A STUDY OF STATUS OF RETRIEVAL MECHANISM FOR PATIENTS TAKING ANTITUBERCULAR TREATMENT UNDER NTEP

2021 ◽  
pp. 47-49
Author(s):  
Jai Kishan ◽  
Achchhar Singh ◽  
Puneet Aggarwal
Keyword(s):  
Tertiary Care ◽  
Respiratory Medicine ◽  
Tertiary Care Centre ◽  
The Past ◽  
Antitubercular Treatment ◽  
The Status ◽  
History Of ◽  
Retrieval Mechanism ◽  
Lost To Follow Up

Introduction--A observational study was conducted in the Department Of Respiratory Medicine in a tertiary care centre who were taking ATT under DOTS or had history of ATTconsumption in the past. Aim :Aim of the study was to evaluate the status of a retrieval mechanism for patients who are lost to follow-up and to identify the strengths and weakness in the dispersal of medications, monitoring and follow-up of patients and status of retrieval mechanism. Materials and Methods: The study was carried out among 201 patients coming to the Department of Respiratory Medicine who were on ATTunder DOTS or had received ATTin the past. Demographic details and clinical ndings were noted. Data collected was entered into Excel spread sheet and quantitative data were expressed as number and percentage. Results- Among 201 participants 17.4% missed their doses whereas 82.6% of the participants took their medications regularly. Among the patients who missed their doses retrieval actions were taken in only 42.9%participants.Among those participants in whom retrieval actions were taken 14.3% were lost to follow up,97.14 % of the participants who missed their doses received multiple days medications. Besides this, 80% of the participants who missed their doses suffered from adverse effects of ATTduring their course of treatment. Conclusion—From this study we conclude that under NTEPmajority of patients are taking ATT regularly but regular follow-up of patients on ATT and retrieval action is not upto the mark and it should be strengthened to prevent development of DRTB and its spread in the community.

A STUDY OF PATIENT’S PROSPECTIVE ABOUT QUALITY OF DIRECTLY OBSERVED TREATMENT SERVICES (DOTS

2021 ◽  
pp. 60-61
Author(s):  
Achchhar Singh ◽  
Puneet Aggarwal ◽  
Jai Kishan
Keyword(s):  
Tertiary Care ◽  
Respiratory Medicine ◽  
Tertiary Care Centre ◽  
The Past ◽  
Treatment Services ◽  
Laboratory Facility ◽  
Directly Observed Treatment ◽  
History Of ◽  
Compliance To Treatment

Introduction--A observational study was conducted in the Department Of Respiratory Medicine in a tertiary care centre who were taking ATT under DOTS or had history of ATTconsumption in the past. Aim :Aim of the study was to 1. To see the patient's perspective of the DOTS services. 2. Behaviour of the DOTS provider,3. Facilities available at the DOTS centre. 4. Waiting period. Materials and Methods: The study was carried out among 201 patients coming to the Department of Respiratory Medicine who were on ATT under DOTS or had received ATT in the past. Demographic details and clinical ndings were noted. Data collected was entered into Excel spread sheet and quantitative data were expressed as number and percentage. Results- In our study among the 201 participants who were on ATTor had history of ATTconsumption in the past, 36.8% of the participants found the attitude of DOTS providers as supportive and helpful. A slightly higher 37.3% people had neutral opinion about it. A huge 70.6% of the participants were satised with the services at the DOTS centre. A good 56.7% of the participants were of the opinion that all their queries concerning TB were satisfactorily answered. Agood 66.7% of the participants were comfortable with the waiting time at the DOTS centre. About half (53.2%) of the participants were satised with the laboratory facility and availability of drugs. 51.7% of the participants were satised with the DOTS provider. Conclusion—. Our study analysed the various aspects of interaction of patient with the DOTS provider and DOTS centre and to judge its efciency in delivering DOTS services. Our study found that DOTS provider is very important for compliance to treatment and patient satisfaction and must for completion of the treatment and we must strengthen the services

scholarly journals Retrospective analysis of paediatric tracheostomy in Indian tertiary care centre

