scholarly journals The impact of taurolock versus heparin lock for the maintenance of central vein catheters patency in pediatric tertiary care hospitals

2020 ◽  
Vol 1 (4) ◽  
pp. 7-12
Author(s):  
Mahdi Bassirian ◽  
Amrollah Salimi ◽  
Enayatollah Noori ◽  
Zahra Moeini ◽  
◽  
...  
Keyword(s):  
Tertiary Care ◽  
Central Vein ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Heparin Lock

scholarly journals Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nikhilesh A. Jibhakate ◽  
Sujata K. Patwardhan ◽  
Ajit S. Sawant ◽  
Hemant R. Pathak ◽  
Bhushan P. Patil ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Stone Disease ◽  
Outpatient Clinics ◽  
Percentage Decrease ◽  
Emergency Procedures ◽  
Number Of Patients ◽  
Long Term Impact ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Near Future

Abstract Background To evaluate the impact of COVID-19 lockdown on non-COVID urological patient’s management in tertiary care urology centres. Methods This is an observational study in which data of patients visiting the urology department of all the MCGM run tertiary care hospitals were recorded for the duration of 1 April 2020 to 31 July 2020 and were compared to data of pre-COVID-19 period of similar duration. Results There was a decrease of 93.86% in indoor admissions of urology patients during the COVID-19 lockdown. Indoor admissions for stone disease, haematuria, malignancy accounted for 53.65%, 15.85%, 9.75%, respectively. Elective surgeries had the highest percentage decrease followed by emergency and semi-emergency procedures. There was a reduction of more than 80% in patients attending outpatient clinics. Stone disease and its consequences were the main reasons for visiting outdoor clinics (39%). A substantial number of patients presented with flank and abdominal pain (14.8%) and benign enlargement of the prostate (10.23%). Malignancy accounted for a very small number of patients visiting outdoor clinics (1.58%). Conclusions COVID-19 pandemic has a profound impact on patient care and education in Urology. There was more than ninety percent reduction in indoor admissions, operative procedures, and outpatient clinics attendance. Once the pandemic is controlled, there will be a large number of patients seeking consultation and management for urological conditions and we should be prepared for it. Surgical training of urology residents needs to be compensated in near future. Long-term impact on urological patient outcome remains to be defined.

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

2010 ◽  
Vol 31 (11) ◽  
pp. 1170-1176 ◽  
Author(s):  
Dominik Mertz ◽  
Nancy Dafoe ◽  
Stephen D. Walter ◽  
Kevin Brazil ◽  
Mark Loeb
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Intervention Group ◽  
Multifaceted Intervention ◽  
Cluster Randomized ◽  
Hospital Acquired ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Mrsa Colonization

Objectives.Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization.Design.Cluster-randomized controlled trial.Setting.Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada.Intervention.After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008.Results.We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group.Conclusion.Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

scholarly journals 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.

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.

scholarly journals 1415. Use of Adjunctive Steroids in Adults with Encephalitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S515-S515
Author(s):  
Ambreen Allana ◽  
Mohammed Samannodi ◽  
Michael Hansen ◽  
Rodrigo Hasbun
Keyword(s):  
Clinical Outcomes ◽  
Brain Mri ◽  
Tertiary Care ◽  
Brain Magnetic Resonance Imaging ◽  
Adverse Outcomes ◽  
Neurological Deficits ◽  
Icu Admission ◽  
Magnetic Resonance Imaging Mri ◽  
Tertiary Care Hospitals ◽  
The Impact

Abstract Background To describe the use and the impact on clinical outcomes of adjunctive steroids in adults with encephalitis. Methods We conducted a retrospective observational study of 230 adults (age >17 years) who met the international consortium definition for encephalitis. An adverse clinical outcome was defined as a Glasgow outcome score of 1–4. The study took place at three tertiary care hospitals in Houston TX, between August 2008 and September 2017. Results A total of 230 adults with encephalitis were enrolled, out of which 121 (52.6%) received steroids. Adjunctive steroids were given more frequently to those with focal neurological deficits (P = 0.013), had a positive cerebrospinal fluid (CSF) HSV PCR (P = 0.013), required mechanical ventilation (MV) (P = 0.011), required intensive care unit (ICU) admission (P < 0.001), had white matter abnormalities (P = 0.014) or had cerebral edema on the brain magnetic resonance imaging (MRI) (P = 0.003). An adverse outcome was seen in 139 (60.7%) of patients. Predictors for adverse outcomes included a Glasgow coma score (GCS) < 8, fever, seizures, ICU admission, and presence of edema on brain MRI. The use of adjunctive steroids did not impact clinical outcomes (P = 0.521). Independent prognostic factors on logistic regression analysis were edema on brain MRI (7.780 [1.717–35.263] P = 0.008), GCS < 8 (6.339 [1.992–20.168] P = 0.002), and fever (2.601 [1.342–5.038] P = 0.005). Conclusion Adults with encephalitis continues to be associated with significant adverse clinical outcomes in the majority of patients. Adjunctive steroids are used in the sicker patients and it is not associated with improved clinical outcomes. Disclosures All authors: No reported disclosures.

scholarly journals P-O08 Effect of socioeconomic deprivation on clinical characteristics and outcomes of patients undergoing an emergency appendectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Gillian Miller ◽  
Khurram Khan ◽  
Lewis Gall ◽  
Y AlAzzawi ◽  
Andrew Macdonald
Keyword(s):  
Surgical Site Infection ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Electronic Records ◽  
Site Infection ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Index Of Multiple Deprivation ◽  
Peak Blood ◽  
Surgical Operations

