scholarly journals Clinical profile of pediatric patients with tuberculosis in a tertiary care centre in India

2020 ◽  
Vol 7 (9) ◽  
pp. 1906
Author(s):  
Ashna Kumar ◽  
Javid Ahmad ◽  
Pooja Bharti ◽  
Vasundhara Bakshi
Keyword(s):  
Pediatric Population ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Abdominal Tuberculosis ◽  
Childhood Tuberculosis ◽  
Diagnostic Methods ◽  
North India ◽  
Tuberculous Lymphadenitis ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: India has one of the highest TB burden globally. Children contribute a significant proportion of TB burden, in whom the diagnosis can be challenging because many childhood diseases mimic TB. Therefore, a high index of suspicion is required for early diagnosis of childhood tuberculosis to prevent poor outcome. Objectives was to evaluate the prevalence and profile of childhood tuberculosis cases and to determine the risk factorsMethods: An observational cross-sectional study was conducted over a period of 6 months at a hospital in north India and the prevalence and profile of the children admitted with the clinical suspicion of tuberculosis was studied. Case specific diagnostic approach was used for diagnosis and the appropriate treatment was instituted.Results: The prevalence of childhood TB was 2.3% among hospitalized children. Of these, 66.5% were males and 33.49% were females. The majority of cases were more than 8 years. The history of contact was present only in 31.1%. Tuberculin skin test was positive in 53.11%. Pulmonary tuberculosis was the most common type of childhood tuberculosis (45.45%) followed by neurological tuberculosis (42.8%), abdominal tuberculosis (6.45%), tuberculous lymphadenitis (2.63%), others (2.61%). Malnutrition was a potent contributing factor present in 91.86%. The mortality rate observed in the study was 9.56%.Conclusions: Owing to the high burden of tuberculosis among pediatric population in India, there is an alarming need to develop more economical and advanced diagnostic methods for better patient management and above all there is urgent need of the hour to educate the masses about the transmission and risk factors for this disease.

scholarly journals Delirium in Critically ill Patients in a Tertiary Care Centre in Western Region of Nepal

2015 ◽  
Vol 12 (2) ◽  
pp. 117-120
Author(s):  
P Thapa ◽  
PK Chakraborty ◽  
JB Khattri ◽  
K Ramesh ◽  
P Sharma
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Significant Proportion ◽  
Adverse Outcomes ◽  
Tube Placement ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background Delirium affects a significant proportion of critically ill patients admitted in hospital. It is associated with various adverse outcomes. Despite its enormous prognostic significance it tends to be underdiagnosed. There is a dearth of studies on risk factors of delirium in our setting.Objectives The main objectives of this study was to find out the prevalence, rate of non recognition and risk factors associated with delirium in hospitalized critically ill patients.Methods A hospital based cross-sectional study was carried out. Data was collected using a predesigned semi-structured proforma and Intensive care delirium screening checklist was used to screen for delirium in patients admitted in various wards of Manipal teaching hospital, Pokhara, Nepal.Results Ninety five cases were included in the analysis. The mean age of study group was 58.9 ± 19.1 years. Delirium was present in 15/95 cases and it was not recognized by treating physician in about one third of cases. Odds ratio (OR) was statistically significantly increased in patients with history of stroke (OR=4.484 95% CI=1.0896;18.459), alcohol use (OR=10.792 95% CI=2.906;40.072), smoking (OR= 4.836 95% CI= 1.411;16.576), use of restraint (OR=17.143 95% CI=4.401;66.766), nasogastric tube placement (OR= 7.731 95% CI=2.348;25.452) and use of Foley’s catheter (OR=12.000 95% CI= 3.072;46.877).Conclusion About 16% of critically ill patients were found to be delirious. In about one third of the cases delirium was not recognized. Both patient related and iatrogenic factors may increase the risk of delirium in hospitalized critically ill patients.Kathmandu University Medical Journal Vol.12(2) 2014: 117-120

scholarly journals CARDIAC MANIFESTATIONS IN DENGUE FEVER: A CROSS SECTIONAL STUDY FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
North India ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Manifestations

scholarly journals Assessment of Depression, Anxiety, and Sleep Disturbance in COVID-19 Patients at Tertiary Care Centre of North India

