Aetiology of arthritis in hospitalised children: an observational study

Background and objectiveArthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis.DesignRetrospective, descriptive case series study.SettingA French tertiary care centre.PatientsChildren under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009.Main outcome measuresDemographic and clinical features were compared with χ2 or Fisher's exact tests and non-parametric tests.Results173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3–14.6) and was lower in the septic arthritis group (1.5 years; 1.1–3.4) than in the JIA group (4.7 years; 2.5–10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01).ConclusionsSeptic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.

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INTRA-ABDOMINAL PATHOLOGIES

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.04.2264 ◽

2012 ◽

Vol 19 (04) ◽

pp. 488-495

Author(s):

GULZAR AHMAD MALIK ◽

MUHAMMAD SAJID ANSARI ◽

SHAHID HUSSAIN CHOUDHARY ◽

Sabir Hussain

Keyword(s):

Relative Frequency ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Female Ratio ◽

Low Level ◽

Primary Surgery ◽

Case Series Study ◽

Tertiary Care Hospitals ◽

Series Study

Objectives: To evaluate relative frequency, reasons, avoidable responsible factors and outcomes of relaparotomy. StudyDesign: Observational case series study Setting: Department of Surgery Unit III BVH Bahawalpur Duration: From 01-9-2009 to 31-8-2010Patients and Methods: All the patients who presented in surgical outdoor, indoor and casualty department with severe intra-abdominalpathologies after primary laparotomies referred from low level, secondary care and tertiary care hospital and underwent relaparotomy electivelyor on demand were included in the study. Retrospectively their demographic characteristics, initial diagnosis with surgical information of primarylaparotomy, factors and outcomes after relaparotomies were analyzed statistically. Results: A total 54 patients were included in the study withmale to female ratio of 1:2. Mean age of the study group was 30.91±12.5 years. Relative frequency of relaparotomy was 5.6%. Common centerof referral was low level hospital 66.7%.Most common indication of relaparotomy was peritonitis in 52%. Most common complication ofrelaparotomy was wound infection 74%. Avoidable factors responsible for relaparotomies were found to be surgery at low level hospitals(77.3%) and by nonqualified surgeons (72.1%). Conclusions: The rate of relaparotomy is very high because of unsupervised primary surgeryin institutions and surgery by unqualified operators in private sector. Many of these are avoidable. In addition to decreasing the complicationrate, primary surgery performed at tertiary care hospitals would decrease need for patients to undergo re-exploration.

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Study of clinico-epidemiological profile of leprosy patients at tertiary care centre of South Gujarat region

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20201580 ◽

2020 ◽

Vol 6 (3) ◽

pp. 355

Author(s):

Kautuk K. Patel ◽

Anjum M. Momin ◽

Ankita A. Mistry ◽

Jignesh B. Vaishnani

Keyword(s):

Tertiary Care ◽

National Level ◽

Public Health Problem ◽

Warning Signs ◽

Tertiary Care Centre ◽

Female Ratio ◽

Male Female Ratio ◽

Leprosy Patients ◽

Epidemiological Profile ◽

Epidemiological Characteristics

Background: Leprosy is a chronic feared illness causes by Mycobacterium leprae. It was eliminated as a public health problem in India in 2005. But still, India contributes more than 60% of all new cases of leprosy.Methods: A retrospective analysis of 307 patients attending the leprosy clinic of the dermatology out patient department, SMIMER, was done for a period of five years from January 2014 to December 2018. The data was analysed for clinical and epidemiological characteristics of the patients.Results: A total of 307 patients visited the leprosy clinic during the study period. More than half patients (60.3%) were between 21-40 years age group. There were 213 males and 94 females with male female ratio of 2.3:1. 72.3% (222) patients were suffering from multibacillary leprosy and 27.7% (85) had paucibacillary disease. Borderline tuberculoid leprosy was the most common type found in 83 patients (27.1%). 16 cases (5.2%) of childhood leprosy (less than 14 years of age) were noted. A total of 214 patients (69.7%) were migrants.Conclusions: Despite of decline at global and national level, leprosy cases show gradual increase. The high proportion of total cases, MB cases, and grade 2 disability cases are warning signs. Continued efforts are required to manage and prevent the disease.

