Archives November 2024

Dr Abhishek Sharma (PhD, Consultant), Dr Smita Sharma (Assistant Professor, TAPMI School of Business, Manipal University Jaipur)

Year: 2024, Volume: 1, Issue: 3, Pages: 154- 165, Date of Publication: 30 November 2024;

Abstract: As the population expands and Healthcare demands escalate, Hospitals are experiencing heightened pressure. Despite improvements in financial aspects, there is an increasing demand to address the needs of both hospital and hospitality, especially in private Institutions. Numerous hospital gathers patient Feedback using Questionnaires, some adhering to worldwide patterns, while other employ proprietary formats. Nonetheless, a standardized feedback questionnaire is absent. This study examines the literature on Patient satisfaction questionnaires in India, providing insights into healthcare and hospitality dimensions while flagging potential deficiencies in present procedures.

Keywords: Patient satisfaction, healthcare quality, survey methodology, India, healthcare evaluation.

Dr Mittal Patel (ENT Consultant, Ahmedabad, Gujarat), Dr Deepak Chhatbar (ENT Consultant, Dhoraji City, Rajkot, Gujarat)

Year: 2024, Volume: 1, Issue: 3, Pages: 166- 178, Date of Publication: 30 November 2024;

Abstract: Neck swellings are a common clinical presentation encountered in medical practice, varying significantly in etiology, pathology, and prevalence based on demographic and geographic factors. This study aims to assess the clinicopathologic features and prevalence of neck swellings in patients presenting to a tertiary care hospital in a Tier 2 city over a 1-year period. A retrospective observational study was conducted, analyzing clinical records, histopathological reports, and diagnostic imaging of 550 patients with neck swellings. Data were categorized based on age, gender, duration of swelling, and pathological diagnosis. The findings highlighted a diverse range of etiologies, including reactive lymphadenopathy, thyroid disorders, congenital anomalies, and malignancies, with notable differences in prevalence based on age and gender. Thyroid swellings were found to be the most common cause among adults, while lymphadenopathy predominated in pediatric cases. The study underscores the importance of early and accurate diagnosis for effective management and better clinical outcomes. This study provides valuable insights into the spectrum of neck swellings in a Tier 2 city setting, emphasizing the need for tailored diagnostic and therapeutic strategies in resource-limited environments.

Keywords: Neck swellings, clinicopathologic assessment, Prevalence, tertiary care hospital, Tier 2 city, Reactive lymphadenopathy, thyroid disorders, congenital anomalies, histopathological analysis, Diagnostic imaging

Dr Ramesh Kumar ( Deputy Director, Govt Sub District Hospital, Bheem, Rajsamand Rajasthan)

Year: 2024, Volume: 1, Issue: 3, Pages: 179-187, Date of Publication: 30 November 2024;

Abstract: Doctors working in private hospitals often face significant occupational stress due to demanding work environments, long working hours, and job insecurity. The high levels of stress can lead to mental health issues, including anxiety, depression, insomnia, and social dysfunction. This study aimed to assess the mental health status of doctors working in private hospitals in a Tier 1 city using the General Health Questionnaire (GHQ 28). The GHQ 28 is a well established tool that screens for psychological distress across four domains: somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression. The study surveyed 54 doctors from various specialties and found that 68% of participants experienced psychological distress. Anxiety and insomnia were the most affected do mains, with 82% of doctors reporting high stress levels. Job insecurity, which affected 61% of the participants, was identified as a major contributor to stress. The findings underscore the urgent need for regular mental health screenings, the implementation of supportive workplace policies, and the introduction of stress management interventions to improve the well being and resilience of healthcare professionals in private hospitals.

Keywords: General Health Questionnaire, doctors’ health, occupational stress, job insecurity, private hospital, mental well-being.

Dr Sunit Saxena ( MD (Anaesthesiology), HOD Anaesthesia and OT, Manipal Hospital, Jaipur), Dr Bhavya Sinha ( 3rd Year PG, DNB Anaesthesia)

Year: 2024, Volume: 1, Issue: 3, Page 188- 196, Date of Publication: 30 November 2024;

Abstract: Introduction- Sleep endoscopy, also known as drug-induced sleep endoscopy (DISE), is a diagnostic tool for evaluating upper airway obstruction in patients with obstructive sleep apnea (OSA). Anesthesia is pivotal in achieving a controlled sedative state that mimics natural sleep, ensuring patient safety and effective visualization of the airway dynamics. This comprehensive study reviews anesthesia techniques and safety considerations for DISE, focusing on optimizing patient outcomes. Methods- The study was conducted over one year with 100 patients clinically diagnosed with OSA. Exclusions included patients with neurological conditions, severe cardiac issues, and active nasal infections. Pre-procedure assessments included pre-anesthesia evaluations, blood tests, and imaging. Anesthesia was administered using Propofol titration, employing the Schneider model to achieve a snoring-apnea cycle. Standardized protocols were followed for patient positioning, monitoring, and sedation depth. Results- Propofol, administered in titrated doses, facilitated a controlled sedative state in all cases, allowing effective visualization of airway collapse. Moderate sedation was achieved in most patients, with minimal adverse events. Complications such as airway obstruction and respiratory depression were rare and managed promptly with established protocols. Discussion- The study highlights the role of anesthetic agents such as Propofol in achieving optimal sedation for DISE, ensuring airway patency and accurate diagnostic outcomes. Key considerations for anesthesiologists include precise drug titration, comprehensive patient monitoring, and readiness to manage potential complications like hypoxemia or aspiration. Conclusion- Anesthesia for sleep endoscopy is critical for the safety and success of the procedure. Adhering to evidence-based sedation protocols, tailored to individual patient profiles, enhances the diagnostic utility of DISE while minimizing risks. This study underscores the importance of anesthetic expertise in managing OSA through sleep endoscopy.

Keywords: Sleep endoscopy, Obstructive sleep apnea, Drug-induced sleep endoscopy, Anesthesia, Propofol, Airway management, Sedation protocols.

Dr Sankhadeb Acharya (Consultant Orthopaedics, Durgapur, West Bengal)

Year: 2024, Volume: 1, Issue: 3, Page 197- 212, Date of Publication: 30 November 2024;

Abstract: Introduction: Prolapsed intervertebral disc (PIVD) is a common spinal disorder causing pain and functional limitations. Conservative management, including physical therapy, medications, and lifestyle modifications, is often the first line of treatment. This study explores the experiences and outcomes of patients undergoing conservative management during their first year of PIVD diagnosis. Methods: A retrospective and descriptive analysis was conducted on patients diagnosed with PIVD who opted for conservative management. Data on patient-reported outcomes, pain levels (using a Visual Analog Scale), functional status (assessed via Oswestry Disability Index), and overall satisfaction were collected through interviews and medical records over 12 months. Results: Among the 100 patients studied, 75% reported significant pain reduction by the end of the first year, while 68% experienced improved functional abilities. Early compliance with physical therapy and adherence to prescribed medications were strongly correlated with better outcomes. However, 12% required surgical intervention due to persistent or worsening symptoms. Challenges reported included difficulty maintaining therapy routines, delayed symptom relief, and the emotional burden of chronic pain. Conclusion: Conservative management for PIVD can effectively alleviate symptoms and improve function during the first year for most patients. Early intervention, patient education, and tailored treatment plans are critical to achieving optimal outcomes. Addressing patient concerns and barriers to compliance can further enhance the success of conservative approaches.

Keywords: PIVD, conservative management, patient experience, physical therapy, pain management, functional recovery.