scholarly journals Factors associated with delays in the search for care in under-5 deaths in Yucatán, Mexico

2021 ◽  
Author(s):  
Bernardo Hernández-Prado ◽  
Elsa María Rodríguez-Angulo ◽  
Erin B Palmisano ◽  
Ricardo Ojeda-Rodríguez ◽  
Rafael Javier Ojeda-Baranda ◽  
...  
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Wait Time ◽  
Cross Sectional Study ◽  
Seguro Popular ◽  
Transport Time ◽  
Cross Sectional ◽  
Public Facilities ◽  
The Mean ◽  
Mean Time

Objective. We examined delays during the search for care and associations with mother, child, or health services characteristics, and with symptoms reported prior to death. Materials and methods. Cross-sectional study compris­ing household interviews with 252 caregivers of children under-5 who died in the state of Yucatán, Mexico, during 2015-2016. We evaluated the three main delays: 1) time to identify symptoms and start search for care, 2) transport time to health facility, and 3) wait time at health facility. Results. Children faced important delays including a mean time to start the search for care of 4.1 days. The mean transport time to the first facility was longer for children enrolled in Seguro Popular and there were longer wait times at public facilities, especially among children who also experienced longer travel time. Conclusions. Providing resources to enable caregiv­ers to access health services in a timely manner may reduce delays in seeking care.

scholarly journals Judicial demand of medications through the Federal Justice of the State of Paraná

2017 ◽  
Vol 15 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Renato Mitsunori Nisihara ◽  
Ana Carolina Possebom ◽  
Luiza de Martino Cruvinel Borges ◽  
Ana Claudia Athanasio Shwetz ◽  
Fernanda Francis Benevides Bettes
Keyword(s):  
Cross Sectional Study ◽  
The State ◽  
Brand Name ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Public ◽  
Online System ◽  
Broad Variety ◽  
The Mean ◽  
Mean Time

ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days.

scholarly journals Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras

2019 ◽  
pp. 1-7
Author(s):  
José A. Sánchez ◽  
Mayra G. Handal ◽  
Juan F. Vílchez Rodriguez ◽  
Sinthia I. Mejía ◽  
Annye P. Pagoaga
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Time Interval ◽  
Pathology Report ◽  
Time Intervals ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
The Mean ◽  
Mean Time

PURPOSE In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals. PATIENTS AND METHODS This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed. RESULTS The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively ( P < .05, when surgery is compared against chemotherapy and radiotherapy). CONCLUSION The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.

scholarly journals Comparative study of intra vaginal misoprostol (PGE1) with intracervical dinoprostone (PGE2) gel for induction of labour

2018 ◽  
Vol 7 (9) ◽  
pp. 3769
Author(s):  
Bina M. Raval ◽  
Nainesh S. Zalavadiya ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta
Keyword(s):  
Caesarean Section Rate ◽  
Cost Effective ◽  
Active Phase ◽  
Cross Sectional Study ◽  
Cervical Ripening ◽  
Cross Sectional ◽  
Misoprostol Group ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Mean Time

Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature.

scholarly journals Sensitivity of Acinetobacter baumannii and Pseudomonas aeruginosa Microorganisms to Colistin Antibiotic by MIC (E-test) in Patients Admitted to the Intensive Care Unit of Firoozgar Hospital

2020 ◽  
Author(s):  
Mahin Jamshidi Makiani ◽  
Maryam Farasatinasab ◽  
Sam Bemani ◽  
Hoda Namdari Moghadam ◽  
Fatemeh Sheibani ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Hospitalization Period ◽  
The Mean ◽  
Mean Time

Background: Nosocomial infections are associated with increased morbidity, mortality, and medical burdens. Pseudomonas aeruginosa and Acinetobacter baumannii are not-fermentative gram-negative bacteria that considered as the most important nosocomial infection. In the current study, we have aimed to evaluate the sensitivity of Acinetobacter baumannii and Pseudomonas aeruginosa microorganisms to the colistin antibiotic. Methods: In this descriptive cross-sectional study, patients admitted to the ICU ward of Firoozgar Hospital from July 2018 to March 2019 were evaluated, and 169 Patients infected with Acinetobacter baumannii, and Pseudomonas aeruginosa were included. Acinetobacter baumannii and Pseudomonas aeruginosa were isolated, and antibiotic sensitivity was determined by the disk diffusion method according to Clinical & Laboratory Standards Institute (CLSI) criteria. E test was also used to determine MIC-50 and MIC-90 of colistin. Results: Acinetobacter baumannii was around 8 times more frequent than Pseudomonas aeruginosa. Colistin resistance was detected in only 4(2.4%). The mean age of patients infected by Acinetobacter baumannii was significantly higher than those infected with Pseudomonas aeruginosa. Moreover, the mean time of the hospitalization period did not show any significant differences in the different groups. Conclusion: Our findings indicated that the majority of isolated Pseudomonas aeruginosa and Acinetobacter baumannii were sensitive to Colistin. Therefore, it could be effectively used for patients with a confirmed diagnosis of Pseudomonas aeruginosa and Acinetobacter baumannii.

