A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

Aim: To determine the factors that affect compliance and adherence to medications of hypertensive patients visiting OPD clinics. Study design: Descriptive-cross sectional study. Place and duration of study: Department of Medicine, Unit 1, Lahore General Hospital, Doctors Hospital & Medical Center and Farooq Hospital Lahore from 1st January 2019 to 31st December 2019. Methodology: One hundred and sixty five patients with hypertension were handed over questionnaire socio-demographic, compliance and adherence were recorded. Results: Patients who maintained BP charting were only 13(7.9%) and those without BP charting were 152(92.1%). Patients taking regular medications were only 20(12.1%). Forgetfulness in taking medications was found in 47.3% of patients. 20.6% of patients were unable to purchase medicines because of financial reasons. Thirty two patients (19.4%) thought that they should not take medicines as they were not having any symptoms. Conclusion: Major causes of non-adherence were expense of medications, lack of symptoms, lack of money, forgetfulness, lack of awareness due to poor educational status and nature of job. Keywords: Compliance, Adherence, Medications, Hypertension, Forgetfulness

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Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.237 ◽

2018 ◽

Vol 35 (1) ◽

Author(s):

Iqra Arshad ◽

Sara Mohsin ◽

Sana Iftikhar ◽

Tahseen Kazmi ◽

Luqman F. Nagi

Keyword(s):

Insulin Therapy ◽

Tertiary Care ◽

Cross Sectional Study ◽

Early Initiation ◽

P Value ◽

Diabetic Patients ◽

Cross Sectional ◽

Creative Commons ◽

Oral Medications ◽

Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.09.6238 ◽

2021 ◽

Vol 28 (09) ◽

pp. 1239-1244

Author(s):

Umair Toqueer ◽

Muhammad Usama Zardad ◽

Mahwish Toqueer ◽

Anila Riyaz ◽

Sana Khan ◽

...

Keyword(s):

Psychological Distress ◽

Tertiary Care ◽

Cross Sectional Study ◽

Junior Doctors ◽

Sectional Study ◽

Cross Sectional ◽

Psychological Distress Scale ◽

Tertiary Care Hospitals ◽

Distress Scale ◽

The Impact

Objectives: To determine stress grades of doctors working in tertiary care hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of Kessler’s score was greater for junior doctors as compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

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DIABETIC RETINOPATHY;

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.08.64 ◽

2018 ◽

Vol 25 (08) ◽

pp. 1256-1260

Author(s):

Nasir Ahmad Chaudhary ◽

Samreen Hameed ◽

Muhammad Sultan Ul Moazzam ◽

Sarmad Zahoor ◽

Sidrah Latif ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Predictive Value ◽

Tertiary Care ◽

Retinal Disease ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Retinal Examination ◽

Tertiary Care Hospitals ◽

Hba1c Levels

Background: Diabetic retinopathy is one of the most common complications ofdiabetes affecting more than 1/4th of the diabetics and is also the leading cause of blindness inmany parts of the globe. Regular fundoscopic examination for screening is a routine practicein tertiary care hospitals but is not available in the primary care centers. This necessitatesthe development of a reliable screening tool which will allow for early referral of those withcomplications to the specialist centers. Objective: To determine the predictive value of HbA1clevels for the presence of diabetic retinopathy. Study Design: A cross-sectional study. Setting:Diabetic Clinic of Mayo Hospital, Lahore. Period: 04 months, January to April 2017. Method:75 diabetic patients who presented in Diabetic clinic were investigated for HbA1c levels andfundoscopic evaluation was done to detect retinal changes. Results: Out of 75 patients, 35(46.7%) were female, 40 (53.3%) were male. Median age of the patients was 51 years. All patientshad HbA1c levels more than 6.0% and 62% patients had detectable changes on fundi while therest had no detectable retinal disease despite elevated HbA1c levels. Positive predictive value(PPV) of elevated HbA1c levels for the presence of diabetic retinal changes was calculated tobe 62.66%. Conclusion: All the patients who had retinal disease on fundoscopy had HbA1clevels of more than 6.0% (PPV = 62.66) which means that elevated HbA1c levels warrant afundoscopic retinal examination to rule out diabetic retinopathy.

