جستجوی مقالات مرتبط با کلیدواژه "tertiary care center" در نشریات گروه "پزشکی"

drug utilization studies are necessary to evaluate the rational use and associated risks of anticoagulants. This study aimed to identify drug utilization pattern and possible drug interactions with the use of anticoagulants in a tertiary care hospital in Bangalore.

This prospective, observational study was conducted on 100 patients and anticoagulants utilization was assessed from Medicine ward of Bannerghatta Apollo hospital in Bangalore, India, during six months.

The most common indication for anticoagulants administration was ischemic heart disease (IHD) + acute coronary syndrome (ACS) with 47% and IHD alone with 22%. Most of the patients received single drug therapy, and parenteral drugs were more preferred than oral ones (91% vs. 6%). Among the medications, heparin (49%) followed by enoxaparin (29%) and fondaparinux (13%) were the most commonly prescribed drugs. Regarding laboratory tests, 29% of the patients were evaluated for the international normalized ratio (INR) and prothrombin time(PT). The finding showed that anticoagulants might interact with corticosteroids, some antibiotics such as piperacillin, azithromycin or other drugs such as tirofiban and losartan.

Anticoagulant drug utilization pattern followed very commonly American College of Clinical Pharmacy (ACCP) guidelines. The inappropriate utilization patterns of anticoagulants may compromise the patient’s  safety.

Globally,it is estimated that approximately 13 million neonates are born prematurely each year. The development of the central nervous system in premature neonates continues outside of the uterus and in the environment of neonatal intensive care unit (NICU). This study aimed to evaluate the physical environment of hospital and nursery in Iran’s tertiary care centers.
This cross-sectional study was conducted on a total of 23 NICUs of nine Universities of Medical Sciences, where students are trained in the neonatal fellowship course, from seven provinces of Iran, 20th July to 21th September 2015. Data analysis was performed using SPSS software, version 16, and descriptive statistics.
In this study, four dimensions of physical environment of hospitals and NICUs including the accessibility of NICU, the physical environment of NICU, infants’ bed space, and the sensory elements of bed spaces were evaluated. The obtained scores for each item was 41.17, 39.95, 38.83, and 39.28 out of 100, respectively. The highest mean score was 71.30 that was related to NICU temperature and ventilation considerations. The lowest mean score was 20, which was related to controlling over the movements around the infants’ beds. The total mean score of the physical environment of hospital and NICU was 39.77.
According to the results, it is recommended to take appropriate action to develop physical space and infrastructures for neonatal care regarding developmental care along with other dimensions.

High‑risk infant follow‑up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran.
In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria. After doing necessary measurements and family education, information was recorded in HRI health certificate and then entered in the access database for analysis.
From 253 eligible HRIs registered, 241 (95%) infants attended the follow‑up clinic after discharge. A total of180 cases were recalled for further visits, 110 of which attended the clinic. Anthropometric indices had an increasing trend in the first 6 months of life. There was no significant relation between ages and stages questionnaire (ASQ) results and infant birth weight, height, and head circumference. The ratios of intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) were 8.7% and 3.1%, respectively. The incidence of congenital hypothyroidism was 2:341 in HRIs.
Although some outcomes, such as ROP, improved in our study compared to similar studies, the findings indicate an impairment of the current follow‑up processes and highlight the necessity to modify the current HRIF program. Ethically, we insist on integrating HRIF program in child health services to promote early childhood development.

The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool.
This prospective study was done at two medicine units (Unit 5 and 10) of Dhaka Medical College Hospital from July to December 2010 where all poisoning cases were seen. A total of 2890 patients were admitted out of which 600 were taken into the study.
Among the poisoning cases 29% were pesticide, 27% travel related poisoning, and 20% benzodiazepine. 70% of poisoning occurred below 30 years of age and male: female ratio was 3:2. Incidence of poisoning was highest among students (31%) and housewives (25%). Majority of the patients were from urban area (76%) and most common intention was suicidal (66%). Familial disharmony was the prime cause (63%) behind poisoning. 42% cases got admitted between 5-8 hours of poisoning and more than 80% patients were admitted in the hospital directly without getting any first aid anywhere. Sixty-eight percent had Glasgow coma scale (GCS) score above 10 during admission. Cardinal clinical features of poisoning were nausea/vomiting (63%), drowsiness (56%), miosis (31%). Seventy percent patients were treated with only general and supportive treatment and specific antidotes were used in 30% cases. Case fatality for pesticide, benzodiazepine/anti-psychotic, rodenticide and snake bite was 6.9%, 2.2%, 8.3% and 3.3% respectively.
To assess the magnitude of problem, awareness of the public for prevention, immediate first aid measures and quick hospital admission is crucial component of poisoning.