scholarly journals Spectrum of gastrointestinal perforation peritonitis in 462 consecutive patients in tertiary care institute of North India

2021 ◽  
Vol 8 (10) ◽  
pp. 2993
Author(s):  
Mahavir Singh ◽  
Satish Dalal ◽  
Mridul Gera
Keyword(s):  
Developing Countries ◽  
Surgical Treatment ◽  
Tertiary Care ◽  
Developed Countries ◽  
Gastrointestinal Perforation ◽  
North India ◽  
Common Site ◽  
Hollow Viscus ◽  
Common Etiology ◽  
Perforation Peritonitis

Background: Gastrointestinal perforation is one of the common surgical emergencies in developing countries. The diagnosis is mainly clinical and is aided by radiological investigations. This study was designed to highlight the spectrum of hollow viscus perforation peritonitis in terms of etiology, clinical presentations, site of perforation, surgical treatment, postoperative complications, and mortality.Methods: The study was a hospital‑based observational study and included 462 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included.Results: Overall stomach was the most common site of perforation (33%). Ileum (26%) was the second common site of perforation. Duodenal perforations were seen in 88 (19%) cases whereas appendicular perforations were seen in 46 (10%) cases. Colonic perforations were least common. Acid peptic disease was the most common etiology of stomach perforations. Enteric fever (63%) was the most common etiology of jejuno-ileal perforation. Other causes include tuberculosis (23%), trauma (8%), malignancy (3%) and idiopathic in rest. Males were six times more commonly affected than females. Peak incidence was noted in the 2nd and 3rd decades of life.Conclusions: Spectrum of perforation peritonitis cases in developing world is different from developed countries The Western literature suggests that foreign body, ischemia, radiotherapy, diverticula, and Crohn’s disease are the main causes of perforations. In contrast to this, infection is the most common cause for perforations in developing countries. 

scholarly journals Update: Primary immunodeficiency disorders among north Indian children

2021 ◽  
Vol 8 (4) ◽  
pp. 465-472
Author(s):  
Rakesh Kumar Deepak ◽  
Prabin Kumar ◽  
Abhinav Saurabh ◽  
Narendra Bagri ◽  
Sonia Verma
Keyword(s):  
Developing Countries ◽  
Primary Immunodeficiency ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Indian Children ◽  
Primary Immunodeficiency Disorders ◽  
Medical Practitioners ◽  
History Of ◽  
The Developed Countries

Primary immunodeficiency disorders (PIDs) are a group of genetic abnormalities characterized by defectin one or more constituents of the immune system.This group of disorders are largely undiagnosed and unreported worldwide due to lack of awareness among the medical practitioners,parents as well as lack of state of art diagnostic facilities. Earlier we had reported the distribution pattern of various categories of PID in children of north India; in this report we are appending the data with current findings.In this retrospective study we pooled data from PIDs workup of 706 children with suspected PIDs, below the age of 18Yrs, in the period of May 2017 October 2019. The clinical assessment and presentation of these children was suggestive of PID. The peripheral blood of these children was used for flow cytometry based immunophenotyping of immune cells. PIDs were classified according to the International Union of Immunological Societies’ (IUIS) criteria.A total of 133 (18.38%) children were diagnosed with one or other form of PID with overall median age was 3.25 years (male: 2.3 and female: 4.2Yrs). Chronic infection, persistent diarrhea and retarded growth were the common warning signsin these patients. Combined humoral and cellular immunodeficiency was observed in 32%, phagocytic defect in 23%, antibody defect in 17%, dysregulated innate immunity in 19% and other well defined syndromes in 9% of total diagnosed PID children. Around 15.78% of PID cases were seen in coupleswithconsanguineous marriage, past family history of PID in 20.30% and families with sibling death of unknown cause in 24.06%. The cause of death of the sibling was not known. PID diagnosed children received prophylactic antibiotics and/or antifungals in addition tospecific therapy for the underlying immune deficiency.The field of PID remainsunexplored worldwide. The awareness in the developed countries is more than that of developing countries like India. The developing countries face several challenges in the diagnosis of PIDs such as awareness among patients and medical practitioners, mostly in the rural settings, lack of sufficient number of tertiary care centres, lack of equipped immunological laboratory to diagnose the disease.

