scholarly journals Hepatorenal Syndrome: Are We Doing Better?

2004 ◽  
Vol 18 (2) ◽  
pp. 121-122
Author(s):  
Florence Wong
Keyword(s):  
Renal Failure ◽  
Medical Records ◽  
Hepatorenal Syndrome ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Alcoholic Cirrhosis ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Common Cause

This is a retrospective study assessing the accuracy of diagnosis, clinical features and outcome of patients coded with a medical record diagnosis of hepatorenal syndrome (HRS) between 1988 and 1998 in a tertiary care centre in Canada. The authors found that, of the 46 patients whose medical records revealed a diagnosis of HRS, only 27 patients (59%) fulfilled the criteria for the diagnosis of HRS defined by the International Ascites Club (IAC) (1). Most patients with HRS were middle-aged men with decompensated alcoholic cirrhosis, jaundice and hepatic encephalopathy. Infection (48%), gastrointestinal bleeding (33%) and overly aggressive paracentesis (27%) were the major precipitants of renal failure. Once HRS developed, the mortality rate was high (93%), with multiorgan failure being the most common cause of death. The authors concluded that diagnostic accuracy is paramount for studies of HRS. In addition, decompensated alcoholic cirrhosis remains the main predisposing factor for HRS, with various other factors precipitating its development.

scholarly journals BENIGN PAROXYSMAL POSITIONAL VERTIGO: OUR EXPERIENCE AT A TERTIARY CARE CENTRE OF CENTRAL INDIA

2020 ◽  
pp. 1-3
Author(s):  
Patel Meghraj Singh
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Duration Of Symptoms ◽  
Common Cause ◽  
Patient Profile ◽  
Positional Vertigo ◽  
Age Range ◽  
Paroxysmal Positional Vertigo

Background: - Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. The diagnosis is often delayed and patients are unnecessarily investigated and treated with drugs. Aim: To analyze the patient profile, duration of symptoms, etiology, associated co-morbidities, type of canal involvement and response to CRP in cases of BPPV. Material & Methods: The present prospective study was conducted at a tertiary care centre from January 2015 to December 2016 in 90 patients with a clinical diagnosis of BPPV. Patient particular and disease specific data were recorded in preset profoma and analyzed. All these patients were treated by different CRP specific for the canal involved. All cases were reassessed for post procedural response. Results: Total 90 patients were included in the study with age range of 20 to 76 year. Mean age was 46.74. Maximum patients (26.67%) were in the age range of 41-50 year with male: female was 1:1.43. The duration of symptoms was in from 2 days to more than 3 years. Most common morbidity was diabetes and most common cause was Idiopathic (82.22%). Most of these patients presented with positional vertigo (94.44%). Right posterior canal was involved in 52 cases (57.78%) and left in 30 (33.33%) cases. Conclusion: BPPV is a common cause of vertigo. More awareness needed about its symptoms, early application of Dix-Hallpike test and Epley’s procedure to reduce the suffering of patients and to reduce unnecessary diagnostic tests and costs.

ACUTE RENAL FAILURE IN ACUTE POISONING: PROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE OF SOUTH INDIA

2011 ◽  
Vol 38 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Shah Sweni ◽  
Ramachandran Meenakshisundaram ◽  
R. Sakthirajan ◽  
Chinnasamy Rajendiran ◽  
Ponniah Thirumalaikolundusubramanian
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Prospective Study ◽  
South India ◽  
Tertiary Care ◽  
Acute Poisoning ◽  
Care Centre ◽  
Tertiary Care Centre

Clinical Profile and Outcome in Patients with Snake Bite in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3567-3572
Author(s):  
Satish Kumar ◽  
Sanghamithra Prabhakaran
Keyword(s):  
Renal Failure ◽  
Secondary Infection ◽  
Tertiary Care ◽  
The Body ◽  
Snake Bite ◽  
Clinical Profile ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Severe Degree

