scholarly journals Hematological changes in patients with malaria in a tertiary care hospital, Multan, Punjab, Pakistan

2021 ◽  
Vol 8 (12) ◽  
pp. 6026
Author(s):  
Naseem Akhter ◽  
Nazishmazari . ◽  
Maliha Asif ◽  
Ahmed Raza Khan ◽  
Umme Habiba ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Plasmodium Species ◽  
Parasite Load ◽  
Malarial Parasite ◽  
Care Hospital ◽  
Significant Difference ◽  
Wbc Count ◽  
Complete Blood Counts ◽  
Hematological Changes ◽  
Patient Department

Background: Malaria is one of the most common human infections and continues to cause significant morbidity and mortality all over the world. To assess and compare the hematological changes in common types of malaria in our patients.Methods: This observational study included 100 diagnosed malaria patients of Multan Medical and Dental college, Multan both from out patient department (OPD) and in-patient department, between March 2020 and March 2021. The diagnosis of malaria was confirmed by thick and thin film stained with Geimsa’s staining for malaria parasite and plasmodium species and the parasite index (MPI) in some cases. Complete blood counts (CBCs) were performed and WBC differential was done on all cases.Results: The most common type of malarial parasite was Plasmodium vivax followed by Plasmodium falciparum and 89% of the patient had thrombocytopenia, 70 % anemia, 23% had leukopenia and 10% had raised WBC count. The mean parasite load was 1.275±0.629%, 20 % of the cases showed neutropenia, 40 % had lymphopenia and 40 % showed monocytopenia. Of all the cases 15 % had neutrophilia, 8 % had lymphocytosis and 5 % had eosinophilia. Thrombocytopenia was slightly more in P. falciparum (58.69%) than P. vivax (30.18%) cases, p>0.05, whereas there was no significant difference in the incidence of anemia in two groups (34.68% vs 33.82%) with p>0.05.Conclusions: P. vivax is the common malarial parasite in our population. Both P. vivax and P. falciparum can cause marked hematological changes including thrombocytopenia, anemia, lymphopenia and monocytopenia.

scholarly journals Prescription Audit of Anti-fungal Treatment of Dermatophytoses in the Dermatology Out Patient Department of a Tertiary Care Hospital

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Oral Treatment ◽  
Clinical Status ◽  
Tertiary Care ◽  
Rank Test ◽  
Care Hospital ◽  
Clinical Failure ◽  
Significant Difference ◽  
Anti Fungal ◽  
Patient Department

Aims: To study the prescriptions of clinically diagnosed cases of dermatophytoses, to evaluate medical treatment of clinical failure cases, any rise in serum ALT (Alanine aminotransferase) levels associated with usage of oral anti-fungal drugs, availability of drugs in the hospital pharmacy and cost minimization of different oral treatment regimens with Griseofulvin, Fluconazole, Itraconazole and Terbinafine. Settings and design: Dermatology Out Patient Department (OPD) of a tertiary care hospital, single centre prospective cohort observational study. Materials and Methods: 370 patients from the Dermatology Out Patient Department (OPD) diagnosed of dermatophytoses were enrolled. Follow-up was done 3±1 weeks apart, twice for newly diagnosed patients and once for patients on ongoing therapy. Two separate blood samples were collected 3±1 weeks apart for estimation of serum ALT. The prime lesion in each patient was graded as mild, moderate and severe. Patients were categorized as clinically cured, clinically improved, or as clinical failure following treatment. Statistical analysis used: Descriptive statistics, Fischer’s exact test and Wilcoxon’s signed rank test. Results: Azoles were the most commonly prescribed antifungals. Clinical status of patients was independent of the oral antifungal drug received (p > 0.05). A statistically significant difference in clinical status between compliant and non-compliant patients was seen (p < 0.05). A statistically significant increase in serum ALT levels was seen (p < 0.05) however, it was not clinically significant. 55.52% of drugs were unavailable in the hospital formulary. The average expenses per prescription was approximately INR 1123.55. Itraconazole was the most expensive treatment regimen followed by terbinafine and fluconazole. Conclusions: There exists a non-uniformity in the management of dermatophytoses due to lack of adequate guidance and nonavailability of drugs and clinical cure of patients depends upon compliance to therapy.

