scholarly journals COVID-19 and multi-system inflammatory syndrome in children: keep a high index of suspicion in all inflammatory disorders

2021 ◽  
Vol 8 (4) ◽  
pp. 747
Author(s):  
Fatima Afreen Ahmad ◽  
Munesh Tomar ◽  
Umang Arora
Keyword(s):  
Health Care Professionals ◽  
Care Center ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Multiple Organ ◽  
Organ System ◽  
Toxic Shock ◽  
Inflammatory Conditions ◽  
High Index Of Suspicion ◽  
Inflammatory Syndrome

COVID-19 pandemic put many challenges for the health care professionals and one of that is the multi-system inflammatory syndrome in children (MIS-C). This syndrome shares its features with other inflammatory conditions including Kawasaki disease and toxic shock syndrome. We are reporting 4 cases from a tertiary care center in COVID-19 hotspot area in the state of Uttar Pradesh who presented with multiple organ system involvement. 

scholarly journals Deep Cerebral Venous Thrombosis—A Clinicoradiological Study

2021 ◽  
Author(s):  
Sujana Gogineni ◽  
Dhananjay Gupta ◽  
R. Pradeep ◽  
Anish Mehta ◽  
Mahendra Javali ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Arterial Occlusion ◽  
Venous System ◽  
Common Risk Factor ◽  
Imaging Characteristics ◽  
Deep Cerebral Venous Thrombosis ◽  
High Index Of Suspicion

AbstractStroke is a common neurological emergency. Almost 80% of strokes are due to arterial occlusion. Venous thrombosis comprises less than 1–2% of all strokes. Involvement of the deep cerebral venous system is still rare and accounts for about 10.9% of all cerebral venous thromboses (CVT). CVT diagnosis is often delayed or missed, because of its variable clinical manifestations. We retrospectively (2015–18) and prospectively (2018–20) reviewed all the cases of CVT in a tertiary care center in south India. Out of a total of 52 CVT cases, 12 were due to the involvement of deep cerebral venous system. Their clinical presentation, imaging characteristics, and outcomes were assessed. The most frequent presentation was headache followed by seizures. Hyperhomocysteinemia was the most common risk factor noted. Imaging characteristics were variable, and a high index of suspicion was required for early diagnosis. All patients had favorable outcome in our study, and except one, all were treated conservatively.

scholarly journals Epidemiological analysis of hip fractures at a tertiary care center: a retrospective study

2018 ◽  
Vol 4 (4) ◽  
pp. 568
Author(s):  
Madharam Bishnoi ◽  
Tabish Tahir Kirmani ◽  
Najmul Huda ◽  
Gaurav Chahal ◽  
Sandeep Bishnoi
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Hip Fractures ◽  
Care Center ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
The Elderly ◽  
Tertiary Care Center ◽  
Epidemiological Analysis ◽  
Number Of Patients

<p class="abstract"><strong>Background:</strong> Hip fractures are a leading cause of morbidity and mortality in the elderly population posing significant burden on health care resources. The purpose of this study is to determine the epidemiological analysis of hip fractures at a tertiary care center.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study done on patients with hip fractures admitted during the period 2015-2017 in Moradabad district of Uttar Pradesh. Case files and radiographs of patients were reviewed for age, gender, nature of trauma, associated comorbidities, type of fracture and presence of osteoporosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the 2015-2017 period, 2214 patients with hip fractures were admitted, out of which 1180 were males and rest females. The mean age of patients was 56.8 years with 41.6% belonging to age group 60-75 years. In elderly patients, a low energy simple fall accounted for &gt;85% of fractures with presence of significant osteoporosis (Singh’s index grade 3). The in hospital mortality was 2.1%. Hip fracture characteristics included intertrochanteric 57.81%, femoral neck 30.26% and sub trochanteric 11.93%. Smoking and medical comorbidities were present in a significant number of patients.</p><p class="abstract"><strong>Conclusions:</strong> With increased longevity, hip fractures are an increasing health care problem. Various preventive measures for osteoporosis and falls will decline the prevalence of these fractures.</p>

scholarly journals Report of a Case of Cold Urticaria Following Cryotherapy – Need for Screening for Untoward Effects of Cryotherapy in Physical Therapy Clinical Practice

