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Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)?

BMJ Open Qual 2021 Sep;10(3)

Academic Neurosurgery, University of Cambridge, Cambridge, UK.

Objectives: To explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).

Design: A retrospective study of PALS user interactions.

Subjects: Individuals undergoing treatment for cSDH between 2014 and 2019. Read More

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September 2021

The Use of Platelet-rich Plasma as a Novel Nonsurgical Treatment of the Female Stress Urinary Incontinence: A Prospective Pilot Study.

Female Pelvic Med Reconstr Surg 2021 Sep 15. Epub 2021 Sep 15.

From the 1st Department of Obstetrics and Gynecology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Objectives: The aim of the study was to evaluate the efficacy and safety of platelet-rich plasma (PRP) for the treatment of stress urinary incontinence (SUI).

Methods: This was a prospective observational pilot study conducted in a tertiary referral unit, enrolling women with SUI booked for SUI surgery. A total of 20 consecutive women met the inclusion criteria and attended all follow-ups. Read More

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September 2021

Hearing Outcomes with Percutaneous and Transcutaneous BAHA® Technology in Conductive and Mixed Hearing Loss.

Otol Neurotol 2021 Oct;42(9):1382-1389

The Ear and Hearing Center, A.R.M.-Advanced Otolaryngology Head and Neck and Maxillofacial Surgery, Assuta Medical Center, Tel Aviv, Israel.

Objectives: To evaluate outcomes of BAHA Connect® and BAHA Attract® implantations, and to examine the prognostic utility of a preimplantation Softband®-attached processor trial.

Study Design: Retrospective case review.

Setting: Tertiary referral center. Read More

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October 2021

Congenital Cytomegalovirus Targeted Screening Implementation and Outcomes: A Retrospective Chart Review.

Otolaryngol Head Neck Surg 2021 Sep 14:1945998211044125. Epub 2021 Sep 14.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, USA.

Objective: To assess the effectiveness and outcomes of a targeted cytomegalovirus (CMV) testing protocol.

Study Design: Retrospective chart review.

Setting: Tertiary care institution. Read More

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September 2021

Patient gender does not influence referral to an orthopaedic surgeon by advanced practice orthopaedic providers: a prospective observational study in Canada.

BMC Health Serv Res 2021 Sep 11;21(1):952. Epub 2021 Sep 11.

School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

Background: The role of an advanced practice physiotherapist has been introduced in many countries to improve access to care for patients with hip and knee arthritis. Traditional models of care have shown a gender bias, with women less often referred and recommended for surgery than men. This study sought to understand if patient gender affects access to care in the clinical encounter with the advanced practice provider. Read More

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September 2021

Periodontal Disease in Patients Visiting a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2021 Apr 30;59(236):384-391. Epub 2021 Apr 30.

Department of Periodontics and Oral Implantology, Kathmandu Medical College, Bhaktapur, Nepal.

Introduction: Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index. Read More

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Anxiety among Patients Visiting for Periodontal Therapy in a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2021 Jul 30;59(239):697-702. Epub 2021 Jul 30.

Department of Periodontics and Oral Implantology, Kathmandu Medical College, Bhaktapur, Nepal.

Introduction: The aetiological factors of dental fear include negative information, witnessing or having a bad experience, and negative conditions related to periodontal treatment. Modified Dental Anxiety Scale Nepali version, is one of the tools used in epidemiological studies to measure dental anxiety in adults. The objective was to find out the prevalence of anxiety among dental patients visiting for periodontal therapy in a tertiary care hospital. Read More

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Study of Self-medication among First and Seventh Semester Medical and Dental Undergraduate Students of Tertiary Care Teaching Hospital in Nepal: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2021 Jan 31;59(233):55-60. Epub 2021 Jan 31.

Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.

Introduction: Although appropriate self-medication can ease minor illness and is time and costeffective, it can lead to irrational drug use and increased resistance, leading to prolonged morbidity. Inclined towards medical information and drug indices, medical students have an open arena for self-medication practice. This study was conducted to find the prevalence of self-medication among first and seventh semester medical and dental students in a tertiary care hospital. Read More

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January 2021

Prevalence of Thyroid Disorder in Pregnant Women Visiting a Tertiary Care Teaching Hospital: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2021 Jan 31;59(233):51-54. Epub 2021 Jan 31.