A Study on Relationship of Thrombocytopenia and Likelihood of Severe Malaria in Patients Admitted With Malaria in a Tertiary Care Hospital of Dakshina Kannada

2019 ◽  
pp. 1-7
Author(s):  
Mukhtarahmed Bendigeri ◽  
Apoorva Panchakshare ◽  
Nazir Attar ◽  
Prakruthi Jaladhar
Keyword(s):  
Renal Failure ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Hepatic Dysfunction ◽  
Severe Disease ◽  
Tertiary Care ◽  
Plasmodium Species ◽  
Malarial Parasite ◽  
Severe Thrombocytopenia ◽  
Care Hospital

Background: Malaria continues to be a huge socioeconomic burden despite various measures taken to curb the spread worldwide. It is also a global concern and more so in countries with a resource-limited setting. This inspired us to look at variables that could represent a severe disease in those limited settings, one such parameter being thrombocytopenia in malaria.   Aims and Objectives: To find the relationship between thrombocytopenia and renal failure, hepatic dysfunction and cerebral malaria (severe malaria) and to identify if thrombocytopenia on the first day of admission increases the likelihood of severe malaria. Methods: The study included 85 patients admitted in Yenepoya medical college hospital with fever and peripheral smear or malarial parasite fluorescent test (MPFT) positive for Plasmodium species. Results: A total of 85 patients were included in the study. It was noted that the patients with profound thrombocytopenia (<20,000/ml) on day 1 were more commonly associated with manifestations of severe malaria-like cerebral malaria, renal failure, and jaundice. Platelet count of <50,000/ml was associated with increased incidence of  renal failure, hepatic dysfunction, and cerebral malaria and increased mortality by an odds ratio of 4.37 on multivariate analysis. Conclusions: It was noted in our study that the presence of thrombocytopenia in a case of acute febrile illness increases the probability of malaria. This finding along with clinical suspicion of malaria should entail early treatment initiation. We have also noted that the presence of profound and severe thrombocytopenia was found to have a statistically significant correlation with cerebral malaria, renal failure and jaundice, and increased mortality.

The Impact of Hospital Accreditation on the Patient Satisfaction of In-Patient Department Services

2018 ◽  
Vol 6 (8) ◽  
pp. 368
Author(s):  
Zuber Mujeeb Shaikh
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Care Delivery ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Survey Questionnaires ◽  
Patient Department

Patient satisfaction is as important as other clinical health measures and is a chief means of assessing the strength of health care delivery. The current competitive environment has driven health care organisations to concentrate on patient satisfaction as a means to acquire and keep market share. If you don’t recognise what your strengths and weaknesses are, you can’t compete effectively. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on the patient satisfaction of In-Patient Department Services. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital in Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower satisfaction rate in in-patient department services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (H0) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question of the questionnaire. Study Design: The closed ended questionnaire was developed considering the in-patient services process by incorporating the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients for completion upon discharge two months before and two months after the accreditation. Study Population: Simple random sampling method was selected, and the researcher had involved conscious patients of all age groups and gender. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: It is very evident from this research that at the 5 % level of significance, the chi-square test indicates that there is a significant difference in the satisfaction with respect to the overall experience in the hospital between before the accreditation group and after accreditation group with p-value <0.001.The responses of satisfaction has improved from N=421 (Satisfied=245, Highly satisfied= 176) from N=241 (Satisfied = 124, Highly satisfied= 117).

