ASSOCIATION OF MULTI-MORBIDITIES WITH SEPSIS IN ADULT PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, KARACHI

2019 ◽  
Author(s):  
Shan-Ul-Haq Siddiqui
Keyword(s):  
Rheumatoid Arthritis ◽  
Socioeconomic Status ◽  
Chronic Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Adult Patients ◽  
P Value ◽  
High Morbidity ◽  
Care Hospital ◽  
The Mean

Background: Multi-morbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services. With advancing medical facilities, a growing proportion of the population is surviving longer with multiple chronic diseases. Sepsis is a life threatening infection with multiple organ dysfunctions leading to very high morbidity and mortality. Treating patients with multi-morbidities have always been more difficult when compared to patients with no co-morbid conditions. Hence, data from this study will empower us in exhibiting effective plans in the management of multi-morbidities with sepsis in our region. The study is aimed to determine the association of multi-morbidities with sepsis in adult patients admitted in a tertiary care hospital. Methods: This is a case-control study conducted in the Medicine Wards and Intensive Care Unit of a tertiary care hospital in Karachi during the period of May 2018 to October 2018. Results: In this study, 52 patients were enrolled. The mean age of patients was 59.35 ± 6.17. Socioeconomic Status showed significant association (p-value 0.034). The mean Sequential Organ Failure Assessment (SOFA) Score was 2.13 ± 1.86. The odds ratio of having cancer [OR: 3.10 (0.10 – 80.1), p-value 0.50] and other multimorbidities like rheumatoid arthritis [OR: 3.30 (0.30 – 33.6), p-value 0.32] in cases of sepsis respectively were more than in controls but the data was not statistically significant. The mean length of hospital stay was 4.71 ± 2.08. Conclusion: Despite our study limitations, a strong association of socioeconomic status with cases and controls in admitted patients was seen and among them, the upper income groups were the most. Although, an association of cancers and multimorbidities like rheumatoid arthritis with cases and controls has been identified, it requires to be researched further. Consensus regarding the definition of multimorbidity should be made.

scholarly journals Assessing the Learning environment of major Specialty PGRs in a tertiary care Hospital by Health Education Learning Environment Survey (HELES)”

2020 ◽  
Vol 3 (1) ◽  
pp. 53-58
Author(s):  
Qamar Ashfaq Ahmad
Keyword(s):  
Health Education ◽  
Learning Environment ◽  
Personal Development ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Three Dimensions ◽  
P Value ◽  
Care Hospital ◽  
System Maintenance ◽  
The Mean

Background: There are many surveys available to quantify educational climate of postgraduate residents but these are lacking in validity and theoretical background. Health education learning environment survey (HELES) with 35 questions in six subscales is used in undergraduates with good results. Objectives: To quantify current health education learning environment of our Post graduate residents of FCPS/MS/MD in Surgery, Medicine and Gynae & Obs in a tertiary care hospital by using HELES tool. This quantification will help Supervisors, Hospital administrators to monitor their programs, suggest and bring improvement.     Methods: A cross sectional study was done in Services Institute of Medical Sciences Lahore from 10th Sep to 1st Oct 2019. A sum of 90 residents in FCPS/MS/MD program with 30 each from Surgery, Medicine and Gynae & Obstetrics were selected.  A predesigned HELES proforma with 35 questions subdivided in 6 factors and 3 main dimensions was used. In “Personal development “a mean score of 34 and above was taken as positive score. In “Relationship” and in “System maintenance” dimension a mean score of 48 and above was taken as positive. Data was analyzed using SPSS 22 and p value of 0.05 was taken as significant. Results: Out of 90 residents, 57 (63.3%) were males and 33 (36.7%) were females without any significant difference between gender. The mean age was 27.4 ± 3.6 years. The mean score of all the residents in Surgery, Medicine and Gynae & Obs in all the three dimensions remained below the average reference values, which implies that our postgraduates are not content with the learning environment they live in.  The comparison of means among different specialties was 0.02 which was statistically significant. Resident’s response in all the three dimensions with their year of training was significant with a p value of < 0.05. 2nd year residents of all specialties scored comparatively high in all the three dimensions Conclusion:  PGRs in the 3 major specialties were dissatisfied with their health education learning environment. Maximum were discontent in Relationship dimension especially in Faculty relationship factor, then in System maintenance and then in Personal development dimension. Residents of Gynae & Obstetrics exhibited significantly low score in System Maintenance dimension.   Key words: Health, education, learning, environment, residents

A STUDY ON HYPONATREMIA IN CIRRHOSIS OF LIVER AND ITS PROGNOSTIC VALUE.

