Hospital Outpatient Departments Research Articles

Examining the hospital costs of children born into relative deprivation in England

ObjectiveTo examine the association between being born into relative deprivation and hospital costs during childhood.DesignRetrospective cohort study.MethodsWe created a birth cohort using Hospital Episode Statistics for children born in NHS...

A Study on Prescription Pattern of Drugs in Orthopaedics Inpatient Department of Navodaya Medical College Hospital and Research Centre in Raichur

A Study on Prescription Pattern of Drugs in Orthopaedics Inpatient Department of Navodaya Medical College Hospital and Research Centre in Raichur

CLINICAL AND LABORATORY PROFILE OF PATIENTS WITH HEPATITIS B INFECTION ATTENDING THE OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN NORTHEAST INDIA

Objective: The objective of this study was to analyze the clinical and laboratory profile of patients with hepatitis B infection-attending outpatient departments of tertiary care hospitals in northeast India. Methods: This was a cross-sectional study conducted in the outpatient department of a tertiary care medical institute situated in northeast India. Eighty patients infected with hepatitis B (on the basis of serological markers) were included in this study on the basis of predefined inclusion and exclusion criteria. Demographic details such as age, gender, and socioeconomic status of all the patients were noted. A detailed history was taken including any history of intravenous drug use, tattooing, sexual contacts, history of blood transfusions, and familial liver disease. Clinical and laboratory profiles (liver function test and serological markers) of all the patients were studied. Ultrasound imaging was done in all the cases. p<0.05 was taken as statistically significant. Results: Out of 80 studied cases, there were 49 (61.25%) males and 31 (38.75%) females. The mean age for males and females was 32.30±8.03 and 34.70±13.52 years, respectively. There was no significant difference in mean age between males and females (p=0.3218). Mother-to-child transmission was evenly distributed with 7 males (8.75%) and 9 females (11.25%) affected. Other risk factors, such as dental implants and surgeries, showed a lower prevalence, with dental implants impacting 2 males (2.5%) and 3 females (3.75%) and surgeries concerning 5 males (6.25%) and 3 females (3.75%). Majority of the patients (52.5%) were asymptomatic and were found to be hepatitis B surface antigen (HBsAg) positive incidentally. HBsAg was positive in all cases. 12 (15%) patients showed the presence of hepatitis B e antigen suggestive of high infectivity. Anti-HBc and anti-HBe were positive in 68 (85%) patients each. Hepatomegaly was seen in 23 cases (28.75%) on ultrasound. Moderate fibrosis on elastography was seen in 2 (2.5%) cases. Conclusion: In cases of hepatitis B, the majority of the patients remained asymptomatic, and many cases no risk factor for hepatitis B virus infection could be identified. It is therefore important to screen the general population for hepatitis B infection.

Unmasking the Hidden Burden: A Delayed Diagnosis of Leprosy Patients With Grade 2 Disability and Its Effects on the Healthcare System in Bangladesh.

Introduction Leprosy remains a significant cause of preventable disability worldwide. Early diagnosis and treatment of leprosy are critical not only to stop its spread but also to prevent physical and social complications and reduce the disease burden. Objectives The study aims to evaluate the factors that lead to a delayed leprosy diagnosis. Methods This study was conducted in the outpatient departments of Leprosy Control Institute and Hospital, Dhaka, Bangladesh, and at Medical College for Women and Hospital, Dhaka,Bangladesh, from March 2023 to June 2023. A total number of 252 male (148) and female (104) patients were selected with any sign of leprosy, including disability, age ranging from 15 to 74 years. Data was collected in a pre-designed structured questionnaire by the researchers. To assess the risk of independent exposures of Grade 2 leprosy disabilities, we used a logistic regression model. A chi-square test showed the association between significant effects and leprosy disabilities. A p-value of 0.05 was considered as significant. For statistical analysis, STATA version 15 (StataCorp LLC, College Station, Texas, USA) was used. Results The study participants exhibited a higher percentage of disability, with a rate of 25.8% for Grade 2 disabilities.In addition to this, males represented a more considerable proportion, 58.7%, than females among leprosy and disability patients across all levels of disability. In our study, lack of money and painless symptoms showed a significant association (p<0.001) with Grade 2 disability. Conclusion The study reveals that Grade 2 disabilities are more common in males and are particularly prevalent in lower socioeconomic groups.