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Appropriateness of Antibiotic Use in Enteric fever inpatients in Tertiary Care Hospitals in Western Nepal: A Cross-Sectional Study

Nepal Journal of Epidemiology ◽

10.3126/nje.v3i1.8289 ◽

2013 ◽

Vol 3 (1) ◽

pp. 236-242

Author(s):

Kadir Alam ◽

P Mishra ◽

NK Angsulee

Keyword(s):

Enteric Fever ◽

Tertiary Care ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Medication Appropriateness Index ◽

Cross Sectional ◽

Western Regional ◽

Inappropriate Antibiotics ◽

Tertiary Care Hospitals

Background: Enteric fever, also known as typhoid fever, is a commonly diagnosed disease in Nepal. Globally, enteric fever affects 21.6 million people and causes 216500 deaths annually. Appropriate use of antibiotics is a key element in the successful treatment of enteric fever. Objective: The study was aimed to study antibiotic use and their appropriateness in the patient with Enteric Fever. Methods: A cross-sectional study was carried out in two tertiary-care hospitals viz. Manipal Teaching Hospital (MTH) and Western Regional Hospital (WRH) in western Nepal between Aug- September 2010. Appropriateness in this study was assessed using Medication Appropriateness Index (MAI) criteria which include indication, effectiveness, dosage, correct directions, practical directions, drug-drug interactions, drug-disease interactions, duplication, duration and expense. Results: Mean use of antibiotics in WRH (2.18±0.87) was not significantly different (P = 0.015) from MTH (2.13±1.11). The Cephalosporin group of antibiotics was used widely to treat enteric fever in both hospitals. On average 1.12 Cephalosporin per patient in MTH and 0.93 Cephalosporin per patient in WRH were used. On average, we found that 31.7% in MTH and 39.5% in WRH of patient’s treatments with antibiotics were inappropriate. Other common types of inappropriateness are expensive drugs [90% (MTH), 92% (WRH)] duplication of antibiotics [53% (MTH), 822% (WRH)], prescribing high generation antibiotics [80% (MTH), 89% (WRH)], and practical direction [17% (MTH), 33% (WRH)]. Conclusion: Conclusively, more than thirty percent of patients in both of hospitals treated for enteric fever received inappropriate antibiotics. Hence we recommend future education or managerial intervention to improve appropriateness. DOI: http://dx.doi.org/10.3126/nje.v3i1.8289 Nepal Journal of Epidemiology 2013;3 (1): 236-242

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"Fungal Skin Diseases and Related Factors in Outpatients of Three Tertiary Care Hospitals of Dhaka, an Urban City of Bangladesh: Cross-Sectional Study"

Biomedical Journal of Scientific & Technical Research ◽

10.26717/bjstr.2021.39.006238 ◽

2021 ◽

Vol 39 (1) ◽

Author(s):

Hamida Khanum

Keyword(s):

Skin Diseases ◽

Tertiary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Urban City ◽

Tertiary Care Hospitals

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C-Shaped Canal in Second Molar of Mandible among Cases of Cone Beam Computed Tomography in Tertiary Care Hospitals: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6722 ◽

2021 ◽

Vol 59 (239) ◽

Author(s):

Neera Joshi ◽

Suraj Shrestha ◽

Sunanda Sundas ◽

Kranti Prajapati ◽

Sharada Devi Wagle ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Tertiary Care ◽

Cross Sectional Study ◽

Cone Beam ◽

Sectional Study ◽

Cross Sectional ◽

Second Molar ◽

Mandibular Second Molar ◽

Tertiary Care Hospitals

Introduction: C-shaped canal configuration is mostly found in the mandibular second molar. The morphological characteristic of a C-shaped canal is the presence of a fin or web connecting the individual canal, making it difficult for cleaning, shaping, and obturation. The objective of this study was to find out the prevalence of C-shaped canal in mandibular second molar among cases of Cone Beam Computed Tomography in tertiary care hospitals. Methods: The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of tertiary care hospitals from 20th June 2020 to 20th December 2020 after receiving ethical approval from the Nepal Health Research Council on 19 June 2020. Cone-beam computed tomography images of 199 mandibular second molars with completely formed roots were used. Teeth with orthodontic braces, root resorption, root canal filling, and post were excluded from the study. The research was conducted taking a tooth as a unit. Convenience sampling was done. Statistical analysis was done by using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of C-shaped canal according to this study is 25 (12.6%) (7.99-17.21 at 95% Confidence Interval). Conclusions: The findings of the study conclude that C-shaped configuration is quite frequent in mandibular second molar among cases of Cone Beam Computed Tomography. A careful pre-operative radiographic evaluation may be helpful for diagnosing C-shaped configuration prior to root canal treatment.

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