scholarly journals Overview of 254 mild cases of COVID-19 in Bangladeshi cohort: a cross-sectional observation

2021 ◽  
Author(s):  
Tahmina Zahan ◽  
Morshed Nasir ◽  
Rawshan Ara Perveen ◽  
Afzal Akhtar ◽  
A. F. M. Mohibur Rahman ◽  
...  
Keyword(s):  
Platelet Count ◽  
Large Scale ◽  
Tertiary Care ◽  
Care Hospital ◽  
Male Predominance ◽  
Neutrophil Lymphocyte Ratio ◽  
Prognostic Features ◽  
Lymphocyte Ratio ◽  
Co Morbidity ◽  
D Dimer

Background: The first recognition of a cluster of COVID-19 patients in China in late 2019, has become a major concern due to its greater transmissibility and vulnerability of the patient to turn to fever, cough, breathlessness, pneumonia then eventually severe acute respiratory distress syndrome requiring intensive care unit (ICU) support. But most of the affected patients get cured following mild symptoms and very only a few of them get hospitalized. The objective of the study was to observe the demographic characteristics, clinical symptoms, comorbidities, and biomarkers (hematological, inflammatory, hepatic, renal, and metabolic) of mild cases of COVID-19 infected patients admitted to the hospital during the peak four months of the pandemic.Methods: Age, sex, symptoms, comorbidities, and biomarkers (Hb%, WBC, lymphocyte, neutrophil, platelet count, HCT(hematocrit), NLR(neutrophil-lymphocyte ratio, d-NLR derived neutrophil-lymphocyte ratio, PLR(platelet-lymphocyte-ratio), d-Dimer, ferritin, CRP(C-reactive protein), PT(prothrombin time), INR(international normalized ratio), SGPT, S.creatinine, HbA1C of all rt-PCR positive mild cases were recorded in this retrospective observational study in a tertiary care hospital dedicated to COVID-19 at Dhaka, Bangladesh was done from 15th May to 9th September, 2020. Age, sex, symptoms, and comorbidities were compared by chi-square test and biomarkers were compared by one-way ANOVA. Results: Out of 254 cases 44 were female and 210 were male with a ratio of 1:4.77. Average age was 39.04. Largest population belongs to the 30-39 years of age range. Among the symptoms, anorexia (18.5%), fever (17.71%), and anosmia (16.9%) were most prevalent symptoms among the mild cases. However, diabetes mellitus (DM) and hypertension (HTN) were predominant comorbidities. Mostly all the biomarkers were significant among groups (Hb%, Total WBC, neutrophil count, platelet count, HCT, NLR, d-NLR, d-Dimer, ferritin, CRP, PT, SGPT, creatinine, HbA1C except lymphocyte count, PLR, and INR. The severity of disease progression depends on the co-morbidity and hyper-responsiveness inflammatory or immunological biomarkers to predict.Conclusions: In mild cases of COVID-19 male predominance was more and the most affected group was 30-39 years. They suffered more from anorexia and fever and DM and HTN were common comorbidities. Mostly all the biomarkers were significant. Moreover, further large-scale studies are needed to evaluate the number of mild cases and their prognostic features to develop and modify the treatment strategy and public health awareness time to time.

scholarly journals Clinical and biomarker profile of COVID-19 patients admitted in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 268-273
Author(s):  
Archana Bhat ◽  
Don Gregory Mascarenhas ◽  
J Manjunath ◽  
Anand Kumar R ◽  
Sucharitha Suresh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
Clinical Signs And Symptoms ◽  
D Dimer

Introduction and Aim:A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19.   Materials and Methods:This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity.   Results:A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe groupwere19.03 vs 4.2, 1025cells/cumm vs 1740cells/cumm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively.   Conclusion:An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.

Comparison of Predictors of Mortality between Young and Elder Covid-19 Patients Admitted in Covid-19 Designated Tertiary Care Hospital

Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 46-54
Author(s):  
Sonal Shah ◽  
Manisha Kapdi ◽  
Jyoti Vora ◽  
Kuldeep Joshi ◽  
Pratik Patel ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Facility ◽  
Health Care Facility ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Predictors Of Mortality ◽  
Co Morbidity

Background: The outbreak of Covid-19 has led to a health emergency and economic crisis worldwide. Mortality in productive age further worsens the crisis, so it is important to understand reasons for death in productive age group. Objective: To identify predictors of mortality and to compare the intensity of rise in inflammatory markers of amongst young Covid-19 decedents in comparison with elder Covid-19 decedents. Method: Record based study of Covid-19 infected admitted patients was conducted in tertiary care hospital. Information of all (n=3131, 209 deceased and 2922 recovered patients) Covid-19 positive patient assessed . Their clinico epidemiological markers were compared between younger (18-45 years) decedents in comparision with elder decedents (>45 years). Mann–Whitney U-test and the Chi-square test for significance were used. Bivariate Multiple logistic regression was used to identify predictors in younger and elder decedents. Results: Case Fatality Rate (CFR) in Covid-19 infected patients was 2.4% and 9.7% amongst younger and elder group respectively. (OR 8.83 : 95% CI 5.9-13.2; p < 0.001). Biomarkers were raised and similar in both groups except Neutrophil Lymphocyte Ratio (NLR) was significantly higher in elder decedent while LDH was significantly higher in younger decedents. Conclusions: Males had higher CFR than females after 45 years of age, which was due to co-morbidity. Reaching late to the health care facility and high LDH were predictors in younger decedent, while male gender, co morbidities and high NLR were more important predictors in elder group.

