scholarly journals Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 637
Author(s):  
Romi Bansal ◽  
Priyanka Garg ◽  
Aastha Garg
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Tertiary Care ◽  
Anaerobic Bacteria ◽  
Diagnostic Methods ◽  
North India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Vaginal Ph ◽  
Criteria For Diagnosis

Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.

scholarly journals Clinical profile of pediatric patients with tuberculosis in a tertiary care centre in India

2020 ◽  
Vol 7 (9) ◽  
pp. 1906
Author(s):  
Ashna Kumar ◽  
Javid Ahmad ◽  
Pooja Bharti ◽  
Vasundhara Bakshi
Keyword(s):  
Pediatric Population ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Abdominal Tuberculosis ◽  
Childhood Tuberculosis ◽  
Diagnostic Methods ◽  
North India ◽  
Tuberculous Lymphadenitis ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: India has one of the highest TB burden globally. Children contribute a significant proportion of TB burden, in whom the diagnosis can be challenging because many childhood diseases mimic TB. Therefore, a high index of suspicion is required for early diagnosis of childhood tuberculosis to prevent poor outcome. Objectives was to evaluate the prevalence and profile of childhood tuberculosis cases and to determine the risk factorsMethods: An observational cross-sectional study was conducted over a period of 6 months at a hospital in north India and the prevalence and profile of the children admitted with the clinical suspicion of tuberculosis was studied. Case specific diagnostic approach was used for diagnosis and the appropriate treatment was instituted.Results: The prevalence of childhood TB was 2.3% among hospitalized children. Of these, 66.5% were males and 33.49% were females. The majority of cases were more than 8 years. The history of contact was present only in 31.1%. Tuberculin skin test was positive in 53.11%. Pulmonary tuberculosis was the most common type of childhood tuberculosis (45.45%) followed by neurological tuberculosis (42.8%), abdominal tuberculosis (6.45%), tuberculous lymphadenitis (2.63%), others (2.61%). Malnutrition was a potent contributing factor present in 91.86%. The mortality rate observed in the study was 9.56%.Conclusions: Owing to the high burden of tuberculosis among pediatric population in India, there is an alarming need to develop more economical and advanced diagnostic methods for better patient management and above all there is urgent need of the hour to educate the masses about the transmission and risk factors for this disease.

scholarly journals Assessment of Various Laboratory Diagnostic Methods in Diagnosis of Cutaneous Tuberculosis. A Study from A Tertiary Care Hospital of North India

2021 ◽  
Author(s):  
Shoaib Khan ◽  
Nahid Nahvi ◽  
Umara Amin ◽  
Yousuf Ul Bashir ◽  
Danish Zahoor
Keyword(s):  
Tertiary Care ◽  
Culture Method ◽  
Diagnostic Methods ◽  
North India ◽  
Care Hospital ◽  
Age Group ◽  
Cutaneous Tuberculosis ◽  
Standard Culture ◽  
Lowenstein Jensen ◽  
Culture Positive

Cutaneous tuberculosis (CTB) is the rarest case of extrapulmonary TB comprising 2% of total cases. It’s often a challenge both clinically and diagnostically. 1) To determine prevalence, age & gender-wise distribution of CTB. 2) To assess various diagnostic, microbiological modalities for the diagnosis of CTB. 76 skin biopsy specimens from suspected CTB lesions were analysed using following methods – Acid-fast Bacilli (AFB) staining (Ziehl-Neelsen method), growth of mycobacteria in culture (Lowenstein-Jensen media), and Gene Xpert MTB/RIF, Histopathological (H&E staining). Of the 76 specimens, 44 were males and 32 were females. The most commonly affected age group was 40–59 years. Infections were least common in 0-19 years age group. AFB was not seen in any of the primary smears. 10 were confirmed as CTB by the recovery of Mycobacterium in solid culture. Of the 10 culture positives, 9 were confirmed as MTB, and 1 was found to be NTM. Staining of 10 culture positive specimens revealed acid fast, beaded rods. Detection of MTB by Gene Xpert gave positive result in 9 cases with all RIF sensitive. All 9 PCR confirmed cases were also culture positive, all 9 were slow growers with a minimum of 5 weeks required for growth on the LJ slant. PCR is the test of choice and should be performed on all specimens of suspected CTB. However when coupled with the “gold standard” culture method, the diagnostic accuracy improves. Also, further, culture helps in identification and isolation of NTM’s.

