scholarly journals Adequacy of Thyroid Homone Replacement in a Tertiary Care Hospital in Nepal-An Observational Study

2021 ◽  
Vol 5 (1) ◽  
pp. 33-38
Author(s):  
H.K. Shrestha ◽  
R. Tamrakar ◽  
A. Shrestha ◽  
M. Uprety ◽  
B. Shrestha
Keyword(s):  
Treatment Outcome ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Well Being ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Levothyroxine Replacement ◽  
Hypothyroid Patients

Background: The therapeutic goal in hypothyroidism is to achieve patients’ well-being and restore serum thyrotropin (TSH) to levels within the reference range. However, inadequate or over replacement is common in patients receiving levothyroxine. The Objective is to assess the treatment outcome of hypothyroid patients visiting outpatient clinic of medicine department of Kathmandu University Hospital, Dhulikhel, Nepal. Method: This is a cross sectional study on diagnosed Primary Hypothyroid patients who were taking levothyroxine replacement for at least six months. Patients were defined as euthyoid if their TSH was in the normal range (0.3-3.6 mmol/L) according to the hospital laboratory. Similarly patients were defined as over treated if TSH is <0.3 mmol/L and undertreated if TSH is >3.6 mmol/L. Results: A total number of 126 patients were enrolled for this study where mean age of participants was 40.88 ± 11.47 years and only 15 (11.1%) were male. Mean duration of hypothyroidism was 3.45 ± 2.57 years and mean Levothyroxine dose was 58.93 ± 26.89 mcg. In this study, nearly 70% of participants have normal TSH level. Similarly, 21% of participants have higher level of TSH and 9% have low TSH level. Multivariate logistic regression analysis did not show any significant co relation between treatment outcome and various variables. Conclusion: Treatment of hypothyroidism with levothyroxine being most effective, easily available, simple regimen and not costly, still one third of patients are not meeting the treatment outcome. However, being the pioneer study from Nepal, this study suggests improved treatment outcomes compared to similar studies from other countries.

scholarly journals Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad Hanif Khan ◽  
Raheela Hanif ◽  
Rumina Tabassum ◽  
Waris Qidwai ◽  
Kashmira Nanji
Keyword(s):  
Nonverbal Communication ◽  
Tertiary Care ◽  
Eye Contact ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Nonverbal Behaviors ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

Bleeding Disorders among women Presenting with Menorrhagia at Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2851-2853
Author(s):  
Muhammad Sarwar Khan ◽  
Kiran Aamir ◽  
Aamir Ramzan ◽  
Aasma Naz ◽  
Khalil Ahmed Memon ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Von Willebrand Disease ◽  
University Hospital ◽  
Common Finding ◽  
Initial Contact ◽  
Care Hospital ◽  
Bleeding Disorders ◽  
Cross Sectional ◽  
Early Management

Objective: To study the spectrum of bleeding disorders among women, presenting to the study setting with complaints of menorrhagia. Methodology: This observational cross-sectional study was conducted up on 121 women, during a period of 6 months, who were approached via non-probability, consecutive sampling, presenting to the Dept. of Gyneacology & Pathology – Liaquat University Hospital, Hyderabad with menorrhagia. Data obtained from patient interviews and laboratory investigations were recorded into a self-structured questionnaire after taking written informed consent. The data obtained was analyzed using SPSS v. 21.0. Results: The mean age of the women was 28.13 years (±5.21 SD). Among the underlying hemostatic pathologies, VWD was the most common i.e. 21 (65.6%), followed by other platelet dysfunctions (Glanzman Thrombasthenia (n=5, 15.6%) and Berard Soulier Syndrome i.e. n=3, 9.4%) comprised the second most common finding. A cause of hemostatic pathology among a minority of patients remained unidentified i.e. n=3 (9.4%). Conclusion: Keeping in view of hemostatic defects, the study concludes that VWD is the commonest bleeding disorder among women presenting with menorrhagia. A routine screening of females with menorrhagia on their initial contact with the hospital can save years of suffering and lead to early management and probable recovery. Keywords: Von Willebrand Disease, Hemostatic Dysfunction, Bleeding Disorders, Platelet Dysfunction, Menorrhagia & Bleeding Complaints among Women

Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

2021 ◽  
Vol 28 (03) ◽  
pp. 338-343
Author(s):  
Shah Ali Ahmed ◽  
Anwarul Haque ◽  
Qalab Abbas ◽  
Humaira Jurair ◽  
Zohra Qamar ud Din ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Central Line ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

scholarly journals Awareness of ultrasonography among antenatal mothers attending the tertiary care hospital in Bundelkhand region of UP

2018 ◽  
Vol 6 (1) ◽  
pp. 277
Author(s):  
Varsha Singh ◽  
Amit Mohan Varshney ◽  
Samarjeet Kaur
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Lower Class ◽  
Well Being ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Obstetric Department

