scholarly journals A six years prospective epidemiological study of acute encephalitis syndrome among children admitted in a rural tertiary care center

2019 ◽  
Vol 6 (5) ◽  
pp. 2125
Author(s):  
Debadyuti Datta ◽  
Balai Ch. Karmakar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Public Health Issue ◽  
Gender Variance ◽  
Chi Square ◽  
College Hospital ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
And Gender

Background: Acute Encephalitis Syndrome (AES) is a major public health issue in India. The common etiologies of AES in India are various infectious agents. There are seasonal and regional variations in etiologies making diagnosis and effective intervention often difficult. Our study represents the epidemiological data that will help in planning management in larger perspective.Methods: This is a six years prospective observational study conducted in the Department of Pediatrics, North Bengal Medical College Hospital, Darjeeling from January 1st, 2013 to December 31st, 2018. In this study all clinically diagnosed AES cases were included fulfilling inclusion and exclusion criterion.Results: 585 out of 39420 patients (1.48%) were diagnosed clinically as AES over six years. Male patients (372) contributing to 63.6% and female patients (213) 36.4% of the study. Majority cases (271) were seen in the age group of 1-5 years amounting to 46.3% with mean age 5.1±3.6 years. In July 2014 number of cases were maximum 59 (10%) followed by May 2013 20 (3.4%). Among the 585 AES cases, 263 (45%) were suspected for viral etiology (JE= 84, 14.3%). Total 457 cases (78.1%) were alive with insignificant to age and gender variance. Vaccination status revealed 11 among 15 JE deaths were unimmunized which is statistically significant (p < 0.05) by Chi-square test.Conclusions: The magnitude and etiologies of AES need to be explored and understood in various geographic regions and in different seasons to have a better insight for development of future policies to reduce the burden.

CLINICAL PROFILE OF AES CASES IN A TERTIARY CARE CENTER OF NORTH BENGAL

2021 ◽  
pp. 71-73
Author(s):  
Sharma S ◽  
Chakrabarti D ◽  
Saha S ◽  
Banik S ◽  
Mondal S
Keyword(s):  
Scrub Typhus ◽  
Care Center ◽  
Tertiary Care ◽  
Babinski Sign ◽  
Neck Stiffness ◽  
Cross Sectional ◽  
Altered Sensorium ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
North Bengal

Introduction: The clinical features of Acute Encephalitis syndrome (AES) vary widely across the world and little documentation is available from North Bengal. Materials and methods: A cross –sectional observational study was conducted at the Department of Medicine of a teaching hospital in North Bengal. 104 AES cases were enrolled and clinically evaluated and investigated as per the study protocol. Results:JE (72%) was most common causative agent followed by HSV Encephalitis (11.5%), Scrub Typhus (9.6%) and Dengue Encephalitis (2.88%). Male cases were predominant than female in our study. Fever and altered sensorium were most common presentation followed by seizures (51.9%), headache (29.8%), vomiting (18.2%), and hemiplegia (4.8%). Neurological evaluation revealed 80% of the patients had neck stiffness followed by positive Babinski sign (45.19%) and hypertonia (35%). Conclusions: JE is the commonest cause of AES in North Bengal and seizures are the commonest neurological manifestation after altered sensorium.

A Study of Hyponatremia in Acute Encephalitis Syndrome: A Prospective Study From a Tertiary Care Center in India

2017 ◽  
Vol 34 (5) ◽  
pp. 411-417 ◽  
Author(s):  
Usha Kant Misra ◽  
Jayantee Kalita ◽  
Rajesh Kumar Singh ◽  
Sanjeev Kumar Bhoi
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cerebral Salt Wasting ◽  
Urinary Osmolality ◽  
Salt Wasting ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Sodium Correction ◽  
A Prospective Study

Purpose: To evaluate the frequency and causes of hyponatremia in acute encephalitis syndrome (AES) and its effect on outcome. Patients and Methods: Consecutive patients with AES were subjected to neurological evaluation including Glasgow Coma Scale, focal weakness, movement disorder, and reflex changes. The etiology of AES was based on blood and cerebrospinal fluid enzyme-linked immunosorbent assay and polymerase chain reaction. We have categorized patients into neurological or systemic AES. Hyponatremia was diagnosed if 2 consecutive serum sodium levels were below 135 mEq/L, 24 hours apart. Serum and urinary osmolality and electrolytes were measured on alternate days. Fluid intake, output, and body weight were measured daily. The hyponatremia was categorized into syndrome of inappropriate secretion of antidiuretic hormone (SIADH), cerebral salt wasting (CSW), or miscellaneous group. Outcome at 1 month was assessed by modified Rankin scale. Results: Of 79 patients, 34 had neurologic AES and 45 had systemic AES; 22 (27.8%) patients had hyponatremia. The neurologic AES as compared to systemic AES was more commonly associated with hyponatremia (38.2% vs 20%, P = .07), need longer hospitalization (25.0 vs 12.5 days, P = .003), and longer time for sodium correction (13.3 vs 8.2 days, P = .05). The hyponatremia was due to CSW in 12 patients, SIADH in 2 patients, and indeterminate in 8 patients. Thirty-six patients had poor outcome (15 died) and 43 had good outcome which was not related to hyponatremia. Conclusion: Hyponatremia occurs in one-third of patients with AES, being commoner in neurologic AES, and CSW is the commonest cause.

