scholarly journals Study of procalcitonin in neonatal sepsis with blood culture in suspected sepsis in North India

2021 ◽  
Vol 8 (7) ◽  
pp. 1241
Author(s):  
Munna Lal Jaipal ◽  
Ajit Kumar Shrivastava ◽  
Prema Ram Choudhary
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Tertiary Care ◽  
Clinical Signs ◽  
North India ◽  
Care Hospital ◽  
Negative Blood Culture ◽  
Suspected Sepsis ◽  
Cross Sectional ◽  
Number Of Patients

Background: Sepsis can occasionally be difficult to demonstrate, and its difference from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT) assay is one of the biomarkers of sepsis. The aim of the study was to investigate the value of procalcitonin, in the early diagnosis of neonatal sepsis.Methods: A cross-sectional study was conducted at tertiary care hospital in New Delhi. It included all neonates with clinical signs of sepsis. The neonates were divided into two groups as sepsis, and healthy neonates. The PCT level was measured by using ELISA technique and compared between the two groups. Statistical analysis was performed using SPSS windows version 20.0 software.Results: In this study total number of patients included 350, out of which 175 were clinically suspected sepsis cases and 175 were healthy controls. 68 (39%) neonates were show positive blood culture and 107 (61%) neonates were representing negative blood culture report in study group. The mean serum value of PCT was significantly (p<0.001) higher in sepsis neonates. The serum PCT value was significantly increased in neonate’s sepsis with positive blood culture (p<0.001) and negative blood culture (p<0.001) as compared to healthy neonates.Conclusions: It is concluded from this study that the PCT assay was established to be a valuable biomarker of sepsis in this study. The assay might be performed and reported quickly and gave precious information before availability of culture results. This might assist in avoiding unnecessary antibiotic therapy.

EVALUATION OF GRADING OF BREAST MALIGNANCIES ON FINE NEEDLE ASPIRATES AND COMPARISON OF TWO GRADING SYSTEMS AT A TERTIARY CARE HOSPITAL OF NORTH INDIA

2021 ◽  
pp. 192-194
Author(s):  
Shazia Bashir ◽  
Aamir Hussain ◽  
Irm Yasmeen
Keyword(s):  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Breast Cancers ◽  
Cross Sectional ◽  
Fine Needle Aspirates ◽  
Grading Systems ◽  
Grade Ii ◽  
Grade 3 ◽  
High Degree

AIM: To evaluate and compare the cytograding of breast cancers using Robinson's and Moriquand's grading methods MATERIAL AND METHODS: This study was a cross-sectional retrospective study conducted over a period of three years w. e .f October 2014 to October 2017 and includes diagnosed or highly suspicious malignant cases of breast carcinoma. Slides were retrieved from the cytology section of Department of Pathology, GMC Jammu. A total of 84 cases of breast cancers were studied and grading was done using Robinson's and Mouriquand's methods and the two grading methods were then compared. RESULTS: Out of 84 cases of breast cancers , on using Robinson's grading method , 11 cases [13.10%] were graded as grade 1, 65 cases [77.38%] were graded as grade 2 and 8 cases [9.52%] cases as grade 3. 9 (10.71%) cases are graded as Grade I by Mouriquand's method with score less than 5. 68(80.95%) cases were graded as Grade II with score 5-9 and 7 (8.33%) were graded ad Grade III with score ≥10. On doing comparison between the two cytograding methods, we found a high degree of concordance between the two systems [ 96.42% ] . The relationship observed between the scores obtained by the two methods was also seen to be highly signicant. CONCLUSION: There is possibility of comprehensive cytograding of breast cancers by using the two different methods proposed by Robinson's and Moriquand's but out of the two methods inspite of a high degree of concordance between the two methods , the grading system of Robinson's because of its more objective set of criterias and easy reproducibility has been found to be easier and better.

