scholarly journals A study on role of thrombocytopenia in retinopathy of prematurity

2020 ◽  
Vol 7 (2) ◽  
pp. 346
Author(s):  
Aswathy Benedict ◽  
Mario Joseph Bukelo
Keyword(s):  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Significant Risk ◽  
P Value ◽  
Care Hospital ◽  
Hospital Data ◽  
Retrospective Case ◽  
Oxygen Exposure ◽  
Increased Risk

Background: Retinopathy of Prematurity (ROP) is one of the causes of avoidable blindness in India. Globally ROP is estimated to affect more than 50,000 infants annually and in India, every year, 500 children are estimated to become blind from ROP. Many a times, lack of trained professionals and lack of timely referral are found to be setbacks in ROP diagnosis and treatment in developing nations. The aim of the study was to study if thrombocytopenia is a risk factor for retinopathy of prematurity and does supplemental oxygen with thrombocytopenia increases the risk of ROP.Methods: It was a retrospective case control study done in a tertiary care hospital. Data was collected from 177 preterm admitted to NICU over a period of 3 years from March 2015-2018.Results: A total of 177 preterm admitted to the NICU was included in this study. 77 had ROP and were taken as cases, while 100 were controls. Out of the cases, 55.6% had thrombocytopenia (OR-2.47, p value: 0.003). 89% (n =69) of cases had significant oxygen exposure (OR-8.65, p value 0.0001; 95% CI: 2.00-10.75). Oxygen exposure and thrombocytopenia coexisted in 57% of cases, with 4 times increased risk of ROP (OR-4.51, p value: 0.0001).Conclusions: Thrombocytopenia is a significant risk factor for retinopathy of prematurity in preterm. The presence of thrombocytopenia with significant oxygen exposure tends to accentuate the risk further. Future prospective studies with long term follow up are warranted to establish other risk factors.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Predictors of mortality in adult patients with dengue: a study from South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1605 ◽  
Author(s):  
Vasudeva Acharya ◽  
Mohammed Fahad Khan ◽  
Srinivas Kosuru ◽  
Sneha Mallya
Keyword(s):  
Renal Failure ◽  
Prothrombin Time ◽  
Tertiary Care ◽  
P Value ◽  
Bleeding Tendency ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Prolonged Prothrombin Time ◽  
Risk Of Death ◽  
Increased Risk

Background: Dengue is one of the important causes of acute febrile illnesses in India. Dengue can be a fatal disease, however there are no reliable markers which can predict mortality among these patients.Methods: A prospective cross sectional study was done in patients who were admitted to a tertiary care hospital with features of dengue fever. A total of 364 patients with IgM dengue serology positive were included in the study. Relevant clinical and laboratory parameters were collected from all patients. Association between clinico-laboratory parameters with mortality was studied using appropriate statistical methods.Results: Among the 364 patients recruited in this study, 14 (3.85%) patients died. Mortality among patients with age group 18-40 years was 2.04%, in patients aged above 40 years was 7.56%. Mortality among patients with hypotension was 42.42% (14 out of 33), bleeding manifestations was 15.38% (8/52), platelets <20,000/mm3 was 10.41% (10/96), ALT >200 was 13.04% (6/46), AST>200 was 12.34% (10/81), prolonged prothrombin time was 60%(12/20), renal failure was 28%(14/50), encephalopathy was 31.57% (6/19), multi organ dysfunction syndrome(MODS) was 43.33% (13/30), acute respiratory distress syndrome (ARDS) was 45.45% (5/11), pleural effusion was 7.5% (6/80).Conclusions: The overall mortality in the present study was 3.85%. Following variables were associated with increased risk of death among the dengue patients: Age >40 years, presence of hypotension, platelets <20000 cells/mm3, ALT>200U/L, AST>200U/L, prolonged prothrombin time, presence of renal failure, encephalopathy, MODS, ARDS and bleeding tendency (p value <0.05). Early identification of factors associated with mortality can help to make appropriate decision on care required.

