scholarly journals Evaluation of prevalence, clinical spectrum and outcome of acute ITP in children in a tertiary care centre in Odisha, India

2017 ◽  
Vol 4 (4) ◽  
pp. 1470
Author(s):  
Jyotiranjan Champatiray ◽  
Deepak Kumar Behera ◽  
Akhil Krishnamoorthy ◽  
Shreesh Bhat
Keyword(s):  
Past History ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Complete Recovery ◽  
Tertiary Care Centre ◽  
Thrombocytopenic Purpura ◽  
Number Of Patients ◽  
Acute Itp ◽  
Post Graduate Institute

Background: Idiopathic thrombocytopenic purpura (ITP), also known as immune thrombocytopenic purpura is one of the commonest bleeding disorders encountered in children between the ages of 2 to 10 years affecting both sexes. The objectives of the study were to collect the prospectively data including age, gender, bleeding type, platelet count and other laboratory tests, treatments, responses to treatment and outcomes in children with acute ITP from 1month to 14 years of age over a period of two years.Methods: The present study was conducted in the Department of Paediatrics Shrirama Chandra Bhanj, Medical College and Hospital and Sardar Vallabhbhai Patel Post Graduate Institute of Paediatrics, Cuttack during the period October 2011-Septmber 2013.Results: Total 36 cases of hospitalized acute ITP patients were studied out of 29200 cases. Prevalence of acute ITP was found to be 12.3 per 10,000 of all hospitalized children above 1 month. Male children outnumbered female children by Ratio 1.2. Past history of URTI was present in 78% of cases. Petechaie/purpura was the universal presenting features followed by Oral / Gum bleeding in 67% of cases. 8% of patient experienced clinical bleeding requiring blood transfusion and platelet transfusion. Mean duration of Hospital stay was 6.34 days. Maximum number of Patients (69%) had complete recovery and 14% each had persistent and chronic course.Conclusions: ITP is a common pediatrics disease presenting at any age with low morbidity and mortality. Most children with acute ITP recover in weeks to months. A long-term hospital based prospective study is suggested to know any significant risk factor in patient presenting with acute ITP.

scholarly journals Maternal haemoglobin and perinatal outcome in a tertiary care hospital in Jammu city, India

2017 ◽  
Vol 6 (11) ◽  
pp. 5060
Author(s):  
Indu Kaul ◽  
Isha Sunil ◽  
Aakriti Gupta
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Care Hospital ◽  
Third Trimester ◽  
Tertiary Care Centre ◽  
Fetal Outcomes ◽  
Maternal Anemia ◽  
Moderate Anemia

Background: Maternal anemia is a common problem worldwide. The objective of this study was to assess the prevalence of anemia in women attending a tertiary care centre in their third trimester of pregnancy and to study the relation of maternal hemoglobin with perinatal outcome.Methods: This study was conducted in the Department of Obstetrics and Gynecology, SMGS Hospital, Jammu for a period of one year from Nov. 2015 to Oct. 2016. A total of 767 women in their third trimester (>28 weeks) were enrolled and were followed till delivery. Their hemoglobin levels were noted and its association with adverse maternal and fetal outcomes was studied.Results: It was seen that out of 767 patients, 193 (25.16%) were non-anemic and 574 (74.83%) were anemic out of which 343 (44.71%) were mildly anemic, 160 (20.86%) had moderate anemia and 70 (9.12%) had severe anemia. There was increased incidence of preterm delivery, PPH, preeclampsia, eclampsia, CCF, mortality & blood transfusions in the anemic group as compared to the non-anemic group. Among the adverse fetal outcomes, there was increased incidence of intrauterine deaths, intrauterine growth restriction, NICU admissions, meconium stained liquor, low birth weight babies and APGAR scores <7/10 among the anemic group as compared to the non-anemic group.Conclusions: Maternal anemia is a significant risk factor for adverse maternal and perinatal outcome and its prevalence continues to be high especially in developing countries like India. So, correction of maternal anemia still remains one of the most important step towards better obstetrical care.