scholarly journals Clinical profile of patients of acute pulmonary thromboembolism

2019 ◽  
Vol 6 (4) ◽  
pp. 1089
Author(s):  
Arundhati Diwan ◽  
Supriya Barsode ◽  
Chandrakant Chavan ◽  
Rohit Jakhotia ◽  
Krishnapriya Vadlapatla
Keyword(s):  
Pulmonary Embolism ◽  
Risk Factor ◽  
Mortality Rate ◽  
Tertiary Care ◽  
Pulmonary Angiography ◽  
Clinical Profile ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
History Of

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.

scholarly journals The role of neutrophil/lymphocyte ratio in predicting the severity of sepsis in a tertiary care hospital in South India: a retrospective study

2020 ◽  
Vol 8 (5) ◽  
pp. 1624
Author(s):  
Alfy Ann George ◽  
Teju P. Thomas ◽  
Abdul Gaffoor
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
P Value ◽  
Risk Category ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background: Sepsis, a syndrome of dysregulated host response to infection leading to life-threatening organ dysfunction, is having a substantial burden in health system. The outcome in sepsis is often time dependent. None of the clinical manifestations nor the age-old markers like ESR, CRP, etc. have proven diagnostic or prognostic of sepsis. This study aims to assess the role of neutrophil: lymphocyte ratio (NLR) in assessing the severity of sepsis within the initial 24 hrs of admission.Methods: Authors did a retrospective observational study in 208 sepsis patients admitted in the MDICU. The NLR was calculated and the study population was grouped into those with an NLR of more than or equal to 5 and those with less than 5. The patients were also grouped based on the number of organs impaired due to sepsis. The association between these groups were then assessed.Results: 46 patients (60.5%) with single organ involvement had NLR <5; 30 patients (39.5%) had NLR >5; 27 patients (42.2%) with two organ involvement had NLR <5 and 37 patients (57.8%) had NLR >5. Among patients with more than two organ involvement, 8 patients (21.6%) had NLR <5 and 29 patients (78.4%) had NLR >5. It was found that there is statistically significant association between increase in number of organs involved and NLR more than 5. The chi square test value was 15.691 with a p value was less than 0.001.Conclusions: In the current study, we have evaluated the role of NLR in sepsis. NLR calculated on the day of admission is a simple parameter that helps to stratify patients into severe risk category. A significant association was found with higher NLR and the number of organs impairment in sepsis.

scholarly journals Clinical and laboratory parameters of confirmed and probable COVID-19 patients: experience from a tertiary care hospital of Bangladesh

2020 ◽  
pp. 6-11
Author(s):  
Hasna Fahmima Haque ◽  
AKM Shaheen Ahmed ◽  
Samira Humaira Habib ◽  
Maliha Sulzana ◽  
Rahul Prasad Ghosh ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care Hospital ◽  
Virus Disease ◽  
Tertiary Care ◽  
Disease Classification ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Male Predominance ◽  
Corona Virus ◽  
D Dimer

Background: Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was previously known as novel corona virus 2019 (2019-nCoV), causes corona virus disease 2019 (COVID-19). Since 8 March 2020, COVID -19 emerged in Dhaka city and rapidly spread throughout the country. This study evaluated the sociodemographic, clinical and laboratory parameters of confirmed and probable COVID-19 patients in a tertiary care hospital. Methods: This cross-sectional study was conducted in BIRDEM General Hospital, Dhaka, Bangladesh from May to October 2020. Adult (>18 years) patients having clinical symptoms and signs of COVID-19, irrespective of sex were included in this study. Diagnosis was confirmed by positive reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 from nasopharyngeal samples of patients and the disease classification was done following national guidelines. Results: Total patients were 141with a mean age of 59.74±11.0 years; majority was from urban areas and there was male predominance. Diabetes mellitus (91.5%) and hypertension (75.2%) were common co-morbidities. Common clinical presentations were fever (100%), cough (97.2%), fatigue (88.7%) and shortness of breath (61.7%). Laboratory investigations revealed lymphopenia (73.8%), elevated level of C-reactive protein (94.3%) and positive D-dimer (99.4%). Chest x-ray showed bilateral shadows in 73.8% cases and 42.6% had COVID pneumonia in high-resolution computed tomography (HRCT) scan of chest. Nearly three-fifths (58.9%) of the study subjects had moderate COVID-19 and 70.92% patients were shifted to the COVID-dedicated hospitals. Conclusions: COVID-19 affects mostly the older males. Majority was diabetic and hypertensive. Common symptoms were fever, cough and respiratory distress. Common laboratory findings were lymphopenia, high CRP, positive D-dimer and bilateral shadows on lung imaging. Birdem Med J 2020; 10, COVID Supplement: 6-11

