Clinic Attendance Research Articles

278 Outpatient "Did Not Attend" Episodes: A Cohort Study Investigating Influencing Factors

Abstract Aim Outpatient "Did Not Attend" (DNA) episodes represent a significant financial burden to healthcare systems, with an estimated cost of £1 billion for the NHS. Understanding factors that contribute to DNA episodes is crucial for optimizing healthcare resource utilization. We examined a cohort of outpatient clinics within the general surgery department at South Tees Hospitals NHS Foundation Trust to identify factors associated with DNA episodes. Method A prospectively collected database of all outpatient clinics was interrogated from 01/01/2021, to 31/03/2023. Information on patient age, gender, appointment type (new vs. follow-up, face-to-face vs. remote), index of multiple deprivation (IMD) decile, and driving distance was recorded for each clinic attendance. Results Of 19,769 clinic appointments, 1,509 (8%) resulted in DNAs. Disproportionate number of patients with DNAs resided in the lowest IMD decile (19%), compared to other deciles (range: 6.4%-10%). Driving distance did not differ between attended (median: 16 km, IQR: 6-30 km) and DNA groups (median: 15 km, IQR: 5-30 km). DNA rates did not vary between remote (8%) and face-to-face (7%) clinics. Multivariable binary logistic regression found older age, IMD, and hospital site as predictors of outpatient DNA. Individuals who were younger and from the lowest IMD decile were more likely to DNA. Conclusions Outpatient DNA is multifactorial. Travel distance/duration and remote consultations did not influence attendance in our cohort. Working-age patients and those residing in lower IMD deciles were more likely to DNA. Solely relying on remote consultations may not be sufficient to effectively address DNA episodes.

Health Promotion Practices among Pregnant Women Attending Antenatal Clinics at a Tertiary Hospital in Nigeria.

A cross-sectional study conducted in a semi-urban tertiary healthcare hospital in South western Nigeria to assess health promotion practices and associated sociodemographic factors among pregnant women attending antenatal clinics. A total of 220 pregnant women were studied. Results showed that 95.0% of the participants had good health promotion practices with physical activities having the lowest while spiritual values had the highest score. Moreover, age, religion, education, and occupation were significantly associated with health promotion practices among the pregnant women.

Does clinical experience influence the effects of team simulation training in stroke thrombolysis? A prospective cohort study

ObjectivesAfter introducing a team simulation training programme at our hospital, we saw a reduction in door-to-needle times (DNT) for stroke thrombolysis but persisting variability prompting further investigation. Our objective is...

Assessment of Medication Compliance and Follow-Up Clinic Attendance Among Patients With Cardiovascular Diseases in the Jazan Region.

Cardiovascular diseases are common causes of mortality in Saudi Arabia and the world. This study aims to assess medication compliance and regularity of follow-up for cardiovascular patients in the Jazan region. An analytical cross-sectional approach was used to target all registered cardiovascular patients attending the cardio clinic in a Jazan region hospital. Data were collected using an interview questionnaire developed by the researchers with the help of experts. The questionnaire included the patients' sociodemographic data, clinical characteristics, disease-related data, drugs, and appointments. The study included 259 patients diagnosed with cardiac disease. About 53.7% of the patients were males. All the cases had the disease for one year or more. About 56% of the patients hadno difficulty remembering their medications, while 44% had problems remembering to take them. More than half of the patients had good medication adherence, and 79.6% had good appointment adherence. Only 20.4% of patients had a poor adherence rate. The adherence rate for the patients' medication and appointments was satisfactory due to high patient awareness. On the other hand, poor adherence was related more to non-Saudi patients.

