ABSTRACT
Aims: Psychiatric patients have a high rate of readmission. So, we need to understand what kind of patients are more likely to be readmitted, to predict the clinical and social factors that place them at risk, and to identify potential limitations in existing healthcare delivery systems. Objective of the study was to find out and compare sociodemographic and clinical profiles of patients getting first admission and readmission. Methods: It was a retrospective, record-based observational study from computerised database of the institute and the case record files of patients for one year. Variables like age, sex, religion, marital status, locality, education, occupation, and diagnosis were studied. Analysis was done by chi-square test using the Statistical Package for the Social Sciences (SPSS) version 16.0. Results: The total number of admissions during this period was 876, among which 463 had been admitted previously in the institute and 60 had been admitted more than once in the time period. Among new admissions and readmissions, majority were unemployed, unmarried, Hindu males, 16-30 years of age, and had schizophrenia and related spectrum diagnosis (F20-F29). No significant difference in readmission rates were found for sex, marital status, religion, educational status, or locality. Readmission rates among housewives were seen less than expected. There were significant differences among different diagnoses in terms of readmission (p<0.001), with F30-F39 showing more than expected readmissions and F10-F19 showing more than expected first admission with less than expected readmissions. Conclusions: Current study reviews the scenario of mental healthcare utilisation. Decreased readmission rates of women and of patients with substance abuse disorders warrants further community-based research.
ABSTRACT
The objective of this study was to document maternal and child health care workers' knowledge, attitudes and practices on service delivery before, during and after the 2014 EVD outbreak in rural Guinea. We conducted a descriptive cross-sectional study in ten health districts between October and December 2015, using a standardized self-administered questionnaire. Overall 299 CHWs (94% response rate) participated in the study, including nurses/health technicians (49%), midwives (23%), managers (16%) and physicians (12%). Prior to the EVD outbreak, 87% of CHWs directly engaged in managing febrile cases within the facility, while the majority (89% and 63%) referred such cases to another facility and/or EVD treatment centre during and after the EVD outbreak, respectively. Compared to the period before the EVD outbreak when approximately half of CHWs (49%) reported systematically measuring body temperature prior to providing any care to patients, most CHWs reported doing so during (98%) and after the EVD outbreak (88%). The main challenges encountered were the lack of capacity to screen for EVD cases within the facility (39%) and the lack of relevant equipment (10%). The majority (91%) of HCWs reported a decrease in the use of services during the EVD outbreak while an increase was reported by 72% of respondents in the period following the EVD outbreak. Infection prevention and control measures established during the EVD outbreak have substantially improved self-reported provider practices for maternal and child health services in rural Guinea. However, more efforts are needed to maintain and sustain the gain achieved
Subject(s)
Guinea , Health Knowledge, Attitudes, Practice , Health Personnel , Hemorrhagic Fever, Ebola , Maternal-Child Health ServicesABSTRACT
Background: Chest trauma is a leading cause of morbidity and mortality among all age groups.. This retrospective study has been undertaken to analyse the pattern of chest injuries among patients admitted in a tertiary care centre. Methods: All the in-patient records of patients, admitted with abdominal injuries in the emergency department of the Teerthankar Mahaveer Medical College & Research Centre, located in Moradabad (U.P.). Results: There were total 139 cases of chest injuries, during the study period. 84 victims were in 2nd to 4th decades of life, 18 in 5th decade, 8 in 1st decade and the remaining 19 patients were in either extremes of age groups. The male to female ratio was 2.4:1. There were 111 cases of blunt chest injuries and 28 cases of penetrating injuries. Most common X ray findings were haemothorax, seen in 94 cases followed by pneumothorax in 59 cases and multiple rib fractures in 50 cases. Blunt injuries were caused due to accidents in 102 cases and homicides in 9 cases. Penetrating injuries were caused due to accidents in 15 cases and homicides in 13. The mortality rate was 6.4%. Conclusion: Chest Injuries were more common among males than females.
ABSTRACT
Background: Abdominal trauma is a leading cause of morbidity and mortality among all age groups. This retrospective study has been undertaken to analyse the pattern of abdominal injuries among patients admitted in a tertiary care centre. Methods: All the in-patient records of patients, admitted with abdominal injuries in the emergency department of the Teerthankar Mahaveer Medical College & Research Centre, located in Moradabad (U.P.) during the one year period from 1st December 2011 to 30th November 2012, were analysed. Results: There were total 87 cases of abdominal injuries, during the study period. 51 victims were in 2nd to 4th decades of life, 12 in 5th decade, 11 in 1st decade and the remaining 12 patients were in either extremes of age groups. The male to female ratio was 3.3:1. There were 61 cases of blunt abdominal injuries and 26 cases of penetrating injuries. Most commonly injured viscus in blunt trauma was bowel, and in cases of penetrating injuries, spleen. Blunt injuries were caused due to accidents in 57 cases and homicides in 4 cases. Penetrating injuries were also most commonly caused due to accidents in 16 cases and homicides in 10 the mortality rate was 4.6%. Conclusion: Abdominal Injuries were more common among males than females.