scholarly journals Bactibilia-effect on postoperative course and outcome in patients with bilio-pancreatic diseases

2021 ◽  
Author(s):  
A. Dinakar Reddy ◽  
Anuroop Thota ◽  
Vanga Devi Harsha
Keyword(s):  
Significant Relationship ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Infectious Complications ◽  
Biliary Stent ◽  
Microbiological Analysis ◽  
Care Hospital ◽  
Male Predominance ◽  
Biliary Tract Surgery ◽  
Local Antibiotic

Background: Bactibilia is detrimental to the outcomes of biliary tract surgery. The present study was undertaken to determine the microbial flora of bile and their significance to post-operative infectious complications and morbidity.Methods: A retrospective study of patients with biliopancreatic diseases who underwent surgery from Jan 2017 to March 2020 in a tertiary care hospital were analyzed. The samples were assessed for bile microbiological flora, and a search for their possible link with post-operative infectious complications and morbidity was carried out.Results: A total of 90 bile samples were assessed. The mean age of the study group was 51.8 SD-13.6 years with male predominance. Bactibilia was found in 39 cases (43.3%), mostly in patients with malignant diseases, older than 50 years and females. Escherichia coli was the most common organism. Post-operative infectious complications were seen in twenty cases, thirteen of them in bactibilia-associated patients, showing statistical significance. Statistical significance was found between the presence of pre-operative biliary stent and bactibilia and between diabetes mellitus and bactibilia. Nine out of 24 patients with comorbidities had post-operative infectious complications. No significant relationship was found between pre-operative jaundice and comorbidities with bactibilia. Conclusions: The present study showed a statistically significant relationship between the presence of pre-operative biliary stent and bactibilia and also the incidence of post-operative infectious complications and bactibilia. Microbiological analysis of bile is a valuable tool in prognosticating the post-operative complications, thereby guiding us to provide adequate therapy and helps to establish local antibiotic guidelines.

scholarly journals MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mri Findings ◽  
Mri Scan ◽  
Cross Sectional ◽  
Adc Value ◽  
Group 2 ◽  
Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

scholarly journals Knowledge in palliative care of nursing professionals at a Spanish hospital

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Elena Chover-Sierra ◽  
Antonio Martínez-Sabater ◽  
Yolanda Lapeña-Moñux
Keyword(s):  
Palliative Care ◽  
Basic Education ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Study Data ◽  
Care Hospital ◽  
Cross Sectional

Resume Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care.

scholarly journals An evaluation of knowledge, attitude and practice of pharmacovigilance among medical students and doctors at a tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 324 ◽  
Author(s):  
Ravindra S. Beedimani ◽  
Sameer Uz Zaman ◽  
Subrahmanyam Darb ◽  
Sharat Chandra Potturi
Keyword(s):  
Medical Students ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Doctors ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Validated Questionnaire ◽  
Correct Definition ◽  
Knowledge Attitude And Practice

Background: Drugs are one of the most commonly used interventions in medical therapeutics. Spontaneous reporting of adverse drug reactions (ADRs) is the backbone of pharmacovigilance (PV) program. Under-reporting of ADRs by prescribers was possibly due to lack of knowledge, attitude and practices regarding PV. This study was done to assess the knowledge, attitude, and practice (KAP) of medical students (grouped to sixth and eighth semester) and medical doctors about PV in a tertiary care hospital.Methods: It was a questionnaire based cross-sectional study administered to 246 medical students and doctors. Study tool was a validated questionnaire containing 15 questions to evaluate KAP of PV among medical students and doctors. A descriptive analysis of data was done where necessary, statistical significance for associations between the group and their responses to questionnaire was provided using Pearson Chi square test and Fisher exact test.Results: Sixty-eight percent of the participants (90% doctors; 76% eighth-semester and 46% sixth-semester medical students) know the correct definition of PV. Sixty-one percent of the participants (67% sixth-semester, 61% doctors and 53% eighth-semester) think that reporting is a professional obligation for them. Only 15% of the participants have ever been taught or trained on how to report an ADR.Conclusions: Medical doctors and students lack adequate knowledge and practice of reporting ADRs, but they seem to have a positive attitude towards the PV program. Our study findings strongly suggest that there is a great need to create awareness amongst them to promote reporting of ADRs.

