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opencc-by-4.0Oct 2016View details →

Assessing the Nature and Quality of Emergency Obstetric Care for Preventing Maternal and Perinatal Mortality in 8 Secondary and Tertiary Hospitals in Nigeria: Results of a Formative Research Study

Nigeria suffers some of the highest rates of maternal and perinatal mortality in the world. Poor quality of obstetric care is a key factor, and although not quantified at a national level, local studies suggest that high rates of maternal and perinatal deaths are due to clinical management errors in hospitals. This project therefore explored the nature of existing practices and quality of clinical management of three leading causes of maternal and perinatal deaths (primary postpartum haemorrhage, eclampsia, and obstructed labour); implement an intervention package aimed at improving the quality of clinical management of these causes of deaths; and test the effectiveness of this package on quality of care indicators and maternal and perinatal outcomes. The study follows a quasi-experimental research design, using interrupted time series analysis for assessment over a three year period. Six public secondary care hospitals and two public tertiary care hospitals in both north and south of Nigeria were selected randomly. Formative research was conducted in all eight hospitals, and thereafter the intervention will be carried out in four hospitals, with the remaining four hospitals functioning as control sites. Clinical outcomes will be compared between intervention and control sites in a total of 2334 cases of PPH, preeclampsia/eclampsia and obstructed labour (based on an anticipated 50% reduction in case fatality rates, significance level of 0.05 and 80% power). This will consist of 1167 cases in the intervention sites and 1167 in the control sites. Maternal and perinatal mortality rates will serve as primary outcome measures. Secondary outcomes involve quality of care drawn from United Nations process indicators, skilled attendance index and data derived from this formative audit phase of the project. The results will enable the identification of a system-wide quality of care framework for improving the delivery of emergency obstetric care for the prevention of maternal and perinatal morbidity and mortality in Nigeria.

opencc-by-4.0Oct 2016View details →

Assessing the Nature and Quality of Emergency Obstetric Care for Preventing Maternal and Perinatal Mortality in 8 Secondary and Tertiary Hospitals in Nigeria: Results of a Formative Research Study

Nigeria suffers some of the highest rates of maternal and perinatal mortality in the world. Poor quality of obstetric care is a key factor, and although not quantified at a national level, local studies suggest that high rates of maternal and perinatal deaths are due to clinical management errors in hospitals. This project therefore explored the nature of existing practices and quality of clinical management of three leading causes of maternal and perinatal deaths (primary postpartum haemorrhage, eclampsia, and obstructed labour); implement an intervention package aimed at improving the quality of clinical management of these causes of deaths; and test the effectiveness of this package on quality of care indicators and maternal and perinatal outcomes. The study follows a quasi-experimental research design, using interrupted time series analysis for assessment over a three year period. Six public secondary care hospitals and two public tertiary care hospitals in both north and south of Nigeria were selected randomly. Formative research was conducted in all eight hospitals, and thereafter the intervention will be carried out in four hospitals, with the remaining four hospitals functioning as control sites. Clinical outcomes will be compared between intervention and control sites in a total of 2334 cases of PPH, preeclampsia/eclampsia and obstructed labour (based on an anticipated 50% reduction in case fatality rates, significance level of 0.05 and 80% power). This will consist of 1167 cases in the intervention sites and 1167 in the control sites. Maternal and perinatal mortality rates will serve as primary outcome measures. Secondary outcomes involve quality of care drawn from United Nations process indicators, skilled attendance index and data derived from this formative audit phase of the project. The results will enable the identification of a system-wide quality of care framework for improving the delivery of emergency obstetric care for the prevention of maternal and perinatal morbidity and mortality in Nigeria

opencc-by-4.0Apr 2023View details →

ANION GAP OR SERUM LACTATE-IN SEARCH OF A BETTER PROGNOSTIC MARKER IN SEPSIS A CROSS-SECTIONAL STUDY IN A RURAL TERTIARY CARE HOSPITAL

master data sheet

opencc-by-4.0Jul 2023View details →

STROBE checklist_Study of compliance to treatment advised to patients attending medicine OPD in a tertiary care ruraral hospital

STROBE checklist of the study titled, "Study of compliance to treatment advised to patients attending medicine OPD in a tertiary care ruraral hospital."

opencc-by-4.0Jul 2023View details →

Compliance worksheet_Study of compliance to treatment advised to patients attending medicine OPD in a tertiary care rural hospital

This is a worksheet of the data obtained from the questionnaires used for the study titled, "Study of compliance to treatment advised to patients attending  medicine OPD in a tertiary care rural hospital."

ClinicalTrials.gov36/100

Screening for Postpartum Depression Using EPDS and HAM-D in Mothers Within 72 Hours After Delivery at a Tertiary Care Center (SOS-Mamma Study)

ClinicalTrials.gov study NCT07025902. IPD Sharing: NO. Countries: 1. Publications: 1.

ClinicalTrials.gov36/100

Levetiracetam Versus Phenobarbitone for the Treatment of Neonatal Seizures in a Tertiary Care Hospital.

