scholarly journals Abdominal tuberculosis: a clinical study in a tertiary care hospital

2017 ◽  
Vol 4 (10) ◽  
pp. 3423
Author(s):  
Jawahar Krishnaswamy ◽  
Khalilur Rahaman ◽  
Reshma S. ◽  
Bharath N.
Keyword(s):  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Abdominal Tuberculosis ◽  
Care Hospital ◽  
Delay In Diagnosis ◽  
Male Predominance ◽  
Diagnosis And Management ◽  
Gi Symptoms

Background: Abdominal tuberculosis is the sixth most common form of extrapulmonary site of infection after lymphatic, genitourinary, bone and joint, miliary and meningeal TB with a rising incidence in recent years. Tuberculosis can affect any part of the gastro-intestinal (GI) tract including anus, peritoneum and hepato-biliary system. The clinical manifestations of abdominal tuberculosis are non-specific and mimic various GI disorders and cause delay in diagnosis and management. The aim of this study is to study the incidence of abdominal tuberculosis, percentage of acute presentation, to study and analyse clinical presentation, various diagnostic modalities, role of surgery and to evaluate the spectrum of surgeries done for abdominal tuberculosisMethods: Study was done by analyzing 108 cases in our tertiary care hospital, Chennai, India, during the period of June 2015 to January 2016. All suspected and diagnosed cases of abdominal tuberculosis were included in the study. The relevant clinical information, laboratory results, microbiological and radiological investigations were recorded. Histopathological examination of all the resected or excised specimens was done to detect tuberculosis in all the cases.Results: Out of 108 cases with abdominal tuberculosis, the average age of presentation was between 21 and 40 years with a slight male predominance (male:female = 1.1:1). Abdominal pain (92%) was the most common presenting symptom followed by anorexia (70%), loss of weight (70%), and intestinal obstruction (13%). 29 cases underwent surgical management. All patients were put on anti-tubercular treatment and majority showed good response to therapy.Conclusions: Abdominal tuberculosis should be considered as a differential diagnosis in patients with vague GI symptoms. To diagnose abdominal tuberculosis, high degree of suspicion is needed, and its incidence being common in people with lower socioeconomic status. This study gives a basic outline of presentation, diagnosis and management of abdominal tuberculosis in developing country. 

scholarly journals Clinicopathological Profile of Sino-nasal Masses at a Tertiary Care Hospital: A Descriptive Study

2021 ◽  
Vol 29 (2) ◽  
pp. 133-139
Author(s):  
Nitin Deosthale ◽  
Priyal Patil ◽  
Sonali Khadakkar ◽  
Pavani Garikapati ◽  
Kanchan Dhote ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Careful Examination ◽  
Care Hospital ◽  
Male Predominance ◽  
Neoplastic Lesion ◽  
Number Of Patients

Introduction The Sino-nasal mass is a common clinical entity. Although it has varied aetiology ranging from non-neoplastic to neoplastic, clinical presentation is overlapping that poses diagnostic dilemma. Objective of the study was to study the clinical profile of Sino-nasal masses in terms of demographic profile, clinical presentation and clinicopathological diagnosis. Materials and Methods A descriptive study was carried out at tertiary care hospital for 2 years. Clinically diagnosed cases of sino-nasal masses were included in the study. Previously treated cases, congenital lesions were excluded. Provisional diagnosis was made based on clinical and radiological evaluation. Diagnosis on histopathological examination was considered as definitive. Results Total of 75 patients were included in the study. Demographic data showed slight male predominance (M:F= 1.08:1), with most patients from age group 31-40 years (26.67%). Nasal obstruction was the most common presenting symptom. The number of patients with non-neoplastic lesion was 48; 17 patients had neoplastic benign lesions while 6 patients had neoplastic malignant lesions. Conclusion Large number of patients presents with trivial symptoms but need careful examination and appropriate diagnosis. Inflammatory lesions outnumbered neoplastic lesions in our study. Clinical suspicion and appropriate investigations can guide in timely intervention and management of these patients reducing the morbidity and mortality in these patients.

ISOLATED BENZODIAZEPINE TOXICITY AND THE USE OF FLUMAZENIL: AN EYE-OPENING ANTIDOTE CASE REPORT IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 231-233
Author(s):  
Siddharth Panikkar ◽  
Gigy Varkey Kuruttukulam ◽  
Manju Manmadhan ◽  
Jithin Antony Bose ◽  
Jacob Chacko ◽  
...  
Keyword(s):  
Case Report ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Delay In Diagnosis ◽  
Patient Medication ◽  
Common Causes ◽  
Eye Opening ◽  
Ct Brain ◽  
The 1960S

Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological, laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically. Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case report.

scholarly journals Nasomaxillary swellings: our experience at tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 469
Author(s):  
Mukesh Rawat ◽  
Archana Lall ◽  
Kavita Sachdeva
Keyword(s):  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Inverted Papilloma ◽  
Nasal Endoscopy ◽  
Common Symptom ◽  
Fungal Sinusitis ◽  
Care Hospital ◽  
Malignant Lesions

