Bleeding Disorders among women Presenting with Menorrhagia at Tertiary Care Hospital

Objective: To study the spectrum of bleeding disorders among women, presenting to the study setting with complaints of menorrhagia. Methodology: This observational cross-sectional study was conducted up on 121 women, during a period of 6 months, who were approached via non-probability, consecutive sampling, presenting to the Dept. of Gyneacology & Pathology – Liaquat University Hospital, Hyderabad with menorrhagia. Data obtained from patient interviews and laboratory investigations were recorded into a self-structured questionnaire after taking written informed consent. The data obtained was analyzed using SPSS v. 21.0. Results: The mean age of the women was 28.13 years (±5.21 SD). Among the underlying hemostatic pathologies, VWD was the most common i.e. 21 (65.6%), followed by other platelet dysfunctions (Glanzman Thrombasthenia (n=5, 15.6%) and Berard Soulier Syndrome i.e. n=3, 9.4%) comprised the second most common finding. A cause of hemostatic pathology among a minority of patients remained unidentified i.e. n=3 (9.4%). Conclusion: Keeping in view of hemostatic defects, the study concludes that VWD is the commonest bleeding disorder among women presenting with menorrhagia. A routine screening of females with menorrhagia on their initial contact with the hospital can save years of suffering and lead to early management and probable recovery. Keywords: Von Willebrand Disease, Hemostatic Dysfunction, Bleeding Disorders, Platelet Dysfunction, Menorrhagia & Bleeding Complaints among Women

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Pattern of upper gastrointestinal diseases: an audit of 1000 cases based on endoscopic findings from a tertiary care hospital in Mysore

International Surgery Journal ◽

10.18203/2349-2902.isj20182395 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2412

Author(s):

Shashikumar H. B. ◽

Madhu B. S. ◽

Motati Harshini

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Gastrointestinal Symptoms ◽

Gastrointestinal Diseases ◽

Cross Sectional Study ◽

Common Finding ◽

Care Hospital ◽

Cross Sectional ◽

Endoscopic Findings ◽

Upper Gastrointestinal

Background: Fibreoptic endoscopy is a highly efficient diagnostic tool, which is now increasingly being used in the diagnosis of upper gastrointestinal diseases. This study has been carried out to evaluate the distribution of various upper gastrointestinal diseases based on endoscopic findings in a tertiary care hospital in Mysore.Methods: A cross-sectional study was conducted based on data from endoscopic register of 1000 subjects who underwent endoscopy for various upper gastrointestinal symptoms from 1st January 2017 to 31st December 2017(one year).Results: Mean age of the study population was 50.23 years (SD-15.46). Minimum age was 12 years and maximum was 88 years. About 44.7% of the study subjects belonged to 40-60 age group.61.6% of the study subjects were males. Most common indication was pain abdomen (32.1%) followed by dysphagia (22.2%). Of the 1000 study subjects 18.6% had normal findings. Most common finding was Gastritis / Duodenitis /Gastric erosions (28%). Malignant lesions were noted among 11.1%, of which esophagus and stomach are 5.4% and 4.9% respectively.Conclusions: Endoscopic diagnosis is useful for early detection of UGI diseases and helpful for their management.

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Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country

ISRN Family Medicine ◽

10.1155/2014/473654 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Fahad Hanif Khan ◽

Raheela Hanif ◽

Rumina Tabassum ◽

Waris Qidwai ◽

Kashmira Nanji

Keyword(s):

Nonverbal Communication ◽

Tertiary Care ◽

Eye Contact ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Nonverbal Behaviors ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9±10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

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Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.03.5241 ◽

2021 ◽

Vol 28 (03) ◽

pp. 338-343

Author(s):

Shah Ali Ahmed ◽

Anwarul Haque ◽

Qalab Abbas ◽

Humaira Jurair ◽

Zohra Qamar ud Din ◽

...

