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ABSTRACT Objective Consequently, in this study, we aimed to evaluate 1,203 cases of referral to a quaternary vascular surgical service, in São Paulo, Brazil, over a 6-year period, to assess the appropriate need for referral; in addition to the prevalence of surgical indications. Methods In this retrospective analysis, we reviewed the institutional records of participants referred from Basic Healthcare Units to a vascular surgical service inside the Brazilian Unified Health System, between May 2015 and December 2020. Demographic and clinical data were collected. The participants were stratified, as per the reason for referral to the vascular surgical service, previous imaging studies, and surgical treatment indications. Referral appropriateness and complementary examinations were evaluated for each disease cohort. Finally, the prevalence of cases requiring surgical treatment was defined as the outcome measure. Results Of the 1,203 referrals evaluated, venous disease was the main reason for referral (53%), followed by peripheral arterial disease (19.4%). A considerable proportion of participants had been referred without complementary imaging or after a long duration of undergoing an examination. Referrals were regarded as inappropriate in 517 (43%) cases. Of these, 32 cases (6.2%) had been referred to the vascular surgical service, as the incorrect specialty. The percentage of referred participants who ultimately underwent surgical treatment was 39.92%. Carotid (18%) and peripheral arterial diseases (18.4%) were correlated with a lower prevalence of surgical treatments. Conclusion The rate of referral appropriateness to specialized vascular care from primary care settings was low. This may represent a subutilization of quaternary surgical services, with low rates of surgical treatment.
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Objetivo: Determinar la frecuencia y describir las características de referencias injustificadas, en base a diagnósticos no pertinentes, enviadas al servicio de consulta externa adultos de un hospital de tercer nivel. Material y métodos: Estudio transversal, observacional y descriptivo, realizado en el Hospital Cayetano Heredia (HCH) en el periodo abril a diciembre del 2019. Se utilizaron los datos del aplicativo "REFCON" con una población de 99 891 referencias. Para la variable "justificación de la referencia", se utilizó un listado de diagnósticos que no deberían derivarse a hospitales de la DIRIS Lima Norte. Adicionalmente, se estudiaron las variables de edad, sexo, grupo etario, especialidad de destino, categoría del EESS de origen, distrito de origen, y diagnóstico del grupo de referencias injustificadas. Se utilizó estadística descriptiva. Resultados: La frecuencia de referencias injustificadas fue de 8,4 %. El 34,2 % fue de pacientes adultos; el 65,8 %, de adultos mayores; y el 67 %, de pacientes mujeres Las especialidades con más referencias injustificadas fueron cardiología, geriatría, medicina interna, medicina familiar y neurología. Los diagnósticos injustificados más frecuentes fueron hipertensión esencial, lumbago no especificado y cefalea. Conclusiones: La frecuencia de referencias injustificadas al HCH por diagnósticos no pertinentes fue 8,4 %, tasa similar a otros dos estudios, pese a la emisión de una lista de diagnósticos que no deberían derivarse a hospitales de la DIRIS Lima Norte.
SUMMARY Objective: To determine the frequency and to describe the characteristics of unjustified ambulatory referrals bases on no pertinent diagnosis done at an adult outpatient clinic of a third level Peruvian hospital. Methods: A cross-sectional study was carried-out from April to December 2019 at Hospital Cayetano Heredia. Data were extracted from REFCON with a population of 99 891 referrals. To justify the reference, a list of diagnosis that does not require referral was used. In addition, variables such as age, sex, specialty of destination, category of EESS, district of origin and diagnosis of the unjustified referral. Descriptive statistics was used. Results: the frequency of unjustified referrals was 8.4%; 34.2% comprised the adult population; 65.8% were elder and 67% were female. Specialties with more unjustified referrals were geriatrics, internal medicine, family medicine and neurology. The most common unjustified diagnosis was essential hypertension, nonspecific low back pain and headache. Conclusions: Despite of socializing a list of unjustified referral diagnosis a frequency of 8,4% remain in this category, which is like results from two previous studies.