Prognostic factors in methanol poisoning

2007 ◽  
Vol 26 (7) ◽  
pp. 583-586 ◽  
Author(s):  
H. Hassanian-Moghaddam ◽  
A. Pajoumand ◽  
S.M. Dadgar ◽  
Sh. Shadnia
Keyword(s):  
Mortality Rate ◽  
Cross Sectional Study ◽  
Time Interval ◽  
Poison Center ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

The aim of this study was to assess the clinical and laboratory factors in methanol poisoned patients to determine the prognosis of their toxicity. This survey was done as a prospective cross-sectional study in methanol-poisoned patients in Loghman-Hakim hospital poison center during 9 months from October 1999—June 2000. During this time 25 methanol-poisoned patients were admitted. The mortality rate was 12 (48%). Amongst survivors, three (23%) of the patients developed blindness due to their poisoning and the other 10 (77%) fully recovered without any complication. The mortality rate in comatose patients was nine (90%) while in non-comatose patients it was three (20%) ( P < 0.001). There was a significant difference in mean pH in the first arterial blood gas of patients who subsequently died (6.82 ± 0.03) and survivors (7.15 ± 0.06) ( P < 0.001, M-W). The mean time interval between poisoning and ED presentation in deceased patients were (46 ± 15.7) hours, in survived with sequelae were (16.7 ± 6.7) and in survived without sequelae were (10.3 ± 7.2) hours ( P < 0.002, K-W). We found no significant difference between the survivors versus the patients who died regarding methanol. Simultaneous presence of ethanol and opium affected the outcome of the treatment for methanol intoxication favourably and unfavourably, respectively. In our study, poor prognosis was associated with pH < 7, coma on admission and >24 hours delay from intake to admission. Human & Experimental Toxicology (2007) 26: 583—586.

scholarly journals Utilization of Health Facility–Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Demisu Zenbaba ◽  
Biniyam Sahiledengle ◽  
Diriba Dibaba ◽  
Mitiku Bonsa
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Facility ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Delivery Service ◽  
The Past ◽  
Southeast Ethiopia ◽  
Delivery Services

Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility–based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility–based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility–based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.

scholarly journals To explore the impact of following the pre-operative fasting guidelines by ASA (American society of anesthesiologists), in improving patient outcome.

2021 ◽  
Vol 28 (7) ◽  
pp. 1018-1021
Author(s):  
Maqsood Ahmed Siddiqui ◽  
◽  
Ashok Perchani ◽  
Hamid Raza ◽  
Ahmeduddin Soomro ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Start Time ◽  
Time Duration ◽  
Cross Sectional ◽  
Emergency Procedures ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Objective: To analyze the occurrence and consequences of a prolonged preoperative-fasting. Study Design: Cross-sectional study. Setting: Large tertiary care hospital in Pakistan. Period: October 2018 to October 2019. Material & Methods: We collected data for all the procedures that occurred during the study period and divided the cases into emergency procedures, add-on procedures and elective cases. We excluded the first cases of the day and excluded the emergency and add-on cases. We studied the patients NPO duration and their scheduled start time of the procedure and compared with their actual start time of the procedure. Results: The study population was n= 434 cases. Of these 434 cases n= 164 cases were performed on time and n= 270 cases were delayed by 60 minutes or more from their scheduled time. The most frequent reason was a previous cases running longer than expected in 59.25% of the cases, the second most common reason was a change in sequence and order of the procedures which was the case for delay in 14.44% of the cases. The overall mean time of NPO for the patients was found to be 770.1 +/- 130.6 minutes, for the delayed cases the mean time duration of NPO was 812.3 +/- 105.3 minutes. The mean time of case delay was 155.2 +/- 102.7 minutes for overall cases and for the significantly delayed case the mean time period of delay was 190.2 +/- 92.1 cases. Conclusion: Our results showed that 60% of the cases have a prolonged NPO status due to delays in start of their surgical procedure as compared to the scheduled times.

scholarly journals Clinical Epidemiology and Paraclinical Findings in Tuberculosis Patients in North of Iran

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Farhang Babamahmoodi ◽  
Ahmad Alikhani ◽  
Jamshid Yazdani Charati ◽  
Amir Ghovvati ◽  
Fatemeh Ahangarkani ◽  
...  
Keyword(s):  
Clinical Epidemiology ◽  
Wide Spectrum ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Cross Sectional ◽  
Significant Difference ◽  
North Of Iran ◽  
History Of ◽  
The Mean ◽  
Mean Time

