scholarly journals Hypocalcemia is associated with disease severity in patients with dengue

2014 ◽  
Vol 8 (09) ◽  
pp. 1205-1209 ◽  
Author(s):  
Godwin R Constantine ◽  
Senaka Rajapakse ◽  
Priyanga Ranasinghe ◽  
Balasundaram Parththipan ◽  
Ananda Wijewickrama ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Prognostic Indicator ◽  
Cross Sectional Study ◽  
World Health ◽  
Free Calcium ◽  
Cross Sectional ◽  
Tropical Regions ◽  
Probable Case ◽  
Significant Difference

Introduction: Dengue hemorrhagic fever (DHF) is a major cause of morbidity and mortality in tropical regions. Serum free calcium (Ca2+) is known to be important in cardiac and circulatory function. We evaluated association between serum Ca2+ level and severity of dengue. Methodology:A cross-sectional study was carried out at a tertiary care private hospital in Sri Lanka. A probable case of dengue was diagnosed and classified according to World Health Organization criteria and confirmed by either IgM antibody, PCR, or NS1 antigen detection. Socio-demographic details were collected using an interviewer-administered questionnaire. Results: The sample size was 135. The mean age was 26.1 years, and the majority were males (n = 80, 59.3%). DHF was diagnosed in 71 patients (52.6%). Mean serum Ca2+ level of the study population was 1.05 mmol/L (range 0.77–1.24). Mean serum Ca2+ was significantly higher in patients with dengue fever (DF) (1.09 mmol/L) than in those with DHF (1.02 mmol/L) (p < 0.05). A significant difference was observed between mean serum calcium levels of DHF I and DHF II. Prevalence of hypocalcemia in DHF and DF patients was 86.9% (n = 60) and 29.7% (n = 11), respectively (p < 0.05). Conclusions: Serum Ca2+ levels significantly correlated with dengue severity. Serum Ca2+ levels were significantly lower and hypocalcemia was more prevalent in patients with DHF than in patients with DF. Further studies are required to determine whether hypocalcemia can be utilized as a prognostic indicator and to evaluate effectiveness of calcium therapy in prevention of dengue complications.

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.

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 investigation on the frequency of thoughts, readiness and suicide attempt in individuals with thalassemia

2021 ◽  
Vol 15 (6) ◽  
pp. 1847-1853
Author(s):  
Sahar Attar ◽  
Nour Mohammad Bakhshani ◽  
Qasem Miri Aliabad
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Statistical Tests ◽  
Genetic Diseases ◽  
Thalassemia Major ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
The World

Background and Aim: Thalassemia major is one of the most common chronic genetic diseases in the world and in Iran that can impose many adverse effects on the self and society. Psychologically, patients with thalassemia are under stress. According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide. It is important to identify the people who have the highest risk factors for suicide. The present research investigates the frequency of thoughts, readiness and suicide attempts in people with thalassemia. Methods: This was a cross-sectional study. Its sample was 150 patients with thalassemia in the age range of 10 to 46 years whom we selected through census by sampling at convenience. We gave to patients a standardized Beck Suicide Thought Assessment Questionnaire. We analyzed the research data using descriptive and inferential statistical tests. Results: From among 150 patients with thalassemia in this study, 57.3% of the respondents were male and 42.7% were female. The results showed that there was a negative and significant relationship between suicide thoughts and attempts and age (-0.234) (P <0.05). The mean prevalence of suicide in men (1.89) was significantly higher compared to women (0.79) (P <0.05). We did not observe significant difference in prevalence of suicide thoughts and attempts between married and single groups with a mean difference (0.69) (P <0.05) and, in different educational groups, no significant difference was reported (P> 0.05). Conclusion: The findings of this research showed that among patients with thalassemia, the prevalence of suicidal ideation has a significant percentage. Since suicidal ideation provides a platform for preparation and attempt to commit suicide, so by providing mental health services and regular screening, we can take an effective step to prevent this problem among patients with thalassemia. Keywords: Thalassemia, Suicidal ideation, Suicide.

PRESCRIPTION PATTERN OF PSYCHOTROPIC DRUGS IN A PSYCHIATRY OPD OF A TERTIARY CARE HOSPITAL – A CROSS SECTIONAL STUDY.