scholarly journals Management Strategy of Patients Attending at Epilepsy Clinic in a Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 6 (1) ◽  
pp. 3-8
Author(s):  
Mohammad Sayeed Hassan ◽  
Md Shafikul Islam Khan ◽  
Paritosh Kumar Sarkar ◽  
Anwar Israil ◽  
Ferdous Ara ◽  
...  
Keyword(s):  
Partial Seizure ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Partial Epilepsy ◽  
Absence Seizure ◽  
Care Hospital ◽  
Cross Sectional ◽  
Tonic Seizure ◽  
Number Of Patients ◽  
Generalized Epilepsy

Background: Epilepsy is a neuronal disorder that is observed globally but still it is not explored very well in most parts of the world. Objective: The aim of our study was to determine the types of epilepsies along with their treatment strategies among patients attending the outdoor epilepsy clinic in a referral tertiary care hospital. Methodology: This cross sectional study was carried out from the records of weekly epilepsy clinic of Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from January 2018 to August 2019. Data were collected through a predesigned questionnaire containing information about demography, clinical features, EEG and imaging findings and treatment of patients. Results: A total number of 1832 patients were recruited. There was a male (55.3%) and urban (61.1%) predominance. Most (75.1%) of the patients were young (age range from 10 to 29 years). A large number of patients were student (44.4%) and 24.2% were unemployed. The duration of epilepsy in most patients were less than 5 years (40.7%). 58.3% patients took various forms of indigenous treatment prior to attending this clinic. 54.7% patients had no comorbid illness. EEG was abnormal in 34.5% patients of which 24.4% had focal abnormality and 10.1% had generalized epileptic discharge. In brain imaging (CT/MRI) only 16.4% showed abnormal findings. 49.5% patients were suffering from generalized epilepsy whereas 44.6% had partial epilepsy. Among the generalized epilepsy group, most of them had generalized tonic clonic seizure (GTCS) (75.4%), while 8.9% had absence seizure and 7.9% had tonic seizure. In partial epilepsy group, the majority were secondary generalized seizure (74.7%), followed by complex partial seizure (CPS) (18.7%) and simple partial seizure (6.6%).42.7% patients got single antiepileptic drug whereas 37.4% patients received dual drug. Polytherapy (three or more drugs) were prescribed in 14% patients. Valproic acid was the highest prescribed drug (29.3%) either as monotherapy or in combination. Carbamazepine (27.4%) was the second common drug followed by Levetiracetam (15.1%). Conclusion: Epilepsy affects almost all groups of the society. Most of the patients remain seizure-free with judicious anti-epileptic drugs. Therefore, more effort is needed for early accurate diagnosis and appropriate treatment of epilepsy Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 3-8

scholarly journals Sepsis Criteria and Revision in Toxicological Intensive Care Unit

2020 ◽  
Vol 10 (4) ◽  
pp. 31452.1-31452.10
Author(s):  
Haleh Talaie ◽  
◽  
Maryam Nazari ◽  
Habib Emami ◽  
◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Coagulase Negative Staphylococci ◽  
International Consensus ◽  
Suspected Sepsis ◽  
Cross Sectional ◽  
Arterial Blood ◽  
Study Results

Background: Sepsis is one of the significant causes of mortality in hospitalized patients. This cross-sectional study was performed to determine the frequency of positive blood culture and assess sepsis criteria based on Third International Consensus Definitions (related to Sequential Organ Failure Assessment score) and clinical and paraclinical findings (i.e., on-admission leukocytosis, increased lactate level, and fever) in poisoned patients admitted to the Toxicological Intensive Care Unit (TICU). Methods: Medical records of a total of 2000 poisoned patients admitted to the TICU of Loghman Hakim Hospital from 2016 to 2018 were assessed. Among them, 189 cases (9.45%) with suspected sepsis were considered eligible to be enrolled in the study. Results: Of 189 cases, 146 (77.24%) had possible signs and symptoms of sepsis as well as SOFA score higher than two with positive blood culture in 81 cases (55%). The Mean±SD serum level of lactate was 25.97±16.32 on admission. The most common pathogen detected in blood culture was coagulase-negative Staphylococci in 35 (24.0%) out of 146 cases. Glasgow Coma Scale (GCS) less than 12, age older than 50 years, and bilirubin more than 1.2 mg/dL were found as independent predictors of sepsis on multivariate analysis. Conclusion: Based on our findings, it is proposed that the sepsis definition should not be restricted to the guidelines. The patients’ poisoning background and presence of many confounding factors, including poisoning-induced on-admission increased lactate levels, leukocytosis, and disturbed arterial blood gas provide a critical decision-making situation to confirm sepsis according to guidelines.

