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

Author(s):  
Syed Vaqar A. Shah ◽  
Farmud Ansari ◽  
Sayed S. Sohrab ◽  
Kadir Alam ◽  
Deependra P. Sarraf

Background: Hospitalization in patients with coronavirus disease 2019 (COVID-19) is affected by pre-existing chronic medical conditions and the disease severity. Co-morbidities and the disease severity also affect the survival rate of these patients. Objectives of the study was to describe the baseline clinical profile, co-morbidities and disease severity and to assess the predictors of the mortality in hospitalized adult patients with COVID-19 in a tertiary care hospital in Nepal.Methods: A cross-sectional study was conducted in 168 adult patients admitted with COVID-19 in Nobel Medical College Teaching Hospital, Biratnagar for two months. Demographics, comorbidities, disease severity, oxygen requirement, and treatment outcome were studied.Results: The mean age of the patients was 57.1 years with 56.5% male. Out of 168, 16.7% and 10.1% of the participants had currently or in the past used alcohol or tobacco products respectively. Hypertension (28.6%) and chronic lung disease (16.1%) were the most common co-morbidities. The overall case-fatality rate was 17.9% with 32.1% and 56.3% in the severe and critical COVID-19 subgroup respectively. The mortality rate for patients without co-morbidities was 2.4% which increased to 63.6% for those with three or more co-morbidities. Age, disease severity, and the number of co-morbidities were found to be associated with increased mortality (p<0.05) whereas gender was not.Conclusions: The presence of pre-existing chronic diseases and increased severity of the disease were associated with increased mortality in hospitalized COVID-19 patients.

2021 ◽  
Vol 23 (4) ◽  
pp. 352-356
Author(s):  
Syed Vaqar Ahmad Shah ◽  
Farmud Ansari ◽  
Sayed Sartaj Sohrab ◽  
Kadir Alam ◽  
Deependra Prasad Sarraf

Hospitalization and survival rate in patients with coronavirus disease 2019 (COVID-19) is affected by pre-existing chronic medical conditions and the disease severity. The objectives of the study were to describe the baseline clinical profile, co-morbidities, disease severity and to assess the predictors of mortality in hospitalized adult patients with COVID-19 in a tertiary care hospital in Nepal. A cross-sectional study was conducted for two months on 168 adult COVID-19 patients admitted to Nobel Medical College Teaching Hospital Biratnagar. Demographics, comorbidities, disease severity, oxygen requirement, and treatment outcomes were studied. The mean age of the patients was 57.1 years and 56.5% were male. Out of 168, 16.7% and 10.1% of the participants had currently or in the past used alcohol or tobacco products respectively. Hypertension (28.6%) and chronic lung disease (16.1%) were the most common co-morbidities. The overall case-fatality rate was 17.9%, with 32.1% and 56.3% in the severe and critical COVID-19 subgroup respectively. The mortality rate for patients without co-morbidities was 2.4% which increased to 63.6% for those with three or more co-morbidities. Age, disease severity, and the number of co-morbidities were found to be associated with increased mortality (P<0.05), whereas gender was not. The pre-existing chronic diseases and increased severity of the disease were associated with increased mortality in hospitalized COVID-19 adult patients.


2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Rupak Bishwokarma Ghimire ◽  
Khilasha Pokhrel ◽  
Sanjubabu Shrestha

Introduction: Pyoderma is defined as any purulent skin disease and represents infections inepidermis and dermis or hair follicles. This study aims to find out the prevalence of communityacquired pyoderma in dermatological outpatient department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out among patients who presented atdermatology outpatient department of Kathmandu Medical College Teaching Hospital betweenDecember 2018 and March 2019 after ethical clearance from institutional review committee.Convenience sampling method was done. Data was collected and analysis was done using SPSSsoftware, point estimate at 95% CI was calculated along with frequency and proportion for binarydata. Results: Out of 385 cases, 72 (18%) cases were of community-acquired pyoderma. Prevalence ofcommunity-acquired pyoderma is 72 (18%) at 95% CI(). Primary pyoderma was seen in 49 (12.72%)mainly folliculitis 17 (4.41%), furunculosis 16 (4.15%), impetigo 6 (1.55%), abscess 6 (1.55%) andbacterial paronychia 4 (1.03%). Staphylococcus aureus was the most common organism isolated in 42(58.3%) cases and Staphylococcus epidermidis was isolated in 3 (4.17%) cases. Staphylococcus aureuswas most sensitive to Vancomycin 42 (100%) followed by Gentamycin 40 (95.2%), Ciprofloxacin 40(95.2%) and Ceftriaxone 40 (95.2%). Highest resistance was seen to Azithromycin in 13 (30.95%),followed by Cloxacilllin in 11 (26.19%). Males were affected predominantly in 49 (68.06%) ascompared to females in 23 (31.94%). Conclusions: Prevalence of community-acquired pyoderma is high among patients visitingdermatological outpatient departments of a tertiary care hospital compared to other studies.Antibiotic resistance of commonly used antibiotics are increasing and thus proper cultureand sensitivity reports may be required to guide our treatment


2018 ◽  
Vol 5 (1) ◽  
pp. 202 ◽  
Author(s):  
Sreenivasulu T. ◽  
Jahnavi K.

