scholarly journals Pediatric Autoimmune encephalitis: Experience from a Tertiary Care Hospital in Bangladesh

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Kanij Fatema ◽  
Md Mizanur Rahman
Keyword(s):  
Psychiatric Disorder ◽  
Movement Disorder ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Treatment Modalities ◽  
Oral Steroid ◽  
Clinical Feature ◽  
Temporal Region ◽  
Care Hospital

Background: Autoimmune encephalitis (AIE) are distinct group of encephalitis where production of autoimmune antibody causes neuroinflammation. The core clinical features are encephalopathy, psychiatric disorder, movement disorder and seizure. The investigation and treatment modalities are different from that of infectious encephalitis. There are limited studies in pediatric population in particularly in developing country like Bangladesh. Thus this study has been done to describe patients with AIE from a tertiary care hospital. Method: This is a retrospective study done in children of 1-16 year from January 2018 to December 2019. AIE was diagnosed on the basis of clinical, electrographic and neuroimaging features and was confirmed with detection of autoantibody in CSF. Treatment was given according to the published literature with immunotherapy mainly. Results: Total 15 children were studied, 14 patients were antiNMDAR encephalitis and 1 was antiMOG antibody syndrome. Mean age was 5.98 and 4.5 year respectively. Seizure was the most common clinical feature, mostly focal in nature. Other manifestations were movement disorder, psychiatric disorder, loss of consciousness etc. Most of the patients had abnormal EE, focal epileptic discharge being the commonest. Eight out of 15 had abnormal MRI of brain. Cortical  hyperintensity was important feature located mostly in temporal region. In the case of antiMOG antibody syndrome there was demyelinating lesion in multiple areas. Cornerstone of the treatment was mostly combination immunotherapy with IV methylprednisolone and IV immunoglobulin followed by oral steroid. Majority of the patients showed improvement however 3 patients had complete recovery. Complications observed were epilepsy, speech disorder, cognitive disorder, behavioural disorder, ataxia and visual impairment. Conclusion:  Timely diagnosis and prompt treatment of AIE is very important as proper treatment can cause significant improvement.  

scholarly journals Microbiological Screening and Antimicrobial Sensitivity Profiling of Wound Infections in a Tertiary Care Hospital of Bangladesh

2020 ◽  
pp. 101-106
Keyword(s):  
Wound Infection ◽  
Primary Care Physicians ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Antimicrobial Sensitivity

Wound infection is a major problem in hospitals in developing countries. Wound infection causes morbidity and prolonged hospital stay thus this prospective study was conducted for a period of seven months (January 2019 to July 2019). A total of 217 specimens (wound swabs and pus exudates) from wound infected patients in a Tertiary Care Hospital in Bangladesh. A retrospective study of the microbiological evaluation was done by cultural growth as well as Gram staining and biochemical examination to identify the bacterial isolates. Finally, the antimicrobial vulnerability testing was performed by Kirby-Bauer disc diffusion conventional method. A total of 295 samples were tested. Out of which 217 (73.5%) were found culture positive. E. coli was the most predominant gram-negative isolates whereas Staphylococcus aureus and Coagulase-negative Staphylococcus were the most commonly isolated gram-positive organisms. Antimicrobial sensitivity profile of bacterial isolates revealed imipenem, meropenem, amikacin, and nitrofurantoin to be the most effective antimicrobials against gram-negative isolates, whereas imipenem, meropenem, amikacin, nitrofurantoin, amoxiclav, and gentamicin were the most effective drugs against gram-positive isolates. The result of this examination contributes to the identification of basic causative microbes involved in wound infection and findings of antibiotic susceptibility patterns can be helpful for primary care physicians to optimize the treatment modalities, articulate policies for empiric antimicrobial therapy, and to minimize the rate of infection among wound infected patients.

scholarly journals Role of therapeutic phlebotomy in management of case of porphyria cutanea tarda (PCT) admitted in tertiary care hospital Vadodara  

