ROLE OF CONVENTIONAL HYSTEROSALPINGOGRAPHY IN THE WORK UP OF FEMALE INFERTILITY IN RURAL TERTIARY CARE HOSPITAL, INDIA

2021 ◽  
pp. 4-9
Author(s):  
P Lakshmi ◽  
V Venkatarathnam ◽  
Ramesh Kumar
Keyword(s):  
Tertiary Care Hospital ◽  
Social Stigma ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Female Infertility ◽  
Care Hospital ◽  
Tubal Patency ◽  
Study Results ◽  
Tubal Blockage

Background: Infertility is a major problem throughout the world. In a country like India, it is associated with a social stigma. The cause can be multifactorial and many couples are seeking medical help for infertility nowadays. As part of the female infertility workup, hysterosalpingography plays an important role. Methods And Material: A retrospective study was done in the department of Radiodiagnosis of a rural tertiary care hospital, India. All patients who were referred for hysterosalpingography study as part of infertility workup between January 2018 and December 2020 to the department of Radiodiagnosis were included in the study. Results: A total of 173 patients are included in the study. Out of these 173 patients, 3 women had repeat Hysterosalpingography studies. 43.2% of these studies are abnormal. 56.8% cases showed normal ndings. Tubal abnormalities were the most common accounting for 34.6% of the total studies. Uterine abnormalities were seen in 6.8% of the total studies. Both fallopian tube and uterine abnormalities were seen in 1.7%. Post-operative follow-up imaging was available for 3 patients. All three patients had a bilateral tubal block in the rst study and showed tubal patency in post recanalization HSG study. Conclusion: Hysterosalpingography is a lesser invasive procedure, cost-effective, and does not require anesthesia compared to laparoscopy. This is a huge advantage, especially in a rural setup. It can be considered as a screening investigation along with an ultrasound examination. Tubal blockage is the most common abnormality accounting for nearly one-third of the causes of infertility in our study. Tuberculosis should always be ruled out as a cause of tubal blockage in India where it is more prevalent.

Telemedicine During A Crisis: Challenges, Opportunities & Way Forward At A Tertiary Care Hospital (Preprint)

2021 ◽  
Author(s):  
Sadia Masood ◽  
Zanaib Samad ◽  
Sarah Nadeem ◽  
Unzela Ghulam
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Successful Implementation ◽  
Care Hospital ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Innovative Strategy

BACKGROUND Telemedicine is utilized to deliver health care services remotely. Recently, it is well established due to pandemics because it can help the patients get required supportive care while minimizing their hospital exposure. In the future, it will continue to be used as a convenient, cost-effective patient care modality. OBJECTIVE The objectives were to identify physicians' challenges during teleconsultations and recognize the opportunities and strengths of this modality during the pandemic in a lower-income country. METHODS This cross-sectional study was conducted in a tertiary care hospital. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. RESULTS A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (,47.6%). 46 (54.8%) have laid between the age group 30-40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of fewer than 15 years or categorized in the age of 50-60 years faced challenges while using this modality. CONCLUSIONS During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians is the main obstacle toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians.

scholarly journals Adverse events following immunization with pentavalent vaccine in a tertiary care hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 82
Author(s):  
Sharad Bansal
Keyword(s):  
Adverse Events ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Care Hospital ◽  
Immunization Programs ◽  
Global Alliance ◽  
Immunization Program ◽  
Pentavalent Vaccine ◽  
Mild Fever

