scholarly journals Establishment of CTPA Local Diagnostic Reference Levels with Noise Magnitude as a Quality Indicator in a Tertiary Care Hospital

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 680
Author(s):  
Hanif Haspi Harun ◽  
Muhammad Khalis Abdul Karim ◽  
Mohd Amiruddin Abd Rahman ◽  
Hairil Rashmizal Abdul Razak ◽  
Iza Nurzawani Che Isa ◽  
...  
Keyword(s):  
Body Size ◽  
Quality Indicator ◽  
Tertiary Care ◽  
Pulmonary Arteries ◽  
The Body ◽  
Care Hospital ◽  
Diagnostic Reference Levels ◽  
Ct Scanner ◽  
Reference Levels ◽  
Dose Length Product

This study aimed to establish the local diagnostic reference levels (LDRLs) of computed tomography pulmonary angiography (CTPA) examinations based on body size with regard to noise magnitude as a quality indicator. The records of 127 patients (55 males and 72 females) who had undergone CTPAs using a 128-slice CT scanner were retrieved. The dose information, scanning acquisition parameters, and patient demographics were recorded in standardized forms. The body size of patients was categorized into three groups based on their anteroposterior body length: P1 (14–19 cm), P2 (19–24 cm), and P3 (24–31 cm), and the radiation dose exposure was statistically compared. The image noise was determined quantitatively by measuring the standard deviation of the region of interest (ROI) at five different arteries—the ascending and descending aorta, pulmonary trunk, and the left and right main pulmonary arteries. We observed that the LDRL values were significantly different between body sizes (p < 0.05), and the median values of the CT dose index volume (CTDIvol) for P1, P2, and P3 were 6.13, 8.3, and 21.40 mGy, respectively. It was noted that the noise reference values were 23.78, 24.26, and 23.97 HU for P1, P2, and P3, respectively, which were not significantly different from each other (p > 0.05). The CTDIvol of 9 mGy and dose length product (DLP) of 329 mGy∙cm in this study were lower than those reported by other studies conducted elsewhere. This study successfully established the LDRLs of a local healthcare institution with the inclusion of the noise magnitude, which is comparable with other established references.

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

Establishing local diagnostic reference levels for adult computed tomography in Morocco

2022 ◽  
Author(s):  
M. El Mansouri ◽  
M. Talbi ◽  
A. Choukri ◽  
O. Nhila ◽  
M. Aabid
Keyword(s):  
Computed Tomography ◽  
Adult Patients ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Head Ct ◽  
Ct Examination ◽  
Japanese Studies ◽  
The Uk

In Morocco, the radiation doses received by adult patients are increasing due to the number of CT examinations performed and the larger number of computed tomography (CT) scanners installed. The aim of this study was to evaluate the radiation doses received by patients for the most common adult CT examinations in order to establish local diagnostic reference levels (DRLs). Data from 1016 adult patients were collected during 3 months from four Moroccan hospitals. Dose length product (DLP) and volumetric computed tomography dose index (CTDIvol) were evaluated by determining the 75th percentile as diagnostic reference levels for the most common examinations including head, chest and abdomen. The DRL for each examination was compared with other studies. The established DRLs in Morocco in terms of CTDIvol were 57.4, 12.3 and 10.9 for CT examinations of the head, chest, abdomen, respectively. For DLP, they were 1020, 632 and 714, respectively. These established DRLs for CTDIvol were almost similar to the UK DRLs at all examinations, higher than the Egyptian DRLs and lower than the Japanese DRLs at the head CT examination, lower than the DRLs from Egypt and Japan at the CT abdomen examination. In terms of DLP, the DRLs were higher than those of the British studies, lower than those of the Egyptian and Japanese studies at the head CT examination were higher at chest CT and lower at abdominal CT than those of all selected studies. The higher level of established DRLs in our study demonstrates the requirement of an optimization process while keeping a good image quality for a reliable diagnosis.

