scholarly journals Clinical characteristics and predictive mortality risk factors in hospitalised children with COVID-19 illness during the first and second wave: single centre experiences from a tertiary paediatric hospital in Mumbai

2021 ◽  
Vol 9 (1) ◽  
pp. 83
Author(s):  
Shakuntala S. Prabhu ◽  
Vrushabh S. Gavali ◽  
Radhika Mathur ◽  
Sudha Rao ◽  
Lakshmi Shobhawat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Disease ◽  
Tertiary Care ◽  
Demographic Parameters ◽  
Paediatric Hospital ◽  
Co Morbidity ◽  
Short Period ◽  
Inflammatory State ◽  
Adults And Children ◽  
Second Wave

Background: Coronavirus disease 2019 (COVID-19) pandemic has affected both adults and children alike. It presented in cluster of cases in short period of time all across the world. In India, there were two such clusters called as first and second wave. World over mortality was more in adults than in children. But, few children also had severe disease during these waves.  Also, some presented with inflammatory state secondary to COVID-19 infection which is called as Multisystem Inflammatory syndrome in children (MIS-C). As major population affected with severe disease were older people this disease in initial phases was most studied in this population. It is thus necessary to observe and analyse disease manifestations, pattern and risk factors in children and also contrast these variables between the two waves. The objectives of the study was to compare and contrast clinico-demographic parameters and outcome predictors in children admitted with COVID-19 during the first and second waves.Methods: This is a retrospective analytical study comparing aforementioned parameters of children (with and without co-morbidity) admitted with COVID-19 infection between the two waves of pandemic in a tertiary care public pediatric hospital in Western Maharashtra.Results: First wave had 176 cases admitted over six months while the second wave had 185 cases over only three months. While proportion of cases with pneumonia requiring ICU stay was significantly higher in wave 2, those with MIS-C requiring inotropes was higher in wave 1. There was no difference in other clinico-demographic parameters of these cases irrespective of co-morbidity. Pneumonia, severe disease, hypoxia, need for inotropes or ICU care predicted poor outcome in both the waves.Conclusions: Though the pattern of presentation was different, the clinico-demographic variables and predictors of mortality were comparable between the two waves.  

scholarly journals Recurrent Emergency Department Users: Two Categories with Different Risk Profiles

2019 ◽  
Vol 8 (3) ◽  
pp. 333 ◽  
Author(s):  
Ksenija Slankamenac ◽  
Meret Zehnder ◽  
Tim Langner ◽  
Kathrin Krähenmann ◽  
Dagmar Keller
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Services ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Co Morbidity ◽  
Ed Visits ◽  
Morbidity Index

Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.

scholarly journals Clinical characteristics and factors influencing the outcome of hospitalised COVID-19 patients in a semi-urban primary healthcare center

2021 ◽  
Vol 14 (2) ◽  
pp. 42-54
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Chinmay Saha Podder ◽  
Nandini Chowdhury ◽  
Md Mohim Ibne Sina ◽  
SKM Shameem Kawser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Rt Pcr ◽  
District Health ◽  
Factors Associated ◽  
Negative Outcome

Background and objectives: Various new manifestations and risk factors for COVID-19 have been unveiled in the course of the current pandemic. Understanding the clinical spectrums as well as the risk factors associated with the adverse outcome of the disease is critical to combat this pandemic. This study was conducted to identify the clinical features, overall outcome and the factors associated with adverse outcome of the hospitalised COVID-19 patients in a semi-urban healthcare setting. Methods: This study was conducted at Debidwar Upazila (sub-district) Health Complex under the Cumilla district from April 2020 to October 2020. Reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients, aged 18 years and above, admitted at the Health Complex were enrolled in the study. All patients were followed till their recovery, referral or death. The data were collected in a pre-designed semi-structured questionnaire that included demographic, epidemiological, clinical and laboratory parameters. Result: Out of 50 RT-PCR positiveCOVID-19 adult participants, 30 (60%) were males and 20 (40%) were females. Twenty-four percent, 36%, and 40% of the patients had mild, moderate and severe disease respectively. The most common clinical symptom was fever (96%), followed by cough (86%) and shortness of breath (60%). Hypertension (54%), diabetes mellitus (40%), bronchial asthma (20%) and chronic obstructive pulmonary disease (COPD, 14%) were the major co-morbid conditions. Of the total cases, 2 (4%) died and 8 (16%) required referral to tertiary care hospital while 40 (80%) recovered. COPD was associated with poor outcome (OR 19; 95% CI: 2.88, 125.31; p < 0.05). Smokers were 7 times more likely to exhibit the negative outcome than non-smokers (95% CI: 1.52, 32.33; p < 0.05). Conclusion: In this study, COPD was associated with a negative outcome. Further study with larger sample should be carried out to determine the spectrum of risk factors. Ibrahim Med. Coll. J. 2020; 14(2): 42-54

scholarly journals Clinical profile and outcome of children with congenital heart diseases admitted with acute events in a paediatric tertiary care unit in North Karnataka