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

2021 ◽  
Vol 8 ◽  
pp. 204993612110365
Author(s):  
Kundan Mishra ◽  
Suman Kumar ◽  
Sandeep Ninawe ◽  
Rajat Bahl ◽  
Ashok Meshram ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Myeloid Leukemia ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
The Mean ◽  
Acute Myeloid

Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

scholarly journals Detection of SARS-CoV-2 and Other Infectious Agents in Lower Respiratory Tract Samples Belonging to Patients Admitted to Intensive Care Units of a Tertiary-Care Hospital, Located in an Epidemic Area, during the Italian Lockdown

2021 ◽  
Vol 9 (1) ◽  
pp. 185
Author(s):  
Adriana Calderaro ◽  
Mirko Buttrini ◽  
Sara Montecchini ◽  
Giovanna Piccolo ◽  
Monica Martinelli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Infectious Agents ◽  
Epidemic Area ◽  
Significant Difference

The aim of this study was the detection of infectious agents from lower respiratory tract (LRT) samples in order to describe their distribution in patients with severe acute respiratory failure and hospitalized in intensive care units (ICU) in an Italian tertiary-care hospital. LRT samples from 154 patients admitted to ICU from 27 February to 10 May 2020 were prospectively examined for respiratory viruses, including SARS-CoV-2, bacteria and/or fungi. SARS-CoV-2 was revealed in 90 patients (58.4%, 72 males, mean age 65 years). No significant difference was observed between SARS-CoV-2 positives and SARS-CoV-2 negatives with regard to sex, age and bacterial and/or fungal infections. Nonetheless, fungi were more frequently detected among SARS-CoV-2 positives (44/54, 81.4%, p = 0.0053). Candida albicans was the overall most frequently isolated agent, followed by Enterococcus faecalis among SARS-CoV-2 positives and Staphylococcus aureus among SARS-CoV-2 negatives. Overall mortality rate was 40.4%, accounting for 53 deaths: 37 among SARS-CoV-2 positives (mean age 69 years) and 16 among SARS-CoV-2 negatives (mean age 63 years). This study highlights the different patterns of infectious agents between the two patient categories: fungi were prevalently involved among SARS-CoV-2-positive patients and bacteria among the SARS-CoV-2-negative patients. The different therapies and the length of the ICU stay could have influenced these different patterns of infectious agents.

scholarly journals Association of Antimicrobial Susceptibility and Treatment Outcome in Acne Vulgaris Patients: A Pilot Study

2020 ◽  
Vol 12 (04) ◽  
pp. 233-238
Author(s):  
Ashvini K. Yadav ◽  
Suneel Bhooshan ◽  
Allen Johnson ◽  
Dinesh P. Asati ◽  
Shashwati Nema ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Antimicrobial Susceptibility ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Care Hospital ◽  
In Vitro Susceptibility ◽  
Persistent Infections ◽  
Significant Difference ◽  
Cutibacterium Acnes

Abstract Purpose Cutibacterium acnes (C. acnes) is an emerging pathogen that is highly resistant to antibiotics and is capable of causing persistent infections that are difficult to treat. Methods & Materials Acne vulgaris patients visiting dermatology OPD of our tertiary care hospital during the study period of 2 months were recruited. Skin swabs were collected, and the sample was processed on 5% sheep-blood agar for anaerobic culture by the GasPak method. Isolates were identified by the standard biochemical test. Antimicrobial susceptibility testing was performed for clinically relevant antibiotics by the E-strip method. The clinical response was evaluated after 1-month follow-up to the prescribed antibiotics. Results Minocycline, doxycycline, ceftriaxone, and tetracycline were the most effective antibiotics. Nonsusceptibility to clindamycin and erythromycin were observed in 11.9% and 31% isolates, respectively, with 9.5% isolates being nonsusceptible to both. For none of the antibiotics we found significant difference in the proportion of susceptible and nonsusceptible isolates between mild, moderate, and severe grades of acne vulgaris. For none of the antibiotic regimens, significant difference was observed between nonresponders and responders. Twenty-seven patients received clindamycin and among them 16 of 19 responders and 6 of 8 nonresponders yielded growth of clindamycin-susceptible isolates (p = 0.57). Conclusion We observed significant prevalence of resistant strains of C. acnes among patients with acne vulgaris. No association was observed between in vitro susceptibility results and treatment outcome.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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