scholarly journals Tracheostomy in a tertiary care hospital: epidemiology, indications and complications

2020 ◽  
Vol 6 (5) ◽  
pp. 826
Author(s):  
Anchal Gupta ◽  
Palak Gupta ◽  
Vikrant Mahajan ◽  
Padam Singh Jamwal
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Upper Airway ◽  
Neck Surgery ◽  
Pediatric Care ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Female Ratio ◽  
Male Female Ratio

<p class="abstract"><strong>Background:</strong> Tracheostomy is one of the most frequently performed surgeries in the emergency department, Intensive care units and at bedside in the present scenario. The aim of our study is to outline the frequent indications, to analyse various complications and to evaluate the outcomes of tracheostomy in our setting in our Institution.</p><p class="abstract"><strong>Methods:</strong> This retrospective study was conducted in the Department of ENT and Head &amp; Neck Surgery, SMGS Hospital, Jammu from January 2018 to January 2020. The cases were recorded from ENT Department and also intensive medical care, intensive neonatal and pediatric care, intensive respiratory care, surgical intensive care units of our institution. We included all the emergency, elective and prophylactic tracheostomies in this group.  </p><p class="abstract"><strong>Results:</strong> Out of 100 patients included in our study, male: female ratio was 2.7:1. 61 (61%) patients were in the age group of 41 to 60 years. The mean age was 43 years. In our study 58 (58%) tracheostomies were done on emergency. 38 (38%) were done electively whereas rest 4 (4%) were done prophylactically. 37 (37%) tracheostomies were done for upper airway obstruction, followed by artificial ventilation done in 36 (36%) patients. The most indication was carcinoma seen in 17 (17%) patient followed by head injury seen in 16 (16%) patients. The most common complication was surgical emphysema seen in 8(8%) tracheostomies followed by haemorrhage in 6 (6%) tracheostomies.</p><p class="abstract"><strong>Conclusions:</strong> Tracheostomy still remains a life saving procedure in the surgical management of airway if performed timely despite its few complications.</p>

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.

Etiology and outcomes for patients infected with HIV in intensive care units in a tertiary care hospital in China

2014 ◽  
Vol 87 (3) ◽  
pp. 366-374 ◽  
Author(s):  
Jiang Xiao ◽  
Wen Zhang ◽  
Yingxiu Huang ◽  
Yunfei Tian ◽  
Wenjing Su ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Halitosis: Its Aetiology and Psychosocial Impact- A Hospital Based Study

2021 ◽  
Vol 29 (2) ◽  
pp. 145-150
Author(s):  
Gopika Kalsotra ◽  
Monica Manhas ◽  
Sachin Gupta ◽  
Heemani Bhardwaj ◽  
Parmod Kalsotra ◽  
...  
Keyword(s):  
Social Life ◽  
Laryngopharyngeal Reflux ◽  
Systemic Disease ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Psychosocial Impact ◽  
Care Hospital ◽  
Female Ratio ◽  
Study Results ◽  
A Prospective Study

Introduction Halitosis means bad or unpleasant odour from oral cavity. It causes embarrassment to the patients and affects their social life and communication. This study aims to find the causes of halitosis and to assess its psychosocial impact. Materials and Methods A prospective study was conducted in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care hospital. It included 165 patients, presenting to the ENT OPD with chief complains of oral malodour for at least 3 months. The patients in the age above 15 years and below 75 years, irrespective of gender, were included in the study. Results The age of the patients ranged from 15 to 75 years with a mean age of 52.24 ± 15.67 with male: female ratio of 7:10. The most common cause of halitosis in the present study included chronic rhinosinusitis (38.7%), gingivitis/periodontitis (19.39%), tonsillitis (4.84%), laryngopharyngeal reflux (2%), deep neck space infections (1.2%). In 23.56%, the halitosis was a symptom of an underlying malignancy. Conclusion Halitosis from an extra oral origin can be the sign of an underlying systemic disease or malignancy. The consultation should be done with the periodontist, ENT specialist and a physician.