Precision Medicine for COVID-19 Based on the Inflammatory Response

Background The threat due to the global pandemic of the coronavirus disease 2019 (COVID-19) demands a search for effective treatments to combat the severity of the infections and their associated morbidity and mortality in vulnerable populations. One of the medications with putative antiviral, anti-inflammatory, and immunomodulatory effects is fluvoxamine, a selective serotonin reuptake inhibitor and σ-1 receptor agonist. A few studies have reported doses of 100–300 mg/day to be effective. Aim This retrospective study evaluates the outcomes of an individually tailored dosing strategy for fluvoxamine, based on measurements of inflammatory status, in treating COVID-19-positive individuals in India. Methods This study included patients with severe acute respiratory syndrome coronavirus 2 infection visiting the outpatient department of a super speciality hospital in India from February to July 2021. Fluvoxamine was initiated at 50 mg or 100 mg twice daily based on their individual C-reactive protein (CRP) and D-dimer status. By day five, patients with rising or static levels of CRP and D-dimer were up-titrated. Results In a population of 104 individuals infected with COVID-19, 10 required up-titration of dose, and 94 patients did not need up-titration. Overall, there was very low mortality (N = 1) and hospitalization rate (8.7%). Those individuals who required an up-titration on day five had significantly elevated CRP and D-dimer levels compared to those who were maintained at the initial dose of 50 mg twice daily. In such patients, up-titration of the dose on day 5 appeared to offer better treatment benefits and outcomes. In our study population, there was only one mortality during the course of COVID-19. Conclusions Given the individual variability in the host immune response to severe acute respiratory syndrome coronavirus 2 infection, tailoring the dose of a drug such as fluvoxamine based on the inflammatory status of the individual may be beneficial. Individually tailored dosing could combat disease progression while reducing side effects.

Preliminary observation of wearable balance diagnosis and treatment system in evaluating dynamic and static balance function in patients with vestibular vertigo

A newly developed wearable balance diagnosis and treatment system was studied to evaluate the indexes of the abnormal balance function in patients with vestibular vertigo. A cross-sectional study was carried out. A total of 30 patients diagnosed with non-acute vestibular vertigo in the outpatient department of Eye, Ear, Nose and Throat Hospital Affiliated to Fudan University from July 2022 to May 2023 were selected as the vertigo group, including 13 males and 17 females, and aged (45.7±13.9) years. Meanwhile, 20 healthy controls (8 males and 12 females) were included as the control group, with a mean age of (43.6±8.0) years. The static balance and limits of stability (LOS) function of all subjects were assessed with wearable balance diagnosis and treatment system developed under the leadership of Eye & ENT Hospital of Fudan University. In the static balance test, the ratio of eyes open with cushions to eyes open without cushions in the vertigo group was less than that of the control group[1.20% (0.92%, 1.53%) vs 1.49% (1.22%, 1.81%), P=0.008], indicating that patients with non-acute vestibular vertigo may compensate static balance ability earlier. In vertigo group, the directional control in 8 directions, the maximum excursion in anterior, posterior, right anterior and right posterior directions, the endpoint excursion in the posterior, right posterior, and left posterior directions were all smaller than those of the control group (all P<0.05). The reaction time in the left posterior direction of vertigo group was longer than that of the control group (all P<0.05). Those results indicated that the directional control, maximum excursion and endpoint excursion of LOS could be considered as important reference indexes for dynamic balance function.

Economic impact analysis of a minimally invasive temperature-controlled radiofrequency device versus nasal surgery for the treatment of nasal airway obstruction in the United States

Objective To determine the economic impact of a minimally invasive temperature-controlled radiofrequency (TCRF) device for treating nasal airway obstruction (NAO). Methods A budget impact model was developed for two scenarios: a reference scenario of functional rhinoplasty surgery with concomitant septoplasty and inferior turbinate reduction (ITR) performed in the hospital outpatient department where TCRF is not an available treatment option and a new scenario consisting of in-office TCRF treatment of the nasal valve and ITR. A payor perspective was adopted with a hypothetical population plan size of one million members. Costs were estimated over a time horizon of 4 years. The eligible population included patients with severe/extreme NAO and nasal valve collapse (NVC) as the primary cause or significant contributor. Data inputs were sourced from targeted literature reviews. Uncertainty within the model structure and input parameters was assessed using one-way sensitivity analysis. Results The introduction of a TCRF device resulted in population-level cost savings of $20,015,123 and per-responder average cost savings of $3531 through a 4-year time horizon due to lower procedure costs and complication rates of the device relative to the surgical comparator. Results were robust when varying parameter values in sensitivity analyses, with cost savings being most sensitive to the prevalence of NAO and estimated response rates to functional rhinoplasty and TCRF. Conclusions In patients with severe/extreme NAO, with NVC as the primary or major contributor, introducing TCRF with ITR as a treatment option demonstrates the potential for significant cost savings over functional rhinoplasty with septoplasty and ITR.

Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study.

Chronic obstructive pulmonary disease (COPD) is closely associated with frailty, and prevention of acute exacerbations is important for disease management. Moreover, COPD patients with frailty experience a higher risk of acute exacerbations. However, the frailty instruments that can better predict acute exacerbations remain unclear. (1) To explore the factors influencing frailty and acute exacerbations in stable COPD patients, and (2) quantify the ability of multidimensional frailty instruments to predict acute exacerbations within 1 year. In this retrospective longitudinal study, stable COPD patients were recruited from the outpatient department of Sichuan Provincial People's Hospital from July 2022 to June 2023. COPD patients reviewed their frailty one year ago and their acute exacerbations within one year using face-to-face interviews with a self-developed frailty questionnaire. Frailty status was assessed using the Frailty Index (FI), frailty questionnaire (FRAIL), and Clinical Frailty Scale (CFS). One-way logistic regression was used to explore the factors influencing frailty and acute exacerbations. Multivariate logistic regression was used to establish a prediction model for acute exacerbations, and the accuracy of the three frailty instruments was compared by measuring the area under the receiver operating characteristic curve (AUC). A total of 120 individuals were included. Frailty incidence estimates using FI, FRAIL, and CFS were 23.3%, 11.7%, and 15.8%, respectively. The three frailty instruments showed consistency in COPD assessments (P<0.05). After adjusting for covariates, frailty reflected by the FI and CFS score remained an independent risk factor for acute exacerbations. The CFS score was the best predictor of acute exacerbations (AUC, 0.764 (0.663-0.866); sensitivity, 57.9%; specificity, 80.0%). Moreover, the combination of CFS plus FRAIL scores was a better predictor of acute exacerbations (AUC, 0.792 (0.693-0.891); sensitivity, 86.3%; specificity, 60.0%). Multidimensional frailty assessments could improve the identification of COPD patients at high risk of acute exacerbations and facilitate targeted interventions to reduce acute exacerbations in these patients.

Effect of compassion fatigue on emotional labor in female nurses: Moderating effect of self-compassion.

A two-stage survey design with a convenience sample. Participants were female nursing staff recruited from emergency departments, intensive care units, ward nursing units, and outpatient departments of medical centers, regional hospitals, and district hospitals in Taiwan. A total of 300 questionnaire copies in each of the first and second stages were distributed, and 272 pairs of responses were retrieved (valid response rate = 91%). The reliability and validity of the questionnaire were tested, and confirmatory factor analysis was conducted with AMOS 21. The proposed hypotheses were verified using hierarchical regression conducted with SPSS version 25.0. This study revealed that compassion fatigue positively predicted surface acting (β = 0.12, p < 0.05) and negatively predicted deep acting (β = -0.18, p < 0.01) and expression of genuine emotions (β = -0.31, p < 0.01). In addition, self-compassion negatively moderates the relationships between compassion fatigue and surface acting (β = -0.12, p < 0.05), and positively moderates the relationships between compassion fatigue and expression of genuine emotions (β = 0.15, p < 0.01). To avoid excessive consumption of emotional resources, nurses with high compassion fatigue may employ surface acting by engaging in emotional labor without making an effort to adjust their feelings. Nurses need also be sympathized with, and such sympathy can come from hospitals, supervisors, colleagues, and, most crucially, the nurses themselves. Hospital executives should propose improvement strategies that can prevent the compassion fatigue on nurses, such as improving nurses' self-compassion.

Lip Print Pattern among Children Visiting Dental Out patient department.

