scholarly journals Retinoblastoma Presentation and Survival: A four-year analysis from a tertiary care hospital

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Nida Zia ◽  
Ahmer Ahmer Hamid ◽  
Sundus Iftikhar ◽  
Muhammad Hamza Qadri ◽  
Anzal Jangda ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Warning Signs ◽  
External Beam Radiation ◽  
Tumor Type ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Beam Radiation

Objective: To study the clinical presentation, treatment, and outcome of Retinoblastoma (Rb) in a tertiary care hospital of Pakistan. Methods: A retrospective study was conducted in the Department of Pediatric Hematology Oncology, The Indus Hospital (TIH), Karachi from 1st June 2013 to 30th June 2017. Data including patients’ demography, clinical symptoms and duration, laterality, extent of the tumor, type of treatment, relapse, and final outcome were extracted and evaluated with respect to progression and survival. Results: A total of 93 patients were included; 34.4% were boys. The median age at presentation was 30 months. Leukocoria was the commonest symptom (61.3%), followed by proptosis (37.6%). Unilateral disease was seen in 59.1%, extraocular tumors in 43.5% and metastasis in 28.1%. Enucleation was performed on 46.2%, chemotherapy given to 80.6% and external beam radiation therapy to 29.3% patients. Conclusion: Delayed presentation, recurrent disease, extraocular disease and metastasis on presentation were factors affecting outcome in our cohort. Awareness about the early warning signs and symptoms in both public and health professionals for early recognition and timely management are mandatory to decrease morbidity and mortality. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1720 How to cite this:Zia N, Hamid A, Iftikhar S, Qadri MH, Jangda A, Khan MR. Retinoblastoma Presentation and Survival: A four-year analysis from a tertiary care hospital. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S61-S66. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1720 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 Clinico-laboratory profile and outcome of dengue fever among children attending a tertiary care hospital of rural Telangana, India

2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
V. Shekar ◽  
K. Praveen Kumar ◽  
C. Soren ◽  
K. Venkataramana Reddy ◽  
N. Dharani
Keyword(s):  
Dengue Fever ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Presenting Symptoms

Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals A study of Acute Liver Failure in adults in a tertiary care hospital

2019 ◽  
Vol 5 (6) ◽  
pp. 204-207
Author(s):  
Dr. Mohini Singh ◽  
◽  
Dr. Srilakshmi Sathiyaseelan ◽  
Devarasetty Shashank ◽  
Dr. S.R. Ramakrishnan ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Viral Hepatitis ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Care Hospital ◽  
Arterial Blood ◽  
Function Test

Acute liver failure (ALF) is a condition with rapid deterioration of liver function resulting in hepatic encephalopathy and/or coagulopathy in patients with previously normal liver. Acute liver failure (ALF) is an uncommon condition associated with high morbidity and mortality. The prognosis is poor for untreated cases of Acute liver failure, so early recognition and management of patients with acute liver failure is crucial. A cause for acute liver failure can be identified in 60 to 80 percent of patients. Identifying the underlying cause of the liver failure is important because it influences the approach to management and provides prognostic information. Aims and Objectives: The aim of our study is to identify the clinical features, etiology and outcome of acute liver failure in a tertiary care hospital. Materials and Methods: This study is an observational study where patients with Acute Liver Failure admitted in ICU in our institution after meeting the diagnostic criteria for Acute liver failure were included in the study. Details of history, relevant symptoms and baseline investigations included, complete blood count, blood glucose, renal function test, serum electrolytes, liver function test (LFT), prothrombin time, international normalized ratio (INR), lactate dehydrogenase (LDH), creatine kinase (CK)], arterial blood gas analysis, arterial lactate, arterial ammonia, amylase and lipase level and pregnancy test (if female) and ultrasonography (USG) abdomen were recorded, MRI brain and other investigations relevant to the admission diagnosis, co morbidities and aetiology if needed were recorded. All the patients received standard supportive treatment for ALF. Results: In this study of 57 patients, majority of the patients were from the age group 41 to 50 years (17 patients) and 31 to 40 years (13 patients). 36 patients were male and 21 patients were females. Jaundice and encephalopathy was observed in all 57 (100%) patients, 24 (42%) patients had INR >2.5, 27 (47%) patients had serum creatinine >1.2 mg/dl and 18 (31.5%) patients had serum ammonia levels >100 micromol/L. The lowest value for serum aminotranferase was observed in infections (other than viral hepatitis) and maximum value was observed in drugs leading to ALF.In 20 (35%) patients viral hepatitis was the cause for ALD, followed by drugs and toxins which was the cause of ALD in 18 (31.5%) patients. Infections other viral hepatitis as the aetiology for ALF was observed in 16 (28%) of patients. Ischemic hepatitis was observed in 1 and Wilson’s disease was noted in 2 patients. Total 6 (10.5%) patients out of 57 patients had died, 4 patients with hepatitis B infection, 1 patient with paracetamol over dosage and 1 patient with dengue fever had died. Conclusion: Viral hepatitis and drugs are the commonest cause for acute liver failure. The aetiology of ALF varies significantly worldwide. Determining the etiology of acute liver failure requires a combination of detailed history taking and investigations. A broad evaluation is required to identify a cause of the acute liver failure, as the prognosis is poor in untreated cases of acute liver failure, so early recognition and management of patients with acute liver failure is crucial.

