scholarly journals Utility of lung ultrasound in childhood pneumonia in a tertiary care center

2020 ◽  
Vol 7 (6) ◽  
pp. 1237
Author(s):  
Niharika Shetty ◽  
Sarala Sabapathy ◽  
Mallesh K.
Keyword(s):  
Lung Ultrasound ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Childhood Mortality ◽  
Mortality And Morbidity ◽  
Childhood Pneumonia ◽  
Inter Observer Variability ◽  
Ultrasound Findings ◽  
Valuable Role

Background: Pneumonia is a major cause of childhood mortality and morbidity worldwide. Chest radiography has been used as a modality for diagnosing but has the disadvantage of radiation exposure and inter-observer variability. Hence studies have explored the possibility of using lung ultrasound in the diagnosis of pneumonia. To assess lung ultrasound (LUS) findings in childhood pneumonia and to correlate lung ultrasound findings with clinical findings.Methods: 210 children between 2 months to 5 years admitted in the hospital with diagnosis of pneumonia were enrolled in the study. They underwent LUS within 24 hours of admission and the results were analysed.Results: Out of the 210 patients enrolled in the study, 41 (19.5%) had positive LUS findings. However, LUS findings correlated well with clinical findings in cases with very severe pneumonia.Conclusions: This study showed that lung ultrasound cannot be used a sole diagnostic tool in childhood pneumonia, but it has a valuable role in detection of complications. Lung ultrasound will require more training for detection of early indicators of pneumonia.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals An Unusual Visit from an Old Foe: Oral Presentation of Syphilis in a Teenage Patient

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Bedirhan Tarhan ◽  
Sydur Rahman ◽  
Diana Halloran ◽  
Jeremy Sites ◽  
Avni Bhatt ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Hospital Medicine ◽  
Adolescent Females ◽  
Clinical Findings ◽  
Secondary Syphilis ◽  
Pediatric Hospital ◽  
Syphilis Infection ◽  
Macular Rash ◽  
Inguinal Lymphadenopathy

The authors report an atypical case of secondary syphilis in an adolescent female presenting to a tertiary-care center with fever, weight loss, oral sores, painful inguinal lymphadenopathy, and transient macular rash. Given the lower prevalence of syphilis in adolescent females, this infection was not included on the initial differential diagnosis. The evolving presentation of syphilis over time complicates the diagnosis and management of these infections, as it did for the patient in this report. The authors provide a detailed discussion of the patient’s clinical findings, including the protean features of syphilis infection. This case is particularly relevant to the fields of general pediatrics and pediatric hospital medicine.

scholarly journals Prevalence of ear cleaning and its characteristic physical findings in patients visiting tertiary care center in Bhutan

2018 ◽  
Vol 4 (1) ◽  
pp. 42-45
Author(s):  
Tika Ram Adhikari ◽  
Sonam Jamtsho
Keyword(s):  
External Auditory Canal ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Tertiary Care Center ◽  
Ear Canal ◽  
Cross Sectional ◽  
Bony Canal ◽  
Physical Findings

Introduction: Many studies have been done on prevalence and complications of ear bud across the globe but very few talk about the characteristics physical findings associated with ear cleaning. We aim to find the prevalence and characteristic physical findings of cotton bud usage in patients visiting a tertiary care center in Bhutan. Methods: A cross sectional study in a tertiary care center in Bhutan over a period of one month. Results: The prevalence of ear cleaning was 92.15%. The most common physical finding was shiny external auditory canal (66%), excoriations in the external auditory canal (longitudinal furrowing along the floor or Circular scratch marks)(52%), erythema and edema of ear canal (46.6%), wax in the bony canal near tympanic membrane(9.3%), stenosed external auditory canal (3.8%), cotton wool remnants in ear canal(2.8%). Conclusions: It is important to recognize these characteristic clinical findings of cleaning the ear so that proper counseling can be given against its usage and prevent undue complications associated with it.

scholarly journals Changing pattern of birth weight over a decade in rural India

2017 ◽  
Vol 6 (10) ◽  
pp. 4625 ◽  
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit P. Gavhane ◽  
Swati D. Gagare ◽  
Kunal H. Aher ◽  
Dhruval K. Bhavsar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Economic Status ◽  
Tertiary Care ◽  
Childhood Mortality ◽  
Care Hospital ◽  
Maternal Weight ◽  
Mortality And Morbidity ◽  
The Government

Background: Birth weight is one of the important determinants of neonatal wellbeing. Birth weight has many determinants that mainly include maternal nutritional status and the term of gestation. Low birth weight is associated with high neonatal and childhood mortality and morbidity. Over the years the birth weight is showing the increasing trend in developing countries like India. The study aimed at finding out the changing pattern of birth weight over a decade in rural India.Methods: A retrospective analysis of over 45,000 births that took place in Tertiary care hospital from year 2008-2017was undertaken. The socio economic determinants of birth weight were studied.Results: The incidence of low birth weight declined from 47 percent to 35 percent over ten years. The mean rise in birth weight in ten years was observed in both male (176 grams) and female (151grams).The incidence of very low birth and extremely low birth was found declined. There was positive co relationship between improved birth weight and improved socio economic status, delay in age at marriage, higher maternal weight gain during pregnancy, improved pre pregnancy nutritional status of women.Conclusions: There is steady decline in incidence of low birth weight over last ten years in study area. Improved maternal health, better nutrition, improved quality of antenatal care and various efforts and actions from the government side have contributed in improving the birth weight.