Lip print patterns are unique in every individual. The uniqueness of lip print pattern assists in the personal identification. The objectives of the present study were to study the different lip print patterns among the children visiting Kanti Children's Hospital, and to compare the distribution of lip print patterns based on gender and race. A cross-sectional study was conducted among 300 children visiting the Dental Outpatient Department of Kanti Children's Hospital, Kathmandu, Nepal. Convenience sampling method was used to choose the study subjects. Digital photography method was used to record the image of lips. The study showed 'Long vertical' (Type I) as the most frequent (41%) type of lip print pattern, whereas 'Unspecified' (Type V) was the least frequent (2.7%) type. Prevalence of 'Type I' pattern was significantly higher in males as compared to females (p=0.007) whereas prevalence of 'Type IV' pattern was significantly higher in females as compared to males (p=0.006). 'Type I' pattern was the commonest lip print pattern among both Caucasians and Mongolian, whereas 'Type V' (2%) and 'Type IV' (3.7%) were the least common lip print patterns in Caucasians and Mongolian children respectively. 'Long vertical' (Type I) was the most common lip print pattern among the children visiting the Dental Outpatient Department of Kanti Children's Hospital, Kathmandu, Nepal. Nevertheless, in higher or lesser numbers, all kinds of lip print patterns as described by Suzuki and Tsuchihashi were seen in the study population.

The Relationship Between Resilience and the Intention to Leave Among Staff Nurses at Governmental Hospitals in the Al-Baha Region of Saudi Arabia.

Background Nurses with high intent to leave can cause substantial problems for healthcare organizations, such as staffing shortages and higher expenses due to hiring and onboarding new nurses. In light of the increasing demands placed on nurses in understaffed and overloaded healthcare systems, nurses frequently face various pressures and difficulties in their field of work, including high workloads, irregular hours, complicated patients, and infectious disease exposure; resilience is critical for handling stress and hardship at work. Nurses will thus retain their jobs for longer. This study aimed to determine the relationship between resilience and the intention to leave among staff nurses. Methods This study utilized a quantitative, cross-sectional correlation design. It comprised three Saudi Ministry of Health-affiliated facilities in the Al-Baha region(King Fahad Hospital, Prince Mashari Hospital, and Mikhwah General Hospital). The study sample comprised nurses employed in critical areas and inpatientand outpatient hospital departments using convenience sampling and inclusion and exclusion criteria. An online questionnaire involving three sections was given out.The first part collected sociodemographic data, the second part included the Connor-Davidson Resilience Scale 25 (CD-RISC-25), and the third included the Anticipated Turnover Scale (ATS). Results This study found a moderate degree of intention to leave and resilience. Most participants in the survey held a bachelor's degree (75.8%), and around 87.1% of the sample consisted of women. About half of the sample (57.2%) were married; 67.6% of the participants were not Saudi nationals; and regarding the number of children, the majority (53.8%) were childless. Overall, 318 nurses working in acute and outpatient departments and critical regions participated. According to the study, 73.3% of the participants reported a moderate intention to quit, whereas 50.9% had moderate resilience. Similarly, a significant negative relationship was found between nurses' intention to leave and resilience. Conclusions In the current study, resilience has a statistically significant negative relationship with the nurses' intention to leave. Hospital management must consider the amount of work and the excessive work schedule to reduce nurses' intentions to leave. One way to do this is by assigning tasks to employees, minimizing their workload through flexible work schedules and shorter duty hours, and fostering teamwork among coworkers by ensuring clear communication and cooperation. Interventions like orientation programs for new nurses, regular meetings, seminars, and training sessions can improve nurse resilience.

Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

BackgroundSchizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights...

The prevalence of dry eye in patients with psoriasis attending a tertiary care hospital in western Maharashtra

: Psoriasis affects 0.5–11.4% of adults. Psoriasis is caused by a complicated chain of immune cells and cytokines, containing tumour necrosis factors (TNF), interleukin (IL)-17, 22, and 23. Psoriasis causes systemic inflammation, which can cause arthritis, cardiovascular disease, and metabolic syndrome. Our study explores dry eye in Western Maharashtra's psoriasis patients at a tertiary care hospital. A tertiary care hospital outpatient dermatology and ophthalmology department psoriasis patients were included in a cross-sectional research. Patient ages spanned from 20 to 60 years. The anterior and posterior ocular segments were examined, and dry eye was assessed. OSDI, Schirmer's test, TBUT, and corneal and conjunctiva staining has been scored. The PASI score has been received. Degree of dry eye was assessed using Dews dry eye grading system. Dry eye was present in 63.1 percent of people. Cases included 24.4% with mild dryness in their eyes. Moderate dryness made up 46.3% of cases, and severe dryness made up 29.3% of cases. The PASI score and dry eye did not have a statistically significant connection (P=0.355). A PASI score of 10 to 25 indicated the most severe case of dry eye, followed by a score of 10 (29 eyes) and &amp;#62;25. (23 eyes). A total of 81.5 percent of eyes had abnormal OSDI scores, 56.2 percent had abnormal TBUT scores, and 49.2 percent had abnormal Schirmer Test results. Dry eye in psoriasis patients requires dermatologist-ophthalmologist teamwork for comprehensive therapy. Psoriasis, especially in long-lasting cases, can lead to meibomian gland dysfunction.

