Anaesthetic management of patients undergoing deep brain simulation: A retrospective review of 8 cases from a tertiary care center of Pakistan

Objectives: To review anaesthesia related outcome, perioperative complications and overall length of stay (LOS) in hospital for patients who had deep brain stimulation (DBS). Methods: The study was retrospective review of patients medical records diagnosed with Parkinson disease (PD) and underwent DBS at The Aga Khan University Hospital, Karachi from 2017-2019. Data was reviewed from file notes and patient chart and recorded on predesigned Performa. Frequency and percentages were used to present the data. Results: All patients were anaesthetized using Sleep-Awake-Sleep technique (SAS). Dexmedetomidine was mainly used for conscious sedation. Bispectral index monitor (BIS) was used to monitor the depth of sedation, and kept between 70-85 during sedative phase. All patients had successful intraoperative neurological monitoring, stimulation, and placement of electrodes. Total duration of anesthesia varied significantly in between the patients. Maximum duration was 600 minutes. None of our patient had any intraoperative event related to anaesthetic management. Overall five patients had some adverse events during ward stay. Mean LOS in hospital was four days. Conclusion: Anaesthetic management of DBS is well-tolerated. It requires dedicated team. The SAS technique is excellent for intraoperative neurophysiological monitoring. Careful selection of sedative agents and monitoring depth of anaesthesia using BIS would be beneficial in terms of improving related outcomes. doi: https://doi.org/10.12669/pjms.36.7.2870 How to cite this:Ahmed U, Shafiq F, Kumar D, Ahsan K, Ghaffar W, Bari E. Anaesthetic management of patients undergoing deep brain simulation: A retrospective review of 8 cases from a tertiary care center of Pakistan. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2870 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.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab049 ◽

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.

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Fever of unknown origin: a retrospective review of pediatric patients from an urban, tertiary care center in Washington, DC

World Journal of Pediatrics ◽

10.1007/s12519-019-00237-3 ◽

2019 ◽

Vol 16 (2) ◽

pp. 177-184 ◽

Cited By ~ 1

Author(s):

Ann Marie Szymanski ◽

Hugo Clifford ◽

Tova Ronis

Keyword(s):

Retrospective Review ◽

Fever Of Unknown Origin ◽

Pediatric Patients ◽

Care Center ◽

Tertiary Care ◽

Unknown Origin ◽

Washington Dc ◽

Tertiary Care Center

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Management of Retrosternal Goiter without Sternotomy: A Retrospective Review in a Tertiary Care Center

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1406 ◽

2020 ◽

Vol 11 (3) ◽

pp. 47-49

Author(s):

Prashanth Veerabhadraiah ◽

Pruthvi R Shivalingaiah ◽

Chandni R Pillai ◽

Sachin S Nair ◽

Kiran C Hanumanthappa

Keyword(s):

Retrospective Review ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Retrosternal Goiter

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Incidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care center

Transfusion ◽

10.1111/trf.13200 ◽

2015 ◽

Vol 55 (11) ◽

pp. 2597-2605 ◽

Cited By ~ 21

Author(s):

Vighnesh Bharath ◽

Kathleen Eckert ◽

Matthew Kang ◽

Ian H. Chin-Yee ◽

Cyrus C. Hsia

Keyword(s):

Natural History ◽

Intravenous Immunoglobulin ◽

Aseptic Meningitis ◽

Retrospective Review ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

History Of

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

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.6.2334 ◽

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.

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Anaphylaxis in Omani Patients: A Study from a Tertiary Care Center

Oman Medical Journal ◽

10.5001/omj.2021.113 ◽

2021 ◽

Author(s):

Salem Al Tamemi ◽

Yusra Al Lamki ◽

Shafiq Ur-Rehman Naseem ◽

Nabila Al Siyabi ◽

Bushra Al Siyabi ◽

...

Keyword(s):

Clinical Features ◽

Allergic Disease ◽

Clinical Symptoms ◽

Care Center ◽

Tertiary Care ◽

University Hospital ◽

Tertiary Care Center ◽

Total Ige ◽

Sultan Qaboos University ◽

True Incidence

Objective: Anaphylaxis is an acute and potentially fatal allergic reaction. To the best of the author’s knowledge, no studies have yet been conducted to evaluate the spectrum of anaphylactic reactions among Omani patients. As such, this study aimed to describe the clinical features, causes, investigation, and management of anaphylaxis among patients presenting to a tertiary care center in Oman. Methods: This retrospective study took place between August 2005 and June 2020 at the allergy and immunology clinic of the Sultan Qaboos University Hospital, Muscat, Oman. All patients diagnosed with anaphylaxis during the study period were included. Data were collected from electronic medical records. Results: A total of 100 patients were diagnosed with anaphylaxis during the study period. Of these, 52% were male. The mean age was 15.9  16.2 years, with 70% being <18 years old. The eosinophil count ranged from 0–16.9 ×109 /L, with a mean of 0.8  2.2 ×109 /L and a median 2 of 0.30 (IQR: 0.15-0.65) ×109 /L. Total IgE levels ranged from 25–8,706 kIU/L, with a mean of 935.1  1369.5 kIU/L and a median of 500.4 (IQR: 186.0-972.5) kIU/L. Overall, the majority of patients had a family history of allergies (72%), other concomitant allergic condition (66%) and were all prescribed epinephrine (100%). The most common cause of anaphylaxis was food (65%), the second most frequent trigger was insect venom (32%). The majority of patients had one category cause (81%) however two or more causes were present in 19% of the patients. Clinical symptoms manifested most frequently as cutaneous (92%), and respiratory (85%). The majority of patients (87%) demonstrated involvement of more than one bodily system. Total IgE levels were significantly higher in patients with concomitant presence of other allergic conditions 1193.8 kIU/L compared to patients without another concomitant allergic disease mean 503.6 kIU/L (p=0.03). In addition, concomitant other allergic disease is significantly higher in patients <18 years of age 75.4% compared to patients >18 years of age 45.2% (p= 0.01). Conclusions: Due to its life-threatening nature, knowledge of the epidemiology and clinical features of anaphylaxis in different populations is necessary in order to deliver rapid treatment. This study found that the clinical features of anaphylactic patients in Oman were similar to those reported elsewhere. Further research is needed to determine the true incidence of anaphylaxis in Oman in order to minimize associated morbidity and mortality.

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