scholarly journals Current Disease pattern and Out-come of patients in a Medical Unit of a Pediatric Hospital

2020 ◽  
Vol 10 (2) ◽  
pp. 386-388
Author(s):  
M Mizanur Rahman ◽  
Mirza Md Ziaul Islam ◽  
M Atiqul Islam ◽  
AKM Tajuddin Bhuiyan ◽  
AFM Ashik Imran ◽  
...  

Background: Epidemiological trends of diseases and causes of mortality is not constant, it is always changing. Analysis of admitted patients gives us information on the burden of diseases in the community as well as cause of mortality. Objectives: To determine current pattern of admissions and their outcomes in a tertiary care Pediatric hospital. Material and Methods: A descriptive study was carried out at Dhaka Shishu (Children) Hospital over a period of one year from 1st January to 31st December, 2015. All the admitted patients during the study period were included and data were collected from medical records for analysis of age, residence, mode of admission, referral source, disease profile and outcome. Final diagnosis and mortality were grouped according to involved organ system. Data were analyzed by using SPSS version 17.0. Results: Total 1424children with a male and female ratio of 1.5:1 were admitted in one year. Patients younger than 5 years were 73%and 27% were less than one year. Respiratory infection, neurologic, hematology, oncologic conditions were the main diseases. Mortality was 2.6% and it was highest in nonspecific infection group followed by respiratory, hematologic, neurologic, and oncologic diseases. Mean duration of hospital stay was 11.5 days. Most patients 59.1% were admitted through Emergency Department(ED) and came directly to the hospital. Fifty percent of admissions were from Dhaka and neighboring areas and rest were from other cities and rural areas of Bangladesh. Conclusion: Non-specific infection, respiratory or neurologic diseases are main diseases found in admitted patients and these diseases were the main contributor to death as well. Most of the patients approach directly to this hospital and also through emergency department. Northern International Medical College Journal Vol.10 (2) Jan 2019: 386-388

2016 ◽  
Vol 12 (2) ◽  
pp. 11-16
Author(s):  
Upendra Pandit

Background: Primary documentation of a patient is crucial for making effective healthcare decision and improvements in the quality of care. The objective of this study was to assess the quality of current documentation practice in tertiary care hospitals. Materials and methods: This was an assessment of medical documentation practice of one year from the period of January 2010 to December 2010 in Chitwan Medical College, Teaching Hospital. Total 184 patients' discharge files were enrolled and reviewed. Documentation was reviewed in its quality such as completeness, Coherent, consistency and Legibility.Results: In overall pooled analysis, High omission rate was observed in final diagnosis, results (cure, improved, referral and death), hospital stay, and final case summary. Although, satisfactory performance was observed in complete set of forms (72.2%); Patient consent for treatment &release authorization forms (78.2%) and treatment chart (60.8%), the overall pooled performance in ten components showed50% performance gap. Study demonstrated that documentation and its legibility, coherent and consistency in all departments needs substantial improvements in the institution.JNGMC Vol. 12 No. 2 December 2014, Page: 11-16


Author(s):  
Ramesh A. ◽  
Sampath V. ◽  
Shvedha M.

<p class="abstract"><strong>Background:</strong> Leprosy is a chronic infectious granulomatous disease caused by <em>Mycobacterium leprae</em>. The disease primarily affects peripheral nervous system, the skin and certain other tissues. It is a spectral disease which is classified into five groups based on clinical, histopathological and bacteriological and immunological criteria as tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), borderline lepromatous (BL), lepromatous (LL) according to Ridley-Jopling classification. Adequate clinical information combined with histopathology and bacteriological index is helpful not only in classification of different types of leprosy, but also useful for management of cases.The objective of the study was to correlate clinical diagnosis with histopathological findings of leprosy.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted for one year from January to December 2018 in Leprosy clinic, Department of Dermatology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai. The histopathological findings were compared with clinical diagnosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total number of cases attended leprosy clinic from January 2018 to December 2018 was 167 cases, among those 49 clinically diagnosed cases were included in the study. Out of 49 cases, maximum number of patients belonged to 30-50 years age group. Male to female ratio was 3.9: 1. Hypopigmented, hypoaesthetic patches were commonly seen. Clinically as well as histopathologically BT leprosy was common.The maximum histological correlation seen in lepromatous leprosy (100%) followed by BT (80%).</p><p class="abstract"><strong>Conclusions:</strong> The study emphasises the role of skin biopsy in confirming the clinical diagnosis of leprosy and also as a therapeutic guide.</p>


Author(s):  
Varun Dogra ◽  
Silvi Sandhu ◽  
Ishfaq Ahmad Gilkar ◽  
Umer Mushtaq ◽  
Shyam Gupta