Distribution of age, gender and body weight in AMI patients in a tertiary care center of Eastern India

2021 ◽  
Vol 12 (6) ◽  
pp. 75-58
Author(s):  
Tanushri Khatua ◽  
Tanima Mandal ◽  
Mita Saha ◽  
Biswajit Majumder
Keyword(s):  
Body Weight ◽  
Family History ◽  
Care Center ◽  
Tertiary Care ◽  
Positive Family History ◽  
Premenopausal Women ◽  
Care Hospital ◽  
Risk Of Mortality ◽  
And Gender ◽  
Risk Predictors

Background: The leading cause of death in the world is coronary heart disease (CHD). In India, CHD manifests almost a decade earlier than in Western countries. Gender differences play an important role in the pathophysiology of AMI. Body weight and family history are claimed to be the indicators of relative risk of mortality. Aims and Objective: To look for the age and gender distribution pattern in patients with recent diagnosed AMI and to find out the association of some of the risk factors like BMI, family history. Materials and Methods: A descriptive study was conducted in a tertiary care hospital with 50 recent diagnosed AMI patients of either sex as cases after considering the inclusion and exclusion criteria. The biochemical parameters were measured by validated methods. Results: On statistical analysis, 58% of total AMI cases occurred before 50 years of age; out of which 18% belong to 31 - 40 years, 40% belong to 41- 50 years. Out of total 50 AMI cases, 60% is male and 40% is female. Obesity seen in 14% cases and 56% is overweight; 16% having positive family history. Conclusion: The study indicates a trend of early age onset AMI. Increased body weight and positive family history can be the risk predictors. It is suggested that younger age males and premenopausal women should not be ignored regarding the risk of MI. Further studies are required for verification.

scholarly journals SCREENING FOR CONGENITAL HYPOTHYROIDISM WITH UMBILCAL CORD BLOOD TSH LEVEL ‘AN EXPERIENCE FROM A TERTIARY CARE CENTER'

2020 ◽  
pp. 26-27
Author(s):  
Rohan Modi ◽  
Harsh Mod ◽  
Aabha Phalak ◽  
Rutvik Parikh ◽  
Vilas Kavad ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Cord Blood ◽  
Congenital Hypothyroidism ◽  
Care Center ◽  
Tertiary Care ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Screening Programs ◽  
Serum Tsh

BACKGROUND:- Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. Screening for congenital hypothyroidism can be helpful in preventing mental retardation among general population. Umbilical cord blood TSH (CBTSH) estimation has been universally accepted and is one of the most cost effective screening programs in the field of preventive medicine and public health. AIMS AND OBJECTIVES:- This study was aimed to find the effectiveness of cord blood TSH as a screening tool for congenital hypothyroidism. MATERIALS AND METHODS:- This hospital based cross sectional study was conducted at GCS Medical College Hospital & Research Centre, Ahmedabad, over a period of one year in 1687 neonates. All newborns delivered at the institute were subjected to cord blood TSH level estimation and a repeat Serum TSH estimation was done at or after 72 hours of life. Diagnosis of congenital hypothyroidism is confirmed postnatally by standard Serum TSH value cut offs as per age. Data collected and statistically analysed. RESULTS:- Out of 1687 neonates born during the study period, 1548 formed the study group. 805 (52%) were males and 743(48%) were females. The birth weight of babies ranged from 850 gms to 4300 gms. The value of CBTSH varied from 1.3mIU/L to 101.4mIU/L with mean CBTSH of 7.21mIU/L. 28(1.8%) babies had CBTSH levels >20mIU/L. Out of which four were later diagnosed to have congenital hypothyroidism. All four had CBTSH levels >20mIU/L. All other neonates with CBTSH levels less than 20mIU/L were found to have normal screening later postnatally. CONCLUSION:- The current study concludes that cord blood TSH is a sensitive marker to screen for congenital hypothyroidism in neonates. A cut off value of cord blood TSH >20mIU/ml can be used for screening purpose.

scholarly journals Parental stress: a neglected entity

2019 ◽  
Vol 6 (6) ◽  
pp. 2357
Author(s):  
Nusrat R. Inamdar ◽  
Anvesh S. Tamboli ◽  
Anupama V. Mauskar ◽  
Suchit Tamboli
Keyword(s):  
Socioeconomic Status ◽  
Parental Stress ◽  
Tertiary Care ◽  
Stress Factors ◽  
Chi Square ◽  
College Hospital ◽  
Cross Sectional ◽  
Number Of Children ◽  
Monitor Alarms ◽  
Sick Children