Neurodevelopmental outcome of healthy term newborn with serum bilirubin >15 mg/dl at one year

2020 ◽  
pp. 1-6
Author(s):  
P. Dubey ◽  
J. Shrivastava ◽  
B.P. Choubey ◽  
A. Agrawal ◽  
V. Thakur
Keyword(s):  
Serum Bilirubin ◽  
Tertiary Care ◽  
Neurodevelopmental Outcome ◽  
Significant Risk ◽  
Central India ◽  
Significant Risk Factor ◽  
Motor Domain ◽  
Medical Emergency ◽  
One Year ◽  
Group 1

BACKGROUND: Neonatal hyperbilirubinemia is a common medical emergency in early neonatal period. Unconjugated bilirubin is neurotoxic and can lead to lifelong neurological sequelae in survivors. OBJECTIVE: To find out the association between serum bilirubin and neurodevelopmental outcome at 1 year of age using Development Assessment Scale for Indian Infants (DASII). METHODS: A prospective cohort study was conducted in the Department of Pediatrics of a tertiary care institution of Central India between January 2018 and August 2019. Total 108 term healthy neonates, with at least one serum bilirubin value of >15 mg/dl, were included. Subjects were divided into three groups based on the serum bilirubin; group 1: (15–20 mg/dl) –85(78.7%) cases, group 2: (20–25 mg/dl) –17(15.7%), and group 3: (>25 mg/dl) –6(5.5%). Developmental assessment was done using DASII at 3, 6, 9, 12 months of age. RESULTS: Out of 108 cases, 101(93.5%) received phototherapy, and 7(6.5%) received double volume exchange transfusion. Severe delay was observed in 5(4.6%) and mild delay in 2(1.9%) cases in the motor domain of DASII at one year. Severe delay in the motor domain was associated with mean TSB of 27.940±2.89 mg/dl and mild delay with mean TSB of 22.75±1.76 mg/dl (p = 0.001). On cluster analysis, delay was observed in locomotion 1 score in 11(13%) cases (p = 0.003) and manipulation score in 6(7.1%) cases in group 1. CONCLUSION: Increased serum bilirubin was a significant risk factor for the delayed neurodevelopment in babies with neonatal jaundice. Even a moderate level of bilirubin significantly affects the developmental outcome.

Initial high rate of misdiagnosis in Crimean Congo haemorrhagic fever patients in an endemic region of Turkey

2009 ◽  
Vol 138 (1) ◽  
pp. 139-144 ◽  
Author(s):  
N. TASDELEN FISGIN ◽  
L. DOGANCI ◽  
E. TANYEL ◽  
N. TULEK
Keyword(s):  
Seasonal Pattern ◽  
Antiviral Treatment ◽  
Tertiary Care ◽  
High Rate ◽  
Haemorrhagic Fever ◽  
Endemic Region ◽  
Tertiary Care Centre ◽  
Number Of Patients ◽  
Epidemic Area ◽  
Crimean Congo Haemorrhagic Fever

SUMMARYCrimean Congo haemorrhagic fever (CCHF) has been an emerging tick-borne infection in some parts of Turkey since 2002, with a number of fatalities. Many of the initial non-specific symptoms of CCHF can mimic other common infections. Additionally, the seasonal pattern of the epidemic, and the waning attention of healthcare workers to the yearly index cases caused some delays in appropriate patient care and treatment. Between March 2004 and August 2008, 140 confirmed adult cases were evaluated retrospectively for initial diagnosis and treatment delays. This study clearly demonstrated that there are particular delays (4·8 days) in the referral system to initiate effective antiviral treatment in the tertiary-care centre which significantly affect fatality rates (P>0·05). A large number of patients (n=95, 68%) received an initial misdiagnosis of various infections other than CCHF. In conclusion, continuous medical education regarding CCHF in the epidemic area is essential in order to achieve a better survival rate from this deadly infection.