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HEMORRHAGIC STROKE;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2626 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1204-1208

Author(s):

Faisal Shahab ◽

Irfan Murtaza Shahwani ◽

Shuaib Ansari ◽

Syed Zulfiquar Ali Shah

Keyword(s):

Blood Pressure ◽

Hemorrhagic Stroke ◽

Case Series ◽

Health Sciences ◽

Hypertensive Retinopathy ◽

Age Group ◽

Female Ratio ◽

Case Series Study ◽

Male To Female ◽

Series Study

Objectives: To identify the frequency of risk factors in hemorrhagic stroke at Liaquat university of medical and health sciences. Patient and methods: This Descriptive case series study of six months was carried out in the department of medicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of age with hemorrhagic stroke on CT were enrolled in the study after taking consent from caretaker of patients. Detailed history focusing on hypertension, diabetes and smoking and their duration was taken. Blood pressure was recorded and fundoscopy was done to find out diabetic or hypertensive retinopathy. Thorough neurological examination and fasting / random blood glucose level was evaluated while the data was done was analyzed using SPSS version 16. Results: A total of 100 patients were included in the study during study period. 61% of patients were in > 50 years of age group with mean age of 53.4±11 years. A total of 66 (66%) were male; with male to female ratio was 2:1. Hypertension was present in 63% of cases, Diabetes was found in 24% cases and 44 patients were cigarette smokers. Conclusions: It was concluded that high blood pressure, diabetes mellitus and smoking are associated with hemorrhagic stroke.

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Acute flaccid myelitis—Clustering of polio-like illness in the tertiary care centre in Southern India

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmy052 ◽

2018 ◽

Vol 65 (4) ◽

pp. 309-314 ◽

Cited By ~ 5

Author(s):

Syed N Sarmast ◽

Vykuntaraju K Gowda ◽

Maaz Ahmed ◽

Basvaraja GV ◽

Jitender Saini ◽

...

Keyword(s):

Spinal Cord ◽

Grey Matter ◽

Electrophysiological Study ◽

Tertiary Care ◽

Case Series ◽

Tertiary Care Centre ◽

Limb Weakness ◽

Laboratory Findings ◽

Acute Flaccid Myelitis ◽

Case Series Study

Abstract Introduction Acute flaccid myelitis (AFM) is characterized by limb weakness with spinal cord grey matter lesion on imaging or electrodiagnostic evidence of spinal cord motor neuron injury. This Poliomyelitis-like illness is rare in children, and its natural course is not yet well defined. Purpose of the study The purpose of the study was to report the clinical presentation, laboratory findings, management and outcome of children with AFM. Materials and methods This is a prospective case series study. Results Nine children met the case definition given by CDC. All cases presented with prodromal symptoms followed by acute onset asymmetrical limb weakness. Maximum weakness is reached within 4 days from the day of onset. Cerebrospinal fluid analysis shows that pleocytosis with viral markers for arboviruses and enteroviruses was negative. Electrophysiological study revealed decreased muscle action potential in all. MRI of the spinal cord showed predominantly grey matter involvement. Conclusion AFM should be one of the differential diagnoses in any child presenting with acute flaccid paralysis.

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A Case Series Study of Eighty-Five Chronic Spontaneous Urticaria Patients Referred to a Tertiary Care Center

Annals of Dermatology ◽

10.5021/ad.2014.26.1.73 ◽

2014 ◽

Vol 26 (1) ◽

pp. 73 ◽

Cited By ~ 10

Author(s):

Line Kibsgaard ◽

Anna Cecile Lefevre ◽

Mette Deleuran ◽

Christian Vestergaard

Keyword(s):

Care Center ◽

Tertiary Care ◽

Case Series ◽

Chronic Spontaneous Urticaria ◽

Tertiary Care Center ◽

Case Series Study ◽

Series Study

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An overview of endoscopic stapedotomy in a tertiary care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202207 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1102

