scholarly journals The role of neutrophil/lymphocyte ratio in predicting the severity of sepsis in a tertiary care hospital in South India: a retrospective study

2020 ◽  
Vol 8 (5) ◽  
pp. 1624
Author(s):  
Alfy Ann George ◽  
Teju P. Thomas ◽  
Abdul Gaffoor
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
P Value ◽  
Risk Category ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background: Sepsis, a syndrome of dysregulated host response to infection leading to life-threatening organ dysfunction, is having a substantial burden in health system. The outcome in sepsis is often time dependent. None of the clinical manifestations nor the age-old markers like ESR, CRP, etc. have proven diagnostic or prognostic of sepsis. This study aims to assess the role of neutrophil: lymphocyte ratio (NLR) in assessing the severity of sepsis within the initial 24 hrs of admission.Methods: Authors did a retrospective observational study in 208 sepsis patients admitted in the MDICU. The NLR was calculated and the study population was grouped into those with an NLR of more than or equal to 5 and those with less than 5. The patients were also grouped based on the number of organs impaired due to sepsis. The association between these groups were then assessed.Results: 46 patients (60.5%) with single organ involvement had NLR <5; 30 patients (39.5%) had NLR >5; 27 patients (42.2%) with two organ involvement had NLR <5 and 37 patients (57.8%) had NLR >5. Among patients with more than two organ involvement, 8 patients (21.6%) had NLR <5 and 29 patients (78.4%) had NLR >5. It was found that there is statistically significant association between increase in number of organs involved and NLR more than 5. The chi square test value was 15.691 with a p value was less than 0.001.Conclusions: In the current study, we have evaluated the role of NLR in sepsis. NLR calculated on the day of admission is a simple parameter that helps to stratify patients into severe risk category. A significant association was found with higher NLR and the number of organs impairment in sepsis.

scholarly journals ROLE OF HEMATOLOGICAL PARAMETERS IN EARLY DIAGNOSIS OF COVID-19 IN A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang
Keyword(s):  
Early Diagnosis ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil

Comparison of Predictors of Mortality between Young and Elder Covid-19 Patients Admitted in Covid-19 Designated Tertiary Care Hospital

Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 46-54
Author(s):  
Sonal Shah ◽  
Manisha Kapdi ◽  
Jyoti Vora ◽  
Kuldeep Joshi ◽  
Pratik Patel ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Facility ◽  
Health Care Facility ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Predictors Of Mortality ◽  
Co Morbidity

Background: The outbreak of Covid-19 has led to a health emergency and economic crisis worldwide. Mortality in productive age further worsens the crisis, so it is important to understand reasons for death in productive age group. Objective: To identify predictors of mortality and to compare the intensity of rise in inflammatory markers of amongst young Covid-19 decedents in comparison with elder Covid-19 decedents. Method: Record based study of Covid-19 infected admitted patients was conducted in tertiary care hospital. Information of all (n=3131, 209 deceased and 2922 recovered patients) Covid-19 positive patient assessed . Their clinico epidemiological markers were compared between younger (18-45 years) decedents in comparision with elder decedents (>45 years). Mann–Whitney U-test and the Chi-square test for significance were used. Bivariate Multiple logistic regression was used to identify predictors in younger and elder decedents. Results: Case Fatality Rate (CFR) in Covid-19 infected patients was 2.4% and 9.7% amongst younger and elder group respectively. (OR 8.83 : 95% CI 5.9-13.2; p < 0.001). Biomarkers were raised and similar in both groups except Neutrophil Lymphocyte Ratio (NLR) was significantly higher in elder decedent while LDH was significantly higher in younger decedents. Conclusions: Males had higher CFR than females after 45 years of age, which was due to co-morbidity. Reaching late to the health care facility and high LDH were predictors in younger decedent, while male gender, co morbidities and high NLR were more important predictors in elder group.

scholarly journals The role of concha bullosa in chronic rhinosinusitis: our experience at a tertiary care hospital

2020 ◽  
Vol 6 (7) ◽  
pp. 1326
Author(s):  
Afshan Fathima ◽  
Ramappa Arabhanvi ◽  
Karthik Shamanna ◽  
Lyra Joy
Keyword(s):  
Chronic Rhinosinusitis ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Lateral Wall ◽  
Anatomical Variations ◽  
P Value ◽  
Care Hospital ◽  
Concha Bullosa ◽  
Chi Square ◽  
Chronic Maxillary Sinusitis