Background. Mycobacterium tuberculosis (M.TB) causes a wide spectrum of clinical diseases. The prevalence of TB is different in various parts of Iran and throughout the world. The present study aimed to determine the clinical epidemiology and paraclinical findings of TB. Methods. A cross-sectional study was conducted from 2008 to 2013. Patient demographic, clinical, and radiologic characteristics, picked up from the TB patient’s files, were collected using a standard questionnaire format. Data was entered and analyzed using the SPSS version 16 statistical software and P value < 0.05 was considered statistically significant. Results. Out of 212 patients enrolled in this study 62% were male and the mean age was about 50 years old. 98.6% were Iranian, and 46.2% were rural. Prevalence of smear-positive TB was 66.4%. Prevalence of positive PPD was 50.7% with no significant difference between HIV-positive and -negative patients (P = 0.8). Prevalence of diabetes mellitus was 17%. 36% of the patients had history of smoking and about 29.3% were addicted to narcotics. Cough was the most common symptom (94.5%) and 84% had sputum. 15 cases (7%) had extrapulmonary TB. The mean time between the onset of symptoms and admission was 46.5 days. The delay for admission between urban and rural populations was not significantly different (P = 0.68); but for those who were in prison, the delay was significant (P = 0.02). About 46% of the patients had cavitary lesions in CXRs. Conclusion. Timely diagnosis of TB especially in prisoners by understanding its most important epidemiologic characteristics and clinical features can help to make an early treatment and prevent spread of mycobacteria and their complications.

scholarly journals Pediatrician's knowledge on the management of the infant who cries excessively in the first months of life

2014 ◽  
Vol 32 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Ana Carolina C. Marcon ◽  
Mário César Vieira ◽  
Mauro Batista de Morais
Keyword(s):  
Diagnostic Tests ◽  
Ph Monitoring ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Brazilian Society ◽  
Esophageal Ph ◽  
Infant Colic ◽  
The Mean ◽  
Mean Time

OBJECTIVE: To evaluate the attitude, the practice and the knowledge of pediatricians regarding the management of the infant who cries excessively in the first months of life.METHODS: Descriptive cross-sectional study that enrolled pediatricians (n=132) randomly interviewed at a Pediatric meeting in Brazil, in August 2012. The data were collected by a self-administered standardized form after reading the hypothetical case of an infant who cried excessively.RESULTS: The majority of the participants were females, the mean age was 39 years and the average mean time working in the specialty was 14 years; 52.2% were Board Certified by the Brazilian Society of Pediatrics. The diagnosis most often considered was gastroesophageal reflux disease (62.9%), followed by infant colic (23.5%) and cow's milk allergy (6.8%). The diagnostic test most frequently mentioned was 24-hour esophageal pH-monitoring (21.9%). The medications most frequently indicated were domperidone (30.3%), the combination of domperidone with ranitidine (12.1%) and paracetamol (6%).CONCLUSIONS: In the approach of the infant who cries excessively, diagnostic tests are frequently requested and unnecessary medical treatment is usually recommended.

scholarly journals Continuous Glucose Monitoring for the Detection of Hypoglycemia in Patients With Diabetes of the Exocrine Pancreas

2020 ◽  
pp. 193229682097474
Author(s):  
Channabasappa Shivaprasad ◽  
Kolla Gautham ◽  
Kejal Shah ◽  
Soumya Gupta ◽  
Preethika Palani ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Exocrine Pancreas ◽  
Glucose Monitoring ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Mean ◽  
Mean Time

Background: Detailed evaluations of hypoglycemia and associated indices based on continuous glucose monitoring (CGM) are limited in patients with diabetes of the exocrine pancreas. Our study sought to evaluate the frequency and pattern of hypoglycemic events and to investigate hypoglycemia-specific indices in this population. Methods: This was a cross-sectional study comprising 83 participants with diabetes of the exocrine pancreas. CGM and self-monitoring of blood glucose (SMBG) were performed on all participants for a minimum period of 72 hours. The frequency and pattern of hypoglycemic events, as well as hypoglycemia-related indices, were evaluated. Results: Hypoglycemia was detected in 90.4% of patients using CGM and 38.5% of patients using SMBG. Nocturnal hypoglycemic events were more frequent (1.9 episodes/patient) and prolonged (142 minutes) compared with day-time events (1.1 episodes/patient; 82.8 minutes, P < 0.05). The mean low blood glucose index was 2.1, and glycemic risk assessment diabetes equation hypoglycemia was 9.1%. The mean time spent below (TSB) <70 mg/dL was 9.2%, and TSB <54 mg/dL was 3.7%. The mean area under curve (AUC) <70 mg/dL was 1.7 ± 2.5 mg/dL/hour and AUC <54 mg/dL was 0.6 ± 1.3 mg/dL/hour. All of the CGM-derived hypoglycemic indices were significantly more deranged at night compared with during the day ( P < 0.05). Conclusion: Patients with diabetes of the exocrine pancreas have a high frequency of hypoglycemic episodes that are predominantly nocturnal. CGM is superior to SMBG in the detection of nocturnal and asymptomatic hypoglycemic episodes. CGM-derived hypoglycemic indices are beneficial in estimating the risk of hypoglycemia.

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