ClinicalTrials.gov study NCT07401433. IPD Sharing: NO. Countries: 1. Publications: 2.

opencc-zeroJul 2020View details →

Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland

Objectives: To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant Clostridioides difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI. Design: Cross-sectional study. Setting: Monocentric study in a tertiary care hospital, Geneva, Switzerland Participants: Among 4562 adult patients tested for C. difficile between March 2017 and March 2019, 208 patients with discordant tests' results (positive nucleic acid amplification test [NAAT+]/negative enzyme immunoassay [EIA-]) were included. Main outcome measures: Treatment for CDI. Results: CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal computed tomography scan with signs of colitis (OR 14.7; 95% CI 1.96-110.8) was the only factor associated with CDI treatment. Conclusions: The proportion of NAAT+/EIA- patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat.

opencc-zeroDec 2017View details →

Data from: Validation of the hospital frailty risk score in a tertiary care hospital in Switzerland: results of a prospective, observational study

Objectives: Recently, the Hospital Frailty Risk Score based on a derivation and validation study in the United Kingdom has been proposed as a low-cost, systematic screening tool to identify older, frail patients who are at greater risk of adverse outcomes and for whom a frailty-attuned approach might be useful. We aimed to validate this Score in an independent cohort in Switzerland. Design: Secondary analysis of a prospective, observational study (TRIAGE study). Setting: One 600-bed tertiary care hospital in Aarau, Switzerland Participants: Consecutive medical inpatients aged 75 years or older that presented to the emergency department or were electively admitted between October 2015 and April 2018. Primary and secondary outcome measures: The primary endpoint was all-cause 30-day mortality. Secondary endpoints were length of hospital stay, hospital readmission, functional impairment, and quality of life measures. We used multivariate regression analyses. Results: Of 4957 included patients, 3150 (63.5%) were classified as low risk, 1663 (33.5%) intermediate risk, and 144 (2.9%) high risk for frailty. Compared to the low-risk group, patients in the moderate risk and high-risk groups had increased risk for 30-day mortality (odds ratio [OR] 2.53, 95%CI 2.09 to 3.06, P<0.001 and OR 4.40, 95%CI 2.94 to 6.57, P<0.001) with overall moderate discrimination (area under the ROC curve 0.66). The results remained robust after adjustment for important confounders. Similarly, we found longer length of hospital stay, more severe functional impairment and a lower quality of life in higher risk group patients. Conclusion: Our data confirms the prognostic value of the Hospital Frailty Risk Score to identify older, frail people at risk for mortality and adverse outcomes in an independent patient population. Trial registration number: ClinicalTrials.gov; Identifier: NCT01768494

opencc-zeroDec 2016View details →

Data from: Are patients with cancer with sepsis and bacteraemia at a higher risk of mortality? A retrospective chart review of patients presenting to a tertiary care centre in Lebanon

Objective: Most sepsis studies have looked at the general population. The aim of this study is to report on the characteristics, treatment and hospital mortality of patients with cancer diagnosed with sepsis or septic shock. Setting: A single-centre retrospective study at a tertiary care centre looking at patients with cancer who presented to our tertiary hospital with sepsis, septic shock or bacteraemia between 2010 and 2015. Participants: 176 patients with cancer were compared with 176 cancer-free controls. Primary and secondary outcomes: The primary outcome of this study was the in hospital mortality in both cohorts. Secondary outcomes included patient demographics, emergency department (ED) vital signs and parameters of resuscitation along with laboratory work. Results: A total of 352 patients were analysed. The mean age at presentation for the cancer group was 65.39±15.04 years, whereas the mean age for the control group was 74.68±14.04 years (p<0.001). In the cancer cohort the respiratory system was the most common site of infection (37.5%) followed by the urinary system (26.7%), while in the cancer-free arm, the urinary system was the most common site of infection (40.9%). intravenous fluid replacement for the first 24 hours was higher in the cancer cohort. ED, intensive care unit and general practice unit length of stay were comparable in both the groups. 95 (54%) patients with cancer died compared with 75 (42.6%) in the cancer-free group. The 28-day hospital mortality in the cancer cohort was 87 (49.4%) vs 46 (26.1%) in the cancer-free cohort (p=0.009). Patients with cancer had a 2.320 (CI 95% 1.225 to 4.395, p=0.010) odds of dying compared with patients without cancer in the setting of sepsis. Conclusions: This is the first study looking at an in-depth analysis of sepsis in the specific oncology population. Despite aggressive care, patients with cancer have higher hospital mortality than their cancer-free counterparts while adjusting for all other variables.

opencc-zeroOct 2022View details →

Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India

Aims and objectives: The purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swabs. Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from the eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method. Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA, and only one of them had ocular manifestations out of the eleven. Conclusion: In our study, the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on the presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.

opencc-zeroOct 2022View details →

Characterization of virulence factors and antibiotic resistance pattern of uropathogenic Escherichia coli strains in a tertiary care center