scholarly journals Etiology and Outcome of Acute Liver Failure in Children—The Experience of a Single Tertiary Care Hospital from Romania

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 282
Author(s):  
Alina Grama ◽  
Cornel Olimpiu Aldea ◽  
Lucia Burac ◽  
Dan Delean ◽  
Bogdan Bulata ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Metabolic Disorders ◽  
Metabolic Diseases ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Vital Role ◽  
Care Hospital ◽  
Neonates And Infants

Background: Acute liver failure (ALF) is a rare disease, associated with high mortality, despite optimal medical therapy without emergency liver transplantation. Knowing the possible cause of ALF plays a vital role in the management, as the child could benefit from effective specific therapies in emergencies. Methods: We have analyzed the etiology and outcome of ALF in children followed-up in a tertiary care hospital between January 2012–December 2018. The patients were grouped into different age categories: neonates (0–1 month), infants (1–12 months), children (1–14 years), and teenagers (14–18 years). Results: 97 children (46 males, 47.42%, the mean age of 7.66 ± 8.18 years) were admitted with ALF. The most important causes of ALF were in neonates and infants, infections (72.72%), and metabolic disorders (43.47%), in children and adolescents were the toxic causes (60% and 79.41%). The mortality rate was 31.95% (31 patients), mainly in ALF due to infections or metabolic disorders. Conclusions: In neonates and infants, the main causes of ALF were infections and metabolic diseases, while in older children and teenagers, were toxin-induced liver injuries. The mortality among neonates and infants was significantly higher than in other ages. Early recognition and immediate therapeutic intervention could improve the outcome of these patients.

scholarly journals Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

2021 ◽  
Author(s):  
Harsha Prasada Lashkari ◽  
Manisha Madkaikar ◽  
Aparna Dalvi ◽  
Maya Gupta ◽  
Jacinta Bustamante ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Southern India ◽  
Care Hospital ◽  
Optimal Care ◽  
Inborn Errors ◽  
Inborn Errors Of Immunity

Abstract Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and offered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodeficiencies (ESID) criteria (working definition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody deficiencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classification. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and efforts to provide optimal care for children with possible IEI in this center.

scholarly journals Factors influencing delayed presentation of breast cancer at a tertiary care hospital in Pakistan

2018 ◽  
Vol 2 (1) ◽  
pp. e1141
Author(s):  
Mehreen Baig ◽  
Iram Sohail ◽  
Humera Naz Altaf ◽  
Omar Shahzad Altaf
Keyword(s):  
Breast Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Factors Influencing

Delayed presentation of anorectal malformations in a tertiary care hospital in India

2021 ◽  
Author(s):  
Gali Divya ◽  
Vijay Kumar Kundal ◽  
Pinaki R. Debnath ◽  
Rajasekhar Addagatla ◽  
Anil Kumar Garbhapu ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Anorectal Malformations ◽  
Care Hospital ◽  
Delayed Presentation

scholarly journals Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital

2019 ◽  
Vol Volume 11 ◽  
pp. 1087-1096 ◽  
Author(s):  
Faisal Gulzar ◽  
Muhammad Shoaib Akhtar ◽  
Rafshan Sadiq ◽  
Sajid Bashir ◽  
Sajida Jamil ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Breast Cancer Patients

scholarly journals Recognizing Early Warning Signs for Patient Safety: Study in Pakistan’s Tertiary Care Hospital

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Rufina Soomro
Keyword(s):  
Patient Safety ◽  
Early Warning ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Warning Signs ◽  
Care Process ◽  
Care Hospital ◽  
Safety Study ◽  
Early Warning Signs

It is not uncommon for hospitalized patients to exhibit early warning signs before deteriorating. Clinical deterioration can happen at any point in a patient’s illness, or care process. Nurses are expected to have skills to enable them to assess precisely the severity of deterioration, as nurses are the first to encounter the patients. In keeping views we as team have develop module on Recognition of Early Warning signs for Nurses to assess their knowledge, educate them and reassess their knowledge

scholarly journals Efficacy of Emergency Severity Index (ESI) in Early Identification of Patients with Sepsis and Septic Shock at Triage

2020 ◽  
Author(s):  
Emad Uddin Siddiqui ◽  
Noman Ali ◽  
Mirza Noor Ali Baig ◽  
Ahmed Raheem ◽  
Nazir Najeeb ◽  
...  
Keyword(s):  
Septic Shock ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
Area Under The Curve ◽  
Severity Index ◽  
Care Hospital ◽  
Emergency Severity Index ◽  
Optimal Cutoff ◽  
Sepsis And Septic Shock

Abstract Objectives The objective of the study is to determine the efficacy of Emergency Severity Index (ESI) tool in early recognition of “sepsis” and “septic shock” at the triage of an emergency room at a tertiary care hospital in Pakistan.Results A total of 240 patients were included in this study. The area under the curve (AUC) for the ESI score I for septic shock was 0.943 [0.921–0.964] with the optimal cutoff value of 2.0 with sensitivity of 88.5% and specificity of 100%. Similarly, the sensitivity and specificity of ESI score II for the diagnosis of sepsis was found to be 100.00% (CI 97.63–100.00%) and 66.28% (CI 55.28% to76.12%) with accuracy of 87.92% (83.11–91.76%)

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