scholarly journals Mean platelet volume (MPV) as a diagnostic marker in neonatal sepsis

2019 ◽  
Vol 6 (3) ◽  
pp. 1036
Author(s):  
Prathyusha . ◽  
Shreekrishna G. N. ◽  
Sinchana Bhat ◽  
Sahana P.
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Diagnostic Marker ◽  
Tertiary Care ◽  
Study Groups ◽  
Care Hospital ◽  
Neonatal Deaths ◽  
Significant Difference ◽  
Group B

Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8±1.52, 10.82±1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.

scholarly journals Antimicrobial usage and its quantification for neonatal sepsis at a tertiary care hospital neonatal intensive care unit

2019 ◽  
Vol 8 (9) ◽  
pp. 2046
Author(s):  
Manjari Kumari ◽  
Suparna Chatterjee ◽  
Tapas Som ◽  
Pinaki Chattopadhyay
Keyword(s):  
Intensive Care ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Care Hospital ◽  
Sensitivity Pattern ◽  
Prescribing Trends ◽  
Days Of Therapy ◽  
Significant Difference ◽  
Culture Positive

Background: Antimicrobial therapy for neonatal sepsis is challenging as its judicious use can save neonates while its inappropriate use can lead to rapid emergence of resistant strains. Quantification of consumption of antimicrobial agents (AMA) has not been undertaken in Indian neonatal intensive care units (NICU) setting. This prospective observational study evaluated the antimicrobial prescribing pattern and quantified its consumption in clinically suspected neonatal sepsis (NS) cases.Methods: Clinically suspected NS cases admitted over study period of 18 months in a tertiary care level III NICU were enrolled. Data of antimicrobials prescribed, its consumption, culture sensitivity profile of organisms isolated were collected.Consumption was quantified by computing the days of therapy (DOT) per 1000 patient-days (PD).Results: 150 clinically suspected NS cases were enrolled; 37.33% were culture positive. The most common AMA prescribed were netilmicin (94.67%), piperacillin-tazobactam (88.67%). Only 0.67% cases received reserve antimicrobials like colistin, vancomycin and linezolid. 58% received 2 AMA, 39.33% received ≥3 agents. Total antimicrobial consumption was 614.86 DOT/1000 PD and 21.68 DOT/ neonate. Statistically significant difference in total AMA consumption amongst culture positive versus negative cases (p <0.001) was observed but difference was not significant in EOS versus LOS (p=0.95).Conclusion: Usage of antimicrobials for neonatal sepsis was guided by sensitivity pattern of local prevalent flora and clinical response. Usage of reserve antimicrobials were restricted. However, consumption of AB was higher compared to developed countries and we intend to use the study outcome data for antibiotic stewardship program to reduce antibiotic consumption and modify prescribing trends at the study setting.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

A Randomised Double-Blind Trial of Pentoxifylline Alone versus Pentoxifylline Plus N Acetyl Cysteine in the Treatment of Severe Alcoholic Hepatitis in a Tertiary Care Hospital in Mysore, Karnataka

2021 ◽  
Vol 8 (8) ◽  
pp. 399-404
Author(s):  
Anurag Lavekar ◽  
Deepak Suvarna ◽  
Aradya V ◽  
Nandeesh P ◽  
Vijayakumar R ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Alcoholic Hepatitis ◽  
Tertiary Care ◽  
Study Groups ◽  
Care Hospital ◽  
Double Blind ◽  
Term Survival ◽  
Significant Difference ◽  
Severe Alcoholic Hepatitis ◽  
Acetyl Cysteine

BACKGROUND Proven therapeutic options for treating severe alcoholic hepatitis are limited. The study was conducted to compare pentoxifylline alone versus combination of Pentoxifylline plus N acetylcysteine in severe alcoholic hepatitis patients. METHODS A randomised, parallel, double blind, active controlled trial was conducted in which, 240 cases were considered for analysis and were divided into two study groups i.e. tablet pentoxifylline alone versus tablet pentoxifylline plus tablet N acetylcysteine. The pentoxifylline group received 400 mg thrice daily for one month and the other group received tablet pentoxifylline 400 mg thrice daily with tablet N–acetyl cysteine 600 mg twice daily for one month. Enrolled patients were called for follow up at one and three months. The parameters were compared between the two study groups statistically and the results were obtained. RESULTS Forty-nine (20.4 %) patients expired in 3 months, out of which 35 (14.5 %) expired at the end of 1st month. There was no significant difference in survival between two groups at the end of one and three months (P = 0.58 and 0.10 respectively). Although liver function test (LFT), PT-INR (prothrombin timeinternational normalised ratio) improved significantly from baseline in both the groups (P < 0.0001), no significant difference was observed between the two groups. Prevalence of hepatic encephalopathy was significantly low in pentoxifylline plus N-acetylcysteine group at one and three months (P = 0.04 and 0.02 respectively). CONCLUSIONS Addition of N acetyl cysteine to pentoxifylline helps in reducing hepatic encephalopathy in patients with severe alcoholic hepatitis; however, it does not improve the short-term survival. KEYWORDS Pentoxifylline, N-acetylcysteine, Alcoholic Hepatitis, Liver Disorder

scholarly journals The pattern of admission and their related outcomes in NICU of a tertiary care teaching hospital, Udaipur, Rajasthan, India

