Analysis of Pain Manifestation and Its Management in Adults

Introduction: Pain is link with significant disable due mobility, avoidance of activity, falls, depression and anxiety, sleep impairment, and isolation. Objectives: The main objective of the study is to clinically analyse the pain manifestation and its management in adults. Methods: This cross sectional clinical audit was done in Services hospital Lahore during January 2020 till June 2020. The data was collected from a large number of patients undergoing intermediate to major surgery and thus have high analgesic requirements. Medical folders that were not available or had missing notes were excluded. The folders were requested from the Medical Records Department and reviewed by four investigators. Results: The data was collected from 169 patients. The mean age of the patients was 38 years. Pain was assessed in 85 of the 168 patients (51%) (62 of the 110 urogynaecology patients; 23 of the 58 orthopaedic patients) and reassessed in 55 of the 85 patients (65%) who had received an initial pain assessment. The ward doctor (intern, registrar or specialist) assessed pain in 67% of the 85 patients evaluated. Conclusion: It is concluded that a significant proportion of the pain interventions appeared to be based on the professional knowledge of the practitioner and not supported by evidence-based guidelines of pain management.

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Mohs micrographic surgery: a study of 83 cases

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962012000200006 ◽

2012 ◽

Vol 87 (2) ◽

pp. 228-234 ◽

Cited By ~ 7

Author(s):

Flavianne Sobral Cardoso Chagas ◽

Bruno de Santana Silva

Keyword(s):

Cell Carcinoma ◽

Medical Records ◽

Cross Sectional Study ◽

Mohs Micrographic Surgery ◽

Micrographic Surgery ◽

Cross Sectional ◽

The Mean ◽

Nasal Region ◽

Cure Rates ◽

Observation Period

BACKGROUND: Mohs micrographic surgery can achieve high cure rates in the treatment of skin cancer and remove a minimum of healthy tissue. OBJECTIVES: To characterize patients undergoing Mohs micrographic surgery and study issues related to the number of surgical stages. METHODS: A descriptive, retrospective, cross-sectional study was conducted in a micrographic surgery reference center for the period of 2004 to 2010. Data was collected from medical records of 79 patients (83 surgeries). RESULTS: We studied 43 women and 36 men. The mean age was 57.5 ± 14,6 years. Skin types II and III were the most frequent, accounting for 41% and 36.1%, respectively. The most frequent tumor was the basal cell carcinoma (89.1%), and the solid subtype was the most common (44.6%), followed by sclerodermiform histological subtype (32%).The most frequent location was the nasal region (44.6%). The large majority of the operated tumors were recurrent lesions (72.7%). Half of the tumors measured 2 cm or more. In 68.7% of the cases two or more surgical stages were necessary for the removal of the tumors. The observation period was 2 or more years in 75% of the tumors. There was 01 post-Mohs recurrence and 02 patients had metastases during the observation period (both with squamous cell carcinoma). CONCLUSION: The findings coincide with those of the literature, recurrent tumors and tumors larger than 2cm needed more surgical stages for their removal, although there was no statistic difference (p=0,12 and 0,44 respectively).

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Association between endometriosis, headache, and migraine

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.1177/2284026518818975 ◽

2019 ◽

Vol 11 (1) ◽

pp. 19-24 ◽

Cited By ~ 4

Author(s):

Burcin Karamustafaoglu Balci ◽

Zehra Kabakci ◽

Damla Y Guzey ◽

Bartu Avci ◽

Murathan Guler ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Medical Records ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Autonomic Nervous ◽