2021 ◽  
pp. 4-5
Author(s):  
Evuri Pramod Reddy ◽  
Pathan Fardeeba Khanam
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Hepatorenal Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Electrolyte Imbalance ◽  
P Value ◽  
High Morbidity ◽  
Care Hospital ◽  
Cirrhotic Patients

BACKGROUND: Hyponatremia is an electrolyte imbalance that commonly occurs in hospitalized patients. In cirrhotic patients with advanced stage of disease there is release of ADHthat causes impairment in renal excretion of free 2,3 water resulting in dilutional hyponatremia in combination with renal vasoconstriction.This study was taken up to nd the prevalence of the hyponatremia and association between hyponatremia and the occurrence of major complications in patients with liver cirrhosis in a tertiary care hospital. AIMS AND OBJECTIVES 1. To study the prevalence of hyponatremia in cirrhotic patients attending a tertiary care hospital. 2 To evaluate the association between hyponatremia and complications in ci . rrhosis among patients attending a tertiary care center and its prognostic signicance. METHODS: It is a cross-sectional study done in Katuri Medical College & Hospital over a period of 13 months between june 2018 to june 2019. Patients were selected based on clinical examination,biochemical tests and ultrasound abdomen and divided into three groups as those having a sodium levels of < 130, 131 to 135 and >136 meq/l and patients having sodium levels <135 meq/l were considered hyponatremic.MELD score was calculated at the time of admission. RESULTS: There was signicant difference with respect to MELD score in three groups (p value =< 0.0001) and with respect to complications of liver cirrhosis namely portal hypertension, hepatic encephalopathy ,hepatorenal syndrome CONCLUSION: Hyponatremiain cirrhosis are associated with severe complications like hepatic encephalopathy, hepatorenal syndrome and high morbidity and mortality

scholarly journals Impact of Socioeconomic Inequalities on Child Malnutrition

2020 ◽  
pp. 114-119
Author(s):  
Zamir Ahmed Qambrani ◽  
Asif Nadeem Jamali ◽  
Habibullah Siyal ◽  
Sarah Azhar ◽  
Hafiz Syed Imran-ul Haque ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Tertiary Care Hospital ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Chi Square Analysis

Socioeconomic status and the education of mother plays important role in providing better health care and nutrition to children. To the best of our knowledge the major population of Pakistan belongs to middle class and identification of malnutrition in our setups may help the policy makers to develop certain parameters to provide better nutrition to children under 5 years of age. The aims of current study were to analyze the prevalence of malnutrition and their association with different socioeconomic status in tertiary care hospital of Hyderabad. Study Design: Cross sectional. Place and Duration of Study: Study was performed at nutritional stabilization center of pediatric department of tertiary care hospital Hyderabad during the month of July 2019 to January 2020. Methodology: Preformed proforma was designed to record the data of participants. Hospital protocols using WHO guidelines (17) i.e. 10 steps for in-patient care of severe malnutrition were started & followed with feeding F-75 & F-100. Data was analyzed on SPSS-20. Results: The minimum age recorded was 8 months and maximum was found to be 45 months (3 years 9 months). 72% were females and 70% of participants had Weight to height ratio below normal. Prevalence of severe acute malnutrition was found to be 35.2%. After admission and management protocols 91.6% were recovered however, mortality was observed in 8.9% participants. Chi square analysis of all socioeconomic groups showed highly significant results with severe acute malnutrition (p-value= 0.001). Conclusion: Current study concluded a high prevalence of SAM in Pakistani population that is about 35.2%, out of which majority was from lower socioeconomic class.

scholarly journals Assessment of Knowledge, Attitude, Handwashing Practices and its associated factors Among Mothers of Children Presenting in Paediatric Department of a Tertiary Care Hospital of a Developing Country.

2021 ◽  
Vol 5 (4) ◽  
pp. 418
Author(s):  
Shahzaib Maqbool ◽  
Maryam Haider ◽  
Ather Iqbal ◽  
Arham Ihtesham ◽  
Waleed Inayat Mohamed ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Residential Area ◽  
Care Hospital ◽  
Paediatric Department ◽  
Level Of Knowledge ◽  
The Mean ◽  
Knowledge And Attitude ◽  
Area Occupation

Objective: Despite remarkable progress in scientific methods and measures against infectious disease transmission, the prevalence of infectious diseases is still on the rise in resource-poor countries. Hand hygiene is considered an effective way of fighting against deadly infectious diseases. Our study aimed to assess knowledge, attitude, and hand hygiene practices among mothers of children presenting for routine paediatric check-up in the department of paediatrics in a tertiary care hospital of Rawalpindi.Materials and Methods: It’s a descriptive cross-sectional study involving 400 mothers from the paediatric department of the Holy family hospital (HFH), Rawalpindi. A convenient sampling technique was used to select the study participants. A semi-structured, pre-tested questionnaire that included demographic details, knowledge, attitude, and practice levels were assessed through validated questionnaires used in previously published studies. Descriptive statistics were used for demographic details and chi-square analysis was used to find an association between handwashing practice with knowledge and attitude. A P<0.05 was taken as significant. Data analysis was done through SPSS.v.23.Results and Discussion: In total, 400 females participated in the study and the mean age (±SD) was 32.4±10.2 years. The mean age of children was 31.2±12.2 months. The level of good handwashing knowledge and attitude was 93% and 60% respectively. However, the level of good handwashing practice was just 40%. The age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, showed significant association with handwashing practices.Conclusion: In our study handwashing practice among mothers was relatively low. Age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, were significantly associated with handwashing practices.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 418-423

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital

2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Hospital ◽  
Barrier Method ◽  
Unintended Pregnancies ◽  
Attitude And Practice ◽  
Complete Knowledge ◽  
The Mean ◽  
Medical Healthcare

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Age Group ◽  
Number Of Patients ◽  
The Mean ◽  
Collection Form ◽  
Time Of Admission ◽  
Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

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