2021 ◽  
Vol 8 (1) ◽  
pp. 16-22
Author(s):  
Dr. Ujjwal Mittal ◽  
◽  
Dr. Vivek Parasher ◽  
Dr. Rahul Khatri ◽  
Dr. Samarth Yadav ◽  
...  
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Extremely Low Birth Weight ◽  
Neonatal Deaths

Introduction: To achieve MDG4 (Millennium Developmental Goals-4), a substantial reduction inearly neonatal deaths will be required. The first steps in improving early neonatal survival are todocument the number and rate of deaths and identify their common causes. As per the NationalFamily Health Survey-3 report, the current neonatal mortality rate (NMR) in India is 39 per 1000 livebirths, neonatal deaths account for nearly 77% of all infant deaths (57/1000) and nearly half ofunder-five child deaths (74/1000). This study was undertaken to study the disease pattern andoutcome of neonates admitted to the neonatal intensive care unit (NICU) of a tertiary care teachinghospital located in Udaipur, Rajasthan. Material and methods: The age, sex, gestational age, andmorbidity and mortality profile of all NICU admissions in 5 years was determined and the differencebetween Inborn (those born in the Teaching Hospital) and Out born was calculated. Morbidity riskfactors to reduce NMR in Udaipur were determined. Results: A total of 2648 neonates wereadmitted to NICU during the study period, out of which none were excluded from the study. Theratio of Male to Female admitted was 1.30:1. The major causes of morbidity were MeconiumAspiration Syndrome (16.16%), Respiratory Distress Syndrome(10.12%), Cong. HeartDefects(8.76%), Neonatal Sepsis(4.83%) and Hypoxic-Ischemic Encephalopathy(5.66%). In thisstudy, the overall mortality rate was 9.96%. Most of the Deaths were due to MAS(25.75%),RDS(15.90%), Neonatal Sepsis(10.22%), and HIE(12.87%). Neonates with birth weight <1000ghad poor outcomes compared to neonates with birth weight >2500g. Conclusion: This studyidentified Prematurity, Extremely low birth weight, MAS, and Neonatal Sepsis as major causes ofMorbidity and MAS, RDS as the major contributors to neonatal mortality. Improving antenatal care,maternal health, and timely referral of high-risk cases to tertiary care hospitals will help to improveneonatal outcomes.

scholarly journals Trends and Determinants of Perinatal Mortality in a Tertiary Care Hospital of Nepal

2021 ◽  
Vol 20 (1) ◽  
pp. 77-82
Author(s):  
Yuba Nidhi Basaula ◽  
Radha Kumari Paudel ◽  
Ram Hari Chapagain
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Neonatal Sepsis ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Perinatal Mortality Rate ◽  
Increasing Trend

Introduction: Perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20 to 30 per thousand births. This study was carried out to review the different aspects of PMR and classifying them and identify the causes of perinatal and neonatal deaths and assessing the need for improvement in quality of pregnancy and newborn care. Methods: It was a retrospective study carried out in Bharatpur Hospital, Chitawan, Nepal. Data of all stillbirths from 22 weeks of pregnancy and neonatal deaths up to seven days of life was taken from monthly perinatal audit and annual mortality review. The data was taken from July 2017 to Jun 2019. All the perinatal deaths were then classified. Results: Over a two year period, there were total 25,977 births and total death was 369. Thus perinatal mortality rate was 12.3 per thousand births. Still births (fresh and macerated) contributed almost 82.4% of the perinatal deaths and neonatal death contributed 17.6% of total deaths. Deaths related to unexplained intrauterine fetal death (IUFD) showed an increasing trend and have increased by more than 20% in past two years from 39.1% to 60.8%. Deaths due to perinatal asphyxia, neonatal sepsis, respiratory distress syndrome and extreme prematurity were increased. Conclusions: PMR over the two years has shown increasing trend at our institute. There is need to improve antenatal, obstetric as well as intra-partum services to further reduce the still birth as well as deaths due to prematurity, RDS, neonatal sepsis and perinatal asphyxia.