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Mohanakrishnan Jagadevan ◽  
Bhanumathy Mohanakrishnan ◽  
Gopisankar Balaji ◽  
Malathi Munisamy ◽  
Salaja Murugesan ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Health Care Professionals ◽  
Physical Therapist ◽  
Care Center ◽  
Tertiary Care ◽  
Cold Urticaria ◽  
Screening Process ◽  
Cold Stimulation ◽  
Systemic Complications ◽  
First Choice

Introduction:Musculoskeletal rehabilitation is one of the frontline domains in physical therapy practice. In most countries, physical therapists prefer independent practice with referrals from general practitioners and orthopedic surgeons. Under these circumstances, the physical therapist may be the first contact professional handling these individuals who may not have adequate medical records with their personal medical history. Cryotherapy for pain relief could be the first choice of pain management opted by a musculoskeletal therapist. That is when both the therapist and the patient have to be aware of the undesirable effects of cryotherapy application and its potential local and systemic complications. The outcome of this paper could be an initiative for a standardized screening process to be incorporated into physical therapy practice. Clinical Findings:A 30-year-old man with left knee pain who underwent exercise therapy in the physiotherapy unit of a tertiary care center developed erythematous rashes around the knee following ice application. It was noted that the patient was not aware of the same in the past. The patient was attended by a dermatologist, and a diagnosis of cold urticaria was made following confirmation with cold stimulation test. Conclusion:From this study, it may be concluded that the awareness of cold-induced urticaria has to be emphasized on both patients and health care professionals. A simple screening protocol should be made mandatory in orthopedic physical therapy practice, which would suffice this purpose. Keywords: Urticaria, cryotherapy, Physical therapy

Extensive Acquired Cholesteatoma in Children: When the Penny Drops

2005 ◽  
Vol 114 (7) ◽  
pp. 539-542 ◽  
Author(s):  
Craig W. Semple ◽  
Murali Mahadevan ◽  
Robert G. Berkowitz
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Acute Otitis Media ◽  
Retrospective Chart Review ◽  
Computed Tomographic ◽  
Recurrent Acute Otitis Media ◽  
Tympanostomy Tubes ◽  
Acquired Cholesteatoma ◽  
High Index Of Suspicion ◽  
Conductive Hearing

Objectives: To determine the factors associated with the diagnosis of acquired cholesteatoma (AC) in children, we performed a retrospective chart review at a tertiary care center. Methods: We reviewed children with a diagnosis of AC that extended beyond the mesotympanum in the presence of a nonintact tympanic membrane who underwent surgical treatment over a 14-year period. Results: There were 116 children (78 male, 38 female) between 3 and 18 years of age (mean, 9.5 years). Their average period of management in a specialist otolaryngology clinic before the diagnosis of cholesteatoma was made was 3.2 years, and 68% of the children had previously undergone insertion of tympanostomy tubes. Symptoms and signs included chronic otorrhea (59%), recurrent acute otitis media (58%), and conductive hearing loss (51%). The diagnosis of AC was eventually made after office otoscopy (26%), temporal bone computed tomography (24%), or examination under anesthesia (17%). In 33% of children, the diagnosis was made only after surgical exploration of the middle ear and mastoid. Conclusions: Our data underscore the importance of maintaining a high index of suspicion for AC in managing children with long-standing otologic symptoms, and considering otomicroscopy, computed tomographic scanning, or tympanomastoid exploration if medical treatment fails.

scholarly journals Peri-partum cardiomayopathy-not a rare entity, clinical profile in a rural tertiary care center in Gujarat, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1544 ◽  
Author(s):  
Rumi Bhattacharjee ◽  
Nitin Raithata ◽  
Molina Patel ◽  
Smruti Vaishnav
Keyword(s):  
Heart Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Fetal Outcome ◽  
Obstetric Complications ◽  
Tertiary Care Center ◽  
Diagnostic Dilemma ◽  
High Risk Factors ◽  
High Index Of Suspicion