2021 ◽  
Author(s):  
Ramakant Yadav ◽  
Prashant Yadav ◽  
Sushil Shukla Kumar ◽  
Raj Kumar
Keyword(s):  
Sleep Disturbance ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
Psychological Problems ◽  
North India ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patient Health ◽  
Novel Coronavirus

Abstract Background and Objective The novel Coronavirus pandemic surfaced in Wuhan, China in December 2019 and spread rapidly across the globe. In recent available literature, most of the studies were done to estimate the burden of psychiatric problems among general population due to this pandemic, Therefore, this study was planned to assess depression, anxiety, and sleep disturbance among Coronavirus disease-2019 (COVID-19) patients. Materials and Methods A hospital-based, cross-sectional study was done from June 2020 to August 2020 among 100 COVID-19 patients who were admitted and fulfilled the inclusion criteria. Assessment of depression, anxiety, and sleep disturbance were done by patient health questionnaire-9 (PHQ-9) scale, generalized anxiety disorder-7 (GAD-7) scale and Pittsburg sleep quality index (PSQI), respectively. Results In this study, 73% were males and 27% were females. The mean age of the patients in present study was 42.90 ± 16.33 years. This study reveals that depression was in 27%, anxiety in 67%, and sleep disturbance in 62% of patients. Depression and anxiety were found significantly associated with presence of comorbidity and severity of illness (p < 0 0.05). The association of sleep disturbance with severity of illness was also found statistically significant (p < 0.05). Conclusion The risk of psychological stress is high in COVID-19 patients. The psychological problems among COVID-19 patients are commonly related to the consequences of disease, and severity and contagiousness of the disease. Therefore, in this present pandemic situation, it is more important to identify these psychological problems among COVID-19 patients, so that better care and timely interventions can be done with respect to psychological issues.

scholarly journals Changing Clinical Pattern of Sheri-Amaranthji Yatra Patients Attending a Tertiary Care Centre in North-India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 27-32
Author(s):  
Mohd Sarwar ◽  
Ghulam Hassan Yatoo ◽  
Shariq Rashid Masoodi
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Significant Proportion ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Clinical Pattern ◽  
Hindu Religion ◽  
Minor Ailments

INTRODUCTION: The sacred cave of Amaranth, located deep in the Himalayas, is one of the holiest pilgrimage sites of Hindu religion in general and among Shiva followers in particular. Because of high altitude, rough terrain and harsh weather, pilgrims are prone to sicknesses which sometimes may prove fatal. OBJECTIVES: To study the profile and outcome among Shri-Amarnathji Yatra patients attending a Tertiary Care Centre in North-India, and to examine whether there is any change in the clinical pattern of yatra patients over time METHODS: This was a prospective, observational study carried out during the yatra period of 2017. Ninety-seven Yatra patients who were on a pilgrimage to Shri-Amarnathji cave and referred to SKIMS between July and August 2017 for various illnesses were studied. All the necessary clinical details were recorded in a pre-designed and pre-tested Proforma prepared for the study; admitted patients were followed from admission till discharge. The profile and outcome of illness of these 2017 Yatra patients were compared with the results of the study conducted in the year 2011. RESULTS: Out of 97 Yatra patients ( referred to our Centre, 54 (55.7%) patients were managed in the outpatient department (OPD) of the hospital; the majority of these patients (33, 61%) were male and were having minor ailments. Out of these 54 patients managed in OPD, 18 (33%) had respiratory tract infection, while 11 (20%) had Hypertension. Patients who were sick (n=43) were admitted and managed in the Accident & Emergency (A&E) Department of the institute. Majority of the admitted patients were males (74%); trauma, particularly road traffic accidents constituted 32.5%, followed by acute myocardial infarction (16.3%). Out of admitted 43 Yatra patients, 36 (84%) patients improved, five patients (12%) expired, one was discharged on request, and one referred to a higher centre for further management. CONCLUSION: As compared to previous studies, more male patients were admitted this time, most of whom were in the age-group of 21-40 years. The proportion of patients due to injury and road traffic accident has increased, forming a significant proportion of the referred cases. INTRODUCTION: The sacred cave of Amaranth, located deep in the Himalayas, is one of the holiest pilgrimage sites of Hindu religion in general and among Shiva followers in particular. Because of high altitude, rough terrain and harsh weather, pilgrims are prone to sicknesses which sometimes may prove fatal. OBJECTIVES: To study the profile and outcome among Shri-Amarnathji Yatra patients attending a Tertiary Care Centre in North-India, and to examine whether there is any change in the clinical pattern of yatra patients over time METHODS: This was a prospective, observational study carried out during the yatra period of 2017. Ninety-seven Yatra patients who were on a pilgrimage to Shri-Amarnathji cave and referred to SKIMS between July and August 2017 for various illnesses were studied. All the necessary clinical details were recorded in a pre-designed and pre-tested Proforma prepared for the study; admitted patients were followed from admission till discharge. The profile and outcome of illness of these 2017 Yatra patients were compared with the results of the study conducted in the year 2011. RESULTS: Out of 97 Yatra patients ( referred to our Centre, 54 (55.7%) patients were managed in the outpatient department (OPD) of the hospital; the majority of these patients (33, 61%) were male and were having minor ailments. Out of these 54 patients managed in OPD, 18 (33%) had respiratory tract infection, while 11 (20%) had Hypertension. Patients who were sick (n=43) were admitted and managed in the Accident & Emergency (A&E) Department of the institute. Majority of the admitted patients were males (74%); trauma, particularly road traffic accidents constituted 32.5%, followed by acute myocardial infarction (16.3%). Out of admitted 43 Yatra patients, 36 (84%) patients improved, five patients (12%) expired, one was discharged on request, and one referred to a higher centre for further management. CONCLUSION: As compared to previous studies, more male patients were admitted this time, most of whom were in the age-group of 21-40 years. The proportion of patients due to injury and road traffic accident has increased, forming a significant proportion of the referred cases.

