ABSTRACT
Objectives@#Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation. @*Methods@#Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding. @*Results@#Healthcare workers highlighted that working with the digital health system was initially arduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports, rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computers saved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensive about the use of computer-based data for monitoring their work performance. Patients appreciated that their previous records were now available on the computer for easy retrieval. @*Conclusions@#The usefulness of the digital health application was appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibility in delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependence on computers and digital technicians.
ABSTRACT
We studied serum sodium levels within 2 hours of admission of 100 children aged 2months to 5 years admitted with diagnosis of lower respiratory infections(pneumonia,bronchiolitis, bronchitis, empyema and WALRI). Methods: In our study out of these 100 cases 33(33%) cases were having hyponatremia (s.sodium<135mEq/L) &0ut of33(33%) cases 17(51.5%) cases had mild hyponatremia i.e. s.sodium 131-134mEq/L, 14(42.5%) cases had moderate hyponatremia i.e. s.sodium 126-130mEq/L & 2(6%)cases had severe hyponatremia i.e. s.sodium <125mEq/L. These Children with hyponatremia were evaluated for plasma osmolality, urinary sodium and osmolality on day of admission and after appropriate fluid therapy. Results: Out of these 33 cases, the probable cause of hyponatremia was the syndrome of inappropriate secretion of antidiuretic hormone in 27(81.8%) cases (as suggested by their plasma osmolality,urinary sodium and urine osmolality). Symptoms and signs indicative of severe LRIs were about one and a half times more frequent and the mean duration of hospital stay was 49.2% longer in children with hyponatremia than with isonatremia. Two children (2%) with severe hyponatremia had complications in the form of convulsions associated with transitory altered sensorium for 2-3 days. The recovery from hyponatremia with timely intervention showed a good improvement in clinical symptomology of respiratory distress and there was no mortality in the studied cases. Conclusion: Thus it is concluded that,presence of hyponatremia in LRI’s increases the morbidity of these patients in the form of prolonged hospital stay and occurrence of complications like seizures followed by deranged sensorium in some cases.
ABSTRACT
Osteoma is the most common benign tumor of the paranasal sinuses. Turbinate osteomas are very rare and only five middle turbinate, two inferior turbinate and one superior turbinate osteoma cases have been reported. We present a rare case of osteoma of the left inferior turbinate in a patient presented with unilateral nasal obstruction that was removed endoscopically and conduct a literature review on turbinate osteomas arising from differen t turbinates.
ABSTRACT
Background: Fine Needle Aspiration Cytology (FNAC) is a simple, rapid, cost effective and reliable technique which can be used as a routine outpatient department (OPD) procedure and first line of investigation in diagnosing a variety of superficial and deep lesions. Lymphadenopathy is of great clinical significance and the underlying cause may range from a treatable infectious etiology to malignant neoplasms. In this study, we describe the diagnostic utility of FNAC in the assessment of lymph node lesions with an emphasis on the diagnosis of non-neoplastic, benign and malignant neoplastic processes. Cytomorphological patterns of tuberculous lymphadenitis were also observed. Methods: This was a retrospective study and a total of 736 patients including all age groups and both sexes presenting with palpable or deep lymph nodes in FNAC clinic of our institute over a period of 2 years were included in our study. FNAC was conducted with 22-24 Gauge disposable needles attached to 20c.c syringes. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou stain. Leishman stain was done on air dried smears. Ziehl- Neelsen (ZN) staining was done wherever required. Results: Out of 736 aspirations from lymph nodes, the most frequent cause of lymphadenopathy was found to be Tuberculosis with 419 cases (56.92%). The next frequent diagnosis was reactive lymphadenitis with 193 cases (26.22%) followed by metastatic lymphadenopathy in 47 cases (6.38%). A diagnosis of lymphoproliferative disorder was rendered in 20 cases (2.71%). In 10 cases (1.35%) FNAC was inconclusive. Conclusion: In our study, the predominant cause of lymphadenopathy was tuberculous lymphadenitis, seen in more than half of total cases, followed by reactive lymphadenopathy and malignant neoplasms. FNAC was helpful in establishing the diagnosis in 98.65% of the cases.