Effect of Anterior Uveitis on Corneal Endothelial Cells

Objective: Investigating the impact of anterior uveitis on changes occurring in corneal endothelial cells. Methods: In this prospective cross-sectional study (cases and controls), the research sample included 43 patients (86 eyes) from the ophthalmic clinic attendees at Tishreen University Hospital in Latakia during the period 2023-2024. Results: The average corneal endothelial cell count was lower in the anterior uveitis group, both granulomatous (2074.16±173.70 cells/mm²) and nongranulomatous (2188.38±165.7 cells/mm²) types, compared to the control group (2696.1±136.60 cells/mm²) with a (p-value <0.01) in all age groups studied. The average percentage of hexagonal cells was lower in the both granulomatous (42.41±2.6%) and non- granulomatous (47.0±2.2%) types, compared to the control group (61.4±2.0%) with a (p-value <0.01) in all age groups studied. The average cell volume change coefficient was higher in the anterior uveitis group, both granulomatous (40.16±2.1) and non-granulomatous (34.70±1.08) types, compared to the control group (29.8±1.36) with a (p-value <0.01) in all age groups studied. Host and disease-related characteristics had no effect on the measured results) p-value=0.184(. ECC was negatively correlated to the duration of uveitis (a=-0.513; p-value<0.001), maximum intraocular pressure during the course of disease (a=-0.472; p-value = 0.0001), and the number of attacks (a=-0.515; p-value<0.001). Conclusion: Corneal endothelial cells are affectd in patients with anterior uveitis, and this negative impact increases with the duration of the disease, the number of attacks, and the presence of elevated intraocular pressure. This negative impact is more pronounced in granulomatous uveitis.

Prevalence of Multi Drug Resistant Coagulase Negative Staphylococci among some Pregnant Women Attending Antenatal Clinic in Yola, Nigeria

Study’s Novelty/Excerpt This study presents findings on the prevalence and characterization of coagulase-negative staphylococci (CoNS) among pregnant women in public health facilities in Yola, revealing a significant prevalence rate of 26.97%. The research highlights the high susceptibility of CoNS to certain antibiotics and the alarming presence of multi-drug resistant and extended spectrum beta-lactamase (ESBL) producing strains. This underscores the necessity for routine screening of pregnant women for CoNS to prevent potential gestational complications, providing crucial data for public health interventions and antibiotic stewardship programs. Full Abstract Coagulase negative staphylococci have been reported to be a frequent agent of uncomplicated UTI in young sexually active women which can also lead to symptomatic infection, low birth weight (LBW) babies and preterm delivery. This study was undertaken to determine the prevalence and characterize coagulase negative staphylococci among pregnant women in public health facilities in Yola. A total of 250 urine samples were collected from pregnant women attending antenatal clinic at Specialist Hospital and Boshang Clinic and Maternity both in Yola. The samples were cultured on cysteine lactose electrolyte deficient medium and isolates characterized using phenotypic methods. The prevalence of coagulase negative staphylococci from this study was 26.97%, Staphylococcus aureus 16.29% and Escherichia coli 36.51%. The frequency of CoNS was highest among age group of 36-40 years and least among 16-20 years (12.5%). CONS isolated from this study demonstrated high susceptibility to pefloxacin, ciprofloxacin, erythromycin, ceftriaxone and streptomycin. Some isolates showed high resistance to ampiclox, cefuroxime and amoxicillin. About 83% of the isolates had multiple antibiotic resistant indexes greater than 0.2 with about 25% of the antibiotic resistance being plasmid mediated. Furthermore, phenotypic screening using the double disk synergy test showed that 20 (40%) of the isolates were extended spectrum beta lactamase (ESBL) producing. This study revealed the presence of multi-drug resistant and ESBL producing coagulase negative staphylococci among pregnant women in the study area. There is therefore the need for pregnant women to be screened for coagulase negative staphylococci to avoid complications during gestation period.

Sex Differences in Outcomes of an Intensive Risk Factor Modification Program in Patients With Atrial Fibrillation.

The outcomes of atrial fibrillation (AF) seem to be variable between males and females. We therefore aimed to determine sex differences in weight loss, cardiorespiratory fitness gain, and recurrence and progression of AF following risk factor management. Of 1415 consecutive patients referred for electrophysiology management of AF, 825 had a body mass index of ≥27 kg/m2; after exclusions, 355 (males, 234; females, 121) were offered risk factor management and participation in a tailored exercise program. Females were older than males (65.5±10.4 versus 62.5±10.6 years; P=0.013) with a higher body mass index (34.1±5.4 versus 32.6±4.1 kg/m2; P=0.003) and more commonly paroxysmal AF (67.8% versus 48.3%; P<0.001). There was no sex difference in clinic attendance (58.7% versus 60%; P=0.82), weight loss (P=0.86), fitness gain (P=0.44), or improvement in AF symptoms (P=0.35). Weight loss (≥10% compared with <10%) was associated with lower total AF recurrence in males (hazard ratio, 0.41 [95% CI, 0.23-0.73]) and females (hazard ratio, 0.41 [95% CI, 0.20-0.83]). Fitness gain (≥2 metabolic equivalents compared with <2 metabolic equivalents) was associated with lower total AF recurrence in females (hazard ratio, 0.13 [95% CI, 0.05-0.30]) but not in males (hazard ratio, 0.63 [95% CI, 0.38-1.04]; P=0.002). There was a trend toward more reversal from persistent to paroxysmal AF in males compared with females (21.8% versus 14.0%; P=0.079). Males and females with AF demonstrate a similar degree of weight loss and fitness gain through structured risk factor management. However, fitness had a much greater benefit for total arrhythmia recurrence in females compared with males, whereas there was a trend toward more AF reversal in males. URL: https://anzctr.org.au; Unique identifier: ACTRN12614001123639.

