scholarly journals Challenges in managing an emergency and trauma ICU during COVID-19 pandemic: Perspective from a tertiary care centre in western Uttar Pradesh (India).

2021 ◽  
pp. 26-31
Author(s):  
Syed Hasan Amir ◽  
Lubna Zafar ◽  
Obaid Ahmad Siddiqui ◽  
Farah Nasreen
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Uttar Pradesh ◽  
Trauma Centre ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
The Government ◽  
Novel Coronavirus

In December 2019, a novel coronavirus (now named COVID-19) was identified as a causative agent for a cluster of pneumonia cases in Wuhan, China.1 Till March 2020, India was one among 50 countries which identified patients tested positive for COVID-19.2 One day curfew was imposed in the country on March 22, 2020 to forewarn the people about the danger the country was going to face. The government of India announced a nationwide lockdown for 21 days from March 25, 2020 with subsequent second, third and fourth lockdowns. This was done to reduce the transmission of disease and flatten the curve. The preparations to manage COVID-19 pandemic crisis began in Jawaharlal Nehru Medical College Hospital Aligarh, a tertiary care centre in western Uttar Pradesh by 15th of March 2020. In April 2020, it was declared as Level 2 COVID care hospital to deal with complicated and critical cases. The establishment of flu clinic, exclusive COVID-19 isolation ward, teleconsultation and widespread screening of patients by Reverse transcriptase polymerase chain reaction (RT PCR) were some measures undertaken to deal with the crisis. The increased burden of patients presenting with bronchopneumonia necessitated augmentation of the existent infrastructure and better utilization of resources. Emergency and trauma centre, JNMCH, AMU Aligarh was also no exception and reorganising emergency trauma ICU as COVID-19 suspect ICU made the functioning of the entire hospital a lot smoother during this unsustainable crisis situation. However, there were several challenges to overcome while designating an emergency and trauma ICU as COVID-19 suspect ICU. There is ample amount of literature available discussing the strategies for preparing a dedicated COVID ICU, however there is relative scarcity of literature on the challenges in managing an emergency and trauma ICU (ETC – ICU) during the pandemic. In this review, we discuss the strategies and planning for converting an emergency and trauma ICU into a COVID suspect ICU in a tertiary care centre in western Uttar Pradesh (India) during the pandemic and the challenges faced. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.26-31

Prevalence and antibiogram of non-fermenting Gram-negative bacilli in blood stream infections: Study in a tertiary care centre, Western Uttar Pradesh, India

2021 ◽  
pp. 004947552097929
Author(s):  
Tarana Sarwat ◽  
Mariyah Yousuf ◽  
Ambreen S Khan ◽  
Dalip K Kakru ◽  
Renu Dutta
Keyword(s):  
Burkholderia Cepacia ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Blood Stream ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Acinetobacter Baumanii ◽  
Blood Stream Infections ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative

Non-fermenting Gram-negative bacilli (NFGNB) are emerging as important cause of blood stream infections. We aimed to determine the prevalence and antibiotic susceptibility pattern of NFGNB isolated from blood of patients with sepsis. We found, in 176 patients, the most common to be Pseudomonas aeruginosa (74) and Acinetobacter baumanii complex (39) followed by Stenotrophomonas maltophilia (16), Sphingomonas paucimobilis (6), Burkholderia cepacia (5) and Ochrobactrum anthropic (1). Generally, organisms showed a good sensitivity towards colistin, carbapenems and fluoroquinolones, whereas cephalosporins were ineffective.

scholarly journals To study pattern of obstetric cases referred at tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2370
Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Maternal Outcome ◽  
Child Health Services ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Diagnosis ◽  
Mode Of Transport

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

scholarly journals Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India

2021 ◽  
Author(s):  
Yamini Marimuthu ◽  
Radhika Kunnavil ◽  
NS Anil ◽  
Sharath Burugina Nagaraja ◽  
N Satyanarayana ◽  
...  
Keyword(s):  
Risk Factors ◽  
South India ◽  
Linear Models ◽  
Tertiary Care ◽  
Male Gender ◽  
Clinical Profile ◽  
Rank Test ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.

scholarly journals Response of leuprolide on gonadal functions of women with overt hypothyroidism: a tertiary care centre study from Uttar Pradesh - India

2019 ◽  
Vol 8 (1) ◽  
pp. 277
Author(s):  
Manish Srivastav ◽  
Alankar Tiwari ◽  
Nihit Kharkwal ◽  
Keshav Kumar Gupta
Keyword(s):  
Human Subject ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Ovarian Response ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Newly Diagnosed ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Healthy Females

Background: Hypothyroidism can cause menstrual disturbances mainly oligoanovualtory cycles and sometimes menorrhagia. It has also been seen to cause subfertility and pregnancy related complications. Various studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there which have done using a gonadotrophin response in that subset of patients. Present study evaluates the response of leuprolide on gonadal functions of women with overt hypothyroidism in a tertiary care centre at Meerut.Methods: In this study 50 females of age 20 to 40 years with newly diagnosed overt hypothyroidism were taken as cases and age and Body Mass Index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol was measured on 2nd day to 5th day of menstrual cycle. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. Post leuprolide test, stimulated LH, FSH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (8.2±3.2 mIU/L) when compared to cases (6.45±2.75 mIU/L) with a p value 0.03(<0.05). Basal estradiol and FSH levels were found to be nearly similar and non-significant in cases and controls. No significant differences were found between stimulated mean LH and estradiol in both the groups. Leuprolide response after stimulation test was found to be sluggish in patients with overt hypothyroidism compared to normal euthyroid controls. This study is the rare one done on human subject in tertiary care centre of India, however large sample and multicentric trials are necessary before establishing the biochemical results.Conclusions: Pituitary and gonadal (ovarian) response to leuprolide was found to have impaired (decreased) in overt hypothyroidism cases. This is the first study to be done in overt hypothyroid subjects to asses both basal and stimulated gonadotropin levels.

scholarly journals Assessment of Knowledge, attitude and practices of Epilepsy Patients’ towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia

2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Negative Attitude ◽  
Median Number ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Medical Attention ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553

Trends of Poisoning in a Tertiary Care Centre of North West Uttar Pradesh

2015 ◽  
Vol 37 (4) ◽  
pp. 396 ◽  
Author(s):  
Jaswinder Singh ◽  
Jaspreet Kaur ◽  
Vinod Kumar ◽  
K.A. Shah ◽  
R.N. Tandon ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Uttar Pradesh ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
North West
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