Outcomes of pleural decortication in a tertiary care hospital of Telangana state

Background: The objective of the study was to study the clinical profile, incidence of postoperative complications in patients undergoing pleural decortication.Methods: The subjects for the study were selected from the cases admitted in a single unit of Department of Cardiothoracic Surgery, Nizam’s Institute of Medical Sciences, Hyderabad during the period of 2016 to 2018 and due ethics committee approval was taken. Collection of data is done from the database including admission record, ICU charts, discharge records and follow-up records. 50 patients underwent surgery. Outcomes and complications were analyzed for 3 years duration.Results: 50 patients were included in this study with different aetiologies that required pleural decortication. The average age of patients in our study was 34 years. Most patients in our study were male (80%) and had history of infection with tuberculosis (42%) and pyogenic (28%) infection. A few patients had history of trauma (12%). Most of the patients suffered from cough (88%), dyspnoea (74%), fever (82%) and haemoptysis (22%). The common postoperative complications we encountered were pleural air leak (37.5%) bleeding (25%) infection (25%) and recurrence (2%). Overall morbidity from pleural decortication was seen in 16 patients, and there was no mortality.Conclusions: The most common reason for pleural decortication is still empyema thoracis secondary to infection in the developing countries. Tuberculosis is still the most common cause leading to fibrothorax requiring pleural decortication followed closely by pyogenic lung infections and trauma.

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Assessment of adherence to ATT among HIV-TB co-infected patients attending the ART centre of a tertiary care hospital of Jharkhand

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20190179 ◽

2019 ◽

Vol 6 (2) ◽

pp. 619

Author(s):

Abhishek Kumar ◽

Vivek Kashyap

Keyword(s):

Prospective Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hiv Positive ◽

Care Hospital ◽

Medical Sciences ◽

Cd4 Cell Count ◽

Common Opportunistic Infection ◽

Cd4 Cell

Background: Despite being preventable and curable, TB is the leading cause of HIV associated mortality. It is the most common opportunistic infection among HIV positive individuals with CD4 cell count <500/ mm3. Worldwide the number of people infected with both HIV & TB is rising. The objective of the study was to describe the socio-demographic profile of HIV-TB co-infected patients and to assess the adherence of HIV TB Co-infected patients to anti tubercular treatment (ATT) attending ART Centre, RIMS, Ranchi.Methods: It was a hospital based prospective study done at Rajendra Institute of Medical Sciences (RIMS), Ranchi. Duration of study was 14 months. A total of 117 patients were registered during the study period and were followed up for adherence to ATT.Results: Out of 117 patients 4 were excluded. Among 113 patients, mostly were male (74.3%) and from rural background (69.9%). Majority (94.7%) of the patients came for regular follow up and took medicines as advised. Adherence was significantly associated with education (p=0.025).Conclusions: In this study it was concluded that education significantly affected adherence to ATT among HIV-TB Co-infected patients of ART Centre of RIMS, Ranchi.

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Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

10.21203/rs.3.rs-1240669/v1 ◽

2022 ◽

Author(s):

Rajesh Verma ◽

Rajarshi Chakraborty ◽

Keerthiraj DB ◽

Kingzang Wangda ◽

Veerendra Verma ◽

...

Keyword(s):

Amphotericin B ◽

Public Awareness ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Imaging Features ◽

Initial State ◽

Northern India ◽

History Of

Abstract Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

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Outcome of primary repair in typhoid ileal perforation at Tertiary Care Hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.3671 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1128-1132

Author(s):

Gulshan Ali Memon ◽

Abdul Hakeem Jamali ◽

Sajjad Hussain Qureshi ◽

Altaf Hussain Ghumro ◽

Mashooq Ali Khowaja ◽

...

Keyword(s):

Postoperative Complications ◽

Tertiary Care Hospital ◽

Primary Repair ◽

Tertiary Care ◽

Care Hospital ◽

Cross Sectional ◽

Ileal Perforation ◽

Surgical Department ◽

Male Patients ◽

The Common

Typhoid ileal perforation is the common complication of typhoid fever in third week of its phase of progression. It is the most common cause of mortality in developing countries. Small perforations are dealt with primary repair and the more complicated disease is treated by multiple other options. Prognosis is good with primary repair with least postoperative complications. Objectives: To detect the outcome of typhoid ileal perforation treated by primary repair at tertiary care hospital. Study Design: Cross sectional study. Setting: Surgical Department of PMC Hospital Nawabshah. Period: From August 2017 to December 2018. Material & Methods: This study included total 70 patients. All patients were admitted from surgical OPD and emergency department of PMCH Nawabshah. Out of 70, 45 (64.28%) were females and 25 (35.71%) were male patients. Age ranged from 27 to 52 and 24 to 47 in females and males respectively. The common presentation was pain in whole abdomen along with distention and fever, vomiting. Plain X ray chest/ Abdomen and ultra sonography showed gas under diaphragm. Primary repair was done and also other surgical options but our study included only the postoperative outcomes of primary repair of typhoid ileal perforation. A few complications were detected after primary repair of the gut perforation. Results: Total 70 patients were included in this study. 45 (64.28%) were females and 25 (35.71%) were male patients. In females, 25 (55%) were found single perforations of less than 1cm whereas 7 (15.5%) had size of perforation less than 1.5 cm. In 25 males, 11 (44%) had single perforations of less than 1cm in size. 2 (8%) had < 1.5 cm size perforations and 12 (48%). Over all complication rate in this study was 26%. Conclusion: Primary repair is the best surgical option to treat typhoid ileal perforation in selected patients with least postoperative complications.

