scholarly journals INTRA-VITREAL BEVACIZUMAB: SAFETY OF MULTIPLE DOSES PREPARATION FROM SINGLE VIAL IN MINOR THEATRE IN TERTIARY CARE CENTRE

2020 ◽  
Vol 35 (4) ◽  
pp. 235-241
Author(s):  
Asfandyar Asghar ◽  
Amna Rizwan ◽  
Naila Obaid ◽  
Ume Sughra ◽  
Badar Ud Din Ather Naeem ◽  
...  
Keyword(s):  
A Priori ◽  
Tertiary Care ◽  
Intravitreal Bevacizumab ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Exposure Study ◽  
Multiple Doses ◽  
Number Of Patients ◽  
Department Of Ophthalmology ◽  
And Storage

PURPOSE: To determine the safety of multiple doses preparation of bevacizumab from single vial in minor theatre in reducing the frequency of endophthalmitis. STUDY DESIGN: Retrospective exposure study PLACE AND DURATION OF STUDY: Department of Ophthalmology, Fauji Foundation Hospital (FFH), Rawalpindi from June 2016 to March 2018. MATERIAL AND METHODS: 1690 eyes belonging to 1001 patients was included using computer logs of patients receiving intravitreal bevacizumab (IVB). In FFH, we allocate three consecutive days every month in order to administer IVB. Approximately 50 patients were typically given IVB over three-days period.1-2 ml (depending upon the number of patients) of bevacizumab was withdrawn in a 3 cc syringe.1 cc insulin syringe with 29 G needle was taken and, 0.05 ml (1.25 mg) bevacizumab was injected from behind using the 3 cc syringe, resulting in preparation of 10-20 injections of IVB. The bevacizumab vial was then stored at 4 degrees Celsius. RESULTS: Total 1690 eyes belonging to 1001 patients were analyzed. The occurrence of endophthalmitis was 2/1690 (0.12%) corresponding to a 95% CI of 0.03%-0.43%, which does not represent an increase in cases as compared to endophthalmitis resulting from using a compounding pharmacy. CONCLUSION: Whereas, a priori, it seems reasonable to assume that aliquot preparation and storage of bevacizumab for intravitreal use particularly by a compounding pharmacy is safer. We, however, show that our preparation of IVB from single vial technique using proper sterilization is equally safe. Due to the reduced cost of our technique, we recommend it, particularly in the developing world.

CLINICAL PROFILE OF OUTPATIENTS ATTENDING DERMATOLOGY DEPARTMENT DURING COVID-19 LOCKDOWN RELAXATION PERIOD IN A TERTIARY CARE CENTRE IN SOUTH INDIA – A CROSS-SECTIONAL ANALYTICAL STUDY

2021 ◽  
pp. 13-16
Author(s):  
Afthab Jameela Wahab ◽  
Pavithra Gunasekaran ◽  
P. Mohan ◽  
V. Sudha ◽  
L. Balamurugan ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Relaxation Period ◽  
Number Of Patients ◽  
Outpatient Practice ◽  
The Impact

Background - The cutaneous manifestations of the novel coronavirus have been well documented. However, there are few studies that relate to the clinical prole of regular dermatology outpatients seeking treatment during the lockdown relaxation period braving the pandemic. With the Aim - view to determine the changes seen in dermatology outpatient practice, this study analysed the clinical prole of new patients attending the Dermatology Outpatient Department (OPD) during the COVID-19 lockdown relaxation period in a tertiary care centre in a metropolitan suburb in South India. New dermatology outpatients during the months of May, June, July and August Method - 2020 were included in the study. Outpatient data for this period was analysed and compared with corresponding data for the same period in the previous two years. There was a Result – decrease in the OP census, number of patients in the extremes of life as well as those with asymptomatic dermatoses. There was an increase in the number of patients with infections, particularly dermatophytosis. There was also a noteworthy absence of dermatological emergencies. Conclusion - In essence, our study shows the impact of COVID-19 pandemic on the routine dermatology outpatient services with signicant changes in the clinical prole of outpatient practice following lockdown relaxation.

APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

scholarly journals EPIDEMIOLOGICAL STUDY OF TRAUMA IN A TERTIARY CARE CENTRE IN NORTHWEST INDIA

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Vaibhav Lakhanpal ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Poojan Thakor ◽  
...  
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Total Mortality ◽  
Public Health Problem ◽  
Common Mechanism ◽  
Mechanism Of Injury ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Keywords Trauma ◽  
Number Of Patients

Objective: Traumatic injuries are a matter of concern worldwide. However, the rapidly changing socio economical dynamics in a developing country like India deeply influence the epidemiology behind trauma. The aim of this study was to document and analyze the epidemiological parameters and characteristics behind trauma victims admitted to our tertiary care centre. Methods: The observational study was carried out over a period of one year (January 2019 to December 2019) enrolling a total of 300 trauma patients. The age, sex, locality, delay in hospitalization, mechanism of injury, sites of injury and outcomes were documented. Results: Injuries occurred predominantly in the 20-40 age group with males being the chief victims. There was a considerable amount of delay in hospitalization ranging from one hour to more than 24 hours while only 7 patients arrived to the emergency within one hour of trauma. Vehicular trauma (54%) was the most common mechanism of injury. Injuries to the extremities (38.6%) and head (28.6%) were the most common sites. A considerable number of patients (45.3%) required care in the intensive care unit. A total of 172 patients required surgical interventions of various kinds and there was a total mortality rate of 6%. Amongst the polytrauma cases, 54 patients (81.8%) required ICU admission, 42 patients (63.6%) required surgical intervention and 6 patients (9.1%) died after admission. Conclusion: The results of this study highlight some of the problems with our existing infrastructure bringing to light the need for stricter enforcement of traffic safety laws and improvement of infrastructure particularly the roadways in rural areas as well as the referral systems. Vehicular trauma should be seen as a public health problem and appropriate interventions should be implemented. Keywords: Trauma, Road Traffic Accidents, Epidemiology, Head injuries

scholarly journals COVID 19 pandemic and cancer treatment: experience at a tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 1055
Author(s):  
Abhishek Pathak ◽  
Anvesh Rathore ◽  
Rajan Kapoor ◽  
Subhash Ranjan ◽  
Alpana Gupta
Keyword(s):  
Cancer Treatment ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Delay ◽  
Treatment Experience ◽  
Exact Number ◽  
Number Of Patients ◽  
Working Principle

Background: In these era COVID Pandemic patients are missing their chemotherapy due to multiple reasons. This study was undertaken to quantify the exact number of patients who had missed their appointment for chemotherapy.Methods: All patients who had appointments for chemotherapy from 20th Mar to 20th Apr were included in the study. Details of malignancies, chemotherapy, duration of delay in patients coming for chemotherapy to be recorded.Results: The total number appointments given for chemotherapy for various malignancies were 301 patients for various malignancies for the duration 20th March to 20th April. The total number of appointments given were 301. Out of the total of 301 patients who had appointment for chemotherapy during this period 131 patients could be given chemotherapy and 170 could not be given chemotherapy. The average delay was of 9 days. The data was distributed into four weeks from 20th March to 20th April. Just before the country wide lock down in first week 20th, 70 patients receiving chemotherapy which drastically reduced in later weeks. Both the cases who could come for chemotherapy and those who could not have been kept under follow up, up to 6 months to reassess their response.Conclusions: This article has been written to highlight the number of patients who could not receive chemotherapy due to ongoing Pandemic with an intention to follow them up for 6 months. Since this pandemic is here to stay it is very important that formulate the working principle for administering chemotherapy.

scholarly journals TO SEE THE IMPACT OF LOCKDOWN IN COVID19 PANDEMIC ON TUBERCULAR PATIENTS IN A TERTIARY CARE CENTRE OF HILLY AREA.

