Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

Download Full-text

Postpartum Hemorrhage in Pregnancy beyond 40 Weeks of Gestation in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6471 ◽

2021 ◽

Vol 59 (237) ◽

Author(s):

Rashmi Bastakoti Gaire ◽

Suman Raj Tamrakar ◽

Anjana Singh Dongol

Keyword(s):

High Risk ◽

Confidence Interval ◽

Postpartum Hemorrhage ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

In Pregnancy

Introduction: Postpartum hemorrhage is defined as a blood loss of 500ml or more within 24 hours after birth. It is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one-quarter of all maternal deaths globally. It occurs in up to 18% of total births. Post-dated pregnancy is a high-risk pregnancy with increased maternal morbidity. This study aims to determine the prevalence of postpartum hemorrhage in pregnancy beyond 40 weeks of gestation in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among pregnant women beyond 40 weeks in Dhulikhel hospital from October 2016 to March 2017. The study was conducted after ethical clearance from the hospital research committee (reference number#128/16). The sample size was calculated and convenient sampling was done. Statistical Package for the Social Sciences is used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and percentage for binary data. Results: Out of 465 ladies enrolled in this study postpartum hemorrhage was seen in 6 (1.29%) (95% Confidence Interval = 0.267-2.31), and the mean age was 24.25+4.8. About 346 (74.4%) had a normal delivery, 104 (22.36%) had cesarean section and 15 (3.22%) had instrumental delivery. Conclusions: Postpartum haemorrhage prevalence is low among the pregnant women beyond 40 weeks compared to the standard study. Postpartum hemorrhage is the common leading cause of maternal mortality. So high-risk cases should be identified and active management should be done to reduce morbidity and mortality.

Download Full-text

Prevalence of high risk obstructive sleep apnoea by Berlin questionnaire in patients with hypertension: study from a tertiary care hospital

Sleep Science and Practice ◽

10.1186/s41606-020-00052-0 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Ozaifa Kareem ◽

Masood Tanvir ◽

G. N. Bader

Keyword(s):

High Risk ◽

Obstructive Sleep Apnoea ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Sleep Apnoea ◽

Berlin Questionnaire ◽

Care Hospital ◽

Cross Sectional ◽

Obstructive Sleep ◽

The Mean

Abstract Background Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of 6 months. OSA was evaluated using the Berlin questionnaire while the daytime sleepiness was determined using Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score >16) was found to be 32.5% (95% CI, p < 0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 37.41 ± 3.396 cm, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 35.45 ± 2.652 cm, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p<0.001). The mean blood pressure (BP) ≥133.52/84.37 mmHg was recorded in patients with a high risk of OSA (95% CI, P < 0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P < 0.05). Conclusion In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.

Download Full-text

Molecular characterization and antimicrobial susceptibility profile of New Delhi metallo-beta-lactamase-1-producing Escherichia coli among hospitalized patients

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_76_17 ◽

2018 ◽

Vol 10 (02) ◽

pp. 149-154

Author(s):

Anjali Agarwal ◽

Jyoti Srivastava ◽

Ujjwal Maheshwari ◽

Mohd Iftikhar

Keyword(s):

Escherichia Coli ◽

Tertiary Care Hospital ◽

Treatment Options ◽

Tertiary Care ◽

Hospitalized Patients ◽

New Delhi ◽

Care Hospital ◽

Beta Lactamase ◽

Cross Sectional ◽

E Coli

ABSTRACT BACKGROUND: Carbapenemase-producing microorganisms are becoming a major concern among hospital-acquired infections. There is also increased multidrug resistance seen among these isolates. AIMS: We have conducted this study to determine the prevalence of New Delhi metallo-beta-lactamase-1 (NDM-1) gene-producing Escherichia coli among hospitalized patients in a tertiary care hospital in Northern India. SETTINGS AND DESIGN: The study was conducted in the Department of Microbiology with the tertiary care hospital settings. It was a prospective cross-sectional observational study conducted during January 2014–August 2014. MATERIALS AND METHODS: A total of 500 nonduplicate E. coli samples were processed. The isolates with reduced susceptibility to ertapenem, i.e., zone diameter between 19 and 21 mm, were considered carbapenemase producers. These isolates were subjected to modified Hodge test for phenotypic confirmation. Polymerase chain reaction was performed on all the screened isolates for molecular detection of NDM-1 gene. STATISTICAL ANALYSIS USED: Chi-square test was used to analyze the data and P < 0.05 was considered statistically significant. RESULTS: Out of 500 E. coli isolates, 61 (12.2%) were screened for carbapenemase production. 47 (9.4%) isolates were positive by modified Hodge test and 36 (7.2%) isolates showed the presence of blaNDM-1 gene (P < 0.05). CONCLUSION: There is an increased prevalence of NDM-1 gene-producing E. coli isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group). Early detection of blaNDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.

Download Full-text

PREVALENCE OF PSYCHIATRIC MORBIDITIES AMONG COVID -19 PATIENTS IN A TERTIARY CARE HOSPITAL, CHENNAI, TAMIL NADU.