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Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz372 ◽

2019 ◽

Vol 6 (10) ◽

Cited By ~ 1

Author(s):

Bryan Walker ◽

Eric Heidel ◽

Mahmoud Shorman

Keyword(s):

Staphylococcus Aureus ◽

Rare Complication ◽

Care Center ◽

Tertiary Care ◽

Care Hospital ◽

Risk Patients ◽

History Of ◽

A Site ◽

Lost To Follow Up

Abstract Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

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Umbilical endometriosis in a 42 years old parous woman: A Case Report

TAJ Journal of Teachers Association ◽

10.3329/taj.v28i1.39070 ◽

2018 ◽

Vol 28 (1) ◽

pp. 48-51

Author(s):

Mosammat Nargis Shamima ◽

Mohd Alamgir Hossain ◽

Shahela Jesmin ◽

Nargis Jahan ◽

Arpita Das

Keyword(s):

Case Report ◽

Tertiary Care ◽

Previous History ◽

Needle Aspiration ◽

Care Hospital ◽

History Of ◽

Needle Aspiration Cytology ◽

High Resolution Ultrasonography ◽

Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51

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A retrospective study of noise induced hearing loss in a tertiary care hospital of Jharkhand - an alarming but ignorant truth

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171190 ◽

2017 ◽

Vol 3 (2) ◽

pp. 340

Author(s):

Pradeep Kumar Singh ◽

Nishant Kumar ◽

Dheeraj Kumar ◽

Nisha Shrivastava ◽

Abhishek Kumar

Keyword(s):

Hearing Loss ◽

Noise Exposure ◽

Tertiary Care ◽

Total Sample ◽

Care Hospital ◽

Age Group ◽

Noise Induced Hearing Loss ◽

Medical Sciences ◽

Urban Males ◽

History Of

Background: Noise induced hearing loss (NIHL) is hearing impairment resulting from exposure to loud sound. People may have a loss of perception of a narrow range of frequencies, impaired cognitive perception of sound, or other impairment, including sensitivity to sound or ringing in the ears. NIHL is 2nd most common cause of hearing loss, next to presbycusis. Most of the population of developing countries is ignorant of the hazards of excessive noise exposure. 1) To describe the socio-demograpic profile of patients in the young age group (18-35 years) with noise induced hearing loss in Rajendra Institute of Medical Sciences (RIMS), Ranchi during June 2015- November 2016. 2) To study the major presenting complaints. 3) To categorize the patients on the basis of degree of hearing loss.Methods: Data for study was collected from RIMS Out Patient Department (OPD) register during period June 2015 – November 2016 (18 months).Total sample size for this period was 50. Templates were generated in MS excel sheet and data analysis was done using SPSS software (version 20). Results: Study showed NIHL was more common in urban (82%) and male (72%) population. More than half (54%) patients presented with hearing loss and 24% with tinnitus. Most of the patients had bilateral mild hearing loss (70%).Conclusions: NIHL is more common in urban males, mostly in age group (26-35 years). More than 2/3rd (68% ) of patients had history of exposure to loud noise.

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Need to suspect fungal etiology in presumed bacterial keratitis - A case report of keratitis due to Scedosporium prolificans

Asian Journal of Medical Sciences ◽

10.3126/ajms.v2i1.4058 ◽

2011 ◽

Vol 2 (1) ◽

pp. 28-30 ◽

Cited By ~ 1

Author(s):

Lata R Chandel ◽

Anuradha Sood ◽

Smriti Chauhan ◽

Kamlesh Thakur

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Fungal Keratitis ◽

Care Hospital ◽

Bacterial Keratitis ◽

Medical Sciences ◽

Prompt Treatment ◽

Acute Presentation ◽

History Of ◽

Scedosporium Prolificans

We describe a case of keratitis with acute presentation and without any history of trauma caused by Scedosporium prolificans; a rare cause of fungal keratitis, from a tertiary care hospital. To the best of our knowledge this is the first such case reported from the region. Because of early diagnosis and prompt treatment the patient could be managed well. Keywords: Keratitis; Scedosporium prolificans; Prompt treatment DOI: 10.3126/ajms.v2i1.4058 Asian Journal of Medical Sciences 2 (2011) 28-30

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Persistent Symptoms in Post-COVID-19 Patients Attending Follow-Up OPD at Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu, Nepal

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6030113 ◽

2021 ◽

Vol 6 (3) ◽

pp. 113

Author(s):

Anup Bastola ◽

Richa Nepal ◽

Bikesh Shrestha ◽

Kijan Maharjan ◽

Sanjay Shrestha ◽

...