Keyword(s):

Intensive Care ◽

Blood Stream Infection ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Blood Stream ◽

Central Line ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

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Comparative study of maternal and perinatal outcome in pregnancies with and without umbilical cord around foetal neck

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190886 ◽

2019 ◽

Vol 8 (3) ◽

pp. 1096

Author(s):

Pundalik K. Sonawane ◽

Deep M. Bhadra

Keyword(s):

Umbilical Cord ◽

Tertiary Care ◽

Cross Sectional Study ◽

Common Finding ◽

Control Group ◽

Study Group ◽

Care Hospital ◽

Cross Sectional ◽

Nuchal Cord ◽

The Difference

Background: Umbilical cord around neck of the foetus is called the nuchal cord. The aims and objectives are to find out the incidence of nuchal cord around foetal neck at delivery, and to compare and evaluate intrapartum and postpartum maternal and foetal outcome in those with or without nuchal cord at delivery.Methods: It is a prospective cross-sectional study conducted at tertiary care hospital for period of 12 months. Of 1380 patients, 934 patients were enrolled in present study after meeting the inclusion and exclusion criteria of which 150 patients were included in study group who delivered with nuchal cord and 784 patients in control group who delivered without nuchal cord.Results: Present study showed 18.84% incidence of nuchal cord at delivery. Duration of labour was 6.51hrs in study group and 6.15hrs in control group and the difference was statistically significant. Rest of the intrapartum and postpartum events were statistically not significant. Mean length of cord was more in patients delivered with loop of cord around foetal neck as compared to another group and it is statistically significant.Conclusions: Nuchal cord is a common finding at the time of delivery. However, it is per-se not an indication of LSCS and it only increases the operative morbidity.

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CRANIAL ULTRASOUND IN DETECTION OF NEUROLOGICAL LESIONS IN PRETERM NEONATES IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE OBSERVATIONAL STUDY.

10.36106/ijar/6300996 ◽

2020 ◽

pp. 23-25

Author(s):

Badri kumar Gupta ◽

Nand kishor Gupta ◽

Prem Yaday ◽

Sadan Mukhi

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Common Finding ◽

Preterm Neonates ◽

Cranial Ultrasound ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Cranial Ultrasonography

BACKGROUND: Incomplete formation and maturation of the central nervous system makes it extremely vulnerable to injury, in the case of premature neonates. This can result in a broad range of neurodevelopmental abnormalities. Cranial ultrasound is a sensitive tool for the early detection of these.Preterm neonates, defined as childbirth occurring at less than 37 completed weeks of gestation, is a major determinant of neonatal mortality and morbidity because of their greater risk for intraventricular hemorrhage (IVH) and hypoxic ischemic encephalopathy (HIE). The morbidity associated with preterm birth often extends to later life, resulting in enormous physical, psychological and economic costs. Currently, many imaging modalities are available like Cranial Ultrasonography, Computed Tomography and Magnetic Resonance Imaging to detect the intracranial abnormalities in these neonates. However advantages of Cranial Ultrasonography are easy availability, not expensive, easy to perform, quick, can be done at bedside, repeatable and radiation free. The aims of the study were to identify the severity of brain injuries by grading the neurosonographic findings and to correlate the clinical presentations with the neurosonographic findings. MATERIALS AND METHODS: This study is done in Department of pediatrics in Neonatal Intensive Care Unit in Universal College of Medical Sciences ,a tertiary care hospital, Bhairahawa. This cross-sectional study comprise of 60 preterm neonates, referred to Department of Radio diagnosis for cranial ultrasonogram. Ultrasound examination of the neonatal brain done through anterior fontanelle in coronal and sagittal planes within 1st week using healthcare logiq p6 pro ultrasound machine. RESULTS: In this cross-sectional study of 60 neonates, 46 were male and 14 were female. Among 60 babies, 30 (50%) showed normal study and remaining 30 (50%) showed abnormal scan. Among the cases which were abnormal on scan most common finding was GMH (33.3%) and next commonest was periventricular leucomalacia (PVL- 16.7%) noted in 10 babies. CONCLUSION: Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.