Facial Nerve Outcomes in Middle Cranial Fossa vs Translabyrinthine Approaches

2005 ◽  
Vol 133 (6) ◽  
pp. 906-910 ◽  
Author(s):  
Brandon Isaacson ◽  
Steven A. Telian ◽  
Hussam K. El-Kashlan
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Middle Cranial Fossa ◽  
Vestibular Schwannomas ◽  
Care Hospital ◽  
Case Review ◽  
Retrospective Case ◽  
Increased Risk ◽  
Significant Difference ◽  
Cranial Fossa

OBJECTIVE: To compare the final facial nerve outcomes between middle cranial fossa (MCF) vs translabyrinthine (TL) resection of size-matched vestibular schwannomas. STUDY DESIGN AND SETTING: Retrospective case review at a tertiary care hospital. All patients who underwent resection utilizing either MCF or TL approaches with tumors 18 mm or smaller and complete data were included in the analysis. One hundred twenty-four patients were identified meeting the above criteria, with sixty-three in the translabyrinthine group and sixty-one in the middle fossa group. One-week-postoperative and final facial nerve examinations were compared in the two surgical groups. Patients were separately analyzed in subgroups: tumors smaller than 10 mm and those that were between 10 and 18 mm. RESULTS: The tumor size range for the MCF group was 3-18 mm while it was 4-18 mm for the TL group. No statistically significant difference was found in facial nerve outcomes between the two surgical groups, at the first postoperative visit week and at last follow-up. CONCLUSION: Facial nerve outcomes are similar using TL and MCF approaches for resection of vestibular schwannomas up to 18 mm in size. SIGNIFICANCE: Patients undergoing the MCF approach for hearing preservation can be counseled that there is no increased risk of permanent facial nerve weakness, compared to the TL approach. EBM RATING: B-3

scholarly journals SNAPPE II score: predictor of mortality in NICU

2019 ◽  
Vol 6 (2) ◽  
pp. 422
Author(s):  
Sujana Rachuri ◽  
Saritha Paul ◽  
Jaidev M. D.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Hospital Data ◽  
Mortality And Morbidity ◽  
Risk Of Mortality

Background: Advances in the NICU (neonatal intensive care unit) have significantly decreased mortality and morbidity and increased survival rate in neonates. SNAPPE II (Score for Neonatal Acute Physiology-Perinatal Extension II) score, which is a modified version of the SNAP score (Score for Neonatal Acute Physiology) helps in predicting the neonatal mortality. The aim of the study was to assess the risk of mortality using SNAPPE II score in neonates admitted to NICU.Methods: It was a prospective validation study done in a tertiary care hospital. Data was collected from 116 new borns admitted to NICU within 48 hours of birth who required respiratory support between December 2017 to June 2018.Results: A total of 116 newborns admitted to the NICU was included in present study. Out of 116 babies, 56 (48%) had mild SNAPPE-II score, 44 (38%) had moderate score and 16 (14%) had severe score. Among the 44 babies with moderate score, 12 (27%) died, which was statistically significant (P<0.001). Among 16 babies with severe score, 13 (81%) babies died, which was highly statistically significant (P<0.0001). Urine output, seizures, serum pH in the first 24 hours of life are independent predictors of mortality with significant p value (0.001).Conclusions: The SNAPPE-II score recorded in the first 48 hours of life could be a good predictor of mortality in babies admitted to NICU.

scholarly journals PREDICTORS OF MORTALITY IN CHILDREN WITH CYSTIC FIBROSIS

2021 ◽  
Author(s):  
Hardeep Kaur ◽  
Shivam Pandey ◽  
Kana Jat ◽  
RAKESH LODHA ◽  
Sushil Kabra
Keyword(s):  
Cystic Fibrosis ◽  
Early Diagnosis ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Indian Children ◽  
Neonatal Complications ◽  
Factors Associated ◽  
Increased Risk ◽  
Low Bmi