2021 ◽  
Author(s):  
Ramaning Loni ◽  
Pruthvi Ranganath ◽  
Manisha Juvekar ◽  
Nitin Tikare ◽  
L. H. Bidari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Protein Energy Malnutrition ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Congenital Heart Diseases ◽  
Age Group ◽  
Presenting Symptoms ◽  
Co Morbidity

Background: Congenital heart diseases are the predominant causes of paediatric morbidity and mortality. This study was done to know the clinical profile, various acute presentations, and risk factors for repeated hospitalizations and their outcome in children with congenital heart diseases.Methods: This prospective observational study of children in the age group of 0 hour-12 years, who were previously diagnosed and or newly diagnosed with congenital heart diseases.Results: A total of 102 children were present during the study period. The most common age group for congenital heart disease was infancy with 46.1% (47 cases) of children. Acyanotic heart diseases were observed in 73.5% (75 cases) of the total, followed by cyanotic CHD with 14.7% (15 cases), complex CHD with 9.8% (10 cases), and the least, valvular diseases with 2% (2 cases). The most usual presenting symptoms in children with CHDs were breathlessness with 66.7% (67 cases), followed by fever with 54.9% (56 cases) and cough with 48% (49 cases. In this study, 23.5% (24 cases) of the children were completely immunized. The protein-energy malnutrition was present in 51% of cases (52 cases). The 16.7% of them (17 cases) have got the motor developmental delay predominantly. The dysmorphic features were present in 19 cases (18.6%) of total cases. The chest X-ray findings were abnormal in 58.8% (60 cases). The most common risk factor(co-morbidity) in children with CHD was noticed to be anaemia in 43 cases (42.2%).Conclusions: The infancy and early childhood are the most common age group for the presentation of CHDs. Most of them had the associated risk factors (co-morbid) like nutritional anaemia, pneumonia, and failure to thrive.

scholarly journals Adolescents Hospitalized with SARS-CoV-2: Analysis of Clinical Profile and Risk Factors for Severe Disease over a two-year period

2022 ◽  
Author(s):  
Tamoghna Ghosh ◽  
Tejas M Suri ◽  
Kana Ram Jat ◽  
Aditya Kumar Gupta ◽  
Sushma Bhatnagar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Disease ◽  
Tertiary Hospital ◽  
Clinical Profile ◽  
North India ◽  
Mild Disease ◽  
Reactive Protein ◽  
Northern India ◽  
Severity Grading ◽  
Second Wave

Introduction: There is a lack of studies in adolescents with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in adolescents hospitalized with COVID-19. Methods: A retrospective analysis of a prospectively admitted cohort of COVID-19 patients was performed at a tertiary hospital in north India. Adolescents aged 12 to 18 years who were hospitalized during the first wave (March 2020 to December 2020) and the second wave (March 2021 to June 2021) of the pandemic were included. Data on the demographic details, clinical presentation, laboratory parameters, disease severity at admission, treatments received, and in-hospital outcomes were retrieved and logistic regression was used to identify the risk factors for occurrence of moderate or severe disease. Results: The study included 197 adolescents with median (IQR) age 15 (13-17) years, of whom 117 (59.4%) were male. Among these, 170 (86.3%) were admitted during the 1st wave. Underlying comorbidities were present in 9 (4.6%) patients. At the time of hospital admission, 60 (30.9%) patients were asymptomatic. In the severity grading, 148 (84.6%) had mild, 16 (9.1%) had moderate, and 11 (6.3%) had severe disease. Fever (14.9%) and cough (14.9%) were the most commonly encountered symptoms. The median (IQR) duration of hospital stay was 10 (8-13) days and 6 (3.1%) patients died in hospital. The odds of moderate to severe disease were 3.8 for second wave, 1.9 for fever and 1.1 for raised C reactive protein (CRP). Conclusion: In our single-center study from northern India, adolescents admitted with COVID-19 had predominantly asymptomatic or mild disease. Admission during the second wave of COVID-19 pandemic, presence of fever and raised CRP were risk factors for moderate or severe disease.