Background: Esophageal cancer is considered to be a one of the most lethal malignancy. Indian population have seen a lot of changes in the epidemiology of this deadly cancer. However very few studies have been done from northern India regarding the epidemiology and etiopathogenesis of this disease. Majority of esophageal cancers (about 90%) are either squamous cell or Adenocarcinoma. Any factor that causes chronic irritation and inflammation of the esophageal mucosa appears to increase the incidence of the esophageal. The aim of the study was to perform an epidemiological study and determine the various factors that are implicated in the pathogenesis of carcinoma esophagus.Methods: This study was conducted in the department of general surgery, Government Medical College, Jammu, as an observational prospective study. It took into account the patients from 2015 to 2020. A total of 23 patients of carcinoma oesophagus who presented to Outdoor patient wing of department of surgery were included in the study. After detailed history, examination and investigations, the various variables were extracted and data was processed.Results: In this study, the majority of people were from rural areas in their seventh decade of life with males: female ratio of 3:1. The majority of people complained of dysphagia and weight loss. The site of tumor was Gastroesophageal junction.Conclusions: This study emphasised the need of health education in our population, especially in young adults to lessen the risk factors for carcinoma esophagus.


2016 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kim Bjorklund ◽  
Emily A. Eismann ◽  
Roger Cornwall

ABSTRACT Background The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. Objective We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Methods Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Results Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P &lt; .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P &lt; .001). Conclusions Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.


2021 ◽  
Author(s):  
Dipmala Das ◽  
Asitava Deb Roy ◽  
Alka Rawekar

BACKGROUND Mentorship programs are becoming increasingly common in undergraduate medical education all over the world. However, very few medical colleges are running mentorship programs in India. A mentorship program was introduced in our college for the first year MBBS students to help them cope up with the stress of the new environment. OBJECTIVE The aim of this study is to evaluate the mentorship program with regard to its efficacy, utility, limitation and potential for improvement after successful completion of one year of the program. METHODS It was an observational analytical study including 143 mentees and 15 mentors conducted in a tertiary care teaching hospital for five months from November 2019 to March 2020. Two sessions of FGD were carried out involving 7 students in each session. One session of FGD was conducted involving 7 mentors. The feedback was collected with a pre validated questionnaire containing 10 questions (8 close ended and 2 open ended). Feedback of closed ended questions were obtained by using a 5-point Likert scale (1 to 5) where 5 indicated ‘Strongly Agree’ and 1 indicated ‘Strongly Disagree’ RESULTS Most of the mentees (86.7%) and mentors (66.7%) mentioned that mentorship program is necessary for the welfare of the students. However, it was also noted that better communication and frequent meetings can improve the outcome of the program. CONCLUSIONS Mentorship program is deemed essential, however, a well-structured framework and dedicated time from both mentors and mentees will make the program more successful. This type of feedback evaluation is however important to validate such program.


Author(s):  
Jeremy J Moeller ◽  
Joelius Kurniawan ◽  
Gordon J Gubitz ◽  
John A Ross ◽  
Virender Bhan

Background:Previous studies describe significant rates of misdiagnosis of stroke, seizure and other neurological problems, but there are few studies examining diagnostic accuracy of all emergency referrals to a neurology service. This information could be useful in focusing the neurological education of physicians who assess and refer patients with neurological complaints in emergency departments.Methods:All neurological consultations in the emergency department at a tertiary-care teaching hospital were recorded for six months. The initial diagnosis of the requesting physician was recorded for each patient. This was compared to the initial diagnosis of the consulting neurologist and to the final diagnosis, as determined by retrospective chart review.Results:Over a six-month period, 493 neurological consultations were requested. The initial diagnosis of the requesting physician agreed with the final diagnosis in 60.4% (298/493) of cases, and disagreed or was uncertain in 35.7% of cases (19.1% and 16.6% respectively). In 3.9% of cases, the initial diagnosis of both the referring physician and the neurologist disagreed with the final diagnosis. Common misdiagnoses included neurocardiogenic syncope, peripheral vertigo, primary headache and psychogenic syndromes. Often, these were initially diagnosed as stroke or seizure.Conclusions:Our data indicate that misdiagnosis or diagnostic uncertainty occurred in over one-third of all neurological consultations in the emergency department setting. Benign neurological conditions, such as migraine, syncope and peripheral vertigo are frequently mislabeled as seizure or stroke. Educational strategies that emphasize emergent evaluation of these common conditions could improve diagnostic accuracy, and may result in better patient care.