Department of Pathology, Kathmandu Medical College Public Limited, Sinamangal, Kathmandu, Nepal.

Introduction: The function of the thyroid gland is altered during pregnancy. Thyroid disorders during pregnancy are associated with serious maternal and fetal outcomes. Universal screening for thyroid disorders is recommended in the first trimester of pregnancy. Read More

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January 2021

Out of pocket Expenditure on Health Service Delivery at a Tertiary Care Women's Hospital: A Descriptive Cross-sectional Study.

JNMA J Nepal Med Assoc 2020 Dec 31;58(232):1024-1027. Epub 2020 Dec 31.

Department of Public Health, Little Buddha College of Health Sciences, New Baneshwar, Kathmandu, Nepal.

Introduction: Institutional delivery in Nepal is increasing in the past decades and has been the priority program of the government of Nepal. However, due to the hidden costs related to institutional deliveries, the financial burden remains unacceptably high for poor households. The study aimed to find out the major out of pocket expenditure on health service delivery at a tertiary care hospital in Kathmandu, Nepal. Read More

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December 2020

Prevalence of Tracheoesophageal Anomaly Cases among Neonates Undergoing Surgery in a Tertiary Care Children’s Hospital.

JNMA J Nepal Med Assoc 2020 Oct 15;58(230):736-739. Epub 2020 Oct 15.

Department of Surgery, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal.

Introduction: Tracheo-oesophageal anomaly is the abnormal communication between trachea and oesophagus. The most common type of tracheo-oesophageal anomaly is oesophageal atreasia with distal tracheo oesophageal fistula. Tracheo-oesophageal anomaly is a common neonatal problem requiring an urgent surgery. Read More

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October 2020

Skin Cancer Incidence in Organ Transplant Recipients Referred for Benign Skin Conditions.

Dermatol Surg 2021 Aug 25. Epub 2021 Aug 25.

Yale Transplant Dermatology Clinic; Yale School of Medicine; Department of Pathology; Yale New Haven Transplantation Center; Yale Cancer Center; Yale Center for Analytical Sciences; Department of Dermatology.

Background: Solid organ transplant recipients (SOTRs) are at ∼100-fold increased risk for developing skin cancers compared with the general population, with increased morbidity and mortality. These patients are closely followed by dermatology; however, it is unclear how referral reasons from nondermatologic providers affect care in these patients.

Objective: This study examines the reason SOTRs are referred to dermatologic care by nondermatologic providers as a potential predictor of nonmelanoma skin cancer (NMSC) outcomes. Read More

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Introduction of an enhanced recovery pathway results in decreased length of stay in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: A description of implementation strategies and retrospective before-and-after study of outcomes.

J Clin Anesth 2021 Sep 2;75:110493. Epub 2021 Sep 2.

Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America; Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America. Electronic address:

Study Objective: This study assessed whether implementation of an enhanced recovery-based pathway decreased length of stay without increasing readmissions among patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion.

Design: Retrospective observational before-and-after study.

Setting: A tertiary children's hospital. Read More

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September 2021

Profile of Back-Referrals to Special Newborn Care Units.

Indian Pediatr 2021 Sep 4. Epub 2021 Sep 4.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh. Correspondence to: Dr Praveen Kumar, Professor, Department of Pediatrics, PGIMER, Chandigarh.

Objective: To study the outcomes of neonates back-referred from a tertiary care centre to special newborn care units (SNCUs) for step-down care.

Methods: This prospective cohort study was conducted at a tertiary care neonatal unit and SNCUs in neighbouring states. We studied preterm and term neonates back-referred to district SNCUs from September, 2018 to April, 2019. Read More

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September 2021

Long-term efficacy and complications of a multicentre randomised controlled trial comparing Retropubic and Transobturator Mid-Urethral Slings: a prospective observational study.

BJOG 2021 Sep 3. Epub 2021 Sep 3.

University Hospital Plymouth NHS Trust.

Objective: Concerns exist regarding the risks of mid-urethral slings (MUS) for stress urinary incontinence (SUI), particularly the lack of long-term data. We compare patient reported outcomes of a multicentre randomised controlled trial of retropubic (TVT-GYNECARE ) versus transobturator (TOT-MONARC ) tape surgery at 12 years.

Design And Setting: A multicentre study was performed in 11 tertiary referral centres. Read More

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September 2021

Risk Factors and Outcomes of Acute Cardio-renal Syndrome in a Tertiary Care Setting in South India.