Screening Questions ◽

The Mean ◽

Id Migraine

Introduction: Available data suggest that there is an association between endometriosis and a group of disorders including autonomic nervous system irregularities. A deeper understanding of relationship between endometriosis and autonomic nervous system is needed as it may lead to novel discoveries on the causes or consequences of endometriosis. In this study, we analyzed the prevalence of migraine in patients with endometriosis. Methods: In this cross-sectional study, medical records of women were reviewed through January 2013 to December 2017. Women with laparoscopically proven endometriosis (n = 185) were compared with those without endometriosis (n = 168). The 3-item screening questions (ID Migraine™) test was used to screen migraine. Data were analyzed using SPSS v25 (IBM Corporation). The χ2 test was used for analyzing the nominal parameters and group comparisons. Pearson χ2 was used to study the association between endometriosis and migraine. Results: The mean age was 31.86 ± 4.49 years of the endometriosis group and 28.95 ± 5.11 years of the controls (p = 0.408). The two pre-screening questions of ID Migraine test were answered positively by 86 patients of the endometriosis group (75.4%) and by 53 patients of the control group (54.6%) (p = 0.001). Of these patients, 51 (44.7% of endometriosis group) and 26 (26.8% of control group) were diagnosed as having migraine using 3-item Migraine questionnaire (p = 0.007). Conclusion: This study showed that the prevalence of migraine was significantly higher in patients with endometriosis. Because there is a strong correlation, patients with endometriosis should be screened for headache and migraine to increase the benefits of care.

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Clinical characteristics and outcome of vasculitides

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v3i2.20267 ◽

2016 ◽

Vol 3 (2) ◽

pp. 3-9

Author(s):

Buddhi Prasad Paudyal ◽

Anjana Education Rajbhandari

Keyword(s):

Medical Records ◽

Clinical Characteristics ◽

Cross Sectional Study ◽

Health Sciences ◽

Small Vessel ◽

Small Vessel Vasculitis ◽

Cross Sectional ◽

The Mean ◽

Schonlein Purpura ◽

Overall Mortality

Introductions: Vasculitides can cause significant morbidity and mortality if not treated on time. There is lack of data locally. This study aims to define the pattern, clinical characteristics, and outcome of vasculitides.Methods: This was a cross sectional study between January 2011 and December 2015 at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. The medical records of patients diagnosed with vasculitides in adults rheumatology service of the hospital were reviewed.Results: Ninety six patients were diagnosed with vasculitides during the study period. The mean age was 42.2 years. Sixty nine (71.8%) patient had small vessel, 20 (20.8%) large vessel and five (5.2%) had variable vessel vasculitides. Seventy five patients (78.1%) had primary and 21 (21.8%) secondary vasculitides. Cutaneous leucocytoclasticangitis was seen in 27 (28.1%), Takayasu arteritis in 17 (17.7), Henoch-Schonlein purpura in 11 (11.4%) and Rheumatoid arthritis associated vasculitis in nine patients. Purpura was present in all 96 (100%). The overall mortality was 9 (9.3%).Conclusions: Primary vasculitides were more common than secondary forms. Small vessel vasculitis was the most common. Cutaneous symptoms were predominant features. The mortality was attributed to active disease, sepsis, and complications of the primary disease. Journal of Patan Academy of Health Sciences. 2016 Dec;3(2):3-9

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The Social and Psychological Impact of Superficial Dermatophytic Infection using Dlqi and Ghq-12: A Cross-Sectional Study in 174 Patients at a Tertiary Care Centre in Southern-East Rajasthan

10.47363/jdmrs/2021(2)133 ◽

2021 ◽

pp. 1-6

Author(s):

Shivani Saini ◽

◽

Agarwal Shail ◽

Jain Manish ◽

Yadav Devendra ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Impact ◽

Cross Sectional Study ◽

World Population ◽

Sectional Study ◽

Cross Sectional ◽

Number Of Patients ◽

The Mean ◽

The Impact

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications

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The prevalence of potentially beneficial and harmful drug-drug interactions in intensive care units

Drug Metabolism and Personalized Therapy ◽

10.1515/dmpt-2018-0034 ◽

2019 ◽

Vol 34 (1) ◽

Cited By ~ 1

Author(s):

Hossein Ali Mehralian ◽

Jafar Moghaddasi ◽

Hossein Rafiei

Keyword(s):