2013 ◽  
Vol 12 (3) ◽  
pp. 44-48
Author(s):  
Joyabrata Das ◽  
Subash Majumdar ◽  
Subrata Das ◽  
Saiem Nurul Anwar ◽  
Hossain Ahmed ◽  
...  

Background: The liver is the organ most subjected to the development of abscesses and made up 48 % of all visceral abscesses' and 7% of all intra abdominal abscesses. Liver abscess should be suspected when there is a combination of fever, leucocytosis, constitutional symptoms, and pain in the right upper quadrant, and tenderness over the liver or right lower rib cage. The liver is affected by a number of local and disseminated infections; their frequency and types vary considerably around the world. Parasitic disorders are more prevalent in developing countries. Methods: It was a cross-sectional descriptive study. The cases were taken from the admitted patients of Medicine unit of SMCH, Chittagong. The study was conducted over a period of one year with a sample size of 50 patients and sample was taken by purposive sampling. Results: Among 50 patients 40 (80%) were diagnosed as ALA and 10 (20%) were diagnosed as PLA. ALA cases are common in 21-30 years age group & PLA cases are more common in >50 years of age group. Majority of the cases were from rural area. Common clinical features were fever, abdominal pain, nausea and tender hepatomegaly. Diarrhea was present on admission in 7 (15.9%) patients of ALA. Anaemia was common in both but polymorphonuclear leucocytosis was moderate to severe in PLA. Microscopic examination of stool samples for E. Histolytica trophozoites was positive in 3 (7.5%) cases and cysts in 4(10%) cases. Nine patients had right sided pleural effusion. Conclusions: Clinical features are common in both ALA and PLA. Liver abscesses are more common in men and more prevalent in rural areas. ALA more commonly occurs in 21-30 years age group but can occur at any age. Pyogenic abscess is more common in older age group (>50 years) and E. Coli is the commonest organism. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 44-48


Author(s):  
Abu Hasan Sarkar ◽  
Bishnu Ram Das

Background: Japanese encephalitis (JE) is of particular interest as it has a high morbidity and mortality. Neurological sequale is the most dreaded damage caused by JE. It is a preventable disease with specific interventions. The objective of the study was to study the demography, clinical profile and outcome of patients with Japanese Encephalitis admitted to the wards of Internal Medicine and Pediatrics at Jorhat Medical College Hospital.Methods: Hospital based observational study for one year in Jorhat Medical College, Jorhat, Assam.Results: The mean age for JE was 32.25±27 years for male, 27.47±22 years for female and 29.94±24 years overall. Assessment of clinical signs and symptoms showed that fever and change in mental status were present in 100% of JE cases followed by neck rigidity in 79.3% and headache in 68.9%. 44.8% of JE cases had history of seizure, 37.9% had vomiting, 34.5% had irritability, 13.8% were unconscious. The peak of JE incidence occurred in the month of July (77.6%). Complete recovery was seen in 39.2%, followed by death in 32.6% and recovery with neurological sequalae in 28.2% at the time of discharge.Conclusions: Vigorous awareness activities should be carried out to sensitize people on prevention of JE. 


2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.


JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 24-30
Author(s):  
Susan Jalali ◽  
Shahnawaz Hamid Khan ◽  
Farooq A Jan ◽  
Illahay Jalali

Introduction: Poisoning is a common medico-social problem. It is a significant contributor to morbidity and mortality. Knowledge of the epidemiology of poisoning and its changes is important to both emergency physicians and public health practitioners. Our study was to determine the socio-demographic profile, pattern and outcome of the poisoning cases reported to the Emergency Department of a tertiary care hospital. Methods: The study was a Retrospective observational type of study conducted at Sheri-Kashmir Institute of medical sciences, Srinagar J&K.  The patients with acute poisonings presenting to and managed in the Emergency Medicine department between February 2016 to February 2018 were reviewed for inclusion. Data was collected by reviewing records . Using a pre-structured format, case records of poisoning cases were reviewed for gender, age, residence, type of poison, route of poison and outcome of treatment. The collected data was analyzed using descriptive statistical analysis. Results: In the present study the Female: male ratio was 1.9:1 (131 Females and 68 Males).Females outnumbered the males. Highest cases of Poisoning were reported in the age group of 10-20 years. The poisoning in extreme of ages was less observed. Maximum cases of Poisoning belongs to rural areas (60.8%). The most common implicating agents were Pesticides (75.3%). The second common cause of poisoning was drug overdose (20.52%) Maximum cases recovered after treatment (94%). Conclusion: Pattern and magnitude of poisoning are multidimensional and demand multi-sectorial approach for facing this problem. There is a need for stringent pesticide regulation laws and counseling and training programs to reduce the incidence of poisonings. JMS 2018;21(1):24-30


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