2020 ◽  
Vol 6 (3) ◽  
pp. 533
Author(s):  
Digant Patni ◽  
Vishal R. Munjal
Keyword(s):  
Retrospective Analysis ◽  
Tertiary Care ◽  
Care Facility ◽  
Tertiary Care Centre ◽  
Prolonged Intubation ◽  
Changing Trend ◽  
Lost To Follow Up ◽  
Neurological Infection ◽  
Related Mortality

<p class="abstract"><strong>Background:</strong> Tracheostomy is frequently performed surgical procedure. The present study was carried out to assess data on various indications, surgical issues if any, complications and outcomes of paediatric tracheostomy.</p><p class="abstract"><strong>Methods:</strong> This study is a retrospective analysis of 32 paediatric patients between 1 to 12 years of age, who underwent tracheostomy at SAIMS, Indore between June 2015 to June 2019. Data was analysed in terms of patient age, sex, emergency or planned procedure, any surgical challenge, complications and post-operative follow up.  </p><p class="abstract"><strong>Results:</strong> Majority of patients were of prolonged intubation due to respiratory and laryngotracheobronchitis (15.6%) each, neuromuscular disease (15.6%), seizure disorder (9.4%), metabolic disease (9.4%) and neurological infection (6.3%). Obstructive causes included head injury (9.4%), sub-glottic stenosis (6.3%), malignancy (6.3%) and craniofacial anomaly (3.1%). Common complication encountered were partial blockage of tube, peri-stomal granulation and accidental decannulation. There was no tracheostomy related mortality in this study. Out of 32 patients, 16 were successfully decannulated, 6 were lost to follow up, 6 could not be decannulated and 4 expired due to worsening of primary disease.</p><p class="abstract"><strong>Conclusions:</strong> There is a changing trend in indications of tracheostomy and overall complications have reduced due to trained team and better care facility.</p>

scholarly journals When the Disease is Known but the Patient is not. Outcome of 118 such Patients at a Tertiary Care Centre

2018 ◽  
Vol 32 (2) ◽  
pp. 505-512
Author(s):  
Gaurav Jaiswal ◽  
Praveen Kumar Tripathi ◽  
Vardan Kulshreshtha ◽  
Tarun Kumar Gupta
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Tertiary Care ◽  
Good Recovery ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Discharged Patients ◽  
History Of ◽  
A Prospective Study ◽  
Lost To Follow Up

Abstract This is a prospective study, carried out at the Department of Neurosurgery at M.B.G Hospital, R.N.T Medical College, Udaipur, Rajasthan (India). Many patients with history of trauma with head injury, whose identity cannot be ascertained, are admitted in our hospital. The management of these unattended patients from pre-hospital till discharge, rehabilitation or death is full of difficulties especially when surgical intervention has to be done. From March 16, 2015, until March 30, 2016, 118 consecutive patients unattended patients admitted in our department with history of head injury were enrolled in the study. Out of 118 patients, 107 (91%) were male, most were in the age group of 30-39 years. In majority of patients, 115 (97%) principal cause of head injury was road traffic accident. Majority of the patients 49 (41%) had Glasgow coma scale >13 on admission. Twenty three patients 23 (20%) died in hospital, 71 (60%) patients had good recovery. During the course of treatment identity of 115 patients was established and 92 (78%) patients, who survived were discharged to home. Three (3%) patients were shifted to destitute home. All discharged patients were followed at 1 month and 6 month interval. 78 (82%) & 76 (80%) patients showed good recovery (GOS) at 1 month & 6 month respectively. One patient expired at home within one month of discharge and 6 patients lost to follow up at 6 months.

scholarly journals Pre-treatment lost to follow up among presumptive tuberculosis patients in a tertiary care centre, South India