scholarly journals Clinical and dermoscopic patterns of childhood alopecia areata in a tertiary care centre in North India

2021 ◽  
Vol 7 (6) ◽  
pp. 811
Author(s):  
Pooja Bains ◽  
Simplepreet Kaur
Keyword(s):  
Alopecia Areata ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Common Site ◽  
Tertiary Care Centre ◽  
Exclamation Mark ◽  
Epidemiologic Profile ◽  
The Mean

<p class="abstract"><strong>Background:</strong> To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.</p><p class="abstract"><strong>Methods:</strong> The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.</p><p class="abstract"><strong>Results: </strong>The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).</p><p class="abstract"><strong>Conclusions:</strong> No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.</p>

scholarly journals Utility of pleural fluid adenosine deaminase in diagnosing tubercular pleural effusion: a prospective observational study in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1711
Author(s):  
Gayathri Devi H. J. ◽  
Sujith H.
Keyword(s):  
Pleural Effusion ◽  
Observational Study ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Diagnostic Methods ◽  
Care Hospital

Background: The diagnosis of Tubercular (TB) pleural effusion continues to be a challenge in clinical practice, as traditional diagnostic methods are useful but do not provide enough sensitivity and specificity.Methods: This was a prospective observational study carried out at Tertiary care Hospital with study population of 76 patients. Etiological diagnosis was based on clinical history with radiological imaging, biochemical and cytological examination of pleural fluid. Pleural fluid ADA was used as a biomarker for the diagnosis of tubercular pleural effusion.Results: The study included 76 patients with 69.7% (n=53) males and 30.3%(n=23) females. The mean age of patients was 48.97 17.03 years. Of 76 cases of pleural effusion, 62 were exudates and 14 transudates. Tuberculosis was the most common cause among exudates which accounted for 51.3% (n=39) of cases. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), Accuracy of pleural fluid ADA in diagnosing tubercular pleural effusion was 92.3%, 97.3%, 97%, 92% and 94.7% respectively.Conclusions: Pleural fluid ADA can be one of the most reliable biomarkers for the diagnosis of TB pleural effusion considering its high sensitivity and specificity.

scholarly journals Determining the Prevalence of Rifampicin Resistant Tuberculosis in A Tertiary Care Centre of North India by using Rapid Culture Method and Gene Xpert

2021 ◽  
Author(s):  
Bipin Chandra Pokhriyal ◽  
Dimple Raina ◽  
Iva Chandola ◽  
Nidhi Negi ◽  
Hitendra Singh ◽  
...  
Keyword(s):  
Predictive Value ◽  
Tertiary Care ◽  
Culture Method ◽  
Drug Susceptibility Testing ◽  
North India ◽  
Reference Laboratory ◽  
Age Group ◽  
Becton Dickinson ◽  
Tertiary Care Centre ◽  
Diagnostic Efficacy

The objective of the present study is to find the prevalence of Mycobacterium tuberculosis from respiratory samples like sputum, BAL and pleural fluid, compare conventional LJ culture with rapid culture method i.e Mycobacterium growth indicator tube (MGIT) and to determine the pattern of drug resistance by automated methods i.e Gene Xpert. Respiratory samples were collected in sterile, wide-mouth, disposable, leak proof containers without any preservatives. Specimens were inoculated into MGIT for primary isolation of Mycobacteria. The specimen was processed according to the SOP manual provided by Becton Dickinson Company. The tubes were read for increasing fluorescence by MGIT reader. Reported results only when a MGIT tube was positive by the MGIT reader and smear made from the positive broth is also positive for AFB. For further identification, TBcID card test was put from MGIT positive tube and the result was given accordingly as mentioned in the procedure for TBcID kit insert. Polymerase chain reaction (PCR) was done in all 17 positive cases. The drug sensitivity test (CB-NAAT) was done at State Intermediate Reference Laboratory, Chandan Nagar, Dehradun, Uttrakhand as per RNTCP laboratory operational guidelines. In our study total number of samples received from the clinically suspected cases of pulmonary tuberculosis were 156, out of which 11% were positive and 89% were negative. The predominant age group involved was 51-60 years 24%, followed by 61-70 years 22%. In young children and adolescent age group very less number of samples were received i.e. 0-5%. Out of 17 positive samples, 94.11% (16/17) were detected as sensitive for Rifampicin and 5.89% (1/17) were resistant. On the statistical analysis of our data for MGIT, Positive Predictive Value (PPV) was 29% against Negative Predictive Value (NPV) of 100%. The specificity of MGIT was 92% against a sensitivity of 100%. Culture is still needed for species identification, confirmation and drug susceptibility testing. The diagnostic superiority of MGIT, both in terms of sensitivity and specificity has been proven better as compared to LJ in previous other studies and supported by our study as well. In our study, the diagnostic efficacy of MGIT culture was found to be superior as compared to the conventional LJ culture. The positivity rate was 10.89% (17/156) in MGIT & 3.2% (5/156) in LJ culture.

