scholarly journals Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Kevin John John ◽  
Karthik Gunasekaran ◽  
John Davis Prasad ◽  
Divya Mathew ◽  
Sohini Das ◽  
...  
Keyword(s):  
Observational Study ◽  
Major Bleeding ◽  
South India ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Total Leukocyte Count ◽  
Severe Dengue ◽  
Elderly Age ◽  
Tertiary Care Centre

We conducted a retrospective observational study to describe the clinical profile and outcomes of patients admitted with a diagnosis of dengue fever in a tertiary hospital in South India. A total of 159 patients admitted from April 2014 to October 2018 were included in the study. Vomiting (70.4%), myalgia (60.4%), headache (42.1%), abdominal pain (38.4%), bleeding (38%), and rash (37.1%) were the most common symptoms at presentation. The mean duration of hospital stay was 4.9 days (SD ± 2.4), and the median cost was INR 19,708 ($285) (IQR INR 12,968–32,056 ($188–$305)). Major bleeding was associated with elevated SGOT and SGPT, severe dengue, and secondary dengue. Mortality was associated with elderly age; elevated total leukocyte count, serum bilirubin, serum creatinine, SGOT, and SGPT; and high SOFA score. In view of these observations, we recommend stratifying patients according to the WHO classification of dengue and avoiding the use of thrombocytopenia as a single marker of the severity of the illness.

scholarly journals Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043672
Author(s):  
Mahnur Haider ◽  
Gianina Flocco ◽  
Rocio Lopez ◽  
William Carey
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Observational Study ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Care ◽  
Temporal Trends ◽  
Retrospective Observational Study ◽  
Secondary Outcome ◽  
Tertiary Care Centre ◽  
Hepatitis B Screening

ObjectiveHepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in light of recommendations.DesignRetrospective, observational study.SettingSingle, tertiary care centre in the USA.ParticipantsPatients receiving rituximab from January 2005 to December 2017.Primary outcomeTrends of hepatitis B screening prior to initiation of rituximab.Secondary outcomeResults of hepatitis B screening, use of preventive NA therapy and HBr incidence.ResultsOver 13 years, 2219 patients received rituximab. Screening, with at least hepatitis B core antibody (anti-HBc) prior to the first dose of rituximab, improved from 20% to 97%. Because only 4.5% of patients had a positive anti-HBc, the overall HBr incidence was very low (0.42%). In susceptible patients, the incidence of HBr was 8%. In at-risk patients given preventive NA, 96% remained free of HBr. However, only 23% received a preventive NA and no temporal improvement in compliance was seen. Of those with HBr, 87.5% were hepatitis B surface antigen (HbsAg−)/anti-HBc+.ConclusionsIn those treated with rituximab, we demonstrated near-universal anti-HBc screening. Screening unlinked to preventive NA use, in those who are anti-HBc+, is ineffective in reducing HBr. HBr has a high fatality rate. The majority of cases occurred in those who were HBsAg negative. Efforts are needed to educate providers who use rituximab not only to screen for anti-HBc, but to provide preventive NA to those who test positive.

scholarly journals Clinical usage of intravenous immunoglobulin in neonates in a tertiary care centre: a retrospective observational study

2019 ◽  
Vol 6 (5) ◽  
pp. 2173
Author(s):  
Sharath S. Ghalige ◽  
Vaideeswaran M. ◽  
Mangalabharathi S.
Keyword(s):  
Observational Study ◽  
Intravenous Immunoglobulin ◽  
Exchange Transfusion ◽  
Immune Thrombocytopenia ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Study Cohort ◽  
Usage Pattern ◽  
Tertiary Care Centre ◽  
Drug Register

Background: Intravenous Immunoglobulin (IVIG) is a blood product manufactured from pooled plasma. With increasing availability, an increased usage in neonates is being noted, though its utilisation has not been audited thoroughly. The objectives of this study are to describe the usage pattern and indications of IVIG and its outcome in a state-run tertiary care NICU.Methods: This retrospective observational study was carried out at the inborn unit of Department of Neonatology, Madras Medical College, Chennai on a cohort of neonates who received IVIG over 3.5 years from January 2016 to June 2019. Data was collected from drug register, neonatal case records, exchange transfusion register and death register.Results: Our study cohort had 55 neonates who received IVIG over 3.5 years. Indications for IVIG usage were Rh-alloimmunisation (23), ABO-alloimmunisation (7), prophylaxis of perinatal varicella (20), and other immune thrombocytopenia (5). Among 30 neonates with ABO-/Rh-incompatibility, 11 required exchange transfusion (ET). ET rates have shown a decreasing trend during this period. 2 babies with Rh-immunisation and Hydrops expired. None of the babies given prophylaxis for perinatal varicella manifested the disease. Neonates treated for immune thrombocytopenia were successfully discharged.Conclusions: This study shows the IVIG usage pattern in a tertiary care neonatal unit. In neonates with Hemolytic disease due to Rh-/ABO-alloimmunisation treated with IVIG, a reduction in rates of exchange transfusion has been noted. IVIG is being used increasingly for prophylaxis of perinatal varicella and immune related thrombocytopenia with promising benefits. It is prudent to have SOPs for IVIG administration with standardised issue and transfusion forms for documentation to regulate its judicious use. 

scholarly journals Morbidity, mortality and clinico-laboratory profile of COVID-19 related illness in children: a retrospective observational study from a tertiary care centre in India

2021 ◽  
Vol 10 (1) ◽  
pp. 133
Author(s):  
Bijoy Patra ◽  
Manju Nimesh ◽  
Parasdeep Kaur ◽  
Sumantha Patil ◽  
Hema Gupta ◽  
...  
Keyword(s):  
Observational Study ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Third Wave ◽  
Tertiary Care Centre ◽  
Children And Adolescent ◽  
Severe Group ◽  
Laboratory Profile ◽  
Critical Patients

Background: As India is poised for a third wave of SARS Co-V2 infection with a large unvaccinated pediatric population, it becomes imperative and pertinent for a study to find out its demographic, clinico-laboratory profile, and outcome in children with COVID-19 disease and its related illness.Methods: This is a retrospective observational study undertaken for Children and Adolescent admitted in the department of pediatrics of a teaching and tertiary care referral hospital, Delhi.Results: The median age of admitted children with COVID-19 disease was 11 years with an interquartile range 3 to 16 years. The median duration of hospital stay was 10 days (mean: 18±14 days). Mortality was 9/62 (14%). Recovery in non-severe (asymptomatic, mild, moderate) was 41/41 (100%), and in severe and critical illness including MISC was 42.8% (9/21). Mortality in severe and critical patients managed in SARI and COVID ward was 44% (8/18). Death among MISC patient in PICU was 33% (1/3). Difference in CRP rise was significant in severe and non-severe group of COVID-19 (p=0.017).Conclusions: Even though the morbidity and mortality associated with COVID-19 infection and related illness seems to be miniscule, the infection causes significant illness in the subgroup of children who requires hospitalization and can be fatal in those with comorbidity.

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