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis (CRS) is a common and persistent illness that otorhinolaryngologists encounter commonly. It is an important cause of morbidity and accounts for major loss of income. Anatomical variations of the lateral wall of the nose have been reported which can predispose to CRS. The aim of the present study was to determine the percentage of concha bullosa in patients with CRS and to ascertain its relationship with chronic rhinosinusitis.</p><p class="abstract"><strong>Methods:</strong> 100 patients attending the ENT outpatient department, Bangalore Medical College and Research Institute between December 2018 and 2019 were included in the study. Patients clinically diagnosed as CRS underwent diagnostic nasal endoscopy (DNE) and computed tomography (CT) scan of nose and paranasal sinuses, following which the relationship between concha bullosa and CRS was determined. The results were tabulated in excel sheet. Chi square test was applied for qualitative data.  </p><p class="abstract"><strong>Results:</strong> Of the 100 patients of CRS, 40 were males and 60 females. Of the 40 male patients, 16 showed presence of concha bullosa and of the 60 female patients, 28 showed concha bullosa. Headache (92%) was the most common presenting symptom in our study. A statistically significant correlation was noted between the presence of concha bullosa and chronic maxillary sinusitis (p value &lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> Concha bullosa is one of the most common anatomical variations of the lateral wall of the nose. The presence of concha bullosa plays a significant role in the development of chronic rhinosinusitis particularly in chronic maxillary sinusitis.</p>

scholarly journals Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region

2020 ◽  
Vol 17 (12) ◽  
pp. 4516 ◽  
Author(s):  
Narcisa Muresu ◽  
Giovanni Sotgiu ◽  
Laura Saderi ◽  
Illari Sechi ◽  
Antonio Cossu ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Tertiary Care ◽  
Scale Up ◽  
Anal Carcinoma ◽  
Detection Methods ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Hpv Genotypes

Objectives: Anal cancer is a rare disease. However, its incidence is increasing in some population groups. Infection caused by Human Papillomavirus (HPV) is strongly associated with the risk of anal cancer, whose variability depends on samples, histology, and HPV detection methods. The aim of the study was to assess prevalence and distribution of HPV genotypes in patients diagnosed with anal carcinoma. Methods: An observational, retrospective study was carried out in a tertiary care hospital in North Sardinia, Italy. Specimens of anal cancer diagnosed from 2002–2018 were selected. Demographic, epidemiological, and clinical variables were collected to assess their relationship with the occurrence of anal cancer. Results: The overall HPV positivity was 70.0% (21/30), with HPV-16 being the predominant genotype (~85%). The highest prevalence of anal cancer was in patients aged ≥55 years. HPV positivity was higher in women (p-value > 0.05) and in moderately differentiated samples (G2) (p-value < 0.05). p16INK4a and E6-transcript positivity were found in 57% and 24% of the HPV positive samples, respectively. The OS (overall survival) showed a not statistically significant difference in prognosis between HPV positive sand negatives (10, 47.6%, vs. 4, 44.4%; p-value = 0.25). Conclusions: HPV-DNA and p16INK4a positivity confirmed the role of HPV in anal carcinoma. Our findings could support the implementation and scale-up of HPV vaccination in males and females to decrease the incidence of HPV-associated cancers. Further studies are needed to better clarify the prognostic role of HPV/p16 status.

scholarly journals Clinical Profile and Role of Septic Screen in Early Onset Sepsis in a Tertiary Care Hospital of Western Nepal - A Prospective Observational Study

2020 ◽  
Vol 8 (1) ◽  
pp. 14-18
Author(s):  
Binod Kumar Gupta ◽  
Raju Kaphle ◽  
Buby Philip Kurian ◽  
Badri Kumar Gupta
Keyword(s):  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Early Onset Sepsis ◽  
Wide Range

