scholarly journals EPIDEMIOLOGICAL ANALYSIS OF DORSAL SPINE INJURIES IN WESTERN INDIA

2020 ◽  
pp. 1-3
Author(s):  
Pratik H. israni ◽  
Deepak P. Agrawal ◽  
Aniket M Gupta ◽  
Sharad P. Parmar
Keyword(s):  
Early Recognition ◽  
Pelvic Trauma ◽  
Dorsal Spine ◽  
Western India ◽  
Average Delay ◽  
Cross Sectional ◽  
Lower Limb Injury ◽  
Epidemiological Analysis ◽  
Chest Injuries ◽  
Spine Injuries

BACKGROUND: To do epidemiological analysis of the patients with injuries of the spine involving dorsal vertebrae fractures including D1-D9 across western India. This is a cross sectional retrospective analysis of patient with spinal injuries who had D1-D9 level in Civil hospital from January 2018 to December 2019. Our study included 83 patients with detailed history and medical records were analyzed. RESULTS: 83 patients out of which 6:1 M:F ratio & max patients from 30-40 year age group, 53% injured from fall from height, RTA (38%),average injury to hospital delay was 5.7 days , 5 patients of lower limb injury , 2 of upper limb trauma 2 of chest injuries 2 with abdominal and pelvic trauma were associated injuries, average delay in surgery was 4.5 days. ASIA grade at admission was 47 (57%) grade A, 23(27%) grade B, 8(9%) from grade C, 5(7%) of grade D and 0(0%) from grade E. and 46(55%) patients managed conservatively ,37(45%) were managed surgically. The rehabilitation was taken up by 82 (97%) and status of the patient related to bedsores was no bedsores developed in 48 patients (58%) while <10 cm bedsore developed in 19 patients((22%) and >10cm bedsore developed in 16 patients(20%). CONCLUSION : Dorsal spine injuries with SCI required urgent and early recognition and specialized management protocols .The infrastructure in India needs to upgrade awareness, education, patient transportation networks, increase the number of tertiary spinal trauma units spine rehabilitation services might improve spine trauma care.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

scholarly journals Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire
Keyword(s):  
Perinatal Death ◽  
Early Recognition ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Maternal Outcomes ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Common Causes

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed

scholarly journals Study of cardiac manifestations in hypothyroid patients admitted in tertiary care centre

2021 ◽  
Vol 8 (12) ◽  
pp. 1852
Author(s):  
Parshv P. Shah ◽  
Harvy Parikh ◽  
Hemant Shah ◽  
Nilesh Doctor
Keyword(s):  
Early Recognition ◽  
Sinus Bradycardia ◽  
Tertiary Care ◽  
General Medicine ◽  
Thyroid Stimulating Hormone ◽  
Hormone Deficiency ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Manifestation ◽  
Cardiac Manifestations

Background: Hypothyroidism is the most common pathological hormone deficiency. To study various cardiac manifestations in overt and subclinical hypothyroidism.Methods: The cross-sectional analytic study is carried out on 60 patients of hypothyroid subjects in indoor facility of general medicine department in SMIMER hospital.Results: This study shows positive correlation between thyroid stimulating hormone (TSH) level, electrocardiogram (ECG) and echocardiographic findings. In this study, there is female predominance, ECG findings most commonly suggestive of sinus bradycardia and ECHO findings are most commonly suggestive of diastolic dysfunction with pericardial effusion.Conclusions: The early recognition and early initiation of treatment of hypothyroidism may helpful to lowering heart changes as hypothyroidism is reversible cause for cardiac manifestation.

scholarly journals Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis at Muhimbili National Hospital in Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Puneet Kishore Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Fredrick Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background: Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

A survey of scuba diving-related injuries and outcomes among French recreational divers

2019 ◽  
Vol 49 (2) ◽  
pp. 96-106
Author(s):  
David Monnot ◽  
◽  
Thierry Michot ◽  
Emmanuel Dugrenot ◽  
François Guerrero ◽  
...  
Keyword(s):  
Early Recognition ◽  
Initial Response ◽  
First Aid ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Injury Rates ◽  
Residual Symptoms ◽  
Scuba Divers ◽  
Final Treatment ◽  
Severity Scores

Introduction: Few studies are available to appreciate the broad spectrum of dive-related injuries (DI), which are not limited to decompression illness (DCI) and fatalities. Studies supporting injury-management efficacy from early recognition to first-aid, final treatment and outcome are also lacking. This study aims at making an epidemiologic inventory of DI among French scuba divers. Methods: This online, retrospective, cross-sectional survey analyzed self-reported symptoms, context of occurrence, initial response and outcome. The relationships between symptoms and diver characteristics were assessed and severity scores created from the reports. Results: A total of 799 divers responded, of whose questionnaires 784 were sufficiently complete to be analyzed. Approximately one-third (35%) of respondents had never experienced a DI. DCI-like symptoms represent a small fraction of DIs, the most commonly reported being ear barotrauma. Self-reported symptom rates decreased with increasing age and male sex. The ranking dive leader was the primary care provider in 58% of reports and 32% of injured divers never sought help. Management decisions (first aid and/or hyperbaric oxygen treatment) were related to the severity score. Complete resolution was achieved in 84 (74%) of 114 DCI cases, whilst mild (n = 22, 19%) and severe (n = 8, 7%) residual symptoms were reported. One in 10 divers who did not seek treatment for symptoms believed to be related to DCI declared some residual symptoms. Conclusion: Based on these results, diving injury rates may be higher than previously reported. However, the most frequent symptoms appear to be of only a modest nature.