scholarly journals High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 588 ◽  
Author(s):  
Andrés H. Uc-Cachón ◽  
Carlos Gracida-Osorno ◽  
Iván G. Luna-Chi ◽  
Jonathan G. Jiménez-Guillermo ◽  
Gloria M. Molina-Salinas
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
High Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Gram Negative ◽  
Resistance Rates

Background and Objectives: Antimicrobial resistance (AMR) is increasing worldwide and imposes significant life-threatening risks to several different populations, especially to those in intensive care units (ICU). The most commonly isolated organisms in ICU comprise gram-negative bacilli (GNB), and these represent a leading cause of serious infections. This study was conducted to describe the prevalence of resistance in GNB isolated from patients in adults, pediatric, and neonatal ICU in a tertiary-care hospital in Mérida, Mexico. Materials and Methods: A retrospective study was done on samples collected in Neonatal (NICU), Pediatric (PICU) and Adult (AICU) ICU of Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social in Mérida, México. The identification of isolates and antimicrobial susceptibility testing were performed using an automated system. Results: A total of 517 GNB strains were isolated. The most common positive culture was bronchial secretions. Pseudomonas aeruginosa was the prevalent pathogen in NICU and PICU, whereas Escherichia coli was common in the AICU. Overall, GNB exhibited a high resistance rates for Ampicillin (95.85%), Cefuroxime (84.17%), Piperacillin (82.93%), Cefotaxime (78.07%), Ceftriaxone (77.41%), Aztreonam (75.23%), Cefazolin (75.00%), and Ceftazidime (73.19%). There are significant differences in the resistance rates of GNB from different ICUs for penicillins, cephalosporins, carbapenems and fluoroquinolones drugs. Escherichia coli (multidrug-resistant [MDR] = 91.57%, highly resistant microorganisms [HRMO] = 90.36%) and Acinetobacter baumannii (MDR = 86.79%, HRMO = 83.02%) exhibited the highest percentage of MDR and HRMO profiles. The prevalence of the extended-spectrum beta-lactamases (ESBL)-producing isolates was 83.13% in E. coli, 78.84% in Klebsiella pneumoniae, and 66.67% in Proteus mirabilis, respectively. Conclusions: The high resistance rates to drugs were exhibited by our GNB isolates. Continuous surveillance and control of the use of antimicrobials are urgently needed to reduce the emergence and spreading of MDR, HRMO, and/or ESBL-producing bacilli.

scholarly journals PREVALENCE AND DRUG RESISTANCE IN ACINETOBACTER SP. ISOLATED FROM INTENSIVE CARE UNITS PATIENTS IN PUNJAB, INDIA

2018 ◽  
Vol 11 (14) ◽  
pp. 88
Author(s):  
Tanvir Kaur ◽  
Chayanika Putatunda ◽  
Aroma Oberoi ◽  
Ashish Vyas ◽  
Gaurav Kumar
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Sensitivity Pattern ◽  
Acinetobacter Sp

Objective: This study was designed to study the prevalence and antibiotic susceptibility patterns of Acinetobacter sp. as isolated from patients lodged in intensive care units (ICUs) of a tertiary care hospital, Ludhiana, Punjab, India.Methods: The clinical samples were simultaneously streaked on Blood agar and MacConkey agar. The identification of the bacterial isolates was carried out with the aid of Gram stain, motility test and along with a combination of other commonly employed biochemical tests. The antimicrobial susceptibility testing (AST) of all the bacterial isolates was carried out on Muller-Hinton agar through Kirby-Bauer disc diffusion method.Results: Acinetobacter sp. formed a fair allowance contributing at 42% among all ICU culture positive samples. The respiratory tract samples had a major share at 63.15% for all samples attributed to be positive for Acinetobacter sp. nosocomial etiology. The antibiotic sensitivity pattern portrayed that more than 95% of Acinetobacter sp. isolates were multiple drug resistant (MDR) whereas >50% Acinetobacter sp. showed extensive drug resistant (XDR). The last resort for such Acinetobacter sp. nosocomial infections is left to colistin and polymyxin B.Conclusion: Acinetobacter sp. is a highly prevalent microorganism among ICU patients of Ludhiana, Punjab, India, while its potential to acquire resistance toward commonly used antibiotics represents it as a grave threat to the health-care industry, therefore signifying the need for its regular monitoring in the health-care setups.

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