Prevalence of Helicobacter pylori infection in patients with gastric ulcer perforation admitted in a tertiary care centre

Background: Gastric ulcers are one of the most prevalent gastro intestinal diseases. Perforation of gastric ulcer is most common and dreaded complication of a gastric ulcer. Causes of gastric ulcer include Helicobacter Pylori, the NSAID, smoking and alcohol. Helicobacter Pylori infection is a curable cause of gastric ulcer. As prevalence of H. pylori differ in populations, prevalence of H. pylori in our population need to be assessed for determining treatment strategy for gastric ulcer.Methods: Cross sectional study conducted in patients operated for perforation peritonitis and diagnosed to have gastric ulcer perforation in a tertiary care centre. Full thickness biopsy was taken from gastric ulcer perforation edge during the surgery for perforation peritonitis. The biopsy was stained with Giemsa stain and looked for the presence of H. pylori.Results: Helicobacter pylori prevalence was 48.8% in our study. 8 females (out of 16) and 51 males (out of 105) had H. pylori positivity. 43 had history of smoking. Among them 20 were diagnosed to be having H. pylori positive. 26 persons had history of pan chewing. Among pan chewers 17 were H. pylori positive. Among 50 patients with history of alcoholism, 24 got H. pylori positivity. Among 40 patients with history of NSAIDs, 14 were positive for H. pylori.Conclusions: Prevalence of Helicobacter pylori in gastric ulcer perforation in present study is 48.8%. Helicobacter Pylori eradication should be added in treatment protocols for perforated gastric ulcers.

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Expressions of MMPs and TIMP-1 in Gastric Ulcers May DifferentiateH. pylori-Infected from NSAID-Related Ulcers

The Scientific World JOURNAL ◽

10.1100/2012/539316 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Hsiu-Chi Cheng ◽

Hsiao-Bai Yang ◽

Wei-Lun Chang ◽

Wei-Ying Chen ◽

Yi-Chun Yeh ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastric Ulcer ◽

Epithelial Cells ◽

Matrix Metalloproteinases ◽

Matrix Metalloproteinase ◽

Immunohistochemical Staining ◽

Gastric Ulcers ◽

Matrix Metalloproteinase 1 ◽

Two Factors ◽

H Pylori

Background. Two major causes of gastric ulcers areHelicobacter pylori(H. pylori) infection and nonsteroidal anti-inflammatory drug (NSAID) use.Aims. This study aimed to determine if there were different expressions of matrix metalloproteinases (MMPs) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) betweenH. pylori-infected and NSAID-related ulcers.Methods. The 126 gastric ulcer patients (H. pyloriinfectedn=46; NSAID relatedn=30; combined with two factorsn=50) provided ulcer and nonulcer tissues for assessment of MMP-3, -7, and -9 and TIMP-1 expression by immunohistochemical staining.Results. Gastric ulcer tissues had significantly higher MMP-3, -7, and -9 and TIMP-1 expressions than nonulcer tissues (P<0.05).H. pylori-infected gastric ulcers had even higher MMP-7, MMP-9, and TIMP-1 expressions in epithelial cells than NSAID-related gastric ulcers (P<0.05). In patients with the two combined factors, gastric ulcers expressed similar proportions of antral ulcers and MMP-7 and MMP-9 intensities to NSAID-related gastric ulcers, but lower MMP-9 and TIMP-1 thanH. pylori-infected gastric ulcers (P<0.05).Conclusions. H. pylori-infected gastric ulcers express higher MMP-7, MMP-9, and TIMP-1 than NSAID-related ulcers. In patients with the two combined factors, ulcer location and MMP-7 and MMP-9 intensities are similar to NSAID use.

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Pregnancy outcome in women with previous preeclampsia versus women normotensive in previous pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184964 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5045

Author(s):

Jayshree Mulik ◽

Snehalata Suresh

Keyword(s):