Author(s):

Atish B. Gujrathi ◽

Siddharth A. Shroff ◽

Nishikant Gadpayale ◽

Naman Agarwal

Keyword(s):

Hearing Loss ◽

Intraoperative Complications ◽

Adult Population ◽

Tertiary Care ◽

Case Series ◽

Anatomical Variations ◽

Common Symptom ◽

Tertiary Care Centre ◽

Female Ratio ◽

Endoscopic Stapedotomy

Background: Stapedotomy is now one of the most popular and common surgeries done worldwide. Otosclerosis remains the most common single cause of conducting hearing loss in adult population. Females are more frequently affected than males with an approximate 2:1 ratio.Methods: This study consists of 30 patients who underwent stapedotomy for otosclerosis. This study was conducted at Dr Shankarrao Chavan Government Medical College, Nanded, during the period of 2 years (2017-2019). Patients were evaluated and operated. The various anatomical variations, diagnostic dilemmas, intraoperative complications, its management and follow-up were done systematically. Results: Age of patients included in this study ranged from 15 to 50 years. Youngest patient was a 17-year-old male. Age of presentation was most commonly seen in third decade of life. Male to female ratio was 1:2. The most common symptom was hard of hearing followed by tinnitus. In this study, 76.67% of the patient’s had bilateral disease. 66.66% of patients had hearing loss between 41-55 dB with mean pre-operative pure tone average was 51.16 dB. About 80% of patients had successful air bone closure between 0-10 dB after the surgery.Conclusions: Endoscopic stapedotomy seems a feasible and relatively safe surgical technique in limited case series. Cosmetically this procedure was more compliant by the patients however endoscopic stapedotomy requires a significant learning curve and an extreme expertise.

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Tympanoplasty Type-I using tragal perichondrium graft: Our experience

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.4.421 ◽

2019 ◽

Vol 35 (4) ◽

Cited By ~ 2

Author(s):

Fazali Wahid ◽

Sajid Rashid Nagra

Keyword(s):

Tertiary Care ◽

Case Series ◽

Pure Tone Audiometry ◽

Neck Surgery ◽

Tympanic Membrane Perforation ◽

P Value ◽

Type I ◽

Care Hospital ◽

Female Ratio ◽

Case Series Study

Objective: To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital. Methods: This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant. Results: Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 – 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterioinferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with pvalue of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%). Conclusion: Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities. doi: https://doi.org/10.12669/pjms.35.4.421 How to cite this:Wahid FI, Nagra SR. Tympanoplasty type I using tragal perichondrium graft: Our experience. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.421 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Spectrum of paediatric cardiac diseases: a study of 15,066 children undergoing cardiac intervention at a tertiary care centre in India with special emphasis on gender

Cardiology in the Young ◽

10.1017/s1047951110001319 ◽

2010 ◽

Vol 21 (1) ◽

pp. 19-25 ◽

Cited By ~ 6

Author(s):

Viralam S. Kiran ◽

Parrimala P. Nath ◽

Sunita Maheshwari

Keyword(s):

Relative Frequency ◽

Septal Defect ◽

Tertiary Care ◽

Cardiac Diseases ◽

Tertiary Care Centre ◽

Indian Children ◽

Female Ratio ◽

Male Female Ratio ◽

Cardiac Lesions ◽

The Individual

AbstractObjectivesTo analyse the relative frequency and gender ratios in the procedures (both surgical and catheter-based interventions) performed for cardiac diseases in Indian children.BackgroundNot many studies are available in the developing countries with regard to the prevalence, relative frequency, or gender distribution of cardiac diseases in children. As universal newborn screening is not carried out for congenital cardiac diseases, the statistics are difficult to ascertain. Do female and male children with cardiac disease get equal parental preference in terms of surgical correction and catheter interventions in India? This question is also unanswered.MethodsAnalysis of 15,066 consecutive Indian children aged <18 years who were operated upon or had catheter intervention at a single tertiary care centre. Relative frequency and male/female ratios of cardiac lesions in these children were determined and compared with the studies in literature.ResultsOverall male/female ratio in the study was 1.4:1. Ventricular septal defect was the most common lesion (24.2%) with male/female ratio of 1.5:1, followed by tetralogy of Fallot (18.7%, 1.6:1), atrial septal defect (14.4%, 0.9:1) and so on. Male children dominated the total number of procedures performed.ConclusionIn most of the individual cardiac lesions, the relative frequency was different from that of international studies. The gender ratio for the majority of the individual type of cardiac problems was different from that of international references. These findings may suggest a preference for the male child in the treatment of cardiac diseases in India, which could possibly be related to social causes.