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 Prevalence, etiology, and antibiotic resistance profiles of bacterial bloodstream infections in a tertiary care hospital in Northern India: A 4-year study

2018 ◽  
Vol 10 (04) ◽  
pp. 426-431 ◽  
Author(s):  
Surbhi Khurana ◽  
Nidhi Bhardwaj ◽  
Minu Kumari ◽  
Rajesh Malhotra ◽  
Purva Mathur
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Antimicrobial Treatment ◽  
High Morbidity ◽  
Trauma Patients ◽  
Microbiological Analysis ◽  
Care Hospital ◽  
Bacterial Strains ◽  
Klebsiella Species ◽  
Acinetobacter Species

Abstract INTRODUCTION: Bloodstream infections (BSIs) can lead to life-threatening sepsis and are globally associated with high morbidity and mortality. Although BSIs require immediate antimicrobial treatment, their prevalence, etiology, and antimicrobial susceptibilities differ from one country to other. There is a dearth of such data from India. Here, we report the 4-year etiologic data on BSI in trauma patients admitted to a tertiary care referral hospital in New Delhi, India. MATERIALS AND METHODS: A retrospective study was conducted at the trauma center between January 2013 and December 2016. The routine microbiological data on bacterial BSI were recorded and determined retrospectively from the laboratory records. Antimicrobial susceptibility profiles were statistically analyzed. RESULTS: A total of 2017 bacterial strains isolated from blood culture samples were included for microbiological analysis. During the study, the median age of the patients varied from 30 to 35 years, with the percentage of females in the study population varying from 17% to 19%. The predominant pathogens were Gram-negative bacteria, with Acinetobacter species, followed by Klebsiella species being the most commonly isolated organisms throughout the 4 years of study. Among Gram-positive isolates, Staphylococcus species were the leading pathogens (11%–15%). CONCLUSIONS: A detailed analysis of prevalence, etiology of BSIs in India and its resistance profile is crucial for appropriate antibiotic use, clinical management, and formulation of antibiotic policies and preventive measures.

scholarly journals A MYCOLOGICAL STUDY OF CLINICAL SAMPLES FROM SUSPECTED MYCOSES IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (4) ◽  
pp. 267
Author(s):  
Jitendra Chandra Devrari ◽  
Varsha Saxena ◽  
Vidya Pai
Keyword(s):  
Fusarium Species ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Trichophyton Mentagrophytes ◽  
Culture Technique ◽  
Clinical Samples ◽  
Care Hospital ◽  
Superficial Infection ◽  
Male Predominance ◽  
Urease Test

 Objective: The objective of this study was to isolate and identify the fungal agents obtained from clinical samples of suspected mycoses patients attending Yenepoya hospital.Methods: Various clinical samples obtained from patients were subjected to preliminary examination according to standard mycological protocols such as KOH mount, wet mount, Gram’s staining, and Indian ink examination. Causative organisms were identified by macroscopically and microscopically after growth on sabouraud’s dextrose agar (with or without cycloheximide and chloramphenicol) and confirmed by lactophenol cotton blue mount, slide culture technique, urease test, and growth on chrome agar accordingly.Results: Of 274 clinical samples, 125 were culture positive in which the fungal isolates obtained were dermatophytes (all 3 genera), Candida species (including Candida albicans), Fusarium species, Aspergillus fumigatus, and Cryptococcus neoformans. Male predominance was found among the patients being 6:3 male:female ratio.Conclusion: Among the superficial infection, Trichophyton mentagrophytes was found to be predominant isolates; however, in systemic infection, C. albicans was the predominant isolates.

scholarly journals Hospital Outcomes of Infants with Neonatal Opioid Withdrawal Syndrome at a Tertiary Care Hospital with High Rates of Concurrent Nonopioid (Polysubstance) Exposure

2020 ◽  
Author(s):  
Erin Morris ◽  
Tyler Bardsley ◽  
Krista Schulte ◽  
Jeanette Seidel ◽  
Julie H. Shakib ◽  
...  
Keyword(s):  
Withdrawal Syndrome ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Opioid Withdrawal ◽  
Adjunctive Treatment ◽  
Care Hospital ◽  
Hospital Outcomes ◽  
Long Acting ◽  
Opioid Withdrawal Syndrome

