and the majority (74.3%) had taken it orally. When the GCS was computed, 81.40% had that of >5, while the mean came out to be 6.64 ±1.43. The mortality rate here was 17.10%. Conclusion: GCS toll can be a helpful and practical tool in assessing the mortality among the patients of OPP. However, because of the limited literature on the subject further studies are recommended to improve its validity.


2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Prashant Simkhada ◽  
Shradha Acharya ◽  
Roshan Lama ◽  
Sujata Dahal ◽  
Nita Lohola ◽  
...  

Introduction: Emergency department of a hospital is responsible for providing medical and surgical care to patients arriving at the hospital in need of immediate care. Emergency department is not staffed or equipped to provide prolonged care. Duration of stay in the Emergency department directly affects the quality of patient care. Longer length of stay is associated with Emergency department overcrowding, decline in patient care, increased mortality and decreased patients satisfaction. The main aim of this study is to find the mean stay duration of patients in the emergency department of a tertiary care hospital in Nepal.Methods: This is a descriptive cross-sectional study which was conducted in a tertiary care teaching hospital from Jan 15,2019 to Jan 30, 2019. Ethical clearance was obtained from Kathmandu Medical College- Instutional Review Committee. The calculated sample size was 587. Consecutive sampling technique was used. The data thus obtained was entered in SPSS version 20 and necessary calculations were done. Results: The mean emergency stay duration was obtained to be 3.18 hours at 95% confidence interval (C.I  and standard deviation was 2.51 hours. Female had longer mean duration of stay (3.25 hours) compared to male (3.11 hours). The maximum length of stay was 15.3 hours. Most of the patients attending the emergency department were discharged right through the emergency department 398 ( 67.8%). Mean duration of stay was longest (5.06 hours) for the referral group. Conclusions: The mean stay duration in Emergency Department of tertiary care hospital in Nepal is getting shorter compared to similar study done previously.


Author(s):  
Radhakrishnan A. ◽  
Seema S. Bansode-Gokhe

Background: Objective of the study was to study the epidemiological profile of study subjects benefited by Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) and study the spectrum of surgical procedures/therapies/consultations. Methods: It was a hospital record –based retrospective cross sectional study. Approximately 7200 beneficiaries were enrolled in a year. This study was analyzed with 10% beneficiaries (730) data by the convenient purposeful sampling method. Data was analyzed by using SPSS 17 software. Results: The majority of the study subjects (34.7%) belonged to the age group of 40-59 years. The mean age was 38.6.More study subjects were males (55.1%). 99.9% of study subjects had come directly without any referral. 95.2% study subjects were orange ration card holders, 4.1% were yellow ration card holders.78.8% of study subjects got approval from RGJAY society, whereas pre authorization status was cancelled in13.6%.In total surgeries majority of the study subjects utilized orthopaedics surgery (16.3%).In total therapies majority utilized paediatric medical management (18.5%). In conservative management majority utilized cardiology (94.7%) and burns (5.2%). Conclusions: The majority of the study subjects belonged to the age group of 40-59 years. More were males. Majority had come directly without any referral. This reveals the increased awareness about RGJAY among people. This scheme is more utilized by orange ration card holders than yellow card holders. In total surgeries majority utilized orthopaedics surgery. In total therapies majority utilized paediatric medical management. In conservative management majority utilized cardiology and burns. 


2021 ◽  
Vol 15 (10) ◽  
pp. 3381-3383
Author(s):  
Naheem Ahmed ◽  
Khawaja Tahir Aziz ◽  
Rashada Bibi ◽  
Munazza Nazir ◽  
Sadaf Nawaz ◽  
...  

