scholarly journals Bugs and bones: a study of 25 cases of infectious spondylodiscitis

2021 ◽  
Vol 8 (8) ◽  
pp. 1160
Author(s):  
Cynthia A. Sukumar ◽  
Shipra Rai ◽  
Shyamasunder N. Bhat ◽  
Kavitha Saravu
Keyword(s):  
Imaging Modality ◽  
Tertiary Care ◽  
Neurological Complications ◽  
Care Hospital ◽  
Current Management ◽  
Diagnostic Dilemma ◽  
Neurological Morbidity ◽  
Infectious Spondylodiscitis ◽  
Magnetic Resonance Imaging Mri ◽  
Epidemiological Profile

Background: Infectious spondylodiscitis (IS) is an illness that presents a diagnostic dilemma. It is often associated with significant neurological morbidity, hence early diagnosis and treatment is crucial. As only a few Indian studies have dealt with IS, our study analyses the unique clinico-epidemiological profile of this disease in India and assesses the current management trends and outcome in these patients.Methods: A retrospective study of 25 cases of microbiologically confirmed IS in a single unit at a tertiary care hospital over an 18-month period (January 2018 to June 2019).Results: A total of 25 cases of IS were considered with a mean age of 49 years. Among the cases of non-tubercular spondylodiscitis (NTS), the organisms isolated were methicillin-resistant Staphylococcus aureus (MRSA), Brucella, Escherichia coli and Citrobacter. The average time taken from onset of symptoms to diagnosis was 3 months in tubercular spondylodiscitis (TS) cases and 5 months in NTS cases. Neurological complications were seen in 32% of the patients. Magnetic resonance imaging (MRI) was the imaging modality used to confirm diagnosis in up to 80% of the patients. Medical and surgical management were required in 84% of the cases.Conclusions: The clinical conundrum in IS primarily due to its atypical presentation. The higher tubercular burden of IS was also confirmed in our study and the time taken to presentation was markedly longer compared to the western data. Therefore, understanding the clinical spectrum of this disease helps overcome hurdles of recurrence and debilitating neurological morbidity. 

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

scholarly journals Clinico-epidemiological profile of patients admitted with Plasmodium vivax malaria in a tertiary care hospital, Delhi

2018 ◽  
Vol 5 (12) ◽  
pp. 5420 ◽  
Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Vivax Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Hospital ◽  
Who Criteria ◽  
Epidemiological Profile ◽  
Safdarjung Hospital

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.

scholarly journals ROLE OF ULTRASOUND AS AN IMAGING MODALITY IN NEOPLASTIC OVARIAN MASSES IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 6 (94) ◽  
pp. 6858-6862
Author(s):  
Singhal R P ◽  
Pardaman Singh Setia ◽  
Kawal Preet Kaur ◽  
Virinder Mohan ◽  
Payal Bansal
Keyword(s):  
Tertiary Care Hospital ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Care Hospital ◽  
Ovarian Masses

scholarly journals Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study

2018 ◽  
Vol 5 (3) ◽  
pp. 851
Author(s):  
Ravikumar Tenali ◽  
Naveen Kumar Badri ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Tertiary Care ◽  
Epidemiological Surveillance ◽  
P Value ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary ◽  
Epidemiological Profile

Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the   study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.

Clinico-epidemiological study and microbiological correlation of tinea incognito at a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 212-216
Author(s):  
Monisha K ◽  
Jagannath Kumar V
Keyword(s):  
Tertiary Care ◽  
Fungal Culture ◽  
Care Hospital ◽  
Diagnostic Dilemma ◽  
Steroid Abuse ◽  
Systemic Corticosteroids ◽  
Study Population ◽  
Tinea Incognito ◽  
General Physical ◽  
Systemic Examination

Tinea incognito also known as steroid-modified tinea are dermatophytic infections modified by the use of topical or systemic corticosteroids. Dermatophytic infection being very common and very simple to diagnose, is a diagnostic dilemma due to steroid abuse. Hence making a simple curable infection into a chronic persistent dermatological condition. As a treating doctor it’s important to recognize and educate the patients regarding the tinea infections and steroid abuse. To study the various morphological presentations, epidemiology and etiological agent of tinea incognito. An observational study was performed with 100 cases from 2017 to 2019 in the department of Dermatology & Venerology, SS Institute of Medical Sciences and Research, Davangere, Karnataka, India. The baseline data, thorough general physical, local, and systemic examination were done with reference to clinical features of tinea incognito. Skin scraping were collected and subjected to potassium hydroxide (KOH) preparation. The part of the sample was inoculated into Sabouraud’s Dextrose Agar (SDA) media for fungal culture. Later the fungus was identified by standard techniques. The mean age of study population was 32.83 years. The males outnumbered females in our study. Almost 29% cases remain asymptomatic followed by 34% itching and 37% burning sensation. The source of drug responsible for tinea incognito were highly suggested by friends (29%) with the combination use of drugs account for 35% of study population. 77% cases showed erythema followed by 48% of hypopigmentation. The scraping of lesion showed positive KOH mount in 71% and T.mentagrophytes were the most common dermatophyte grown in SDA medium. Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.

scholarly journals A Study of Clinical, Microbiological, and Echocardiographic Profile of Patients of Infective Endocarditis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Soumik Ghosh ◽  
Ratnakar Sahoo ◽  
Ranjit Kumar Nath ◽  
Nandini Duggal ◽  
Adesh Kumar Gadpayle
Keyword(s):  
Infective Endocarditis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Northern India ◽  
Predominant Symptom ◽  
Prolonged Duration ◽  
Persistent Bacteremia ◽  
Epidemiological Profile ◽  
Rheumatic Heart

Infective endocarditis, a great masquerader, is a clinical entity which may present with a myriad of manifestations. Its changing epidemiological profile has been studied in the previous decades in both the developed and the developing nations. In this study, we strived to uphold the evolving clinical profile and its outcome from a government tertiary care hospital in Northern India. It was a descriptive, cross-sectional, observational study conducted over two years’ period involving 44 patients diagnosed with definite infective endocarditis, according to modified Dukes’ criteria. Demographic, clinical, microbiological, and echocardiographic data were analysed. Mean age of patients was 31 years. Rheumatic heart disease with regurgitant lesions was the commonest risk factor. Dyspnea and fever were the predominant symptom, and pallor and heart failure the commonest sign. Cultures were positive in 52% with Staphylococcus, the major isolate. Transesophageal echocardiography fared better than transthoracic one to define the vegetations. Mortality is reported in 4.5%. Prolonged duration of fever, pallor, hematuria, proteinuria, rheumatoid factor positivity, and large vegetations proved to be poor prognostic variables. Culture positive endocarditis, with persistent bacteremia, had higher incidence of acute renal failure. Right sided endocarditis was frequent in congenital lesions or IV drug user, whereas left sided endocarditis mostly presented with atrial fibrillation.

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