Background: Ultrasound examination during pregnancy has become an integral part of antenatal care throughout the world. This technology is an important tool for the obstetricians, to reassure their patients regarding the well-being of their fetus in utero. The objective of this study was to assess the awareness of USG among pregnant women.Methods: This cross-sectional study was carried out among pregnant women attending the ANC clinic of Obstetric department of MLB Medical College Hospital, Jhansi, UP from March to May 2018. The study included 300 pregnant women and data was collected by using pre tested questionnaire.Results: The study reveals that 51.3% of participants were in the age group of 20-25 yr and 50% of them belong to upper lower class, most of them unskilled (83.4%), 63.3% of participants depicted that USG is done only to confirm the pregnancy and 81% of women considered that it is beneficial during pregnancy and 65% was known that USG can be used to determine sex of the foetus.Conclusions: Awareness regarding the uses of ultrasonography during pregnancy was found to be average. There is need to create more awareness in community about the USG uses and PCPNDT act and its provisions. There is need of creating more awareness about the safety, utility and frequency of USG during antenatal period to avoid misuse.

scholarly journals Surgical audit: A process of self-evaluation for better future.

2020 ◽  
Vol 27 (05) ◽  
pp. 1049-1053
Author(s):  
Muhammad Kaleem Ullah ◽  
Muhammad Usman Hashmi ◽  
Mohsin Sarwar ◽  
Abdulaleem ◽  
Anosh Aslam Khan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Numerical Data ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Mortality Data ◽  
Care Hospital ◽  
Health Care Planning ◽  
Cross Sectional ◽  
Local Study ◽  
Patient Department

Objectives: To describe the pattern of thoracic surgical diseases at a tertiary care hospital in South-Punjab Pakistan. Study Design: Descriptive, cross-sectional study. Setting: Nishtar Medical University hospital Multan, Pakistan. Period: From 01-01-2018 to 31-12-2018. Material & Methods: All the patients who were admitted through the out-patient department or referred from other units, over the year 2018, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, a surgical procedure performed, type of anesthesia-induced and the mortality. Data were analyzed using IBM SPSS statistics version 20. Mean and percentages were used for numerical data. Data were presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations. The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system.

scholarly journals Extra-Articular Manifestations of Rheumatoid Arthritis & its relation with Treatment Outcome: a tertiary care hospital experience

KYAMC Journal ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 570-573 ◽  
Author(s):  
Nazma Akter ◽  
Nazmul Kabir Qureshi ◽  
Md Azizul Hoque ◽  
Md Mujibur Rahman
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Outcome ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
American College Of Rheumatology

Objective: This study was done to determine frequency of extra-articular manifestations (ExRA) in patients with rheumatoid arthritis (RA) and its relation with treatment outcome in a tertiary care hospital, Dhaka.Methods: A cross sectional study was conducted upon 50 patients of rheumatoid arthritis of both gender aged ranging 30 to 60 years attending different medicine units of Shaheed Suhrawardy Medical College & Hospital during the period of May to October, 2011 who fulfilled the 1987 American College of Rheumatology criteria for RA. Demographic characteristics, extra-articular manifestations were recorded and some information was gathered by document review according to DAS28 (disease activity score 28.)Results: Among 50 patients female to male ratio was 9:1. The average age was 43.72±10.95 (SD) in years with maximum age 60 years and minimum age 30 years. Extra-articular manifestations were reported in 86.0% of patients. Hematological involvement (82%) was the most common extra-articular manifestation. Average DAS 28 was more in patients who had extra-articular manifestations than patients who had no extra -articular manifestation.Conclusion: Significant proportion of patients with female predominance visited at a tertiary care hospital due to RA. ExRA were present in a substantial proportion of a hospital based sample and is generally associated with a worse disease outcome. Hematological system involvement was the commonest. Early recognition and treatment are important to decrease disease activity.KYAMC Journal Vol. 6, No.-1, Jul 2015, Page 570-573

scholarly journals Study of prevalence and types of anemia in primary hypothyroidism

2019 ◽  
Vol 6 (5) ◽  
pp. 1574
Author(s):  
Rakesh K. Yadav ◽  
Mansoor Ahmad ◽  
Manoj K. Mathur ◽  
Vishal Dhingra
Keyword(s):  
Tertiary Care ◽  
Hypochromic Anemia ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Primary Hypothyroidism ◽  
North India ◽  
Common Disease ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hypothyroid Patients