Sujets)
Humains , Soins de santé primaires , Orientation vers un spécialiste , Diagnostic , Centres de soins tertiairesRésumé
Background: Congestive cardiac failure/congestive heart failure (CCF/CHF) is one of the major public health problem seen in more than 23 million people worldwide. Drug utilization studies were stood as a powerful exploratory tool to ascertain the role of drugs in determining the therapeutic efficacy, cost effectiveness and also in minimizing the adverse effects due to it during the treatment of a disease. Aims and Objectives: The present study undertaken to describe the drug utilization pattern in patients of CHF in a tertiary care hospital. Materials and Methods: This is a Prospective, Observational, and Non-interventional study. The study was undertaken after obtaining the ethical committee approval in the in-patient department of Medicine. Case records of 100 patients were obtained and treatments were noted. Results: The present study had 60 male and 40 female patients admitted and undergoing treatment for CCF. Most of them were above 50 years of age and the most common comorbidity among them were hypertension (25%) followed by diabetes mellitus (19%). The most commonly used drugs were diuretics and antihypertensives. Conclusion: In our study, patients use of more than 2 ?3 drugs (Polytherapy) was found very common than use of one drug (Monotherapy).
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COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.
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Background: An infant’s birth weight is a reliable index of intrauterine growth and a sensitive predictor of newborn chances of survival, growth and long-term physical and psychosocial development. Low birth weight has been defined as birth weight <2.5 kg regardless of gestational age. The incidence of low birth weight (LBW) in India varies between 25–30% and of which 60–65% are because of intrauterine growth retardation. Aim & Objective: To determine the incidence and various determinants of low birth weight among babies delivered at rural tertiary care hospitals in central Uttar Pradesh. Methods and Material: The study was conducted at UPUMS, Saifai, Etawah, among pregnant women who delivered babies from 1st January 2018 to 31st December 2018. Details regarding age of the mother, gravida, parity, gestation period, presence of complications, the procedure for delivery and birth weight of the newborn were recorded and analyzed using SPSS software (version 23) Results: A total of 7615 deliveries were conducted (53.2% were males, 46.8% were females). The mean birth weight of babies was 2.65 Kg with S.D ± 0.52. Preterm babies were 32% while 67% were term babies and 23% of babies were low birth weight. There was a statistically significant association between birth weight of babies and factors like age of mother, parity of mother, gestation period, and presence of complications during the antenatal period. Conclusions: Prompt identification of high-risk factors, prevention of premature delivery, increasing the use of health services during pregnancy and management of the risk factors would reduce the incidence of low birth weight.
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Background: Optimal infant and young child feeding practices (IYCF) are effective public health intervention to enhance child survival, nutrition and development. There is also documented evidence regarding the pro-tective effect of optimal IYCF practices against diarrhoea and ARTI. The objective is to assess knowledge and practices regarding IYCF among study participants & to explore the association of feeding practices of mothers with the morbidities (infections) in their children. Methodology: The present study was a hospital based cross-sectional study, carried out during September 2019 to March 2021. A total of 380 mothers of children less than two years attending OPD of Institute of child health, Nirmal hospital private limited, a tertiary care multi-specialty hospital was interviewed using pre-designed and pretested questionnaire. Results: Feeding practices during early days of life to be reasonably good among study participants with al-most 2/3rd of the study participants practicing them. Mean number of morbidity episodes requiring consulta-tion were significantly lower in the children whose mothers practiced optimal IYCF practices. Conclusion: Poor feeding practices in children had significant association with morbidity episodes of diar-rhoea and ARTI in children.