INTRODUCTION: Neonatal sepsis is an important cause of neonatal mortality and morbidity with wide range of clinical manifestations. This study was aimed to study the clinical characteristics of sepsis along with the role of septic screen for early diagnosis of septicemia. MATERIAL AND METHODS: A prospective observational hospital based cross-sectional study was conducted in 113 screen positive newborns over a 12-month period at Universal College of Medical Sciences, Teaching Hospital Bhairahawa, Nepal. RESULTS: Out of 489 cases admitted to the NICU during the study period, 113 babies with screen positive sepsis were included in the study. Poor feeding (46%, n=52), respiratory distress (38.9%, n=44) and lethargy (30.1%, n=34) were top three clinical presentations in neonates with sepsis followed by seizures, jaundice, vomiting, fever and hypothermia respectively. 57.5% (n=65) of clinical sepsis cases enrolled had culture positivity with staphylococcus aureus in 41.5% (n=27) and Coagulase negative Staphylococcus (CONS) in 27.7% (n=18).  Klebsiella was the third common organism isolated in blood culture (23.1%, n=15). The sensitivities and specificities of two-test and three-test combinations in proven sepsis was calculated. Two-test combinations showed sensitivities between 33-100% and specificities between 30-90% whereas three-test combinations showed the sensitivities and specificities between 60-100% and 20-90% respectively. CONCLUSION: Poor feeding, respiratory distress and lethargy were common presentations in early onset neonatal sepsis. Three-test combination of septic screen had no overall advantage over two-test combination in the present study.

scholarly journals Feasibility of The Use of Neutrophil To Lymphocyte Ratio (NLR) As An Adjunct To Cytology To Suggest Thyroid Malignancy: A Prospective Study

2021 ◽  
Author(s):  
Pawan Kumar Tiwari ◽  
Biju Varghese ◽  
Arunjeet KK ◽  
Pankaj P Rao ◽  
Dronacharya Routh
Keyword(s):  
Tertiary Care ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Neutrophil To Lymphocyte Ratio ◽  
P Value ◽  
Care Hospital ◽  
Thyroid Malignancy ◽  
Class Iii ◽  
Lymphocyte Ratio ◽  
Area Under Roc Curve

Abstract Background: Inflammation is known to be associated with cancer development and progression. NLR is a simple and efficient marker of inflammation in numerous malignancies. Aim: The study aimed to investigate usefulness of neutrophil to lymphocyte ratio (NLR) as an adjunct to Fine needle aspiration cytology (FNAC) to suggest thyroid malignancy confirmed by histopathological report post operatively in Bethesda class III, IV & V.Methods: Prospective observational study at a tertiary care hospital over 2 years.Results: NLR in the benign group and malignant group were 1.75+0.23 and 2.19+0.29 (mean + SD) respectively (p-value <0.001). Area under ROC curve plotted was 0.823 (p-value <0.001), with recommended cut-off of 1.9. Relatively high sensitivity and specificity at 87.5 % and 82.5% implies excellent diagnostic accuracy.Conclusion: NLR with a value of 1.9 or higher is recommended as predictor of malignancy in thyroid nodule.

scholarly journals Association of Acute Otitis Media with Breast Feeding Position Among Infants in a Tertiary Care Hospital of Pakistan

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Samia Tul Rasool ◽  
Sana Mansoor ◽  
Tayyab Mumtaz Khan ◽  
Ashar Alamgir ◽  
Maida Meer ◽  
...  
Keyword(s):  
Otitis Media ◽  
Breast Feeding ◽  
Tertiary Care ◽  
Acute Otitis Media ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Educational Levels ◽  
Breastfed Infants ◽  
Chi Square Test

Acute otitis media (AOM) is the commonest disease of childhood. High incidence of AOM might be due to immature Eustachian Tube and immaturity of immune system. Exclusive breast feeding is protective against acute otitis media, however, improper breastfeeding  position can increase AOM occurrence in infants. This study aims to assess the association of improper breastfeeding position with occurrence of Acute otitis media in infants and to assess association of Maternal educational levels with feeding positions. 220 breastfed infants satisfying inclusion criteria with diagnosed AOM were enrolled. Study was conducted over a period of 6 months from August 2019 to January 2020. Demographic details and Detailed history regarding feeding positions and maternal educational levels were obtained through a Self-structured proforma from parents. Data analysis was done through descriptive statistics and chi square test and p value less than 0.5 was set significant. Out of 220 infants, 123(55.90%) were male and 97(44.10%) were females. AOM was more common in male infants than female infants, however it was not statistically significant(p=0.169). The mean age for enrolled infants(1-12months) was 6.90(±3.413). Statistically significant association between increase incidence of AOM and breastfeeding position was found(p=0.032). We also found a statistically significant association between maternal educational levels and breastfeeding position (p= 0.000). In this study, we have noted that Breastfeeding in supine position is associated significantly with increase in incidence of AOM. Feeding positions are statistically associated with Maternal Educational levels.