J Assoc Physicians India 2021 Aug;69(8):11-12

Department of Cardiology, Madras Medical Mission, Chennai, Tamil Nadu.

Aims And Objectives: To study the incidence,risk factors and in hospital mortality of Type I Cardiorenal syndrome(CRS1). To study the incidence of hyperkalemia in patients receiving Acei, ARB's or MRA Materials and Methods: Prospective observational cohort study done between June and December 2015 in Madras Medical Mission, Chennai. Consecutive patients admitted with ACS/ADHF were studied and clinical, biochemical and laboratory data was collected. Read More

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Contemporary Outcomes of Surgery for Primary and Recurrent Genitourinary Fistulae in a Well-resourced Country.

Eur Urol Open Sci 2021 Sep 31;31:41-46. Epub 2021 Jul 31.

Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.

Background: Urinary fistula (UF) is a global health problem but less common in well-resourced countries. Over the past decade there has been a trend toward managing UF in dedicated centres. Most of the evidence for surgical treatment is from individual case series, with few publications that involve high numbers. Read More

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September 2021

Multicentric Hospital-Based Surveillance of Pertussis Amongst Infants Admitted in Tertiary Care Facilities in India.

Indian Pediatr 2021 Aug;58(8):709-717

Department of Pediatrics, KEM Hospital Research Centre, Pune, India. Correspondence to: Dr Ashish Bavdekar, Associate Professor, Consultant Pediatric Gastroenterologist, Department of Pediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411 011.

Objective: To estimate the disease and economic burden of pertussis amongst hospitalised infants in India.

Design: Multicentric hospital-based surveillance study.

Participants: Hospitalised infants with clinical suspicion of pertussis based on predefined criteria. Read More

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Delayed Femoral Artery Occlusion After Total Hip Arthroplasty via the Posterior Approach: A Single-Case Report From Thailand.

Arthroplast Today 2021 Oct 17;11:38-40. Epub 2021 Aug 17.

Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Arterial injury after total hip arthroplasty is rare, but the consequences of this complication are serious and potentially life-threatening. Here, we report a case of delayed-onset common femoral artery occlusion after total hip arthroplasty that was performed via the posterior approach at Siriraj Hospital-Thailand's largest university-based national tertiary referral center. Our case was successfully treated with arterial thromboembolectomy. Read More

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October 2021

Prevalence of SARS-CoV-2 IgG antibodies in health care workers at a tertiary care academic medical center - An assessment of occupational infection risk.

Am J Infect Control 2021 09;49(9):1158-1161

College of Medicine, University of Kentucky, Lexington, KY; College of Pharmacy, University of Kentucky, Lexington, KY; Markey Cancer Center, University of Kentucky, Lexington, KY. Electronic address:

Background: The purpose of this study was to assess the occupational SARS-CoV-2 infection risk among health care workers (HCW) at University of Kentucky HealthCare (UKHC) by evaluating the prevalence of SARS-CoV-2 antibodies.

Methods: This is a prospective cohort study of HCW at UKHC. SARS-CoV-2 IgG antibody seropositivity was measured in a CLIA-certified laboratory utilizing the Abbott Architect SARS-CoV-2 IgG antibody assay. Read More

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September 2021

Palliative care and COVID-19 in the Australian context: a review of patients with COVID-19 referred to palliative care.

Aust Health Rev 2021 Aug 27. Epub 2021 Aug 27.

ObjectivePalliative care has played a key role in the response to the coronavirus disease 2019 (COVID-19) pandemic in Australia. This review of consecutive patients with COVID-19 referred to the palliative care consultancy service of a tertiary health service in Melbourne describes the palliative care experience with COVID-19 in Australia.MethodsThe experiences of 55 patients (median age 86 years; interquartile range (IQR) 81-90 years; 55% male; median Charlson comorbidity score 6 (IQR 5-8); 85% with Australia-modified Karnofsky Performance Status ≤50; 67% from residential aged care facilities) were reviewed to collect relevant data points. Read More

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Understanding barriers to implementing referral procedures in the rural and semi-urban district hospitals in Tanzania: Experiences of healthcare providers working in maternity units.

PLoS One 2021 26;16(8):e0255475. Epub 2021 Aug 26.

