scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

scholarly journals Persistence of Symptoms after Acute COVID-19 Infection- An Experience from a Tertiary Care Centre in South India

2021 ◽  
Author(s):  
Binu Areekal ◽  
Sudhiraj Thiruthara Sukumaran ◽  
Andrews Mekkattukunnel Andrews ◽  
Sreejith Parayil Nanu ◽  
Indira Madhavan ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Tertiary Care ◽  
Structured Interview ◽  
P Value ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Persistent Symptoms ◽  
Number Of Patients

Introduction: Coronavirus Disease-19 (COVID-19) pandemic is posing a challenge not only with sheer number of people infected but also with the large number of patients with persistent symptoms of COVID-19 infection. A proper understanding of the magnitude and associated factors of persistent COVID-19 symptoms will go a long way in planning treatment and control strategies. Aim: To determine the proportion of patients who have persistent symptoms post acute COVID-19 infection and to determine the factors associated with it, among those who have been discharged from Government Medical College, Thrissur, Kerala, India. Materials and Methods: The current cross-sectional study was conducted among 335 patients who were admitted and discharged with COVID-19 infection in Government Medical College, Thrissur, Kerala, a tertiary care institution in southern India between December 2020 and February 2021. They were contacted through a telephonic interview 28 days from symptom onset through a semi-structured interview schedule. The questions included basic demographic details, symptomatology at admission, persistent symptoms at 28 days after onset and other clinical details including comorbidities. For defining post COVID-19 symptom persistence National Institute for Health and Care (NICE) guidelines were used. Association between persistent symptoms and selected factors was done by Chi-square test. Results: Out of the 335 patients, the persistence of symptoms of COVID-19 infection after 28 days of symptom onset was 221 (66%) (CI 60.7-79.8). Persistence of two or more COVID-19 symptoms after 28 days of onset was seen in 120 (35.8%). The most common persistent symptoms among the patients were fatigue in 109 (32.5%) of people followed by dyspnoea in 77 (23%), cough in 45 (13.4%) and myalgia in 37 (11%) patients. Highest persistence was seen in Category C patients where symptoms were persisting in 75%. Persistence was also higher in those with Diabetes Mellitus (DM), those who received oxygen support and those who were in Intensive Care Unit (ICU) or on ventilator and the association was statistically significant (p-value <0.05). Conclusion: The study shows that two-third of patients still continues to have persistent symptoms even after 28 days of symptom onset. Health systems should be prepared to face the consequences of morbidities caused by post COVID-19 syndrome.

scholarly journals Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India

2017 ◽  
Vol 5 (7) ◽  
pp. 3059 ◽  
Author(s):  
V. Sujaritha ◽  
M. Partheeban ◽  
T. Thiviya ◽  
M. Sowmiya
Keyword(s):  
Mental Illness ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Educational Status ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Gender Influence ◽  
Positive Attitudes ◽  
Doctors And Nurses

Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude.

scholarly journals Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire
Keyword(s):  
Perinatal Death ◽  
Early Recognition ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Maternal Outcomes ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Common Causes

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed

scholarly journals Cross sectional study to assess the awareness of pharmacovigilance among post graduate residents of tertiary care medical college hospital of central India

2018 ◽  
Vol 7 (3) ◽  
pp. 386
Author(s):  
Pooja Solanki Mishra ◽  
Gopal Gudsurkar
Keyword(s):  
Graduate Student ◽  
Single Point ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Post Graduate ◽  
Global Database ◽  
Medical College ◽  
Post Graduate Student

Background: Pharmacovigilance knowledge and awareness in post graduate student doctors is key factor for proper implementation of PvPI. This study was planned to evaluate the knowledge &awareness of pharmacovigilance in post graduate students in tertiary care centre in Indore.Methods: It was a single point cross sectional questionnaire-based study conducted in a tertiary care Institute MGM Medical College & M.Y. Hospital in the state of Madhya Pradesh at Indore. It was conducted among post graduate student doctors from various clinical departments. Total of 150 questionnaires were distributed, 115 of them were returned back and were analysed.Results: Overall knowledge level was satisfactory. 91.30% knew about ADR while 95% were aware about PVPI. 13% knew about local AMC at Indore while only 4.34% knew global centre for Pharmacovigilance is at Sweden Uppsala. 86.95% thought Med watch as global database for ADR against only 13% knew its Vigibase. 96.50% thought ADR reporting is necessary. 97.40% thought it should be included in UG curriculum. 95.65% had not reported any ADR till date while 86.95% had not seen an ADR form.Conclusions: Post graduate doctors are the prime candidates to impart the importance of pharmacovigilance. The study strongly suggested that there was a great need to create awareness among the post graduate doctors to improve the reporting of ADRs.

