scholarly journals Evaluation of pedicled flaps for type IIIB open fractures of the tibia at a tertiary care center

2021 ◽  
Vol 48 (4) ◽  
pp. 417-426
Author(s):  
Madhubari Vathulya ◽  
Mohit Dhingra ◽  
Hawaibam Nongdamba ◽  
Debarati Chattopadhyay ◽  
Akshay Kapoor ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Significant Positive Correlation ◽  
Tertiary Care ◽  
Perforator Flap ◽  
Soft Tissue Coverage ◽  
Local Flaps ◽  
Flap Necrosis ◽  
Pedicled Flaps ◽  
Positive Correlation ◽  
Type Iiib

Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center.Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation.Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03).Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

scholarly journals Prescribing pattern and awareness about anemia among in-patients in a tertiary care teaching hospital

2018 ◽  
Vol 5 (9) ◽  
pp. 4000
Author(s):  
Mohammed Sarfaraz ◽  
A. S. Archana ◽  
Bhavana Kalwa ◽  
Monish Abraham Mathew ◽  
Shilpa Anna Kuriakose ◽  
...  
Keyword(s):  
Folic Acid ◽  
Teaching Hospital ◽  
Significant Positive Correlation ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Prescribing Pattern ◽  
Tertiary Care Teaching Hospital ◽  
Positive Correlation ◽  
Care Teaching

Background: Anemia is a major public health problem in India affecting people in all age groups with major consequences for human health as well as economic development. Hence the study aims to assess prescribing pattern of physicians in anemia and to create awareness among in-patients in a tertiary care teaching hospital.Methods: A prospective and observational study was carried out in 180 in-patients admitted to General Medicine department in a tertiary care teaching hospital diagnosed with anemia for 6 months. Data was collected from case sheets of patients and assessed for prescribing pattern and direct interview was conducted with patients using standardized KAP questionnaire on anemia.Results: Among 180 in-patients, 126 patients (70%) were females and 54 patients (30%) were males. As part of the therapy, folic acid with vitamin combinations (37 prescriptions) followed by elemental iron with folic acid combinations (32 prescriptions) were most prescribed drugs. KAP questions were scored appropriately and compared with hemoglobin levels. Knowledge level of patients was not significantly correlated (i.e., p=0.254) with their haemoglobin levels. There was a highly significant positive correlation (i.e., p=0.006) between attitude scores of patients and haemoglobin levels. A significant positive correlation (i.e., p=0.001) was found between practice scores of patients and hemoglobin levels.Conclusions: This study clearly showed that prescribing pattern of drugs in anemia patients’ needs to be continuously evaluated. To address the issue of anemia, the patient’s awareness should be enhanced.

scholarly journals An Analysis of Drug-Drug Interactions in a Tertiary Care Hospital in Kerala: A Retrospective Study

2021 ◽  
Author(s):  
Jihana Shajahan
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Providers ◽  
Positive Correlation ◽  
Duration Of Hospital Stay ◽  
The Impact

Introduction: Concomitant use of several drugs for a patient is often necessary for achieving therapeutic response. Understanding the profile of Drug-Drug Interactions (DDI) will help health care providers to optimise therapy for better patient outcomes, reinforcing the concept of rational drug use. Aim: To analyse the frequency, mechanisms and severity of DDIs in a tertiary care hospital at Kerala. Materials and Methods: A retrospective cross-sectional study among 350 inpatients of a tertiary care hospital in Kerala from August 2020 to September 2020. Prescriptions containing ≥3 drugs were collected from inpatient medical records. A drug interaction check was performed using the Lexicomp drug interaction checker software. Results: DDIs were present in 74.6% of prescriptions and the average number of interactions was found to be 2.78. Most number for interactions was in the age group 61-80. Average number of DDI was significantly high among patients >60 years. Percentage of prescriptions with DDI and average number of DDI was found to be increasing with increase in number of drugs. Average number of interactions were maximum (5.01) in the group >10. Drug groups most commonly involved in interactions were antiplatelets, oral hypoglycaemic agents, bronchodilators, antibiotics, diuretics, insulin, statins, beta blockers, Proton Pump Inhibitors (PPI) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The most common interventions for minimising the impact of DDIs were changing the timing of drug administration, monitoring for symptoms/signs/lab values/drug levels or both. There was a significant positive correlation between duration of hospital stay and number of DDI. Conclusion: This study threw light upon the pattern and profile of DDIs among inpatients of a tertiary care hospital in Kerala. Elderly people (>60 years) were most prone for DDIs. Percentage of prescriptions with DDI and average number of DDIs was found to be increasing with increase in number of drugs. There was a positive correlation between duration of hospital stay and number of DDI.