Intensive Care ◽

Drug Interaction ◽

Drug Interactions ◽

Intensive Care Units ◽

Medical Records ◽

Potential Ddis ◽

Cross Sectional ◽

Text Book ◽

The Mean ◽

Potential Interactions

Abstract Background The present study was conducted with the aim of investigating the prevalence of potentially beneficial and harmful drug-drug interactions (DDIs) in intensive care units (ICUs). Methods The present cross-sectional prospective study was conducted in two ICUs in Shahr-e Kord city, Iran. The study sample was consisted of 300 patients. The Drug Interaction Facts reference text book [Tatro DS. Drug interaction facts. St Louis, MO: Walters Kluwer Health, 2010.] was used to determine the type and the frequency of the DDIs. Results The participants consisted of 189 patients men and 111 women. The mean age of patients was 44.2 ± 24.6 years. Totally, 60.5% of patients had at least one drug-drug interaction in their profile. The total number of DDIs found was 663 (the mean of the total number of drug-drug interactions was 2.4 interactions per patient). Of all the 663 interactions, 574 were harmful and others were beneficial. In terms of starting time, 98 of the potential interactions were rapid and 565 of them were delayed. In terms of severity, 511 of the potential interactions were moderate. Some of the drugs in the patients’ medical records including phenytoin, dopamine, ranitidine, corticosteroid, dopamine, heparin, midazolam, aspirin, magnesium, calcium gluconate, and antibiotics, the type of ventilation, the type of nutrition and the duration of hospital stay were among the factors that were associated with high risk of potential DDIs (p < 0.05). Conclusions The prevalence of potentially beneficial and harmful DDIs, especially harmful drug-drug interactions, is high in ICUs and it is necessary to reduce these interactions by implementing appropriate programs and interventions.

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NECROTISING FASCIITIS : PREVELANCE AND DISTRIBUTION OF CAUSATIVE MICROORGANISM IN A MALAYSIA TERTIARY HOSPITAL - A 2 YEAR STUDY

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00048 ◽

2020 ◽

Vol 8 (5_suppl5) ◽

pp. 2325967120S0004

Author(s):

A.H M.Asyraf ◽

S Ashraf- Fareeq ◽

S Zulfahrizzat ◽

HS Arvinder-Singh ◽

Vasantha Kumari Neela ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Medical Records ◽

Group B Streptococcus ◽

Tertiary Hospital ◽

Lower Limbs ◽

Cross Sectional ◽

Causative Microorganism ◽

The Mean ◽

Group B

The objective of this study was to evaluate the prevalence of microorganism isolates types, antibiotic usage preference, the prevalence of diabetic amputations in necrotizing fasciitis (NF) and predicitive factors of amputation. Methodology: This study was a cross-sectional study conducted by looking at medical records ttraced from Hospital Seremban identifying all necrotizing fasciits admissions in the year of 2017/2018. The researchers first traced all medical records via electronic medical records. All case records were reviewed and identifiers were removed. Patients with missing notes/medico-legal cases were excluded from this study. Results: A total of 159 records were traced of which none met the exclusion criteria. The mean age of patients were 56.09 (SD:12.20), mean days stayed at hospital 25.09 (17.70) and the mean number of days patients were on at least one antibiotic was 18.87 (41.78). From the total, 145 (91.2%) were suffered at the lower limbs, 68 (42.8%) suffered an amputation [of which 31 were above-knee-amputations], 97 (61.0%) suffered from sepsis and 19 (11.9%) suffered mortality. 139 (87.4%) of the patients were diabetics, 105 (66.0%) were hypertensives and 87 (54.7%) were immunocompramised. The majority were caused by unknown aetiology [103 (64.8%)], 131 (82.4%) presented with erythema/cellulitis and 116 (73.0%) had good prognosis. The commonest type of NF was type 2 [103 (64.8%)]. The top 3 commonest isolates were Pseudomonas aeruginosa (15.7%), Klebsiella pneumoniae (12.6%) and β haemolytic Group B Streptococcus (10.7%). The 3 commonest antibiotics started were ampicillin/sulbactam combination (69.8%), ceftazidime (9.4%) and amoxycillin/clavulanate (4.4%). The mean LRINEC score was 7.72 (SD:2.31). Among the 139 diabetics, 68 (48.9%) ended up with an amputation. Among the 102 patients having both diabetes and hypertension (n=102), 50% suffered an amputation. A cross tabulation done showed that Klebsiella pneumoniae (17.2%), β haemolytic Group B Streptococcus (15.5%) and Proteus mirabillis (13.8%) were the common causative organisms in an amputation. A regression analysis done to identify predictive variables for an amputation showed no statistical significant variables. Conclusion: Proper handling of seafood during preparation should be encouraged as a simple bite may turn deadly. Initiation of antibiotics according to suspected organisms should be performed to prevent worsening of soft tissue infections. Conclusion: From this study, we concluded that the commonest type of isolates at our centre was Pseudomonas aeruginosa and the commonest antibiotic choice was the ampicillin/sulbactam combination and nearly half of diabetics with NF ended up with an amputation. There were no predictive factors for an amputation among the collected variables

