scholarly journals Challenges and perceptions of cancer patients attending a tertiary care center during COVID 19 Pandemic Era: Patient’s Perspective

2020 ◽  
Vol 11 (6) ◽  
pp. 15-20
Author(s):  
Yashna Gupta ◽  
Laxman Pandey ◽  
Pankaj Kumar Garg ◽  
Amit Sehrawat ◽  
Sweety Gupta ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Patient’S Perspective ◽  
Hospital Patients ◽  
Anticancer Treatment ◽  
The Government ◽  
Immunocompromised State

Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to their immunocompromised state related to the disease and anticancer treatment. There is a lack of literature assessing the patient’s perspective of the present crisis and its impact on their treatment. Aims and Objective: The present study aimed to address the challenges and sufferings faced by patients with cancer during their treatment in the current COVID-19 pandemic era. Materials and Methods: A single-institute, cross-sectional questionnaire-based observational study was conducted in a tertiary care teaching hospital. Patients attending the Oncology outpatient department were enrolled in the study. Results: One hundred patients (64 males, 36 females) with a mean age of 47.17 years (range-24-71) participated in the study. The majority of patients (89%) were aware of the COVID 19 symptoms and did not confuse them with cancer symptoms. Most of them were aware of preventive measures like frequent hand washing, sanitizer usage, and face masks to reduce the risk of infection. Almost half of them encountered difficulties in commuting to the Hospital. Most (83%) of them were worried about treatment delay and disease progression due to the COVID-19 pandemic. Almost half of the patients (54%) were fearful of acquiring the infection from the radiotherapy machine and immobilizing devices. Two-third of the patients (64%) were afraid to carry the virus back to their homes. Awareness regarding our Hospital’s teleconsultation facility was limited among patients. Conclusion: The present study underscores the success of ongoing COVID-19 awareness programs run by the government. However, there is an urgent need to address the various challenges encountered by patients with cancer. The strengthening of telemedicine facilities may reduce the in-person visits made by the patients.

scholarly journals Knowledge, attitude and experiences of menopause in the postmenopausal women at a tertiary care center: a cross sectional study

2018 ◽  
Vol 7 (11) ◽  
pp. 4758
Author(s):  
Shivraj More ◽  
Sujatha P. ◽  
Karthiga Karthiga
Keyword(s):  
Postmenopausal Women ◽  
Care Center ◽  
Tertiary Care ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Government

Background: Menopause is an inevitable milestone in the reproductive life of every woman. The objective is to investigate menopausal knowledge, attitude, symptoms and management among the participants, to identify the differences according to their educational status and to examine correlations of knowledge, attitude and symptoms pertaining to menopause.Methods: This cross-sectional study was conducted for a period of 10 months in postmenopausal women attending a tertiary care center in Pondicherry, India with a structured questionnaire developed on the basis of the objective of the study.Results: 330 postmenopausal women were recruited, and all were aware of their postmenopausal status. Mean age at menopause was 45.91±2.66 years. 54.5% were aware about what menopause was while 5.5% were unaware. 12.1% had proper knowledge about cause of menopause, whereas 3.6% said it is due to god’s decision / turning point. Most prevalent symptoms were tiredness (89.6%) followed by vasomotor symptoms like hot flushes (88.5%) and night sweats (80.3%). Only 2.1% had used HRT for menopausal symptoms.Conclusions: Depth of knowledge is more important when concern is about greater health disrupter which tends to be imperceptible for a long time such as bone health and cardiovascular risk profile. Thus, the government could concentrate on providing health services to women in post reproductive age group also besides women in the reproductive age.

scholarly journals 1182Vaccine hesitancy among health care workers: A study amidst COVID-19 vaccine drive in India

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Medha Mathur ◽  
Navgeet Mathur
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
Vaccination Site ◽  
Validated Questionnaire ◽  
Care Workers ◽  
The Government