2021 ◽  
pp. 191-194
Author(s):  
Kishore M S ◽  
Narendra Kumar ◽  
S Sindhu
Keyword(s):  
Psychotropic Drugs ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescription Pattern

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.

scholarly journals Effect of dengue hemorrhagic fever on thrombomodulin level

2009 ◽  
Vol 49 (5) ◽  
pp. 259
Author(s):  
Hendra Widjaja ◽  
Max F. J. Mantik
Keyword(s):  
Endothelial Cells ◽  
Dengue Hemorrhagic Fever ◽  
Pediatric Patients ◽  
Hemorrhagic Fever ◽  
Cross Sectional Study ◽  
Blood Analysis ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Difference ◽  
Difference Test

Background Thrombocyte and endothelial cells play animportant role in dengue hemorrhagic fever pathogenesis.Thrombomodulin is a part of glycoprotein membrane inendothelial cells. Therefore, thrombomodulin level willincrease if endothelial cells disruption occurs.Objective To acknowledge the correlation between thedegree of dengue hemorrhagic fever and thrombomodulinlevel.Methods This was a cross-sectional study. Subjects werehospitalized pediatric patients with age ranging from oneto 13 year old in pediatric ward at Pro£ Dr. R.D. KandouHospital, Manado, who had fever. Three milliliters of bloodwere taken from vein, and were divided for two tests whichwere routine blood analysis and thrombomodulin analysis.Different data resulted from the dengue hemorrhagic fevergroup were processed, and analyzed statistically using F Testand LSD (least significant difference) test. The relationbetween dengue hemorrhagic fever and thrombomodulinwas analyzed with Spearman correlation coefficient.Results There was a significant result in the difference ofthrombomodulin level on four dengue hemorrhagic fevergroups which were classified according to the severity ofdengue hemorrhagic fever. There was a very significantpositive correlation between the severity of denguehemorrhagic fever and thrombomodulin level in detectingendothelial cells impairment.Conclusion Thrombomodulin level can be used as amarker to detect endothelial cells impairment in denguehemorrhagic fever. Higher grade of dengue hemorrhagicfever will have higher thrombomodulin level.

scholarly journals Food intolerances and associated symptoms in patients undergoing Fobi-Capella technique without gastric ring

2015 ◽  
Vol 28 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Marcella de Arruda MOREIRA ◽  
Patrícia Ramos Maciel ESPÍNOLA ◽  
Camila Wanderley de AZEVEDO ◽  
Cinthia Karla Rodrigues do Monte GUEDES
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Food Intolerance ◽  
World Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
One Year ◽  
Health Organization ◽  
Nutritional Monitoring ◽  
Height Data

BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period.

scholarly journals Evaluation of Drug Use Patterns of Out Patient Attendees in a Tertiary Care Teaching Hospital in Dermatology and Venereology Department as a Tool to Promote Rational Prescribing

2014 ◽  
Vol 4 (1) ◽  
pp. 4-9
Author(s):  
Nushrat Noor ◽  
Md Jamal Uddin ◽  
Mohammad Afsan ◽  
Hafiza Akhter ◽  
Farhana Kabir
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Healthcare Delivery ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Carbon Paper ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Prescribing Indicators

Background: Drug utilization studies are pre requisite for the formulation of drug policies. They offer useful methods for teaching and training in drug therapy and also identify the problems that arise from drug usage in healthcare delivery system and highlight the current approaches to the rational use of medicines. Objectives: The main objective of the prescription audit or evaluation was to measures for improving the prescription practices and to generate information on the core prescribing indicators proposed by the World Health Organization (WHO). Methods: This was a descriptive type of cross sectional study. The study was conducted in the Out Patient Department (OPD) of Dermatology & Venereology in a tertiary care private hospital, Dhaka, Bangladesh in between January and March’2012. A total of 300 prescriptions were obtained with the help of a pre-inserted carbon paper in a special format using WHO core prescribing indicators. Results: The average number of drugs per encounter was 3.8 and no single drug was prescribed by generic name. Use of antibiotic (56% of encounters) was frequent, but injection use (2.67% of encounters) was within the recommendation of WHO. The use of fixed drug combinations (FDCs) was 15.28% of prescribed drugs. Only 22.08% drugs were prescribed from national essential medicine list. Conclusion: The findings from the current study showed a trend towards inappropriate prescribing. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21158 Update Dent. Coll. j: 2014; 4 (1): 04-09

scholarly journals Do We Feel Safe About the Surgical Safety Checklist? A Cross-Sectional Study Between Two Periods