Background: Dengue is the most common fever. Among all flavi-viruses, it is the most common. It can cause around 50-100 million infections. Every year 2-5 lakh cases of Dengue hemorrhagic fever occur. The objective of the research was to study clinical profile of patients with Dengue fever at a tertiary care hospital.Methods: Present study was cross sectional study. The patients were interviewed and examined at one point of time and later they were never followed which is similar to the cross-sectional study design. Present study was carried out in the hospital. This was done in the department of General Medicine of a tertiary care hospital. Present study was carried out over a period of one year.Results: In the present study, there were 78 males and 22 females. The sex ratio was 3.5:1. Maximum number of males (29.5%) was in the age group of 15-25. Among females, the maximum (40.9%) were in the age group of 26-35 years and 46-55 years (9%). The most common presenting symptom was fever in all cases followed by headache in 90%. Among bleeding manifestations, epistaxis, gum bleeding and hematuria (15%) were the common symptoms. Most patients presented with generalized lymphadenopathy in 52%. 56 patients showed only hepatomegaly and 46 splenomegaly, and 30 patients showed hepato splenomegaly. 99 showed leucopenia and 10 were anemic and 25 showed platelet count less than 1,50,000cells/cumm.Conclusions: Males were commonly affected. Younger age group of 15-25 was most commonly affected and fever and headache were the most common presenting symptoms. These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue.


Author(s):  
Sankareswari R. ◽  
Ghurunaath T. R. ◽  
Ramya Sreevarshni Shunmugha Sundharam

Background: Iatrogenic bladder injuries (IBI) are more common during obstetric and gynaecological procedures averaging 2.6 IBIs per 1000 surgeries. The objective of the study was to estimate the incidence of IBIs during OBG procedures in a tertiary care hospital at Puducherry. To study the proportion and clinical profile of the IBIs where the management of an urologist was indicated intra-operatively.Methods: This cross-sectional study was conducted in a tertiary care hospital in Puducherry by analysis of records of OBG surgeries conducted during the 5 years’ period from 2011 to 2015. The occurrence of IBIs during obstetric and gynaecological surgeries was estimated and the records of those with injuries were analysed retrospectively.Results: The overall incidence of Iatrogenic Bladder Injuries (IBI) among the OBG surgeries was 1.33% (n=19). Iatrogenic Bladder Injuries (IBI) frequently happened during Gynaecological procedures (73.7%, n=14) than during Obstetric procedures (26.3%, n=5). The incidence of bladder injuries intra-operatively was more frequent during dissection of bladder (57.9%, n=11) and opening the abdomen (36.8%, n=7). The requirement of urologist was more felt during posterior bladder wall injuries (26.3%, n=5).Conclusions: The occurrence of IBIs was more common during Gynaecological procedures than during obstetric procedures. Most of the gynaecological procedures especially hysterectomies require the expertise presence of an urologist.


2021 ◽  
Vol 15 (7) ◽  
pp. 1886-1889
Author(s):  
Ghazala Farrukh ◽  
Shazia Sukhera ◽  
Fida Muhammad ◽  
Aneela Amjad ◽  
Qamar Zaman ◽  
...  

Background and Objective: The COVID-19 pandemic is an ongoing health challenge for both developed and developing countries worldwide. The epidemiological and clinical features of COVID-19 should be analyzed in our country. The current study aims to evaluate the demographic features and clinical profile of COVID-19 patients ina Tertiary Care Hospital of Rahim Yar Khan, Pakistan. Materials and Methods: This observational, cross-sectional study was conducted on 85 patients with positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) verified by nasopharyngeal swabs and throat at Covid 19 setup in Sheikh Zayed Hopsital, Rahim Yar Khan, Pakistan for period of six months i.e from September 2020 to February 2021. Institutional consensus protocol and COVID-19 SOPs were followed to investigate each individual. Various parameters such as symptom presentation, demographics’ details, ventilator therapy and oxygen required, and co-morbidities were studied. Results: The mean age of the patients was 37.6±5.7 years with an age range of 15 to 81 years. Of the total 104 patients enrolled, 60 (58%)were male and 44 (42%). The prevalence of COVID-19 caused by contact was 67 (65%).Symptomatic patients out of enrolled were 49 (47.1%). In this study, a significant association was found between severe COVID-19 and parameters such ashypertension and diabetes history, and patients having age above 65 years. Out of104 COVID-19 positive patients, symptomatic complaints were as follows; Cough 29(27.9%), fever 63 (60.6%), and breathe shortness 12 (11.5%). Tachypnea (RR>24), hypoxia and comorbid illness were found 32 (31%), 27 (25.8%), and 45 (43.2%)respectively. About 19 (18.2%) patients needed intensive care unit admission with 5 (4.8%) required immediate ventilation assistance. Mortality was 3.8% (4 patients) observed in this study. Conclusion: The COVID-19 pandemic mortalityrate is higher among patients above 60 years of age and with co-morbidities. TheCOVID-19 majority of patients presented in our hospital were of young or average age and asymptomatic. Respiratory symptoms were present in half and fever was recorded in more than half patients. Comorbidities patients were more venerableto the COVID_19 complications. Early admission and aggressive treatment must beprovided to COVID-19 patients to help reduce the mortality rate. Keywords: COVID-19,Comorbidities, Hypoxia


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