An Outbreak of Pyodermas Among Neonates Caused by Ultrasound Gel Contaminated With Methicillin-SusceptibleStaphylococcus Aureus

2000 ◽  
Vol 21 (12) ◽  
pp. 761-764 ◽  
Author(s):  
Klaus Weist ◽  
Constanze Wendt ◽  
Lyle R. Petersen ◽  
Hans Versmold ◽  
Henning Rüden
Keyword(s):  
Hip Joint ◽  
Case Control Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
University Hospital ◽  
Good Physical Condition ◽  
Rapd Pcr ◽  
Control Study

Objective:To investigate an outbreak of methicillin-susceptibleStaphylococcus aureus(MSSA); infections in a neonatal clinic.Design:Prospective chart review, environmental sampling, and genotyping by two independent methods: pulsed-field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). A case-control study was performed with 31 controls from the same clinic.Setting:A German 1,350-bed tertiary-care teaching university hospital.Results:There was a significant increase in the incidence of pyodermas with MSSA 10 neonates in good physical condition with no infection immediately after birth developed pyodermas. A shared spatula and ultrasound gel were the only identified infection sources. The gel contained MSSA and was used for hip-joint sonographies in all neonates. PFGE and RAPD-PCR patterns from 6 neonates and from the gel were indistinguishable and thus genetically related clones. The case-control study revealed no significant risk factor with the exception of cesarean section (P=.006). The attack rate by days of hip-joint sonography between April 15 and April 27, 1994, was 11.8% to 40%.Conclusions:Inappropriate hygienic measures in connection with lubricants during routine ultrasound scanning may lead to nosocomialS aureusinfections of the skin. To our knowledge this source ofS aureusinfections has not previously been described.

scholarly journals Clinical spectrum of facial hypermelanosis: a descriptive study from a tertiary care centre

2020 ◽  
Vol 6 (2) ◽  
pp. 212
Author(s):  
Mohammed Thoyyib ◽  
Roshni Menon ◽  
Brinda G. David
Keyword(s):  
Tertiary Care ◽  
Clinical History ◽  
Climatic Conditions ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Pigmentary Disorders ◽  
Number Of Patients ◽  
The Face ◽  
Detailed Clinical History

<p class="abstract"><strong>Background:</strong> Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.</p><p class="abstract"><strong>Methods:</strong> This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.<strong></strong></p><p class="abstract"><strong>Results:</strong> The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.</p><p><strong>Conclusions:</strong> FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.</p>

scholarly journals The prevalence of gastroesophageal reflux disease and its association with various risk factors in a tertiary care centre in West Bengal

2021 ◽  
Vol 9 (3) ◽  
pp. 780
Author(s):  
Anant Parasher ◽  
Kunal Ranjan
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Urban Areas ◽  
West Bengal ◽  
Past History ◽  
Tertiary Care ◽  
Time Interval ◽  
Number Of Patients ◽  
Study Population

Background: Gastroesophageal Reflux (GER) is the regurgitation of gastric contents and acid into the esophagus. Frequent and abnormal amounts of reflux leads to Gastroesophageal reflux disease (GERD) which causes symptoms like heartburn, regurgitation, and /or other complications. In view of absence of any data on the prevalence of GERD from this part of India, the current population based study was conducted to study the prevalence of GERD and its association with various risk factors.Methods: In this community based prospective cross-sectional observational study, 500 patients from rural and urban areas of West Bengal were included during the one year period from July 2014 to June 2015.Results: Out of a total of 500 patients studied, the percentage of patients with GERD in our study population was found to be 31.3%. Out of 292 males enrolled for the study, number of patients with GERD was 66 (22.6%) as compare to females where the same was found to be 43.26% (90/208). The majority (68.2%) of patients had mild GERD, 18.5% had moderate GERD whereas only 13.3% of patients had severe GERD.Conclusions: The percentage of patients with GERD in our study population was found to be 31.3%. It was observed to be significantly associated with increasing Body Mass Index (B.M.I), smoking, the female gender, a sedentary lifestyle, dinner to bed-time interval of ≤2 hours, chronic NSAID use, and a past history of abdominal surgery.