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Factors Associated With Use of Telemedicine for Follow-Up of SLE in the COVID-19 Outbreak

Frontiers in Medicine ◽

10.3389/fmed.2021.790652 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ho So ◽

Evelyn Chow ◽

Isaac T. Cheng ◽

Sze-Lok Lau ◽

Tena K. Li ◽

...

Keyword(s):

Care Delivery ◽

Significant Proportion ◽

Damage Index ◽

Physician Global Assessment ◽

Full Time ◽

Systemic Lupus ◽

Cross Sectional ◽

Factors Associated ◽

The Mean

Objective: To investigate the factors associated with telemedicine (TM) use for follow-up of Systemic Lupus Erythematous (SLE) patients in the COVID-19 pandemic.Methods: This was a single-centered cross-sectional study conducted in Hong Kong. Consecutive patients followed up at the lupus nephritis clinic were contacted for their preference in changing the coming consultation to TM in the form of videoconferencing. The demographic, socioeconomic, and disease data of the first 140 patients opted for TM and 140 control patients preferred to continue standard in-person follow-up were compared.Results: The mean age of all the participants was 45.6 ± 11.8 years, and the disease duration was 15.0 ± 9.2 years. The majority of them were on prednisolone (90.0%) and immunosuppressants (67.1%). The mean SLEDAI-2k was 3.4 ± 2.4, physician global assessment (PGA) was 0.46 ± 0.62 and Systemic Lupus International Collaborating Clinics (SLICC) damage index was 0.97 ± 1.23. A significant proportion of the patients (72.1%) had 1 or more comorbidities. It was found that patients with higher mean PGA (TM: 0.54 ± 0.63 vs. control: 0.38 ± 0.59, p = 0.025) and family monthly income > USD 3,800 (TM: 36.4% vs. control: 23.6%; p = 0.028) preferred TM, while full-time employees (TM: 40.0% vs. control: 50.7%; p = 0.041) preferred in-person follow-up. These predictors remained significant in the multivariate analysis after adjusting for age and gender. No other clinical factors were found to be associated with the preference of TM follow-up.Conclusion: When choosing the mode of care delivery between TM and physical clinic visit for patients with SLE, the physician-assessed disease activity and patient's socio-economic status appeared to be important.

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Stomach Cancer in Patients Referred to Tohid Hospital in Sanandaj, 2012 - 2018: An Epidemiological Study

Journal of Archives in Military Medicine ◽

10.5812/jamm.111506 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Mastore Rahimi ◽

Ghodratollah Roshanaei ◽

Javad Faradmal ◽

Bayazid Ghaderi ◽

Leila Moradi

Keyword(s):

Gastric Cancer ◽

Stomach Cancer ◽

Cross Sectional Study ◽

Cross Sectional ◽

Quit Smoking ◽

Common Cancer ◽

Number Of Patients ◽

High Prevalence ◽

The Mean ◽

Spss Software

Background: Stomach cancer is the fourth most common cancer in the world and first cancer in Iran. The northern and northwestern regions of the country are areas with a high prevalence of gastrointestinal cancers, especially gastric cancer. Different factors are effective in the incidence of this cancer. Objectives: The present study aimed to evaluate the epidemiology of gastric cancer. Methods: This research was a cross-sectional study. All patients referred to Tohid Hospital in Sanandaj between 2012 and 2018 were examined. Data were extracted using patients' medical records. Descriptive information was collected through SPSS software, and the results were analyzed. Results: The number of patients in this study was 553. The mean age was 66.9 years, and the highest age group was 60 - 80 years. Four hundred twelve patients were male, and 141 were female. In 50% of patients, the location of the cardiac tumor was gastric. Chemotherapy was the most common treatment in more than 60% of patients. Conclusions: The results of this study show that smoking is unfortunately high in patients in this province. An educational intervention to quit smoking is recommended. Smoking is an important risk factor for gastric cancer, and this intervention may also be effective in reducing the incidence of this disease.