10.36106/ijsr/4322050 ◽

2021 ◽

pp. 63-64

Author(s):

Anupama Roshan S ◽

Priyasubhashini. M ◽

M Mathivanan

Keyword(s):

Tamil Nadu ◽

Acute Stress ◽

Tertiary Care Hospital ◽

Treatment Options ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Medical College ◽

The Difference

Background: Due the lack of treatment options, isolation guidelines and fear about the disease, the cases with COVID 19 may experience high psychiatric related disorders. Hence this study was conducted to assess the prevalence of psychiatric morbidities among the cases with COVID 19 in a tertiary care hospital. Methods: Cross sectional study in the Department of Psychiatry at Government Medical College , Omandurar Government Estate, Chennai, a tertiary care teaching hospital during the period of April 2020 to September 2020. A total of 11,704 cases with COVID-19 were included in the study. Demographic details and psychiatry related clinical prole were assessed and entered in a proforma. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: Overall prevalence of psychiatric morbidities among the COVID 19 cases was reported as 24.4% with signicant difference in prevalence among males and females. Most common psychiatric illness reported was COVID related anxiety (16.5%) followed by COVID related depression (6.6%), insomnia (0.87%), alcohol dependence syndrome (0.3%), acute stress reaction (0.03%), intellectual disability (0.03%), psychosis (0.02%) and hemophobia (0.008%). The difference in proportion of cases with various psychiatric morbidities like insomnia, COVID related anxiety, COVID related depression, and alcohol dependance syndrome among the male and female genders was found to be statistically signicant. Conclusion: Almost one fourth of the COVID cases are suffering from psychiatric morbidities. It can be recommended that all the cases with COVID can undergo screening and counseling for the psychiatric disorders.

Download Full-text

Prevalence of High Risk Obstructive Sleep Apnoea by Berlin Questionnaire in Patients with Hypertension: Study from a Tertiary Care Hospital

10.21203/rs.3.rs-50792/v2 ◽

2020 ◽

Author(s):

Ozaifa Kareem ◽

Masood Tanvir ◽

Ghulam Nabi Bader

Keyword(s):

High Risk ◽

Obstructive Sleep Apnoea ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Sleep Apnoea ◽

Berlin Questionnaire ◽

Care Hospital ◽

Cross Sectional ◽

Obstructive Sleep ◽

The Mean

Abstract Background: Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods: A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of six months. OSA was evaluated using the Berlin questionnaire while the daytime sleepiness was determined using Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results: High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score ˃16) was found to be 32.5% (95% CI, p˂0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 37.41 ± 3.396 cm, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 35.45 ± 2.652 cm, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p˂0.001). The mean blood pressure (BP) ≥133.52/84.37 mm Hg was recorded in patients with a high risk of OSA (95% CI, P<0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P<0.05).Conclusion: In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.

Download Full-text

Prevalence of Obstructive Sleep Apnoea in Patients with Hypertension: Study from a Tertiary Care Hospital

10.21203/rs.3.rs-50792/v1 ◽

2020 ◽

Author(s):

Ozaifa Kareem ◽

Masood Tanvir ◽

Ghulam Nabi Bader

Keyword(s):

High Risk ◽

Obstructive Sleep Apnoea ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Sleep Apnoea ◽

Berlin Questionnaire ◽

Care Hospital ◽

Cross Sectional ◽

Obstructive Sleep ◽

The Mean

Abstract Background: Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods: A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of six months. OSA was evaluated using the Berlin questionnaire and the Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results: High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score ˃16) was found to be 32.5% (95% CI, p˂0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 14.75 ± 1.338 inches, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 13.97 ± 1.045 inches, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p˂0.001). The mean blood pressure (BP) ≥133.52/84.37 mm Hg was recorded in patients with a high risk of OSA (95% CI, P<0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P<0.05).Conclusion: In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.

Download Full-text

Abstract #803175: Different Type 2 Diabetes Risk Assessments Tools Predict Dissimilar Numbers at High Risk: A Cross-Sectional Analysis in a Tertiary Care Hospital

Endocrine Practice ◽

10.1016/s1530-891x(20)39532-x ◽

2020 ◽

Vol 26 ◽

pp. 105

Author(s):

Nazma Akter

Keyword(s):

Type 2 Diabetes ◽

High Risk ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Risk Assessments ◽

Care Hospital ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

Download Full-text

Hearing impairment among high risk neonates born in a tertiary care hospital in north Kerala: a cross sectional study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210677 ◽

2021 ◽

Vol 7 (3) ◽

pp. 452

Author(s):

Ahsanu Zaman Kunnath ◽

Anwar Sadath Choolakkaparambu Aboobakker ◽

Bashir Nalakath Kunjimon ◽

Sandeep Sreedhar

Keyword(s):

Risk Factors ◽

Hearing Loss ◽

High Risk ◽

Hearing Impairment ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Congenital Hearing Loss ◽

Cross Sectional ◽

High Risk Children

Background: Hearing is necessary for the proper mental and social development of a new-borns child. Delay in diagnosis leads to improper development of social and mental skills. The prevalence of congenital hearing loss is greater than prevalence of screened metabolic syndromes. There are multiple maternal and intrapartum risk factors associated with hearing impairment. Most of the causes are treatable. Objectives was to find out the proportion of hearing impairment in neonates and its risk factors in a tertiary care hospital in north Kerala.Methods: This cross-sectional research was performed in a tertiary care hospital in Northern Kerala between January 2018 and June 2019 after obtaining informed consent and institutional ethical committee clearance among those who fulfilled the inclusion and exclusion criteria. All the high-risk new-borns were subjected to Otoacoustic examination. Those who did not pass the first OAE were subjected to second OAE after one month. Those who did not pass in the examination were subjected to BERA. Those high risk children who did not pass the BERA were considered having hearing impairment and were subjected to further investigation and appropriate management. Results: The prevalence of hearing impairment was 0.5%. 0.25% were unilateral and 0.25% were bilateral. Pregnancy induced hypertension, premature labour, lower segment Caesarian section, low birth weight, small for gestational age, respiratory distress, hyperbilirubinemia and presence of congenital malformations were significantly associated with hearing impairment. Conclusions: Since most of the congenital hearing loss among high risk neonates can be treated, a nationwide standardized hearing assessment program is advocated for the early detection of high risk children with hearing loss.

Download Full-text