Background: Immunizations currently save 3 million lives per year throughout the world and is one of the most cost-effective health interventions. The Global Alliance for Vaccines and Immunizations (GAVI) and WHO recommended the use of pentavalent to replace the DPT vaccine in developing countries. Vaccines related most side effects are mild and non-serious. Surveillance of adverse events following immunization will enable us to monitor the safety of immunization programs and thereby contribute to validating the immunization program. The main aim of this study is to analyze all suspected adverse events in children reported for pentavalent vaccination.Methods:A prospective, observational epidemiological study was conducted in the department of Paediatrics OPD at tertiary care teaching institute during October 2016 to December 2016. The study was conducted amongst 190 children attending the department of Paediatrics OPD for the second or third dose of pentavalent vaccine.Results: The study shows the following adverse effects after pentavalent injection  127 (66.8%) children had pain at the site of injection, 103(54.2%) mild fever, Swelling at injection site 84(44.2%) and 55(28.9%) children held their leg back due to pain. In majority 85 (44.7%) of children antipyretic and in 65 (34.2%) children analgesic was given was given to relieve the symptoms. The parents were very positive for completing their children’s immunization schedule even though they have faced few symptoms.Conclusions:It can be concluded that all the adverse events reported were mild and could be managed easily without any complications. 

scholarly journals Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

2020 ◽  
Vol 22 (3) ◽  
pp. 106-110
Author(s):  
Supri Raj Shrestha ◽  
B Shakya ◽  
R Oli
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Care Hospital ◽  
Vaccine Preventable Diseases ◽  
Factors Associated ◽  
Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

A CLINICAL STUDY OF ETIOLOGY, OUTCOME AND PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AMONG ICU ADMISSIONS IN RURAL TERTIARY CARE HOSPITAL

2021 ◽  
pp. 201-204
Author(s):  
Shashikantha Shashikantha ◽  
Sohil Sharda. ◽  
Bernice Robert ◽  
Gangurde Bhushan Daulatrao
Keyword(s):  
Acute Kidney Injury ◽  
Prognostic Factors ◽  
Renal Disease ◽  
Tertiary Care Hospital ◽  
Chronic Renal Disease ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Care Hospital ◽  
Study Results

INTRODUCTION: Acute kidney injury is a common occurrence in ICU admissions causing increased morbidity and mortality. Present study aimed to determine the causes and prognostic factors of acute kidney injury in intensive care unit. MATERIAL AND METHODS: This Hospital based Cross sectional Study was conducted at a tertiary care Hospital and Research Center, including 100 patients aged >18 years with Acute Kidney Injury admitted in ICU from the period of October 2018 to June 2020. Patients with chronic renal disease, previous renal transplantation, congenital renal disease were excluded from the study. RESULTS: Most of the patients (63%) were aged above 50 years. Diabetes was found in 55% and hypertension in 26% of AKI cases. Most common cause identied were sepsis, CLD, renal, CNS and CVD. Hypotension occurred in 48% patients, while oliguria occurred in 45% patients. Ventilatory support was required by 43% patients, while 31% patients required haemodialysis. Mortality rate in AKI was 51%. Mortality was signicantly associated with advanced age, presence of Diabetes, and RIFLE criteria. Spot urine <40 meq/L, hyperkalemia, serum creatinine >4 mg/dl, blood urea >100 mg/dl and acidosis were associated with higher mortality. CONCLUSION: Continuous monitoring parameters like Spot Fe Na, Serum Potasium and pH especially in patients at risk, like elderly patients with diabetes, those with sepsis, can help in early identication and appropiate management, thus reduce the incidence or severity of AKI.

Retrospective Analysis of 1230 Patients of Immune Thrombocytopenic Purpura Reporting to a Tertiary Care Hospital in India from 1992–2004.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5294-5294
Author(s):  
Dharma R. Choudhary ◽  
Rajat Kumar ◽  
R. Saxena ◽  
Manoranjan Mahapatra ◽  
Atul Kotwal ◽  
...  
Keyword(s):  
Developing Countries ◽  
Response Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Repeated Measure ◽  
Care Hospital ◽  
Chronic Itp ◽  
Acute Itp