scholarly journals The relationship between feeding and nutritional status: a prospective and observational study conducted in northern region of India

2018 ◽  
Vol 5 (4) ◽  
pp. 1397
Author(s):  
Amarpreet Kaur ◽  
Karnail Singh ◽  
M. S. Pannu ◽  
Palwinder Singh ◽  
Neeraj Sehgal ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Breast Feeding ◽  
Tertiary Care ◽  
Northern Region ◽  
P Value ◽  
Feeding Practice ◽  
Care Hospital ◽  
Age Group ◽  
Chi Square ◽  
Breast Feed

Background: The health of Infants to a great extent depends upon the feeding practices and its awareness among the mothers. This study was conducted in Tertiary care hospital to find the correlation between feeding pattern with nutritional status.Methods: Infants in the age group of 14 weeks to 1 year formed the sample of the study. The nutritional status was assessed in relation to breast feeding practice among infants ≤6 months. Among infants >6 months of age, the nutritional status was assessed in relation to adequacy and timely start of weaning. Correlation was observed, and test of significance was applied through chi square test.Results: Total 591 infants were included in the study out of which 232 infants were ≤6 months of age [120 (51.72%) were exclusively breastfed and 112 (48.28%) were top fed]. Out of these breast feed infants, 86/120 (71.67%) had normal nutrition compared to 54/112 (48.21%) of top-fed babies. Infants >6 months of age were 359 in number [116 (32.31%) were having adequate complementary feed, 111 (30.92%) were having inadequate complementary feed and 132 (36.77%) did not receive any complementary feed]. Out of these infants in the age group of >6 months, 56.90% of adequate complementary feed group, 27.03% of receiving inadequate complementary feed and 27.27% of not received complementary feed were having normal nutritional status. The association between nutritional status and breast feeding in ≤6 months and complementary feed in >6 months has been found to be statistically significant (p value < 0.05, d.f =1).Conclusions: Breastfeeding as well as adequate complementary feed has positive correlation to nutritional status in infants even when compared with the malnourished infants of grade I, II, III and IV.

scholarly journals A study of thyroid dysfunction among elderly in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 448-453
Author(s):  
Sadhna Sharma ◽  
Biju Govind ◽  
T.S.A. Satyamaharshi ◽  
M.Divya Vani ◽  
, M. Shivshankar
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
The Elderly ◽  
P Value ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Cross Sectional

Introduction and Aim: The prevalence of thyroid disorders all over the world is on the rise. However, the diagnosis is complicated among the elderlies due to factors such as non-specific clinical manifestations and interacting medications. The aim of the study is to estimate the prevalence and type of thyroid dysfunction among the elderly. Materials and Methods: The cross-sectional study was undertaken in the Department of General Medicine of a tertiary care teachinghospital. The study included 100 subjects aged above 60 years, of both genders. Data for clinical examination and biochemical tests such as T3, T4, TSH and lipid profile were collected. Reports of USG/FNAC, performed in cases of thyroid nodule, were also checked.Results:The prevalence of thyroid disorders was 22% of the study population. Overt and subclinical hypothyroidism were observed among 4% and 17% respectively, with 1% having hyperthyroidism. Subclinical hypothyroidism was more common among women. No specific trend was observed with increasing age.TPO antibodies were positive among 73% of the cases. Patients with thyroid dysfunction had higher values of triglycerides, total cholesterol and LDL. The proportion of dyslipidemia was significantly higher among elderly with thyroid dysfunction as compared to people with no thyroid dysfunction (90.90% Vs 24.35%, P value < 0.001). Conclusion: Thyroid dysfunction in the elderly is common. Strong clinical suspicion of thyroid diseases in elderly patients presenting with non-specific symptoms is needed. This would aid in the diagnosis of thyroid disorders among the elderly.

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