Attitudes toward an HPV vaccine for condyloma acuminata and willingness to undergo vaccination among STD clinic attendees in China: Focus on STI prevention with HPV vaccine

BackgroundCondyloma acuminata (CA) is a common, and recurrent sexually transmitted disease (STD) that greatly contributes to direct health care costs and has a substantial psychosocial impact. Human papillomavirus (HPV) vaccination (containing L1 protein for HPV types 6 and 11) effectively controls CA.ObjectivesWe investigated attitudes toward the HPV vaccine for CA and willingness to undergo vaccination among STD clinic attendees in China.MethodsAttendees at STD clinics at two selected hospitals in Guangdong and Jiangsu Provinces from May to September 2017 were requested to complete a self-administered questionnaire for this cross-sectional study.ResultsThe participants’ median age was 28 years (IQR: 24.0–34.0), and the sex ratio was balanced; 63.5% were from Guangdong, 36.5% were from Jiangsu, and 44.5% had a history of CA. The vaccine acceptance rate was high among the participants (85.8%,235/274) to whom the HPV vaccine for CA was available, especially among those who had heard of CA (89.0%, AOR = 3.14, 95% CI: 1.29–7.63, p = 0.0114). 95 (34.7%) of 274 participants had a positive attitude toward the HPV vaccine for CA. STD clinic attendees who had heard of the connection between HPV and CA (AOR = 2.56, 95% CI: 1.31-5.00, p = 0.0060), had heard of the HPV vaccines or cervical cancer vaccines (AOR = 1.90, 95% CI: 1.02–3.54, p = 0.0444) and had ever proactively discussed CA or the vaccine with others (AOR = 1.95, 95% CI:1.00-3.79, p = 0.0488) had better attitudes toward the HPV vaccine for CA. Over half of the participants (52.5%) expected the price of the HPV vaccine for CA to be under $90.ConclusionThe acceptance of the HPV vaccine for CA was high among STD clinic attendees in China, and the participants’ self-perceived knowledge of CA and HPV was associated with better attitudes toward the HPV vaccine for CA. Education to improve knowledge is vital for reducing vaccine hesitancy.

Low-dose ondansetron: A candidate prospective precision medicine to treat alcohol use disorder endophenotypes