scholarly journals Changing trends in elective splenectomy at a tertiary hospital in North India - a 10year study.

2017 ◽  
Vol 4 (8) ◽  
pp. 2589
Author(s):  
Babar Rehmani ◽  
Navin Kumar ◽  
Priyank Pathak
Keyword(s):  
Portal Hypertension ◽  
Prospective Observational Study ◽  
Therapeutic Option ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
North India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Vaccination Rates ◽  
Age Range

Background: Spleen is the meeting ground of medicine and surgery and most patients for elective splenectomy are primarily evaluated by physicians and then referred to the surgeons. Both physicians and surgeons need to be aware of the utility of splenectomy as a therapeutic option in various medical conditions. This study looks at the indications for elective splenectomy and the outcomes over a decade at a tertiary care centre in North India. It also evaluates the adherence to protocols recommended for prevention of OPSI in adults.Methods: A hospital based prospective observational study was conducted at a tertiary care hospital situated in Uttarakhand, North India, over a duration of 10 years from October 2006 to October 2016. The inclusion criteria for the study were all the patients undergoing splenectomy for the non-traumatic indications.Results: Sixty-one patients underwent splenectomy in the 10 years’ duration. The age range of patients was from 17-79 years with twenty-six males and rest females. Hypersplenism was the commonest indication for splenectomy. There were eleven cases of primary hypersplenism and there were twenty-five cases of secondary hypersplenism. Portal hypertension was the main cause of secondary hypersplenism requiring splenectomy.Conclusions: The major indications of elective splenectomy were hypersplenism secondary to portal hypertension due to EHPVO and haematological disorders mainly ITP. Mortality is 2.4% and morbidity is 21.4%. Vaccination rates of 75% were seen in planned splenectomy however, no case of OPSI recorded in this series.

scholarly journals A prospective study to evaluate the predictive value of ocular trauma score in cases of mechanical eye injuries in a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 523-527
Author(s):  
Arvind Kumar ◽  
Rupali Verma ◽  
Abha Shukla
Keyword(s):  
Predictive Value ◽  
Ocular Trauma ◽  
Tertiary Care ◽  
Common Source ◽  
Care Hospital ◽  
Eye Injuries ◽  
Tertiary Care Centre ◽  
Ocular Trauma Score ◽  
Globe Rupture ◽  
Trauma Score

Ocular trauma score (OTS) was proposed to predict the visual outcome of patients after ocular trauma, which estimates visual function (visual acuity) after 6 months of ocular trauma. This OTS scale is useful for guiding the treatment and rehabilitation of the patients with eye injury and to provide the valuable information and advice. Aim of this study was to evaluate the predictive value of OTS in cases of mechanical ocular trauma. A prospective interventional study was carried out in a tertiary care centre over a period of 2 years; August 2017 to July 2019. Patients with mechanical eye trauma were included in the study. OTS score was calculated and recorded for each eye at the time of injury. Proper treatment given to each case and followed for six months. Results obtained were compared with standard OTS with respect to final VA. Out of 50 patients mean age was 28.46 years, with majority between 21 to 50 years of age. There were 78% males and 22% were females. Metallic objects were the common source of injury in 27 cases (54%) like iron rod and nail. In cases (fifty eyes) the distribution of OTS variables was; globe rupture 86% (43 eyes), retinal detachment 6% (3 eyes), relative afferent pupillary defect (RAPD) 6% and endophthalmitis 2% (1 eye) respectively. The final visual acuities in OTS categories in our study groups were similar to those in the OTS study group, except for some categories. OTS helps treating ophthalmic team to assess evidence based prognosis of a traumatized eye in advance. With the guidance of OTS the patient and their family can be counselled for further management.