Abstract Background: There is very little published epidemiological data from developing countries regarding ITP and no large series from India. The aim of the study was to analyze the presenting features, response to different therapeutic options and suggest cost effective therapy. Method: The records of hematology department of All India Institute Of Medical Science were analyzed from January 1992 to June 2004. This is a premium tertiary care hospital in India. Diagnosis of ITP was made according to the standard criteria. Response criteria: complete response was defined as a platelet count increase to 100x109 /l or more, for at least 2 months: partial response was defined as doubling of platelet counts from initial levels and &gt; 50x 109/l for at least 2 months; no response included none of the above. Statistical methods: Database was created in MS Access and SPSS ver 11 was used for statistical analysis. Descriptive statistics were calculated and appropriate tests of significance like Chi Square, repeated measure linear model were carried out. Results: During the study period, 1230 patients of ITP were seen in hematology department, with a median age of 19.6 years (range 0.9–80). Females were 51.1% and males 48.9%. Median follow-up was of 9 months (range 0–178). Presenting features were: skin bleed − 91.1%; mucosal bleed − 57.5%; hematuria − 7.2%; gastrointestinal bleed − 12.5% and intracraniall bleed − 2.8%. Per-vaginal bleeding − 31.2 % of females. History of preceding viral fever was seen in 13.1% and palpable spleen in 2.5%. The mean platelet counts at presentation were 34+ 18.3x109/l. There were 595 (48.4%) patients of acute ITP and 635 (51.6%) patients of chronic ITP. Childhood ITP (age ≤ 12 yr) was seen in 46.5% and adult ITP in 53.5%. Response to therapy: Prednisolone was given to 99.6% patients with response of 57.3 %; Intravenous gamma globulin was given to 8.9% with response in 63.6%. Splenectomy was performed in 5% of acute ITP and 15.1% of chronic ITP (p = 0.00). The overall number of splenectomies was 126, with a response rate of 83.3%. Of these 126, acute ITP constituted 23.8% while chronic ITP formed 76.2% of cases. There was no statistically significant difference in response rate in these two groups (p =0.575). Danazole was given to 66 patients with response in 44%. Various other modalities of treatment were given to 24 patients (Anti D-14; Dapsone-2; Cyclosporin-2; Azathioprine-5; and Vincristine with Cyclophosphamide -1 patient), with a response in 25% of patients. The overall response rate with all treatment modalities was 68%: in childhood ITP − 65% and in adult ITP − 70.5%. Childhood ITP did not respond as expected, possibly due to referral bias of more refractory cases being referred to the center. The values of platelets showed a continuous increase during follow up and this increase was statistically significant (P=0.000 for all, Repeated measure model). Conclusion: Pattern of ITP in India is similar to that seen in other centers. In this study Prednisolone was given as first line agent to almost all patients with response in 57.3%; Splenectomy were done in 10.2% of prednisolone refractory or dependent patients with a response in 83.3%. These should form the primary modalities of therapy in developing countries. Significant numbers of patients were refractory to above-mentioned modalities and thus there is a requirement for other cost-effective therapies.

scholarly journals The profile of patients’ complaints in a tertiary care hospital in South India

2018 ◽  
Vol 5 (8) ◽  
pp. 3567
Author(s):  
Mohammed Jezeel Nalakath ◽  
P. M. Thasneem ◽  
K. V. Deepak ◽  
N. A. Uvais
Keyword(s):  
Medical Staff ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Standard ◽  
Cross Sectional Study ◽  
High Rate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Results ◽  
Research Population

Background: Complaints from patients and their carers are important indicators of problems in a healthcare system and provide valuable insights into safety-related problems within healthcare organisations. The objectives of the present study are to identify the frequency distribution of the people complained about, the units complained about and the total number of complaints.Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of a tertiary care hospitals in selected months of May 2017 to August 2017. The data were collected through observation of available documents. Excel software program was used for data analysis.Results: The administration received 692 complaints between the study period. The highest rate of complaints was filed against admission process (30.06%) and the lowest rate of complaints are filed against staff (2.51%). Our study results showed a significantly less complaints against nursing staff and no complaints against medical staff, indicates that the nursing and medical staff of the hospital might be observing medical ethics and professional commitment to a high standard and communicating well with the patients. High rate of complaints against admission unit, house keeping unit and high billing amount indicates the unrealistic expectations prevailing in the minds of clients from the health care provider.Conclusions: The current study generated the profile of patient’s complaints in a tertiary care hospital running in a charitable model. Such data can be utilised to identify common problems and to plan strategies. 