Background: Peri-partum cardiomayopathy (PPCM) in pregnancy has a potential to adversely affect both mother and fetus. Severe cases can be associated with life threatening complications unless managed promptly by multidisciplinary team. The objective was to study maternal and fetal outcome of PPCM patients.Methods: An observational cohort over 4 years (2012 to 2015) was conducted in a Rural tertiary care center. Consecutive antenatal and postpartum women with PPCM were studied for medical and obstetric complications, deliveries, fetal outcome and maternal mortality.Results: The incidence of PPCM was 0.3% and Most patients presented with typical signs and symptoms of heart failure. 55.5% were in NYHA 3 and 4 and 50% had ejection fraction below 30%. 83.3% required ICU admissions of varying length and Maternal mortality was in 1 patient (5.56%). PPCM occurred in 55.5% of ante partum against 44.4% of postpartum patients. Obstetric complications like PPH occurred in 11.1% while poor fetal outcome like preterm deliveries occurred in 50% while still births in 16.67%.Conclusions: The low incidence and rarity of PPCM presents itself with diagnostic dilemma. Obstetrician should have high index of suspicion in patients with heart failure and high risk factors. Early diagnosis and prompt treatment can only improve the outcome.

scholarly journals KNOWLEDGE, ATTITUDE AND PRACTICE OF EPILEPSY AMONG HEALTH CARE PROFESSIONALS IN A TERTIARY CARE CENTER IN RAJASTHAN

2015 ◽  
Vol 4 (83) ◽  
pp. 14531-14540 ◽  
Author(s):  
Sureka R K ◽  
Amit Agarwal ◽  
Kuldeep Singh Yadav ◽  
Surbhi Chaturvedi ◽  
Madhu Bijhawan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

scholarly journals Attitude of Non-Mental Health Professionals Towards Mental Illness in a Tertiary Care Center

2019 ◽  
Vol 2 (02) ◽  
pp. 23-28
Author(s):  
Nishad P. M. A. ◽  
Dilshana N. B. ◽  
Anil Kakunje ◽  
Ravichandra K. ◽  
Kamran Chisty
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Psychiatric Illness ◽  
Positive Attitude ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Objective

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.

Attitude of Non-Mental Health Professionals Towards Mental Illness in a Tertiary Care Center

2019 ◽  
Vol 2 (02) ◽  
pp. 23-28
Author(s):  
Nishad P. M. A. ◽  
Dilshana N. B. ◽  
Anil Kakunje ◽  
Ravichandra K. ◽  
Kamran Chisty
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Psychiatric Illness ◽  
Positive Attitude ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Objective

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.

scholarly journals Nosocomial Staphylococcal Toxic Shock. Case Report

2016 ◽  
Vol 2 (3) ◽  
pp. 142-144
Author(s):  
Manuela Arbune ◽  
Loredana Tercu
Keyword(s):  
Nitrogen Retention ◽  
Sudden Onset ◽  
Multiple Organ ◽  
Fluid Replacement ◽  
Biliary Colic ◽  
Toxic Shock ◽  
Lethal Infection ◽  
History Of ◽  
Staphylococcal Toxic Shock Syndrome ◽  
Inflammatory Syndrome

Abstract Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The etiology is Staphylococcus aureus exotoxin, while enterotoxins act as superantigens. Most cases are identified in women using a vaginal tampon. A 51-year-old female, with a past medical history of biliary dyskinesia, presented in the emergency room complaining of sudden onset of abdominal pain, vomiting, headache, myalgia, and chills. The initial diagnosis was biliary colic and was treated parenterally with Amoxi-clavulanate and fluid replacement. Initially, progress was unsatisfactory. Four days after admission she developed a systemic inflammatory syndrome, diffuse rash, jaundice, oliguria, confusion, persistent hypotension and biological evidence of thrombocytopenia, nitrogen retention, and cholestasis. She was admitted to the intensive care unit. A gluteal phlegmon induced after intramuscular injections was identified and surgically treated. Blood bacteriological cultures were negative, though MRSA was isolated in phlegmon pus. A diagnosis of STSS was based on CDC criteria. The risks of similar infections could be prevented by limiting intramuscular treatments and monitoring invasive procedures.

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