An audit of open access upper gastrointestinal endoscopy by physicians in a rural hospital in Kerala, India
Journal Title: Panacea Journal of Medical Sciences - Year 2017, Vol 7, Issue 1
Abstract
Access to endoscopy in India, particularly in a rural setup, is limited by the cost, trained personnel and limited resources. Literature suggests inappropriate referrals to be high, thereby over stretching this limited procedure, resulting in over-servicing. The present study was carried out to evaluate adherence of primary care physicians to ASGE guidelines when referring patients for upper GI endoscopy in rural Indian population. An observational cross-sectional study on consecutive patients referred to Department of Medicine for upper GI endoscopy. Patients above the age of 40 years were included in the study. All dyspeptic patients above the age of 50 years or patients with alarm findings were considered as appropriate referrals. Descriptive statistics was done.315 patients were included in the study. Appropriate referrals were 57.14%. Majority of the referrals were for dyspepsia and pain abdomen. Among all patients, H pylori infection was positive by rapid urease test in 55.23% indicating inadequate eradication therapy. Important endoscopic findings among the patients were carcinoma stomach, gastric/ duodenal ulcer, varices and gastritis. Among patients with dyspepsia, malignancies were noted in 1.96% of patients. Even though appropriate indications were high, the percentage of positive findings among dyspeptic patients was very low. Adequate eradication therapy for H pylori and empirical acid suppression therapy to reduce symptoms of dyspepsia as well as following strict guidelines for appropriate referrals will improve patient selection for upper GI endoscopy. This can improve efforts aimed at enhancing positive pathology identification, improved quality and efficiency of care.
Authors and Affiliations
Shuba Srinivasan, Jyothi Lingegowda, Sneha Thomas, Ramkumar Kurpad R, Prakash Muddegowda Muddegowda
Keywords
Related Articles
- EP ID EP315948
- DOI 10.18231/2348-7682.2017.0002
- Views 107
- Downloads 0
Adiposopathy- Altered Physiology of Visceral Adipose Tissue
The burden of obesity and associated disorders is ever-increasing in modern lifestyle. Obesity is strongly associated with increase in all-cause mortality. Obesity results from chronic positive energy balance. Excess fat...
Comparison of 90-90 passive hamstring stretching technique plus knee to chest position with 90-90 passive hamstring stretching alone in normal healthy individuals of age 18 to 25 years
Hamstring flexibility plays an important role in physical fitness Hamstring tightness is determined by knee extension deficit Passive stretching is simple and found effective to improve muscle flexibility In clinical set...
Adult granulosa cell tumour with yolk sac like areas in a young female
Granulosa cell tumour (GST) belongs to the sex-cord/stromal tumours of the gonads. We received slides and blocks for review of a 27 years female whounderwent Right oopherectomy. On microscopic examination, architectural...
Porencephaly presenting with anger outbursts: A case report
Porencephaly is an extremely rare congenital disorder characterized by a cyst or a cavity filled with cerebrospinal fluid in the brains parenchyma An 18yearold male with moderate intellectual disability presented with pe...
Effect of mobile phone use on hearing status of medical students of tertiary healthcare hospital
The present study was carried out to evaluate the hearing status in chronic mobile phone users and alteration in hearing status depending on years of mobile usage, per day use and longest dialogue duration in a day. This...