scholarly journals Magnitude of hypothyroidism among patients of cholelithiasis in a tertiary care centre in rural West Bengal: a prospective study

2021 ◽  
Vol 8 (11) ◽  
pp. 3375
Author(s):  
Jaganmoy Maji ◽  
Debjyoti Mandal
Keyword(s):  
Stone Formation ◽  
Tertiary Care ◽  
Gall Stone ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Elder Patients ◽  
A Prospective Study

Background: Cholelithiasis is a common pathology of the gall bladder affecting about 10 to 15% of the adults in western countries and 2 to 29% in India. More than 80% of the patients with cholelithiasis are asymptomatic. Hypothyroidism may cause gall stone formation due to the hyperlipidemia, motility disorders affecting the bile duct and sphincter of Oddi.Methods: This was a descriptive cross-sectional study conducted at Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura from March 2019 to February 2020 for duration of one and half year. The sample size was 54 and consecutive non-probability sampling technique was used for the sampling. All the collected data were recorded in a pre-designed proforma and analyzed in MS excel.Results: Out of 54-patients with cholelithiasis, 28% patients were from the age group 45-54 years.40% patients were hypothyroid pre-dominantly females. Among 30-female patients 11 (26.82%) were hypothyroid and among 11-male patients 2 (15.38%) were hypothyroid. Hypothyroidism in male and female was statistically significant.Conclusions: This study was introduced to determine the relationship between hypothyroidism and cholelithiasis. It was concluded that hypothyroidism was more common in female, obese and elder patients. The gender distribution of the hypothyroidism in patients with cholelithiasis was statistically significant while all other variables were statistically not significant.  

scholarly journals Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

2020 ◽  
Vol 9 (2) ◽  
pp. 516
Author(s):  
Shrusti Parmar ◽  
Nalini Sharma ◽  
Vimla Dhakar
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Public Health Issue ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Early Presentation

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.

scholarly journals Delirium in Critically ill Patients in a Tertiary Care Centre in Western Region of Nepal

2015 ◽  
Vol 12 (2) ◽  
pp. 117-120
Author(s):  
P Thapa ◽  
PK Chakraborty ◽  
JB Khattri ◽  
K Ramesh ◽  
P Sharma
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Significant Proportion ◽  
Adverse Outcomes ◽  
Tube Placement ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background Delirium affects a significant proportion of critically ill patients admitted in hospital. It is associated with various adverse outcomes. Despite its enormous prognostic significance it tends to be underdiagnosed. There is a dearth of studies on risk factors of delirium in our setting.Objectives The main objectives of this study was to find out the prevalence, rate of non recognition and risk factors associated with delirium in hospitalized critically ill patients.Methods A hospital based cross-sectional study was carried out. Data was collected using a predesigned semi-structured proforma and Intensive care delirium screening checklist was used to screen for delirium in patients admitted in various wards of Manipal teaching hospital, Pokhara, Nepal.Results Ninety five cases were included in the analysis. The mean age of study group was 58.9 ± 19.1 years. Delirium was present in 15/95 cases and it was not recognized by treating physician in about one third of cases. Odds ratio (OR) was statistically significantly increased in patients with history of stroke (OR=4.484 95% CI=1.0896;18.459), alcohol use (OR=10.792 95% CI=2.906;40.072), smoking (OR= 4.836 95% CI= 1.411;16.576), use of restraint (OR=17.143 95% CI=4.401;66.766), nasogastric tube placement (OR= 7.731 95% CI=2.348;25.452) and use of Foley’s catheter (OR=12.000 95% CI= 3.072;46.877).Conclusion About 16% of critically ill patients were found to be delirious. In about one third of the cases delirium was not recognized. Both patient related and iatrogenic factors may increase the risk of delirium in hospitalized critically ill patients.Kathmandu University Medical Journal Vol.12(2) 2014: 117-120

scholarly journals Feto-Maternal outcomes in Intrahepatic Cholestasis in Pregnancy in a Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Sita Pokhrel Ghimire ◽  
Ashima Ghimire ◽  
Gauri Shankar Jha ◽  
Manisha Chhetry ◽  
Mahanand Kumar
Keyword(s):  
Intrahepatic Cholestasis ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Liver Function Tests ◽  
Maternal Outcomes ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Cholestasis Of Pregnancy

