scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

scholarly journals A Study of D-Dimer Levels in Acute Febrile Non Covid Conditions in a Tertiary Care Hospital

2021 ◽  
pp. 137-141
Author(s):  
S. Caroline Sylvia ◽  
S. Vinoth
Keyword(s):  
Differential Diagnosis ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Acute Febrile Illness ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
A Prospective Study ◽  
D Dimer

Introduction: Acute undifferentiated febrile illness (AUFI) is caused by a multitude of diverse pathogens, with significant morbidity and mortality in the developing world. This study aims to highlight the gaps in our understanding of  the various differential diagnosis of acute febrile illness  and their prognostic outcomes. In this study, We used d-dimer levels to arrive at a differential diagnosis in acute febrile illness and also used it as a biomarker of disease severity and prognostic outcome. Materials and Methods: A prospective study was conducted at medicine department, Saveetha  medical college and hospital, Thandalam, India  for a period of 3 months from January 2020 - March 2020. Patients who presented to the medicine outpatient department with symptoms of acute febrile illness with non specific symptoms were registered after getting written consent in the study. The plasma concentration of D -dimer levels ,prothrombin time , APTT from which INR were measured. The duration of hospital stay of patients in study was recorded. The data collected was entered into an excel sheet and analysed using SPCC software. Results: A total of 50  patients with acute febrile illness were enrolled in the study. Out of which 37 patients (74./. of patients)  were found to have elevated D dimer levels. These 37 patients with elevated D – dimer levels required longer duration of hospital stay, reflecting the need for more days for recovery.

scholarly journals Serum Zinc Status in Post Menopausal Women Attending in a Tertiary Care Hospital of Bangladesh

2019 ◽  
Vol 9 (2) ◽  
pp. 147-150
Author(s):  
Nadia Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Fahmida Islam ◽  
Shabnam Sarwar Sejooti
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Serum Zinc ◽  
Premenopausal Women ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Zinc Levels ◽  
Serum Zinc Levels

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology , Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal womenaged between 45-70 years were considered as case and another 50 regular menstruating premenopausal women aged between 30-40 years were selected as control. Results: The mean age of case and control groups was 50.5± 2.3 years and 36.5± 4.4 years respectively. In this study serum zinc levels in cases and controls were 71.54 ± 5.69 ìg /dl and 74.68 ± 5.453 ìg/dl respectively, and there was significant difference(p<0.01). Conclusion: Serum zinc level was significantly decreased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum zinc levels might be incorporated in every postmenopausal for possible prevention of complications. Birdem Med J 2019; 9(2): 147-150

scholarly journals Estimation of Serum Copper in Post-menopausal Women Attending in a Tertiary Care Hospital, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Serum Copper ◽  
Copper Level ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113

scholarly journals Comparative Study of Length and Diameter of Umbilical Cord in Normal Vs Gestational Hypertensive cases in a Tertiary Care Hospital in Eastern Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 68-71
Author(s):  
Abhishek Karn ◽  
Subodh Kumar Yadav ◽  
Renu Yadav ◽  
Rakesh Kumar Adhikari
Keyword(s):  
Umbilical Cord ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Factors ◽  
Significant Difference ◽  
The Difference ◽  
Umbilical Cords

INTRODUCTION :- The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.  MATERIAL AND METHODS :- A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.  RESULTS :- The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.  CONCLUSION :- We concluded that gestational hypertension affects the diameter of umbilical cord by decreasing it significantly which may affect normal fetal development.

ASSOCIATION OF HEMATOCRIT-PLATELET INDEX AND HEMATOCRIT SHIFT WITH WARNING SIGNS AND HOSPITAL STAY IN DENGUE PATIENTS AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S277-82
Author(s):  
Muhammad Fahd Bin Haider ◽  
Humaira Zafar ◽  
Syed Zubair Hussain Shah ◽  
Mobaila Akram ◽  
Kamran Malik ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Warning Signs ◽  
Care Hospital ◽  
Cross Sectional ◽  
Duration Of Stay ◽  
Platelet Indices ◽  
Significant Difference ◽  
Duration Of Hospitalization

Objective: To determine the relationship between hematocrit, platelet count, warning signs and duration ofhospitalization in indoor dengue patients. Study Design: Analytical, cross sectional study. Place and Duration of Study: Department of Medicine, Pakistan Air Force Hospital Islamabad and Departmentof Biochemistry and Molecular Biology, AM College, Rawalpindi, from Sep 2019 to Jun 2020. Methodology: A total of 100 indoor patients were recruited using convenience sampling. Their platelets, hema-tocrit and warning signs were recorded on arrival in the hospital. First two parameters were checked every day for the whole duration of stay in the hospital. The WHO standard treatment of dengue was given to the patients. Patient were divided into two groups based upon duration of hospitalization using cut-off of 3 days. Linear regression was used to analyze association of hematocrit-platelet index and hematocrit shift with presence of one or more warning signs and duration of hospital stay. Results: There was statistically significant difference in 3rd day Hematocrit Platelet Indices of patients with short and long hospital stay (p=0.003). 3rd day Hematocrit-platelet indices of patients with and without warning signs also showed statistically significant difference when compared with eachother (p=0.0001). It was stronger than Hematocrit Shift (p=0.82) and platelets considered alone. Conclusion: Day 3 Hematocrit Platelet Indexis more strongly associated with warning signs and duration of stay rather than hematocrit alone. It means both need to be taken into account while monitoring dengue patients. Hematocrit platelet index for severity and duration of hospitalization while Hematocrit shift for fluid therapy.