scholarly journals Study of Anaemia in Children with Severe Acute Malnutrition

2018 ◽  
Vol 37 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Deepak Dwivedi ◽  
Veerendra Singh ◽  
Jyoti Singh ◽  
Sangita Sharma
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Acute Malnutrition ◽  
Folic Acid Deficiency ◽  
Care Hospital ◽  
Macrocytic Anaemia ◽  
Normal Children ◽  
Co Morbidity ◽  
Morphologic Type

Introduction: Severe anaemia is a leading cause of paediatric morbidity, hospitalization, and mortality and it is very important co morbidity in children with severe acute malnutrition. Severe Acute Malnutrition (SAM) with anaemia has been shown to have 2.62 times higher mortality as compared to SAM with no anaemia. So this study was done to evaluate this co-morbidity further. The aim of present study was to determine the prevalence and type of anaemia and to evaluate the possible aetiologies of anaemia in severe acute malnourished (SAM) children.Material and Methods: In tertiary care hospital a cross sectional study was conducted over a period of 8 month with 100 cases of SAM children and 101 cases of normal children. In both cases disorders of primary haematological problem were excluded. Auto analysers were used to measure blood counts. Blood smear was analysed by pathology consultant of institute and recorded for all patients with anaemia. Grade of anaemia and morphologic type of anaemia was analysed. Data were entered in Excel spreadsheets and analysed using SPSS 20.0.Results: Patient with SAM 42% had moderate anaemia and 19% had severe anaemia in contrast 41.6% and 16.8% in NON SAM child respectively. Predominant morphologic type in SAM patient was macrocytic anaemia (33%), while in controls microcytic anaemia (40.6%) was more prevalent.Conclusion: There was a high prevalence of anaemia in SAM children. Major morphologic type in SAM children was macrocytic anaemia which may indirectly show vitamin B12 or folic acid deficiency in these children.  

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

SOCIOECONOMIC STATUS EFFECT ON MANAGEMENT OF HYPERTENSION IN COMMUNITY PHARMACY IN SOUTH- SOUTH ZONE IN NIGERIA

2021 ◽  
Author(s):  
Mgbahurike AA ◽  
Oduogu SO ◽  
Bagbi BM
Keyword(s):  
Blood Pressure ◽  
Socioeconomic Status ◽  
Alcohol Consumption ◽  
Peer Review ◽  
Tertiary Care ◽  
Research Centre ◽  
Community Pharmacies ◽  
Care Hospital ◽  
Co Morbidity ◽  
Significant Difference

Background to study: Effective management of hypertension is influenced by several factors that center on social and economic status of the patient. Identification of these factors will enable informed intervention in the management of hypertensive patients. Objective: The study aimed to determine possible association between blood pressure control and socioeconomic status of patients who are managed in community pharmacies in Rivers State. Method: A descriptive cross-sectional survey of thirty-nine community pharmacies was conducted between July and December 2018.  A total of 195 respondents participated in the study. Every patient’s consent was obtained. Further information on patients’ demographics were extracted from pharmacists’ documentation files. Such include age, medication patient is on, duration of hypertension, co-morbidity, income/ social status, and habits like smoking, alcohol consumption, educational status, and mean blood pressure over the study period. The outcome measure taken as controlled blood pressure was mean BP ≤140/90 mm Hg for the general population and BP 130/80 mmHg for patients with diabetes as co-morbidity. BP >140/90 mm Hg was considered as uncontrolled blood pressure. Result: A total of 195 respondents participated in the study, of which 105(53.8%) were male and 90(46.2%) were female. Out of this number 75(38.5%) were below 40yrs of age, 105(53.8%) were between 41–50yrs of age and only 15(7.7%) were 60yrs and above. More female had BP control compared to the male (OR 1.89, 95% CI (1.16 - 3.0), P=0.009. Patients within ages 41 - 59yrs had more controlled BP compared to older age, 60yrs and above, OR 1.48, 95% CI (0.84 - 2.42) p 0.18. Uncontrolled BP was found more among employed patients and patients with highest monthly income, OR 1.05 95% CI (0.58 - 2.00); OR 1.16 95% CI (0.49 - 2.78) P, 0.36 respectively. Exercise activities have significant impact on BP control as alcohol consumption increased OR of BP control with no significant difference in OR on amount of monthly expenditure on medications. Conclusion: Male gender, employment, and high income earning have negative effect on BP control while exercise is associated with BP control.                    Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 21 October, Available online: 15 November 2021 Academic Editor:  Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: PRESCRIPTION PATTERN OF ANTI-HYPERTENSIVE DRUGS IN A TERTIARY CARE HOSPITAL IN KERALA AND ADHERENCE TO JNC-8 GUIDELINES

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