Patient satisfaction level in outpatient department in a private dental hospital

Background: In the dental field, patient satisfaction played a very important role, specifically finding the strength and weakness in the dental clinic. It also assists in improving the quality of treatment as well as better future planning of treatment. Objective: The present study was planned and conducted with an objective to assess the level of satisfaction among patients attending the outpatient department in a private dental hospital. Materials and Methods: A prospective, cross-sectional, and questionnaire-based study was undertaken in a private dental hospital. Patients of age more than 18 years and of both gender attending outdoor patient department were included in the study. For the purpose of this survey, consecutive sampling was carried out until a sample size of 200 was achieved. The patient satisfaction was assessed using dental satisfaction survey 2002 – questionnaire. Results: Among 31 items, none of the respondents indicated strong agreement or disagreement for 30 items, only for one item, item no. 14 regarding the explanation of cost, respondents indicated strong agreement (106, 53.00%). More than 40% of respondents indicated strong agreement (indicating satisfaction) with the statement for seven items. None of the items have <10% of respondents indicated strong agreement. The respondents expressing strong disagreement (indicating dissatisfaction) with any statement was <10% on 23 of the 31 items. The inter-item reliability of all 31 items of the questionnaire was tested, and the overall satisfaction scale (all items 1–31) produced a high Cronbach’s alpha value of 0.92. Conclusion: Patients’ satisfaction was observed not only for overall satisfaction but also in all sub-scales – context, content, outcome, cost, and facilities.

Twin pregnancies: Maternal and perinatal outcome in a tertiary health centre

Background: Twin gestation brings double happiness but at the same time implies twice the unforeseen complications to the health of the mother and the fetus. Objective: To study the maternal and neonatal outcome in multi fetal pregnancy in a tertiary health centre. Materials and methods: A retrospective observational analysis of 30 twin pregnancies admitted and managed in our centre. Patients were studied for any adverse antenatal complications, mode of delivery and maternal and perinatal outcome. Results: In our study, maximum patients were in age group of 31-35 years (33.3%) and primigravida (46%), admitted with gestational age 32-37 weeks (46.6%). Commonest maternal complication observed was anemia (60%) followed by preterm labour (53.3%), premature rupture of membranes (40%), pregnancy induced hypertension (33.3%). Cesarean section was mode of delivery in maximum (60%), with common indication being Malpresentation (50%). Out of 56 live births, 51.6% were admitted in neonatal ICU for causes like prematurity (58.06%). Prematurity was the leading cause of perinatal mortality and morbidity in twin gestation. Conclusion: Twin gestation has significantly increased risk to both the mother and the fetus. Early recognition and adequate management of twin gestation can decrease associated complications and betterment of maternal and neonatal outcome.

Pacing lead endocarditis due to Aspergillus fumigatus.

Invasive aspergillosis is an opportunistic infection with a high mortality rate that usually occurs in the immunocompromised host. Several cases of fungal infections have been reported after cardiac surgery. We present here a case of Aspergillus fumigatus tricuspid valve endocarditis associated with permanent pacemaker leads. Tricuspid valve vegetectomy was done and the pacing leads were also removed. Culture from the excised vegetation grew Aspergillus fumigatus. The patient was started on IV Amphotericin B for eight weeks. The patient was subsequently followed up in the out-patient clinic, and remains afebrile after one year, with no evidence of any vegetation.

Cardiovascular dysautonomia in patients with lepromatous leprosy.

Autonomic functions were studied by six standard tests in 65 patients with lepromatous leprosy and 25 healthy controls. Dysautonomia was observed in 22 patients, all having the disease for more than five years. Associated peripheral neuropathy, judged clinically, was present in all, except one patient. Of the 22 dysautonomic patients, 9 each had mild or moderate dysantonomia and 4 had severe dysautonomia as per the scoring schedule devised by us. Syncope, gustatory sweating and impotence were the symptoms suggestive of dysautonomia. But not all affected patients reported these symptoms. Involvement of the sympathetic system was more frequent than that of the parasympathetic system. Statistically significant abnormality was seen with Atropine ratio, standing 30:15 beat ratio, postural hypotension and sustained hand grip test. Sustained hand grip test was the one which consistently gave abnormal results in all the 22 dysautonomic patients.

Linear scleroderma. A unique presentation.

A rare case of linear scleroderma with plaques of morphea in hemicorporeal distribution and subclinical systemic involvement is presented. Its possibility of progression into systemic sclerosis, which has not been reported earlier, is discussed.

Dermatoglyphics in leprosy.

In the present study, dermatolyphic parameters were analysed in the handprints of 25 LL/BL, 25 TT/BT and 25 healthy persons, by printer's ink method. Frequency of loops, were more on right hand and whorls were more on left hand in LL patients as compared to normal healthy controls. In TT the whorls were less frequent than in controls. The a-b ridge count in LL patient has shown insignificant difference from control while the same in TT was significantly decreased (P less than 0.05). Distance between distal wrist crease and axial triradius was significantly decreased in LL as compared to normal (P less than 0.05), whereas no such decrease was observed in TT patients.