<p class="abstract"><strong>Background:  </strong>A wide spectrum of lesions may present as nasomaxillary swellings ranges from benign to malignant lesions including fungal sinusitis and fibro vascular lesions example: JNA (Juvenile nasopharyngeal angiofibroma) and Inverted papilloma. Many Pathologies ranging from benign to malignant tumors may mimic a simple Nasomaxillary mass. It is diagnostic challenge to determine pathology behind it. A detailed clinical evaluation with nasal endoscopy and relevant pre-operative investigations including radiological imaging and histopathological examination is essential to reach up to final diagnosis. The aim of the study was to do clinicopathological evaluation of patients presenting with nasomaxillary swelling and correlation of clinical, radiological and Histopathological findings.</p><p class="abstract"><strong>Methods: </strong>This was a prospective observational study on 50 nasomaxillary swelling patients who are presented in the Department of ENT and Head and Neck Surgery of N.S.C.B. MCH Jabalpur, a tertiary care Hospital, between March 2018 to August 2019. A detailed history taking and clinical examination with nasal endoscopy and relevant preoperative investigations including CECT Nose and PNS and histopathological examination was done in all patients.</p><p class="abstract"><strong>Results: </strong>50 Nasomaxillary swelling patients were selected for this study. 30 patients were male and 20 were females. Ages of patients were varied from 12 years to 72 years. 23 patients (46%) were malignant and 27 (54%) were benign. Histopathological examination results shows benign lesions like JNA (6 cases), fungal sinusitis (6 cases), dermoid cyst (1 case), inverted papilloma (3 cases), sebaceous cyst (1 case), jaw lesions (10 cases), (odontogenic like radicular/ infected cyst, dentigerous cyst, cystic ameloblastoma and non-odontogenic like fibrous dysplasia) and malignant lesions like SCC (squamous cell carcinoma) (12 cases), spindle cell sarcoma (2 cases), undifferentiated carcinoma (3 cases), adenocarcinoma (3 cases), adenoid cystic carcinoma (1 case), Invasive pleomorphic sarcoma (1 case) and malignant melanoma (1 case). SCC was most common lesion f/b JNA and fungal sinusitis. Well differentiated SCC was most common histological type (10 out of 12 cases of SCC). Most common symptom was nasal obstruction (66% cases) f/b epistaxis (52% cases) but epitasis was most common symptom among malignant and JNA cases. In 6 cases (3 JNA, 1 inverted papilloma, 1 malignancy and 1 radicular cyst) radiological diagnosis were not correlated with histological findings.</p><p class="abstract"><strong>Conclusions: </strong>Most our cases were malignant nasomaxillary lesions followed by fungal sinusitis and JNA. Most patients presented in advanced stage of disease so rapidly evaluation including nasal endoscopy should be done. CECT scan is essential to determine tumors extent and bony lesions. All patients should undergo hisotopatholigical examination. The final diagnosis should be made on the basis of clinical, radiological and histopathological findings.</p>

scholarly journals A study about Knowledge, Attitude and Practice (KAP) regarding worm infestation among the caregivers of children aged between 5 – 12 years in a tertiary care hospital

2019 ◽  
Vol 10 (3) ◽  
pp. 1818-1820
Author(s):  
Jagadeesan M ◽  
Mariraj I ◽  
Prasanna Karthik S ◽  
Kannan R ◽  
Nivaas M ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Negative Impact ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Care Hospital ◽  
Class Iii ◽  
Nail Biting ◽  
Worm Infestation ◽  
Prophylactic Measures

Worm infection is a public health problem, especially in developing and underdeveloped countries as it has a negative impact on the child’s development. Proper sanitation and personnel hygiene have to be emphasized and monitored to overcome the nutritional deprivement in children. The study is done to evaluate the knowledge and attitude about worm infestation and to assess the deworming practices employed among the caregivers of children aged between 5 – 12 years attending a tertiary care hospital. A cross-sectional descriptive study was conducted among 206 caregivers of pediatric age group after obtaining proper informed consent. The KAP parameters were assessed using a pretested structured questionnaire, and the results were analyzed. Out of 206 caregivers, 61% were mothers, 37% were fathers. Their mean age was 30 years. 41% belong to class III socioeconomic status. 23% were reported to play in the mud, 17% nail-biting and 6% keeping objects in mouth.12% Had open-air defecation practice, which is quite alarming in a developing country.67% were found to have the knowledge and 33% lacked the knowledge about worm infestation. Knowledge was directly proportional to the socioeconomic class. 88% were aware that worm infestation would cause clinical manifestations. 85% preferred allopathy medicines, while 15% preferred homemade remedy. 68% didn’t practice any prophylactic measures, where in 21% of the caregivers dewormed their kid once in 6 months and 11% once a year. The study provides information that most of the caregivers had a good knowledge regarding deworming but failed in practicing necessary measures to control and prevent it. Health education, frequent monitoring, and conducting interventional programs among parents and caregivers would be vital so that the prevalence of the disease can be minimized.