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BACKGROUND: Practicing hand hygiene is a simple yet effective way to prevent Health Care Related Infections. The objectives of the study were to study the knowledge and attitude regarding hand hygiene among nursing staff and study the availability of hand-hygiene facilities in a tertiary care hospital. A METHODS: cross-sectional study was conducted and a total of 100 study participants were selected by simple random sampling. Knowledge and attitude of the nurses were captured by interviewing the nurses and recording the data on pre-tested questionnaire. The results were compiled on Windows Excel spreadsheet and summarized by calculating proportions and percentages. Chi-square test was applied to identify association between knowledge and attitude regarding hand-hygiene and likely determinants. It was found that there was significant positive association between knowledge and attitude of nursing staff and formal training received during previous one year regarding hand hygiene.
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Background: Medical record document explains all the details about the patient’s history, clinical findings, diagnostic test results, pre- and post-operative care, patient’s progress, and medication given. If written correctly, notes will support the doctor about the correctness of treatment. Aim and Objectives: Our objective was to study effectiveness and utility of medical record department at our medical college affiliated tertiary care institution. Materials and Methods: We did an observational study to determine various parameters of medical records such as consent, history and examination findings, pre-operative and intraoperative records, investigation documentation, nursing care chart, and concerned medical person’s signature. The study included 300 files. A medical record checklist was used as a tool for data collection. The study was conducted between January 2021 and January 2022. Data were collected, entered in Microsoft Excel spread sheet, and analyzed using percentage. Results: Out of the 300 files, 186 files belonged to different surgical specialties while the rest were of non-surgical fields. It was found that nursing assessment document was present in 78%, while discharged card copy was found attached in 75.33% files. Furthermore, surgical safety checklist was found in 89.24%, while signature of faculty was absent in 38.3% files. Conclusion: Medical record maintaining and keeping is an essential and vital part of health-care infrastructure, not only for data collection but also for calculating use of resources needed for better delivery of quality services to patients.
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Introduction :Birth weight is one of the most important criteria for determining neonatal and infant survival and is considered a sensitive index of the nation's health and development. The World Health Organization (WHO) defines low birth weight (LBW) as “Birth weight less than 2500 grams” regardless of gestational age, the measurement being taken preferably within the first hour of life. 1)ToObjectives : estimate the prevalence of LBW among sample population at tertiary care hospital. 2)To study the distribution of newborns, according to socio-demographic characteristics of the mother and its association with LBW. A hospital based cross-sectional study was carried out among 500 newborns betweenMethod: December 2020 and November 2021. Participants were selected by systematic random sampling technique. The data were collected from the case file and face-to-face interview. Both descriptive and inferential statistics were used in the analysis. Prevalence of low birth weight was 29.2%. Majority 271Results: (54.2%) of newborn mothers' age group was between 21 to 25 years. More than half 272 (54.4%) newborns were from mothers who studied up to primary level education and more than three forth 389 (77.8%) were from mothers who were housewives. Majority 293 (58.6%) of newborns were from the urban area, around three forth 382 (76.4%) newborns were Hindu and nearly two fifth 194 (38.8%) newborns belonged to lower middle class. Prevalence of low birth weight was significantly higher in mothers aged >35 andyears ?20 , who were illiterate, doing labour work and belonging to lower socio-economic class.years Conclusion: The prevalence of Low Birth Weight was 29.2% among sample population. Socio-demographic variables like maternal age >35 years 20 years, illiteracy, labour work and lower socio-economic class, ? had shown significant risk for delivering Low Birth Weight babies.