scholarly journals Outcome of microbiologically proven pneumonia by nasopharyngeal aspirate of infant attending in a tertiary care hospital

2018 ◽  
Vol 9 (1) ◽  
pp. 267-270
Author(s):  
Marium Begum ◽  
Dipa Saha ◽  
Mahmuda Hasan ◽  
Wahida Hasin ◽  
Nadira Sultana ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Fatality ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Nasopharyngeal Aspirate ◽  
Prolonged Hospital Stay ◽  
College Hospital ◽  
Medical College ◽  
Prolonged Hospital

Background : In Bangladesh, recent estimates suggests that 22% of under-five death and 13.1% of neonatal death is due to pneumonia. Its etiology usually remains unknown and problems is increasing with drug resistant infections.Objective : The aim of this study is to evaluate the outcome of microbiologically proved pneumonia of the infant by nasopharyngeal aspirate culture.Methods : This prospective study was conducted at the Department of Pediatrics and Neonatology, Addin Medical college hospital, Dhaka from January to July 2015. A total of 30 hospitalized infants of either sex with pneumonia fulfilling the WHO criteria and radiologically confirmed were enrolled in the study. Child with congenital heart disease or chronic respiratory disease, who did not give consent were excluded from the study. The study cases were divided into three groups on their final outcome as improved, not improved (prolonged hospital stay) and expired.Results : Among 30 study cases mean age was 39.7±45 days, most of them were male 19 (63%); case fatality rate was 10%. Organisms were isolated from 47.3% cases of nasopharyngeal aspirate culture, among them Gram-ve bacteria were 10 (34%), gram +ve 3 (10%) and fungal 1(3.3%). Mixed bacterial growth were 4(13%) and no growth were 12(40%) cases. Acinetobacter was found in 8 (26.7%), Coagulase negative staphylococcus 2(6.7%). Additionally, MRSA, pseudomonas and E.coli species were identified in 1 (3.3%), 1 (3.3%), and 1 (3.3%) of the cases respectively. All infant who had gram +ve 3(100%) and fungal 1(100%) growth on their nasopharyngeal culture were improved. On the other hand, among the gram –ve cases mortality rate was high 2(20%) and also required prolonged hospital stay 2(20%). Among the cases who had mixed organism 2(50%) of them were improved and 2(50%) required prolonged hospital stay. Majority of the cases were improved 10(83%) those who had no growth on their NPA culture followed by 1(8.3%) had prolonged hospitalization and 1(8.3%) was died.Conclusion : Infant with severe pneumonia having younger age were at greater risk of mortality. Gram – ve organism in nasopharyngeal aspirate culture indicated poorer outcome and required prolonged hospital stay.Northern International Medical College Journal Vol.9(1) July 2017: 267-270

scholarly journals An Analysis of Drug-Drug Interactions in a Tertiary Care Hospital in Kerala: A Retrospective Study

2021 ◽  
Author(s):  
Jihana Shajahan
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Positive Correlation ◽  
Duration Of Hospital Stay ◽  
The Impact

Introduction: Concomitant use of several drugs for a patient is often necessary for achieving therapeutic response. Understanding the profile of Drug-Drug Interactions (DDI) will help health care providers to optimise therapy for better patient outcomes, reinforcing the concept of rational drug use. Aim: To analyse the frequency, mechanisms and severity of DDIs in a tertiary care hospital at Kerala. Materials and Methods: A retrospective cross-sectional study among 350 inpatients of a tertiary care hospital in Kerala from August 2020 to September 2020. Prescriptions containing ≥3 drugs were collected from inpatient medical records. A drug interaction check was performed using the Lexicomp drug interaction checker software. Results: DDIs were present in 74.6% of prescriptions and the average number of interactions was found to be 2.78. Most number for interactions was in the age group 61-80. Average number of DDI was significantly high among patients >60 years. Percentage of prescriptions with DDI and average number of DDI was found to be increasing with increase in number of drugs. Average number of interactions were maximum (5.01) in the group >10. Drug groups most commonly involved in interactions were antiplatelets, oral hypoglycaemic agents, bronchodilators, antibiotics, diuretics, insulin, statins, beta blockers, Proton Pump Inhibitors (PPI) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The most common interventions for minimising the impact of DDIs were changing the timing of drug administration, monitoring for symptoms/signs/lab values/drug levels or both. There was a significant positive correlation between duration of hospital stay and number of DDI. Conclusion: This study threw light upon the pattern and profile of DDIs among inpatients of a tertiary care hospital in Kerala. Elderly people (>60 years) were most prone for DDIs. Percentage of prescriptions with DDI and average number of DDIs was found to be increasing with increase in number of drugs. There was a positive correlation between duration of hospital stay and number of DDI.