scholarly journals A comparative study of impact on cognitive function between diabetic and non-diabetic patients in a tertiary care hospital

2018 ◽  
Vol 7 (8) ◽  
pp. 1547
Author(s):  
Dharnaben A. Patel ◽  
Dhruv J. Patel ◽  
N. D. Kantharia
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Tertiary Care ◽  
The Body ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Proper Understanding ◽  
History Of ◽  
Control Of Diabetes ◽  
The Brain

Background: Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia, polyuria, hyperlipidemia etc, resulting from defects in insulin secretion, insulin action or both. It affects various organs of the body including the brain. Cognitive function is the thinking process of the brain. In any chronic disease evaluation of cognitive function is justified as it may affect various common day to day activities.Methods: It is a prospective, observational and non-interventional study. Thirty diabetic patients who were recently started on insulin i.e. within 7 days were enrolled in the study based on inclusion and exclusion criteria. Thirty non diabetic healthy individuals served as a control. Cognitive function was accessed by Adenbrooke’s Cognitive Examination (ACE III) at the time of enrollment.Results: The results were analysed using paired t-test. Attention, Memory and Visiospatial ability was significantly reduced in diabetic patients compared to control. Verbal fluency and language was also reduced but the change was not significant. Total ACE III score was significantly reduced in diabetic patients compared to control.Conclusions: Cognitive function is significantly reduced in Diabetic patients recently started on insulin. Hyperglycemia could be the possible reason of cognitive decline. Proper understanding of the natural history of Diabetes and the pathogenesis of cognitive decline as well as control of Diabetes can help to prevent development of cognitive dysfunction.

SONOGRAPHIC MEASUREMENTS OF SCROTAL WALL THICKNESS

2021 ◽  
pp. 31-32
Author(s):  
Sahil Gandhi ◽  
Asit Natekar
Keyword(s):  
Wall Thickness ◽  
Tertiary Care ◽  
The Body ◽  
Wall Thickening ◽  
Temperature Sensitive ◽  
Main Function ◽  
Care Hospital ◽  
Sperm Production ◽  
Time Duration ◽  
Anterior Posterior

Main function of scrotum is to hold testes at optimal temperature for spermatogenesis. Sperm production in the testes is a temperature sensitive process. It requires an environment that is 2 to 6°C cooler than the body core. The temperature of the testes is regulated by the scrotal wall. Tunica dartos muscle changes the surface area of the scrotal skin by contracting or relaxing depending on the ambient temperature. This study postulates that if the thickness or the tone of this muscle is more thereby contributing to scrotal wall thickening, it will hamper the thermoregulation and spermatogenesis leading to poor sperm production. This could be an besides varicocoele another cause of male infertility which has been an established cause. This study will help to suspect the patients of infertility caused by thick scrotal wall. This study is aimed to study scrotal wall thickness and with the help of Ultrasonography. to establish norms The study was conducted at department of Radio-diagnosis at the tertiary care hospital, Sangli. The study started after approval of institutional ethical committee. This is a cross sectional observational study for the duration of 4 months. Total number of 50 cases was achieved in this time duration which satised the inclusion criteria. Statistical method used was Student's T test. Scrotal ultrasonography was performed using linear and curvilinear probe with sta (5-12 MHz) (2-5 MHz) on Philips Afniti50, after ndoff pad allowing some time for the dartos muscle to relax and scrotal wall thickness is measured on either side on three surfaces (anterior, posterior and lateral) and means were obtained. This study found that there was no difference between anterior, posterior, lateral wall thicknesses on ipsilateral side or contralateral side. There is no need to take three different wall thicknesses and convenience and suitability of any scrotal wall thickness would be equally effective.

Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

2021 ◽  
Vol 17 (3) ◽  
pp. 216-221
Author(s):  
Fawad Yasin ◽  
Anum Rasheed ◽  
Muhammad Nauman Malik ◽  
Farheen Raza ◽  
Ramish Riaz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
European Commission ◽  
Large Scale ◽  
Radiology Department ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Ct Dose

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length

scholarly journals MP008: Quick to be seen; quick to come back: does first visit CTAS-category predict admission for unplanned returns?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S68-S69
Author(s):  
D. Lewis ◽  
P.R. Atkinson ◽  
J. Fraser ◽  
M. Howlett
Keyword(s):  
Quality Indicator ◽  
Tertiary Care ◽  
Admission Rate ◽  
Care Hospital ◽  
Exact Test ◽  
Admission Rates ◽  
Triage Category ◽  
Important Quality ◽  
Return Visits ◽  
To Come

Introduction: The percentage of unplanned return visits (URV) to the Emergency Department (ED) within 48 or 72 hours of discharge that result in an admission to hospital has been recommended as the top Canadian ED patient safety quality indicator. International data exists although inconsistences exist in the way URV are defined and measured. To our knowledge there are no published Canadian data on the percentage of ED URV admissions. This study examines our own URV data and in particular the correlation between URV admission rates and first visit Canadian Triage Acuity Scale (CTAS) category. Methods: A retrospective analysis of 12-month’s data (January - December 2015) was completed for URV to the ED of a 445 bed regional tertiary care adult and pediatric teaching hospital with 57,000 annual attendances. URV was defined as any patient registering within 72 hours of an earlier visit that had resulted in a discharge from ED. Planned return visits were excluded. The data was analysed for an overall URV percentage, UV percentage by first visit CTAS category, overall percentage of URV admitted and URV admission percentage by first visit CTAS category. Pearson R correlation and Fishers Exact Test were used to test the relationship. Results: During the 12-month period there were 57,025 registrations of which 46,793 patients were discharged. There were 3566 URV (7.62% of those discharged); the number of URV admitted was 532 (1.14 % of those discharged). The return rate/admission rates by CTAS category were: CTAS 1: 6.74%/1.55%; CTAS 2: 7.86%/1.92%; CTAS 3: 8.54%/1.35%; CTAS 4: 5.99%/0.40%; CTAS 5: 5.55%/0.27%. The RR of admission on return for discharged CTAS groups 1 and 2, compared with CTAS 3, 4 and 5 was 1.90 (95 CI 1.57 to 2.30; p<0.0001). Rate of admission on return was negatively correlated with initial CTAS level (Pearson r = -0.89 (95 CI -0.99 to -0.03); R2=0.79; F=11.25; p=0.04). Conclusion: We have demonstrated a relationship between first visit CTAS category and the unplanned return admission rate. If admission is taken as a marker of illness severity, then the likelihood of an inappropriate discharge is inversely proportional to first visit CTAS score. While this makes sense intuitively, our data confirms this relationship in a Canadian tertiary care hospital and supports the reporting of ED URV admission data by first visit triage category as an important quality indicator.

scholarly journals Outcome of Internal Fixation of Metacarpal Fractures of Hand at a Tertiary Care Hospital, Kathmandu

2019 ◽  
Vol 21 (1) ◽  
pp. 35-39
Author(s):  
Praphulla Shrestha ◽  
SR Paudel ◽  
P Chalise
Keyword(s):  
Pain Relief ◽  
Internal Fixation ◽  
Tertiary Care ◽  
Kirschner Wire ◽  
The Body ◽  
Care Hospital ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Hand Fractures

