Clinical and biochemical profile of patients hospitalized with jaundice: Experience from a teaching hospital in north India

Background: Jaundice is a common problem in both medical and surgical practice. For best line of management, it is very essential to differentiate all types of jaundice. The cause can often be correctly anticipated clinically but usually biochemical and radiological imaging investigations are required for confirmation. Here we present a study on clinical and biochemical profile of jaundice patients admitted in a tertiary care hospital.Methods: It was an observational study and all patients admitted with jaundice in the department of medicine meeting inclusion/exclusion criteria were enrolled. Data was collected on a self-designed, pretested and structured format.Results: Out of 100 patients, 77 were males, and median age of 47.5 years. Apart from jaundice, anorexia was the most common presenting complaint (90%), while ascites was the most common finding. Cirrhosis (60%) was the most common cause of jaundice. The mean total bilirubin was 7.9 mg%. Mean Hemoglobin in patients with cirrhosis was 9.7gm/dL. 78% patients of cirrhosis revealed esophageal varices. Majority (80%) showed hypoproteinemia. PT was prolonged >3sec in 87% of cases. On USG shrunken liver was noted in all patients with cirrhosis, enlarged liver was found in two patients of liver abscess while altered echotexture was seen in 66% cases. 90 patients improved, 9 died and only one was referred.Conclusions: Alcoholic liver disease was the leading cause of cirrhosis (92%). Jaundice in general and alcoholic cirrhosis in particular affects mostly the productive age group of the male population and has a high economic burden on our society.

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First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

MedPulse International Journal of Medicine ◽

10.26611/10111931 ◽

2021 ◽

Vol 19 (3) ◽

pp. 23-29

Author(s):

Yogita G Bavaskar ◽

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical History ◽

Care Hospital ◽

Age Group ◽

Number Of Patients ◽

The Mean ◽

Collection Form ◽

Time Of Admission ◽

Second Wave

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

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Follow-Up Care Barriers for Patients with Orofacial Clefts

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211042162 ◽

2021 ◽

pp. 105566562110421

Author(s):

Joshua Van Swol ◽

Bethany J. Wolf ◽

Julia Toumey ◽

Phayvanh Pecha ◽

Krishna G. Patel

Keyword(s):

Outcome Measure ◽

Tertiary Care ◽

University Hospital ◽

Exclusion Criteria ◽

Actual Patient ◽

The Mean ◽

Return Visits ◽

Significant Factors ◽

Patient Attendance

Objective The aim of this study was to evaluate whether a patient with a cleft's age, associated syndrome, cleft phenotype or travel distance affects their follow-up rate. Design This study is a retrospective review of patients with CL/P treated by a craniofacial clinic. Setting The setting was a craniofacial clinic at a tertiary care university hospital. Patients, Participants Candidates were patients seen by the craniofacial clinic between January 2007 and December 2019. An initial pool of 589 patients was then reduced to 440 due to exclusion criteria. Interventions None Main Outcome Measure(s) The outcome measure was actual patient attendance to the craniofacial team compared to the team goal expectation of annual return visits. Results The mean age of participants at the end of the study was 9.0 ± 5.4 years with a mean follow-up period (total possible follow-up period length based on patient age at presentation and study window) of 5.5 ± 3.6 years. There was no association between cleft phenotype, type of syndrome, or distance to the clinic with attendance. Children with syndromes had an 11% decrease in the odds of attending follow-up visits with each 1-year increase in age compared to a 4% decrease in children without syndromes. Conclusions The only significant factors determining patient attendance were the presence of a syndrome and increasing age.

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A STUDY ON PATTERN OF PRESCRIBING MEDICATIONS USED IN SECONDARY PREVENTION OF STROKE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9s3.14071 ◽

2016 ◽

Vol 9 (9) ◽

pp. 328

Author(s):

Lakshmi R ◽

Jithin Kc ◽

Arya G ◽

Lekshmi P Nair

Keyword(s):