Abstract Background Appendicectomy is one of the commonest emergency general surgical operations performed.  Previous studies have shown that socioeconomic status (SES) impact outcomes in a number of diseases.  Currently, there is no study analysing the impact of SES on the outcome of appendectomy.   Our aim was to compare the clinical characteristics and outcomes of adults having an emergency appendectomy between deprived and less deprived SES groups.   Methods A multicentre retrospective observational study of all adult patients who had an emergency appendectomy across four hospitals (two district general and two tertiary care hospitals) between August 2018 and November 2020 was performed.  Patients were identified through pathology records.  Data was extracted from electronic records for demographics, pre-operative (peak) blood results, pre and post-operative imaging, operative details and the clinical outcomes.  Patient’s residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD).  The patients were grouped by SIMD into a more deprived SES group (SIMD 1-5) and a less deprived SES group (SIMD 6-10) and results compared. Results A total of 1,105 patients (57.5% male) were included.  Median age was lower in the more deprived group (35 vs 40 years, p &lt; 0.001).   The less deprived group were more likely to be fitter: ASA-1 grade 51.6% vs 43.5%, p = 0.008.  There were fewer appendectomies in most deprived decile compared to the least deprived decile (5.2 vs 11.3 per 10,000 population per year, p &lt; 0.001).   There was no difference in inflammatory markers, pre-operative imaging, surgical approach, severity of appendicitis and the median length of stay (3 days).  However, there were more surgical site infection in the more deprived group (3.4% vs 0.9%, p = 0.006). Conclusions This study demonstrates that SES does impact on the age of presentation and incidence of appendectomy.  Surgical site infection were seen more frequently in the more deprived patients undergoing emergency appendectomy.  This may be a reflection of the underlying comorbidities.

scholarly journals Effects of Full-Moon Definition on Psychiatric Emergency Department Presentations

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Varinder S. Parmar ◽  
Ewa Talikowska-Szymczak ◽  
Emily Downs ◽  
Peter Szymczak ◽  
Erin Meiklejohn ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mental Health Professionals ◽  
Full Moon ◽  
Tertiary Care ◽  
Lunar Cycle ◽  
Future Research ◽  
Before And After ◽  
Definition Of ◽  
Tertiary Care Hospitals ◽  
The Impact

Objectives. The lunar cycle is believed to be related to psychiatric episodes and emergency department (ED) admissions. This belief is held by both mental health professionals and the general population. Previous studies analyzing the lunar effect have yielded inconsistent results. Methods. ED records from two tertiary care hospitals were used to assess the impact of three different definitions of the full-moon period, commonly found in the literature. The full-moon definitions used in this study were 6 hours before and 6 hours after the full moon (a 12-hour model); 12 hours before and 12 hours after the full moon (a 24-hour model); and 24 hours before and after the day of the full moon (a 3-day model). Results. Different significant results were found for each full-moon model. Significantly fewer patients with anxiety disorders presented during the 12-hour and 24-hour models; however, this was not true of the 3-day model. For the 24-hour model, significantly, more patients presented with a diagnosis of personality disorders. Patients also presented with more urgent triage scores during this period. In the 3-day model, no significant differences were found between the full-moon presentations and the non-full-moon presentations. Conclusions. The discrepancies in the findings of full moon studies may relate to different definitions of “full moon.” The definition of the “full moon” should be standardized for future research.

scholarly journals The Association of PPE Availability, Training and Practices with COVID-19 Sero-prevalence in Nurses and Paramedics in Tertiary Care Hospitals of Peshawar, Pakistan

2020 ◽  
pp. 1-18
Author(s):  
Junaid Ahmad ◽  
Saeed Anwar ◽  
Abdul Latif ◽  
Najib Ul Haq ◽  
Muhammad Sharif ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers ◽  
Healthcare Profession ◽  
Tertiary Care Hospitals ◽  
The Impact

Abstract Background Nurses and paramedics by being the frontline workers of the healthcare profession need to be equipped with the relevant knowledge, skills and protective gears against different forms of infection, including COVID-19. Though the governments and concerned stakeholders have provided P.P.E.s, training and information to protect the healthcare professionals, however until now the scientific literature has virtually not reported the impact of P.P.Es availability, training and practices on the COVID-19 sero-prevalence among the nurses and paramedics. Objective This study aimed to assess the Impact of P.P.Es availability, training and practices on COVID-19 sero-prevalence among nurses and paramedics in teaching hospitals of Peshawar, Pakistan. Methods A cross-sectional survey was conducted with a total of 133 nurses and paramedics as subjects of the study. Results A univariate analysis was done for four variables. The findings indicate that the healthcare professionals (nurses & paramedics) who have received P.P.Es on time at the start of COVID-19 emergence has fewer chances of contracting the COVID-19 infection (O.R = 0.96); while the odds for P.P.Es supplies was 0.73, and the odds of hand hygiene training was 0.95. Conclusion The study concluded that the availability of the P.P.E.s, COVID-19 related training and compliance with W.H.O recommended practices against COVID-19 were instrumental in protection against the infection and its spread.

CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Infectious Diseases ◽  
East Asia ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
South East Asia ◽  
Immunization Status ◽  
Tertiary Care Hospitals ◽  
Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

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