Objective: To determine the frequency of neonatal thrombocytopenia among patients presented with sepsis at tertiary care Hospital. Methodology: This cross-sectional study was conducted at the Department of pediatrics SKBZ/CMH Muzaffarabad, during six months from September 2018 to March 2019. All the diagnosed septic neonates, age < 28 days and either gender were included. Their basic demographic data like age and gender, along with their contact details were taken. The sample of blood was sent in blood culture bottles to hospital laboratory to confirm bacterial growth, that was diagnosed as sepsis. Blood sample was sent to the hospital also to diagnose thrombocytopenia. Reports were consulted by the pathologist. All the data were collected by a structured study proforma. All data were entered and analyzed with the help of SPSS version 22. Results: The mean age of patients was 8.92 ± 5.40 days with minimum and maximum age as 1 and 27 days. There were 117(47.56%) males and 129(52.44%) female cases. A total of 40(16.26%) cases had their maternal hypertension, 54(21.95%) neonates had gram + and 157(63.82%) neonates had Gram negative. A total of 63(25.61%) cases had thrombocytopenia while 183(74.39%) neonates were seen without thrombocytopenia. The frequency of thrombocytopenia was statistically insignificant according to gender and types of culture (p->0.05). Conclusion: It is concluded that frequency of thrombocytopenia in neonatal sepsis was found in a quarter of the cases. In neonatal sepsis, thrombocytopenia must be ruled out at patient’s presentation and must be treated as early as possible as thrombocytopenia is an independent risk factor for sepsis-associated mortality. Keywords: Incidence, thrombocytopenia, neonatal sepsis


2012 ◽  
Vol 18 (1) ◽  
pp. 18-23
Author(s):  
L Khondker ◽  
MM Rahman ◽  
MM Mahmud ◽  
MSI Khan ◽  
H Khan ◽  
...  

A cross-sectional study was carried out for a period of one year in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Seventy female patients having acne vulgaris were selected. The study showed that the mean age of the cases was 22.43 with standard deviation 5.2 years and highest percentage of patients were in the age group 20-24 years (41.4%), highest percentage of patients was unmarried among the cases (74.3%) and proportion of secondary (35.7%) and higher secondary education (20%) were found to be high among the cases. The study showed that proportion of student (65.7%) and housewife (17.1%) were found to be high among the cases. The mean duration of disease was 62.6 months and all the patients had presented with comedones (blackheads and whiteheads). All the patients had acne in the face and it was found that 60% had moderate type acne. Considering the pattern of treatment received, 42.9% of the patients mentioned that they used topical ointment, 37.1% had received herbal medication and 25.7% had received systemic medication. To get an overall impression of the country regarding acne vulgaris, more integrated study is needed. This was a study on a limited number of cases. Future studies must include economical support, then large sample size could be ensured and study finding would be more reliable. There is a great need of epidemiological studies also, with sufficient follow-up, systematic reviews and meta-analyses on this issue. DOI: http://dx.doi.org/10.3329/jdnmch.v18i1.12234 J. Dhaka National Med. Coll. Hos. 2012; 18 (01): 18-23


2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Sandip Bhandari ◽  
Medha Sharma ◽  
Gentle Sundar Shrestha

Introduction: Health care workers are at higher risk of infection with the coronavirus disease as they are directly involved in the treatment of infected patients and perform aerosol-generating procedures. Proper knowledge of this disease can influence the positive attitude, good practices and enhance their safety. We aim to study the knowledge of COVID-19 among health care workers of the tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted among health care workers of Shahid Gangalal National Heart Centre from May 20 to June 19, 2020. Ethical approval was taken from the Institutional Review Board (IRB No: 4-2020). Written informed consent was taken from all respondents. Correct answers were summated to reflect the mean knowledge, expressed as a percentage. Data analysis was done using Statistical Package for the Social Sciences version 21. Results: The mean general knowledge score was 95.7%. The mean medical knowledge score was 70.5%. Only 42 (56.8%) of physicians and 103 (53.6%) of nurses had a higher level of medical knowledge regarding COVID-19. Likewise, very few lab technicians 7 (21.9%) and none of the pharmacists had a higher level of medical knowledge. Conclusions: The healthcare workers of this centre have adequate knowledge regarding COVID-19. However, periodic training for all workers, especially the nurses and allied workers, may help to update the knowledge and hence enhance their safety and that of their patients.