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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a contagious viral pathogen, creating a public health emergency, and affecting lives and livelihood of millions of populations globally. Good knowledge, attitude, and practice are essential to prevent and stop the widespread transmission. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practices regarding COVID-19 among health-care workers (HCWs) in tertiary care hospitals of Odisha. Materials and Methods: The present study is an observational, cross-sectional, and question-based online research. Questions were created on Google forms. Link was generated and given through social media apps. The questionnaire consists of four sections. First section comprised demographic characteristics. Second, third, and fourth sections contain questions on knowledge, attitude, and practice related to COVID-19, respectively. Descriptive and inferential statistical procedures were done through IBM SPSS statistics version 24.0. The research was granted approval by Institute Ethics Committee of IMS and SUM Hospital. Results: Data were analyzed in 430 subjects, 205 females and 225 males. The majority of HCWs have good knowledge score 86.5%, attitude score 80.9%, and practice score 91.2%. The mean knowledge score was 6.6 ± 0.84 and mean attitude score was 28.5 ± 1.89. Knowledge and attitude score was found to be significantly different among age groups and gender, p<0.001. Mean attitude score had a significant difference with working status, P = 0.025. Mean knowledge and attitude score was significantly higher across professions and work experience, P < 0.001. Good practice score varies significantly across professions, P < 0.001. Conclusions: The most of HCWs had good knowledge, positive attitude, and adopted appropriate practices regarding COVID-19. Periodic educational interventions are strongly recommended for HCWs to upgrade their knowledge, attitude, and practices regarding coronavirus diseases.
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Introduction: Asthma is a chronic lung disease characterised by reversible airway obstruction, cellular infiltration, and airway inflammation. The reaction is characterised by the interaction of genetic and environmental variables, as well as the activation of cells in the innate and adaptive immune systems. Method: The study was conducted in the Department of General medicine, in Tertiary Care Center, to study association of serum level of Vitamin D3 and pulmonary function in bronchial asthma patients. As per inclusion and exclusion criteria ,137 patients of bronchial asthma were included in the study. Result: In cases having serum vitamin D3 level <20 ng/ml mean value of FVC, FEV1, FEV1/FVC ratio, was 108.10�.89, 68.56�.40, and 62.35�17. In cases having serum vitamin D3 20-29 ng/ml, mean value of FVC, FEV1, and FEV1/FVC ratio was 109.72�.22, 72.34�.48, and 64.39�97. In cases having serum vitamin D3 >30 ng/ml mean value of FVC, FEV1, and FEV1/FVC ratio, was 115.0�27, 81.0�09, and 70.52�00. Conclusion: Vitamin D3 deficiency was highly prevalent in asthmatic patients, there was a strong correlation between asthma severity and vitamin D3 concentrations and there was a direct and a positive significant correlation between vitamin D3 levels and pulmonary function test in asthmatic patients.
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Background: In India, most individuals with an intellectual disability live with their families. The present study examines the perceived burden of family members, treatment expectations, and awareness of disability benefits for adult individuals with Intellectual Disability (ID). Methodology: A sample of 50 individuals registered in an Adult Psychiatry Unit was referred for intelligence assessment. The assessment was done using standardized psychological tests. Data was gathered using a semi-structured interview schedule during counselling the participants’ family members. Data obtained was examined using descriptive statistics. Results: Average age of participants was 27.5 years, and the majority 64%, were male patients. Comorbid conditions such as seizure disorder, psychosis and obsessive-compulsive disorder (OCD) were present in 46 % of the sample. Caregivers were primarily parents, and a higher level of family burden was due to behavioural problems. Half (50 %) of the sample was unaware of disability benefits. Conclusion: Findings indicate the need to address caregiver burden and plan psychosocial rehabilitation and improve awareness about disability benefits and its implications more consistently across India.
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Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 ± 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.
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Background: Security guards/protective inspectors are a group of professional gray collar workers responsible for safety and security of general public. In healthcare institutions, they play a pivotal role in streamlining the movement of patients, healthcare workers as well as other people as well as keeping a check upon the law-breaking activities within the premises. These professionals are constantly overburdened with responsibility and many of them are under the verge of physical, mental, and emotional crisis leading to various health issues. Aim and Objective: To assess the influence of changing work patterns on the overall physical health of security guards working in the hospital. Materials and Methods: A cross-sectional study was carried out in a tertiary care hospital in the Eastern part of Odisha involving all the security personnel currently working. Universal sampling was opted and 465 personnel participated in this study. Results: Of the total, 213 (45.8%) were between 30 and 40 years of age and 398 (85.5%) were male. 179 (38.4%) were overweight and 52.2% had a waist-hip ratio above normal range for their gender. Prevalence of anemia and Conjunctival xerosis was significantly higher among night shift workers with P < 0.001 whereas hypertension (P = 0.08) and rheumatoid arthritis (P = 0.006) was significantly higher among morning shift workers. Conclusion: Being a distinctive member of the hospital, it is high time that regular health check-ups and social security measures should be made available to them in order to provide quality life which will in turn ensure better hospital safety and security.