Background: Parents feel very stressed when their child is sick and in Intensive care unit. Objectives of study were to identify common parental stressors during their child’s critical illness and to examine its relationship with demographic variables.Methods: It’s a Cross-sectional questionnaire based study done in PICU & NICU of a tertiary care medical college hospital in Mumbai, 62 parents of children admitted to PICU and NICU for at least 24 hours were interviewed using the Parental Stress Scale. The demographic variables were also recorded.The data analyzed using Cluster Analysis, Kruskal Wallis test, Chi- square test and spearman correlation.Results: The main cause of parental stress was to witness the child’s sufferings (unresponsiveness/pain, procedures, tubes, monitors around child) (median of standardized score = 3.9, IQR = 0.5, p <0.005). The median of standardised stress score due to hospital environmental factors (monitor alarms, nurses, doctors around baby, other sick children) was 3.7 (IQR = 0.5) and that due to lack of intimacy with child was 3.6 (IQR =0.4). Age of parent inversely correlated with the level of stress (r = -0.638) and parents of infants were more stressed (p = 0.005). Number of children, socioeconomic status didn’t affect the stress levels.Conclusions: Young parents and parents of infants were more stressful. Socioeconomic status, residential area and parental sex didn’t affect stress. Few stress factors need remedial steps to meet parental needs. The clinician’s awareness about these stressors, may help to provide optimized family-directed care.

scholarly journals Characterization of Child Maltreatment Cases Identified in Health Services

2020 ◽  
Vol 30 ◽  
Author(s):  
Davi Manzini Macedo ◽  
Priscila Lawrenz ◽  
Jean Von Hohendorff ◽  
Clarissa Pinto Pizarro Freitas ◽  
Silvia Helena Koller ◽  
...  
Keyword(s):  
Child Maltreatment ◽  
Middle Childhood ◽  
Parenting Practices ◽  
Family Relationship ◽  
Public Health Issue ◽  
Chi Square ◽  
Developmental Characteristics ◽  
And Gender ◽  
Chi Square Analysis

Abstract Child maltreatment is a severe Public Health issue. To understand its associated factors, our study analyzed 14.564 cases of child maltreatment recorded in the state of Rio Grande do Sul between 2010 and 2014. In our study, we analyzed immediate contextual aspects (child’s gender and developmental stage, perpetrator’s gender, family relationship between the victim and the perpetrator) and intermediate aspects (health professionals’ response). Chi-square analysis showed that girls were more likely to be vulnerable to sexual and psychological abuse, especially in middle childhood. Boys, on the other hand, were more likely to experience neglect in infancy and physical abuse in middle childhood. Males were the main perpetrators. Our results are discussed, based on a theoretical review of the sociocultural conceptions of child developmental characteristics, parenting practices, and gender roles. We suggest changes in the notification process and case referral.

scholarly journals CMET-18. IMPACT OF KRAS MUTATION STATUS ON THE EFFICACY OF IMMUNOTHERAPY IN LUNG CANCER BRAIN METASTASES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi55-vi55
Author(s):  
Adam Lauko ◽  
Assad Ali ◽  
Soumya Sagar ◽  
Addison Barnett ◽  
Hong Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Checkpoint Inhibitors ◽  
Care Center ◽  
Tertiary Care ◽  
Wild Type ◽  
Chi Square ◽  
Kras Mutations ◽  
Mutational Status

Abstract BACKGROUND Immunotherapy is increasingly used in patients with non-small cell lung cancer brain metastases (NSCLCBM). KRAS mutations are associated with worse prognosis and there is no FDA approved targeted therapy. KRAS mutations are associated with increased expression of PD-L1. We evaluated the outcomes of NSCLCBM with KRAS mutations treated with immune checkpoint inhibitors (ICI). METHODS We reviewed 800 patients with NSCLCBM treated at our tertiary care center. 226 had known KRAS mutational status, 121 of which received immunotherapy. Overall survival (OS) was calculated from either the start of immunotherapy (when both groups received immunotherapy) or from the date of diagnosis of brain metastasis. Kaplan-Meier method and Cox Proportional hazard model were utilized to determine differences in OS and the Chi-square test was utilized to determine differences in PD-L1 expression. RESULTS In 109 patients where both KRAS and PD-L1 status were known, KRAS mutations had greater PD-L1 expression (80.1% vs 61.9% positive, p=0.04). There was no difference in OS between KRAS mutant vs KRAS wild-type patients treated with immunotherapy. Median survival from the start of immunotherapy was 15.6 vs 15.5 months respectively (p=0.7), after adjusting for age, KPS, lesion number and extra-cranial metastasis (HR = .91, p=.7). Patients with KRAS mutations treated with immunotherapy versus those who received chemotherapy had a 1-year OS from the diagnosis of brain metastasis of 60.9% vs 38.7% respectively (trending towards significance, p=0.05). KRAS wild-type patients treated with immunotherapy versus those who did not receive immunotherapy had a 1-year OS from the diagnosis of brain metastasis of 61.9% vs 62.5% (p=0.85), respectively. DISCUSSION KRAS mutations are associated with increased PD-L1 expression. Use of immunotherapy negates the poor outcomes seen traditionally in patients with NSCLCBM and KRAS mutations and it improves survival compared to use of chemotherapy. Our experience supports the use of immunotherapy in these patients.

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