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2022 ◽  
Vol 7 (4) ◽  
pp. 624-629
Author(s):  
Maya Sharma ◽  
Seema Rajvanshi ◽  
Sunita Khurana ◽  
Rajkumar Arora

During the second wave of covid 19[SARS- Co V-] pandemic, there is a sudden increase in number of mucormycosis infection cases in India. The present study is an attempt to understand the presentation, course and outcome of rhinoorbital mucormycosis in a group of patients who reported to Ophtalmology and Otorhinolaryngology department of our Govt. District Hospital (secondary referral centre) for enhancing measures for prevention and management. Patients who reported to our Government district hospital with signs or symptoms suggestive of rhino orbital mucormycosis during May-June 2021 were included in the study with consent of ethical committee, patients and patient’s relatives. Total 17 cases were reported and followed. Clinical examination was done for all the patients. History of the presenting complaints and underlying illness with COVID -19 was elicited. Underlying comorbid status was recorded. Patients were followed as all of them were referred to higher centre for further management as per the guidelines issued by directorate medical and health services, rajasthan, Jaipur.13(76.4%) patients were from rural and 4 (23.5%) were from urban area. 11(64.7%) patients had RT-PCR +ve, 6 had RT-PCR _ve, 2 did not have RT-PCR report. 15(88.7%) patients had high blood sugar at presentation mean being 315.7mg%. 9 (52.9%) developed mucormycosis during their treatment for COVID in hospital. 8(47.05%) presented in OPD. 9 patients had treatment with inhalational Owhile 8 patients did not have treatment with O Death rate was high (70.5%) among our patients. Patients who survived (29.4%) had only initial symptoms and signs at presentation therefore could be managed earlier. None of our patient had vaccination for COVID. Our study was done at secondary referral centre, all the previous studies were done at tertiary referral centres; therefore it shows the course of disease mainly among rural population ; most of them presented very late and had poor outcomes. It shows the need of more awareness about COVID and mucormycosis among people especially in rural areas. High blood sugar either due to treatment with steroids or pre existing is a major risk factor for Rhino orbital mucormycosis. Being RT- PCR negative for COVID 19 does not rule out the associated possible complication of Rhino orbital mucormycosis. Early diagnosis and management remains the key factor for managing Rhino orbital mucormycosis.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262269
Author(s):  
Adam Konrad Asghar ◽  
Thandaza Cyril Nkabinde ◽  
Mergan Naidoo

Background Internationally, there has been a focus on ensuring that Caesarean deliveries are performed only when indicated, to ensure the best outcome for mother and baby. In South Africa, despite a variety of health system interventions, maternal and perinatal mortality remain unacceptably high. Objectives To describe and compare the clinical outcomes related to the mode of delivery, for patients managed at rural primary healthcare level. Methods This retrospective cross-sectional observational analytical study was conducted at a deep rural district hospital in northern KwaZulu-Natal, South Africa. Maternity Case Records and Caesarean delivery audit tools from 2018 were reviewed. Results In total, 634 files were retrieved. The Caesarean delivery rate in the sample was 30.8% (193 of 634 deliveries), and according to the Robson classification, groups 5 and 1 were the biggest contributors to Caesarean delivery. All Caesarean deliveries were deemed to have been medically indicated. As compared to those whose delivery was normal vaginal, the odds of having post-partum haemorrhage were 25 times higher, and the odds of having any complication were three times higher, if a mother delivered by Caesarean (p<0.001). In neonates who were delivered by Caesarean, the odds of being admitted to nursery were four times higher than those delivered vaginally (p<0.001). Conclusion Showing a significantly higher risk of maternal and neonatal complications, this study validated Caesarean delivery at rural primary care as a potentially dangerous undertaking, for which adequate precautions should be taken. There is a need for interventions targeting rural healthcare in South Africa, to ensure that obstetric services are offered to patients in as safe a manner as possible in this environment.


Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 76
Author(s):  
Idah Moyo ◽  
Siyabulela Eric Mgolozeli ◽  
Patrone Rebecca Risenga ◽  
Sheilla Hlamalani Mboweni ◽  
Livhuwani Tshivhase ◽  
...  

The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore and describe the nurse managers’ experiences during COVID-19 in order to identify gaps and lessons learnt. A descriptive phenomenological research approach was used to explore the experiences of ten nurse managers who were purposively selected from different units of a selected district hospital. Data was collected through telephonic unstructured individual interviews and analysed using Colaizzi’s seven steps method. The study revealed that nurse managers experienced human resource related challenges during COVID-19, worsened by the fact that vacant posts were frozen. It also emerged that there was a shortage of material resources that affected patient care. Nurse managers also indicated that COVID-19 brought a lot of administrative duties plus an additional duty of patient care. Also, nurse managers who had previously contracted COVID-19 experienced stigma and discrimination. The government needs to address resource related challenges in rural public hospitals and provide continuous support to nurse managers, particularly during a pandemic like COVID-19.


2021 ◽  
Vol 3 (1) ◽  
pp. 087-094
Author(s):  
Sylivester Wanyaseleli Mkama

Background: Cervical cancer is a preventable and is the third most commonly diagnosed cancer in women worldwide. About 83% of the world′s new cases and 85% of all cervical cancer-related deaths occur in developing countries. However, lack of knowledge and awareness can result in underutilization of the preventive strategies. Healthcare professionals with adequate knowledge play a greater role in educating the general public on the belief and practices of the cancer of cervix. We assessed the knowledge, attitudes, and practices of cervical cancer and screening amongst female nurses at Chunya District Hospital, Mbeya, Tanzania. Method: We conducted a cross-sectional study on female nurses at Chunya District Hospital, Mbeya, Tanzania. Data were collected using a predesigned and self –administered questionnaire. The questionnaire included specific sections to test the participant′s knowledge, attitude, and practices related to cervical cancer and screening. Data analysis was done using descriptive statistics. Results: Data from 138 participants were included in the final analysis. The age of the participants was between 20-59 years. The majority of participants had good level knowledge of cervical cancer (in terms of risk factors, signs and symptoms, ways of prevention and ways of screening). All 138 (100.0%) participants knew that Pap smear test is a useful test for detection of cervical cancer and 127 (92.0%) had undergone Pap smear testing. Conclusion: Our study population showed good knowledge of cervical cancer as a disease. The participants had a good knowledge of Pap smear testing and the majority had undergone testing themselves. This study highlights the need for formal educational programs to public to improve knowledge regarding the risk factors and early signs and symptoms of cervical cancer.


2021 ◽  
Author(s):  
Yusriadi Yusriadi

The purpose of this study is to examine the impact of hospital image and quality of service on Discharge Against Medical Advice (DAMA) via patient satisfaction at Majene District Hospital. This research was performed in the hospital room of the Majene District Hospital from July to August 2020. The type of analysis used is quantitative research to explain the dependent variable's effect on the independent variable and the mediating variable. This study population was all 102 patients with DAMA at Majene Hospital, as the population was deemed limited and the whole population was sampled. The test results of the coefficient of determination of the path analysis of substructure 1 resulted in a modified R square value of 0.235. In this case, it is argued that patient satisfaction is affected by the hospital picture and quality of service by 23.5 percent. In comparison, the remaining 76.5 percent is influenced by other variables not analysed in this review. The outcome of the measurement of standardized beta coefficients, the effect of the hospital picture (X1) on patient satisfaction (Y1) is 0.228, and the service quality (X2) on patient satisfaction (Y1) is 0.325.


2021 ◽  
Vol 25 (3) ◽  
pp. 229-234
Author(s):  
Eugène Ndirahisha ◽  
Patrice Barasukana ◽  
Joseph Nyandwi ◽  
Sébastien Manirakiza ◽  
Rhamadhan Nyandwi ◽  
...  

