The common causes leading to pancytopenia in patients presenting to tertiary care hospital

Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological, laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically. Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case report.

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A STUDY ON CHROMOBLASTOMYCOSIS IN A TERTIARY CARE HOSPITAL (DMCH), LAHERIASARAI, BIHAR

10.36106/2736095 ◽

2021 ◽

pp. 36-38

Author(s):

Jibachh Prasad Sah ◽

Pramanand Jha ◽

R. S. Prasad ◽

Debarshi Jana

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Common Species ◽

Care Hospital ◽

Dematiaceous Fungi ◽

Himalayan Belt ◽

Common Clinical Presentation ◽

Nodular Lesions ◽

The Common ◽

Causative Fungus

Background: Chromoblastomycosis, a chronic subcutaneous mycosis, is caused by several dematiaceous Fungi, the most common being Fonsecaea pedrosoi. A majority of cases from India have been reported from the sub-Himalayan belt and South India. Aim: The aim was to study chromoblastomycosis in around Darbhanga reason of Bihar including demographic and clinicomycological prole. Materials and Methods: This report is a retrospective hospital record-based analysis of all cases of chromoblastomycosis who presented to the dermatology outpatient department of our tertiary care hospital during the past 3 years. Results : A total of 11 cases of chromoblastomycosis were diagnosed during the above period. The disease was seen predominantly in middle-aged male. The lower extremity (72.7%) was more commonly affected. Verrucous and nodular lesions are the common clinical presentation. Sclerotic bodies are demonstrated in potassium hydroxide mount and histopathological section in 81.8% and 90.9% cases, respectively. The causative fungus was isolated in 90.9% and cass with F. pedrosoi, as the most common species

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A clinical study of pattern of geriatric dermatosis in tertiary care hospital of Rajasthan

IP Indian Journal of Clinical and Experimental Dermatology ◽

10.18231/j.ijced.2021.028 ◽

2021 ◽

Vol 7 (2) ◽

pp. 148-152

Author(s):

Bajrang Soni ◽

Priyanka Meena

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Age Group ◽

Physiological Changes ◽

Geriatric Population ◽

Detailed History ◽

Medical College ◽

Pathological Conditions ◽

The Common

: Geriatric health care has received lot of attention nationwide due to increase in life expectancy over the time. Among the various health issue geriatric dermatosis are one of the most common reason for regular OPD visits. This study was done to inquest the spectrum of cutaneous manifestation and the factors responsible for causing physiological and pathological changes in the skin of elderly people.: Three hundred consecutive patients aged more than 60 yrs of age attending the out patient department of dermatology at PDU Medical College & hospitals Churu were subjected for study. A detailed history was taken. A complete general, systemic & Cutaneous examination was done along with relevant investigation were carried out. Findings were collated in Performa for analysis and interpretation of data. A total of 300 patients were enrolled in the study out of which 59 % were male and 41 % were female. Pruritis was the commonest complain elicted in 68.5 % of patients. Among the physiological changes xerosis was the commonest seen in 63 % of patients and infecions followed by eczems was the common pathological conditions. The population of 60 yrs and above is a rapidly growing dermatology clientele with both physiological and pathological manifestations. This study highlights the various dermatoses peculiar to the geriatric population and aims at sensitizing the fraternity to the specific needs of this special age group.

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Study of perinatal autopsies in tertiary care hospital 20 year experience

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172906 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2914 ◽

Cited By ~ 1

Author(s):

N. S. Kamakeri ◽

Ramalingappa C. A. ◽

Vinayraju D.

Keyword(s):

Congenital Abnormalities ◽

Neonatal Period ◽

Tertiary Care Hospital ◽

Perinatal Death ◽

Tertiary Care ◽

Care Hospital ◽

Pathological Findings ◽

Meconium Aspiration ◽

Perinatal Autopsy ◽

Common Causes

Background: Losing a baby is painful. Looking for answers can help. Although nothing can change the loss, a perinatal autopsy may offer answers to better understand what happened. A perinatal autopsy is a medical exam done on the fetus or infant to help explain the cause of death. This exam may also find the underlying reason for an illness, disease or birth defect.Methods: Babies of mothers with bad obstetrics history, died in utero, neonatal period and baby deaths of unknown cause were subjected for clinical autopsy in the last 20 years. Based on the major and associated pathological findings, an attempt was made to find the cause of death.Results: Immaturity of the organs found to be the most common cause for perinatal death. Meconium aspiration pneumonia, external congenital abnormalities are found to be the other common causes for perinatal mortality.Conclusions: Perinatal autopsies are the effective method of finding the cause of perinatal death, and helps to some extent in preventing the future loses.