scholarly journals Evaluation of adverse drug reactions of anti-tubercular drugs in the treatment of tuberculosis in tertiary care hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 1430
Author(s):  
Krishnakanth K. ◽  
Jagadeesh A. ◽  
Swetha T. D.
Keyword(s):  
Adverse Drug Reaction ◽  
Adverse Drug Reactions ◽  
Adverse Drug Events ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Cross Sectional ◽  
Medicine Department ◽  
Study Results

Background: Adverse drug reactions are very common among patients on anti-tubercular treatment. Hence, the current study was done to evaluate the adverse drug reaction (ADR) profile in patients receiving anti-tubercular treatment (ATT).Methods: A 6 months prospective, cross-sectional observational study was performed in collaboration with Pulmonology Medicine department. WHO-UMC scale and Naranjo scale was used to evaluate the ADRs.Results: Ninety-two patients receiving ATT presented with 113 adverse drug events (ADE). Males were more affected than females. DOTS category-1 regimen was mostly responsible for ADE. Addition of drugs for the management of ADR events was done.Conclusions: The study results show more ADRs related to ATT demanding increased collaboration between NTEP 2020 and Pharmacovigilance Programme of India to enhance drug safety in this field.

scholarly journals THE PHARMACOECONOMIC IMPACT OF GASTRO-PROTECTIVE AGENTS AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 92-96
Author(s):  
NIRUPAMA KULKARNI ◽  
MOPIDEVI RASI ◽  
NAZARIYA NIZAR ◽  
NISHOJA DAVID ◽  
PRASAD N BALI ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Cost Benefit Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Cost Effective ◽  
Care Hospital ◽  
Statistical Tool ◽  
Protective Agents ◽  
Cost Effective Treatment ◽  
Study Results

Objectives: The study aimed to evaluate the pharmacoeconomic impact of gastro-protective agents (GPA) by carrying out cost-benefit analysis (CBA) and cost-effective analysis (CEA). Methods: This prospective observational study was carried out by simple randomization technique at Karnataka Institute of Medical Science, Hubballi. Data used were socio-economic details based on modified B. G Prasad scale. Current Index of Medical Specialists updated version March 2021 was used for CBA and CEA. Regression analysis was the statistical tool used in the study. Results: A total of 120 participants were included in the study. 57.5% were male and 42.5% were female. 3.33% were pediatrics, 32.5% were young adults, 37.5% were elder adults and 26.67% were geriatrics. Out of 120 samples, 94 participants were prescribed with pantoprazole, other drugs prescribed include domperidone and pantoprazole, rabeprazole, and ranitidine. The CBA revealed ratio of benefits over costs for pantoprazole was 3.86, ranitidine was 9.31, pantoprazole and domperidone was 0.84 and rabeprazole was 0.84. Additional cost of 138.30 Indian Rupee must be spent on pantoprazole over ranitidine to get cost-effective treatment without disease for one whole year. Conclusion: The CBA revealed that maximum patients received benefits for pantoprazole. CEA gives an idea on best effective treatment over two drugs of different class. Our study concludes that pantoprazole is deemed to be superior over other drugs of GPA prescribed among study participants.

scholarly journals LOW VISION DEVICES

2015 ◽  
Vol 22 (10) ◽  
pp. 1345-1350
Author(s):  
Muhammad Saad Ullah ◽  
Sohail Safdar ◽  
Muhammad Nabeel Ahmad
Keyword(s):  
Tertiary Care Hospital ◽  
Low Vision ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Age Group ◽  
Vision Assessment ◽  
Study Results ◽  
Two Age Groups