Analysis of Major Problems Faced by Small Firms in North India

2015 ◽  
Vol 15 ◽  
pp. 150-160
Author(s):  
Davinder Singh ◽  
Jaimal Singh Khamba ◽  
Tarun Nanda
Keyword(s):  
Economic Growth ◽  
Developing Countries ◽  
Economic Development ◽  
Small Firms ◽  
Small And Medium Enterprises ◽  
Developed Countries ◽  
North India ◽  
Small Enterprises ◽  
Employment Generation ◽  
Medium Enterprises

Micro, Small and Medium Enterprises (MSMEs) have been noted to play a significant role in promoting economic growth in less developed countries, developing and also in developed countries. Worldwide, the micro and small enterprises have been accepted as the engine of economic growth of any nation. Small and Medium Enterprises are the backbone of the economies, because it trigger employment, output, export, poverty alleviation, economic empowerment, economic development etc. in developed as well as in developing countries. It is more important to developing countries as the poverty and unemployment are burning problems. MSMEs have been playing a momentous role in overall economic development of a country like India where millions of people are unemployed or underemployed. Therefore, the growth of small sectors is essential for the growth in the GDP, employment generation, total manufacturing production and export. India, being one of the fastest growing economies of the world, needs to pay an honest attention for the utmost growth of MSMEs for its increased contribution in above areas.

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>

Therapy Outcome in Childhood ALL: Experience from a Tertiary Care Centre in North India.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 916-916
Author(s):  
Ram Kumar Marwaha ◽  
Ketan Kulkarni ◽  
Amita Trehan ◽  
Deepak Bansal
Keyword(s):  
Platelet Count ◽  
Survival Data ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Rank Test ◽  
Childhood All ◽  
Cure Rates ◽  
Lost To Follow Up

Abstract Survival in childhood ALL, in resource challenged nations, has not kept pace with cure rates of over 80% in developed countries. This descriptive study was designed to assess survival data and identify risk factors for adverse outcome. Data obtained from case records of 762 patients with ALL was analyzed. Information regarding the clinical-demographic profile, therapy and course of illness were recorded. Status and duration at last follow-up were utilized to generate Kaplan-Meier survival curves. The mean age at presentation was 5.7±0.23 years (M:F::3.2:1). Caretakers of 230 (30.2%) patients opted for no therapy. There were 68 and 60 deaths in induction and remission phases respectively. Besides these, 111 children either defaulted therapy (23) or were lost to follow up (88). Relapsed disease was documented in 125 cases. The 5 year overall and event-free survival was 46 and 34% respectively. The p values for survival analysis using the Log-rank test for groups formed according to the gender, age, symptom-diagnosis interval, TLC and platelet count were 0.19, 0.02, 0.08, <0.001, 0.001 respectively. Bulk disease (p=0.047), mediastinal adenopathy (p=0.045), TLC (p=0.016), platelet count (p=0.031) and administration of 2 intensification blocks (p=0.012) were found to be significant predictors of outcome by univariate and multivariate analysis. The holistic management of ALL in children requires financial resources, a strong psychosocial structure and access to quality supportive care. Almost one third of our patients opted for no therapy. The other problem areas identified were a high proportion of therapy defaulters, lost to follow up and infection related deaths during induction and remission phases. TLC >50000/microliter and platelet count <30000/microliter had an adverse impact on survival. The administration of both early and delayed intensification improved survival. The introduction of remedial measures for tapping the difficulties identified, would undoubtedly improve cure rates in children with ALL in developing nations.