2020 ◽  
pp. 33-34
Author(s):  
Subhash Chander ◽  
Ritin Sharma ◽  
Ankit Chaudhary ◽  
Rakesh Chauhan
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Healthcare Services ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Hilly Area ◽  
Number Of Patients ◽  
Group B ◽  
The Impact

Aim: To see the impact of lockdown in Covid19 Pandemic on Tubercular patients in a Tertiary care Centre of hilly area. Material and Methods: The study was conducted among adult patients in a tertiary health centre in a rural area. Study was conducted through lockdown period, comparing it with corresponding period in 2019. Tuberculosis patients or suspects were categorized in two groups. Group A was designated for participants in the year 2020 during lockdown period. Group B was data taken from time period similar to lockdown period in the year 2019. Data from two groups was compared. Observations: There was a 44.1% decline in number of male patients, whose sputum was examined by microscopy for tuberculosis. In case of female patients, decline was 68.6%. This decrease was present in all phases, more in 1st phase, 69.1%. During lockdown period number of patients presenting to medicine department were 45% compared to previous year ( 5129 vs 11280), sputum positive diagnosed during lockdown and similar period in 2019 were (84.4%) 27 vs 32 ( p 0.016). OPD declined by 54.5% during lockdown, however diagnosed tubercular cases by CBNAAT declined by 44.4%. Conclusion: COVID 19 pandemic greatly affected the routine healthcare services. Lockdown period saw a decline in number of patients presenting to outdoor as well as indoor patients. There was a decline in number of tuberculosis suspects as well as number of diagnosed tuberculosis patients. However decline in tuberculosis patients was less as compared to overall patients.

scholarly journals How Much Does It Cost to Manage Paediatric Tuberculosis? One-Year Experience from The Hospital for Sick Children

1998 ◽  
Vol 9 (6) ◽  
pp. 354-358
Author(s):  
Cheryl L Main ◽  
Ethel Ying ◽  
Elaine EL Wang
Keyword(s):  
Cost Analysis ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Pulmonary Tb ◽  
Number Of Patients ◽  
Positive Culture Result ◽  
Sick Children ◽  
One Year ◽  
The Cost

BACKGROUND: Tuberculosis (TB) is a major infection with nearly eight million cases annually worldwide. Although the majority of these cases are in the developing world, TB is also a problem in Canada.OBJECTIVE: To determine the cost of diagnosis and management of paediatric TB in Canada.DESIGN: Cross-sectional study.SETTING: In-patients and out-patients at The Hospital for Sick Children, Toronto, a tertiary care centre.PATIENTS: Patients were included if they had clinical or radiological evidence of TB infection with a positive tuberculin skin test or a positive culture result, and were treated from July 1, 1995, to June 30, 1996. Twenty-two patients met the criteria for inclusion in the study.OUTCOME MEASURES: Patient characteristics, types of disease, types and numbers of investigations, number of in-patient days and out-patient appointments, course of TB treatment, TB-related complications and antimicrobial resistance were obtained from charts. Costs were derived from allocated hospital costs, Ontario Health Insurance Plan billings and costs provided by the Pharmacy Department at The Hospital for Sick Children.RESULTS: The total cost for one year of management of paediatric TB in a tertiary care centre was $211,576. Pulmonary TB affected one-half of the study patients but accounted for one-quarter of the cost. One case of meningitis resulted in almost the same costs as all cases of pulmonary TB. Hospitalization was the largest contributor to overall cost, accounting for three-quarters of the total. The remaining costs in order of their contribution to overall costs were antimicrobial treatment, out-patient appointments, diagnostic imaging and TB cultures.CONCLUSIONS: From a hospital’s perspective, the costs of managing each of the 22 patients was approximately $10,000. However, there was great variability between patients, with much greater costs for those who required hospitalization or numerous investigations because TB was not suspected. To the authors’ knowledge, this is the first time that such a cost analysis has been performed for a paediatric population. A cost analysis provides a better measure of the burden of illness than is indicated by the absolute number of patients.

scholarly journals Clinical profile of scrub typhus patients in a tertiary care centre in Himachal Pradesh, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3266
Author(s):  
Ritin Sharma ◽  
Roshan Lal ◽  
Sanjay Mahajan ◽  
Satish Chaudhary
Keyword(s):  
Primary Care Physicians ◽  
Scrub Typhus ◽  
Monsoon Season ◽  
Tertiary Care ◽  
Himachal Pradesh ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
High Grade Fever ◽  
Number Of Patients