Background: Urinary tract infections (UTIs) are the most prevalent bacterial infection in humans. The uropathogenic E. coli (UPEC) express a wide range of virulence factors that contribute to their pathogenicity. The emergence of Multidrug resistance(MDR)-associated UTI is increasing off late. Hence this study was undertaken to monitor the distribution of virulence factors among UPEC strains and to note the antibiogram, outcome and type of associated UTI. Methods: A prospective cross-sectional time-bound study of 6 months was done on clinically significant urinary isolates of Escherichia coli. Detection of haemolysin production and serum resistance was done by phenotypic methods. Genotypic characterization of the virulence genes (papC, iutA, hlyA, cnf1) was done by multiplex PCR. Demographic data, clinical history, antibiogram and type of UTI were collected from clinical case records. Results: 75 E. coli isolates from patients with suspected urinary tract infections were included. Females had a higher preponderance of UTI (66.7%).93% of the patients were adults and the remaining 7% were from the paediatric population. 24 (32%) isolates showed haemolysis by plate haemolysis method, and all 75 (100%) isolates were serum resistant. Out of 75 isolates, 65 were positive for at least one of the four targeted genes, while the remaining 10 isolates were negative for all 4 genes. Multidrug resistance was found in 40 (53.3%) isolates. 97.4% of the UTI cases had a favourable clinical outcome at discharge. Mortality due to urosepsis was 2.6%. Conclusion: The association of hemolysin production with resistance to imipenem and norfloxacin in UPEC strains was significant. The presence of the hlyA gene is positively associated with ceftazidime resistance. Nitrofurantoin, piperacillin tazobactam and cefaperazone sulbactam maybe suitable candidates for empirical therapy of UTIs. Drugs like aminoglycosides, carbapenems and fosfomycin may be used as reserve drugs in the treatment of MDR-UTI. However, inappropriate usage can gradually increase antibiotic resistance. Hence, proper selection of antibiotics in hospitals taking into account the local antibiogram is needed to reduce the emergence of antibiotic resistance.

zenodo32/100

CONCORDANCE OF BRONCHOSCOPIC AND RADIOLOGICAL FINDINGS IN SUSPECTED LUNG CANCER AND ITS OUTCOME- A CROSS SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL

Background Bronchoscopy and CT thorax are the most common investigations utilized to screen and diagnose lung cancer. Their individual utility in diagnosing lung cancer has been described affirmatively in existing literature. Studies correlating the airway characteristics of the two modalities in lung cancer are few. Objectives To analyze and characterize lung lesions bronchoscopically and correlate the same radiologically by CT of the thorax and thus assess its positive predictive value. Methods 56 consecutive adults who presented to Respiratory Medicine Department at a tertiary care hospital in South India from November 2018 to June 2020, having Clinico-radiological suspicion of malignancy and fulfilling study criteria were recruited. They were subjected to CECT of thorax and bronchoscopy. All bronchoscopic procedures were performed using a protocolized number of passes for biopsy. The baseline demographic and clinical data, findings of bronchoscopy and CT and biopsy reports were recorded. Cohens kappa coefficient was used to estimate the agreement of findings on the two modalities. Statistical analysis was performed using SPSS software. Results Bronchoscopy was normal in 22.14 % of cases, the corresponding CTs also revealed normal airway. Bronchoscopy revealed airway lesions in 78.6 % cases; the corresponding CT revealed airway abnormalities in only 46.41 % of cases, among these 52.1 % of cases revealed an exophytic growth. There was fair strength of agreement for the two modalities in the detection of airway lesions of lung cancer. [k= 0.38, p = <0.001]. CECT thorax has a negative predictive value of 44 %, a sensitivity of 59.1 % and specificity of 100 % at 95 % CI in the detection of airway lesions. Conclusion CT is not definitive in the evaluation of lung cancer, especially in those with central disease. Combination of the two modalities improves the diagnostic outcome in patients with lung cancer. Keywords- Thoracic Oncology, Bronchogenic Carcinoma, Adenocarcinoma of lung, Bronchoscopy, Diagnostic Imaging, Multidetector Computed Tomography.

opencc-by-4.0Jul 2023View details →

restrictedIPD-UNDECIDEDFeb 2026View details →

PRetest prObability of Infectious ENDOCARDITIS for Appropriate Criteria Regarding Transesophageal ECHOcardiography in Tertiary Care Facilities (PRO ENDOCARDITIS ECHO-Study)

ClinicalTrials.gov study NCT03365193. IPD Sharing: Not stated. Countries: 1. Publications: 1.

Effect of Implementing Evidence-based Practice and Nurse's Behavior Change on Quality of Care in Intensive Care Unit: Focus on Ventilator Associated Pneumonia in a Tertiary Hospital in Bangladesh

ClinicalTrials.gov study NCT06624540. IPD Sharing: NO. Countries: 2. Publications: 1.

Critical Incidents Related to Anesthesia and Intensive Care: A Study in a Tertiary Hospital

ClinicalTrials.gov study NCT02681159. IPD Sharing: NO. Countries: 1. Publications: 1.

Effect of Negative Pressure Wound Therapy for Soft Tissue Injuries of Foot and Ankle in Patients at a Tertiary Care Hospital

ClinicalTrials.gov study NCT04569305. IPD Sharing: NO. Countries: 1. Publications: 1.