Relevance . Noncommunicable diseases are a serious public health problem due to their high incidence and mortality rate. Globally, noncommunicable diseases cause 41 million deaths every year, accounting for 71% of the total number of deaths. Cardiovascular diseases, accounting for 44% of all noncommunicable diseases, are the leading causes of death. Early identification of the main risk factors for cardiovascular diseases and treatment of associated diseases are a prerequisite for maintaining the health of the population. Objective: To identify the main risk factors for cardiovascular disease in patients living in rural areas of the mountainous region and attending the Mabayi District Hospital in Burundi. Patients and Methods . An open-label retrospective study conducted at the Mabayi District Hospital in Burundi from January 2014 to December 2017. The study included patients whose medical examination revealed at least one risk factor for cardiovascular diseases. The study was approved by the ethics committee of the Kamenge University Hospital and the Faculty of Medicine of the University of Burundi. Data analysis was carried out using Microsoft Word 2007 and Epi-Info TM 7.2.1.0 software. Results and Discussion . Among the 20 297 examined patients, the average age was 50 16.7 years, the extreme values were 14 and 101 years. Male patients accounted for 51.1%. 903 patients (4.5%) had at least one risk factor. The main risk factors were high blood pressure (52.6%), diabetes (42.0%) and alcohol abuse (27.4%). Conclusion . Residents of rural areas of the mountainous region of Burundi have a high frequency of risk factors for cardiovascular diseases, which must be taken into account when organizing medical and preventive measures to prevent cardiovascular diseases.


2021 ◽  
pp. 8-14
Author(s):  
P. Swathi ◽  
K. Radhikajyothi

BACKGROUND: Preterm birth remains a major health issue worldwide. Preterm delivery affects over 7–12% of births in India and is responsible for up to 75% of neonatal deaths. Despite advances in medical technology, the prevalence of preterm birth is increasing. Discovery of antenatal corticosteroid for fetal maturation and its adoption into clinical practice highlights several fascinating and universal truths about science and medicine. The challenge in human studies is to demonstrate antenatal corticosteroid administration in pregnancy contributes to developmental programming and how this is manifested in later life. The World Health Organization recommends the use of one course of antenatal steroids for all pregnant women between 26 and 35 weeks of gestation who are at risk of preterm delivery within 7 days. Both, the American College of Obstetricians and Gynaecologists and the Royal College of Obstetricians and Gynaecologists recommend their use between 24 and 34 weeks of gestation (1). The use of antenatal steroids after 34 or 35 weeks of gestation is not recommended unless there is evidence of fetal pulmonary immaturity. Despite this, antenatal steroids are widely used globally across all gestational periods. In a diverse country like India, diversity in clinical practice is a reality. Hence, the present research study intends to study the maternal and perinatal outcomes with antenatal corticosteroid administration in preterm deliveries at Government district hospital, Nandyal in South India. AIMS AND OBJECTIVES Ÿ To determine the incidence of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To determine the severity of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To compare the neonatal mortality among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS with those whose mothers did not receive ACS. Ÿ To determine the effectiveness of antenatal corticosteroid administration in preventing early neonatal respiratory distress syndrome in early preterm labour versus late preterm labour. Ÿ To determine the effectiveness of ACS administration in preventing neonatal complications with respect to the mode of delivery. METHODOLOGY: Study was conducted at Government District Hospital, Nandyal from 01/01/2019 to 30/10/2019. A structured questionnaire was prepared under guidance of thesis guide. All pregnant women with gestational age between 28 completed weeks to 37 completed weeks, presenting in OPD either in labour or getting admitted due to any other maternal medical complication, are initially assessed thoroughly to estimate the gestational age by history, LMP, early USG, and clinical examination. They are given a course of ACS if they were not expecting delivery within next 1 hour, after explaining the benets and risks of ACS as per recommendations of Federation of International st Gynecology and Obstetrics. Those who did not receive ACS or those who delivered within 24hrs of administration of 1 dose of ACS were considered as subjects in NACS group. Those who received ACS were considered as subjects in ACS group. After delivery, the neonate is followed up in NICU until discharged or until 7 days whichever is shorter. Mother is followed up for any clinical signs of infection, until she is discharged. Data is analyzed scientically. RESULTS: In Antenatal corticosteroids group (ACS), there were 36 subjects within 20 years, 43 subjects between 20-25 years, 29 subjects between 25-30 years, 25 subjects between 30-35 years. In No Antenatal corticosteroids group (NACS), there were 32 subjects within 20 years, 49 subjects between 20-25 years, 25 subjects between 25-30 years, 10 subjects between 30-35 years. Study observed that Antenatal corticosteroids group had lower incidence of Respiratory distress syndrome compared to No Antenatal corticosteroids group (12.07% versus 23.28%). Antenatal corticosteroids group had lower incidence of severe Respiratory distress syndrome compared to No Antenatal corticosteroids group (21.3 % versus 33.33%) among those who had Respiratory Distress Syndrome. Antenatal corticosteroids group had fewer admissions to NICU than No Antenatal corticosteroids group (20.69% versus 33.62%). Antenatal corticosteroids group had lower mortality than No Antenatal corticosteroids group (12.07 % versus 22.41%). Antenatal corticosteroids group had 35 % less chances of Respiratory distress syndrome compared to No Antenatal corticosteroids group. In No Antenatal corticosteroids group, subjects who underwent vaginal delivery had 10% less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. In Antenatal corticosteroids group, subjects who underwent vaginal delivery had 14.29 % less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. Antenatal corticosteroids group had maternal infection rate comparable to No Antenatal Corticosteroids group. CONCLUSION: Use of antenatal corticosteroids was found to be benecial in pregnant women with Gestational age of 28 completed weeks to less than 37 completed weeks at Government District hospital, Nandyal. Antenatal corticosteroids did not have statistically signicant adverse effects (i.e. increased rate of infection) in mothers.