CLINICAL PROFILE OF OUTPATIENTS ATTENDING DERMATOLOGY DEPARTMENT DURING COVID-19 LOCKDOWN RELAXATION PERIOD IN A TERTIARY CARE CENTRE IN SOUTH INDIA – A CROSS-SECTIONAL ANALYTICAL STUDY

2021 ◽  
pp. 13-16
Author(s):  
Afthab Jameela Wahab ◽  
Pavithra Gunasekaran ◽  
P. Mohan ◽  
V. Sudha ◽  
L. Balamurugan ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Relaxation Period ◽  
Number Of Patients ◽  
Outpatient Practice ◽  
The Impact

Background - The cutaneous manifestations of the novel coronavirus have been well documented. However, there are few studies that relate to the clinical prole of regular dermatology outpatients seeking treatment during the lockdown relaxation period braving the pandemic. With the Aim - view to determine the changes seen in dermatology outpatient practice, this study analysed the clinical prole of new patients attending the Dermatology Outpatient Department (OPD) during the COVID-19 lockdown relaxation period in a tertiary care centre in a metropolitan suburb in South India. New dermatology outpatients during the months of May, June, July and August Method - 2020 were included in the study. Outpatient data for this period was analysed and compared with corresponding data for the same period in the previous two years. There was a Result – decrease in the OP census, number of patients in the extremes of life as well as those with asymptomatic dermatoses. There was an increase in the number of patients with infections, particularly dermatophytosis. There was also a noteworthy absence of dermatological emergencies. Conclusion - In essence, our study shows the impact of COVID-19 pandemic on the routine dermatology outpatient services with signicant changes in the clinical prole of outpatient practice following lockdown relaxation.

Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades

2021 ◽  
Vol 25 (4) ◽  
pp. 271-276
Author(s):  
U. N. Siakia ◽  
V. Vishwajeet ◽  
R. Kumar ◽  
V. Suri ◽  
K. Joshi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Reproductive Organs ◽  
Hospital Inpatient ◽  
Tertiary Care Centre ◽  
Autopsy Study ◽  
Atypical Symptoms ◽  
Significant Burden ◽  
Post Graduate Institute ◽  
The Brain ◽  
Significant Mortality

BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS: Data on autopsy-confirmed cases of dTB from over three decades (1988–2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS: During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION: A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.

APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

scholarly journals EPIDEMIOLOGICAL STUDY OF TRAUMA IN A TERTIARY CARE CENTRE IN NORTHWEST INDIA

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Vaibhav Lakhanpal ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Poojan Thakor ◽  
...  
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Total Mortality ◽  
Public Health Problem ◽  
Common Mechanism ◽  
Mechanism Of Injury ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Keywords Trauma ◽  
Number Of Patients

Objective: Traumatic injuries are a matter of concern worldwide. However, the rapidly changing socio economical dynamics in a developing country like India deeply influence the epidemiology behind trauma. The aim of this study was to document and analyze the epidemiological parameters and characteristics behind trauma victims admitted to our tertiary care centre. Methods: The observational study was carried out over a period of one year (January 2019 to December 2019) enrolling a total of 300 trauma patients. The age, sex, locality, delay in hospitalization, mechanism of injury, sites of injury and outcomes were documented. Results: Injuries occurred predominantly in the 20-40 age group with males being the chief victims. There was a considerable amount of delay in hospitalization ranging from one hour to more than 24 hours while only 7 patients arrived to the emergency within one hour of trauma. Vehicular trauma (54%) was the most common mechanism of injury. Injuries to the extremities (38.6%) and head (28.6%) were the most common sites. A considerable number of patients (45.3%) required care in the intensive care unit. A total of 172 patients required surgical interventions of various kinds and there was a total mortality rate of 6%. Amongst the polytrauma cases, 54 patients (81.8%) required ICU admission, 42 patients (63.6%) required surgical intervention and 6 patients (9.1%) died after admission. Conclusion: The results of this study highlight some of the problems with our existing infrastructure bringing to light the need for stricter enforcement of traffic safety laws and improvement of infrastructure particularly the roadways in rural areas as well as the referral systems. Vehicular trauma should be seen as a public health problem and appropriate interventions should be implemented. Keywords: Trauma, Road Traffic Accidents, Epidemiology, Head injuries

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