scholarly journals Etiology and clinical spectrum of acute undifferentiated fever illness in patients in a tertiary care hospital Sheri Kashmir institute of medical science Soura, Jammu and Kashmir

2021 ◽  
Vol 9 (1) ◽  
pp. 15
Author(s):  
Sheenam Gazala ◽  
Mohmad Saleem Chesti ◽  
Syed Mushfiq
Keyword(s):  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Categorical Variables ◽  
Care Hospital ◽  
Continuous Variables ◽  
Jammu And Kashmir ◽  
And Gender

Background: Current study aimed at s to delineate the etiology and clinical parameters associated with AUFI presenting to emergency department in a tertiary care hospital.Methods: This was a prospective hospital based study carried out at emergency medicine, SKIMS hospital, Soura Kashmir, India July 2017 to august 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever.Results: Total numbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patients were diagnosed enteric fever (N=59, 33.9%) followed by UTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%) while rest of cases were associated with other viral illnesses (N=70, 40.5%) based on clinical basis and inconclusive laboratory results.Conclusions: Enteric fever was found to be the most common cause of acute undifferentiated fever followed by dengue and other viral illnesses, although causes and clinic spectrum of AUFI is varied.

scholarly journals Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Noman Ali ◽  
Nadeem Ullah Khan ◽  
Shahid Waheed ◽  
Syed Mustahsan
Keyword(s):  
Emergency Department ◽  
Enteric Fever ◽  
Care Center ◽  
Tertiary Care ◽  
Practical Importance ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Continuous Variables

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital. Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever. Results: A total of one hundred and fifty five patients were included. Out of these 97 (62.6%) were males and 58 (37.4%) were females. Most patients (25.2%, n= 39) were diagnosed as malaria followed closely by dengue fever (n=33, 21.3%) and then enteric fever (n= 10, 6.5%). while 41.9% (n=65) were diagnosed as suspected viral fever based on clinical judgment and inconclusive laboratory results. Conclusion: Malaria was found to be the most common confirmed cause of acute undifferentiated fever followed by dengue and enteric fever. The provision of accurate epidemiological data will enable resources to be directed towards key areas and will be of practical importance to clinicians. doi: https://doi.org/10.12669/pjms.36.6.2334 How to cite this:Ali N, Khan NU, Waheed S, Mustahsan S. Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2334 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

scholarly journals Clinical profile of hemodialysis patients attending a tertiary care hospital in Delhi, India

2021 ◽  
Vol 8 (12) ◽  
pp. 6000
Author(s):  
Mithilesh Kumar ◽  
Shipra Saini ◽  
Lokesh Parashar ◽  
Rajesh Chetiwal ◽  
Tanisha Kalra ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Kidney Diseases ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital ◽  
Age Group ◽  
Av Fistula ◽  
Demographic Profiles ◽  
Viral Marker

Background: CKD (chronic kidney disease) is one of the major complications of diabetes and hypertension. With increase in prevalence of non-communicable diseases, the patients presenting with the symptoms of CKD are also rising. Most of the patients suffering from CKD eventually land up on renal replacement therapy, putting extra burden economically as well as psychologically to the self and their family. The aim of the study is to find out the socio demographic and clinical profile of the patients suffering from CKD attending a tertiary care hospital in Delhi.Methods: It was a record based descriptive analysis, conducted between January 2019 and June 2019 in one of the ESIC (Employee State Insurance Corporation) hospital of Delhi. Medical Records of the only those patients were considered whose complete data were present in the record file. Data about Socio demographic profiles , clinical data, duration of CKD, duration of haemodialysis, viral markers, number of blood transfusions, vascular access, number of failed AV fistula etc. were entered in MS Excel and analysed through SPSS 11.Results: Hospital records of 473 CKD patients undergoing hemodialysis were analyzed. It was found that 315 (67%) were males and 158 (33%) were females. Majority of the patients i.e. 245 were in the age group of 41-60 years followed by 166 who were in the age group of 21 to 40. Out of total patients, 195 (41.2%) participants were undergoing hemodialysis twice a week, 276 (58.4%) thrice a week, 2 (0.4) patients were undergoing hemodialysis session four times a week. Majority of the participants i.e. 414 (88%) were Hindu. Out of total 473 participants, 439 (93%) participants had sero negative for viral marker (i.e. HbsAg, HCV, HIV I and II) and 33 (7%) participants were sero positive for viral marker. Most common etiology of CKD was found to be hypertension in our study followed by diabetes.Conclusions: Patients suffering from chronic kidney diseases are increasing day by day with increasing prevalence of hypertension. Most of the patients of CKD patients were middle aged males. Most of the patients have to visit 3 times a week to any health care institution for hemodialysis.  Many of the patients are getting infected with viral hepatitis during course of the illness.