BackgroundAlcohol use disorder (AUD) is among the leading causes of morbidity and mortality worldwide, and over 95 million people live with alcohol dependence globally. The estimated heritability of AUD is 50–60 %, and multiple genes are thought to contribute to various endophenotypes of the disease. Previous clinical trials support a precision medicine approach using ondansetron (AD04, a 5-HT3 antagonist) by segregating AUD populations by the bio-genetic endophenotype of specific serotonergic genotypes and the bio-psychosocial endophenotype of the severity of drinking or both. By targeting the modulation of biogenetic signaling within the biopsychosocial context of AUD, low-dose AD04 holds promise in reducing alcohol consumption among affected individuals while minimizing adverse effects. MethodsThis was a phase III, 6-month, 25-site, randomized, placebo-controlled clinical trial using AD04 to treat DSM-V–categorized AUD individuals who were pre-stratified into the endophenotypes of heavy or very heavy drinking individuals and possessed a pre-defined profile of genetic variants related to the serotonin transporter and serotonin-3AB receptor. Participants (N = 303) presented moderate to severe AUD, >80 % were men, mostly in their fifties, and >95 % were of European descent. Low-dose AD04 (approx. 033 mg twice daily) or a matching placebo was administered twice daily for 6 months. Brief Behavioral Compliance Enhancement Treatment (BBCET [53]) was administered every two weeks to enhance medication compliance and clinic attendance. ResultsThere was a significant reduction in the monthly percentage of heavy drinking days, PHDD (-46·7 % (2·7 %), 95 %CI: -52·1 % to -41·2 % vs. -38·1 % (2·9 %), 95 %CI: -43·8 % to -32·5 %, respectively; LS mean difference=-8·5 %; p = 0.03) among AD04-treated vs. placebo-receiving heavy drinking individuals at month 6. Heavy drinking individuals were also less likely to be diagnosed with AUD [Month 1: -32·0 % (2·8 %), 95 %CI: -37·5 % to -26·5 % vs. -23·2 % (2·9 %), 95 %CI: -28·9 to -17·5 %; LS mean difference= -8·8 %; p = 0·026)], and improved on the WHO quality of life BREF scale with a significant effect for at least a 1-level downward shift (OR = 3.4; 95 % CI: 1·03–11·45, p = 0·044). Importantly, heavy drinking individuals, as distinct from very heavy drinking individuals, were the bio-psychosocial endophenotype more predictive of therapeutic response to AD04. AD04 had an exceptional safety and tolerability profile, like the placebo's. ConclusionsIn this Phase 3 clinical trial, AD04 was shown to be a promising treatment for currently drinking heavy drinking individuals with AUD who also possess a specific genotypic profile in the serotonin transporter and serotonin-3AB receptor complex. Using AD04 to reduce the harm of AUD in heavy drinking individuals who are currently drinking, without the necessity of abstinence or detoxification from alcohol use, is an important advance in the field of precision medicine. AD04’s adverse events profile, which was like placebo, should enhance accessibility and acceptance of modern medical treatment for AUD by lowering the incorrect but commonly perceived stigma of personal failure.

Remote symptom monitoring with patient-reported outcome measures in outpatients with chronic kidney disease (PROKID): a multicentre randomised controlled non-inferiority study.

The increasing incidence of chronic kidney disease (CKD) is straining the capacity of outpatient clinics. Remote healthcare delivery might improve CKD follow-up compared with conventional face-to-face follow-up. Patient-reported outcomes (PROs) are used to empower remote follow-up and patient engagement. The consequences of shifting from face-to-face follow-up to remote outpatient follow-up on kidney function, health resource utilisation and quality of life remain unknown. We conducted a multicentre pragmatic non-inferiority trial at three outpatient clinics in the Central Denmark Region. A total of 152 incident outpatients with CKD were randomised (1:1:1) to either PRO-based, PRO-telephone follow-up or standard of care (SoC). The primary outcome was the annual change in kidney function measured by the slope of the estimated glomerular filtration rate (eGFR). The non-inferiority margin was an eGFR of 2.85ml/min/1.73m2/year. Mean differences were estimated using intention-to-treat (ITT), per protocol and random coefficient models. Mean eGFR slope differences between PRO-based and SoC were -0.97ml/min/1.73m2/year [95% confidence interval (CI) -3.00-1.07] and -1.06ml/min/1.73m2/year (95% CI -3.02-0.89) between PRO-telephone and SoC. Non-inferiority was only established in the per-protocol analysis due to CIs exceeding the margin in the ITT group. Both intervention groups had fewer outpatient visits: -4.95 (95% CI -5.82 to -4.08) for the PRO-based group and -5.21 (95% CI -5.95 to -4.46) for the PRO-telephone group. We found no significant differences in quality of life, illness perception or satisfaction. Differences in the eGFR slope between groups were non-significant and results on non-inferiority were inconclusive. Thus, transitioning to remote PRO-based follow-up requires close monitoring of kidney function. Reducing patients' attendance in the outpatient clinic was possible without decreasing either quality of life or illness perception.ClinicalTrials.gov identifier: NCT03847766.

Pattern and causes of missed appointments in a Nigerian Psychiatric Hospital: A cross-sectional study.

Psychiatric patients exhibit a higher rate of missed appointments compared to other medical specialities, leading to provider frustration, increased relapse, and suboptimal outcomes. This study investigates the patterns and correlates of missed appointments among outpatients at the Federal Neuropsychiatric Hospital in Calabar, Nigeria. A cross-sectional study involving 403 consecutive outpatient clinic attendees was conducted. The study questionnaire inquired about sociodemographic characteristics and hospital utilization. The Oslo Social Support Scale, the Internalized Stigma of Mental Illness Scale, the Perceived Devaluation and Discrimination Scale, and the Treatment Perception Questionnaire were administered. The mean participant age was 36.19 years (SD = 11.25), with females constituting 52.6%. Missed appointments occurred in 16.6%. The primary reasons for missed appointments included financial difficulties, forgetfulness, and distance to the hospital. Factors significantly associated with missed appointments were marital status (married), having children, believing appointments were too frequent, medication nonadherence, and concerns about medication cost (P < .05). Additionally, individuals who received unorthodox or delayed traditional care during their first mental health episode were more likely to miss appointments (P < .05). Missed appointments are prevalent among psychiatric patients, often attributed to financial challenges, forgetfulness, and geographical barriers to the hospital. Some of these factors are modifiable, suggesting targeted interventions in adherence improvement programs are needed.