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals Prevalence and outcome of anaemia among pregnant women attending tertiary care hospital in Visakhapatnam

2017 ◽  
Vol 5 (1) ◽  
pp. 203
Author(s):  
Radha Kumari Paladugu ◽  
Srinivas Jagath Pentakota ◽  
Sushma N.
Keyword(s):  
Socioeconomic Status ◽  
Developing Countries ◽  
Pregnant Women ◽  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Developed Countries ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Study Population

Background: Anaemia in pregnancy is now considered as a major public health problem, caused by iron deficiency. WHO has estimated that prevalence of anaemia in developed and developing countries in pregnant women is 14% in developed countries and 51 percent in developing countries and 65-75% in India. Various programmes regarding anaemia prophylaxis and maternal health have been implemented but still the prevalence of anaemia related complications among pregnant women continues to be high. Hence the present study was conducted to study the prevalence and pregnancy outcome as a result of anaemia in a tertiary care center in Visakhapatnam. Methods: A cross sectional descriptive study was carried out from June 2016 to August 2016 in the Department of Obstetrics and Gynecology among postnatal women in King George hospital, Visakhapatnam. A semi-structured questionnaire was prepared and information regarding age, socioeconomic status, parity, gestational age interval between pregnancies and outcome and complication of pregnancy were collected. Results: Mean age of study population is 22.4 years. Out of 100 women involved in the study 65 are from urban areas 29 from rural areas and 6 from tribal areas. Majority of the study population 66% were having HB% between 8-11% i.e. mild anaemia. When Outcome of pregnancy was seen in relation to anaemia majority of the women had live births (90%) followed by 7% IUDs and 2% still births. Conclusions: Majority of the women are in the age group of 20-24 years. Socioeconomic status is directly related to anaemic status of the women. Majority of the women had complication of puerperal sepsis. 

scholarly journals Intestinal obstruction in a tertiary care centre in India: are the differences with the Western experience becoming less?

2021 ◽  
Author(s):  
Suvendu Sekhar Jena ◽  
Ravi Chandra Reddy Obili ◽  
Sri Aurobindo Prasad Das ◽  
Ruchir Bhavsar ◽  
Sanket Solanki ◽  
...  
Keyword(s):  
Developing Countries ◽  
Intestinal Obstruction ◽  
Demographic Data ◽  
Tertiary Care ◽  
Developed Countries ◽  
Western World ◽  
Tertiary Care Centre ◽  
Duration Of Symptoms ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background: Patients with intestinal obstruction consist of a major proportion of emergency room visits and the complication is associated with significant morbidity and mortality. It has a diverse etiology and varies from region to country. In developed countries it is mainly due to adhesions and in developing countries due to obstructed hernias. Although there are numerous studies from the western world there have been few recent publications from the developing world. Method: We retrospectively analyzed all the patients admitted for intestinal obstruction to our department from January 1996 to December 2019. Their demographic data, duration of symptoms before presenting to the hospital and duration of stay before surgery in the hospital were noted along with cause and level of obstruction. The type of procedure, any post-operative complications, mortality or re-exploration were also noted. Post-operative complications were graded as per Clavien Dindo classification. Results: A total of 986 patients presented with intestinal obstruction during this period out of which 743 patients underwent surgery. There were 429 (57.74%) males 314 (42.26%) females who had a mean age of 50.1 years (range 11 to 96 years). The commonest cause of obstruction was adhesions in 273 (36.7%) followed by carcinoma [130(17.5%)], tuberculosis [111(14.9%)], stricture [94(12.7%)] and hernia (5.4%) patients. Colorectal surgery was the most common previous procedure in the adhesive group [85(31.1%)]. Colon cancer was the common cause in carcinoma group. Ileum was the most common site of obstruction [329(44.3%)]. The overall operative mortality was 41 (5.5%). Conclusion: Postoperative adhesions are now the commonest cause of intestinal obstruction in our referral center with a comparable mortality rate with western reports. Though the etiology of intestinal obstruction is shifting towards the western pattern, tuberculosis, obstructed inguinal hernia still consists a major chunk of patients in developing countries.

