scholarly journals Assessment of Risk Factors and Prevalence of under Nutrition Using Composite Index of Anthropometric Failure (CIAF) among under 5 Children in a Tertiary Care Center

2021 ◽  
pp. 353-360
Author(s):  
M. Devika ◽  
N. Kishore
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Composite Index ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Major Health ◽  
Under Nutrition ◽  
Child Morbidity ◽  
Measuring Tape

Background: Under nutrition is a major health problem in the developing countries especially India. It has a significant impact to child morbidity and mortality. Objective: To assess the risk factor and prevalence of under nutrition among children under 5 years of age, using conventional indices and the Composite Index of Anthropometric Failure (CIAF), and then comparing their estimated results. Materials and Methods: This cross-sectional study was carried out in the pediatrics department (outpatient and inpatient) from January 2021 to March 2021 using sample size of 300. Attendants of Toddler’s were interviewed with semi structured proforma and height and weight of toddler were measured by measuring tape and weighing machine respectively. Informed consent was obtained. MS excel was used for data analysis after compilation. Results: CIAF identified 96% of childrens to have under nutrition. By using conventional indices it was seen that 62.8% of the children were underweight, 50% were stunted and 44.4% were wasted. Conclusion: CIAF gives a better estimate of under nutrition than currently used conventional indices; and identifies more children with multiple anthropometric failures.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals An observational study on patient compliance and adverse drug reactions of antihypertensives drugs in a tertiary care center of Bihar

2021 ◽  
Vol 6 (4) ◽  
pp. 190-193
Author(s):  
Mrityunjay Kumar Pandit ◽  
Kumar Gaurav ◽  
Jeetendra Kumar
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Antihypertensive Drugs ◽  
Care Center ◽  
Adult Population ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
High Dose ◽  
Cross Sectional ◽  
Institutional Ethics

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.

scholarly journals Correlation of Platelet Count and Hematocrit Levels to the Severity of Dengue Hemmoraghic Fever Patients at RSD dr. Soebandi Jember

2021 ◽  
Vol 7 (3) ◽  
pp. 156
Author(s):  
Salma Naqiyyah Tirtadevi ◽  
Rini Riyanti ◽  
Desie Dwi Wisudanti
Keyword(s):  
Platelet Count ◽  
Negative Correlation ◽  
Predictive Value ◽  
Medical Records ◽  
Secondary Data ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Major Health

Dengue hemorraghic fever (DHF) is an infectious disease caused by the dengue virus and It is still be a major health problem in Southeast Asia, especially in Indonesia. Kabupaten Jember is still categorized as a dengue endemic area with its disease development expanding from year to year. This study aims to determine the correlation of platelet count and hematocrit levels to the severity of DHF patients at RSD dr. Soebandi Jember, as well as knowing whether the platelet count and hematocrit levels can be used as a predictive value for the severity of DHF patients at RSD dr. Soebandi Jember. This study used an observational analytic study with a cross-sectional study design. The data of this study used secondary data from the medical records of DHF patients at RSD dr. Soebandi Jember. The results of this study with a total of 68 samples showed that there was a significant negative correlation between the platelet count to the severity of DHF patients (p = 0,000, r = -0,487). The hematocrit levels showed an insignificant and negative correlation to the severity of DHF patients (p = 0,658, r = -0,055). The platelet count can be used as a predictive value for the severity of DHF patients. Keywords: DHF, platelet count, hematocrit levels, severity of DHF patients  

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.

Life-Limiting Conditions at a University Pediatric Tertiary Care Center: A Cross-Sectional Study

2018 ◽  
Vol 21 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Annemarie Bösch ◽  
Julia Wager ◽  
Boris Zernikow ◽  
Ralf Thalemann ◽  
Heidi Frenzel ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Ischemic Stroke Subtypes: Socio-demographic Factors, Risk Factors, and Outcomes in Southern Sri Lanka

2021 ◽  
Vol 31 (4) ◽  
pp. 509-518
Author(s):  
Sathyajith Buddhika Ambawatte ◽  
Dulmini Nadeesha Weerathunga ◽  
Athula Dissanayake ◽  
Surangi Chandhi Somaratne ◽  
Kanishka Athukorala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Sri Lanka ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Analysis ◽  
Cross Sectional Study ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Cross Sectional

Background: Stroke is a heterogeneous, catastrophic disease. A comprehensive clinical analysis of ischemic stroke (IS) risk factors and outcomes is crucial for optimum management in resource-poor settings.Methods: A prospective cross-sectional study of acute cerebrovascular disease (ACVD) involving 592 patients was con­ducted in a tertiary care center in Sri Lanka from November 2018 to May 2019. We aimed to describe the ACVD subtypes and the relationship of IS subtypes and subtype-categories (as defined by the Oxfordshire Community Stroke Project clinical clas­sification) with risk factors, severity, and outcome.Results: The majority (63.3%) had IS. Partial anterior circulation syndromes (PACS), total anterior circulation syndrome (TACS), posterior circulation syndromes (POCS), and lacunar syndromes (LACS) accounted for 102 (29.7%), 58 (16.9%), 88 (25.7%) and 95 (27.7%) of the cases, respectively. The most common PACS sub-category was higher-cerebral-dysfunction-with-homonymous-hemianopia (HCD+HH,39 cases;38.2%). Cerebellar-signs-without-long-tract-signs (CS-LTS) sub-category constituted the highest among POCS (47 cases; 53.4%). The leading sub-category within LACS was pure-motor (PM) strokes (43 cases; 45.3%).Patients aged ≥50 years (adjusted-OR [AOR]2.439; 95%CI,1.163-5.116;P=.018), IHD(AOR 2.520; 95%CI,1.347-4.713; P=.004) and BMI>23kg/m2(AOR 2.607; 95% CI,1.420-4.784; P=.002) were 2.5 times more likely to associate with TACS. Patients with a history of TIA (AOR 1.910; 95%CI,1.036-3.524; P=.038) and arrhyth­mias (AOR 5.933; 95%CI,3.294-10.684; P<.001) were 1.9 and 5.9 times more likely to be associated with POCS respectively. Those with hypertension were 2.3 times more likely to associate with LACS (AOR 2.233; 95%CI,1.270-3.926; P=.005).NIHSS(P<.001), mRS on admission (P=.001) and in 3 months (P<.001), deaths during hospital stay (P=.003) and within 28 days (P<.001) had a stronger relationship with individual stroke subtypes.Conclusion: The comparative risk of different IS subtypes depends on differ­ent risk factors. The findings of this study demonstrate that sub-categories within each stroke subtype may behave independently with regard to risk factors and outcomes, thus warranting the need for individual assessment. Ethn Dis. 2021;31(4):509-518; doi:10.18865/ed.31.4.509

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