COVID-19: An Experience from a Tertiary Care Hospital of Nowshera

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemic Area ◽  
History Of ◽  
Severity Of The Disease ◽  
Age Range

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.

scholarly journals Stigma for Mental Disorders among Nursing Staff in a Tertiary Care Hospital

2020 ◽  
Vol 11 (02) ◽  
pp. 237-244
Author(s):  
Sandeep Grover ◽  
Neha Sharma ◽  
Aseem Mehra
Keyword(s):  
Mental Disorders ◽  
Nursing Staff ◽  
Mentally Ill ◽  
Positive Attitude ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
North India ◽  
Care Hospital ◽  
Cross Sectional

Abstract Objective This study aimed to evaluate the prevalence of stigma for mental disorders among nursing staff in a tertiary care hospital, and the secondary objective of the study was to assess the correlation of stigma with the socio-demographic profile and previous experience with mentally ill patients. Methods This cross-sectional study was performed among the 210 nurses working in a tertiary care multispecialty teaching public sector hospital in north India. They were evaluated on community attitudes toward the mentally ill (CAMI) scale. Results About two-thirds of the participants (67.1%) were females and had done graduation (64.2%) in nursing. Nearly 50% of the study participants had an experience of working with mentally ill patients. Female had a more significant positive attitude on the domain of social restrictiveness. Authoritarianism had a significant positive correlation with benevolence and social restrictiveness domains. The benevolence domain had a significant correlation with all other domains. Social restrictiveness domain also had a significant correlation with other domains. Conclusion Nurses have a positive attitude toward mentally ill patients.

scholarly journals An Audit of Rational Use of Antibiotics in a Tertiary Hospital

2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Number Of Patients ◽  
Rational Use Of Antibiotics

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67

scholarly journals Antimicrobial Resistance Patterns in Clinically Significant Isolates from Medical Wards of a Tertiary Care Hospital in North India

2020 ◽  
Vol 12 (03) ◽  
pp. 196-202
Author(s):  
Venkatesh Sudharsan Vaithiyam ◽  
Neha Rastogi ◽  
Piyush Ranjan ◽  
Niranjan Mahishi ◽  
Arti Kapil ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Resistance Pattern ◽  
Resistant Organism ◽  
Care Hospital ◽  
Cross Sectional ◽  
Drug Resistance Pattern ◽  
Clinically Significant ◽  
Medical Wards

Abstract Background The global burden of infections due to multidrug-resistant organism (MDRO) has a significant impact on patients’ morbidity and mortality along with increased healthcare expenditure. Aim This article estimates the prevalence of MDRO and the spectrum of clinical infectious syndromes caused by these organisms in medical wards of a tertiary care hospital in India. Design and Methods A cross-sectional observational study was performed among patients admitted in medicine wards diagnosed with the various infectious syndromes and one or more clinically significant positive culture at a tertiary care hospital in North India over a period of 18 months. Results Out of 323 clinically significant microbiological culture isolates from 229 patients included in the study, 86 (27%) isolates showed multidrug resistance (MDR) pattern, 197 (61%) isolates showed possible extremely drug-resistance pattern, and only 40 (12%) isolates showed nonmultidrug-resistance pattern of antibiogram. Conclusion The prevalence of MRDOs is high in clinically significant culture isolates from medicine wards in India. This emphasizes the importance of appropriate antibiotic usage and implementation of antibiotic stewardship programs in this part of the world.

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