2020 ◽  
Vol 7 (6) ◽  
pp. 2266
Author(s):  
Revathi Ulaganeethi ◽  
Divya Nair ◽  
Gomathi Ramaswamy ◽  
Shivangi Choubey ◽  
Saka Vinod Kumar ◽  
...  
Keyword(s):  
Sputum Sample ◽  
Tertiary Care ◽  
Drop Out ◽  
Sputum Smear ◽  
Referral Letter ◽  
Tertiary Care Centre ◽  
The Common ◽  
Pre Treatment ◽  
Lost To Follow Up

Background: At tertiary care centres, presumptive tuberculosis (TB) patients who come from far off places and are more likely to drop out during diagnosis or before treatment initiation. We aimed to describe the proportion lost during diagnosis or before treatment and also assessed the reasons for the loss to follow up.Methods: We did a hospital based descriptive study, reviewing laboratory register and referral register to assess the status of submission of second sputum and referral letter, respectively, for patients visiting a designated microscopy centre at a teaching hospital. Reasons for lost to follow up were assessed through telephonic interviews.Results: Out of a total 2025 presumptive TB patients, 315 (15.6%, 95% CI 14.0-17.2) did not provide a second sputum sample. ‘Symptoms had reduced or subsided’ (30%), ‘not aware that second sample needs to be given’ (23%) and ‘visited other hospital’ (14%) were the common reasons reported for the same. A total of 270 (13.3%) patients were sputum smear positive; of them 92 (34.1% CI 28.4-40.1) did not collect referral letter. Among those who were referred, 66% were referred within a week. Deaths, ‘busy in routine work’ and treatment at other government hospitals were the common reasons reported for not collecting referral letter.Conclusions:One out of seven patients did not submit a second sputum sample and one third of sputum smear positive TB patients did not collect the referral letter. Follow up mechanisms needs to be strengthened in the national program to reduce this pre-treatment lost to follow up.  

scholarly journals Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Bryan Walker ◽  
Eric Heidel ◽  
Mahmoud Shorman
Keyword(s):  
Staphylococcus Aureus ◽  
Rare Complication ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Risk Patients ◽  
History Of ◽  
A Site ◽  
Lost To Follow Up

Abstract Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

896 THE NATURAL HISTORY OF IDIOSYNCRATIC DRUG-INDUCED LIVER INJURY (DILI): FOLLOW-UP IN A COHORT OF PATIENTS IDENTIFIED IN A SINGLE TERTIARY CARE CENTRE

2008 ◽  
Vol 48 ◽  
pp. S336 ◽  
Author(s):  
B. Garcia-Munoz ◽  
S. Lopez-Ortega ◽  
Y. Borraz ◽  
A. Fernandez Castaner ◽  
M.C. Lopez-Vega ◽  
...  
Keyword(s):  
Liver Injury ◽  
Natural History ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
History Of

Unruptured intracranial aneurysms in children: 18 years’ experience in a tertiary care pediatric institution

2019 ◽  
Vol 24 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Daniel-Alexandre Bisson ◽  
Peter Dirks ◽  
Afsaneh Amirabadi ◽  
Manohar M. Shroff ◽  
Timo Krings ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Natural History ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Tertiary Care ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Mean Size

