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Discharge Against Medical Advice Among Children In Paediatrics Department In A Tertiary Hospital In Kolar

2023-05-01T00:00:00Z

Title: Discharge Against Medical Advice Among Children In Paediatrics Department In A Tertiary Hospital In Kolar Authors: Jefrin Anto, B C.; Beeregowda, Y C.; Narendra, R R Abstract: Discharge against medical advice (DAMA) is a serious concern because the patients leave medical facilities too soon and are suspected to suffer from probable adverse consequences. The aim of the study is to identify the reasons of discharge against medical advice in both infants and children. A prospective observational study was performed between January 2022 to June 2022 after obtaining parental consent and institutional ethical committee permission. All the patients between the age group of 1 month to 17 years who are discharged against medical advice were included in the study. Total of 373 cases were discharged during the study period among which 30 were DAMA cases. Data were analysed with IBM SPSS Statistics for Windows, Version 23.0. In this study, out of 373 Children discharged, 30 were discharged against medical advice. The most common reason was financial issue 36% and no health awareness regarding the disease course which was 20%. On comparing the reasons for DAMA with various demographic characteristics, effect of occupation on reason for DAMA was statistically significant with a p value of 0.038. This study concludes that financial issues and unawareness about the health issues were the most common reasons for DAMA though they were not statistically significant. Hence proper counselling and measures to help the patients to overcome the financial burden would reduce the rate of DAMA. Furthermore, studies are required to support the evidence and to decrease the rate of DAMA.

Acute Complications in neonates with birth asphyxia undergoing therapeutic hypothermia”-A Cross sectional observational study in a tertiary teaching hospital in kolar.

2023-05-01T00:00:00Z

Title: Acute Complications in neonates with birth asphyxia undergoing therapeutic hypothermia”-A Cross sectional observational study in a tertiary teaching hospital in kolar. Authors: Mathumitha, T.; Narendra, R R.; Beeregowda, Y C Abstract: encephalopathy (HIE) account for a quarter of these deaths and an unknown number of survivors with lifelong disability.The aim of the study is to determine the acute complications occurring in neonates with birth asphyxia undergoing therapeutic hypothermia in a tertiary care hospital in Kolar.A cross sectional observational study was done from May 2021 to June 2022 and neonates with birth asphyxia were included in the study. Acute complications occurring in these neonates were analyzed based on the clinical and laboratory parameters. p value (Probability that the result is true) of <0.05 was considered as statistically significant after assuming all the rules of statistical tests. Out of 23 birth asphyxia neonates included in the study, the mean age of the neonates was 76.52+87.7 minutes. 14(60.9%) were males and 9(39.1%) were females with 3(13%) being <2.5kg and 20 >2.5kg. Thompson score used in this study to assess the neurological status ranged between 8 and 13 with mean value of 10.26+1.25. Among the clinical parameters, sinus bradycardia and cardiac arrhythmia(p<0.05) had statistically significant association with outcome of neonates who underwent therapeutic cooling. Thrombocytopenia (p<0.05) and Culture proven sepsis(p<0.05) were the laboratory parameters which had statistically significant association with outcome. This study reveals that Therapeutic hypothermia does not increase mortality in birth asphyxia infants. However, complications like sinus bradycardia, cardiac arrhythmia, thrombocytopenia requiring platelet transfusion and culture sepsis were commonly observed in neonates who received therapeutic cooling.

A Study of the Prediction of Mortality in a Tertiary Care Hospital Using the Modified Sick Neonatal Score (MSNS): An Observational Cross Sectional Study

2023-03-01T00:00:00Z

Title: A Study of the Prediction of Mortality in a Tertiary Care Hospital Using the Modified Sick Neonatal Score (MSNS): An Observational Cross Sectional Study Authors: Abhinay, R.; Chevva Prakash, Reddy.; Beere, Gowda Abstract: Purpose: India is a major contributor to neonatal deaths worldwide. There is a paucity of amenities for the management of neonatal health issues in rural areas of our country. Hence, there is a need to invent a reliable scoring system for the analysis of neonatal mortality. Aim: The aim of the study is to evaluate the Modified Sick Neonatal Score (MSNS) as a predictor of mortality in neonatal care units in resource-limited settings. Materials and methods: This cross-sectional observational study was performed in the intensive care unit of our hospital. All the data were collected and analyzed using IBM Corp.'s Statistical Package for Social Sciences (SPSS) software. Results: Overall, 71 participants were considered for the present study. The common clinical diagnoses noticed in our participants were meconium aspiration, malformation, and jaundice. The MSNS score compared between expired and discharged participants is found to be statistically significant with p<0.05. Conclusion: The MSNS scoring system is considered an ideal scoring system for detecting early mortality in neonates.

A comparative study of pre-sleep activities affecting the sleep of rural and urban adolescents in Tumkur district

2022-05-01T00:00:00Z

Title: A comparative study of pre-sleep activities affecting the sleep of rural and urban adolescents in Tumkur district Authors: Vidya, M P; Karthik, S; Ruchi Dhar Abstract: Background: Sleep affects mental, emotional and physical wellbeing of an adolescent. On an average for adequate development an adolescent should sleep for at-least 8 to 10 hours per day. Objectives: To study the pre-sleep activities affecting the sleep of rural and urban adolescents. Methods: A cross-sectional questionnaire-based school survey was designed with a sample size of 992 for the adolescents aged between 10 to 16 years of age. Children with illnesses that affected their sleep were excluded from the study. A pre-designed questionnaire was distributed to each of them. Later the data was tabulated in Microsoft excel and statistical analysis was done using software SPSS 22.0. Result: On comparing various factors that affect sleep, it was found that 27.62% of the subjects consumed beverages like tea and coffee before sleep, 42.64% used mobile phones before sleep, 58.06% watch television late at night, 41.73% consume dinner late in the night i.e., after 10 pm and 28.53% have sleep disturbance due to exam stress and fear. The use of mobile phones before sleep and late-night dinners was more among the adolescents residing in the urban areas compared to those in the rural areas which was statistically significant (p<0.0001). Conclusion: Pre sleep activities have a major impact on the quality of sleep, hence addressing them is essential.