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A study of surgical site infections in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20194577 ◽

2019 ◽

Vol 6 (11) ◽

pp. 3911 ◽

Cited By ~ 1

Author(s):

Ayush Jain ◽

Anuradha Tolpadi ◽

Bhupendra Chaudhary ◽

Ansh Chaudhary ◽

Ankita Misra

Keyword(s):

Nosocomial Infections ◽

Antimicrobial Agents ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Laboratory Data ◽

Surgical Site Infections ◽

Health Concern ◽

Care Hospital ◽

Duration Of Surgery ◽

Common Causes

Background: Health care-associated infections remain as an important public health concern. Surgical site infections (SSIs) are known to be one of the most common causes of nosocomial infections worldwide.Methods: A prospective observational study was conducted across 12 months (May 2018-April 2019) in a tertiary care hospital. The present study includes 223 patients who were undergoing clean and clean contaminated surgery in the hospital. Contaminated and dirty surgeries were excluded. The demographic data of the patient, diagnostic criteria used, associated risk factors, use of prophylactic antimicrobial agents, the type and duration of surgery, clinical evaluation of wound and laboratory data was collected. All the pus samples or wound swabs of clinically suspects of SSI cases received in the Department of Microbiology were inoculated and interpreted according to Centre for Disease Control and Infection guidelines.Results: The study included 223 patients who underwent surgery in the hospital. Amongst them 9 (4%) developed SSI. The incidence of SSI was 4.03%. There was a direct relationship observed between the occurrence of SSI and certain co-morbid conditions such as diabetes. It was also observed that prolonged surgeries above two hours and females were more predisposed to develop a surgical site infection.Conclusions: SSIs being one of the most common causes of nosocomial infections. It was also the most important factor responsible for significant morbidity, mortality, unwanted prolonged hospitalization and additional cost of treatment in surgical patients which can be reduced by strictly following the guidelines of infection control along with judicious and rational use of antibiotics.

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Adverse drug reactions or events in children with assessment of causality and severity: a retrospective analysis from Bhavnagar

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205127 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1883

Author(s):

Jayendra R. Gohil ◽

Aniket B. Sarwade ◽

Hardik R. Chauhan ◽

Jay R. Jasani ◽

Hinal R. Gujrati

Keyword(s):

Adverse Drug Reactions ◽

Adverse Drug Events ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Drug Reactions ◽

Pediatric Age Group ◽

Skin Redness ◽

The Common ◽

Probable Category

Background: Objective was to study the occurrence of adverse drug reactions in pediatric age group in a tertiary care hospital setting.Methods: A retrospective study was undertaken to analyze adverse drug events in pediatrics wards of a tertiary care hospital. Any event marked as ‘suspected adverse drug reaction’ was included in the study and ADR forms were analyzed for causality and severity. Other parameters like age and sex, class of drug, types of ADR, commonly involved systems and polypharmacy were studied.Results: Total 74 cases of admitted patients (13 deaths: 11 infants, 6 neonates) with severe ADR were studied of whom 39% were females. Antimicrobials were the commonest drug class (54%) with Skin most commonly involved. 77% cases were of probable category according to Naranjo’s scale of causality assessment. 11% cases were prescribed polypharmacy.Conclusions: Antibiotics were the class of drug causing maximum ADRs. The commonest system involved was skin. Redness, itching & rashes were the common symptoms. Antimicrobials should be used judiciously. Polypharmacy should be avoided. ADR reporting should be strengthened. Extra vigilance is required for infants and neonate’s prescriptions.

