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114 results for “tertiary care”
Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India
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Data from: Oral Cancer: clinical presentation and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan
<p>Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (p<0.05). Odds of developing buccal mucosa tumors in chewers (of any type of substance) and gutka users were 2 and 4 times higher than non-chewers respectively. Middle age, chewing habits, and occupation were significantly associated with late stage presentation of OSCC (p<0.05). In conclusion, male patients belonging to low SES in their forties who had chewing habits for years constituted the bulk of OSCC. Buccal mucosa was the most common site in chewers and the majority presented with late stage tumors.</p>
Data from: Burden of scrub typhus among patients with acute febrile illness attending tertiary care hospital in Chitwan, Nepal
<p><span><b>Objectives: </b>Scrub typhus is an emerging neglected tropical disease, reported from many parts of Asia including Nepal. This study aims to determine the seroepidemiology of scrub typhus among febrile patients attending Chitwan Medical College Teaching Hospital (CMCTH), Bharatpur, Nepal.</span></p> <p><span><b>Study design and setting: </b>This was a hospital laboratory based prospective study conducted in CMC-TH (a 600-bed hospital) located in Bharatpur, Chitwan district of Nepal.</span></p> <p><b>Participants</b><b>: </b> A total of 1797 patients visiting CMC-TH with acute febrile illness (temperature more than 38<sup>0</sup>C) were enrolled in this study.</p> <p><span><b>Methods: </b>A total of 1797 blood samples were collected from patients presenting with acute febrile illness. The samples were processed for detection of antibody for scrub typhus by Enzyme Linked Immunosorbent Assay (ELISA) for specific immunoglobulin M (IgM) antibody and Weil-Felix test. </span></p> <p><span><b>Results: </b>Out of 1797 serum sample of febrile patients, 524 (29.2%) were scrub typhus positive. Maximum seropositive cases were from Chitwan district 271 (51.7%) with predominance among females 314 (35.9%). Scrub typhus was common among age group 51-60 years (37.2%) and farmers 182 (37.8%). Highest<b> </b>seropositivity was found in July 60 (57.7%). Fever was common clinical symptom. Thrombocytopenia was seen in 386 (73.7%) and raised transaminase AST 399 (76.1%) among seropositive cases. Weil-Felix test positive were 397 (22.1%) and IgM ELISA 524 (29.2%). The correlation between IgM ELISA and Weil-Felix test showed statistically significant association (r = 0.319, p<0.001).</span></p> <p><span><b>Conclusion: </b>High prevalence of scrub typhus implies that acute febrile patients should be investigated for scrub typhus with high priority. There is utmost need of reliable diagnostic facilities at all level of health care system in Nepal. Infection with scrub typhus was found high and this calls for an urgent need to introduce vaccine against scrub typhus. More sustain and vigorous awareness programs need to be promoted for early diagnosis, treatment and control. </span></p>
Knowledge and use of complementary therapies in a tertiary care hospital in France: a preliminary study
<p><b>Purpose</b>: Few studies have clarified the use of complementary therapies (CTs) in France. The main objective of this preliminary study was to evaluate knowledge of CTs in four representative groups of patients: patients suffering from cancer, patients presenting with a chronic noncancerous disease, chronic dialysis patients and nonchronic or cancerous patients needing surgery.</p> <p><b>Methods</b>: <span>A formalized questionnaire </span>was<span> designed by two psychologists, an oncologist and an anesthesiologist in charge of the Pain Clinic and Support Care Unit. One</span> <span>hundred eleven patients were enrolled</span>,<span> and all </span>agreed<span> to complete the questionnaire.</span></p> <p><b>Results:</b> Eighty (72%) patients did not know the term "complementary therapies" (patients who were "not aware of CTs"), and 24 (21.6%) patients knew the term "complementary therapies" (patients who were "aware of CTs"), while seven patients were not sure of the meaning. There were no differences between aware and unaware patients in gender (p=0.27), age (p=0.24), level of education (p=0.24) or professional occupation (p=0.06). Knowledge about CTs was significantly different among the different categories of patients (p=0.03), with the only statistically significant difference between groups being between oncologic patients receiving ambulatory chemotherapy and patients presenting with a chronic noncancerous disease (p=0.004).</p> <p><b>Conclusion: </b>This preliminary study clearly highlights that patients and health caregivers are not aware of CTs and that there is a need for better communication about CTs.</p>
Data from: Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital
Background: Controversy exists as to whether obesity constitutes a risk-factor or a protective-factor for the development of nosocomial Infection (NI). According to the obesity-paradox, there is evidence that moderate obesity is a protective-factor. In Mexico few studies have focused on the nutritional status (NS) distribution in the hospital setting. Objectives: The aim of this study was to estimate the distribution of NS and the prevalence of nosocomial infection NI among adult elective surgery (ES) patients and to compare the clinical and anthropometric characteristics and length of stays (LOS) between obese and non-obese patients and between patients with and without NI. Methods: We conducted a cross-sectional study with a sample (n = 82) adult ES patients (21–59 years old) who were recruited from a tertiary-care hospital. The prevalences of each NS category and NI were estimated, the assessments were compared between groups (Mann-Whitney, Chi-squared or the Fisher's-exact-test), and the association between preoperative risk-factors and NI was evaluated using odds ratios. Results: The distribution of subjects by NS category was: underweight (3.66%), normal-weight (28.05%), overweight (35.36%), and obese (32.93%). The prevalence of NI was 14.63%. The LOS was longer (p<0.001) for the patients who developed NI. The percentages of NI were: 33.3% in underweight, 18.52% in obese, 17.39% in normal-weight, and 6.90% in overweight patients. Conclusion: The prevalence of overweight and obesity in adult ES patients is high. The highest prevalence of NI occurred in the underweight and obese patients. The presence of NI considerably increased the LOS, resulting in higher medical care costs.
Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study
<p><b>Objective</b>:<b> </b>To analyze and compare the clinical outcomes between patients ≥80 years and patients 65-79 years, presented to our Emergency Department (ED) with the two most common Gastric Emergencies (GE) clinical presentation, i.e. gastric bleeding and gastric perforation.</p> <p><b>Design</b>: Single-center retrospective cohort study.</p> <p><b>Participants:</b> A total of 1011 patients were enrolled: 421 patients aged ≥80 years were compared to a group of 590 patients aged 65-79 years.</p> <p><b>Primary and secondary outcome measures</b>:<b> </b>The primary outcome was to compare the overall mortality. Secondary outcomes included major complications, in-hospital length of stay (LOS), and need for surgical procedures.</p> <p><b>Results</b>: Patients ≥80 years with GE had different presentation at Emergency Department compared to younger patients: they had higher gastrointestinal bleeding (24.9% vs. 16.3%; <i>p </i>= 0.001), anemization (14.5% vs. 8.8%; <i>p= </i>0.005), and shock (10.9% vs. 5.1%; <i>p</i> = 0.001) rates. Median LOS, cumulative major complications and mortality rates were similar among the two groups.</p> <p>Multivariate analysis identified shock, gastric malignancy, and gastric fistula as independent predictors for survival.</p> <p><b>Conclusions</b>: Patients ≥80 years with GE did not have a higher mortality rate and cumulative major complications as compared to younger elderly patients. Invasive treatments were not associated to a different prognosis in this age group.</p>
Post COVID syndrome among symptomatic COVID-19 patients: a prospective study in a tertiary care center in Bangladesh
<p><b>Background:</b> Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incidence, association, and risk factors associated with development of the post-COVID-19 syndrome.</p> <p><b>Methods</b>: We<b> </b>conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate <25/breath/minute with no dyspnea), and oxygen saturation >93% without assisted oxygen inhalation.</p> <p><b>Findings:</b> Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02–1.48, p=0.03), those who required a prolonged time for clinical improvement (p<0.001), and those showing COVID-19 positivity after 14 days (RR: 1.09, 95% CI: 1.00–1.19, p<0.001) of initial positivity. Patients with severe COVID-19 at presentation developed post-COVID-19 syndrome (p=0.02). Patients with fever (RR: 1.5, 95% CI: 1.05–2.27, p=0.03), cough (RR: 1.36, 95% CI: 1.02–1.81, p=0.04), respiratory distress (RR: 1.3, 95% CI: 1.4–1.56, p=0.001), and lethargy (RR: 1.2, 95% CI: 1.06–1.35, p=0.003) as the presenting features were associated with the development of the more susceptible to develop post COVID-19 syndrome than the others. Logistic regression analysis revealed female sex, respiratory distress, lethargy, and long duration of the disease as risk factors.</p> <p><b>Conclusion:</b> Female sex, respiratory distress, lethargy, and long disease duration are critical risk factors for the development of post-COVID-19 syndrome. </p>
Small Bowel Capsule Endoscopy: Experience From a Single Large Tertiary Care Centre
ClinicalTrials.gov study NCT05228379. IPD Sharing: UNDECIDED. Countries: 0. Publications: 4.
