scholarly journals Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Noman Ali ◽  
Nadeem Ullah Khan ◽  
Shahid Waheed ◽  
Syed Mustahsan
Keyword(s):  
Emergency Department ◽  
Enteric Fever ◽  
Care Center ◽  
Tertiary Care ◽  
Practical Importance ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Continuous Variables

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital. Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever. Results: A total of one hundred and fifty five patients were included. Out of these 97 (62.6%) were males and 58 (37.4%) were females. Most patients (25.2%, n= 39) were diagnosed as malaria followed closely by dengue fever (n=33, 21.3%) and then enteric fever (n= 10, 6.5%). while 41.9% (n=65) were diagnosed as suspected viral fever based on clinical judgment and inconclusive laboratory results. Conclusion: Malaria was found to be the most common confirmed cause of acute undifferentiated fever followed by dengue and enteric fever. The provision of accurate epidemiological data will enable resources to be directed towards key areas and will be of practical importance to clinicians. doi: https://doi.org/10.12669/pjms.36.6.2334 How to cite this:Ali N, Khan NU, Waheed S, Mustahsan S. Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2334 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.

scholarly journals Etiology and clinical spectrum of acute undifferentiated fever illness in patients in a tertiary care hospital Sheri Kashmir institute of medical science Soura, Jammu and Kashmir

2021 ◽  
Vol 9 (1) ◽  
pp. 15
Author(s):  
Sheenam Gazala ◽  
Mohmad Saleem Chesti ◽  
Syed Mushfiq
Keyword(s):  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Categorical Variables ◽  
Care Hospital ◽  
Continuous Variables ◽  
Jammu And Kashmir ◽  
And Gender

Background: Current study aimed at s to delineate the etiology and clinical parameters associated with AUFI presenting to emergency department in a tertiary care hospital.Methods: This was a prospective hospital based study carried out at emergency medicine, SKIMS hospital, Soura Kashmir, India July 2017 to august 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever.Results: Total numbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patients were diagnosed enteric fever (N=59, 33.9%) followed by UTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%) while rest of cases were associated with other viral illnesses (N=70, 40.5%) based on clinical basis and inconclusive laboratory results.Conclusions: Enteric fever was found to be the most common cause of acute undifferentiated fever followed by dengue and other viral illnesses, although causes and clinic spectrum of AUFI is varied.

Microbiological and antimicrobial pattern of diabetic foot ulcers (DFUs) at a tertiary care center in North West, Pakistan

2021 ◽  
pp. 1-13
Author(s):  
Muhammad Arshad Siddiqui ◽  
Hamza Naeem ◽  
Muhammad Mohsin Ali ◽  
Fawad Ahmad Randhawa ◽  
Shahida Nazir ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Tertiary Care Center ◽  
Continuous Variables ◽  
Tissue Samples ◽  
North West ◽  
Antimicrobial Sensitivity ◽  
Diabetic Foot Infections

Abstract Objective: To determine the pattern of antimicrobial sensitivity of common microorganisms isolated from diabetic foot infections presenting at a tertiary care center in North West, Pakistan. Methods: 201 patients were included in the study, which was conducted over a period of 08 months from January 2019 to August 2019, at the Diabetes & Footcare Clinic (DFC), Mayo Hospital Lahore. Deep-seated tissue samples (0.5 x 0.5 cm) were taken from ulcer bed and immediately sent for culture & sensitivity (C&S) testing. Antimicrobial susceptibility was determined in accordance with Clinical & Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was performed using SPSS version 26.0. Data was presented as Mean ± SD for continuous variables & frequency with percentage for categorical variables. Results: Mean age of participants was 53.05 ± 10.70, from which 66.7 % (134) were male. Grade 3 DFUs (51.7%) and grade 2 DFIs were most prevalent (62.7%). Out of 201 tissue specimens, 389 bacterial isolates were collected. Monomicrobial specimens accounted for 28.4%, with the rest (71.6%) being polymicrobial. Gram negative organisms were 238 (61.11%) while the rest (38.89%) were gram positive organisms. There was a high incidence of methicillin resistant S. aureus (MRSA) at 64.58%. Highest susceptibility of S. aureus was reported with vancomycin and fusidic acid at 100% and 79.35%. Continuous...

scholarly journals Frequency of congenital birth defects in newborn babies born at Hyderabad, Sindh.