Hand fractures are different from other fractures elsewhere in the body. Functional impairment of hand leads to a prominent issue to the patient. We have a common practice of treatment of hand fractures by using kirschner wire(s). The internal fixation using plates and screws for metacarpal fractures of the hand is technically demanding but it is beneficial to the patients as it permits early mobilization and better pain relief. We studied the outcome of this type of internal fixation of the metacarpal fractures at Nepal Medical College. We included 26 patients above 18years with isolated extraarticular, closed and open Swanson I metacarpal fractures of the hand. Fractures with rotation of the digit and unacceptable angulation, shortening and unstable fractures were included. Pain was evaluated by visual analogue scale and function using American Society for Surgery of hand Total Active Flexion (ASSHTAF) score. The mean pain score (VAS) was 0.27 at 12 weeks. The ASSHTAF score showed excellent results in 92.3% patients at 12 weeks. At the final follow up 92.3% patients had excellent results, 3.8% had good and 3.8% had poor results. Fracture union was seen in all patients at final follow up. The study shows that internal fixation of unstable metacarpal fractures gives significant pain relief to the patient and an excellent functional outcome.

ADULT CT EXAMINATIONS IN ALGERIA: TOWARDS UPDATING NATIONAL DIAGNOSTIC REFERENCE LEVELS

2020 ◽  
Vol 190 (4) ◽  
pp. 364-371
Author(s):  
Nadia Khelassi-Toutaoui ◽  
Ahmed Merad ◽  
Virginia Tsapaki ◽  
Fouzia Meddad ◽  
Zakia Sakhri-Brahimi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Institutional Evaluation ◽  
Starting Point ◽  
First Results ◽  
Ct Radiation ◽  
Computed Tomography Dose Index

Abstract A pilot study has concerned the most frequent computed tomography examinations (CT). This represents the first results based on actual survey for diagnostic reference levels (DRLs) establishment in Algeria. A total number of 2540 patients underwent this survey that has included the recording of CT parameters, computed tomography dose index (CTDIvol) and dose-length product of the head, thorax, abdomen, abdomen–pelvis (AP), lumbar spine (LS) and thorax–abdomen–pelvis (TAP) performed on standard patients. The proposed DRLs are 71 mGy/1282 mGy.cm for head, 16 mGy/555 mGy.cm for thorax, 18 mGy/671 mGy.cm for abdomen, 21 mGy/950 mGy.cm for AP, 36 mGy/957 mGy.cm for LS and 18 mGy/994 mGy.cm for TAP. The rounded 75th percentile seems to be higher in some examinations compared to the literature. Our findings confirm the need to optimise our practice. These results provide a starting point for institutional evaluation of CT radiation doses.

scholarly journals Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

2018 ◽  
Vol 10 (03) ◽  
pp. 332-337 ◽  
Author(s):  
Amit Banik ◽  
Sanjeev H. Bhat ◽  
Abhay Kumar ◽  
Agnijeet Palit ◽  
Kandregula Snehaa
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
The Body ◽  
Diffusion Method ◽  
Blood Collection ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Disk Diffusion Method ◽  
Antimicrobial Sensitivity

ABSTRACT PURPOSE: Bloodstream infection can range from inapparent bacteremia until fulminant septic shock with high mortality. Microorganisms present in circulating blood whether continuously, intermittently, or transiently are a threat to every organ in the body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy. OBJECTIVE: The objective of this study was to perform bacteriological analysis and assess drug sensitivity patterns of isolates from blood stream infections. DESIGN: Retrospective observational study was conducted from May 2015 to February 2017 at a tertiary care hospital, Port Blair, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified using standard biochemical tests and subjected to sensitivity testing according to Modified Kirby–Bauer’s disk diffusion method. Data for the source of blood collection and duration of incubation were noted and compared. RESULTS: A total of 270 (14.24%) pathogens were isolated from 1895 bacteremia suspect patient blood specimens. Contamination was observed at a rate of 1.63%. Gram-positive cocci (60.37%) were predominant organisms recovered followed by Gram-negative Bacilli (36.29%) and Yeasts (3.33%). Staphylococcus aureus, CoNS, and Acinetobacter spp. were the primary pathogens isolated. Aminoglycosides, carbapenems, and glycopeptides were the most effective drugs for treating bacteremia. CONCLUSIONS: Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

Sign in / Sign up

Export Citation Format

Share Document