2020 ◽  
Vol 8 (1) ◽  
pp. 4-6
Author(s):  
Ashu Dogra
Keyword(s):  
Aminolevulinic Acid ◽  
Tertiary Care Hospital ◽  
Porphyria Cutanea Tarda ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Clinical Feature ◽  
Care Hospital ◽  
Skin Symptoms ◽  
Characteristic Clinical Feature

Porphyria cutanea tarda is the most frequent type of Porphyria worldwide & presents with skin symptoms mainly. Porphyrias can affect peripheral, autonomic and central nervous system. In Porphyria conditions there is accumulation of heme precursors 5 Aminolevulinic acid, Porphobilinogen and porphyrins which are associated with characteristic clinical feature with acute neurovisceral attacks and skin lesions. This case report summarizes Case of PCT that was successfully managed with Therapeutic Phlebotomy.

scholarly journals Characteristics and clinical features of children presenting with acute myocarditis at a tertiary care hospital.

2021 ◽  
Vol 28 (12) ◽  
pp. 1701-1704
Author(s):  
Farhan Zahoor ◽  
Bushra Madni ◽  
Muhammad Imran ◽  
Muhammad Naveed ◽  
Fazal ur Rehman ◽  
...  
Keyword(s):  
Clinical Features ◽  
Rural Areas ◽  
Tertiary Care Hospital ◽  
Acute Myocarditis ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Clinical Feature ◽  
Care Hospital ◽  
Male Predominance

Objective: To find out characteristics and clinical features of children presenting with acute myocarditis at a tertiary care hospital. Study Design: Observational Study. Setting: Department of Pediatrics, Sughra Shafi Medical Complex, Sahara Medical College, Narowal, Pakistan. Period: February 2020 to February 2021. Material & Methods: A total of 71 children aged 1 month to 15 years admitted with acute myocarditis were enrolled. Acute myocarditis was labeled as short history of illness in otherwise healthy child, echocardiography evident of left ventricular dysfunctioning, cardiac biomarkers showing cardiac damage as well as electrocardiography showing acute myocarditis. Age was represented as mean and standard deviation whereas qualitative variables like gender, area of residence and clinical features were shown as frequency and percentages. Results: Out of a total of 71 children, there were 38 (53.5%) were male. Median age was recorded to be 16.6 months. Majority of the cases, 42 (59.2%) belonged to rural areas of residence. Tachycardia was the commonest clinical feature noted in 65 (91.5%) children, irritability was seen in 50 (70.4%), tachypnea in 48 (67.6%) while poor feeding was noted 44 (62.0%) children. Hepatomegaly was noted in 39 (54.9%) children. Hypotension was recorded in 35 (49.3%) children. Conclusion: Male predominance was seen among children presenting with acute myocarditis. Tachycardia, irritability, tachypnea and poor feeding were the commonest clinical features observed.

scholarly journals Prevalence of Intermediate Syndrome among Admitted Patients with Organophosphorous Poisoning in a Tertiary Care Hospital

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Ananta Uprety ◽  
Binod Pantha ◽  
Lochan Karki ◽  
Suresh Prasad Nepal ◽  
Milan Khadka
Keyword(s):  
Binary Data ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Clinical Feature ◽  
Point Estimate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Ethical Approval ◽  
History Of