Background: Scrub typhus a zoonotic disease caused by gram negative bacteria O. tsutsugamushi, is endemic in Himachal Pradesh. This illness occurs mainly in monsoon and post monsoon season. study design of  this study was conducted in a tertiary care centre in Himachal Pradesh between July 2015 and June 2016. All the indoor patients with age above 18 years with a diagnosis of scrub typhus were included in this study.Results: Out of total 180 patients, 130 were female patients. Most patients were in the age group 21-30 (23.3%). All the patients presented with history of fever, but 54 patients presented with high grade fever. Other Most common symptom was chills and rigours (81%), followed by vomiting and headache each 32%, cough 31%. On examination 21% patients had eschar,14% patients had lymphadenopathy. Most number of patients presented in the month of September (51.6%), followed by August (33.3%).Conclusion: Scrub typhus being an important differential of acute undifferentiated fever in this region, should not be missed by primary care physicians, as once multi organ dysfunction sets in, mortality rate starts rising. So, there is a high need of sensitization of doctors and people about this illness so that early diagnosis and early treatment can be ensured.

scholarly journals Clinical study of central serous chorioretinopathy presenting in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4200
Author(s):  
Ramamani Dalai ◽  
Rajashree Rout ◽  
Manjula Pradhan ◽  
Prasanta Kumar Nanda
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Tertiary Care ◽  
Population Based ◽  
Tertiary Care Centre ◽  
Population Based Study ◽  
Medical College ◽  
Number Of Patients ◽  
Department Of Ophthalmology ◽  
Common Causes ◽  
The Common

Background: Central Serous chorioretinopathy (CSCR) is one of the common causes of visual handicap affecting young people of highly intellectual professionals at the peak of their career which can lead to irrecoverable loss of vision.Methods: The present prospective observational population-based study was conducted in the Department of Ophthalmology, S.C.B. Medical College, Cuttack, Odisha from October 2013 to September 2015. The total number of patients attended the Outpatient Department (OPD) during the study period were 1,83,199. Amongst which 123 patients diagnosed to have CSCR were selected for the present study.Results: Incidence of CSCR during in this study period was 0.06%. The age group most commonly affected was 31 to 40 years. Males were affected 7 times more commonly than females. Increased incidence was noticed in bank employees (21.1 %) and IT professionals (17.8%).Conclusions: There was increased incidence of the disease in people under stressful life condition.

Facial pain in a Neurological Tertiary Care Centre — Evaluation of the International Classification of Headache Disorders

Cephalalgia ◽  
2005 ◽  
Vol 25 (9) ◽  
pp. 689-699 ◽  
Author(s):  
K Zebenholzer ◽  
C Wöber ◽  
M Vigl ◽  
P Wessely ◽  
CL Wöber-Bingöl
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Tertiary Care ◽  
International Classification ◽  
Care Centre ◽  
Headache Disorders ◽  
Tertiary Care Centre ◽  
Persistent Idiopathic Facial Pain ◽  
Number Of Patients

The aim of this study was to examine the diagnostic spectrum of facial pain and to evaluate the clinical features relevant to the differential diagnosis in a neurological tertiary care centre. This is the first investigation comparing the first with the second edition of the International Classification of Headache Disorders (ICHD-I, ICHD-II) in consecutively referred patients comprising a broad spectrum of disorders without restricting the inclusion to certain diagnoses. Studying 97 consecutive patients referred for facial pain, we found trigeminal neuralgia or other types of cranial neuralgia in 38% and 39% according to ICHD-I and ICHD-II, respectively; persistent idiopathic facial pain was diagnosed in 27% and 21%, respectively. The proportion of patients who could not be classified was 24% in ICHD-I and 29% in ICHD-II. Six per cent of the patients had cluster headache or chronic paroxysmal hemicrania, the remaining 5% had various other disorders. The agreement between ICHD-I and ICHD-II was very good to perfect. In ICHD-II, sensitivity and specificity were similar to ICHD-I, the specificity and negative predictive value were imrpoved in single features of trigeminal neuralgia, but were widely unchanged in persistent idiopathic facial pain. The number of patients who could not be classified was larger in ICHD-II than in ICHD-I. Modifying the diagnostic criteria for different types of facial pain, in particular changes in the criteria of persistent idiopathic facial pain, might be helpful in reducing the number of patients with unclassifiable facial pain.

Sign in / Sign up

Export Citation Format

Share Document