Diabetes Mellitus ◽

Secondary Prevention ◽

Tertiary Care ◽

Age Group ◽

Data Collection Form ◽

Comorbid Conditions ◽

Exclusion Criteria ◽

Prescribing Pattern ◽

Number Of Patients ◽

Collection Form

ABSTRACTObjectives: The main objectives of this study were to estimate the demographic details of patients with the first incidence of stroke and to study thevarious risk factors for ischemic stroke.Methods: It was a retrospective, observational study carried out for 1 year at the Department of Stroke Medicine of a tertiary care teaching hospitalin Kerala, India. A total of 636 patients were admitted under stroke medicine during the period from July 1, 2014, to July 1, 2015, and who satisfiedthe inclusion and exclusion criteria were included in the study. A standardized data collection form was prepared and necessary data were collectedfrom patient’s medical records.Results: The maximum number of patients was in the age group of 60-69 years. 65.1% patients were residing in the rural area. 60.7% patients weremale. Most of them had hypertension as common comorbidity (21.35%) and the highest number of patients had diabetes mellitus and hypertension(21.7%). Majority of the patients were prescribed with antiplatelets (94.91%), followed by statins (93.8%).Conclusion: A strict control on the comorbid conditions and sticking on to the medications can prevent the occurrence of future stroke.Keywords: Stroke, Secondary prevention, Drugs, Prescribing pattern.

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Assessment of Various Laboratory Diagnostic Methods in Diagnosis of Cutaneous Tuberculosis. A Study from A Tertiary Care Hospital of North India

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.2.06 ◽

2021 ◽

Author(s):

Shoaib Khan ◽

Nahid Nahvi ◽

Umara Amin ◽

Yousuf Ul Bashir ◽

Danish Zahoor

Keyword(s):

Tertiary Care ◽

Culture Method ◽

Diagnostic Methods ◽

North India ◽

Care Hospital ◽

Age Group ◽

Cutaneous Tuberculosis ◽

Standard Culture ◽

Lowenstein Jensen ◽

Culture Positive

Cutaneous tuberculosis (CTB) is the rarest case of extrapulmonary TB comprising 2% of total cases. It’s often a challenge both clinically and diagnostically. 1) To determine prevalence, age & gender-wise distribution of CTB. 2) To assess various diagnostic, microbiological modalities for the diagnosis of CTB. 76 skin biopsy specimens from suspected CTB lesions were analysed using following methods – Acid-fast Bacilli (AFB) staining (Ziehl-Neelsen method), growth of mycobacteria in culture (Lowenstein-Jensen media), and Gene Xpert MTB/RIF, Histopathological (H&E staining). Of the 76 specimens, 44 were males and 32 were females. The most commonly affected age group was 40–59 years. Infections were least common in 0-19 years age group. AFB was not seen in any of the primary smears. 10 were confirmed as CTB by the recovery of Mycobacterium in solid culture. Of the 10 culture positives, 9 were confirmed as MTB, and 1 was found to be NTM. Staining of 10 culture positive specimens revealed acid fast, beaded rods. Detection of MTB by Gene Xpert gave positive result in 9 cases with all RIF sensitive. All 9 PCR confirmed cases were also culture positive, all 9 were slow growers with a minimum of 5 weeks required for growth on the LJ slant. PCR is the test of choice and should be performed on all specimens of suspected CTB. However when coupled with the “gold standard” culture method, the diagnostic accuracy improves. Also, further, culture helps in identification and isolation of NTM’s.

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Epidemiological study, clinical spectrum and associations of childhood vitiligo in a tertiary care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20163976 ◽

2016 ◽

Vol 2 (4) ◽

pp. 86

Author(s):

Rangaraj Murugaiyan

Keyword(s):

Tertiary Care ◽

Significant Proportion ◽

Clinical Spectrum ◽

Age Group ◽

Care Centre ◽

Inclusion Criteria ◽

Common Site ◽

Tertiary Care Centre ◽

Exclusion Criteria ◽

The Past

Background: Childhood vitiligo is a special subtype and is seen in significant proportion of vitiligo patients. There are only a few clinical studies in the past which address the clinical spectrum of vitiligo in children. This study on eighty cases of childhood vitiligo will cover the epidemiology and clinical spectrum.Methods: To study the epidemiology, clinical spectrum and associations in childhood vitiligo. Inclusion criteria: all new cases of vitiligo in children under 12 years attending the outpatient department of Dermatology, exclusion criteria: old treated cases of vitiligo and age more than 12 years. Statistical analysis was done using mean and percentage of means.Results: Most common age group affected includes 4-6 years. Most common site of initial lesion was head and neck followed by upper limb, lower limb and trunk. Most common clinical type was vitiligo vulgaris followed by focal type then segmental. Lip tip type was least common type. Conclusions: Childhood vitiligo is a serious issue and the knowledge of its various patterns and associations needs to be updated at regular intervals.