Background: There is a lack of studies on outcomes in cystic fibrosis (CF) in children from developing countries like India. Identifying risk factors for mortality may help identify the high-risk group and plan policy management of such patients. Objective: To determine the factors associated with outcomes among Indian children with CF. Design: Retrospective analysis of data collected from January 2010 to Dec 2020. Setting: Tertiary care hospital in Northern India. Participants: Children diagnosed with CF during the study period. Methods: We extracted data related to demography, clinical features, laboratory data and outcome from children’s medical records with CF. Bivariate and multivariate analysis was performed to identify variables associated with mortality. Results: We enrolled 178 children, and there were 32 (18.0%) deaths. Significant factors associated with mortality included history of neonatal complications; hazard ratio (HR): 8.5 (95% CI, 3.0 - 23.9, p < 0.001), low Z-scores for body mass index (BMI) at the time of diagnosis; HR: 7.1 (95% CI 2.3 - 22.0, p < 0.001), FEV1/FVC at the time of diagnosis; HR: 5.1 (95% CI, 1.65 - 15.4, p-value < 0.004), and FEV1 25-75; HR: 3.6 (95% CI, 1.1- 11.8, p-value = 0.03). Conclusions: Factors associated with increased risk of mortality included presence of neonatal complications, low BMI and lower pulmonary function test results. Low BMI and low PFT indices are modifiable and possibly can be improved by early diagnosis. A new-born screening test may help in early diagnosis and identification of the neonatal problem of CF.

Endovascular Embolization in the Treatment of Epistaxis

2019 ◽  
Vol 160 (5) ◽  
pp. 822-828 ◽  
Author(s):  
Phillip Huyett ◽  
Brian T. Jankowitz ◽  
Eric W. Wang ◽  
Carl H. Snyderman
Keyword(s):  
Tertiary Care ◽  
Surgical Techniques ◽  
Case Series ◽  
Major Complication ◽  
Endovascular Embolization ◽  
High Risk Group ◽  
Care Hospital ◽  
Retrospective Case ◽  
Increased Risk ◽  
Operative Control

Objective The cost-effectiveness of endovascular embolization (EE) for intractable epistaxis has been questioned, especially as endoscopic surgical techniques have become standard of care at many institutions. Our objectives were to review the safety profile and effectiveness of EE for epistaxis. Study Design Retrospective case series. Setting Tertiary care hospital. Subjects There were 54 patients and 64 unique encounters. Patients were 66.7% male, with a mean age of 64.5 years. Bleeding disorders were present in 18.8%, hypertension was present in 71.7%, and 61.1% were on anticoagulant/platelet drugs. Methods Charts of patients undergoing EE for epistaxis between 2005 and 2015 were retrospectively reviewed. Results The immediate bleeding control rate was 92.6%. Three patients died within 1 week of EE and were excluded from further analysis. Overall, 64.7% of the remaining patients had no further episodes of epistaxis. Thirteen patients (25.4%) rebled within 1 week, 11 of whom required repeat EE or operative control. Five patients (9.8%) rebled more than 1 week following the procedure with 4 requiring repeat EE or operative control. The major complication rate was 7.4% and included transient stroke, diplopia, facial skin necrosis, and extraperitoneal hemorrhage. Conclusion While the immediate success rate of EE for epistaxis was comparable to the literature, the overall short- and long-term rebleed rate was high in this selected population. The results suggest that patients who are referred for EE represent a high-risk group with increased risk of repeat hemorrhage and morbidity. Patients who undergo EE for epistaxis should be carefully monitored for complications, including repeat hemorrhage.

scholarly journals Sex differences in clinical presentation in acute MI

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Ashwin Kodliwadmath ◽  
Naren V. Nimbal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Care Hospital ◽  
Acute Mi