2021 ◽  
Vol 10 (1) ◽  
pp. 31-35
Author(s):  
Rinku Ghimire ◽  
Rupesh Kumar Shreewastav

Background: Prescription of rational drugs is needed to save critically ill patients. This study was conducted to assess the prescription patterns of drugs in the intensive care unit. Materials and Methods: A descriptive cross-sectional study among patients admitted in intensive care unit from March 2020 to February 2021 after approval from the Institutional Review Committee (ref no. 344 /2019). Demographic profile, prescription patterns, the average number of drugs used, route of administration, and duration of hospitalization were recorded based on the pre-structured questionnaires. Convenient sampling was chosen. Data were analyzed by SPSS, version 20. Results: Prescription patterns of 225 were analyzed. The mean age was 55.60 ± 20.16 years with a male predominance of 131(58.2%). Cardiac disorders 57(25.3%) were the most common admitting diagnosis followed by pulmonary, neurological, and kidney disorders. The average length of hospital stay was 4.14 days (range 1-38 days). A total of 887 drugs were prescribed. The mean number of drugs prescribed per patient was 7.71 ± 1.92. Parenteral drugs accounted for 81.39%. Antibiotics were prescribed to all patients. Intravenous fluids were given to 62.2% of patients, blood and blood products to 21.33%. Thromboprophylaxis was used in 15 (6.7%) patients. Seven hundred twenty-two (81.39%) drugs were injectables, 129(14.54%) were used by the oral or nasogastric route and 36 (4.05%) were inhaled drugs. Conclusion: Newer generations antibiotics were the most commonly prescribed drugs. Pantoprazole, Metoclopramide, and Hydrocortisone were the top three most commonly prescribed individual drugs. There was marked underuse of thromboprophylaxis, analgesics, and sedatives.  


Author(s):  
Devi Revathi ◽  
Sathvika Reddy ◽  
Lakshmi Prasanna V ◽  
Aruna C Ramesh

Objective: Poisoning is a growing health-care burden in developing countries like India. Predicting the nature of the intention behind poisoning and type of poisoning agent involved will help in facilitating appropriate treatment measures, hence, improving the patient’s quality of life.Methods: The prospective, observational study was conducted in a tertiary care multispecialty hospital for 6 months from November 2016 to April 2017 and involved a total of 133 patients. Treatment and outcomes of the patients were collected, documented in a data collection form. Chi-square test and logistic regression analysis were applied.Results: The mean age of the study participants was 27.76±15.5 with predominance seen in age groups of <30 years (59.3%), females (52.6%), and married (49.6%). Intentional poisoning (69.1%) through oral ingestion (81.2%) of medications (51.6%) in solid forms (60.2%) was predominant. Patients presenting with systemic manifestations (70.4%) arrived in a time duration >1 h (66.2%), received first aid (62.4%), and supportive care (52.7%). Higher ingestion of physical forms was significantly observed in both single (OR: 4.5) and married (OR: 3). The outcomes were correlated with poison severity score and patients with mild symptoms recovered (60.9%).Conclusion: The use of medicines for intentional poisoning continues to be rampant in younger age groups and married individuals. Educational programs with more accentuation on the data regarding toxic substances along with preventive measures are to be implemented to make mindfulness among the overall population.


Author(s):  
Latha Sannasi

Background: Urbanization has brought a lot of health issues in the citizens. Commuting for work has become more common. People around the world use different means of commute like public transport or driving a car to work. The increase in time of commute may be associated with many health hazards. In this study we try to study the impact of driving duration on hand muscle power.Methods: A prospective cross sectional study was conducted in a tertiary care hospital. About 32 persons who drive car for their work participated in this study after giving their consent. Subjects grouped in to two categories long commuters, who drive for greater or equal to one hour and short commuters less than one hour. Muscle power tested on two occasions immediately after driving and four hour after driving with a help of hand grip dynamometer. Demographic details were collected. The two groups compared for muscle power and body mass index (BMI).Results: The long commuters had less muscle power in comparison with short commuters and it was significant. The average BMI of long commuters was in obesity range were as the average BMI of short commuter is less and it was statistically significant.Conclusions: Driving for greater than one hour is associated with obesity and reduced muscle power immediately after driving. 


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