Site of Service Disparities Exist for Total Joint Arthroplasty.

The rate of outpatient total joint arthroplasty procedures, including those performed at ambulatory surgical centers (ASCs) and hospital outpatient departments, is increasing. The purpose of this study was to analyze if type of insurance is associated with site of service (in-patient vs outpatient) for total joint arthroplasty and adverse outcomes. We identified patients undergoing unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), or total hip arthroplasty (THA) using Current Procedural Terminology codes in a national administrative claims database. Eligible patients were stratified by type of insurance (Medicaid, Medicare, private). The primary outcome was site of service. Secondary outcomes included general complications, procedural complications, and revision procedures. We evaluated the associations using adjusted multivariable logistic regression models. We identified 951,568 patients for analysis; 46,703 (4.9%) patients underwent UKA, 607,221 (63.8%) underwent TKA, and 297,644 (31.3%) underwent THA. Overall, 9.6% of procedures were outpatient. Patients with Medicaid were less likely than privately insured patients to receive outpatient UKA or THA (UKA: odds ratio [OR], 0.729 [95% CI, 0.640-0.829]; THA: OR, 0.625 [95% CI, 0.557-0.702]) but more likely than patients with Medicare to receive outpatient TKA or THA (TKA: OR, 1.391 [95% CI, 1.315-1.472]; THA: OR, 1.327 [95% CI, 1.166-1.506]). Patients with Medicaid were more likely to experience complications and revision procedures. Differences in site of service and complication rates following hip and knee arthroplasty exist based on type of insurance, suggesting a disparity in care. Further exploration of drivers of this disparity is warranted and can inform interventions (eg, progressive value-based payments) to support equity in orthopedic services. [Orthopedics. 2024;47(3):179-184.].

Overall time spent by clients from entry to exit and associated factors in out-patient departments in public hospitals of Jimma Zone southwest, Ethiopia.

The overall time refers to the amount of time a patient spends in a health care facility, from the time he or she enters to the time he or she leaves. As a result of the imbalance between supply and demand, waiting times occur. Ethiopian hospitals are being reformed to improve the quality of care they provide. The time a patient spends in the hospital is one of the most important indicators of quality of care, as it provides insight into customer satisfaction and provider success. However, the overall time patients spend in hospitals was not studied. The study aimed to assess the overall time spent by clients from entry to exit and associated factors in the outpatient departments of Jimma zone hospitals. An institution-based cross-sectional study was conducted. Patients from outpatient units at Jimma zone public hospitals participated in the study from March 15 to May 17, 2018. Data were collected using a time and motion tool coupled with an interviewer-administered structured questionnaire on 249 samples. Participants in the study were selected using the consecutive sampling method. Overall time, in terms of waiting and service times at each section unit, and the relationship of socio-demographic and clinical factors with overall time was the main outcome variables. Data were analyzed using descriptive and linear regression analysis. Simple linear regression analysis was used to determine the relationship between the dependent and explanatory variables. Variables were considered significantly associated with the overall time if they had a p-value of less than 0.05 at the 95% confidence interval (CI). The overall response rate was 94.8%. Overall, patients spent a median time of 342.5 minutes. Patients spent 12.7% of the total time as service time and 86% of the time waiting for care. The longest overall times were spent in the laboratory (170 minutes), imaging (95 minutes), other diagnostic units (84 minutes) and examination (83 minutes). The average overall time was increased by 52.03 minutes (95%CI 21.65, 82.412), 4.65 minutes (95%CI 3.983, 5.324), and 96.43 minutes (95%CI 52.076, 140.787) when the patient was referred, the number of patients at the queue was increased by one unit, and patients who had other diagnostic tests performed respectively with P <0.005 &adjusted R2 = 0.522. The majority of patients stayed for a longer period. Most time was spent waiting for services, particularly in the examination, laboratory, and imaging units. This is strongly related to high patient load, an absence of some services, being referred patients, and patients who had other diagnostic tests. To reduce the number of patients in the queues, hospitals should work hand in hand with the Ministry of Health to enforce policies that are understood and adopted by all workers in the lower healthcare facilities. And hospital administrators are working to strengthen the triaging system to screen patients with minor illnesses. This is because most patients with minor illnesses queue with those with more complicated illnesses. Finally, we recommend that researchers conduct further research on service quality.