Diagnosis of Bacterial Vaginosis by Conventional Methods in the Patients at a Tertiary Care Hospital

2016 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Ved Prakash ◽  
Prem P Mishra ◽  
Lata Agrawal ◽  
HK Premi
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Health Concern ◽  
Care Hospital ◽  
Age Group ◽  
Vaginal Ph ◽  
Conventional Methods

ABSTRACT Background Bacterial vaginosis (BV) is highly prevalent among women especially in reproductive age group but it is found also in other age groups. Bacterial vaginosis is a great health concern in India because of its complications. Most of the healthcare centers in India are not well-versed in advance diagnostics for BV. Aim To assess the utility of conventional methods for diagnostic evaluation of BV in the patients of different age groups. Materials and methods In this 1 year cross-sectional study, the vaginal swabs were collected from women with signs and symptoms of BV like complaints of vaginal discharge, odor, itching, back ache, etc. attending the department of obstetrics and gynecology of a tertiary care hospital in Western UP. These specimens are subjected to vaginal pH determination and are sent to department of microbiology for Gram stain, wet-mount and whiff test. Amsel's criteria were used for confirming BV. Results A total of 206 women included in the study, n = 63 (29.61%) were found to be having BV based on Amsel's criteria. The mean age of the females were found to be 30.77 years. The most affected age group was found to be 26 to 35 years, n = 33 (54%). The vaginal pH was significantly higher in n = 61 (29.61%) women with BV. Vaginal discharge was prevalent in n = 108 (52.43%) women. Presence of clue cells and positive whiff test were found to be in n = 63 (30.58%) and n = 61(29.61%). Conclusion The characteristics of vaginal discharge, vaginal pH determination, clue cells and whiff test is relatively easier conventional methods for diagnosis of women with BV where better facilities are lacking. These tests are suitable for screening women with BV and in formulating the treatment to check the complications. How to cite this article Mishra PP, Prakash V, Agrawal L, Premi HK. Diagnosis of Bacterial Vaginosis by Conventional Methods in the Patients at a Tertiary Care Hospital. Int J Adv Integ Med Sci 2016;1(1):1-3.

scholarly journals Prescribing pattern in outpatient department of neurosurgery in a tertiary care hospital of North India

2019 ◽  
Vol 7 (7) ◽  
pp. 2798
Author(s):  
Rehana Tabassum ◽  
Syed Sajad Hussain ◽  
Sajad Hussain Arif ◽  
Altaf Ramzan ◽  
Samina Farhat
Keyword(s):  
Lumbar Disc ◽  
Tertiary Care ◽  
Outpatient Department ◽  
North India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Prescribing Pattern ◽  
Prescription Pattern ◽  
Mortality And Morbidity ◽  
Management Protocol

Background: The neurosurgical disorders are amongst the leading cause of global mortality and morbidity. Though surgical intervention is thought to be the main management protocol in the neurosurgical setup but drugs are being equally used especially in the outpatient setting. The present study was carried out in view of the sparse data available on prescribing pattern in neurosurgery.Methods: The present study was conducted by the department of pharmacology in outpatient department of neurosurgery in a tertiary care centre to look into the prescription pattern among these patients.Results: In 268 patients analyzed, mean age was 43.02±15.93 years and 52.23% were females. Majority of our participants (44%) were found to be of young to middle age group (21-40 years). The diagnosis among the study population was spread over large number of diseases. Lumbar Disc Prolapse (LDP) was found to be the leading cause of neurosurgical morbidity, amounting to 32%. As far as the prescription of various drugs in the outpatient of neurosurgery is concerned, Analgesics were the most common drugs prescribed constituting about 48% of the total drugs prescribed followed by GABA analogues and multivitamins which equally formed 41% of the total prescribed drugs.Conclusions: Although the prescription pattern studies among the outpatient neurosurgery patients are very scant, the analysis of prescription studies will be helpful to encourage the rational drug prescribing pattern.

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