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Surgical audit: A process of self-evaluation for better future.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.4208 ◽

2020 ◽

Vol 27 (05) ◽

pp. 1049-1053

Author(s):

Muhammad Kaleem Ullah ◽

Muhammad Usman Hashmi ◽

Mohsin Sarwar ◽

Abdulaleem ◽

Anosh Aslam Khan ◽

...

Keyword(s):

Tertiary Care ◽

Numerical Data ◽

Cross Sectional Study ◽

University Hospital ◽

Mortality Data ◽

Care Hospital ◽

Health Care Planning ◽

Cross Sectional ◽

Local Study ◽

Patient Department

Objectives: To describe the pattern of thoracic surgical diseases at a tertiary care hospital in South-Punjab Pakistan. Study Design: Descriptive, cross-sectional study. Setting: Nishtar Medical University hospital Multan, Pakistan. Period: From 01-01-2018 to 31-12-2018. Material & Methods: All the patients who were admitted through the out-patient department or referred from other units, over the year 2018, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, a surgical procedure performed, type of anesthesia-induced and the mortality. Data were analyzed using IBM SPSS statistics version 20. Mean and percentages were used for numerical data. Data were presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations. The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system.

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Antibiotics prescreption pattern and resistance profile of common isolates at Soba university hospital in Khartoum, Sudan, a retrospective cross sectional study

10.21203/rs.3.rs-22973/v1 ◽

2020 ◽

Author(s):

Fatima Ahmed ◽

Abubaker Koko ◽

Ola Mohamed ◽

Reem Elhag ◽

Sufian Khalifa ◽

...

Keyword(s):

Complete Blood Count ◽

Tertiary Care ◽

Generation Cephalosporin ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Global Public Health ◽

Sectional Study ◽

Cross Sectional ◽

Resistance Profile

Abstract Introduction: Antimicrobial resistance (AMR) is an incrrasingly global public health threat. An average of 45% of all patients are prescribed antibiotics. Nearly 50% of these prescribed antibiotics are unnecessary and they may promote the emergence of resistant strains. Antimicrobial stewardship programs have been introduced to tackle this problem. In this study we aim to determine the pattern of antibiotics prescription and resistance profile of common bacterial isolates at Soba university hospital , Sudan. Methods: A retrospective cross sectional study that was conducted at the medicine and surgery wards in a tertiary care hospital . Records of all patients who were admitted during the study period were included. A presented data collection form was used to collect information. Results: Records of 269 inpatients were reviewed. The mean age of patients was 49.5±18.7 years. The most frequently reported diagnoses on admission included cerebrovascular accidents and chronic liver disease, with 10.6% and 7.1% respectively. Je mean duration of stay at the hospital was 6.6 ± 6 days. Almost 81.8% of admitted patients recieved antibiotics. The majority (38.7% and 34.2%) were given one, and two antibiotics, respectively. Most of the antibiotics were administered intravenously (82.1%). Third generation cephalosporin antibiotcs (38%) and metronidazole (21.7%) were the most frequently prescribed. No documented indication for antibiotic prescriptio was found in 40.5% of cases. The main reason for stopping antibitics was the patients discharge (63.6%). Of patients recieving antibiotics, only 5 (1.9%) had undergone culture. Complete blood count (CBC) was requesed in nearly all patients (99.2%). A total of 100 cultures were performed during the study time. Most of them were urine cultures (64%). Escherichia Coli was isolated from 14 (29.2%) cultures. Resistance percentage was highest for erythromycin, and oxacillin (100% for both). Conclusion: The study shows a trend of antibiotic misuse. Most patients recieved antibiotics without documented indication. Antibiotics sensitivity results showed high levels of resistance among isolated organisms. We recommended a wider study and formulation and impementation of clear guidlines to regulate antibiotics use.

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Frequency and determinants of postpartum depression.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.4081 ◽

2020 ◽

Vol 27 (05) ◽

pp. 1017-1021

Author(s):

Muhammad Umar Ghafoor ◽

Rabia Arshed Usmani ◽

Zaidan Idrees Choudhary ◽

Shahbaz Ahmad ◽

Aftab Nazir ◽

...