Background: Acute myocardial infarction differs in women and men with respect to risk factors and clinical presentation. There are studies carried out worldwide on this issue but few from India. This study was done to study the sex based differences in the risk factors and clinical features of acute MI in patients with Indian ethnicity.Methods: Comparative prospective study consisting of 100 women as study group and 100 men as control group with acute MI, who were admitted in a tertiary care hospital, from December 2016 to June 2017.Results: Chest pain was the main complaint in majority of the women (82%) and men (88%). Radiation of chest pain (87%) and sweating (90%) were significantly present in men compared to women (65% and 62% respectively), while breathlessness was significantly present in women (78%) compared to men (64%) and fatigue in women (76%) significantly more than men (55%). Smoking was a significant risk factor in men (69%) compared to women (5%), while diabetes mellitus was a significant risk factor in women (62%) compared to men (39%).Conclusions: Women with acute MI had more atypical presentation of symptoms, similar risk factors, compared to men except for smoking which was more significant in men and diabetes more common in women.

scholarly journals A Comparative Study of Serum 25-Hydroxy Vitamin D Levels in Children with Seizures Receiving Monotherapy and Polytherapy

2021 ◽  
Vol 11 (01) ◽  
pp. e331-e337
Author(s):  
Nazeem Fathima A. ◽  
Radha Kumar ◽  
Dev Kumar V. ◽  
Devanand Gulab Chaudhary
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Hospital Setting ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

AbstractThe association between serum 25-hydroxy vitamin D (25(OH)D) antiepileptic drugs (AEDs) and bone health in individuals with epilepsy has been recognized for more than 30 years. Several studies indicate an increased risk for bone loss in patients on antiepileptic medication as well as low levels of serum 25(OH)D. Patients on polytherapy AED are at a higher risk of adverse drug effects compared with those on monotherapy. The present study assessed serum 25(OH)D levels in children receiving AED and compares those children receiving monotherapy versus polytherapy. This is a prospective cross-sectional study conducted in a tertiary care hospital setting on children with seizures receiving AEDs for period of more than 6 months. Participants were enrolled in three groups: 25 children on monotherapy, 25 children on polytherapy, and 25 healthy controls. Serum 25(OH)D level was performed for all children and analyzed. Serum 25(OH)D levels were normal in 52%, insufficient levels in 43.3%, and deficient in 6.7% of children. Vitamin D level was insufficient in 40% of children receiving monotherapy and 52% receiving polytherapy AED. Vitamin D deficiency was present in 4% in monotherapy group and 16% in polytherapy group which was statistically significant (p-value 0.047). Vitamin D deficiency was higher in children receiving AED compared with normal controls. Vitamin D deficiency and insufficiency were higher in children on polytherapy. Our study emphasized the importance of monitoring vitamin D levels in children receiving AED to detect abnormalities in vitamin D levels.

Evaluating Vancomycin Use at a Pediatric Hospital: New Approaches and Insights

2005 ◽  
Vol 26 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Maureen K. Bolon ◽  
Alana D. Arnold ◽  
Henry A. Feldman ◽  
David H. Rehkopf ◽  
Emily F. Strong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Factor Analysis ◽  
Risk Factor ◽  
Tertiary Care ◽  
Significant Risk ◽  
Risk Factor Analysis ◽  
Cell Transplant ◽  
Care Hospital ◽  
Inappropriate Use ◽  
Tertiary Care Medical Center

