OBJECTIVES To quantify the risk glaucoma patients are at, having their eye treatment omitted on admission to non-ophthalmic wards at a tertiary referral centre. DESIGN A criterion audit surveying all adult inpatients on 13 wards at a tertiary referral centre on two separate dates to reduce convenient sample bias. SETTING A tertiary referral centre in the West Midlands of England. PARTICIP...

OBJECTIVES To evaluate the effects of a government insurance programme covering tertiary care for the poor in Karnataka, India--Vajpayee Arogyashree Scheme (VAS)--on treatment seeking and postoperative outcomes. DESIGN Geographic regression discontinuity. SETTING 572 villages in Karnataka, India. PARTICIPANTS 3478 households in 300 villages where VAS was implemented and 3486 households in...

Estrogen-like chemicals, so-called xenoestrogens, have become a topic of concern because they are potentially capable of disturbing the hormonal balance of wildlife and humans. Effluents of wastewater treatment plants (WWTPs) are presumably the major source of xenoestrogens in the aquatic environment. In this study, we investigated eight WWTPs with respect to their input, elimination efficiency...

BACKGROUND Whether to cover cardiovascular disease costs is an increasingly pressing question for low- and middle-income countries. We sought to identify the impact of expanding national insurance to cover primary prevention, secondary prevention, and tertiary treatment for cardiovascular disease in India. METHODS AND RESULTS We incorporated data from coverage experiments into a validated mic...

Critical care specialists should be familiar with the initial management of injured patients. Dividing the evaluation and treatment of the patient into the primary, secondary, and tertiary surveys ensures that the multiply injured patient will be managed expeditiously. The primary survey identifies the acute life-threatening problems that must be managed immediately. The secondary survey identi...

Introduction Among patients with cholelithiasis, choledocholithiasis may also be present in about 18% of cases. They can be treated through various endoscopic, laparoscopic, and open surgical procedures. Objective The objective of this study was to determine the outcome of patients with choledocholithiasis being treated in our setup. Methods This descriptive case series was conducted at Holy Fa...

Aims and method In up to a quarter of patients, schizophrenia is resistant to standard treatments. We undertook a naturalistic study of 153 patients treated in the tertiary referral in-patient unit of the National Psychosis Service based at the Maudsley Hospital in London. A retrospective analysis of symptoms on admission and discharge was undertaken using the OPCRIT tool, along with preliminar...

background : gestational trophoblastic neoplasia (gtn) disease is excessive and inappropriate proliferation of trophoblast after termination of the pregnancy. many attempts have been made to improve follow-up procedures, but no studies have evaluated human chorionic gonadotrophin (hcg) as a post treatment indicator. thus we aimed to know β-hcg variability in post treatment pregnancies.   method...

Introduction: Inappropriate administration of antimicrobials has led to increased antibiotic resistance as well as burden of infectious diseases. Antibiotic stewardship programs (ASPs) help prevent resistance through improved utilization of antimicrobial agents while potentially decrease costs of treatment. Method: We reviewed 186 infectious disease (ID) consultations from two internal disea...