Keyword(s):

Postpartum Depression ◽

Postnatal Depression ◽

Medical Information ◽

Tertiary Care ◽

Depression Scale ◽

Cross Sectional Study ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Cross Sectional

Objectives: This study was designed to evaluate the frequency of postpartum depression in new mothers at a tertiary care hospital in Faisalabad and identify the factors associated with the condition. Study Design: Cross-sectional study. Setting: Obstetrics and Gynecology Department of Independent University Hospital, Faisalabad. Period: Over a period of three months from February 2018 to May 2018. Material & Methods: Included 213 subjects selected through nonprobability purposive sampling patients who had given birth in the last six months were included in the study. The Punjabi version of Edinburgh Postnatal Depression Scale was used to assess for depression. Socio-demographic and medical information was collected on a pre-designed proforma. Data was analyzed using SPSS version 23. Chi square test was applied to ascertain association. Results: Out of the total 213 participants, 33.8% (n=72) of the study sample were suffering from postnatal depression. The socio-demographic profile of the depressed patients showed that most of them were uneducated (84.72%), housewives (77.78%) living with extended families (68.06%). The difference in the number of depressed women among extended and nuclear families was found to be statistically significant (p-value of 0.004). The study also showed that women suffering from postpartum depression were less likely to breastfeed their babies (p-value 0.046). Conclusion: Postpartum depression was identified in more than one thirds of the females included in this study. This high number should raise an alarm for all health professionals. Detection through mandatory screening and early intervention can prevent the adverse consequences this disorder carries for the mother and the child.

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Adequacy of Thyroid Homone Replacement in a Tertiary Care Hospital in Nepal-An Observational Study

Journal of Diabetes and Endocrine Association of Nepal ◽

10.3126/jdean.v5i1.38802 ◽

2021 ◽

Vol 5 (1) ◽

pp. 33-38

Author(s):

H.K. Shrestha ◽

R. Tamrakar ◽

A. Shrestha ◽

M. Uprety ◽

B. Shrestha

Keyword(s):

Treatment Outcome ◽

Tertiary Care ◽

Multivariate Logistic Regression Analysis ◽

Well Being ◽

Cross Sectional Study ◽

University Hospital ◽

Care Hospital ◽

Cross Sectional ◽

Levothyroxine Replacement ◽

Hypothyroid Patients

Background: The therapeutic goal in hypothyroidism is to achieve patients’ well-being and restore serum thyrotropin (TSH) to levels within the reference range. However, inadequate or over replacement is common in patients receiving levothyroxine. The Objective is to assess the treatment outcome of hypothyroid patients visiting outpatient clinic of medicine department of Kathmandu University Hospital, Dhulikhel, Nepal. Method: This is a cross sectional study on diagnosed Primary Hypothyroid patients who were taking levothyroxine replacement for at least six months. Patients were defined as euthyoid if their TSH was in the normal range (0.3-3.6 mmol/L) according to the hospital laboratory. Similarly patients were defined as over treated if TSH is <0.3 mmol/L and undertreated if TSH is >3.6 mmol/L. Results: A total number of 126 patients were enrolled for this study where mean age of participants was 40.88 ± 11.47 years and only 15 (11.1%) were male. Mean duration of hypothyroidism was 3.45 ± 2.57 years and mean Levothyroxine dose was 58.93 ± 26.89 mcg. In this study, nearly 70% of participants have normal TSH level. Similarly, 21% of participants have higher level of TSH and 9% have low TSH level. Multivariate logistic regression analysis did not show any significant co relation between treatment outcome and various variables. Conclusion: Treatment of hypothyroidism with levothyroxine being most effective, easily available, simple regimen and not costly, still one third of patients are not meeting the treatment outcome. However, being the pioneer study from Nepal, this study suggests improved treatment outcomes compared to similar studies from other countries.

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