2021 ◽  
Author(s):  
Danah Alsadun ◽  
Hassan Arishi ◽  
Abdullah Alhaqbani ◽  
Reema Alzighaibi ◽  
Emad Masuadi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Positive Impact ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Significant Difference

ABSTRACT Introduction The aim of this study was to evaluate the change in the healthcare providers' perceptions regarding the World Health Organization Surgical Safety Checklist (WHO SSC) and patient safety in the operating room (OR) at a tertiary hospital in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted at King Abdulaziz Medical City. Data were collected from two years (2011 and 2019) for comparison. The co-investigators distributed a self-administered Likert scale questionnaire in the various operating areas (35 ORs). Results The total sample was 461. Number of participants enrolled from both years was 235 (51%) and 226 (49%), respectively. The results indicated a statistically significant difference in the attitude of the participants regarding all aspects of patient safety in the OR when the two periods were compared (p &lt; 0.001). Similarly, healthcare providers' perceptions regarding the importance of the WHO SSC increased from 50% (2011) excellent to 68% excellent (2019) (p &lt; 0.001). Conclusions Currently, more healthcare providers recognize the importance of the WHO SSC, and more have a positive attitude toward teamwork, communication, and feeling free to speak out when surgical safety is compromised. All of these cultural changes have positive impact on the overall safety of the OR; however, there are still aspects requiring improvement to provide a safer OR and surgery. Educational interventions regarding the importance of communication and teamwork would improve the safety of surgical care in the OR.

scholarly journals Lifestyle of school going adolescents in Mumbai, India: a cross sectional study

2018 ◽  
Vol 5 (6) ◽  
pp. 2284
Author(s):  
Shalaka P. Patil ◽  
Balaji Almale
Keyword(s):  
Tertiary Care ◽  
Critical Evaluation ◽  
Cross Sectional Study ◽  
World Health ◽  
Specific Response ◽  
Age Group ◽  
Sectional Study ◽  
Cognitive Changes ◽  
Cross Sectional ◽  
Hiv Aids

Background: Adolescents, as defined by World Health organization, constitute individuals in between the age group of 10 to 19 years. Children, youth and young people are the other groups which have ages which overlap with the adolescent age group. The hormonal changes at this age are responsible not only for physiological growth but also emotional and cognitive changes. Lifestyle in this age group may have lasting and, in many cases, lifelong implications. We conducted this cross-sectional study to holistically analyse lifestyle of school adolescents in Mumbai.Methods: This was a cross sectional study conducted in the in a tertiary care medical college. The students belonging to an English medium co-education school of a metropolitan city were included in this study on the basis of a predefined inclusion and exclusion criteria. A culturally acceptable questionnaire was structured in simple language and used in this study. Demographic data was asked. All questions were closed ended and requiring specific response the questionnaire was subjected to critical evaluation by experts from the field of Public Health Pediatrics, high school teachers, heads of schools, experts from Social justice and law input from the experts were incorporated in the questionnaire. Statistical analysis was done using SSPE 22.0 Software.Results: A total of 538 adolescents were studied in this cross-sectional study. There were 270 boys (50.18%) and 268 (49.82%) girls with a M:F ratio of 1:0.95. Mean age of the studied cases was found to be 12.4±1.44 years. Majority of the adolescents were found to be residing in buildings (66.36%) and average family size was found to be 5.63±3.34 members Majority of the boys and girls (66.92%) were not having any knowledge about HIV/AIDS.7.06% adolescents were found to have suicidal or homicidal thoughts. 93.31% adolescents liked to come to school and 83.83% claimed to be obedient.Conclusions: This cross-sectional study highlights the fact that adolescents have a significant amount of psychosocial problems. Important amongst these included inclination towards substance abuse, suicidal or homicidal thoughts and ignorance about HIV/AIDS. Strategies to tackle these issue needs to be devised so as to tackle these problems faced by adolescents.

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