Association of dyslipidemia with severity of meibomian gland dysfunction in a tertiary care hospital of Uttarakhand region

2021 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Aeshvarya Dhawan ◽  
Keyword(s):  
Lipid Profile ◽  
Significant Positive Correlation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Meibomian Gland ◽  
Low Density Lipoproteins ◽  
Meibomian Gland Dysfunction ◽  
Low Density ◽  
Care Hospital ◽  
Positive Correlation

AIM: To analyse the association between dyslipidemia and severity of meibomian gland dysfunction (MGD) in a tertiary care hospital of Uttarakhand region. METHODS: This prospective observational study was conducted over a period of one year including 50 consecutive patients of MGD. Patients underwent detailed history (including Ocular Surface Disease Index Questionnaire) and examination (including meibum quality, expressibility and numerical staining). MGD was graded according to the guidelines submitted by the International Workshop on Meibomian Gland Dysfunction and Management in 2011. Fasting lipid profile of all the patients was done. Various parameters of lipid profile including total cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL), high density lipoproteins (HDL) and very low density lipoproteins (VLDL) were correlated with MGD severity. Chi-square test was done for statistical analysis (P<0.05). RESULTS: Stage 2 MGD was the most common disease entity (60%, n=30). A significant positive correlation was noted between increasing age and severity of MGD (P=0.004). High TC (>200 mg/dL), TG (>150 mg/dL), LDL (>130 mg/dL) and VLDL (>22 mg/dL) levels had a significant positive correlation with the severity of MGD (P=0.001, 0.019, 0.001, 0.016 respectively). CONCLUSION: Monitoring the fasting lipid levels may aid in establishing the severity of MGD and further studies may be conducted to establish the role of treatment of dyslipidemia in MGD.

Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study

2017 ◽  
Vol 126 (7) ◽  
pp. 555-560
Author(s):  
Jason E. Cohn ◽  
Andrew Touati ◽  
Mark Lentner ◽  
Mark Weitzel ◽  
Casey Fisher ◽  
...  
Keyword(s):  
Symptom Score ◽  
Significant Positive Correlation ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Clinical Score ◽  
Clinical Findings ◽  
Laryngeal Edema ◽  
Common Symptom ◽  
Positive Correlation

Objectives: The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients. Methods: A retrospective chart review was conducted to identify symptoms and clinical findings associated with self-extubation. A novel scoring system was developed and used to quantify these findings. Symptom score included all symptoms that patients reported after self-extubation. Clinical score consisted of laryngeal findings visualized on nasopharyngeal laryngoscopy. Finally, a total self-extubation score was calculated as the sum of the symptom and clinical scores. Additionally, duration of intubation and endotracheal tube size were correlated with these scores. Results: Sixty (n = 60) patients who self-extubated in our institution’s intensive care unit were identified. Average calculated symptom, clinical, and total self-extubation scores were 0.92, 1.43, and 2.35, respectively. The most common symptom observed was hoarseness (62%), while the most common clinical finding was posterior laryngeal edema (58%). A significant positive correlation was found between duration of intubation and both symptom score and total self-extubation score (r = 0.314, P = .008 and r = 0.223, P = .05, respectively). Symptom score predicted clinical score with a significant positive correlation present (r = 0.278, P = .02). Conclusions: This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.