BACKGROUND The clinical profile and outcome of snake bite varies from place to place and depends on a number of factors including the type of snake bite, place of snake bite, time of bite, season, and duration of presentation after bite. The clinical profile, factors affecting the outcome and the outcome have not been previously well studied. METHODS This is a cross-sectional observational study conducted for a duration of six months from January 2021 to June 2021. Subjects meeting inclusion criteria were enrolled in the study group after obtaining written consent. Patients were evaluated based on the standard pro-forma with detailed history and clinical examination. All relevant investigations to assess systemic envenomation, treatment and outcome were documented in all the patients. RESULTS In the study, 204 (68 %) were male patients and 96 (32 %) were female patients. 108 (36 %) were admitted with venomous snake bite and 192 (64 %) were with non-poisonous snake bite. 52 patients had snake bite on the upper extremities, 234 had snake bite on the lower extremities, 8 patients had snake bite on the trunk whereas 6 patients had bite on other areas of the body. 202 patients had swelling at the bite site, 222 had pain at the site of bite, 86 patients had oozing of blood and 6 patients had vague somatic symptoms. 132 patients had local oedema, 148 had local tenderness, 66 patients had skin necrosis and 16 patients developed blisters at the site of bite. 124 patients had systemic manifestations of which 24 patients had vomiting, 12 patients developed abdominal pain, 10 patients developed anuria/oliguria, 14 patients developed hypotension, 12 patients developed bleeding manifestations, 10 patients developed neurological symptoms and 2 snakebite patients had syncope. Complications and mortality in poisonous snake bite due to renal failure was observed in 38 patients with a mortality of 1 patient, 10 patients developed intravascular haemolysis, 8 patients developed unexplained hypotension, 18 patients developed secondary infection, 4 patients developed intra-cerebral bleeding and 15 patients developed neurotoxity with a mortality of 2 patients. CONCLUSIONS Snake bite is a common problem encountered in tertiary care centres and the most common encountered type of snakebite was haemotoxic bite. Pain at the bite site was the commonest symptom and tenderness at bite site was the commonest sign in patients with snake bite. Mortality in venomous bite was 3.7%. Prolonged bite to needle time, development of renal failure, leukocytosis, neurotoxicity and severe degree of coagulopathy were factors associated with adverse outcome. KEYWORDS Clinical Profile, Outcome, Snake Bite, Tertiary Care Centre

EPIDEMIOLOGICAL PROFILE OF FUNGAL KERATITIS IN PATIENTS ATTENDING A TERTIARY CARE CENTRE IN BIHAR

2021 ◽  
pp. 32-34
Author(s):  
Kumar Vikram ◽  
Gyan Bhaskar ◽  
Shailesh Kumar ◽  
Rakesh Kumar ◽  
Namrata Kumari
Keyword(s):  
Tertiary Care ◽  
Public Health Problem ◽  
Fungal Species ◽  
Fungal Keratitis ◽  
Agricultural Activity ◽  
Major Public Health Problem ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Epidemiological Characteristics

Introduction: Corneal blindness is a major public health problem worldwide and fungal keratitis is one of its predominant causes. The etiological and epidemiological pattern of fungal keratitis varies signicantly with patient population, geographical region and prevailing socioeconomic conditions. Objectives:The objective of the study was to identify the specic pathogenic agents and to study epidemiological characteristics of fungal keratitis presenting at a tertiary care centre in Patna, Bihar. Materials And Methods: Corneal scrapings were obtained from clinically suspected patients of keratomycosis during the period of 18 months from May 2015 to October 2016. The scraping material was processed and identied by standard laboratory techniques. Demographic and clinical features of the patients were also collected. Results: Out of total 115 suspected fungal corneal ulcers, 63(54.78%) were positive for fungal etiology. Of these, 53(84.13%) were positive on KOH mount. 40(63.49%) and 35(55.56%) were positive in Gram stain and culture respectively. In culture, aspergillus spp (16;45.71%) were the predominant fungal species, followed by fusarium spp (12;34.29%). Males (35/63;55.56%) were more commonly affected. 22 out of 63 patients (34.92%) were of age group 31-45 years. Majority of patients were farmers (68.25%). Corneal trauma (50.79%) was the most common predisposing factor in which trauma due to vegetative matter (53.13%) was most signicant. Conclusion: Fungal keratitis continues to be a cause of concern to ophthalmologists. Agricultural activity and related ocular trauma are principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis.

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