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Abstract Background: Respiratory distress syndrome (RDS) is Mexico's second leading cause of neonatal mortality. The 75% reduction in mortality due to RDS has been attributed to the use of nasal continuous positive airway pressure (nCPAP). A survey was conducted to determine the perception of the medical staff regarding the availability of nCPAP equipment and supplies in Mexican hospitals with neonatal intensive care units (NICUs). Methods: We sent a survey via e-mail to several neonatologists in each state of the country, requesting only one response per hospital. We performed statistical analysis with SPSS software. Results: We received 195 surveys from private (HPri) and public (HPub) hospitals with NICUs nationwide: 100% of HPri and 39% of HPub. More than 75% of the nursing and medical staff had received formal training in nCPAP in 11% of HPri and 5% of HPub. The perceived availability of CPAP equipment was 83.7% vs. 52.1%; nasal cannula supply, 75.5% vs. 36.3%; air/oxygen blender availability, 51.0% vs. 32.9%, in HPri and HPub, respectively. The observed differences were statistically significant. Significant differences were also found among healthcare institutions. Conclusions: The availability of CPAP equipment and consumables between HPub and HPri is unbalanced and is lower in public institutions. Bubble CPAP is not included essential equipment in the national catalog of instruments and equipment for public hospitals, and its request is complicated. The training of CPAP staff and the availability of bubble CPAP and supplies in public hospitals should be improved.
Resumen Introducción: El síndrome de dificultad respiratoria (SDR) es la segunda causa de mortalidad neonatal en México. La reducción del 75% de la mortalidad por SDR se le ha atribuido al uso de la presión positiva nasal continua de las vías respiratorias (nCPAP). Se realizó una encuesta con el objetivo de conocer la percepción del personal médico acerca de la disponibilidad del equipo e insumos para nCPAP en hospitales de México que cuenten con unidades de cuidados intensivos neonatales (UCIN). Métodos: La encuesta se envió por correo electrónico a varios neonatólogos de cada estado del país y se solicitó una sola respuesta por cada hospital. El análisis estadístico se realizó con el software SPSS. Resultados: Se recibieron 195 encuestas respondidas tanto de hospitales privados (HPri) como públicos (HPub) que cuentan con UCIN a escala nacional: el 100% de HPri y el 39% de HPub. Más del 75% del personal de enfermería y médico recibió una capacitación formal en nCPAP en el 11% de HPri y el 5% de HPub. La percepción de disponibilidad de equipos de presión positiva continua de las vías respiratorias (CPAP) fue del 83.7% vs. el 52.1%; el abasto de cánulas nasales, del 75.5% vs. el 36.3%; la disponibilidad del mezclador aire/oxígeno, del 51.0 % vs. el 32.9%, en HPri y HPub, respectivamente. Las diferencias fueron estadísticamente significativas. También se encontraron diferencias significativas entre las instituciones de salud. Conclusiones: La disponibilidad de equipo y material de consumo para CPAP entre HPub y HPri es desequilibrada, y es menor en las instituciones públicas. El CPAP burbuja no se encuentra incluido en el cuadro básico de equipo médico y se dificulta su solicitud. Debe mejorarse la capacitación del personal en CPAP y la disponibilidad de CPAP burbuja e insumos en los hospitales públicos.