scholarly journals Factors influencing Outcome of Extradural Hematoma in a Tertiary Care Hospital of Dera Ghazi Khan, Pakistan

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Liaqat Jalal ◽  
Atta-ur-Rehman Khan ◽  
Muhammad Shaukat Farooq ◽  
Muhammad Tahir Nouman
Keyword(s):  
Developing Countries ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Extradural Hematoma ◽  
Medical College ◽  
Poor Outcome ◽  
Factors Influencing ◽  
Significant Difference

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan. Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant. Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male.  Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001). Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.

scholarly journals Correlation of the severity of HRCT findings with the other hematologic parameters & viral load in patients with confirmed COVID – 19 Infection

2021 ◽  
Vol 12 (9) ◽  
pp. 4-10
Author(s):  
Anjali Goyal ◽  
Misha Antani ◽  
Suhani Agarwal ◽  
Chandni Gadara ◽  
Milap Shah ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Viral Clearance ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Duration Of Hospital Stay ◽  
Severity Scores ◽  
Wbc Count ◽  
D Dimer

Background: The latter half of 2019 saw the spread of a highly contagious and fatal respiratory tract disease originating in the Hubei province of Wuhan in China which was labelled as COVID 19. Although a multi organ disease, it is seen to spread through the respiratory tract with lung being the primary target. Aims and Objective: The study was conducted to correlate the severity of lung involvement as assessed by the HRCT severity, with the Viral Severity index, laboratory parameters, duration of hospital stay, viral clearance and resolution of lung symptoms. Materials and Methods: An observational retrospective study was carried out from the laboratory records of consecutive 208 patients admitted to the tertiary care hospital between March 2020 to May 2020. Results: Out of a total of 208 patients, 200(96%) recovered and 8(4%) expired. The expired patients showed a higher average age (50.79+/- 17.42; 62.25+/-12.37) years in the recovered & expired patients respectively (p=0.06). A longer duration of hospital stay was seen in the expired patients (15.05+/-9.55&18.62+/-10.22) days in the recovered & expired patients respectively. A low average (Hemoglobin) Hb values (12.17+/-2.01&10.9+/-2.31) g/dl in the recovered and expired patients respectively along with a higher total WBC count was seen in the expired patients (8.62+/-3.81& 16.86+/-12.79) k/U in the recovered and expired patients with a highly significant p value of < 0.001). Higher CT severity scores were seen in the expired patients (10.74+/-5.57&17.12+/-6.55) in the recovered and expired patients respectively (p=0.0018). None of the expired patients had a normal D Dimer level. HRCT values and the Rising D Dimer levels tend to show a positive correlation with the disease outcome and progression. The Higher Viral severity and HRCT score was associated with a longer duration of hospital stay reflecting a higher duration of viral clearance. Conclusion: The Chest CT scores along with the laboratory parameters like the total WBC count and the D Dimer levels can together act as important parameters to monitor the Covid 19 disease course.

scholarly journals Clinical profile of dehydration fever in neonates in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 718
Author(s):  
Muhammad Hassan ◽  
Adarsh E. ◽  
Rajanish K. V.
Keyword(s):  
Weight Loss ◽  
Birth Weight ◽  
Urine Output ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Factors Affecting ◽  
Medical College ◽  
Significant Difference ◽  
Daily Urine

Background: The aim of this study was to determine the clinical profile of neonates admitted with dehydration fever and ascertain the maternal and neonatal factors affecting it.Methods: A observational descriptive study was conducted at Rajarajeswari Medical College and hospital, population included neonates who were admitted in NICU with dehydration fever.Results: The study were conducted among 50 neonates admitted with dehydration fever. Majority of neonates (72%) were diagnosed with dehydration fever on day 3 of life. 84 % neonates were born to primiparous mothers. In the study there was significant difference in mean birth weight, weight at admission and percentage of weight loss between birth weight and weight at admission with respect to symptoms on presentation. Mean % of weight loss was 12.06 when dehydration fever was presented with fever, 11.29 when dehydration fever presented with decreased urine output, 18.44 when presented with both fever and decreased urine output and 12.73 when presented with jaundice these values were statistically significant.Conclusions: Dehydration fever occurs most commonly on day 3 or after, effective measures should be initiated for early diagnosis and prevention of complications like effective breast-feeding counselling, proper techniques, good latching and supplementation of artificial feeds if required and monitoring of daily weight and daily urine output.

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