scholarly journals 1030. Risk Predictive Model for Candida Endocarditis in Patients with Candidemia: A 12-year Experience in a Single Tertiary Care Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S307-S307
Author(s):  
Kap Sum Foong ◽  
Ryan Kronen ◽  
Ana S Salazar ◽  
Kevin Hsueh ◽  
Charlotte Lin ◽  
...  
Keyword(s):  
Predictive Model ◽  
Tertiary Care Hospital ◽  
Hematologic Malignancy ◽  
Case Reports ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Series ◽  
Valvular Disease ◽  
Invasive Infection ◽  
Care Hospital

Abstract Background Candida endocarditis (CE) is a rare but an invasive infection associated with a high mortality rate. The current understanding of this infection is poorly defined from case reports, case series and small cohorts. This study aimed to assess the risk factors for CE in patients with candida bloodstream infections (CBSI). Methods We conducted a retrospective analysis of all hospitalized patients diagnosed with CBSI at a large tertiary care hospital between 2002 and 2015. Data included demographics, comorbidities, laboratory parameters, and outcomes. Univariate and multivariable logistic regression analyses were used to build the predictive model. Results Of 1,873 cases of CBSI, 47 patients were identified to have CE. The most commonly isolated species were C. albicans (59.6%) followed by C. parapsilosis (16.2%). On univariate analysis, preexisting valvular disease (7.95, 95% CI [3.16, 20.02]) was associated with a higher risk of CE (P < 0.05). Factors such as isolation of C. glabrata (0.17, 95% CI [0.04, 0.68]), hematologic malignancy (0.09, 95% CI [0.01, 0.68]), and total parenteral nutrition (TPN) (0.40, 95% CI [0.17, 0.95]) were all associated with a lower risk of CE. In multivariable modeling, the factors of valvular disease (5.05, 95% CI [1.77, 14.43]), isolation of C. glabrata (0.19, 95% CI [0.05, 0.80]), hematologic malignancy (0.09, 95% CI [0.01, 0.66]), and total parenteral feeding (0.43, 95% CI [0.17, 1.09]) remained significant. The final model had a C-statistic of 0.82. The crude 90-day mortality for CE was 48.9%, similar to the overall CBSI mortality of 42.1%. Conclusion In a population of patients with CBSI, previous valvular disease was the only factor associated with a greater risk of development of CE. Use of TPN, hematologic malignancy, and isolation of C. glabrata were protective factors. A predictive model may reduce the need for expensive and sometimes invasive diagnostic imaging such as trans-esophageal echocardiography, as a subset of patients may be at low enough risk for CE not to warrant them. Disclosures All authors: No reported disclosures.

scholarly journals Case series of paediatric adnexal torsion: rare yet urgent entity

2016 ◽  
Vol 6 (1) ◽  
pp. 315 ◽  
Author(s):  
Vineet Mishra ◽  
Shaheen Hokabaj ◽  
Priyankur Roy ◽  
Rohina Aggarwal ◽  
Bhumika Vyas ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Conservative Surgery ◽  
Paediatric Population ◽  
Ovarian Torsion ◽  
Care Hospital ◽  
Paediatric Age ◽  
High Degree

Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

scholarly journals FACTORS ASSOCIATED WITH SEVERITY OF ILLNESS IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL IN SOUTHERN INDIA

2018 ◽  
Vol 11 (3) ◽  
pp. 272
Author(s):  
Melissa Sherrel Pereira ◽  
Chandrashekar Udyavara Kudru ◽  
Sreedharan Nair ◽  
Girish Thunga ◽  
Vijayanarayana Kunhikatta ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Hospital Setting ◽  
Severity Of Illness ◽  
Southern India ◽  
Severe Dengue ◽  
Care Hospital ◽  
Factors Associated

 Objective: Denguefeveris one of the important tropical disease of public health significance caused by flavivirus. It is a major cause of morbidity and mortality worldwide. Identification of factors associated with severity of dengue can improve the prognosis of the disease.This study tried toassess the factors associated with severity of dengue.Methods: A record based study was conducted in a tertiary care hospital setting in southern India. A total of 550 case files were reviewed to ascertain demographic, clinical and laboratory parameters among confirmed cases of dengue. The severity of dengue was categorized using WHO 2009 classification.Results: Of 550 records reviewed, 449 (81.6%) were classified as non-severe dengue and 101 (18.4%) as severe dengue. Factors associated with severe dengue on univariate analysis were: gender, backache, skin rash, nausea and vomiting, abdominal distension, haemorrhage, breathlessness, oliguria, hepatomegaly, splenomegaly, ascites, leukopenia, hypoproteinemia, and elevated serum alanine transaminase (ALT) >63 IU/L.On multivariate analysis,haemorrhage (OR=11.75, 95%; CI=6.38-21.62), oliguria (OR=4.01, 95%; CI=1.32-12.15), ascites (OR=2.68, 95%; CI=1.19-6.01), ALT>63 IU/L (OR=1.77, 95%; CI=1.01-3.1) and hypoproteinemia (OR=5.57, 95%; CI=2.82-10.98) were found to have significant association with the development of severe dengue.Conclusion: This study indicates thatwhen dengue patients present with bleeding episodes, ascites, oliguria,raised ALT and low serum protein levels, clinicians should be alert to the appearance of severe complications. Early identification of these factors will help clinicians to recognise the severity of dengue illness and enable them to implement appropriate interventions.