Getting to Know Your Patient: Content Analysis of Patients' Answers to a Questionnaire for Promoting Person-Centered Care.

Person-centered care (PCC) encourages patients to actively participate in health care, thus facilitating care that fits the life of the patient. Therefore, health care professionals (HCPs) need to know the patient. As part of a broad policy for improving PCC, a digital questionnaire ("We would like to know you") consisting of 5 questions has previously been developed to help HCPs to get to know the patient with the help of patient and staff involvement. The purpose of this study was to provide insight into the content and aims of the questionnaire to understand its potential and usability. We conducted a qualitative, retrospective content analysis of patients' answers using NVivo Pro (QSR International). The questionnaire was used in the outpatient neuro-oncology department of a Dutch academic hospital. Of 374 invited patients, 78 (20.9%) completed the questionnaire. We selected a sample of 42 (54%) of the 78 patients. Patients used a median of 16 (IQR 7-27) words per question, and most answers were easily interpretable. When asked about important activities, social activities, sports, or maintaining a normal life were most frequently mentioned. Patients wrote about fear of the disease, its possible influence on life, or fear of the future in general. Patients wanted HCPs to know about their care and communication preferences or shared personal information. They formulated expectations about effective treatment, communication, and the care process. The questionnaire seems usable because patients provide interpretable answers that take little time to read, which HCPs can use to personalize care. Our study shows the potential of the questionnaire to help deliver PCC.

A Descriptive Analysis of Access to Assistive Technology in Children With Acquired Brain Injury: The Right to Assistive Devices.

Pediatric clinicians caring for children with acquired brain injury have noted that many individuals requiring assistive technology (AT) go unserved or face delays until devices are obtained, with potential adverse implications for recovery and development. In this article we map the pathways by which AT is prescribed and assess delays and barriers to access. We conducted a retrospective chart review of patients with moderate to severe brain injury admitted to Blythedale Children's Hospital over a 2-year period using a database drawn from the medical record. We identified 72 children diagnosed with brain injury requiring at least 1 device. Devices were used to improve mobility and positioning, self-care, safety, and communication, and enable access to other technologies and foster social integration. We found that 55% of devices were delivered, with most deliveries to home or the hospital's outpatient department for fitting, training, and instruction. Time to delivery ranged from 12 to 250 days with an average of 69.4 days. Twenty percent of nondeliveries were attributable to change in medical status, transfer to a skilled nursing facility, or continued inpatient status, while 31% were canceled by the family. Other nondeliveries were attributed to insurance coverage. We also found that the medical record is not designed for the longitudinal tracking of devices, indicating the need for a prospective process to document the AT trajectory. Instead of tolerating delays and denials, there should be a normative expectation that children have a right to medically necessary devices, consistent with disability law. This analysis was undertaken as a step toward formulating a prospective means of tracking AT recommendations, approvals, denials, and/or deliveries. Our findings should be understood as a promissory note toward structural reforms that are reflective of society's responsibility to better meet the needs of vulnerable children and their families.

Utilization of repeat services in the outpatient department of Dewi Sartika general hospital, Kendari City, 2023

The reutilization of services in outpatient clinics of hospitals plays a crucial role in enhancing the quality and effectiveness of healthcare services. This study aims to analyze the factors associated with service reutilization in hospital outpatient clinics using a cross-sectional design and quantitative approach. Data were collected through questionnaires from 100 respondents at Dewi Sartika General Hospital in Kendari, Southeast Sulawesi, during October-November 2023, using accidental sampling techniques. The analysis results indicate that factors such as service quality, family encouragement, facilities, location, and patient attitudes are significantly associated with service reutilization in outpatient clinics. Univariate analysis was used to describe sample and variable characteristics, while bivariate analysis involved correlation testing to evaluate the relationships among variables. The conclusion of this study highlights the importance of enhancing communication, education, and family support in influencing patient decisions to reuse the same services at the hospital. The development of family support programs, patient empowerment, family-friendly policies, and periodic program evaluations are crucial steps in improving patient experiences and healthcare outcomes. Recommendations include critical steps such as enhancing communication, education, and family support, as well as developing structured family support programs, empowering patients, implementing family-friendly policies, and conducting regular program evaluations. It is expected that the implementation of these recommendations will improve patient experience, enhance adherence to treatment, and overall improve healthcare outcomes.