Introduction: Organophosphorous poisoning is a common problem prevalent in Nepal. Intermediate syndrome is a common clinical feature seen among the patients those have ingested poison. There is a scarcity of data related to intermediate syndrome and other general complications in patients with organophosphorous poisoning in context of Nepal. This study was carried out to observe the prevalence of intermediate syndrome and the general complications of oraganophosphorus poisoning among admitted patients in a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted at a tertiary care hospital from April 2008 to June 2009 after ethical approval was from Institiutional Review Board of tertiary care hospital. Forty four patients with history of ingestion of organophosphorus poisoning within 24 hours were included in our study through convenience sampling. Clinical examinations were done to look for Intermediate syndrome. Data was entered in Statistical Package for Social Sciences and point estimate at 95% of CI was calculated along with frequency and proportion for binary data. Results: Out of 44 patients, features of intermediate syndrome were seen in 40 (90.9%) at 95% of CI (84.2-97.6) patients in the study. The frequency of intermediate syndrome signs like weakness of neck flexion, inability to sit up and swallowing difficulty were seen among the patients. Complications like pneumonia 4 (9.09%), hyponatremia 3 (6.8%), hypokalemia 1 (2.27%) and bradycardia 1 (2.27%) were seen in the study. Mortality seen in the study was 2 (4.5%) among the admitted patients. Conclusions: Prevalence of intermediate syndrome was higher compared to other studies done in similar settings. Complications like pneumonia, hyponatremia, hypokalemia and bradycardia were seen among the patients.

scholarly journals Treatment modalities for scrotal swellings and its outcome at a tertiary care hospital

2019 ◽  
Vol 3 (3) ◽  
pp. 387-390
Author(s):  
Dr. Saiyad Jameer Bhasha T ◽  
Dr. Mohamed Afjal ◽  
Dr. Syed Shahid Irfan
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Modalities ◽  
Care Hospital

scholarly journals Clinicohematological profile of pancytopenia: a study from a tertiary care hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 478
Author(s):  
Rakesh Kumar Yadav ◽  
Sujit Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Clinical Feature ◽  
Study Group ◽  
Care Hospital ◽  
Female Ratio ◽  
B12 Deficiency

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.

scholarly journals STUDY OF CLINICO-RADIOLOGICAL PARAMETERS IN DIAGNOSIS OF PEDIATRIC TUBERCULOSIS AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 1-3
Author(s):  
Bhanu Desai ◽  
Rushi Patel ◽  
Yashvi Vijaykumar Dattani ◽  
Tamannaben Rameshbhai Ninama ◽  
Amay Himanshu Khara ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Clinical Feature ◽  
Care Hospital ◽  
Pulmonary Tb ◽  
Microbiological Testing ◽  
Childhood Tb ◽  
Pediatric Tuberculosis

Background: Global TB burden in India in children is about 2.2 lakh per year, among which pulmonary TB is most common presentation. Childhood TB contributes to about 10-20% of all TB in high burden countries and accounting for 8-20% TB related deaths. Children up to 14 years constitute about 35% of the population in our country and are expected to contribute about 10% of the case load. In order to achieve ‘Zero death by TB’, additional focus has to be directed towards TB in children. Paediatric clinical feature is variable in tuberculosis. Many cases of primary TB infection in children are asymptomatic and remain completely unnoticed or accidentally discovered at a later stage. In this study we looked for clinical and radiological presentation of childhood TB and its correlation in diagnosis within a period of 1 year in a tertiary care hospital. Methods: Total 254 children suspected of having tuberculosis were enrolled in the study and various microbiological, laboratory and radiological tests were used to diagnose the patients. Clinical samples were processed using standardized protocols. CBNAAT was the initial test of choice for microbiological confirmation. Results: Among 254 children, 69(27%) had pulmonary tuberculosis, extrapulmonary tuberculosis was found in 76(30%) children. Fever was the most common (in 100% cases) symptom in pulmonary TB. Most common radiological presentation was segmental consolidation (44%). Amongst 69 pulmonary TB patients, 16(23%) were Rifampicin resistant by CBNAAT method. Conclusion: Primary childhood TB being paucibacillary, makes microbiological diagnosis (gold standard) difficult. In relevant clinical setting, certain radiological lesions may be highly suggestive of tuberculosis: miliary pattern, hilar and/or paratracheal lymphadenopathy with or without parenchymal involvement and fibro-cavitatory lesions. All presumptive TB cases with these radiological patterns are considered to be probable TB and should be subjected to microbiological testing to confirm the diagnosis.

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