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Introduction : The Coronavirus disease 2019 (COVID-19) primarily involves respiratory system but may also affect the Cardiovascular System leading to abnormal ECGs. Its early recognition is crucial as it may be associated with increased mortality. Hence we aimed to find out various Electrocardiographic (ECG) manifestations of COVID19 patients admitted in a Tertiary Care Hospital and its relation to disease severity. Methods : We performed a hospital-based retrospective observational study between April, 2021 to November 2021 and analyzed the ECG changes at admission by three Cardiologists according to standard definitions and diagnostic criteria. Results : Out of 579 patients, ECG of 473 was available for analysis. ECG was normal in 227 (48%) and abnormal in 246 (52%) patients. Most common abnormal ECG finding in COVID19 patients was Sinus Tachycardia(19.5%) and less common findings were Sinus Bradycardia (5.3%), Incomplete Right Bundle Branch Block (RBBB) (3.2%), atrial fibrillation (2.5%), complete RBBB (2.3%), atrial premature complexes (2.3%), S1Q1T3 pattern (2.1%), first degree AV block (1.5%), ST-T wave changes (1.3%), Atrial flutter (1.1%). In mechanically ventilated patients, incidence of acute Right Ventricular Pressure Overload (RVPO) related ECG findings were more frequent. Conclusion : There is a wide spectrum of ECG manifestations in COVID-19 patients which varies depending upon the severity of COVID as well as prior Cardiovascular status, associated comorbidities and need for ventilatory support. Knowledge of ECG changes might help in risk stratification and triaging of COVID-19 patients.
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Background: The use of Complementary and Alternative Medicine (CAM) dates back to being quite pervasive amongst patients suffering from chronic ailments such as cancer, diabetes, hypertension, and migraine. While data pertaining to the use of CAM among adults with migraine is limited and mostly undercover thereby veiling their effects. Hence, this analysis was taken up to project the paradigm of CAM usage among sufferers of migraine in our domain. Aim and Objectives: To examine various attributes of CAM utility in patients of migraine. Materials and Methods: Following the approval by the Institutional Ethics Committee vide order no. IEC/GMC/2019/767 dated November 26, 2019, this study was performed in migraine patients visiting Medicine out patient department of Government Medical College and Hospital, Jammu over a span of 3 months. After receiving their consent, they were confronted with a prevalidated questionary consisting of two sections viz. socio-demographic profile and CAM use aspects. Results: A total of 100 patients were inducted in our research, of which 64 agreed to use various CAM modalities alongwith ongoing conventional migraine therapy. Females (73.43%) belonging to rural setting (57.81%) depicted quite high use of CAM than their male (26.56%) counterparts. Ayurvedic balm/oil massage (56.25%) was the most common type of CAM used with family/friends (59.37%) being major informants about various CAM practices. The less educated patients (46.87%) showed relatively more use of CAM than in illiterates (9.37%). 53.12% of those on CAM proclaimed about its safety, being less costly (18.75%) yet effective (14.06%). Only 29.68% of patients disclosed about their CAM use to their treating doctor while the majority (70.31%) were non-revealers. Conclusion: CAM is prevalent in patients suffering from migraine with more propensity among females of rural strata. Ayurvedic balm/oil massage was the most extensively practiced CAM. Ironically, a vast chunk of patients did not reveal regarding CAM usage to their treating physician. As such there’s a dire need to embolden such patients to divulge regarding CAM to their treating doctor so as to thwart any impending undesired interplay.