scholarly journals Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 637
Author(s):  
Romi Bansal ◽  
Priyanka Garg ◽  
Aastha Garg
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Tertiary Care ◽  
Anaerobic Bacteria ◽  
Diagnostic Methods ◽  
North India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Vaginal Ph ◽  
Criteria For Diagnosis

Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.

scholarly journals Role of Macronutrients in the Prevention of Pre-Eclampsia - A Cross Sectional Study at a Tertiary Care Centre in North India

2020 ◽  
Vol 7 (42) ◽  
pp. 2414-2419
Author(s):  
Vandana Gangadharan ◽  
Gaurie Srivastava ◽  
George Koshy ◽  
Varghese Koshy
Keyword(s):  
Serum Calcium ◽  
Serum Magnesium ◽  
Tertiary Care ◽  
Normal Pregnancy ◽  
Maternal Serum ◽  
North India ◽  
Base Line ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Calcium And Magnesium

BACKGROUND Role for macronutrient supplementation in preventing pre-eclampsia is now backed with evidence which is evolving rapidly. We wanted to study and compare serum calcium and serum magnesium levels in pre-eclamptic women and women with normal pregnancy. METHODS 30 women with normal pregnancy and 30 women with preeclampsia were included in the study. Their serum calcium and magnesium levels were estimated using colorimetry. RESULTS Serum calcium levels in normotensive patients was found to be 9.3 ± 0.95 mg / dL and in preeclamptic patients, it was 8.3 ± 0.85 mg / dL. Serum magnesium levels were found to be 1.94 ± 0.24 mg / dL and 1.57 ± 0.125 mg / dL in normal and pre-eclamptic women respectively. These values were affected by age, parity, BMI, socio-economic status, and nutrition before and during pregnancy. CONCLUSIONS Low values of maternal serum calcium along with magnesium are related to preeclampsia which might have an association in this disease. We also realised that evaluation of base-line levels of serum calcium and magnesium are necessary during early pregnancy. Constant monitoring of blood pressure is also essential. Adequate intake of macronutrients is essential for maintaining health of both mother and child. Hence, measurable and realistic efforts must be made along these lines. Nutrition is a key concern in pregnant women and is pivotal in ensuring health in this vulnerable group. KEYWORDS Pre-Eclampsia, Serum Calcium, Serum Magnesium, Pregnancy, Macronutrients

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