scholarly journals Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Wajid Jawaid ◽  
Muhammad Irfan ◽  
Sundus Mehtab Shafee ◽  
Sidra Javed Barry ◽  
Sayed Mustafa Mahmood Shah ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Status Epilepticus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Male Gender ◽  
Care Hospital ◽  
Factors Affecting ◽  
Cns Infections ◽  
History Of

Objectives: This study aimed to evaluate the etiology, outcomes and prognostic factors associated with status epilepticus (SE) admissions in Neurology Department of a tertiary care hospital. Methods: A retrospective review was performed on all SE admissions at Dr. Ruth K.M. Pfau Civil Hospital Karachi over a five-year period from July 2015 to June 2020. Demographic, clinical, and etiological factors were investigated for prognostic value. Statistical tests were applied to determine significant prognostic factors. A five percent significance level was used. Results: A total of 176 patients were included in the study. Mortality was reported in 22 cases (12.5%) and morbidity at six months was observed in 44 cases (25.0%). Male gender, previous history of SE, prolonged seizure duration, and late presentation to hospital were significantly associated with mortality (p<0.05). De novo cases of SE tended to be older (p=0.048) and were associated with morbidity at follow-up (p=0.000). The most common causes of epilepsy in our patients with SE were CNS infections (n=54) and Idiopathic epilepsy (n=34). Non-compliance to medicines/under-dosing was the most common provocative factor (n=68). Acute symptomatic causes of SE were more likely to be associated with greater morbidity (p=0.000). Refractory and super-refractory SE were strongly associated with higher mortality (p=0.000). A longer duration of hospital stay was associated with higher morbidity (p=0.000). Conclusion: Male gender, poor control of seizures, CNS infections, prolonged seizures, delayed hospital arrival and refractory/super-refractory status epilepticus were key determinants of mortality in our setting. Previous history of status epilepticus, and acute and symptomatic etiologies were associated with higher morbidity. doi: https://doi.org/10.12669/pjms.38.1.5195 How to cite this:Jawaid W, Irfan M, Shafee SM, Barry SJ, Shah SMM, Shahbaz N. Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.5195 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 A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India

2017 ◽  
Vol 7 (1) ◽  
pp. 266
Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Care Hospital ◽  
History Of ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.

scholarly journals Prevalence and associate risk factors of asymptomatic bacteriuria in pregnancy with bacterial pathogens and their antimicrobial susceptibility in a tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 558 ◽  
Author(s):  
Udayagiri Venkata Rohini ◽  
Gurram Swetha Reddy ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Asymptomatic Bacteriuria ◽  
Diffusion Method ◽  
Care Hospital ◽  
History Of

Background: Asymptomatic bacteriuria (ASB) is defined as the presence of actively multiplying bacteria, which is greater than 105/ ml of urine within the urinary tract excluding the distal urethra, at a time when the patient has no symptoms of UTI. Untreated and undiagnosed ASB is associated with adverse maternal and perinatal outcomes. The objective was to determine the profile, prevalence, microbiological isolates with susceptibility, and risk factors of ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Andhra Pradesh, India.Methods: A prospective cross sectional study with 200 pregnant women was conducted for a period of 3 months from January to March 2016. The mid- stream urine specimen was collected and processed from all the cases and social and baseline obstetric data was collected. The isolates from all the cases of ASB were identified by standard biochemical tests. Antimicrobial susceptibility was performed by Kirby- Bauer disc diffusion method and interpreted as per CLSI guidelines.Results: Prevalence of ASB in our study was 30.5%, mean age of the cases was 27.3± 2.9 years. ASB was most common in 25- 30 year’s age group, during 3rd trimester and among multiparous and multigravidae. Previous history of UTI, pre-eclampsia was having significant association among cases with ASB. Escherichia coli was the predominant isolate in the study followed by K. pneumoniae, CONS (Coagulase-Negative Staphylococci), Staphylococcus aureus, citrobacter and Enterococci.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women during all trimesters must be considered in preventing the complications and adverse foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.

scholarly journals A study on risk factors of abortion in a tertiary care hospital in Thrissur District, Kerala

2020 ◽  
Vol 9 (10) ◽  
pp. 4118
Author(s):  
Vivek Sunil ◽  
Sruthi Mankara Valsan
Keyword(s):  
Risk Factors ◽  
Genetic Factors ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Care Hospital ◽  
Infectious Agents ◽  
History Of ◽  
Control Study

Background: Abortion is the spontaneous termination of pregnancy before 22 weeks or if the foetus weighs less than 500 gm. Spontaneous abortions may occur as a result of genetic factors, infectious agents, uterine abnormalities and other maternal factors. The present study was undertaken to study risk factors of abortion in a tertiary care hospital in Thrissur district.Methods: A hospital based case control study was done during a five month period. The sample size was calculated using the formulae [(Zα + Zβ)2 × 2 × PQ]/d2. Total 40 mothers admitted with abortion were taken as cases and 40 mothers admitted with conditions other than abortion of the same trimester were taken as controls. Data was collected with the help of an interviewer administered semi structured questionnaire.Results: Out of total 80 mothers, 46.2% of them belongs to 21-25 age group and more than half, 66.2% of the mothers were primi gravida. There was a statistically significant association between mother’s occupation and occurrence of abortion. The abortion rates were higher among overweight mothers, but this difference was not statistically significant. Among obstetric determinants, previous history of abortion, primi gravida mothers, and history of travel had higher risk for abortion with odds ratio 3.5, 2.8, and 2.72 respectively.Conclusions: Previous history of abortion and history of travel contributes to higher risk of abortion. Interventions could be targeted more on women with prevalent risk factors to increase health profits.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Congenital Heart ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

scholarly journals The clinical study of dermatophytosis in a tertiary care hospital of konkan region, Maharashtra

2021 ◽  
Vol 7 (4) ◽  
pp. 315-319
Author(s):  
U Ketan Raju ◽  
Hanamant G Bobade ◽  
Anil Mishra
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hair Shaft ◽  
Care Hospital ◽  
Common Site ◽  
Tinea Cruris ◽  
Nail Changes ◽  
Male Preponderance ◽  
History Of ◽  
Epidemiological Characteristics

Dermatophytes are aerobic fungi that produce proteases that digest keratin and allows colonization, invasion and infection of the stratum corneum of the skin, the hair shaft, and the nail. This study was an attempt on the part of the author to find out the incidence and various clinico-epidemiological characteristics of Dermatophytosis in skin OPD of Tertiary care Hospital, B.K.L.W.R.M.C., Dervan. The study was carried on 2444 patients of Dermatophytosis attending the OPD, out of which 49.79% of the cases were Tinea Cruris (TC). The age group of 11-20 years showed maximum prevalence of Dermatophytosis (22.17%). 58% of the patients had diffuse lesions. Body involvement was seen in 87% of cases. Itching was the most common condition associated with Dermatophytosis. 35% of the patients reported with family history of Tinea Cruris.Circumscribed variety of TC was found to be most common variant mostly observed in 2and 4 decade, with a male preponderance. Groin was the most common site with multiple lesions. Nail changes was most commonly associated with TC.

scholarly journals Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Research Centre ◽  
Care Hospital ◽  
Microbiological Techniques ◽  
History Of ◽  
Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

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