Pregnancy Outcome ◽

Perinatal Outcome ◽

Tertiary Care ◽

Subsequent Pregnancy ◽

Care Centre ◽

Tertiary Care Centre ◽

Previous Pregnancy ◽

Index Pregnancy ◽

History Of ◽

Adverse Pregnancy

Background: Women with history of preeclampsia have reportedly higher risk of development of preeclampsia in subsequent pregnancies, along with other adverse pregnancy outcomes. Authors aimed to study the incidence of recurrent preeclampsia and compare the pregnancy outcome in women with history of preeclampsia in previous pregnancy with those who were normotensive in previous pregnancy and further compare outcomes in women with recurrent preeclampsia between their previous and index pregnancy.Methods: Pregnancy outcome was studied in women with preeclampsia in previous pregnancy (cases) and compared with women normotensive in previous pregnancy (controls). Further analysis of cases was done by dividing them into subgroups: those with recurrent preeclampsia in index pregnancy (A1) and those normotensive in index pregnancy despite being pre-eclamptic in previous pregnancy (A2). Total 100 cases and 100 controls were enrolled in the study, which was conducted at present tertiary care centre from January 2012 to June 2013.Results: Out of total 200 participants (100 cases, 100 controls) enrolled in the study; 58 out of 100 cases had recurrent preeclampsia and remaining 42 remained normo-tensive in index pregnancy. Among 100 controls, 93 were normotensive in index pregnancy.Conclusions: Women with history of preeclampsia in previous pregnancy had adverse maternal and perinatal outcome in subsequent pregnancy when compared to the women who were normotensive in the previous pregnancy. But when compared with their own previous preeclamptic pregnancy, they had better pregnancy outcome with good perinatal outcome in their index pregnancy.

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Incidence of steroid modified tinea in tertiary care centre Lucknow

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20184465 ◽

2018 ◽

Vol 4 (4) ◽

pp. 579

Author(s):

Savita Chaudhary ◽

Priyanka Shukla ◽

Khushboo Gupta ◽

Gaurav Paliwal

Keyword(s):

Tertiary Care ◽

Common Species ◽

Topical Steroids ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Detailed History ◽

Microbiological Profile ◽

History Of ◽

Common Variety

Background: Rampant use and abuse of topical steroids has led to increase in number of cases of superficial dermatophytosis of skin, nail and hair. In most of the cases they are resistant to topical as well as oral antifungals even after prolong course of treatment. Our study aims to analyse epidemiological and microbiological profile of steroid modified tinea (SMT).Methods: Clinically diagnosed tinea patients with history of usage of topical steroids were included in our study. Detailed history was taken and clinical examination along with KOH mount and culture was done.Results: 980 patients were screened of which 550 patients with history of using topical steroids were included in our study. Most common age group was 20 to 29 years with male: female of ratio approximately 3:1 and disseminated form was the most common variety. KOH mount was positive in 76% cases and culture was positive in 72% cases. Most common species came out to be T. Mentagrophytes followed by T. rubrum. Among non-dermatophyte group, Candida was the commonest.Conclusions: There is rise in incidence of dermatophytosis, especially steroid modified one and cases of disseminated tinea are rising.

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Effect of treatment on the quality of life of cervical cancer patients: a prospective study from a tertiary care centre of West Bengal

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20195871 ◽

2019 ◽

Vol 7 (1) ◽

pp. 300

Author(s):

Manisha Sarkar

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Cancer Patients ◽

West Bengal ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Financial Difficulties ◽

History Of

Background: Cervical cancer is one of many health care ironies. Better survival rates demand better quality of life (QoL). The aim of present study was to determine the change in QoL of cervical cancer patients due to treatment.Methods: An observational prospective study was conducted from July 2017 to June 2018 among 80 new cervical cancer patients without any prior history of treatment for cervical cancer, attending radiotherapy department of a tertiary care centre of West Bengal using a semi-structured schedule and European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ). Information was collected on socio-demographic and clinical aspects and QoL domains. Those with history of surgery for cervical cancer, advanced stage of disease were excluded. EORTC QLQ was administered at baseline and one month after completion of treatment. Data was analysed by percentage, means±standard deviation, range and Wilcoxon signed rank test etc. using SPSS-16.Results: Only 60 patients could be analysed as 10 patients died and 10 lost to follow-up. After treatment there was a significant improvement in global health, physical, emotional and cognitive functioning as well as decrease in symptoms like fatigue, pain, insomnia, appetite loss and constipation along with worsening of financial difficulties. There was significant improvement in body image, decrease in problems of symptom experience, peripheral neuropathy and menopausal symptoms after treatment.Conclusions: The cervical cancer patients show an overall improvement in their QoL in most of the domains after one month of treatment except worsening of financial difficulties.