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Clinical and dermoscopic patterns of childhood alopecia areata in a tertiary care centre in North India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20214206 ◽

2021 ◽

Vol 7 (6) ◽

pp. 811

Author(s):

Pooja Bains ◽

Simplepreet Kaur

Keyword(s):

Alopecia Areata ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

Common Site ◽

Tertiary Care Centre ◽

Exclamation Mark ◽

Epidemiologic Profile ◽

The Mean

Background: To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.Methods: The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.Results: The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).Conclusions: No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.

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Incidence Structure of Thymus Tumors in the Kharkiv Region and Analysis of Diagnostically Significant Parameters of Immune Response in Patients with Thymomas

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.05.069 ◽

2021 ◽

Vol 6 (5) ◽

pp. 69-75

Author(s):

I. V. Belozоrov ◽

◽

O. S. Protsenko ◽

N. O. Remnyova ◽

L. I. Chumak ◽

...

Keyword(s):

Immune Response ◽

T Lymphocytes ◽

Phagocytic Index ◽

Histological Classification ◽

Age Group ◽

Male Population ◽

The Mean ◽

The Complement System ◽

Tumors Of The Thymus

The purpose of the study was to determine the structure of the incidence of thymus tumors in the Kharkiv region, taking into account the histological classification of thymus tumors and to analyze diagnostically significant indicators of the immune response of patients with thymomas. Materials and methods. The medical histories of 158 patients aged 16 to 80 years with diseases of the thymus gland were studied during 2006-2019. The indices of phagocytic activity of granulocytic neutrophils in blood heparinization, phagocytic index, phagocytic number, phagocytosis completion index and activity of proteins of the complement system were analyzed. We also analyzed the indices of the number of T- and B-lymphocytes obtained using monoclonal antibodies (CD2+, CD3+, CD4+, CD8+, CD16+, CD19+) (immunofluorescence method). Results and discussion. The structure of the incidence of tumors of the thymus in the Kharkiv region was determined, taking into account the histological classification of tumors of the thymus and indicators of the immune status of patients with thymomas. The relationship was determined between the indicators of the phagocytic activity of granulocytic neutrophils and the activity of proteins of the complement system, as well as changes in the ratio of the subpopulation composition of T-lymphocytes in patients with different types of thymomas. Lymphoepithelial thymoma is most widespread in male population in the age groups 40-59 and 20-39 years, and the lymphoid thymoma – in male population in the age group 20-39 years and female population in the age group 40-59 years. The significant decrease (p <0.05) in the mean value of the phagocytic index was revealed in group of patients with lymphoid thymomas. The subpopulations of T-lymphocytes CD3+ and CD4+ were significantly reduced (p <0.05) in group of patients with lymphoepithelial thymomas. The subpopulations of T-lymphocytes CD4+ and CD8+ were significantly reduced (p <0.05) in group of patients with lymphoid thymomas. The increasing of the mean values of markers CD16+ and CD19+ (p <0.05) in all study groups indicates that the processes of antibody production in patients with thymomas are activated regardless of the type of thymoma. Conclusion. The structure of thymus pathology in the population of the Kharkiv region is characterized by the predominance of tumor pathology in the general structure of thymus pathology, which is 51.3%. The lymphoepithelial and lymphoid thymomas are the most common tumors of the thymus and were recorded in 64.2% and 30.8% of patients with thymomas, respectively

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375. Cryptococcal Antigenemia in Advanced HIV Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.448 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S196-S196

Author(s):

Jatin Ahuja ◽

Manish Soneja ◽

Naveet Wig ◽

Immaculata Xess ◽

Ashutosh Biswas ◽

...