Patient-related factors associated with severe heat-related illnesses in Karachi: A hospital perspective

2020 ◽  
pp. 1-8
Author(s):  
Saima Kanwal ◽  
Sara Sajid ◽  
Noreen Nasir ◽  
Syed Ahsan ◽  
Aysha Almas
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Tertiary Care Hospital ◽  
Heat Stroke ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Related Factors ◽  
Hospital Perspective ◽  
The Mean

Abstract In 2015, Karachi saw its first ever epidemic of severe heat-related illnesses that resulted in an extraordinary number of hospital admissions, especially in the intensive care, for fatal heat stroke within-hospital mortality of 3.7%.We conducted this study to elucidate the patient-related factors that lead to an increase in hospital admissions with heat-related illnesses in a tertiary care hospital. It was a descriptive case series conducted in the department of medicine at the Aga Khan University in June 2015. A total of 134 patients were admitted with heat-related illnesses of which 76(56.7%) were males. The mean age of the patients was 66 ±14.5 years. Heatstroke was present in 86 (64.2%) patients, followed by heat exhaustion in 48 (35.8%) and in-hospital mortality from heat-related illnesses was 5(3.7%). Continuous...  

scholarly journals Frequency and Outcome of Hypoglycemia in Severely Malnourished Children at Tertiary Care Hospital Larkana

2021 ◽  
pp. 51-56
Author(s):  
. Rizwana ◽  
. Bhagchand ◽  
Gulab Rai ◽  
Chetan Das ◽  
Shanti Lal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Serum Glucose ◽  
Care Hospital ◽  
Anthropometric Measures ◽  
Malnourished Children ◽  
Case Series Study ◽  
Gender And Age ◽  
Mid Upper Arm Circumference

Objective: To determine frequency and outcome of hypoglycemia in severely malnourished children at tertiary care Hospital Larkana. Methodology: This descriptive, case series study was carried out at the department of Pediatric Medicine Chandka Medical Hospital Larkana, during 6 months. Severely malnourished children of both gender and age between 6 months to 5 years were enrolled. Severity of malnutrition was evaluated as per standard anthropometric measures i.e. height, body weight, MUAC (mid upper arm circumference) by standard MUAC tape. Hypoglycemia was assessed by checking random blood sugar on glucometer. All the data was recorded via self-made proforma and analyzed by using SPSS version 20. Results: Mean age of the patients was 24.27±15.30 months. Mean MUAC was 9.39±1.56. There were 96 (52.20%) females and 88 (47.80%) males. Mean serum glucose level was found to be 86.02±21.58 mg/dL. There were 23(12.50%) patients with hypoglycemia and out of which 16 (69.60%) patients expired and 7 (30.40%) patients survived. Conclusion: Hypoglycemia was found to be 12.50% in severely malnourished children and it was significantly associated with adverse outcome.

scholarly journals Identification of Risk Factors for Typhoid Fever in Children Admitted in a Tertiary Care Hospital

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Soma Halder ◽  
◽  
Md. Ekhlasur Rahman ◽  
Mst Mukta Sarker ◽  
Fabia Hannan Mone ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Group ◽  
Major Public Health Problem ◽  
Care Hospital

Enteric fever remains a major public health problem in developing countries like Bangladesh. Improvement in the health facility, vaccination, and health-related awareness program the incidence of enteric fever among children is not decreased. The study aimed to find out the risk factors for enteric fever in hospitalized children in a tertiary care hospital. Methodology: We conducted a hospital-based case-control study to identify the risk factors in children residing in Dhaka city. We enrolled 50 enteric fever cases as a case group and 50 age-matched febrile patients as a control group. Result: Out of 50 cases, 2 patients were below one year and most of them were pre-school aged 26(52%). Univariate analysis showed that enteric fever is more who take food with the help of the mother and caregiver (OR=7.1); 95% CI= 26.7 -61.3) and never or rarely wash hands before preparing food and before feeding (OR= 5.7; 95% CI= 23.2 -52.8). Cases were eating outdoors at the mobile food vendors and consuming ice-cream regularly (OR=2.28; 95% CI=1- 39) whereas the control group also took street food but less frequently. Conclusion: Enteric fever is an exclusive food and water-borne systemic disease and one of the major public health problems in Bangladesh. Not only overcrowding, unsafe drinking water are the common risk factors but also hand washing both children and caregiver, poor food habit is the important risk factors. So, health education to children and food handlers may reduce the incidence of enteric fever in children.

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