scholarly journals High Waist to Hip Ratio as a Risk Factor for Ischemic Stroke Patients Admitted in a Tertiary Care Hospital

1970 ◽  
Vol 9 (1) ◽  
pp. 30-34
Author(s):  
Md Habib Khan ◽  
Sanjoy Kumar Chakraborty ◽  
Rajat Sanker Roy Biswas
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Stroke Patient ◽  
Tertiary Care ◽  
Care Hospital ◽  
Ischemic Stroke Patient ◽  
College Hospital ◽  
Cross Sectional ◽  
Waist To Hip Ratio ◽  
Co Morbidity

Context: Stroke is a problem now days. The purpose of this study is to see the association of high waist-to-hip ratio with ischemic stroke and also to see the correlation with other risk factors of ischemic stroke. Study type: Hospital based cross sectional descriptive study Methods: It is a study conducted on purposively selected (non probability) hospitalized patients who had been admitted into neuromedicine ward of Chittagong Medical College Hospital (CMCH), Chittagong prooved during a period of 6 months extending from 1st January 2009 to 31st June 2009. 50 cases with CT scan prooved ischemic stroke of brain were interviewed and examined and had measurements of waist and hip circumference and waist to hip ratio (WHR) were calculated. Results: 64% of the ischemic stroke patient had abnormal WHR. The correlation with other risk factors showed that 90% of ischemic stroke patient had other co-morbidity. Among them 76% patient had hypertension, 38% patients had history of smoking, 16% patients had diabetes mellitus and 12% patients had dyslipidaemia. Conclusion: The results reveal that high waist to hip ratio might have an association with ischemic stroke. Key words: Ischemic stroke; Waist-to-Hip Ratio (WHR). DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8145 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 30-34

scholarly journals Clinical profile, bacterial profile and outcomes in an intensive care unit of a tertiary care hospital in south India: one year study

2017 ◽  
Vol 4 (1) ◽  
pp. 156
Author(s):  
Ajay Kumar Sarvepalli ◽  
Prakash Kalakappa Dharana
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Intensive Care ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Gram Negative ◽  
Co Morbidity

Background: Infections still remain as one of the major cause of mortality in low and lower- middle-income countries as reported by Global Burden of Diseases study. Intensive care units (ICU) are a major source of infections in tertiary care hospitals. Widespread multi-drug resistant gram positive and gram negative bacterial isolates are also associated with infections in ICU. A hospital based epidemiological study was to determine the risk factors; bacterial isolates, antibiotic sensitivity and outcomes in ICU patients.Methods: This prospective study was done at Narayana Medical College and Hospital for 12 months from 1st February 2015 to 31st January 2016. All the risk factors were noted. Patient’s outcome noted as death, recovery and transfer to palliative care. Data entry and analysis performed in Microsoft excel, p valve < 0.001 was considered significant.Results: Three hundred and thirty patients were included in the study (age: 56.16±15 years, 57.6% males). 159 (48.2%) were direct admissions, 103 (31.2%) were transfers from other hospitals. Major cause of admission was neural (29.1%) followed by cardiovascular (21.8%). HTN (52.4%) was major co-morbidity followed by type-2 DM (47.3%). 51.9% culture positivity (n = 539) was observed with sputum 83.6% and blood 24.2%. Gram-negative pathogens were predominant which includes Acinetobacter baumanii (13.8%), Escherichia coli (20%), Klebsiella pneumoniae (14.3%), Pseudomonas aeruginosa (9%), Enterobacter aerogenes (5.1%). Candida Sp and MRSA, VRE were isolated. In the study 255(77.3%) recovered, 38(11.5%) progressed to death and 37(11.2%) transferred to palliative care. Higher mortality was noticed with Acinetobacter baumani (81.6%).Conclusions: High prevalence of gram-negative bacterial infections and multi-drug resistant isolates was noted in Indian ICUs.

scholarly journals Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

2021 ◽  
Vol 28 (4) ◽  
pp. 425-431
Author(s):  
Sudhir BHANDARI ◽  
◽  
Shivankan KAKKAR ◽  
Amitabh DUBE ◽  
Mohnish GROVER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
High Morbidity ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Invasive Fungal Diseases ◽  
Co Morbidity ◽  
History Of ◽  
Second Wave

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).

CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Infectious Diseases ◽  
East Asia ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
South East Asia ◽  
Immunization Status ◽  
Tertiary Care Hospitals ◽  
Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

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