AbstractObjectives:To characterize vancomycin use at a pediatric tertiary-care hospital, to discriminate between initial (≤ 72 hours) and prolonged (> 72 hours) inappropriate use, and to define patient characteristics associated with inappropriate use.Design:Vancomycin courses were retrospectively reviewed using an algorithm modeled on HICPAC guidelines. Data were collected regarding patient demographics, comorbidities, other medication use, and nosocomial infections. The association between each variable and the outcome of inappropriate use was determined by longitudinal regression analysis. A multi-variable model was constructed to assess risk factors for inappropriate initial and prolonged vancomycin use.Setting:A pediatric tertiary-care medical center.Patients:Children older than 1 year who received intravenous vancomycin from November 2000 to June 2001.Results:Three hundred twenty-seven vancomycin courses administered to 260 patients were evaluated for appropriateness. Of initial courses, 114 (35%) were considered inappropriate. Of 143 prolonged courses, 103 (72%) were considered inappropriate. Multivariable risk factor analysis identified the following variables as significantly associated with inappropriate initial use: admission to the surgery service, having a malignancy, receipt of a stem cell transplant, and having received a prior inappropriate course of vancomycin. No variables were identified as significant risk factors for inappropriate prolonged use.Conclusions:Substantial inappropriate use of vancomycin was identified. Prolonged inappropriate use was a particular problem. This risk factor analysis suggests that interventions targeting patients admitted to certain services or receiving multiple courses of vancomycin could reduce inappropriate use.

scholarly journals Study of pulmonary function test in asymptomatic smokers and non-smokers between 30-50 years of age in a tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 959
Author(s):  
Kekhrielhouto Sophie ◽  
Neelima Singh ◽  
Avinash John Dharvey
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Tertiary Care ◽  
Significant Risk ◽  
Uncontrolled Hypertension ◽  
Chronic Obstructive ◽  
P Value ◽  
Care Hospital ◽  
Age Group ◽  
Function Test

Background: Tobacco smoking is widely prevalent all over the world and it continues to rise in developing countries. Smoking has a deleterious effect on pulmonary functions. Smoking is the single most significant risk factor contributing to the development of Chronic obstructive airway diseases (COPD). Spirometry by a trained health professional gives an indication of lung health by measuring airway abnormality. Objectives were to study pulmonary function test (PFT) in smokers and non-smokers between 30-50 years and to study the correlation of PFT with pack years.Methods: Apparently healthy subjects, 50 smokers and 50 non-smokers between 30-50 years without any symptoms were included as subjects. Patients with uncontrolled hypertension, recent myocardial infarction and pulmonary TB were excluded. Ex-smokers were excluded from the study. Patients with acute respiratory illness, severe systemic illness, chest trauma and dementia were also excluded. After proper history taking and clinical examination, measuring height and weight (vitals, pulse rate, respiratory rate, blood pressure) the selected individual was subjected to spirometry using ATS criteria (American Thoracic Society criteria). Spirometry was performed using UNI-EM spirometer. Collected data was analyzed using Statistical Package for the Social Service (SPSS) software version 17.Results: In this study 94 males and 6 females were enrolled as subjects. Maximum number of the patient 49 cases (49%) presented in the age group of 30-35 years, followed by 23 cases (23%) in 36-40 years age group. Of these 49 cases,15 were smokers while the rest 34 were non-smokers (P=0.0007). In 100 cases studied, 39% showed normal PFT and 61% shows abnormal PFT. Among smokers (out of total 50 cases) pulmonary function test (PFT) was abnormal in 36 cases (72%) while in non-smokers, 25 (50%) had abnormal PFT (P-value-0.024). This data indicates that smoking is highly associated with an abnormal PFT pattern. Out of 100 cases both smokers and non-smokers, 11 (73.33%) underweight cases with (BMI<18.4) showed abnormal PFT. In 50 smokers, maximum cases 29 (58%) had normal BMI (18.5-22.9) (P value 0.0002). Abnormal PFT was observed in 25 (50%) non-smokers (P=0.001). Abnormal PFT was seen in 30 (69.77%) smokers with pack years <15 and 6 smokers (85.6%) with pack years >15 (P-value 0.383).Conclusions: Smoking is common in males between 30-35 years age group. Smoking is highly associated with an abnormal PFT. Cessation of smoking should be encouraged and PFTs from time to time in asymptomatic adults both smokers and non-smokers will be useful for early identification of abnormalities.

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