Abstract Background After the launch of COVID-19 vaccine by the government of India in 2021, the current study was conducted to assess the vaccine hesitancy among health care workers regarding COVID-19 vaccination and its safety, efficacy, rolling out strategy and undesirable effects. Methods This cross-sectional study, conducted on health care workers vaccinated at a tertiary care center of southern Rajasthan using a pre-designed and pre-validated questionnaire to collect data through the ‘Exit Interview’ technique after consent and ethical approval. Results Out of 3102, 56.8% were male and 43.2% were female health care workers. Out of total 80.7% and 73.2% of study participants perceived the vaccine as safe and effective respectively. The vaccine hesitancy was contributed due to apprehension for undesirable effects following immunization (19.3%). The commonest undesirable effect was pain at the injection site. The perception regarding the timing of rolling out of vaccine and readiness for COVID appropriate behavior after vaccination was significant (p < 0.001). The mean time spent at vaccination site was 33.90 (±11.34) minutes ranging 5-120 minutes (median = 35; interquartile range (IQR) = 10; 95% confidence interval (CI) = 33.50-34.30). Conclusions The study concludes that the apprehension of undesirable effects contributed to vaccine hesitancy, but it was perceived safe and effective by health care workers. Key messages The vaccine hesitancy among general population and vaccine acceptance will be affected directly by instance shown by health care workers who presented themselves at the forefront both for battling the pandemic and accepting the vaccine.

scholarly journals PATTERN OF CANCER CASES REGISTERED IN A TERTIARY CARE CENTER IN KATHUA DISTRICT OF J&K: A CROSS SECTIONAL STUDY

2020 ◽  
pp. 1-2
Author(s):  
Deepak Abrol ◽  
Anuj Kapoor ◽  
Pawan Kumar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Age Group ◽  
Important Public Health Problem ◽  
Cross Sectional ◽  
Medical College ◽  
Area Distribution ◽  
The Government

Introduction:Cancer is an important public health problem in India, with 10 lakh new cases occurring every year in the year. Cancer pattern varies in different regions and depends on genetic, environmental, dietary, social and other factors. Aim and objectives: This study was undertaken to determine magnitude and pattern of cancer cases reporting in the hospital. Methodology: This was a hospital-based retrospective study undertaken in the Government Medical College Kathua. GMC, Kathua is one among st the ve new medical colleges established in Jammu & Kashmir. The records of cancer patients generated from 1st November 2018 to 1 November 2019 were analyzed. All the cancer cases who reported either for diagnosis in any of the hospital OPD or for the treatment (radiotherapy/ chemotherapy/ surgery) were included. Data was entered in the MS Excel for analysis Results: Out of total 272 patients registered, females accounted for 56.6% and males for 43.3%. Hindu patients were in majority (84.2%). Most of the cases (37.1%) were in the age group 60-80. Pattern of cancer was different in the two sexes. In males, maximum cases were of lung cancer and in females, Ca breast was the most common followed by the cervical cancer Conclusion: This hospital-based study indicates the cancer prole in Kathua district. Females were found to be more affected than that of males with majority of the cases in the late 40s age group. Rural area and urban area distribution was found to be almost similar.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Characteristics of infective endocarditis in a cancer population

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001664
Author(s):  
Cullen Grable ◽  
Syed Yusuf ◽  
Juhee Song ◽  
George M Viola ◽  
Owais Ulhaq ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Mortality Data ◽  
Limited Information ◽  
Tertiary Care Centre ◽  
Indwelling Catheters ◽  
Patients With Cancer ◽  
Duke Criteria ◽  
Immunocompromised State

BackgroundInfective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE.ObjectivesLimited information exists about IE in patients with cancer. We aimed to evaluate the characteristics of patients with cancer and IE at our tertiary care centre, including a comparison of the microorganisms implicated and their association with mortality.MethodsA retrospective chart review of patients with cancer who had echocardiography for suspicion of endocarditis was conducted. A total of 56 patients with a confirmed diagnosis of cancer and endocarditis, based on the modified Duke criteria, were included in the study. Baseline demographics, risk factors for developing IE, echocardiography findings, microbiology and mortality data were analysed.ResultsFollowing the findings of vegetations by echocardiography, the median survival time was 8.5 months. Staphylococcus aureus was the most common organism identified as causing endocarditis. The mitral and aortic valves were the most commonly involved sites of endocarditis. Patients with S. aureus endocarditis (SAE) had a significantly poorer survival when compared with patients without SAE (p=0.0217) over the 12-month period from diagnosis of endocarditis.ConclusionsOverall survival of patients with cancer and endocarditis is poor, with a worse outcome in patients with SAE.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals An observational study on patient compliance and adverse drug reactions of antihypertensives drugs in a tertiary care center of Bihar

2021 ◽  
Vol 6 (4) ◽  
pp. 190-193
Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Antihypertensive Drugs ◽  
Care Center ◽  
Adult Population ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
High Dose ◽  
Cross Sectional ◽  
Institutional Ethics

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.

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