Knowledge of Intestinal Parasitic Infection and Anemia among Pregnant Women Attending Antenatal Clinic in Ogun State

A study was conducted at General Hospital Ijebu Igbo antenatal section to investigate the prevalence of intestinal parasitic infection and anemia in pregnant women. A questionnaire was administered to 42 pregnant women who attended the antenatal section of the clinic during the study period. Out of these 42 pregnant women, 18 (42.9%) provided both fecal and blood samples for parasitological and hematological analysis. 50% of the respondents fall within 16-25years age group, while those within 36-45years have the lowest percentage (22.2%). 50% have the knowledge of the helminth infection, out of the 9(50%) that have the knowledge, only 7(77.8%) have the knowledge of how the infection is being transmitted. Of 18 respondents, 13(72%) have the knowledge of anemia, and 5(28%) of them had no prior knowledge of it. The parasitological analysis revealed three intestinal parasite which are Ascaris lumbricoides (22.2%), Enterobius vermicularis (11.11%) and Entamoeba histolytica (5.56%). There were no reported cases of severe anaemic condition in this hospital based study. This suggests that the awareness level of anemia and parasitic infection is moderately high. Therefore, screening for intestinal parasites and deworming of infected pregnant women should be included in antenatal care.

Prevalence of Pregnancy Induced Hypertension in Women Attending Antenatal Clinic in a Tertiary Care Hospital in Maharashtra

Background- Blood pressure (BP) ≥140/90 mmHg, taken after a period of rest, on two occasions or ≥160/110 mmHg on one occasion in a previously normotensive woman is labeled as pregnancy-induced hypertension. [1,2] Pregnancy-induced hypertension (PIH) is a pregnancy-specific condition that includes gestational hypertension, pre-eclampsia (PE), and eclampsia (E). It is linked to intrauterine death, abruptio placentae, maternal mortality, and intrauterine growth retardation (IUGR) [3, 4]. Aim - to find the prevalence of pregnancy induced hypertension in women attending antenatal clinic in a tertiary care hospital. Materials and methods- Total 200 pregnant women with a gestational age of 20 weeks or greater visiting ANC clinic were included in the study during the period of 5 months (December 2023 to April 2024) at VVP rural hospital, Loni. Demographic details and blood pressure were collected. Data collected was analyzed using Microsoft Excel 2013 and pspp version 1.0.1. Results- Mean age of participant mothers was 23.2 years. Out of total 200 participants, 15 (7.5%) women presented with PIH (8, gestational hypertension and 5, pre-eclampsia and 2, eclampsia). Mean age of pregnant women presenting with PIH was 29 years as compared to the mean age of pregnant women without PIH which was 22 years. Out of 15 participants with PIH, 10 were primigravida, 8 and 3 were from lower and lower middle class respectively. Conclusion- PIH is still important problem and health education and awareness is still needed especially in rural communities.