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 Endoscopic Findings of Upper Gastrointestinal Diseases at a Tertiary Care Hospital in Dhaka

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 22-26
Author(s):  
Md. F Alam ◽  
AKM S Kabir ◽  
Md. N Islam
Keyword(s):  
Gastric Cancer ◽  
Esophageal Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Gastrointestinal Diseases ◽  
Lateral Position ◽  
Care Hospital ◽  
Ulcer Disease ◽  
Endoscopic Findings ◽  
Gi Symptoms

Endoscopic findings help the clinical to give the treatment properly The purpose of the present study was to find out common findings of UGI endoscopy at a tertiary care hospital in Dhaka. This retrospective study was conducted in the Department of Gastroenterology at Holy Family Red Crescent Hospital, Dhaka from 14th October 2009 to 25th June 2013 among all the patients presented with GI symptoms. Endoscopies were documented on a computer-based datasheet. Under topical lidocaine, a Fujinon EG fiber optic Upper GI scope was passed through the mouth of a patient in left lateral position through the upper esophageal sphincter into the esophagus stomach and duodenum. Biopsies were collected and histopathology reports were recorded A total number of 2632 patients were recruited for this study and endoscopy was done of which 1406(53.4%) cases were reported as abnormal findings. Male (52.1%) was predominant than female (47.9%). Maximum patients were diagnosed as peptic ulcer disease (54.2%) followed by varices with or without gastropathy (20.04, gastric cancer (11.5%), esophageal cancer (9.6%) and gastritis with or without duodenitis which were 267cases, 154cases, 128cases and 63(4.7%) cases respectively. The most common cause of UGI bleeding was due to PUD (43.1%) followed by varices (34.7%), Gastric cancer (12.5%). The most common endoscopic findings are the PUD, varices with or without gastropathy, gastric cancer, esophageal cancer and gastritis with or without duodenitis.

scholarly journals Cryptococcal Meningitis: A Retrospective Cohort of a Brazilian Reference Hospital in the Post-HAART Era of Universal Access

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Aline Z. de Azambuja ◽  
Gustavo Wissmann Neto ◽  
Guilherme Watte ◽  
Luciana Antoniolli ◽  
Luciano Z. Goldani
Keyword(s):  
Risk Factors ◽  
Intracranial Hypertension ◽  
Amphotericin B ◽  
Opportunistic Infection ◽  
Cryptococcal Meningitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Southern Brazil

Objective.Cryptococcus neoformansis a common opportunistic infection in adults with acquired immunodeficiency syndrome worldwide. However, limited data exist for HIV-infected patients in the post-HAART (highly active antiretroviral therapy) era in Brazil. The aim of this study was to describe the clinical characteristics and outcomes of cryptococcosis in a cohort of patients attending a teaching tertiary care hospital in southern Brazil after the introduction of HAART in Brazil.Patients and Methods. A retrospective study was conducted in tertiary care hospital in southern Brazil. Detailed data on risk factors, clinical manifestations, diagnosis methods, treatment, and prognosis of patients with meningeal cryptococcosis were evaluated from January 2009 to December 2016.Results. Seventy-nine cases of cryptococcal meningitis were identified. Most of the patients presented positive CSF (cerebrospinal fluid) cultures forCryptococcus neoformans(96%). The prevalence of males and females with meningeal cryptococcosis was similar. The age of the patients ranged from 5 to 67 years. The median time of hospitalization was 28 days. The most common underlying disease was HIV (82%), followed by solid transplant (10%). Fever, nausea, vomiting, headache, and altered mental status were the most common clinical manifestations. Initial opening intracranial pressures varied from 30 to 130 cm H2O. CNS imaging abnormalities include hydrocephalus and hypodensities. Widened Virchow–Robin spaces were described in only 2 patients (2.5%). Induction treatment of the majority of the patients consisted of amphotericin B and flucytosine (67%) followed by amphotericin B and fluconazole (19%). Multivariate analysis of Cox regression identified headache at presentation, mechanical ventilation, CSF glucose <20 mg/dL, and CSF cryptococcal antigen ≥1 : 1000 for independent risk factors for death. All-cause 30-day and 60-day mortalities were 19% and 24%, respectively.Conclusions. Meningeal cryptococcosis mostly caused byC. neoformanscontinues to occur predominantly in HIV-infected adults despite HAART being widely distributed in Brazil. Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Despite adequate antifungal treatment and management of intracranial hypertension in a reference tertiary care hospital, mortality was high. Identification of risk factors and additional treatment modalities, especially for intracranial hypertension, are necessary to improve care for patients with cryptococcal meningitis.

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