Background Intrahepatic cholestasis of pregnancy has poor feto-maternal outcomes. To date there has been sparse publications regarding impact of intrahepatic cholestasis in feto-maternal outcomes in our setting. Therefore, we aimed to study the feto-maternal outcome in patients with intrahepatic cholestasis of pregnancy.Material and Methods A hospital based prospective cross-sectional study carried out in department of Obstetrics and Gynecology of Nobel Medical College, Biratnagar, Nepal from 1st January 2014 to 30th December 2015 in women who presented with pruritus in third trimester of pregnancy and having deranged liver function tests. All the cases were followed from admission to discharge. Socio-demographic, clinico-laboratory profile and feto-maternal outcomes were recorded in a preformed structured proforma. Descriptive statistics was used to present the data.Results Among 6,780 women admitted for delivery, 80 had cholestasis of pregnancy with incidence of 1.15%. 83% were of 18-35 years and 65% were primigravida. Most distressing symptom was generalized pruritus (75.0 %). The cesarean delivery rate was 46.25% and labor induction rate was (47.5%). Fetal complications were seen in majority of cases that included meconium aspiration syndrome 26 (32.5%), intrapartum fetal distress 21 (26.25%) and requirement of: intensive care 38 (48.75%). There were 7 perinatal and 3 neonatal deaths.Conclusion Intrahepatic cholestasis of pregnancy seems fairly common among pregnant women. It may be responsible for a large number of perinatal and neonatal deaths especially after 36 weeks of gestation. A large prospective study is needed to address the problems in time.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 20-25

scholarly journals Maternal and perinatal morbidity and mortality in COVID-19 positive obstetrics patients in tertiary care centre

2021 ◽  
Vol 10 (7) ◽  
pp. 2676
Author(s):  
Medha . ◽  
Neeta Chaudhary ◽  
Smita Tyagi ◽  
Kirtigiri G. Goswami
Keyword(s):  
Intensive Care ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Health Crisis ◽  
Medical College ◽  
Satisfactory Condition ◽  
Fluctuating Course

Background: COVID-19 disease had been declared as a public health crisis by WHO by the end of 2019. The effect of SARS-CoV-2 infection on pregnancy including symptoms, disease severity, risk of vertical transmission and perinatal and neonatal outcome have been the subject of research. Preliminary studies showed a fluctuating course of the disease ranging from asymptomatic or mild symptoms to even maternal death. However, recent evidences suggest that effect of COVID-19 infection during pregnancy may not lead to adverse maternal and neonatal outcome.Methods: In this cross sectional prospective observational study, we analysed 60 pregnant women infected with SARS- CoV-2 and their neonatal outcome, who tested positive for COVID-19 at district hospital, and were referred to Muzaffarnagar Medical College, were enrolled in this study.Results: The majority 96.7% (58) of these women were asymptomatic with cough being the most common symptom which was present in 3.3% (2) of the women. 24(75%) women developed pneumonitis radiologically, but they were asymptomatic, so intensive care was not required. Along with 76.08% (35) perinatal/neonatal outcomes were observed normal.Conclusions: In this study we observed that most of the women with COVID-19 were asymptomatic or with mild symptoms. Even though they were asymptomatic, most of the patients showed pneumonitis changes radiologically but still they didn’t require any intensive care, had good recovery postpartum and were discharged under satisfactory condition. The neonatal outcome was highly favourable.

scholarly journals Position of parotid papilla and commissure of lip in relation to maxillary occlusal plane among patients visiting a tertiary care centre of Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
P Mehta ◽  
S Chhetri
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Occlusal Plane ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Exact Position ◽  
The Mean ◽  
Edentulous Patients

Introduction: The exact position of the Parotid papilla and commissure of the lip plays a crucial role in determining the maxillary occlusal plane which directly facilitates rehabilitating edentulous patients with a removable complete denture. Since the beginning, many authors have conducted different studies regarding its position but multiple variations in its location have been noted. Also, this type of study has not been conducted in the Nepalese population which drags the urge to determine the position of these soft-tissue landmarks in context to the Nepalese population. Objective: To determine the position of parotid papilla and commissure of lip in relation to the maxillary occlusal plane. Materials and Methods: A descriptive cross-sectional study was conducted in the 45 dentate subjects visiting Nobel medical college from November 2019 to April 2020. A vestibular impression was made, stone index fabricated and vernier caliper was used to locate position of parotid papilla & commissure of lip. All the data were collected and statistically analyzed. Results: The mean measurement of distances between maxillary occlusal plane and parotid papilla was 3.69 ± 1.19 mm and between maxillary occlusal plane and commissure of lip was 0.41 ± 0.83 mm respectively. Conclusion: This study showed that the position of the parotid papilla was superior to the position of the maxillary occlusal plane with a mean distance of 3.69mm. The commissure of lip was found to be at the level of maxillary occlusion plane in highest number of cases followed by a superior position with least at the inferior position with respect to the maxillary occlusal plane.

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