Assessment of first-time attendees at a pain clinic using a pain inventory tool

Aims: Pain presents a complex challenge affecting the quality of life of over a million adults annually. Understanding the variety and distribution of pain types is vital for effective management and intervention strategies. This study aimed to assess the characteristics and distribution of pain among first-time attendees at a pain clinic using the Brief pain inventory (BPI). Methods: A cross-sectional survey was conducted with 100 adult outpatients at the pain clinic of the İstanbul Training and Research Hospital from July to November 2012. The BPI was administered face-to-face and demographic data were collected. Individuals under 18 years of age, mentally retarded, previous pain clinic attendance, cancer pain, or diagnosed rheumatic diseases was excluded. Written informed consent was obtained from all participants. Descriptive statistics were used to describe the means, standard deviations, and frequency distributions. Results: The study included 100 adult patients with a mean age of 46.4, predominantly female (65%), who sought treatment for various pain complaints at a pain clinic. The majority reported throbbing (41% knee, 31% lumbar, and 65% shoulder) and exhausting pain (74% knee, 73% lumbar, and 65% shoulder), with significant proportions experiencing constant pain, especially in the knee (82%) and lumbar region (81%). Regular analgesic use was noted in 54% of the patients, with 65% requiring daily medication, indicating high demand for pain management. Despite treatment, 90% expressed the need for stronger pain relief and 50% reported side effects from analgesics. Various nonpharmacological methods have been used, such as hot compression (38%) and relaxation techniques (30%). Conclusion: The study reveals the significant pain burden among first-time pain clinic patients, with throbbing and exhausting sensations prevalent in knee and lumbar regions. The extensive use of analgesics and need for stronger pain relief indicate ongoing pain management challenges. The adoption of nonpharmacological methods highlights the need for a multifaceted approach. These findings emphasize the necessity of tailored, multidimensional pain management strategies for enhanced patient care and quality of life.

Ten-Year Review of the Postpartum Maternal Health Clinic at the Kingston Health Sciences Centre

ObjectivesThe postpartum Maternal Health Clinic (MHC) sees patients who have experienced pregnancy complications identified as pregnancy-related cardiovascular disease (CVD) risk indicators (hypertensive disorders of pregnancy, gestational diabetes, placental abruption, idiopathic preterm delivery, and intrauterine growth restriction) at 6 months postpartum for CVD risk screening. This project aimed to summarise the past 10 years of the MHC and identify trends in patient characteristics, patient CVD risk assessments, and clinic attendance over time. MethodsPatients included in this study have experienced 1 or more pregnancy-related CVD risk indicator(s) and have delivered between April 2011 and April 2021. MHC patient data and the Better Outcomes Registry Network database were utilised to compare eligible and participating patient data during clinically significant time periods. ResultsThe clinic has seen 1030 patients in the last 10 years and their characteristics have remained largely consistent. However, there has been an increase in the proportion of patients seen because of a hypertensive disorder and an increase in the proportion of patients with obesity, abnormal total cholesterol, and elevated fasting glucose. Additionally, CVD risk scores and the prevalence of metabolic syndrome have remained consistent over the years. Regarding the clinic’s outreach, patient eligibility for the MHC has been increasing while attendance has been decreasing over time. ConclusionsOverall, there remains a need to screen these patients for CVD risk and counsel them on risk reduction. There is also an opportunity to increase patient recruitment to improve attendance and to address the increased need for CVD risk screening and counselling in the community.

Trends of Buprenorphine Prescribing for Opioid Dependence Before, and During the Early and Later Part of the COVID-19: A Study from a Large Publicly-Funded Opioid Agonist Treatment Services in India.

The COVID-19 pandemic has affected the availability and access to medications for opioid dependence (OD). We examined the monthly trends in new buprenorphine/naloxone (BNX) treatment episodes, number of clinical visits for BNX, BNX dispensed per person, and BNX prescription over 56-month, which included pre-pandemic, during early, and later part of pandemic (Jan 2017 - Aug 2022). Research data were collected from the pharmacy database of a large publicly funded treatment center in India. A flexible, low-threshold service was adopted in April 2020 in response to the lockdown implemented on 25 March 2020. Change Point analyses were performed to examine monthly trends visually and statistically. We used Autoregressive integrated moving averages to forecast trends from April to Aug 2020 and March to August 2022, using Jan 2017 to March 2020 and March 2020 to February 2022 as training datasets. 993 patients were started on BNX treatment, 40452 BNX clinic attendances were made, 1401393 BNX tablets were dispensed, and 6795 new patients with OD were registered. The observed data for clinic attendance for BNX was significantly lower than the projected estimates in April -Aug 2020; however, observed new treatment episodes and monthly BNX prescriptions were within the 95% projected estimates; BNX dispensed per person was significantly more than the projected estimate. In contrast, observed BNX prescription trends surpassed the upper limit of 95% CI in March-Aug 2022. A low-threshold and flexible treatment service could mitigate the unintended consequences of pandemic-induced restrictions.