Study to Assess the Autopsy in Relation with Age and Gender in Tertiary Care Hospital of Hyderabad, Sindh, Pakistan

2021 ◽  
Vol 15 (8) ◽  
pp. 2151-2153
Author(s):  
Aisha Khalid ◽  
Sadia Abdul Qayyum ◽  
Ikram Ahmed Tunio ◽  
Abdul Majeed Memon ◽  
Sono Mal ◽  
...  
Keyword(s):  
Road Traffic ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age And Gender ◽  
Firearm Injury ◽  
Relevant Role ◽  
Autopsy Examination ◽  
And Gender ◽  
Diagnostic Technologies

Objective: To assess the autopsy in relation with age and gender in tertiary care hospital of Hyderabad, Sindh, Pakistan. Study Design: Retrospective, observational and non-interventional study Place and Duration of Study: Medicolegal Department of Liaquat University of Medical and Health Sciences Hyderabad from 1st January 2017 to 31st December 2018. Methodology: Three hundred and eighty-one patients were enrolled. Results: According to cause of death, 88 (23.10%) were died due to road traffic accident, firearm injury 73 (19.16%) and asphaxial death 70 (18.37%), assault 65 (17.06%), poisoning 37 (9.71%), electric shock 30 (7.87%) and undetermined 18 (4.72%) respectively. Conclusion: The relatable factors such as age and gender with the suicidal cases in results of autopsy examination which plays the most relevant role in the medical practices even after the advancement of diagnostic technologies. Key words: Assess, Autopsy, Age, Gender, Tertiary care hospital

scholarly journals The Pattern of Substance Abuse in the Psychiatry Department of a Tertiary Care of Srinagar Hospital, Jammu and Kashmir, India

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Mudasir Maqbool ◽  
Ginenus Fekadu ◽  
Dinka Dugassa ◽  
Firomsa Bekele ◽  
Ebisa Turi ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Psychiatric Disorders ◽  
Nuclear Family ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Health Concern ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Jammu And Kashmir ◽  
The Mean

Background: Substance-use related disorders (SUD) are a major public health concern worldwide, especially in developing nations. Currently, it is characterized by high rates of mortality and morbidity. Moreover, through increased utilization of healthcare services, it causes both direct and indirect significant medical expenditures. Objectives: The current study aimed to evaluate the pattern of Substance abuse in the department of psychiatry of a Tertiary Care Hospital, Srinagar, Jammu, and Kashmir, India. Methods: This is a descriptive, cross-sectional, and open study conducted in the psychiatry inpatient department of a tertiary care hospital, Srinagar, Jammu, and Kashmir, India, for 7 months (January to May 2020). Results: Over a period of seven months, a total of 135 participants were recruited (105 males and 30 females). Most of them were Muslim (96.29%), married (68.14%), and living as a nuclear family (75.55%). Tobacco (Nicotine) was the most commonly used substance by those admitted to the psychiatry ward (62.96%), followed by cannabis (11.11%) and opioids (11.11%). The most comorbidity associated with substance abuse was psychiatric disorders (36.84%), followed by neurological disorders (21.05%), and gastrointestinal disorders (7.89%). Among those with psychiatric disorders, 14 (10.37%) had mood (bipolar) disorders. A total of 1129 medicines were prescribed for 135 patients. The mean ± standard error of the mean (SEM) of the prescribed medicines was 8.48 ± 3.3. The average number of drugs per encounter was 8.48%. Conclusions: In this study, cigarette smoking (nicotine) was the most commonly abused substance. It can be justified by the fact that Kashmir is a conflict zone, and many people suffer from the post-traumatic stress disorder. Hence, a collaborated effort is necessary to improve the prescribing pattern and to enhance the rational use of medications for better treatment outcomes.

scholarly journals Drug utilization study in OPD of a tertiary care hospital in a rural area of Jalna, Maharashtra, India by using WHO prescribing indicators

2017 ◽  
Vol 7 (1) ◽  
pp. 52 ◽  
Author(s):  
Shruti Chandra ◽  
Imran Nawaz Khan ◽  
Mohd Mateenudin ◽  
Ajay Chandrakapure ◽  
Syed Maaz ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Science ◽  
Care Hospital ◽  
Cross Sectional ◽  
Rational Use ◽  
Tertiary Teaching ◽  
Drug Utilization Studies ◽  
Key Dimensions

Background: Drug utilization studies (DUS) are used as potential tool in the evaluation of healthcare system. DUS are conducted to facilitate the rational use of drugs in populations. The indicators of prescription in practice measure the performance of health care provider in several key dimensions related to appropriate use of drug. Therefore, the present study was undertaken to analyze the prescription written by doctors in a Tertiary Care Hospital in rural area.Methods: Present study is a cross sectional, prospective and observational study. The study was conducted in a rural tertiary, teaching hospital at JIIU’s Indian Institute of Medical Science and Research, Warudi, Taluka Badnapur from January 2017 to September 2017 for duration of 9 months. Data was obtained from 300 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Average number of drugs in the present study was found to be 2.85. Percentage of drugs prescribed by generic name is 13.48%. Percentage of encounters with an antibiotic prescribed 60%. Percentage of encounters with an injection prescribed 4.33%. Percentage of drugs prescribed from essential drugs list 72.91%.Conclusions: These types of studies help to design policy for rational use of drugs and motivation of physician for rational use of drugs.