2021 ◽  
Vol LIII (3) ◽  
pp. 71-83
Author(s):  
Aleksey S. Sozinov ◽  
Ivan A. Mitrofanov

Based on archival data and literary sources, the article presents the history of the Kazan psychophysiological laboratory of V.M. Bekhterev during the years of his work in Kazan (18851893). The circumstances of the creation of the psychophysiological laboratory, its locations (during the years of Bekhterevs work, it changed two rooms) and equipment are described. The main scientific directions of V.M. Bekhterev and his students during the Kazan period of activity, the history of their appointment to the positions of residents and assistants of the Department of Psychiatry are analysed. The reasons and history of creation of a psychophysiological laboratory at the clinical base of the University in the Kazan District Hospital are described.


Author(s):  
Theodore Gondwe ◽  
Yongi Yang ◽  
Simeon Yosefe ◽  
Maisa Kasanga ◽  
Griffin Mulula ◽  
...  

Background: Malaria continues to be a major public health problem in Malawi and the greatest load of mortality and morbidity occurs in children five years and under. However, there is no information yet regarding trends and predictions of malaria incidence in children five years and under at district hospital level, particularly at Nsanje district hospital. Aim: Therefore, this study aimed at investigating the trends of malaria morbidity and mortality in order to design appropriate interventions on the best approach to contain the disease in the near future. Methodology: Trend analysis of malaria morbidity and mortality together with time series analysis using the SARIMA (Seasonal Autoregressive Integrated Moving Average) model was used to predict malaria incidence in Nsanje district. Results: The SARIMA model used malaria cases from 2015 to 2019 and created the best model to forecast the malaria cases in Nsanje from 2020 to 2022. An SARIMA (0, 1, 2) (0,1,1)12 was suitable for forecasting the incidence of malaria for Nsanje. Conclusion: The mortality and morbidity trend showed that malaria cases were growing at a fluctuating rate at Nsanje district hospital. The relative errors between the actual values and predicted values indicated that the predicted values matched the actual values well. Therefore, the model proved that it was adequate to forecast monthly malaria cases and it had a good fit, hence, was appropriate for this study


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