Prevalence of Dyslipidemia, Drug Therapy Problems, and Medication Adherence in Type 2 Diabetes Mellitus Patients in North Central Nigeria

Background Patients with diabetes mellitus have an increased risk of developing dyslipidemia, predisposing them to macro- and microvascular consequences such as coronary heart disease. Aim The aim of this study was to assess the prevalence of dyslipidemia, drug therapy problems (DTPs), and medication adherence in type 2 diabetes mellitus (T2DM) patients in a tertiary hospital in North Central Nigeria. Method This study was a cross-sectional convenient sampling of eligible patients conducted in the General Outpatient Department of General Hospital, Ilorin, from March to May 2022. A validated questionnaire was administered to obtain all relevant information on sociodemographic information, and blood samples were collected in a medium plain heparinized tube and sent to the laboratory where fasting blood sugar, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values were calculated as appropriate. Morisky's Medication Adherence Scale 8 (MMAS-8) was used to capture patient's adherence level, and DTP was assessed using the Pharmaceutical Care Network Europe (PCNE) Criteria version 7. Ethical approval was obtained from the Ministry of Health, Ilorin. Statistical Package for Social Sciences was used to analyze the data collected for descriptive and inferential statistics. Results The mean age of the respondents was 60 ± 0.7 years. Of the 60 respondents, 25 (41.67%) were males and 35 (58.33%) were females. All the respondents had dyslipidemia, 30% respondents were identified with a DTP of nonadherence, 16.7% needed additional drug/monitoring, dosage was too low in 11.7%, and 11.6% could not afford their medication due to high cost. In all, 45 (75%) respondents had poor sugar control and 33 (55%) had poor blood pressure control. Using MMAS-8, the majority (41, [68.30%]) of the respondents were found to have poor adherence to their diabetic medications. Conclusion High prevalence of dyslipidemia, poor medication adherence, and DTPs were found in the T2DM patients in this study.

A Cross-Sectional Study about Demographic and Medical Characteristics of Hypertensive Pregnant Women in Two Secondary Healthcare Facilities, in Ilorin, Nigeria

Background Hypertension is one of the major causes of related maternal deaths worldwide and it is one of the most common medical disorders encountered during pregnancy. Aim This study aimed at assessing the demographic and medical characteristics of hypertensive pregnant women in two secondary healthcare facilities, in Ilorin, Nigeria Method This was a cross-sectional study among 104 pregnant women with hypertension attending the outpatient department of General Hospital and Civil Service Clinic, Ilorin between March and May 2021. A validated self-administered questionnaire was used to obtain information on sociodemographics. Data on the medical characteristics of the respondents and their medications were extracted from the respondent's medical files. Ethical approval was obtained from the Ministry of Health and General Hospital, Ilorin. For statistical analysis for categorical measurements, the frequencies and percentages were computed. Results Seventy-five percent of the correspondents were below 36 years old, 97% were married, 79% had tertiary education, and 74% were above 24 weeks of gestation. About 68% of the correspondents had blood pressure more than or equal to 140/90 and 10% had blood pressure more than 160 mm Hg systolic or more than 100 mm Hg diastolic. About 78.8% of the correspondents had a family history of hypertension, 13.5% had a family history of diabetes mellitus, and 22.1% had a family history of obesity. About 27.9% had pre-existing hypertension, 61.5% developed hypertension before the end of 20 weeks of gestation, and 10.6% developed hypertension after 20 weeks of gestation. About 24% had their antihypertensive medication changed during pregnancy, 38.5% were treated with methyldopa, 31.7% with nifedipine, and 27% with nifedipine and methyldopa. Majority (83.6%) of the respondents were not adherent to their medications. Conclusion Two-third of the patients had poor blood pressure control irrespective of the fact that all were under drug therapy. Family history and large body mass index are the main risk factors for the development of hypertension during pregnancy. Noncompliance may play a significant role in no drug response.