P430 Impact analysis of an updated Did Not Attend policy on long term clinic attendance

P430 Impact analysis of an updated Did Not Attend policy on long term clinic attendance

Congenital fetal malformations: The challenges of diagnosis and management in a resource-poor nation – the role of ignorance: A case report

Regular ante-natal clinic attendance is routine and recommended for every pregnant mother worldwide. Antenatal care services are usually made easily accessible to all pregnant women and offered in most centres within or near communities. This is to encourage all would-be mothers to access the opportunity of being reviewed by trained experts when pregnant. During such visits, necessary routine investigations are carried out and the results are reviewed and acted upon by the midwife/physician. One such investigation is the obstetric ultrasound which should be done at least two times before delivery. This may not always be possible in a poor resource region like ours. Even where feasible, ignorance may militate against its use. So, invariably, many fetal congenital malformations are missed antenatally and diagnosis is only made at birth. Such was the case of Mrs XX. Unfortunately, even after delivery of the malformed baby ignorance still prevailed against proper management of the newborn.

Assessment of Oral Health Problems: A Questionnaire-Based Study in a Clinic Setting

This research endeavors to explore and assess prevalent oral health problems within a clinic setting through a comprehensive questionnaire-based study. Oral health is a vital aspect of overall well-being, and this study aims to shed light on the various oral health issues affecting patients attending at Bloo Dental Solutions, at Rourkela. The research focuses on understanding patient awareness, dental hygiene practices, and lifestyle factors that may contribute to the prevalence of oral health problems. By utilizing a structured questionnaire, the study collects and analyzes data to provide valuable insights into the oral health status of clinic attendees. The study engaged a diverse group of participants, comprising 32 individuals, who voluntarily participated in the research during their clinic visits. The questionnaire was meticulously designed to cover a spectrum of topics, including dental hygiene practices, oral or dental problems, type of medicine taken, and lifestyle factors influencing oral health. The findings of the study reveal a 100% prevalence of oral health problems among the participants. Common issues identified include dental caries, irreversible pulpitis, and chronic gum gingivitis. This prevalence underscores the need for a more in-depth understanding of the factors contributing to these issues and the development of targeted interventions. Analysis of dental hygiene practices among participants indicates that 6.25% reported brushing their teeth twice daily, while 93.75% admitted brushing their teeth once in morning daily. The study highlights a correlation between consistent dental hygiene practices and reduced instances of oral health problems. However, the presence of a significant proportion with irregular habits suggests a need for targeted education on the importance of regular and thorough oral care routines. The study delves into the awareness levels of participants regarding common oral health problems and preventive measures. Surprisingly, 31.25% of participants demonstrated a lack of awareness regarding the importance of flossing and regular dental check-ups. This lack of awareness underscores the necessity for oral health education programs to bridge the knowledge gap and empower individuals to take proactive measures in maintaining their oral health. In discussing the results, the research advocates for the implementation of comprehensive oral health education and awareness campaigns within the clinic setting. In conclusion, this questionnaire-based study contributes valuable insights into the oral health status of clinic attendees. The results underscore the need for proactive measures, including targeted education programs and awareness campaigns, to address the identified gaps in knowledge and practices. By fostering a culture of preventive oral care, this research aims to pave the way for improved oral health outcomes within the clinic population.

E-cigarette use in pregnancy in Australia: A cross-sectional survey of public antenatal clinic attendees.

E-cigarette use has rapidly increased amongst young people in Australia, however the prevalence of use amongst pregnant people is not known. The aim of this study was to examine the prevalence of e-cigarette use and dual use of e-cigarettes and tobacco cigarettes, characteristics associated with use and reasons for use amongst a sample of pregnant Australian people attending public antenatal clinics. A cross-sectional survey was conducted with 4024 pregnant people attending antenatal appointments, between July 2021 and December 2022, in one local health district in New South Wales, Australia. Main outcome measures were current use of e-cigarettes, dual use with tobacco cigarettes, participant characteristics associated with use and reasons for use. 1.24% of pregnant people used e-cigarettes, 34% of these were dual smokers. Being a current smoker (OR 39.49; 95% CI 9.99-156.21) or ex-smoker (OR 29.86; 95% CI 8.75-101.95) were associated with e-cigarette use. Quitting smoking was the most reported reason for use (52%). This study is the first to report on the prevalence of e-cigarette use amongst pregnant people in Australia. We found that a small proportion of pregnant people use e-cigarettes and that many are dual users or ex-smokers. E-cigarette use and rates of dual use in pregnancy in Australia appear lower than internationally, however they are similarly being used as a smoking-cessation aid by many. As regulatory environments relating to e-cigarette access change in Australia, large-scale studies are required to continue to monitor e-cigarette use and dual use in pregnancy.