scholarly journals Reducing the Risk of Severe Complications among Patients withClostridium difficileInfection

2011 ◽  
Vol 25 (7) ◽  
pp. 368-372 ◽  
Author(s):  
Kamran Manek ◽  
Victoria Williams ◽  
Sandra Callery ◽  
Nick Daneman
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Rapid Onset ◽  
Complication Rates ◽  
Care Hospital ◽  
Clinical Factors ◽  
Blood Cell Count ◽  
First Line ◽  
Repeat Infection

BACKGROUND: The incidence and severity ofClostridium difficileinfections are increasing, and there is a need to optimize the prevention of complicated disease.OBJECTIVE: To identify modifiable processes of care associated with an altered risk ofC difficilecomplications.METHODS: A retrospective cohort study (with prospective case ascertainment) of allC difficileinfections during 2007/2008 at a tertiary care hospital was conducted.RESULTS: Severe complications were frequent (occurring in 97 of 365 [27%]C difficileepisodes), with rapid onset (median three days postdiagnosis). On multivariable analysis, nonmodifiable predictors of complications included repeat infection (OR 2.67), confusion (OR 2.01), hypotension (OR 0.97 per increased mmHg) and elevated white blood cell count (OR 1.04 per 109cells/L). Protection from complications was associated with initial use of vancomycin (OR 0.24); harm was associated with ongoing use of exacerbating antibiotics (OR 3.02).CONCLUSION:C difficileinfections often occur early in the disease course and are associated with high complication rates. Clinical factors that predicted a higher risk of complications included confusion, hypotension and leukocytosis. The most effective ways to improve outcomes for patients withC difficilecolitis are consideration of vancomycin as first-line treatment for moderate to severe cases, and the avoidance of unnecessary antibiotics.

scholarly journals DAPSONE INDUCED DRESS: A CASE REPORT

2017 ◽  
Vol 10 (5) ◽  
pp. 4 ◽  
Author(s):  
Balaji Ommurugan ◽  
Amita Priya ◽  
Manu Matthew George ◽  
Meena Kuamri Kamalkishore ◽  
Mohan Babu Vittalrao Amberkar
Keyword(s):  
Rare Case ◽  
Liver Toxicity ◽  
Tertiary Care Hospital ◽  
Drug Effect ◽  
Tertiary Care ◽  
Organ Damage ◽  
Multiple Organ ◽  
Care Hospital ◽  
First Line ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms. is a very dangerous adverse drug effect causing rashes, eosinophilia, and multiple organ damage. Many drugs are implicated in causing DRESS with most common ones being antimicrobials and antiepileptics. Dapsone used in the treatment of Hansen’s disease as a first-line agent is known for causing many side effects ranging from nausea, vomiting, insomnia, anaphylaxis, hypersensitivity reactions, rashes, muscle weakness, abdominal pain, and so on. Hence, we report a rare case of dapsone-induced DRESS in a tertiary care hospital in South India.Keywords: Dapsone, Adverse effect, Liver toxicity, Rashes, Eosinophilia.

scholarly journals Ultrasound-guided percutaneous renal biopsy at a university hospital: retrospective analysis of success and complication rates

2021 ◽  
Vol 54 (5) ◽  
pp. 311-317
Author(s):  
Orlando Vieira Gomes ◽  
Bianca Alencar Dias de Almeida ◽  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Guilherme Bruno Pires Marques Locio ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Complication Rates ◽  
Care Hospital ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Second Procedure

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.

scholarly journals Outcome of Cranioplasty Done within and Beyond 2 Months after Decompressive Craniectomy for Traumatic Brain Injury

2021 ◽  
Vol 10 (10) ◽  
pp. 711-714
Author(s):  
Khongbantabam Vyas ◽  
Khaidem Mani Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Categorical Variables ◽  
P Value ◽  
Consecutive Series ◽  
Complication Rates ◽  
Care Hospital