Keyword(s):

Multivariate Analysis ◽

Care Center ◽

Tertiary Care ◽

Latex Agglutination ◽

Cd4 Count ◽

North India ◽

World Health ◽

P Value ◽

The Mean

Abstract Background Diagnostic importance of asymptomatic cryptococcal antigenemia is being increasingly recognized in the last few years. Recently, WHO (World Health Organization) has recommended routine screening of CrAg (cryptococcal antigen) among PLHA with CD4 ≤100/mm3, albeit this procedure is not yet adopted by many developing countries including India. Methods We conducted a prospective observational study in a large tertiary care center of North India, upon ethical clearance. Latex agglutination test was performed to assess serum CrAg levels, followed by the lumbar puncture for detection of CrAg levels in the CSF. We analyzed the prevalence and treatment outcomes of cryptococcal antigenemia among PLHA with CD4 ≤ 100 cells/mm3. Detailed clinical examination was conducted, with follow-up of upto 3 months. Multivariate analysis was performed for the estimation of risk factors. Results The mean age (years) and BMI (kg/m2) of all the participants were 41.4 ± 11.2 and 22.1 ± 2.6, respectively. Notably, the mean CD4 count (cu.mm) at the time of recruitment was 62.3 ± 20.5. Noteworthy, 62 (60.8%) of the patients were ART naïve. We found 9.8% (n = 10) of the patients were positive for serum CrAg, and only 2.9% (n = 3) had clinical features of meningitis and 6.8% (n = 7) were asymptomatic (subclinical) CrAg positive. Strikingly, 3.9% (n = 4) of the asymptomatic cryptococcal antigenemia patients were also positive for CrAg in CSF, with 1.9% (n = 2) were only serum CrAg positive, and 1 patient was lost to follow-up (Graph 1). Multivariate analysis revealed that patients with long duration of HIV (P = 0.04), headache symptoms (P = 0.004) and possessing features of meningismus (P value=0.08) are more likely to be CrAg positive. Conversely, patients on fluconazole were protective against cryptococcal antigenemia (P = 0.1) as shown in Table 1. Overall mortality observed was 11.3% among advanced HIV patients. Moreover, mortality in CrAg-positive patients was 33.3% in comparison to CrAg-negative patients who had 9% (P = 0.06) in 3-months follow-up. Conclusion Cryptococcal antigenemia is common (9.8%) among patients with CD4 count ≤100/mm3 in India. Screening for CrAg should be made routine for PLHA with CD4 count ≤100/mm3 and if required preemptive treatment to be given in this regard. Disclosures All authors: No reported disclosures.

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Clinicoepidemiology and treatment outcome of acute intestinal obstruction in adult in KIMS Amalapuram: a retrospective observational study

International Surgery Journal ◽

10.18203/2349-2902.isj20205370 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4139

Author(s):

Y. Anantha Lakshmi ◽

K. V. Narasimha Reddy

Keyword(s):

Intestinal Obstruction ◽

Acute Intestinal Obstruction ◽

Age Group ◽

Exclusion Criteria ◽

Common Procedure ◽

Case Record ◽

Common Etiology ◽

The Mean ◽

Study Case ◽

Surgical Admission

Background: The intestinal obstruction is a common potentially risky surgical emergency in all age group globally. This is responsible for 12% to 15% of surgical admission due to acute abdomen. Obstruction to gastrointestinal tract can occur at all labels but it is small intestine which more commonly involved. To improve the outcome early diagnosis and management is essential. Present study has been designed to study the epidemiology, demography and clinical presentation of acute intestinal obstruction and to study the complications and outcome of surgical management of acute intestinal obstruction.Methods: In present study patients admitted with diagnosis of acute intestinal obstruction during study period were enrolled for this study as per inclusion and exclusion criteria. As per that 126 patients were enrolled for this study. Case record of all patients were closely reviewed and analysed thoroughly.Results: The mean age of the patients was 54.64±12.93 years. The acute intestinal obstruction was more common in 41 to 60 years of age group that is (44.45%). Regarding etiology of acute intestinal obstruction 44.45% patient adhesion was the etiology of obstruction. Resection of adhesion was most common procedure done for removal of obstruction (42.85%).Conclusions: Adhesion was most common etiology and pain abdomen and tachycardia was common presentation. Regarding management of obstruction resection of adhesion was most common procedure done for removal of obstruction. Infection of wound was common complication.

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