Objective Neonatal opioid withdrawal syndrome (NOWS) describes infants' withdrawal signs and symptoms after birth due to an interruption of prenatal opioid exposure. Many infants with NOWS are also exposed to nonopioids, however. This study was to determine hospital outcomes of infants exposed to opioids alone or coexposed with nonopioid substances (polysubstance). Study Design We reviewed infants of ≥34 weeks of gestation with prenatal opioid exposure from April 2015 to May 2018. We compared the median lengths of stay (LOS) and treatment (LOT) and the percentages of infants requiring pharmacologic and adjunctive treatment in infants exposed to opioids alone or polysubstance. We used Wilcoxon's test for continuous outcomes or Chi-squared test for categorical outcomes to determine statistical significance. We used multivariable regression model to calculate each drug category's estimates of adjusted mean ratios for LOS and LOT plus estimates of adjusted odds ratios for pharmacologic/adjunctive treatments. Results Of the 175 infants, 33 (19%) infants had opioid exposure alone. Opioid exposure included short- and/or long-acting opioids. A total of 142 (81%) had polysubstance exposure with 47% of mothers using nicotine products. We saw similar hospital outcomes between infants exposed to opioids alone or polysubstance; however, a higher percentage of infants with both short- and long-acting opioid exposure required pharmacologic treatment compared with either opioid alone. Focusing on individual drug categories, we detected differential hospital outcomes in which short-acting opioids decreased LOT, whereas long-acting opioids increased LOS, LOT, and need for pharmacologic and adjunctive treatment. Coexposure of opioids with stimulants decreased LOT and reduced need for adjunctive treatment. Coexposures with antidepressants increased LOT, while with antiepilepetics increased LOS. Conclusion Because infants with NOWS often have coexposures to other nonopioid substances, appreciating the associated risks of individual or combination of drugs in modulating hospital outcomes may help counsel families on their infants' expected hospital course. Key Points

scholarly journals Clinicohormonal Parameters as a Primary Step to Differentiate Normosmic Idiopathic Hypogonadotropic Hypogonadism and Kallmann Syndrome in a Tertiary Care Hospital in Eastern India

2021 ◽  
Author(s):  
Ram Chandra Bhadra ◽  
Dona Saha ◽  
Arjun Baidya
Keyword(s):  
Genetic Disorder ◽  
Hormone Replacement ◽  
Hypogonadotropic Hypogonadism ◽  
Tertiary Care ◽  
Serum Testosterone ◽  
Kallmann Syndrome ◽  
Care Hospital ◽  
Cross Sectional ◽  
Idiopathic Hypogonadotropic Hypogonadism ◽  
Male Predominance

Introduction: Idiopathic hypogonadotropic hypogonadism is a rare gonadal dysgenesis in which puberty does not take place naturally. It occurs due to insufficient pulsatile secretion of Gonadotrophin-Releasing Hormone (GnRH) and the resulting Follicle-Stimulating Hormone (FSH) and Luteinising Hormone (LH) deficiency leads to absence of or delayed sexual maturation. Kallmann syndrome is an uncommon genetic disorder characterised by hypogonadotropic hypogonadism associated with anosmia or hyposmia. When anosmia is absent, the same is referred as normosmic Idiopathic Hypogonadotropic hypogonadism (nIHH). Aim: To find out the significant differences between Kallmann syndrome and nIHH based on clinical features and biochemical assessment as a primary measure to initiate the treatment early. Materials and Methods: This hospital based cross-sectional observational cohort study was conducted in Department of Endocrinology, Nilratan Sircar Medical College and Hospital, Kolkata, India. The study was done on 55 cases of IHH presenting to the department with delayed secondary sexual characteristics. Results: Out of these 55 cases, 45 (81.8%) were of nIHH and only 10 (18.2%) cases were of Kallmann Syndrome. It was found that both the conditions show male predominance. Smell abnormalities were present only in Kallmann group. The level of serum testosterone was significantly higher (p<0.05) in nIHH subjects (mean-35.59 ng/dL) than patients with Kallmann Syndrome (mean-14.90 ng/dL). Patients with Kallmann syndrome showed significantly reduced pubic and axillary hair development and absence of gonadal development. Conclusion: Absence of puberty with anosmia/hyposmia with low serum FSH and LH, drastically reduced serum testosterone, are factors that point towards the diagnosis of Kallmann syndrome even in absence of genetic study, which is helpful for initiation of hormone replacement therapy for treatment.

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