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Cerebrovascular disorders in childhood: etiology, clinical presentation, and neuroimaging findings in a case series study

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000200002 ◽

2006 ◽

Vol 64 (2a) ◽

pp. 181-185 ◽

Cited By ~ 10

Author(s):

André P.C. Matta ◽

Keila R.F. Galvão ◽

Betânia S. Oliveira

Keyword(s):

Cerebrovascular Disorders ◽

Case Series ◽

First Episode ◽

Motor Deficits ◽

Left Middle Cerebral Artery ◽

Vascular Area ◽

Case Series Study ◽

Neuro Imaging ◽

Series Study ◽

Careful Investigation

OBJECTIVE: To describe the main etiologies, neurological manifestations and neuro-imaging findings among children with sequelae of cerebrovascular disorders. METHOD: Case series study of children whose diagnosis was stroke sequelae. Variables studied were age at the time of first episode, number of episodes, etiology, motor deficits, epilepsy, and effected vascular territory. RESULTS: Twenty three patients were studied. Average age at first episode was 6.91 (±2.08) years. Fourteen patients were female. The number of stroke events per patient ranged from one to five. The most frequent etiologies were heart disease and sickle cell anemia. The most frequent neurological deficit was right hemiparesis. Nine patients experienced seizures. The left middle cerebral artery was the most affected vascular area. CONCLUSION: Our findings are similar to those described in the literature. Despite a careful investigation, some causes of stroke remain unidentified.

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Case Report: Multiple Sclerosis Relapses After Vaccination Against SARS-CoV2: A Series of Clinical Cases

Frontiers in Neurology ◽

10.3389/fneur.2021.765954 ◽

2021 ◽

Vol 12 ◽

Author(s):

Riccardo Nistri ◽

Elena Barbuti ◽

Virginia Rinaldi ◽

Laura Tufano ◽

Valeria Pozzilli ◽

...

Keyword(s):

Multiple Sclerosis ◽

Central Italy ◽

Case Series ◽

First Episode ◽

Temporal Association ◽

Case Series Study ◽

Mri Scans ◽

Using Data ◽

Disease Modifying Treatment ◽

Series Study

Objective: To describe a temporal association between COVID-19 vaccine administration and multiple sclerosis (MS) relapses.Methods: This case series study was collected in four MS Centres in Central Italy, using data from 16 MS patients who received COVID-19 vaccination and presented both clinically and radiologically confirmed relapses between March and June 2021. We collected patients' relevant medical history, including demographics, MS clinical course, disease-modifying treatment (DMT) received (if applicable), and data from MRI scans obtained after the COVID-19 vaccination.Results: Three out of 16 patients received a diagnosis of MS with a first episode occurring after COVID-19 vaccination; 13 had already a diagnosis of MS and, among them, 9 were on treatment with DMTs. Ten patients received BNT162b2/Pfizer-BioNTech, 2 patients mRNA-1273/Moderna, and 4 patients ChAdOx1 nCoV-19/AstraZeneca. All MS relapses occurred from 3 days to 3 weeks after receiving the first dose of the COVID-19 vaccination or the booster. All patients had evidence of radiological activity on MRI.Discussion: Clinical and radiological findings in these cohort of MS patients confirmed disease re/activation and suggested a temporal association between disease activity and COVID-19 vaccination. The nature of this temporal association, whether causative or incidental, remains to be established.

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