2020 ◽  
Vol 27 (04) ◽  
pp. 707-710
Author(s):  
Sajjad Ali Kazi ◽  
Aamir Memon ◽  
Abdul Hameed Radhan
Keyword(s):  
Pregnant Women ◽  
Birth Defects ◽  
Tertiary Care ◽  
University Hospital ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Continuous Variables ◽  
Observation Study ◽  
Congenital Birth Defects

Objectives: This study has been conducted in a tertiary care hospital to observe the frequency of congenital birth defects in newborn babies born at, Hyderabad, Sindh. Study Design: Prospective observation study. Setting: The Departments of Obstetrics and Pediatrics, Isra University Hospital, Hyderabad. Period: Two years from 2016 to 2018. Material & Methods: All the pregnant women irrespective of their parity and were included in the study after getting informed and written consent from their family heads and after the approval from Hospital’s ethical committee. We have used SPSS version 21.0 software for both data entering and analysis. All the continuous variables were analyzed using student t test and categorical variables were analyzed using chi-square test. P-value of ≤0.05 was taken as statistically significant. Results: A total of 150 pregnant women were included in our study with their mean age and SD was 26.72 ± 7.07 years and the mean years of marriage were 5.95±6 years. Most of the women were multiparous (47%), as compared to nulliparous and grandmultiparous, 33% and 20%, respectively. The prevalence of congenital birth defect was 11.3%, of these 30% had CNS malformations followed by 30% with gastrointestinal, 24% musculoskeletal, 12% genitourinary and 4% had ear malformations. Conclusion: The interfamily marriages (consanguineous marriages) are more common than outside family in study population. The frequency of birth defects was more than i-e: twice higher in interfamily marriages than outside family marriages.

scholarly journals Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study

2020 ◽  
Vol 18 (2) ◽  
pp. 10-14
Author(s):  
S.P. Adhikari ◽  
J. Pariyar ◽  
K. Sapkota ◽  
T.K. Gurung ◽  
S.R. Adhikari
Keyword(s):  
Post Partum ◽  
Care Center ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Tertiary Care Center ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Hospital Experience ◽  
Pregnancy And Postpartum ◽  
Almost All

Background: Pregnant and breastfeeding women are more susceptible to viral infection and in the year 2020 they have to face the COVID-19 pandemic. Since, no successful treatment and vaccine has been developed so far, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups like pregnancy and postpartum period are crucial to manage COVID-19 pandemic. Objective To analyze the knowledge, attitude, practice and hospital experience regarding COVID-19 among post-partum mothers at a tertiary care center of Nepal Method The data collection was based on direct interview after receiving written consent from the research participants, using a semi-structured questionnaire. The questionnaire consisted of 4 major domains- knowledge (8 questions), attitude (6 questions), practice (5 questions) and experience (5 questions). Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result A total of 203 post-partum women participated in the study. Almost all the participants had heard about COVID-19 (96.6%). A majority of them were aware about how COVID-19 gets transmitted and its preventive measures. Most of the participants (88.2%) knew that COVID-19 has effects on pregnancy. Almost all of participants (97%) wore mask during hospital stay. All of the women washed their hands with soap water or alcohol based sanitizer. A majority of the mothers (79.3%) wore mask while breastfeeding their baby. Conclusion The post-partum mothers have good knowledge, attitude, practice and experiences regarding the COVID-19 pandemic.

scholarly journals Impact of Rapid PCR Influenza Testing on the Rate of Inpatient Admissions During Influenza Season at a Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  
Keyword(s):  
Influenza Season ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Turnaround Time ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Rapid Pcr ◽  
The Impact

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None

scholarly journals Medical Trainee Continuity of Care Following Emergency Department Consultations in a Pediatric Hospital

2016 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kim Bjorklund ◽  
Emily A. Eismann ◽  
Roger Cornwall
Keyword(s):  
Emergency Department ◽  
Continuity Of Care ◽  
Broad Spectrum ◽  
Medical Records ◽  
Care Center ◽  
Tertiary Care ◽  
Well Being ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Medical Trainee

ABSTRACT Background The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. Objective We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Methods Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Results Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P &lt; .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P &lt; .001). Conclusions Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.

scholarly journals Clinical and laboratory follow-up after hospitalization for COVID-19 at an Italian tertiary care center

2021 ◽  
Author(s):  
Michele Spinicci ◽  
Iacopo Vellere ◽  
Lucia Graziani ◽  
Marta Tilli ◽  
Beatrice Borchi ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Tertiary Care Center ◽  
Persistent Symptom ◽  
Post Discharge

Abstract We evaluated 100 post-acute COVID-19 patients, a median of 60 days (IQR 48-67) after discharge from the Careggi University Hospital, Italy. Eighty-four (84%) had at least one persistent symptom, irrespective of COVID-19 severity. A considerable number of hospital re-admission (10%) and/or infectious diseases (14%) during the post-discharge period was reported.

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

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