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Assessment of Knowledge and Compliance to Evidence-Based Guidelines for VAP Prevention among ICU Nurses in Tanzania

10.21203/rs.3.rs-117804/v1 ◽

2020 ◽

Author(s):

Vicent Bankanie ◽

Anne Outwater ◽

Li Wang ◽

Li Yinglan

Keyword(s):

Nursing Education ◽

Knowledge Score ◽

Educational Interventions ◽

Cross Sectional Study ◽

Local Context ◽

Evidence Based ◽

Cross Sectional ◽

Effective Measure ◽

The Mean ◽

Evidence Based Guidelines

Abstract Background: Implementation of evidence-based guidelines (EBGs) related to VAP is an effective measure for the prevention of ventilator-associated pneumonia (VAP). While low knowledge regarding the EBGs related to VAP prevention among ICU nurses is still a major concern among nurses in ICUs globally, the situation in Tanzania is scarcely known. This study aimed to assess the ICU nurses’ knowledge, compliance, and barriers toward evidence-based guidelines for the prevention of VAP in Tanzania.Methods: A cross-sectional study, involving ICU nurses of major hospitals in Tanzania, was conducted. A structured questionnaire was administered among 116 ICU. Data analysis included descriptive statistics and independent t-test.Results: The mean knowledge score was 38.6% which is lower than the lowest ever reported knowledge score for EBGs for VAP prevention. Nurses with a degree or higher level of nursing education performed significantly better than the nurses with a diploma or lower level of nursing education(p=0.004). The mean self-reported adherence score for EBGs for the prevention of VAP was 60.8%. The main barriers to the implementation of EBGs for VAP prevention were lack of skills (96.6%), lack of adequate staff (95.5%), and lack of knowledge (79.3%).Conclusion: Considering the severity and impact of VAP, and the higher risks of HAIs in resource-limited countries like Tanzania, the lower level of knowledge and compliance implies the need for on-going educational interventions and evaluation of the implementation of the EBGs for VAP prevention by considering the local context.

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Health literacy and quality of life following rectal resections for cancer

International Surgery Journal ◽

10.18203/2349-2902.isj20184065 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3186

Author(s):

Ba Thinh Nguyen ◽

Toufic El-Khoury ◽

Nimalan Pathmanathan ◽

Peter Loder ◽

Grahame Ctercteko

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Health Literacy ◽

Rectal Cancer Patient ◽

Significant Proportion ◽

Life Assessment ◽

Cross Sectional ◽

Low Health Literacy ◽

The Mean

Background: Health literacy can be a stronger predictor of an individual’s health status than income, employment status, education level, and racial or ethnic group. The prevalence and impact of low health literacy in the rectal cancer patient population has received little attention. This study is a cross-sectional population survey to determine if there is a relationship between health literacy and quality of life in rectal cancer patients.Methods: All rectal cancer patients having a clinical encounter with the Colorectal Unit at Westmead Hospital will be invited to participate in the study. Two validated health literacy screens (REALM-SF and NVS) were administered along with the EORTC QLQ-C30 quality of life assessment. The association between health literacy and quality of life will be examined using Spearman regression.Results: 92 patients were recruited between March 2015 and July 2016. A significant proportion of our patients were found to have low health literacy (29.3 percent and 54.5 percent as measured by the REALM-SF and NVS, respectively). The mean QLQ-C30 summary score was 71.5 and the mean global health score was 69.4 (SD 23.3). There appeared to be no statistically significant correlation between health literacy and quality of life in our study. There was a moderately positive correlation between the NVS and REALM-SF (rho = 0.36, P <0.001).Conclusions: A significant proportion of our patients that have had rectal resections for cancer have low health literacy. We have not been able to demonstrate an obvious association between health literacy and quality of life in the present study.

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