scholarly journals Patterns Of Psychiatric Referrals In A Tertiary Hospital

2020 ◽  
Vol 9 (2) ◽  
pp. 48-52
Author(s):  
R Niroula ◽  
PK Chakrabortty ◽  
P Thapa ◽  
JB Khattri ◽  
K Ramesh
Keyword(s):  
Anxiety Disorder ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Somatoform Disorder ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Medicine Department ◽  
Icd 10

Introduction: Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to patients under non-psychiatric care. Despite evidence of benefits of CLP for patients with psychiatric comorbidities, referral rates from hospital doctors remain low. This has prompted the present study, to assess the frequency and the pattern of psychiatric referral in a tertiary hospital in Nepal. Material And Method: This was a descriptive cross‑sectional study conducted in a tertiary care hospital. The study comprised of 108 patients referred for psychiatric consultation from various out-patient departments (OPD) to C‑L services of psychiatry department. Information was collected using semi‑structured proforma, and diagnosis was made based on Diagnostic Criteria for Research (ICD-10 DCR)and the data were analyzed. Results: A total of 108 patients, male 41(38%) and female: 67(62%) were referred to CLP, the Medicine department sent the maximum number of consultations (57.4%), followed by E.N.T (25.9%), Surgery (16.7%). Psychiatric consultation was sought for various reasons including decreased sleep (37%), appears anxious (27.8%), appears depressed (15.7%), foreign body sensation (11.1%), and mass moving in abdomen (8.3%).The most prevalent ICD-10 diagnosis was depressive episode (44.4%) followed by anxiety disorder (27.8%) and somatoform disorder (19.4%). Conclusion: Our study illustrates the importance of CLP through referral pattern from various OPD in a tertiary care hospital. Majority of referrals were from Medicine department andthe most common reason of referral was decreased sleep. The commonest diagnosis seen in the referred out-patients was depression followed by anxiety disorder and somatoform disorder.

A Study on Day Care Transfusion Services in Transfusion Medicine Department of a Tertiary Care Hospital

2019 ◽  
Vol 3 (01) ◽  
pp. 12-15
Author(s):  
Farida Parvin ◽  
Mohammed Abdul Quader ◽  
Daanish Arefin Biswas ◽  
Mohammed Ali ◽  
Bepasha Naznin ◽  
...  
Keyword(s):  
Day Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fresh Frozen Plasma ◽  
Transfusion Practice ◽  
Care Hospital ◽  
Transfusion Medicine ◽  
Blood Components ◽  
Medicine Department ◽  
Long Term Study

Background: Transfusion of blood components and derivatives in day care unit is an eminent part of management of transfusion dependent patients. Day care transfusion service is an alternative to hospital admission and beneficial for those patients who receive blood more frequently for their survival. Objective: The aim of present study is to assess Transfusion Services provided in a Day Care Unit (DCU) of a tertiary care hospital. Methodology: This study was carried out in DCU of Transfusion Medicine Department, Bangabandhu Sheikh Mujib Medical University, (BSMMU) at Dhaka during January 2014 to December 2014. Data were collected from record registers. Recorded retrospective data were analyzed as percentage and proportion. Results: Total recipients were 718. Among those 424 (59.05%) were male and 294 (40.95%) were female and 562 (78.27%) were between 10 to 40 years. A total of 8587 units of blood components were used during this period. Red Cell Concentrate was most commonly utilized product 6388 (74.39%) followed by Fresh Frozen Plasma (FFP) 1360 (15.83%), Platelet Concentrate 544 (6.33%), Whole blood 260 (3.05%) and Cryoprecipitate 35 (0.40%). Transfusion was required more frequently in thalassaemic 365(50.88%) patients. Haemophilia 77(10.72%) and aplastic anaemia patients 49 (6.82%) were next high. The main transfusion reaction observed during transfusion was febrile non-haemolytic reactions. Conclusion: For increasing use of specific blood product and hassle-free transfusion services this kind of day care unit services should be strengthened. Long term study of this kind will help us to develop safe clinical transfusion practice.

ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer

2021 ◽  
Vol 44 (4) ◽  
pp. E11-16
Author(s):  
Muzammil H. Syed ◽  
Mohammed Al-Omran ◽  
Jean Jacob-Brassard ◽  
Joel G. Ray ◽  
Mohamad A. Hussain ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Hospital ◽  
Reference Standard ◽  
Diagnostic Coding ◽  
Icd 10

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.

scholarly journals Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 31 (2) ◽  
pp. 38-42
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Sharmin Kauser ◽  
Mekhala Sarkar ◽  
Md Masud Rana Sarker ◽  
...  
Keyword(s):  
General Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Major Depressive ◽  
Consultation Liaison Psychiatry ◽  
The Mean ◽  
Inpatient Units

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42

scholarly journals An Audit of Rational Use of Antibiotics in a Tertiary Hospital

2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Number Of Patients ◽  
Rational Use Of Antibiotics

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67

scholarly journals Detection of Oxacillin (Methicillin)-resistant Staphylococcus aureus Isolated from a Tertiary-care Hospital, Georgetown, Guyana

2020 ◽  
pp. 1-7
Author(s):  
Paul Cheddie ◽  
Drovashti Seepersaud ◽  
Tereasia Ramlochan
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Prevalence Survey ◽  
Methicillin Resistant ◽  
Broth Microdilution Method

Background and Aim: Methicillin-resistant Staphylocccus aureus (MRSA) continues to be a major problem globally. Previous data had suggested that the prevalence of MRSA infections in the tertiary hospital setting was 51%. The aim of this study was to conduct a point prevalence survey of MRSA infections occurring at a tertiary-care hospital in Georgetown, Guyana, and to determine to what extent methicillin-resistance was occurring among Staphylococcus aureus isolates utilising the minimum inhibitory concentration (MIC) data. Study Design: This study was based on a prospective, analytical design. Place and Duration of Study: Microbiology department, Georgetown Public Hospital Corporation (GPHC), and Department of Medical Technology, University of Guyana, between May 2019 and July 2019. Methodology: A total of 101 consecutive, non-repetitive, laboratory-identified MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) isolates were tested using an oxacillin broth microdilution method. Results: We found that 65.4% of Staphylococcus aureus were oxacillin (methicillin) resistant with a majority of the isolates being high level oxacillin resistant strains (i.e., MICs > 256 μg/ml) (84.85%). Most of the resistant isolates were collected from patients admitted to medical and surgical wards. Conclusion: Methicillin-resistance continues to be a major problem in the hospital setting and conventional techniques are unlikely to identify all of the potentially resistant isolates.

scholarly journals A comparative study of clinical profile, severity and outcome of acute coronary syndrome in women and men admitted to a tertiary hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 634
Author(s):  
Yugandhar Tummala ◽  
Mohamed Hanifah ◽  
B. Amirtha Ganesh
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Cardiac Enzymes ◽  
Major Health ◽  
Coronary Syndrome ◽  
Appropriate Treatment ◽  
Artery Disease ◽  
Worse Prognosis

Background: Coronary artery disease (CAD) has emerged as a major health burden in developing countries. Many recent reports concluded that women with CAD have a worse prognosis than men and also with regards to invasive interventions when compared to men. In this study, author determined the comparative outcomes of ACS in women when compared with men.Methods: This study was conducted in a tertiary care hospital from November 2016 to March 2018. History taking, ECG, cardiac enzymes, 2D-Echo and angiogram were done to diagnose ACS and the appropriate treatment was given. The severity was assessed and compared the outcomes along with complications.Results: The total of 112 patients were treated for ACS, in which, 55 were females and the remaining 57 were males. Majority of the patients in both genders was between the ages of 51-60. In males, STEMI noted 50.8%, NSTEMI in 36.8%, UA in 12.2%. In females, STEMI is noted in 62%, unstable angina in 32.7%, NSTEMI in 27.2%. Six patients (11%) had mortality in the women group and one (1.8%) had died among men.Conclusions: Atypical presentation of ACS was more common in females. Women with ACS had higher complications and higher mortality than men.

scholarly journals Evaluation of adverse drug reactions of anti-tubercular drugs in the treatment of tuberculosis in tertiary care hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 1430
Author(s):  
Krishnakanth K. ◽  
Jagadeesh A. ◽  
Swetha T. D.
Keyword(s):  
Adverse Drug Reaction ◽  
Adverse Drug Reactions ◽  
Adverse Drug Events ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Cross Sectional ◽  
Medicine Department ◽  
Study Results

Background: Adverse drug reactions are very common among patients on anti-tubercular treatment. Hence, the current study was done to evaluate the adverse drug reaction (ADR) profile in patients receiving anti-tubercular treatment (ATT).Methods: A 6 months prospective, cross-sectional observational study was performed in collaboration with Pulmonology Medicine department. WHO-UMC scale and Naranjo scale was used to evaluate the ADRs.Results: Ninety-two patients receiving ATT presented with 113 adverse drug events (ADE). Males were more affected than females. DOTS category-1 regimen was mostly responsible for ADE. Addition of drugs for the management of ADR events was done.Conclusions: The study results show more ADRs related to ATT demanding increased collaboration between NTEP 2020 and Pharmacovigilance Programme of India to enhance drug safety in this field.

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