scholarly journals BERA in Newborns with Hyperbilirubinemia

2017 ◽  
pp. 31-35
Author(s):  
Edwin Dias
Keyword(s):  
Significant Positive Correlation ◽  
Tertiary Care ◽  
Auditory Pathway ◽  
Auditory Threshold ◽  
Care Hospital ◽  
Positive Correlation ◽  
Significant Prolongation ◽  
Brainstem Response ◽  
Bilirubin Toxicity ◽  
Normal Neonates

BACKGROUND: Neonatal hyperbilirubinemia is a common problem seen in the newborn period, is usually mild and transient without long-lasting sequelae. Bilirubin induced neurologic damage may occur and auditory pathway is the most sensitive past to bilirubin toxicity. Auditory brainstem response (BERA) provides an electro physiologic means of assessing ascending auditory pathway and to localise the lesion. AIMS: To assess the effect of bilirubin toxicity on brainstem auditory pathway among neonates with hyperbilirubinemia using BERA and compare with control of normal newborns. MATERIAL AND METHODS: BERA was recorded in twenty five term newborns admitted to Tertiary care hospital, with hyperbilirubinemia at level exceeding exchange transfusion (mean bilirubin level 25.4+/- 4.66 mg/dl). They were compared with 25 term normal newborns without any risk factor for hearing impairment. The results were analysed by Gaussian test (Z), student unpaired ‘t’ test, chi square test and Mann-Whitney U test. RESULTS: At least one of waves I, III and V was absent in 8% of newborn with hyperbilirubinemia. There was statistically significant prolongation of mean latencies of waves III and V and mean I-V interwave latency in hyperbilirubinemia newborn compared to normal neonates . Auditory threshold was elevated in 6 out of 25 jaundiced newborn. Significant positive correlation between BERA abnormalities and bilirubin levels was found with respect to presence of waves I, III and V and auditory threshold. No significant positive correlation was found between bilirubin levels and BERA latencies. CONCLUSION: BERA abnormalities were noted in form of absence of waves I, III, V,prolongation of latency and interwave latencies and increased auditory threshold in newborns with hyperbilirubinemia as compared to normal neonates. BERA abnormality was also found to be transient and was normal in most of these patients during follow up.

scholarly journals STUDY TO DETERMINE THE RELATION BETWEEN HBA1C, LIPID PROFILE AND CRP IN INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Shubham Bhaskar ◽  
Heena Anjum Tarafdar ◽  
Manish Kumar ◽  
SK Astik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Significant Positive Correlation ◽  
Tertiary Care ◽  
Care Hospital ◽  
Positive Correlation ◽  
Significant Difference

Aim: The aim of this study to determine the relation between HbA1C, Lipid profile and CRP in individuals with type 2 diabetes mellitus. Material and methods: This prospective observational study was carried out in the Department of Medicine in Nalanda Medical College and Hospital at Patna, Bihar India for 1 year. The patients above 30 years with fasting venous blood glucose value equal or more than 100 mg/dl and postprandial glucose >140 mg/dl were include in this study. FBS and PPBS, CRP (immunoturbidimetric method), and HbA1C (ion exchange chromatography using HPLC) lipid profile samples were drawn at entry and at subsequent follow-up with a minimum gap of 3-6 months. Results: There was no significant difference between gender, age and BMI (p>0.05). FBS and HbA1C were directly correlated. PPBS showed a direct correlation with both HbA1C and CRP in this study. There was a significant positive correlation between CRP and total cholesterol (p<0.05). There was no significant correlation between CRP and LDL cholesterol (p>0.05). There was a negative correlation between HDL cholesterol and CRP. There was significant positive correlation between CRP and triglyceride levels (p<0.05). There was significant correlation between CRP and HbA1C (p<0.05). Conclusion: We concluded that the CRP is an additional marker of better glycaemic control and also correlates with the dyslipidaemia profile seen in type 2 diabetes mellitus. Keywords: C-reactive protein, Glycemic control, Hemoglobin A1C, Type 2 diabetes mellitus.

scholarly journals The Potential Diagnostic and Predictive Role of HbA1c in Diabetic, Septic Patients - a Retrospective Single Center Study