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Background: Diabetes is accompanied by a distinct decreased in subject抯 quality of life (QOL) and it shows to elevated disability-adjusted life years than most diseases. Depression shows the degrade QOL and is associated with wretched treatment outcomes and lesser the glycaemic control in diabetes. Objective of this study is to study the association between Quality of Life (QoL) and depression among type2 diabetes mellitus in Andhra Pradesh. Methodology: The present study is a case control study. There were 300 participants including 150 type2 diabetes mellitus patients, & 150 healthy individuals (age and gender matched) were also selected as a control to meet the purpose of the study. Subjects age range was set between 35-65 years. Beck depression inventory (BDI-II) and WHO quality of life scale (QOL BREF) were used for data collection, SPSS-26(v). Results: The study findings showed that significant but negative relation between depression scores and quality of life. 65% have Poor Quality of life & 57% have high depression in Diabetes Patients. 54% have good Quality of life & 78% have Mild Depression in Healthy Individuals. Conclusion: It is concluded that association between depression and sub-scales of quality of life indicating that high depression scores may lead to lower physical and psychological health impacting social relationship and environmental health.
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Background: Medulloblastoma is the commonest embryonal brain tumor in children. It has shown improved outcomes with combined modality treatment. We aimed to study patient characteristics and survival outcomes of patients with this disease across two tertiary care centers in India. Methods: We analyzed data of patients with histological diagnosis of medulloblastoma treated from January 2010 to January 2016. Patient characteristics and follow-up data were retrieved from hospital records. Descriptive statistics were used to describe clinical and pathological characteristics. Overall survival (OS) was calculated from date of diagnosis to death due to any cause. Relapse-free survival (RFS) was calculated from date of diagnosis to occurrence of relapse or death. Result: Out of 26 patients treated, 24 were children and 2 were adults. Median age was 10 years (range = 0.8–22 years). Twenty (76.9%) patients were male. Fifteen (57.7%) patients were stratified as high-risk (HR), rest 11 (42.3%) were categorized as average risk (AR). Histopathology showed classical variety in majority of patients except for 4 (15%) cases, 3 with desmoplastic and 1 with anaplastic subtype. Median follow-up was 49.7 months (range= 4.2–102.5 months). Overall, eight (30.8%) patients relapsed and six (23%) deaths occurred. Five (33.3%) patients in HR category and 3 (27.3%) patients in AR group showed relapse. Median RFS and OS were not yet reached. Five-year RFS was 69.2% whereas five-year OS was 76.9%. Conclusion: This study highlighted patient characteristics and treatment outcomes in Indian patients. With adherence to standard treatment, high remission rates and improvement in mortality rates were achieved.
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Background: 5-fluorouracil (5-FU) was the standard treatment care for colorectal cancer (CRC), however, its efficacy was limited due to safety concerns. Capecitabine and oxaliplatin (CAPOX) treatment was found equivalent to 5-FU in efficacy and preferred now due to easy management and convenience in administration. Hence, the present study aims to determine the efficacy and safety associated with CAPOX treatment in a real world non clinical setting. Methods: 145 treatment-naive and newly diagnosed CRC patients were recruited in the study. Each patient received oxaliplatin 130 mg/m2 infusion over 2 hours on day 1 and oral capecitabine 1000 mg/m2 in divided doses twice daily for the next 14 days of a 21-day cycle. Results: In the adjuvant setting, the observed disease-free survival rate was 62% (n=34) in the colon and 67% (n=15) in the rectum cancer patients at 2 years. The observed overall survival rate in the colon and rectal cancer was 80% (n=44) and 83% (n=18) respectively at 2 years. In the palliative setting the observed progression-free survival rate was 28% (n=13) in the colon and 33% (n=7) in rectal cancer patients at 2 years. The observed OSR at 2 years was 64% (n=30) in the colon and 67% (n=14) in the rectal cancer patients. Thrombocytopenia (17, 11.7%) and diarrhea (8, 5.5%) were the most commonly observed grade 3/4 hematological and gastrointestinal toxicities. Hand-foot syndrome and peripheral neuropathy were the major contributors for dose reduction (14, 9.6%), treatment delay (8, 5.4%), and drug discontinuation (9, 6.1%) in the study cohort. Conclusion: CAPOX treatment was found to be effective but associated with several dose-limiting toxicities.