BACKGROUND Cranioplasty although a simple elective neurosurgical procedure is burdened by considerable morbidity. The timing of doing cranioplasty and a good outcome remains a topic of much debate. We wanted to compare the outcome of doing cranioplasty within (early) and beyond (late) 2 months after decompressive craniectomy for traumatic brain injury. METHODS The study was carried out in a tertiary care hospital. A 5-year retrospective study of patient records was analysed. Consecutive series of traumatic brain injury patients who underwent cranioplasty after decompressive craniectomy from a tertiary care hospital operated by a single neurosurgeon, were studied. Data was analysed using SPSS version 21, IBM. Associations of categorical variables were compared using chisquare test and of continuous variables by using unpaired 2-tailed Student t-test. RESULTS Altogether 90 patients were identified who had undergone cranioplasty after decompressive craniectomy for traumatic brain injury and were grouped into early (within 2 months; 44 patients) and late (beyond 2 months; 46 patients). Cranioplasty operative time was significantly shorter in the early (59.39 mins) than the late (77.28 mins) with a P value of 0.001. Infection rates were significantly higher in the early (4.55 %) than late (0 %), with P value 0.144. Other complication rates were postoperative haematoma (0 % early, 2.17 % late, P = 0.325), hydrocephalus (0 % early, 6.52 % late, P = 0.085), sunken brain (0 % early, 4.35 % late, P = 0.162), and bone graft resorption (0 % early, 2.17 % late, P = 0.325). These differences were not statistically significant though. CONCLUSIONS Early cranioplasty performed within 2 months of decompressive craniectomy has better outcome in the form of reduced hospital stay, decreased cost, and fewer complications. KEY WORDS Traumatic Brain Injury, Decompressive Craniectomy, Outcome, Cranioplasty

A Cost-Outcome Description of the Septic Work-Up for Bacterial Infection in Neonates in a Tertiary Care Hospital

1995 ◽  
Vol 11 (1) ◽  
pp. 11-25 ◽  
Author(s):  
Roger E. Thomas ◽  
Philip Baker
Keyword(s):  
Blood Cell ◽  
Neonatal Sepsis ◽  
Average Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Women's College ◽  
Blood Cell Count ◽  
College Hospital ◽  
Work Up

AbstractAnalysis of the septic work-up of 194 neonates at Women's College Hospital, Toronto, showed that the only antepartum condition predicting neonatal sepsis was the mother being on antibiotics. The only postnatal condition predicting sepsis was a maternal postpartum white blood cell count over 11,000. The average cost for tests for a septic work-up in these 194 mother-neonate pairs was $71.48 (Canadian dollars), and the average cost of tests to find a septic case was $1,066.77.

scholarly journals COLORECTAL CANCER AND ITS RISK FACTORS AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN SOUTHERN KARNATAKA, INDIA

2017 ◽  
Vol 10 (4) ◽  
pp. 109 ◽  
Author(s):  
Rashmi R Aithal ◽  
Ranjitha S Shetty ◽  
Binu V S ◽  
Sneha Deepak Mallya ◽  
Rajgopal Shenoy K ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Risk Factors ◽  
Dietary Habits ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Case Control ◽  
Cancer Case ◽  
Care Hospital

Objective: To determine the association between certain socio-demographic and life style factors with colorectal cancer.Methods: This case-control study was conducted using a pre-designed questionnaire among 100 incident colorectal cancer patients and 200 unmatched controls attending a tertiary care hospital in southern Karnataka. Cases and the controls were interviewed and details regarding their socio-demographic factors were collected. Information on lifestyle factors such as dietary habits, physical activity levels and substance use were documented. They were also assessed for presence of existing co-morbidities and family history of colorectal and other cancers. Multivariable logistic regression was performed to determine the association between various risk factors and colorectal cancer.Results: In the present hospital based study, mean age of the participants was less than 55 years. Sixty three percent of the cases and 54.5% of the controls were males. On multivariable analysis age ≥50years (OR=1.87; 95%CI=1.02-3.45), low physical activity (OR=5.66; 95%CI=3.10-10.34) and low frequency of fruits consumption (OR=4.10; 95%CI=2.21-7.50) and hypertension (OR= 4.65; 95% CI=1.32-16.44) showed a positive association with colorectal cancer. Conclusion: Promoting healthy dietary practices and physical activity among the middle aged population appears to be significant in the context of colorectal cancer prevention in the Indian subcontinent.Keywords: Colorectal cancer, Case–control, Risk factors, Lifestyle, Comorbidities.

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