Keyword(s):

Tertiary Care ◽

Care Hospital ◽

Long Term Effects ◽

Persistent Symptoms ◽

History Of ◽

Polymerase Chain ◽

Disease Hospital ◽

Time Of Presentation

The long-term effects of COVID-19 among survivors is a matter of concern. This research aimed to study persistent symptoms in post-COVID-19 patients attending a follow-up clinic at a tertiary care hospital in Nepal. All patients, presenting to the outpatient clinic during the study duration of six weeks, with history of positive reverse transcriptase- polymerase chain reaction for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at least two weeks prior to presentation, were included. The duration of follow-up ranged from 15 till 150 days with the mean duration of 28 days after diagnosis of COVID-19. Of 118 patients, 43 (36.4%) had a history of mild COVID-19, 15 (12.8%) had moderate, and 60 (50.8%) had severe. At the time of presentation, 97 (82.2%) patients reported that they had at least one persistent/new symptom beyond two weeks from the diagnosis of COVID-19. Dyspnea, fatigue, chest heaviness, and cough were the commonest persistent complaints in 48 (40.7%), 39 (33.1%), 33 (28%), and 32 (27.1%) patients, respectively. The findings in our study highlight the need for extended monitoring of post-COVID-19 patients following discharge, in order to understand and mitigate long-term implications of the disease.

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Pyoderma gangrenosum: A clinico- therapeutic profile of patients attending a tertiary care hospital in Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v8i1.6823 ◽

2012 ◽

Vol 8 (1) ◽

pp. 29-35

Author(s):

C Kharel ◽

S Agrawal ◽

A Rijal ◽

S Bhattarai

Keyword(s):

Ulcerative Colitis ◽

Pyoderma Gangrenosum ◽

Tertiary Care ◽

Lower Limbs ◽

Neutrophilic Dermatosis ◽

Care Hospital ◽

Medical Sciences ◽

Inflammatory Bowel ◽

Therapeutic Profile

Pyoderma gangrenosum (PG) is a primarily sterile inflammatory neutrophilic dermatosis characterized by recurrent cutaneous ulcerations with mucopurulent or hemorrhagic exudate. In many cases, PG is associated with inflammatory bowel disease, rheumatic disorder or neoplasia. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. To study the clinical and therapeutic profile of patients with pyoderma gangrenosum. All patients diagnosed as pyoderma gangrenosum in the department of dermatology from July 14th 2003- July 12th 2008 were included in the study. Demographic profile, clinical features as well as relevant investigations, treatment and follow-up were noted. A total of 8 patients with pyoderma gangrenosum were diagnosed over a 5 year period. There were 3 males and 5 female patients whose ages ranged from 32 to 80 years. Lower limbs were the commonest site to be involved in 6 patients (75%). Recurrent episodes were noted in 4 patients (50%) and among them 3 patients (75%) had multiple ulcers. Histopathological confirmation of the diagnosis was done in 7 patients (87.5%). Association with ulcerative colitis was seen in 2 patients (25%). All patients were treated with dapsone and systemic steroids which showed resolution of the lesions in all patients. Pyoderma gangrenosum was seen more frequently in females and association with ulcerative colitis was seen in 25% of the patients. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 29-35 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6823

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Prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182713 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1057

Author(s):

Edakkattil Rameshkumar ◽

Salini Ajitha

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Externa ◽

Clinical Presentation ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Causative Organism ◽

Care Hospital ◽

Age Group ◽

History Of ◽

The Common

Background: Otitis externa, an inflammatory condition commonly reported in almost all age groups. But the prevalence and etiology are varying on different region. This study was aimed to find out the prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital.Methods: All the patients presented with otitis externa in the outpatient department of ENT were included in the retrospective study. The history of self probing was identified using a questionnaire. The clinical presentation was noticed and organism was isolated from the swab taken from the external ear canal. The non-parametric data was expressed in numbers and percentage. Results: Total 49 patients were included in the study. The average age of patient was 39.5±14.3 years with 24 males and remaining females. Among them, 85.7% (42/49) had a history of self probing (p<0.05). The most prevalent age group for the self probing associated otitis externa was 31 to 40 years. The discharge was the major clinical presentation (40/49) and the common organism isolated was Pseudomonas aeruginosa in 38% of incidence.Conclusions: Self probing was major etiological factor for otitis externa in the age group of 31-40 years. Discharge was the major clinical presentation and the common organism isolated was Pseudomonas aeruginosa. This emphasized the need for a proper awareness programme in the society against self probing to reduce the incidence.

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