scholarly journals Differences and diversity of autoimmune-mediated encephalitis in 77 cases from a single tertiary care center

2019 ◽  
Author(s):  
Abhinbhen Wasontiwong Saraya ◽  
Kanthita Worachotsueptrakun ◽  
Kritchai Vutipongsatorn ◽  
Chanikarn Sonpee ◽  
Thiravat Hemachudha
Keyword(s):  
Behavioral Change ◽  
Care Center ◽  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Numerical Data ◽  
Clinical Findings ◽  
Exact Test ◽  
Abnormal Movements ◽  
Surface Antibody ◽  
Surface Antibodies

Abstract Background Since the discovery of N-methyl-D-aspartate receptor (NMDAr) antibody in 2007, the incidence of autoantibody-mediated encephalitis has risen globally. Here we analyzed and compared groups of autoantibody-associated encephalitis patients based on clinical findings and laboratory results in order to find differences between two major groups of autoantibody-mediated encephalitis: intracellular and neuronal surface antibodies. Methods 77 records of autoimmune encephalitis/encephalomyelitis patients admitted to King Chulalongkorn Memorial Hospital (KCMH) between October 2010 and February 2017 were reviewed. Patients with infections or those with classic central nervous system demyelinating features were excluded. Categorical data was analyzed using chi-square and Fisher’s exact test. Unpaired, two-tailed t-test was performed to analyze numerical data. Results Of 77 patients, 40% presented with neuronal surface antibodies and 33% had intracellular antibodies. The most common autoantibody detected in each group was anti-NMDA receptor antibody (25/31, 81%) and anti-Ri antibody (7/25, 28%) respectively. In the neuronal surface antibody group, behavioral change was the most common complaint (45%), followed by seizures (39%), abnormal movements (29%) and psychosis/mood disorder (23%). In the latter group, seizure was the most common presenting symptom (32%), followed by motor weakness (20%), behavioral change (16%) and abnormal movements (16%). Patients with neuronal surface antibodies were significantly younger (35 vs 48 years old, p=0.04) and were more likely to present with behavioral change (45% vs 16%, p=0.02). Mortality rate was higher in the intracellular group although this was statistically insignificant (16% vs 3.2%, p=0.09). No significant differences were detected in magnetic resonance imaging and cerebrospinal fluid (CSF) profile. Conclusions The prevalence of neuronal surface antibody group was much higher than the intracellular group. In the earlier stages of the disease, both groups have comparable clinical outcomes. Furthermore, it is difficult to distinguish autoantibody-associated encephalitis patients based on clinical data, neuroimaging and CSF profile. Therefore, we recommend that patients with features of autoimmune encephalitis should be screened for both the neuronal surface and intracellular antibodies regardless of clinical presentation.

COMPARISON OF PARKIN SCORE AND NEW BALLARDS SCORE FOR GESTATIONALAGE ESTIMATION- PROSPECTIVE ANALYTICAL STUDY

2021 ◽  
pp. 30-31
Author(s):  
Akshatha S ◽  
P. Bhanuchand ◽  
Chinthana BS
Keyword(s):  
Gestational Age ◽  
Analytical Study ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Age Assessment ◽  
Mortality And Morbidity ◽  
Sick Neonate

In an infant it is important to know correct gestational age , to evaluate the risk , line of management and mortality and morbidity. Most common used method for gestational age assessment is Ballard's score which includes various parameters and neurologic parameters and difcult to assess in sick neonate where parkin score only uses 4 criteria for assessment of gestational age. This prospective analytical study was conducted to compare new Ballard's score and parkin's score between healthy and sick neonates in tertiary care center

Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study

2017 ◽  
Vol 126 (7) ◽  
pp. 555-560
Author(s):  
Jason E. Cohn ◽  
Andrew Touati ◽  
Mark Lentner ◽  
Mark Weitzel ◽  
Casey Fisher ◽  
...  
Keyword(s):  
Symptom Score ◽  
Significant Positive Correlation ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Clinical Score ◽  
Clinical Findings ◽  
Laryngeal Edema ◽  
Common Symptom ◽  
Positive Correlation

Objectives: The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients. Methods: A retrospective chart review was conducted to identify symptoms and clinical findings associated with self-extubation. A novel scoring system was developed and used to quantify these findings. Symptom score included all symptoms that patients reported after self-extubation. Clinical score consisted of laryngeal findings visualized on nasopharyngeal laryngoscopy. Finally, a total self-extubation score was calculated as the sum of the symptom and clinical scores. Additionally, duration of intubation and endotracheal tube size were correlated with these scores. Results: Sixty (n = 60) patients who self-extubated in our institution’s intensive care unit were identified. Average calculated symptom, clinical, and total self-extubation scores were 0.92, 1.43, and 2.35, respectively. The most common symptom observed was hoarseness (62%), while the most common clinical finding was posterior laryngeal edema (58%). A significant positive correlation was found between duration of intubation and both symptom score and total self-extubation score (r = 0.314, P = .008 and r = 0.223, P = .05, respectively). Symptom score predicted clinical score with a significant positive correlation present (r = 0.278, P = .02). Conclusions: This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.

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