Analysis of In-hospital Emergency Team Calls in a German Tertiary Care University Hospital From 2013 to 2016
ClinicalTrials.gov study NCT03786445. IPD Sharing: NO. Countries: 0. Publications: 1.
Comparison of the Outcome of Treatment With Silymarin or N-Aceylcysteine in Patients Taking Anti-Tuberculous Drugs for Tuberculosis at a Tertiary Care Hospital , Karachi
ClinicalTrials.gov study NCT07058090. IPD Sharing: NO. Countries: 0. Publications: 4.
Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study
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Post COVID syndrome among symptomatic COVID-19 patients: a prospective study in a tertiary care center in Bangladesh
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Data from: Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital
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Knowledge and use of complementary therapies in a tertiary care hospital in France: a preliminary study
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Data from: Burden of scrub typhus among patients with acute febrile illness attending tertiary care hospital in Chitwan, Nepal
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Data from: Agreement between electronic and paper Epworth Sleepiness Scale responses in obstructive sleep apnoea: secondary analysis of a randomised controlled trial undertaken in a specialised tertiary care clinic
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Data from: Oral Cancer: clinical presentation and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan
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A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital
<p><strong>ABSTRACT</strong></p> <p>The global spread of antimicrobial resistance (AMR) is an increasing challenge for clinicians in Uganda, where microbiological diagnostics are not routinely available. The aim of this study was to determine pathogen prevalence and antibiotic resistance patterns in patients with wound infections following trauma at a national referral hospital in Kampala, Uganda. In addition, the suitability of currently used empirical treatment options in this setting was evaluated.</p> <p>This prospective, observational study analysed antimicrobial prescriptions, culture results and antimicrobial sensitivity testing (AST) of wound swabs and blood samples from patients with clinical signs of wound infections on the trauma ward.</p> <p>A total of 124 patients (n=99, 79.8% male) with a median age of 30 years (IQR 23-39) were enrolled between October 2021 and January 2022. Wound infections were classified as nosocomial in 69% of the cases. Pathogens were isolated from 122 wound swabs, yielding 238 bacterial isolates. The most prevalent pathogens were gram-negative bacteria including <em>Escherichia coli </em>(n=48, 20.2%) and <em>Acinetobacter </em>spp. (n=43, 18.1%). Empiric treatment consisted of ceftriaxone and gentamicin which was administered to 67.2% (n=78) and 62.1% (n=72) of patients, respectively. High rates of antimicrobial resistance could be demonstrated across gram-negative and gram-positive species towards the most common empiric antibiotics. Following the AST results, over 95% (n=111) of patients required a change of treatment.</p> <p>Our findings demonstrate that current empiric treatment for wound infections is missing its target in hospitalized patients in Kampala. Increased diagnostic capacity and structured antimicrobial stewardship are necessary to tackle the growing problem of AMR in Uganda.</p>
Role of Intralesional Combined Injection of Furosemide and Digoxin in Cutaneous Warts at Tertiary Care Hospital in Karachi.
ClinicalTrials.gov study NCT06821594. IPD Sharing: UNDECIDED. Countries: 1. Publications: 0.
Brain Death Diagnosis at an Academic Tertiary Medical Care Center
ClinicalTrials.gov study NCT03984981. IPD Sharing: Not stated. Countries: 1. Publications: 0.
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Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
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DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.