Causes of hospitalization in patients on maintenance hemodialysis with arteriovenous fistula in a tertiary care hospital in West Bengal, India.

Patients with renal failure and on maintenance hemodialysis (HD) have a higher propensity toward cardiovascular and infectious diseases. The aim of this study was to find the causes for hospital admission in patients suffering from kidney failure and on maintenance HD. This cross-sectional, observational study was conducted in a tertiary care hospital in West Bengal, India, from January to December, 2015. Patients with chronic kidney disease stage 5 for more than one year and on HD with arteriovenous fistula admitted for other than HD were included in the study. Days of hospital stay and current diagnosis were stored for further analysis. Data were expressed in mean, standard deviation, percentage, and frequency. All the statistical tests were carried out in GraphPad prism 6.01. Data of total 49 (30 male, 19 female) patients with mean age 55.8 ± 10.98 years (range 27-75 years) were analyzed. Eighteen (36.73%) and 48 (97.96%) patients were suffering from type 2 diabetes mellitus and hypertension (HTN), respectively. Average stay in hospital was 10.31 ± 6.07 days (range: 5-43 days). Most common causes for hospitalization were left ventricular failure (LVF) (59.18%) followed by respiratory tract infection (RTI) (14.29%). In patients with renal failure receiving maintenance HD, LVF is the most common cause for hospital admission followed by RTI. Hence, the management of HTN and preventive measures for RTI should be stressed in HD patients.

Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest.

BACKGROUND: Reusable suction-cup electrodes are used for recording a 12-lead electrocardiogram (ECG) in resource-limited settings. These electrodes may easily detach if those are attached on a hirsute chest. Additionally, the suction pressure may cause erythema and pain. AIM: The aim of this study was to develop a low-cost strap for holding the suction-cup-based precordial electrodes and to test its applicability to the recording of ECG. MATERIALS AND METHODS: A scrap rubber tube was cut in size so that it can cover all the precordial electrode positions. Slit openings (electrodes can be inserted through these opening) were made on this rubber strap. A cloth and a hook-and-loop fastener were used to make an adjustable fastener. ECG was recorded first on 16 non-hairy males with electrodes placed on the chest with the strap and then with electrodes attached by suction. After that, ECG was recorded on 16 males with hirsute chest first with the electrodes placed with the help of the strap and then with suction (without strap) on the shaved chest. RESULTS: The outcome of this study is a low-cost ECG chest strap for a hirsute chest. Both the negative and positive QRS voltages in six precordial leads recorded with electrodes placed with the strap were similar to that of suction-attached electrodes in both non-hairy and hirsute chest. CONCLUSION: Developed rubber chest strap can be made with minimal cost and expertise in any resource-limited settings. This would help in recording the ECG of a patient with a hirsute chest. This prototype strap has scope for further improvement.

Prescription digitization, online preservation, and retrieval on a smartphone.

BACKGROUND: Medical records are important documents that should be stored for at least 3 years after the commencement of the treatment of an adult patient in India. In a health care facility, patients' data is saved in an online or offline retrieval system. However, in the case of the primary care physician, the data is not commonly kept in an easily retrievable system. AIM: To test the feasibility of using a set of free web-based services in digitization, preservation, and retrieval of prescription on a smartphone by primary care physicians. METHODS: This study was conducted with 12 primary care physicians. They were provided hands-on guides on creating an online form for uploading a prescription and using an application for retrieval of the prescription on a smartphone. Their feedback on the training material was collected by a telephonic survey, which had a 10-point Likert-type response option. Then, an in-depth interview was conducted to ascertain their perception on the tutorial and the process of digitization and retrieval system. RESULTS: All of the participants were able to create an online form on their smartphone. They uploaded their prescription and associated data and were able to retrieve it. The physicians opined positively on the "cost of the system," "portability" on a smartphone and ease of the "tutorial". They opined negatively on the "limited storage," chances of "loss of data," and "time constraints" for entry of the patients' data. CONCLUSION: Free web-based and smartphone applications can be used by a primary care physician for personal storage and retrieval of prescriptions. The simple tutorial presented in this article would help many primary care physicians in resource-limited settings.