Objective: The main objective of the present study was to find out visual outcomeof Low Vision Devices among patients suffering from different diseases causing reduced visualacuity in the area of Dera Ghazi Khan, Southern Punjab, Pakistan. Setting: OphthalmologyDepartment, Dera Ghazi Khan which is a tertiary care hospital. Period: 10th February, 2014 to31st December, 2014. Material and Methods: Patients (n=55) presented for their low visionassessment included two groups age wise as patients equal or more than 18 years age (n=22)and patients less than 18 years (n=33). LOG MAR VA charts, contrast sensitivity test, visualfields through arc perimeters, color vision with color pencils hue 16 test along with objective andsubjective refractions were applied. All the data were entered and analyzed using SPSS version16.00. Results: Patients (n=55) aged 7-90 years presented for their low vision assessment hadmean age 23.73+ 2.9 years. The patients were divided into two age groups. First group was22 (40%) patients equal or more than 18 years age and second consisted of 33(60%) patientsless than 18 years age group. Among the patients examined, 40 (72.7%) were males and 15(27.3%) were females. Our study results revealed that the low vision devices provision wasassociated with a statistically significant improvement in both near and distance visual acuitiesand with patients’ fulfillment. Conclusion: There was a significant improvement in far and nearvisual acuity of the patients suffering from a multiplicity of blindness caused diseases by whichpatients are able to improve their quality of life and able to do their tasks without getting helpfrom others.

Platelet Utilization In a Tertiary Care Hospital: An Opportunity for Reduced Transfusion?

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2575-2575
Author(s):  
Vipra Sharma ◽  
Maya Shah ◽  
Ravi Pullela ◽  
Alice J. Cohen
Keyword(s):  
Disease Transmission ◽  
Tertiary Care Hospital ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Care Hospital ◽  
Tertiary Care Medical Center ◽  
The Mean ◽  
Transfusion Guidelines

Abstract Abstract 2575 Background: Use of platelet (plt) transfusions to treat and prevent bleeding varies widely between hospitals and by medical and surgical services. Standard indications include active bleeding with thrombocytopenia or plt dysfunction, pre or peri-invasive procedure, and prophylaxis for low plt counts. Rising demand for plt transfusions and donor shortage, coupled with the risks of transfusion (including infectious disease transmission and alloimmunization) are concerns which often lead to strict regulation of plt transfusion in hospitals. In order to evaluate appropriate use of plt transfusion based on Newark Beth Israel Medical Center transfusion guidelines, a review of plt use was undertaken at this tertiary care hospital. Design: A retrospective review was performed of plt utilization over a 3 month period from October to December 2009. All charts of hospitalized and outpatient patients receiving plt transfusions were reviewed to determine reasons for plt transfusion. Pre-transfusion plt values, site/service ordering plt transfusions, number of units transfused and cost were determined. Results: 421 plt units were transfused to 125 patients (51.6% female), mean age 44 years (yrs.) (range 0–89). All plt transfusions were single donor units. The mean plt count prior to transfusion for all procedures was 127,000, well above hospital guidelines. The majority of plt utilized were by cardiothoracic (CT) surgery (168/421, 40%) with the highest cost (Table 1). 124/421(29%) of transfusions occurred pre- or peri- invasive procedure, with 88/124 (71%) of those transfusions occurring prior or peri- cardio-thoracic procedure. 83/421 (20%) of transfusions had no clear indication based on hospital guidelines, predominately ordered by CT surgery and occurring post-op for asymptomatic thrombocytopenia (cost $45, 650). The mean plt count at which transfusion was found to have no indication was 55,000 (range 25,000–105,000). 136/421(32%) of the cases were prophylactic transfusions with a plt count < 20,000, with 121/136 (89%) in the oncology patients, and the rest in the medical pts due to sepsis. 114/421(27%) of the transfusions were for bleeding. Only 5 patients, 3 in the CT group, and 2 in neonate group had plt dysfunction as the indication for transfusion prior to procedure. The lowest incidence of plt transfusions without an indication was in the adult oncology department. Conclusion: Platelet utilization varied by departments. CT surgery followed by neonatal and pediatric oncology are the principal users of plt in our tertiary care medical center. CT surgery, general surgery, and neonatal services had the highest pre-transfusion plt counts. As 20% of all transfusions had no clinical reason for plt use (no bleeding, invasive procedure, or severely low plt count) the opportunities may exist for lower platelet usage by educating physicians about compliance to transfusion guidelines in order to decrease the risks associated with transfusion and resultant complications. Disclosure: No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document