SCREENING OF PSYCHOLOGICAL DISTRESS AMONG COLLEGE STUDENTS DURING THE COVID-19 LOCKDOWN PERIOD: A CROSS-SECTIONAL STUDY

2021 ◽  
pp. 55-56
Author(s):  
Vishnu G. Ashok ◽  
Pretty Venis ◽  
Glannie A.R.
Keyword(s):  
Psychological Distress ◽  
Undergraduate Students ◽  
Early Recognition ◽  
Economic Status ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Sleep Habits ◽  
Cross Sectional ◽  
Time Activity

The uncertainty and dread linked with COVID-19 has contributed to a rise in mental health disorders among the general population showing high rates of anxiety, depression, posttraumatic stress disorder, and psychological discomfort. The current study aims to assess the prevalence of psychological distress among undergraduate students of an Arts college in rural Tamilnadu. A cross-sectional study was carried out among 100 undergraduate students of an arts college selected by convenient sampling technique using GHQ-12 questionnaire via online platforms. Among the 100 medical students who participated in the study, 78% were found have severe problems with psychological distress. Leisure time activity like smartphone usage was found to have a signicant association with psychological distress (p<0.05) while other factors like gender, socio-economic status, physical activity, dietary preferences, junk food consumption and sleep habits were not associated statistically. Early recognition of students under stress and counselling will go a long way in helping students adjust to the demands of the educational curriculum.

scholarly journals Does occupational distress raise the risk of alcohol use, binge-eating, ill health and sleep problems among medical doctors? A UK cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027362 ◽  
Author(s):  
Asta Medisauskaite ◽  
Caroline Kamau
Keyword(s):  
Binge Eating ◽  
Sleep Problems ◽  
Early Recognition ◽  
Controlled Trial ◽  
Psychiatric Morbidity ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Coping With Stress ◽  
Cross Sectional ◽  
Randomised Controlled

ObjectivesThis study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems.DesignThis study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290).SettingDoctors were invited through medical Royal Colleges, the British Medical Association’s research panel and a random selection of NHS trusts across various UK regions.Participants417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants).Main outcomes and measuresOutcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and work factors (workplace and years practising medicine).Results44% of doctors binge-drank and 5% met the criteria for alcohol dependence; 24%–29% experienced negative emotions after overeating and 8% had a binge-eating disorder; 20%–61% had some type of sleep problem and 12% had severe/moderate insomnia; 69% had fatigue and 19%–29% experienced other types of ill health problems. The results show that occupational distress and job factors increase the odds of doctors using substances, having sleep problems, presenting with frequent symptoms of ill health and binge-eating. For example, burnout increased the risk of all types of sleep problems, eg, difficulty falling/staying asleep, insomnia (OR ≥1.344; p≤0.036). Even taking into consideration whether or not a doctor works in a hospital, the risk of health problems still rises when doctors have signs of occupational distress.ConclusionEarly recognition of occupational distress can prevent health problems among UK doctors that can reduce the quality of patient care because of sickness-related absence.

scholarly journals The role of workplace social capital, compassion satisfaction and secondary traumatic stress in affective organisational commitment of a sample of Iranian nurses

2018 ◽  
Vol 23 (5) ◽  
pp. 446-456 ◽  
Author(s):  
Seyyed Abolfazl Vagharseyyedin ◽  
Bahare Zarei ◽  
Mahdi Hosseini
Keyword(s):  
Social Capital ◽  
Traumatic Stress ◽  
Secondary Traumatic Stress ◽  
Early Recognition ◽  
Compassion Satisfaction ◽  
Organisational Commitment ◽  
Cross Sectional ◽  
The One ◽  
Workplace Social Capital

Background Affective organisational commitment (AOC) refers to employees’ emotional attachment to the organisation and identification with it. It is vital that nurses explore contributors to their AOC because they stand as the largest group of employees in healthcare organisations. Aim This cross-sectional, analytical study explored the role of workplace social capital (WSC), compassion satisfaction (CS), and secondary traumatic stress (STS) in AOC in a sample of Iranian nurses. Method The study sample consisted of 250 nurses working in eight hospitals affiliated with Birjand University of Medical Sciences, eastern Iran. Participants’ WSC was measured using the Social Capital at Work Scale developed by Kouvonen et al. (2006). CS and STS were measured using CS and STS dimensions of the Professional Quality of Life measure (Version 5) developed by Stamm (2010). Results Significant positive associations were found between WSC and AOC ( p < 0.001), between the cognitive dimension of WSC and AOC ( p < 0.001), between the structural dimension of WSC and AOC ( p < 0.001), and between CS and AOC ( p < 0.001). The correlation between STS and AOC ( p < 0.001) was negatively significant. Conclusion Effort to promote WSC and CS on the one hand and prevention and early recognition of STS on the other hand can enhance nurses’ AOC.

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