OBJECTIVEThere are little data in the literature on the characteristics and natural history of unruptured intracranial aneurysms in children. The authors analyzed their experience with unruptured intracranial aneurysms in the pediatric population at their tertiary care pediatric institution over the last 18 years. The first objective was to assess the imaging characteristics and natural history of these aneurysms in order to help guide management strategies in the future. A second objective was to evaluate the frequency of an underlying condition when an incidental intracranial aneurysm was detected in a child.METHODSThe authors conducted a Research Ethics Board–approved retrospective review of incidental intracranial aneurysms in patients younger than 18 years of age who had been treated at their institution in the period from 1998 to 2016. Clinical (age, sex, syndrome) and radiological (aneurysm location, type, size, thrombus, mass effect) data were recorded. Follow-up imaging was assessed for temporal changes.RESULTSSixty intracranial aneurysms occurred in 51 patients (36 males, 15 females) with a mean age of 10.5 ± 0.5 years (range 9 months–17 years). Forty-five patients (88.2%) had a single aneurysm, while 2 and 3 aneurysms were found in 3 patients each (5.8%). Syndromic association was found in 22 patients (43.1%), most frequently sickle cell disease (10/22 [45.5%]). Aneurysms were saccular in 43 cases (71.7%; mean size 5.0 ± 5.7 mm) and fusiform in the remaining 17 (28.3%; mean size 6.5 ± 2.7 mm). Thirty-one aneurysms (51.7%) arose from the internal carotid artery (right/left 1.4), most commonly in the cavernous segment (10/31 [32.3%]). Mean size change over the entire follow-up of 109 patient-years was a decrease of 0.6 ± 4.2 mm (range −30.0 to +4.0 mm, rate −0.12 ± 9.9 mm/yr). Interval growth (2.0 ± 1.0 mm) was seen in 8 aneurysms (13.3%; 4 saccular, 4 fusiform). An interval decrease in size (8.3 ± 10.7 mm) was seen in 6 aneurysms (10%). There was an inverse relationship between aneurysm size and growth rate (r = −0.82, p < 0.00001). One aneurysm was treated endovascularly with internal carotid artery sacrifice.CONCLUSIONSUnruptured pediatric intracranial aneurysms are most frequently single but can occur in multiples in a syndromic setting. None of the cases from the study period showed clinical or imaging signs of rupture. Growth over time, although unusual and slow, can occur in a proportion of these patients, who should be identified for short-term imaging surveillance.

scholarly journals Spectrum of pediatric renal tumors in a tertiary care centre: Is diagnostic biopsy thing of the past or still an important tool?

2020 ◽  
Vol 5 (4) ◽  
pp. S44
Author(s):  
Ritika Khurana ◽  
Ajay Sharma ◽  
Parth Ganatra ◽  
V.P. Krishnan ◽  
Purva Kanvinde ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Renal Tumors ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
The Past ◽  
Diagnostic Biopsy

scholarly journals IsHelicobacter pyloriBeing Treated Appropriately? A Study of Inpatients and Outpatients in a Tertiary Care Centre

2007 ◽  
Vol 21 (5) ◽  
pp. 285-288 ◽  
Author(s):  
Jose Nazareno ◽  
David K Driman ◽  
Paul Adams
Keyword(s):  
Tertiary Care ◽  
Gastric Biopsy ◽  
Pathology Report ◽  
Tertiary Care Centre ◽  
Delivery Of Care ◽  
Ulcer Disease ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
H Pylori

BACKGROUND:Helicobacter pyloriis causally associated with peptic ulcer disease and gastric cancer. Although effective treatment is available, studies have shown that patients withH pyloriare often not well managed. Recently, there has also been increasing awareness of patient safety concerns arising from missed follow-up of abnormal test results.OBJECTIVE: To examine whether inpatients and outpatients diagnosed withH pylorireceive appropriate treatment.PATIENTS AND METHODS: All patients who were diagnosed withH pyloriby gastric biopsy in London, Ontario between January 1, 2004, and December 31, 2004, were identified. The hospital charts of these patients were reviewed. Outpatient office charts, clinic notes, pathology reports and endoscopy reports were also reviewed.RESULTS: One hundred ninety-three patients were diagnosed withH pyloriby gastric biopsy in 2004. Of the 193 patients, 143 (74%) were outpatients and 50 (26%) were inpatients. Overall, 89% of patients received treatment forH pylori. Ninety-two per cent of outpatients were treated, while only 60% of inpatients received treatment (P<0.001). Among the inpatients, the pathology report was available in 40% of the cases before the patient was discharged from the hospital. After discharge from the hospital, 30% of inpatients received appropriate treatment and follow-up. There was no significant difference in treatment whether the patient was admitted to a medical or a nonmedical service.CONCLUSION:H pyloriis treated relatively poorly in inpatients compared with outpatients. Results of the present study reveal opportunities to improve delivery of care for inpatients on a number of different levels. More research is needed to ensure safety, effectiveness and timeliness in the test result management process.

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