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Clinical characteristics of children presenting with history of sexual abuse to a tertiary care centre in India

Asian Journal of Psychiatry ◽

10.1016/j.ajp.2015.12.007 ◽

2016 ◽

Vol 19 ◽

pp. 44-49 ◽

Cited By ~ 4

Author(s):

Bhaskaran T.S. Sowmya ◽

Shekhar P. Seshadri ◽

Shoba Srinath ◽

Satish Girimaji ◽

John Vijay Sagar

Keyword(s):

Sexual Abuse ◽

Clinical Characteristics ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

History Of

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SPECTRUM OF PERFORATION PERITONITIS AT A TERTIARY CARE CENTRE IN PUNJAB

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/547 ◽

2018 ◽

Vol 7 (20) ◽

pp. 2433-2436

Author(s):

Varun Gupta ◽

Chiranjiv Singh Gill ◽

Sanjeev Kumar Singla ◽

Manvi Gupta

Keyword(s):

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Perforation Peritonitis

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Validity of mannheim peritonitis index in predicting outcome of patients with perforative peritonitis in a tertiary care centre Kerala, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194981 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4140

Author(s):

Alex Mathew ◽

Joby John ◽

Asha Sasikumar

Keyword(s):

Likelihood Ratio ◽

Tertiary Care ◽

Prognostic Index ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

P Value ◽

Care Centre ◽

Roc Curve Analysis ◽

Tertiary Care Centre ◽

Perforation Peritonitis

Background: Perforation peritonitis is one of the most commonly encountered surgical emergencies in our country. The prognosis of secondary peritonitis remains poor despite development in diagnosis and management. Early identification of patients with severe peritonitis may help in selecting patients for aggressive surgical approach.Methods: The study was conducted in 128 cases of perforation peritonitis admitted and treated in the department of surgery in a tertiary care centre. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Patients were first assessed using a predesigned Performa, then MPI score was calculated for each patient and the patients were followed-up till death or discharge from the hospital.Results: The ROC curve analysis shows area under the curve was 0.986 with a standard error of 0.008, 95% CI (0.971 to 1.001), p<0.0001. In our study authors found that for the MPI score of 26, sensitivity was 91.3% and specificity was 92.4%, with a positive likelihood ratio of 12.01 and a negative likelihood ratio of 0.09. Age of the patient, presence of organ failure, associated malignancy, generalised type of peritonitis and the original MPI Score has got a significant association with the final outcome (i.e. p value <0.05).Conclusions: MPI is an excellent prognostic index for peritonitis with high accuracy in individual prognosis that is cheap, cost effective, easily measurable and reproducible. The study accentuates that early diagnosis, appropriate resuscitation and prompt surgical intervention still remain the keystones in the management of perforation peritonitis.

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Screening for Hearing Impairment in High-Risk Neonates in a Tertiary Care Centre in Central Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/605 ◽

2020 ◽

Vol 7 (49) ◽

pp. 2959-2963

Author(s):

Maina J ◽

Rati Santhakumar ◽

Manoj V.C. ◽

Mridula Vellore

Keyword(s):

Risk Factors ◽

High Risk ◽

Hearing Impairment ◽

Otoacoustic Emissions ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Auditory Rehabilitation ◽

History Of ◽

Evoked Response Audiometry

BACKGROUND Hearing loss is a chronic condition, and many cases can be detected in the neonatal period. Recognizing it early is of crucial importance as early auditory rehabilitation would help in child’s comprehensive development. We wanted to assess the prevalence of hearing impairment among high risk newborns admitted to inborn unit of tertiary care centre in Central Kerala and screen for the associated risk factors in these newborns. METHODS Thousand consecutive inborn neonates from Neonatal ICU, Department of Paediatrics, tertiary care centre in Thrissur, Kerala, detected as high risk by Joint Committee on Infant Hearing (JCIH) criteria were enrolled for the study from December 2011 to November 2012 after the approval by Institute’s Ethics Review Board. Risk factor assessment was done before enrolment. A qualified audiologist conducted the test on babies in soundproof chamber. DPOAEs (Distortion Product Otoacoustic Emissions) were used for initial testing after checking ears for debris. Those who failed in the first test were asked to come for a retest after 2 weeks. Those who failed in the retest were asked to report for Brainstem Evoked Response Audiometry (BERA). Those who were diagnosed as having hearing impairment were advised auditory rehabilitation as well as auditory verbal therapy. RESULTS Of the 1000 eligible neonates born in our hospital during the study period (December 2011 to November 2012) 69 were lost to follow up. Among the remaining 931 babies the frequency of hearing impairment was 0.8 %. Among the 931 neonates, 130 had absent response with the first OAE test contributing to 13.9 %. Twenty-one neonates had absent response to second OAE test out of 130 contributing to 16.1 %. The failure rate for second test is 2.2 % of the total population of 931 newborns. Eight of the 21 neonates who were subjected to BERA had severe hearing loss. The prevalence of hearing impairment was 8 per 1000. CONCLUSIONS The prevalence (percentage) of hearing impairment by two staged screening protocol is 0.8 %. Risk factors which were present in these babies were prematurity, low birth weight, low Apgar score, history of exanthematous fever in mother, neonatal jaundice, ototoxic medication history, craniofacial anomalies, and family history of deafness, meningitis and mechanical ventilation. KEYWORDS Otoacoustic Emissions, Brain Stem Evoked Response Audiometry, Risk Factors, Hearing Impairment, Neonates