scholarly journals Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

2020 ◽  
Vol 24 (4) ◽  
pp. 339-343
Author(s):  
Tanveer Hussain ◽  
Misbah Sattar ◽  
Sara Mustafa ◽  
Uzma Batool ◽  
Shafqat Iqbal ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Local Population ◽  
Tertiary Care ◽  
Simple Random Sampling ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after  start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

scholarly journals Changing trends of antibiotic resistance in neonatal sepsis in a tertiary care hospital

2017 ◽  
Vol 6 (6) ◽  
pp. 1344
Author(s):  
Pauline Packiaseeli S. ◽  
Ashok Kumar T.
Keyword(s):  
Antibiotic Resistance ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
P Value ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Neonatal Deaths ◽  
Amoxicillin Clavulanic Acid ◽  
Rational Use Of Antibiotics

Background: Sepsis and other infections cause 15% neonatal deaths in India. The present study is to determine the resistance pattern of pathogens causing neonatal sepsis and to provide antibiogram to pediatricians for better patient management.Methods: Positive Blood culture reports of neonatal sepsis cases detected during the years 2014 and 2015 were studied. The antibiotic resistance of the organisms found during the years 2014 and 2015 were compared by calculating the probability (p value) using the standard formula.Results: Coagulase negative staphylococci (CONS) was the most common organism in 2014 whereas pseudomonas was predominant in 2015.Resistance of CONS to amoxycillin and ceftrioxone has significantly increased in 2015.Also resistance of CONS to vancomycin was noted. Resistance of Pseudomonas to cefuroxime, ceftazidime and amoxicillin/clavulanuic acid combination were increased but not significantly. There was also emerging resistance of pseudomonas to gentamicin and amikacin. Resistance of acinetobacter to cefuroxime, ceftrioxone and gentamicin has increased in 2015 but not significantly. Citrobacter showed a significant increase in resistance to amoxicillin/clavulanic acid combination (p=0.006).Conclusions: Bacterial spectrum causing neonatal sepsis varies in different regions, varies in the same site during different time periods, also their antibiotic resistance pattern varies in different regions and changes constantly. Increase in resistance to commonly used antibiotics stress the need of rational use of antibiotics.

scholarly journals Clinical and Postoperative Outcomes of Cancer Surgeries during the COVID-19 Pandemic: A Comparative Study with its Pre-COVID Surgical Audit at Five Major Tertiary Care Hospitals’ Cancer Departments in India

2021 ◽  
Vol 42 (04) ◽  
pp. 311-318
Author(s):  
Anil Heroor ◽  
Rajnish Talwar ◽  
Rama Joshi ◽  
Sandeep Nayak ◽  
B. Niranjan Naik ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Study Groups ◽  
Mortality Rates ◽  
Complication Rates ◽  
Cancer Management ◽  
Time Period ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Introduction There has been an exponential rise in number of coronavirus disease 2019 (COVID-19)-positive infections since March 23, 2020. However, cancer management cannot take a backseat. Objective The aim of this study was to identify any difference in the complication and mortality rates for the cancer patients operated during the ongoing COVID-19 pandemic. Materials and Methods This was a retrospective study of a prospectively maintained database of five centers situated in different parts of India. Variables such as demographics, intraoperative, and postoperative complications were compared between COVID-19 (group A—March 23, 2020–May 22, 2020) and pre-COVID time period (group B—January 1 to January 31, 2020). Results One-hundred sixty-eight cancer surgeries were performed in group B as compared with 148 patients who underwent oncosurgeries in group A. Sixty-two percent lesser cancer surgeries were performed in the COVID-19 period as compared with the specific pre-COVID-19 period. There was no significant difference in age group, gender, comorbidities, and type of cancer surgeries. Except for the duration of surgery, all other intraoperative parameters like blood loss and intraoperative parameters were similar in both the groups. Minimally invasive procedures were significantly lesser in group A. Postoperative parameters including period of intensive care unit stay, rate of infection, need for the change of antibiotics, and culture growth were similar for both the groups. While minor complication like Clavien-Dindo classification type 2 was significantly higher for group A, all other complication rates were similar in the groups. Also, postoperatively no COVID-19-related symptoms were encountered in the study group. A subset analysis was done among the study groups between those tested preoperatively for COVID-19 versus those untested showed no difference in intraoperative and postoperative parameters. No health-care worker was infected from the patient during the time period of this study. Conclusion Our study shows that there is no significant difference in the incidence of postoperative morbidity and mortality rates in surgeries performed during COVID-19 pandemic as compared with non-COVID-19 time period.

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