Department of Obstetrics and Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Introduction: Maternal and perinatal deaths occurring in low and middle income countries could be prevented with timely access to maternal and new-born care. In order to increase access to maternal and child health services, a well-functioning referral system that allows for continuity of care across different tiers of healthcare is required. A reliable healthcare system, with adequate numbers of skilled staff, resources and mechanisms, is critical to ensuring that access to care is available when the need arises. Read More

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Electronic consultations (eConsults): a proof of concept trial in Australia.

Intern Med J 2021 Aug 25. Epub 2021 Aug 25.

Clinical Informatics, Metro South Health, Princess Alexandra Hospital, Woolloongabba, Qld, Australia.

Background: Electronic consultations (eConsults) allows general practitioners (GPs) to seek the advice of a specialist via secure asynchronous digital communication.

Aims: To report the outcomes of a proof of concept (POC) trial of eConsults for patients with diabetes and endocrine disorders.

Methods: A prospective observational study conducted from Nov 2020 to May 2021. Read More

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Demographics, Biochemical Characteristics, and Phases of Chronic Hepatitis B Virus Infection: Retrospective Analysis From a Secondary Care Setup.

Cureus 2021 Jul 22;13(7):e16558. Epub 2021 Jul 22.

Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Introduction Hepatitis B virus (HBV) is the leading cause of cirrhosis in the developing world. Despite the development of effective vaccine(s) and direct-acting antivirals (DAAs) such as tenofovir and entecavir, the eradication of chronic HBV remains a distant dream in endemic regions. Factors such as treatment naivety, longer duration of disease, late diagnosis, family history of liver disorders and hepatocellular carcinoma, fatty liver disease, multiple comorbidities, alcoholism, use of tobacco products, noncompliance to drugs, and loss to follow-up all contribute to disease progression and development of complications. Read More

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The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre.

Clin Ophthalmol 2021 16;15:3481-3491. Epub 2021 Aug 16.

Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland.

Purpose: This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients.

Patients And Methods: A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021.

Results: The percentage of referrals due to primary RRD during the first year of pandemic (March 2020-February 2021) was 16. Read More

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Comments on: Reworking protocols of ophthalmic resident surgical training in the COVID-19 era - Experiences of a tertiary care institute in Northern India.

Indian J Ophthalmol 2021 09;69(9):2545-2546

Department of Ophthalmology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.

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September 2021

Neurosurgery in octogenarians during the COVID-19 pandemic: Results from a tertiary care trauma centre.

Interdiscip Neurosurg 2021 Dec 19;26:101357. Epub 2021 Aug 19.

Neurosurgical Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, 1345 Govan Road, G51 4TF, United Kingdom.

Background: In 2020, 6% of Scotland's adult population was ≥80 years. Advancements in care mean improved chances of survival at 6-months for older adults following injury to the brain or spine. The Covid-19 pandemic also resulted in local and national policies aimed at protecting the elderly. Read More

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December 2021

Effects of employing primary care doctors in hospital to improve the quality of care and health outcomes of rural patients: A systematic scoping review.

Aust J Rural Health 2021 Aug;29(4):492-501

Rural Clinical School, Medical School, The Australian National University, Acton, ACT, Australia.

Objective: To describe effects of employing primary care doctors in hospital care and their roles in improving the quality of care and health outcomes of rural and remote patients.

Design: A systematic scoping review.

Setting: Peer-reviewed publications were sourced from 3 online journal databases (PUBMED, SCOPUS and Web of Science). Read More

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Clinical and sociodemographic characteristics of glaucoma patients at a tertiary referral facility in Zimbabwe.

Malawi Med J 2021 03;33(1):15-20

Greenwood Park Eye Center, 175 Fife Avenue, Harare, Zimbabwe.

Purpose: To evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe.

Method: A hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma. Read More

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Outcomes of flexible fiberoptic laryngoscopy in patients with stridor: a cross-sectional study in a tertiary care pediatric center in Saudi Arabia.

Ann Saudi Med 2021 Jul-Aug;41(4):216-221. Epub 2021 Aug 22.

From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Successful evaluation of a patient with stridor requires a thorough history and physical examination followed by a flexible fiberoptic laryngoscopy (FFL), which provides visualization of the upper airway.

Objectives: Estimate the prevalence of causes of stridor in children who underwent FFL and compare different age groups. Find any significant associations between symptoms and laryngoscopic findings. Read More

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September 2021