2020 ◽  
Author(s):  
Imre Juhász ◽  
Janka Juhász ◽  
Hajnalka Lőrincz ◽  
Ildikó Seres ◽  
Lilla Végh ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Significant Positive Correlation ◽  
Length Of Hospital Stay ◽  
Positive Correlation ◽  
Emergency Department Admission ◽  
Diagnostic Role ◽  
Predictive Role ◽  
Hba1c Measurement ◽  
Hba1c Levels

Abstract Background: Diabetes mellitus is a major risk factor of sepsis. The potential role of hemoglobin A1c (HbA1c) in diabetic, septic patients has not yet been studied. Results: In our retrospective study we included diabetic, septic patients - in whom the diagnosis of sepsis was based on the Systemic Inflammatory Response Syndrome (SIRS) criteria (112 patients, SIRS group) - who had HbA1c levels measured either in the previous 30 days (SIRS 30d subgroup – 39 patients) or within 24 hours after their Emergency Department admission (SIRS 24h subgroup – 73 patients). We later selected those patients from the SIRS group, whose Sequential Organ Failure Assessment (SOFA) score was ≥ 2 (55 patients, SOFA group) and these patients were also divided based on the time of HbA1c measurement (SOFA 30d subgroup – 21 patients and SOFA 24h subgroup – 34 patients). We analyzed the relationship between laboratory parameters, length of hospital stay and HbA1c. We found a significant positive correlation between glucose and HbA1c, significant negative correlations between white blood cell count (WBC) and glucose, WBC and HbA1c levels in the SIRS 24h and SOFA 24h subgroups. Furthermore there was a significant positive correlation between length of hospital stay and HbA1c in the SOFA 24h subgroup. No significant correlations were found in the SIRS 30d and SOFA 30d subgroups. Conclusions: Based on our results normal WBC with elevated HbA1c might be considered a positive SIRS criterium in diabetic, SIRS 24h patients. Besides this potential diagnostic role, HbA1c might also be an additional prognostic biomarker in diabetic, SOFA 24h patients.

scholarly journals Correlation of transcutaneous bilirubin with total serum bilirubin in neonates with hyperbilirubinemia

2021 ◽  
Author(s):  
Mohanram Venkatesan ◽  
Arulraj Russelian ◽  
Palpandi Velimuthu
Keyword(s):  
Significant Positive Correlation ◽  
Serum Bilirubin ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Positive Correlation

Background: For determining hyperbilirubinemia in a neonate, clinical evaluation, serum bilirubin estimation and trans cutaneous bilirubin estimation are the modalities available. Transcutaneous bilirubinometry (TcB) is routinely used to monitor jaundice in term and near-term infants. Literature shows a positive correlation observed between TcB and total serum bilirubin (TSB). The present study was conducted determine the correlation of TcB with TSB in neonates with hyperbilirubinemia admitted at a tertiary care hospital, ChennaiMethods: A cross sectional study was conducted at a tertiary care hospital, Chennai where 350 neonates who have clinical jaundice and require estimation of serum bilirubin who are admitted to the tertiary care centre, Chennai during December 2020-March 2021 were included in the study. The ROCHE INTEGRA-e 411+ autoanalyzer was used to estimate TSB (mg/dl) using a modified diazo method. The Jaundice Meter JM-103 to measure TcB, (Manufactured by Draeger medical systems, Germany). Pearson corelation coefficient was used to find the correlation between the two variables. P<0.05 was considered to be statistically significant.Results: Out of 350 neonates admitted to the tertiary care centre, term deliveries were 57.1% and pre term were 42.9%. 83.1% were in the age group of 3-7 days. The mean weight of the study population was 2.16±0.60 kg. In term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.90 with p≤0.0001. Among pre term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.96 with p≤0.0001.Conclusions: This study's findings support the use of a TcB metre as a screening tool for clinically significant hyperbilirubinemia.

Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon

2019 ◽  
Vol 15 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Ghada El Khoury ◽  
Hanine Mansour ◽  
Wissam K. Kabbara ◽  
Nibal Chamoun ◽  
Nadim Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Diabetic Patients

Background: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. Objective: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. Methods: The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. Results: A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). Conclusion: Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

Sign in / Sign up

Export Citation Format

Share Document