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Adverse drug reaction profile at psychiatry outpatient department of a tertiary care centre

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20174371 ◽

2017 ◽

Vol 6 (10) ◽

pp. 2428

Author(s):

Ujwala P. Gawali ◽

Harshad V. Kesari ◽

Komal S. Gawand

Keyword(s):

Tertiary Care ◽

Outpatient Department ◽

Uppsala Monitoring Centre ◽

Care Hospital ◽

Causality Analysis ◽

Care Centre ◽

Tertiary Care Centre ◽

Monitoring Centre ◽

History Of ◽

Reaction Profile

Background: Monitoring adverse drug reactions (ADRs) helps in alerting physicians and developing strategies to prevent and minimize the risk of developing ADRs. Data regarding pattern of ADRs due to psychotropic medications is scanty. Hence, the study was planned to assess ADRs among psychiatry outpatients of a tertiary care hospital in Maharashtra.Methods: A prospective, observational study was conducted in psychiatry outpatient department of a tertiary care centre for 3 months. Cases were enrolled by active and passive surveillance after obtaining informed consent. Demographic details, adverse event details, history of medications were recorded. Pattern of ADRs was studied according to demographic parameters, drug class, organ system affected, causality (WHO - Uppsala Monitoring Centre Scale) and severity (modified Hartwig and Siegel Scale).Results: Out of total 1200 patients screened, 77 qualified the inclusion and exclusion criteria and 92 ADRs were reported; overall incidence rate of 6.41%. Maximum ADRs were reported in the age group of 31- 40 years. 63.63% subjects received more than 2 psychotropic drugs. Among 24 types of ADRs observed, tremor (13.04%) was the commonest, closely followed by somnolence. Antipsychotics (45.65%) were most frequently incriminated and central nervous system (46.73%) the most often affected. Trifluoperazine (11.96%) was the commonest drug, followed by olanzapine and haloperidol (10.53% each). Causality analysis yielded 66 ADRs as “probable” and on severity analysis 80.43% were mild.Conclusions: The study provides an insight into pattern of ADRs in psychiatry outpatients. It is prudent to communicate this to treating physicians as well as counsel patients (and caregivers). Initiatives and concerted efforts involving all stakeholders in healthcare can go a long way in decreasing drug-related morbidity and health costs.

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Detection of CagA, VacA, IceA1 and IceA2 virulent genes in Helicobacter pylori isolated from gastric ulcer patients

LaboratoriumsMedizin ◽

10.1515/labmed-2018-0059 ◽

2018 ◽

Vol 42 (4) ◽

pp. 155-162

Author(s):

Lijuan Fan ◽

Ran Li ◽

Hongyun Li ◽

Jian Zhang ◽

Lingyun Wang

Keyword(s):

Helicobacter Pylori ◽

Gastric Ulcer ◽

Virulence Genes ◽

East Asian ◽

Virulence Gene ◽

Gastric Biopsy ◽

History Of ◽

Male Patients ◽

Polymerase Chain ◽

H Pylori

Abstract Background Virulence factors of Helicobacter pylori including cagA, vacA, iceA and their association with clinical manifestation varied widely with different subpopulations. The objective of the study was to determine the prevalence of cagA, iceA1, iceA2, vacA, vacA s1/s2, vacA m1/m2, Western type cagA and East Asian type cagA virulence genes in H. pylori isolated from gastric ulcer patients and evaluate the association of these genes with gender, age, smoking and alcohol consumption. Methods Gastric biopsy samples from 172 patients were collected. H. pylori virulence genes, cagA, vacA, iceA1, iceA2, vacA s1/s2, vacA m1/m2, Western type cagA and East Asian type cagA were detected using polymerase chain reaction (PCR). Results Of the gastric biopsy samples collected, 48.3% of samples grew H. pylori. The vacA (68.7%) was the predominant virulence gene detected and associated with male patients and patients within the age group of 31–40 years. The cagA was the second most common gene detected and significantly associated with alcoholic patients. Conclusions H. pylori infection rate was 48.3% and was associated with patients who were smokers or had a history of smoking. The majority of our isolates were positive for any one of the virulence genes tested indicating that these isolates were highly virulent in nature.

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