Background: Hypothyroidism is common disease with varying frequency between countries. Anemia in hypothyroidism can be normocytic normochromic, microcytic hypochromic and macrocytic hypochromic. Anemia severity is associated with hypothyroidism degree. Objective of this study to study the association between anemia and hypothyroidism and prevalence and types of anemia in primary hypothyroidism (subclinical and overt both).Methods: This cross sectional study was carried out at tertiary care hospital in North India. Newly diagnosed 100 primary hypothyroid patients and 100 controls with age and sex matched evaluated for anemia. Prevalence and types of anemia were studied and severity of anemia was correlated with that of hypothyroidism.Results: Anemia was observed in 90 patients with hypothyroidism. Symptoms due to anemia were higher in cases than in controls. RBCs morphology showed normocytic normochromic in 59, microcytic hypochromic in 26 and macrocytic hypochromic in 15 cases. Serum anti-TPO positivity was present in 71.1% in cases as compared to 33.33% in controls. Anemia was severe in cases with high TSH.Conclusions: Anemia was more prevalent in cases of hypothyroidism than in euthyroid controls. Normocytic normochromic type of anemia was most common type in this study. Serum anti-TPO positivity was 71.1% in cases. There was statistically significant negative correlation between TSH and haemoglobin. Symptoms of anemia were more in hypothyroid patients than in euthyroid anemic patients.

scholarly journals Antibiotics prescreption pattern and resistance profile of common isolates at Soba university hospital in Khartoum, Sudan, a retrospective cross sectional study

2020 ◽  
Author(s):  
Fatima Ahmed ◽  
Abubaker Koko ◽  
Ola Mohamed ◽  
Reem Elhag ◽  
Sufian Khalifa ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Tertiary Care ◽  
Generation Cephalosporin ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Global Public Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Resistance Profile

Abstract Introduction: Antimicrobial resistance (AMR) is an incrrasingly global public health threat. An average of 45% of all patients are prescribed antibiotics. Nearly 50% of these prescribed antibiotics are unnecessary and they may promote the emergence of resistant strains. Antimicrobial stewardship programs have been introduced to tackle this problem. In this study we aim to determine the pattern of antibiotics prescription and resistance profile of common bacterial isolates at Soba university hospital , Sudan. Methods: A retrospective cross sectional study that was conducted at the medicine and surgery wards in a tertiary care hospital . Records of all patients who were admitted during the study period were included. A presented data collection form was used to collect information. Results: Records of 269 inpatients were reviewed. The mean age of patients was 49.5±18.7 years. The most frequently reported diagnoses on admission included cerebrovascular accidents and chronic liver disease, with 10.6% and 7.1% respectively. Je mean duration of stay at the hospital was 6.6 ± 6 days. Almost 81.8% of admitted patients recieved antibiotics. The majority (38.7% and 34.2%) were given one, and two antibiotics, respectively. Most of the antibiotics were administered intravenously (82.1%). Third generation cephalosporin antibiotcs (38%) and metronidazole (21.7%) were the most frequently prescribed. No documented indication for antibiotic prescriptio was found in 40.5% of cases. The main reason for stopping antibitics was the patients discharge (63.6%). Of patients recieving antibiotics, only 5 (1.9%) had undergone culture. Complete blood count (CBC) was requesed in nearly all patients (99.2%). A total of 100 cultures were performed during the study time. Most of them were urine cultures (64%). Escherichia Coli was isolated from 14 (29.2%) cultures. Resistance percentage was highest for erythromycin, and oxacillin (100% for both). Conclusion: The study shows a trend of antibiotic misuse. Most patients recieved antibiotics without documented indication. Antibiotics sensitivity results showed high levels of resistance among isolated organisms. We recommended a wider study and formulation and impementation of clear guidlines to regulate antibiotics use.

scholarly journals A cross sectional study on factors affecting treatment outcome among TB patients

2018 ◽  
Vol 5 (1) ◽  
pp. 175
Author(s):  
Srinivasulu T. ◽  
Jahnavi K.
Keyword(s):  
Treatment Outcome ◽  
Treatment Failure ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cure Rate ◽  
Exclusion Criteria ◽  
Cross Sectional ◽  
Factors Affecting

Background: Many factors affect treatment outcome negatively. Study of these factors is essential to prevent relapse and treatment failure. The objective of the research was to study the factors affecting the treatment outcome among TB patients.Methods: Patients diagnosed to have tuberculosis who are attending the DOTS centre at a tertiary care hospital, and fulfilling the inclusion and exclusion criteria were included in the present study. 50 patients who were being treated under DOTS regime were included in the present study. The study was conducted for a period of two years. The patients were followed for a period of six months to observe the treatment outcome among them.Results: Maximum patient were in the age group of 21-40 years (50%) followed by 41-60 years (28.3%). Cough was present in 76.7% of the cases and was the most common presenting symptom of the cases. The cure rate was significantly more among non alcoholics compared to alcoholics. The cure rate was only 60% among smokers compared to 88.5% among non smokers. The non cure rate was high among smokers i.e. 40% compared to only 11.5% among those who never smoked. This difference was found to be statistically significant.Conclusions: Smoking and alcohol were found to be important risk factors for treatment failure in the present study.

Sign in / Sign up

Export Citation Format

Share Document