scholarly journals COVID-19 and Pregnancy Outcome: An Experience in ‘COVID-19 Management Designated’ Tertiary Care Hospital, Rawalpindi, Pakistan

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 85-91
Author(s):  
Shazia Syed ◽  
Humera Noreen ◽  
Humaira Masood ◽  
Ismat Batool ◽  
Hina Gul ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Pregnant Women ◽  
Clinical Characteristics ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Categorical Variables ◽  
Care Hospital ◽  
Case Series Study ◽  
Maternal And Neonatal Outcomes

Background: The current COVID-19 pandemic has affected almost 17.3 million victims worldwide with mortality of almost 674K. Pregnancy is one of the most susceptible conditions for COVID-19 infection, but limited data is currently available about the clinical characteristics of pregnant women with the disease. Objective; to describe the clinical characteristics, co-morbidities, management, feto-maternal, and neonatal outcome in COVID-19 positive pregnant women. Methodology: A descriptive case series study was conducted in Obs/Gynae dept of Benazir Bhutto Tertiary Care Hospital, Rawalpindi, including all asymptomatic/symptomatic COVID-19 positive pregnant women and clinical suspects (COVID-19 PCR negative women) delivered in our hospital from 01st April 2020 to 31st July 2020. Their medical records were reviewed for clinical characteristics, management, feto-maternal and neonatal outcomes. Continuous variables were expressed in Mean & Range and Categorical variables as number & Percentage. Results: During the study period a total of 17 cases were reviewed. The mean maternal age was 28.94 yrs. Primigravida (07), Multipara (10). Mean gestational age was 37 wks (range; 30-41wks). Presenting symptomatology was varied. Asymptomatic; (29%), COVID-19 specific symptoms; fever & flu (12%), fever&cough (6%), shortness of breath(SOB) alone (6%), fever & SOB(6%) and pregnancy-related manifestations were labour pains (17%), eclampsia(6%), hydrocephalous fetus (6%) and hepatic encephalopathy(6%). The commonest co-morbidity was Hypertensive disorders of pregnancy (24%). Five women (29%) required ICU care. Lower segment caesarean sections(LSCS) (59%), vaginal delivery (41%). Eleven babies delivered with good Apgar score and birth weight. Two were early neonatal deaths (ENND) and 04 were received intra-uterine fetal deaths (IUDs). Fetal demise was associated with strong obstetric risk factors. Out of 13 live-born babies, RT-PCR Covid-19 testing was done in 10 (77%) cases and was negative. One mother was expired due to complications of hepatic encephalopathy, sepsis, and burst abdomen. Conclusion; The clinical course of COVID-19 disease in pregnancy seems to be no different from non-pregnant women. Clinical manifestations are diverse and infection contracted in the third trimester of pregnancy is associated with good feto-maternal and neonatal outcomes.

scholarly journals Identification of Risk Factors for Typhoid Fever in Children Admitted in a Tertiary Care Hospital

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Soma Halder ◽  
◽  
Md. Ekhlasur Rahman ◽  
Mst Mukta Sarker ◽  
Fabia Hannan Mone ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Control Group ◽  
Major Public Health Problem ◽  
Care Hospital

Enteric fever remains a major public health problem in developing countries like Bangladesh. Improvement in the health facility, vaccination, and health-related awareness program the incidence of enteric fever among children is not decreased. The study aimed to find out the risk factors for enteric fever in hospitalized children in a tertiary care hospital. Methodology: We conducted a hospital-based case-control study to identify the risk factors in children residing in Dhaka city. We enrolled 50 enteric fever cases as a case group and 50 age-matched febrile patients as a control group. Result: Out of 50 cases, 2 patients were below one year and most of them were pre-school aged 26(52%). Univariate analysis showed that enteric fever is more who take food with the help of the mother and caregiver (OR=7.1); 95% CI= 26.7 -61.3) and never or rarely wash hands before preparing food and before feeding (OR= 5.7; 95% CI= 23.2 -52.8). Cases were eating outdoors at the mobile food vendors and consuming ice-cream regularly (OR=2.28; 95% CI=1- 39) whereas the control group also took street food but less frequently. Conclusion: Enteric fever is an exclusive food and water-borne systemic disease and one of the major public health problems in Bangladesh. Not only overcrowding, unsafe drinking water are the common risk factors but also hand washing both children and caregiver, poor food habit is the important risk factors. So, health education to children and food handlers may reduce the incidence of enteric fever in children.

scholarly journals Socio-Demographic Factors Affecting the Prevalence of Enteric Fever: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

2020 ◽  
Vol 8 (8) ◽  
pp. 1927-1931
Author(s):  
Mizanur Rahman ◽  
ASM Nawshad Uddin Ahmed ◽  
Jafar Iqbal ◽  
Mohammad Abdullah Al Mamun ◽  
Nazia Hossain ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Factors ◽  
Care Hospital ◽  
Factors Affecting ◽  
Socio Demographic Factors
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