scholarly journals Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3342
Author(s):  
Shivangi S. Gandhi ◽  
Pinal C. Shah
Keyword(s):  
Cervical Cancer ◽  
Developing Countries ◽  
Pap Smear ◽  
Early Stage ◽  
Tertiary Care ◽  
Developed Countries ◽  
Pap Smears ◽  
Papanicolaou Test ◽  
Incidence And Mortality ◽  
Malignant Lesions

Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer.

scholarly journals A study on prescribing errors in in-patients of a corporate tertiary care hospital in North India

2019 ◽  
Vol 8 (8) ◽  
pp. 1855
Author(s):  
Ashish Yadav ◽  
Mohammed R. Rashed
Keyword(s):  
Patient Care ◽  
Error Rate ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Junior Resident ◽  
Care Hospital ◽  
Prescribing Errors ◽  
Patient Identification ◽  
Prescribing Error

Background: Prescribing errors are a subset of medication errors which have a potential for grave harm to the patient. Identification and acknowledgement of such errors can ameliorate much of this danger. Studies of prescribing errors are sparse in India. Such studies, whatever have been conducted, mainly focus on the out-patients or the patients on discharge. Hence, this study was undertaken to study the prescribing errors in prescriptions generated for patients admitted in wards of a corporate hospital in North India.Methods: The prescriptions for in-patients admitted in wards were analyzed for different types of prescribing errors in individual drug orders and prescription as a whole.Results: The prescribing error rate was found to be 3.3% in this study. Of all errors, errors leading to delays in patient care (i.e. Errors of prescription writing) (54.54%) and erroneous copying of the prescription to the drug chart by junior/ resident doctors (Transcription errors) (31.31%) were found to be the major causes of prescribing errors in this study. Of the former category, prescribing a wrong strength (24.24%) and illegible drug orders (12.12%) were the most numerous error subtypes. Errors leading to sub-optimal patient care (i.e. Errors of decision making) were least identified of which Therapeutic duplication (12.12%) was the most common subtype.Conclusions: The error rate found in this study is comparable to the data available from developed countries. However, there are significant differences in the occurrences of error subtypes found in this study as compared to the studies of the west.

scholarly journals Splenomegaly in children

2019 ◽  
Vol 6 (4) ◽  
pp. 1552
Author(s):  
Milind B. Kamble ◽  
Kunj Bihari Meena ◽  
Vimla Kumari Meena
Keyword(s):  
Surgical Treatment ◽  
Hemolytic Anemia ◽  
Tertiary Care ◽  
Common Cause ◽  
Detailed History ◽  
Common Grade ◽  
Common Etiology ◽  
Possible Cause ◽  
Hematological Investigation ◽  
Grade Iii

Background: Splenomegaly occurs when the size of the spleen is increased by cells or tissue components or by vascular engorgement. In childhood, it is generally first suspected upon physical examination. The aim of the present study was to find out the prevalence and possible cause of splenomegaly in children admitted in pediatric ward and NICU at tertiary care center.Methods: In this study, total 124 children of age between 0-12 years with clinically palpable splenomegaly, admitted to the wards were studied during the period of 18 months. A detailed history, thorough clinical and all relevant investigation was done. The enlargement of the spleen was graded as per Hacketts and conventional classification. The prevalence, cause of splenomegaly and outcome of the study was noted.Results: The prevalence of splenomegaly was 1.46%. Most common grade of splenomegaly was grade III (33%) of Hackett’s classification. The most common presenting symptom was fever (75%) and sign was pallor (97%). Most common cause of splenomegaly was hemolytic anemia (80.64%) among which thalasemia was 50% followed by sickle cell anemia 30.64%. Out of 124 patients, 123 (99.1%) received medical treatment while only one patient (0.9%) underwent surgical treatment. Among medically treated patients 18 (14.5%) were recovered completely while 100 (80.6%) improved and 4 (3.2%) stable and two patients were (1.6%) died.Conclusions: In patient with grade III, IV, and V of splenomegaly is more likely to have hemolytic anemia as common etiology and hematological investigation should be given more emphasis in a case of splenomegaly.

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