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A prospective study on risk factors for development of surgical site infections at a tertiary care hospital: a two years study

International Surgery Journal ◽

10.18203/2349-2902.isj20180113 ◽

2018 ◽

Vol 5 (2) ◽

pp. 460

Author(s):

Vakamudi Prakash ◽

Ramalinga Reddy Rachamalli ◽

Jithendra Kandati ◽

Sreeram Satish

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Nosocomial Infections ◽

Antibiotic Susceptibility ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Surgical Site Infections ◽

Care Hospital ◽

Multiple Factors ◽

The Common

Background: Surgical site infections (SSI) are the second most common Nosocomial infections after urinary tract infections accounting to 20-25% of Nosocomial infections worldwide. Based on the depth of the infections, SSI is classified by CDC as superficial incisional, deep incisional and organ/space. The development of SSI is dependent upon multiple factors like class of wound, immune status, type of surgery, type of anesthesia; surgical techniques etc and are interplay of multiple factors. Objective of the present study was conducted in identifying the predictors, risk factors and incidence rates of SSI at a tertiary care hospital. The study also identifies the causative bacterial pathogens and their antibiotic susceptibility patternMethods: A prospective cross-sectional study was conducted for a period of two years by department of general surgery involving all patients who underwent surgery, and pre-operative, intra operative and risk factors of the cases were collected using standardized data collection form. Specimens from the infected wounds were collected and processed for isolation of pathogens. Antibiotic susceptibility of pathogens was done using standard guidelines.Results: The incidence of SSI in present study was 25.34% with 81.58% superficial SSI and 18.42% deep SSI. Laparotomy was the common procedure and 63.2% of cases were females and 41-60 years was the most common age group. Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli were the common pathogens and were sensitive to carbapenems, vancomycin and linezolid. Significant association was observed with presence of pre-morbid analysis, presence of drain, use of povidone iodine alone and development of SSI.Conclusions: In present study the incidence of SSI was significantly high in this hospital and associated with premorbid illness, duration of surgery, presence of drain and use of drain at site of surgery. Staphylococcus aureus was the common pathogen and incidence of MRSA is higher than many other reports. A continuous monitoring and surveillance of patients with a predefined protocol will help in early identification of cases with risk of development of SSI. A feedback of appropriate data to surgeons is highly recommended to reduce the SSI rate in developing countries.

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CLINICAL PROFILE AND COMMON CAUSES OF HAEMOLYTIC ANAEMIA IN A TERTIARY CARE HOSPITAL, NORTHERN KERALA

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/883 ◽

2016 ◽

Vol 3 (76) ◽

pp. 4136-4142

Author(s):

Jog Antony ◽

Reeta J ◽

Sreelakshmi S ◽

Rohit Mathew ◽

Adarsh Surendran

Keyword(s):

Haemolytic Anaemia ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Profile ◽

Care Hospital ◽

Common Causes

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Clinical and biochemical profile of neonatal seizures admitted in neonatal intensive care unit of a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212313 ◽

2021 ◽

Author(s):

Mohanram V. ◽

Arulraj Russelian ◽

Palpandi V.

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Biochemical Profile ◽

Neonatal Seizures ◽

The Common

Background: Several factors contribute to seizures among neonates. To avoid complications from under recognition of clinical seizures and the adverse effects of medications administered, the diagnosis and management of neonatal seizures necessitate an interprofessional approach. Present study was done to study the clinical and biochemical profile of neonates with seizures admitted to a tertiary care hospital, Chennai.Methods: A cross sectional study was conducted where all the neonates from birth to 28 days of life who got admitted in the neonatal intensive care unit (NICU) of a tertiary care hospital-Shri Sathya Sai medical college and research institute were included in the study. Baseline characteristics of all the babies were noted on the prescribed proforma. Thorough physical examination was done and seizures were diagnosed by clinical observation. Clinical details of each seizure episode were recorded like age at onset of seizures, duration of seizure, number and type of seizure.Results: In the present study, 50 neonates satisfying the inclusion and exclusion criteria were included in the study. The main mode of delivery was normal vaginal delivery (50%) followed by LSCS (40%) and assisted delivery (10%). 54% were male and 46% were female and majority of babies were delivered at term i.e., 72% and 28% were pre term babies. The mean day of onset of seizures in the present study was 3.18±2.09. Based on day of onset of seizures, with in 24 hrs (28%), 24 hrs to 72 hrs (46%), 4th day to 1 week (22%), more than 1 week (4%). Based on type of seizure 64% had subtle type, 26% had tonic type and 10% had clonic type of seizures. In this study, 24% had hypoglycemia, and 10 (20%) had hypocalcemia, 14% in the present study had hyponatremia, and 2 (4%) had hypomagnesemia, 2 (4%) had hypernatremia, 6% had combination of hypocalcemia and hypoglycemia.Conclusions: Hypocalcemia, hypoglycemia, hyponatremia were the common biochemical abnormalities observed in our study. Subtle seizures were the common type of seizures observed among both pre term and term infants.

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