scholarly journals Clinicoepidemiological study of acute invasive fungal rhinosinusitis in a tertiary care centre

2021 ◽  
Vol 7 (11) ◽  
pp. 1772
Author(s):  
Rajeshree Chaurpagar ◽  
Priyanka Garud ◽  
Apurva Pawde ◽  
Parag Doifode ◽  
Bhagyashree Chiplunkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
World Health ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
History Of ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>

scholarly journals Study of risk factors of acute respiratory infections in children admitted in a tertiary care hospital of Southern Maharashtra

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Alka C. Kaware ◽  
Nitin H. Kamble ◽  
S. K. Mangulikar
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
High Morbidity ◽  
Acute Respiratory Infections ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of ◽  
Tract Infections

Background: Acute respiratory infections (ARI) is an important cause of mortality and morbidity in children. In India, it constitutes 15% of under five deaths. Various risk factors are responsible for ARI in children. Study of risk factors will help to reduce the high morbidity and mortality due to ARI. The objectives were to study risk factors responsible for acute respiratory infections in children and to find out case fatality rate &/ outcome of acute respiratory infections ARI in children.Methods: A hospital based cross sectional study was done in 2013-14 in a tertiary care centre to study the risk factors associated with ARI in children. All the pediatric patients between 0-12 years admitted in a tertiary care centre at Solapur were enrolled in the study.Results: Acute respiratory tract infections (ARI) were more common in 1-4 years age group i.e. 57.31% (196). It was more common in males i.e. 64.33% (220) than females i.e. 35.67% (122). ARI was more common in lower socio-economic classes i.e. class V (50.58%), class IV (22.52%); in patients whose mothers were illiterate 43.28% and who had history of parental smoking 84.21%. Maximum patients of ARI were having history of overcrowding 75.73%, inadequate cross-ventilation 81.87% and use of smoky chullah 78.65% in their home. Statistically significant association found between ARI cases and these socio-demographic factors. 46.78% (160) were incompletely immunized and 16.37% (56) were not immunized at all. Only 36.84% (126) were completely immunized for their age. Maximum cases of ARI (50.88%) occurred in winter season followed by rainy season (26.90%). Outcome showed that 91.52% (313) were cured, while 1.75% (6) patients died due to ARI.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ARI which can be prevented by effective health education and an appropriate initiative taken by the government.

scholarly journals Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

2021 ◽  
Vol 28 (4) ◽  
pp. 425-431
Author(s):  
Sudhir BHANDARI ◽  
◽  
Shivankan KAKKAR ◽  
Amitabh DUBE ◽  
Mohnish GROVER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
High Morbidity ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Invasive Fungal Diseases ◽  
Co Morbidity ◽  
History Of ◽  
Second Wave

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).

scholarly journals A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 4011 ◽  
Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having &ldquo;some dehydration&rdquo; and &ldquo;dehydration&rdquo; according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean &plusmn; standard deviation age of 25.62 &plusmn; 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p&lt;0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p&lt;0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p&lt;0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21

scholarly journals Prevalence and cause of gestational diabetes mellitus in a tertiary care center in Kolar district: a population based study

2019 ◽  
Vol 8 (7) ◽  
pp. 2709
Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.

scholarly journals Prevalence and determinants of hypertension and diabetes mellitus in an urban area of Coimbatore

2020 ◽  
Vol 7 (5) ◽  
pp. 1807
Author(s):  
Naveen Prabhu Jayaraj ◽  
Jeevithan Shanmugam ◽  
Shanmugapriya Duraisamy ◽  
Loganathan Padmavathy
Keyword(s):  
Diabetes Mellitus ◽  
Life Style ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Vegetarian Diet ◽  
High Morbidity ◽  
Care Hospital ◽  
Elderly Age ◽  
Field Practice ◽  
Sedentary Life Style

Background: Owing to change in behavior and lifestyle patterns, diabetes mellitus and hypertension are in increasing trend worldwide. They are associated with various complications resulting in high morbidity. Early detection of these would necessitate the prevention of complications associated with it and improves the quality of life of the people. The objective of the study was to assess the prevalence and determinants of diabetes mellitus and hypertension among urban population in the field practice area of a tertiary care hospital in Coimbatore.Methods: 299 individuals of both sexes belonging to six wards in the field practice area of a tertiary care hospital in Coimbatore were randomly selected and screened for diabetes mellitus and hypertension. Diagnosis was based on American Diabetic Association and JNC 7 guidelines for diabetes mellitus and hypertension respectively. Data on various factors associated was collected using pretested validated semi structured questionnaire.Results: Overall prevalence of diabetes mellitus and hypertension was found to be 32.44% and 38.8% respectively with newly diagnosed diabetes mellitus and hypertension of 4.02% and 7.37%. Overall adherence was found to be 80%. Factors such as elderly age, sedentary life style, non-vegetarian diet, obesity are found to be associated with both diabetes mellitus and hypertension.Conclusions: Almost one in every third person found to be having either diabetes mellitus/hypertension or both with 20% non-adherence to treatment. This high prevalence necessitates the need for adoption of various strategies to combat the risk factors and to promote healthy life style.

scholarly journals Prevalence of hypothyroidism in patients with type 2 diabetes mellitus attending a tertiary care hospital in a rural area of Bihar, India

2018 ◽  
Vol 6 (11) ◽  
pp. 3721
Author(s):  
Abhishek Kamendu ◽  
Ahmad Nadeem Aslami
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Overt Hypothyroidism ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients

Background: Diabetes has become a major health challenge all over the world. Previous studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexist. The aim of this study was to find out prevalence of hypothyroidism and its associated factors in type 2 diabetes mellitus patients.Methods: Consecutive 200 patients with type 2 diabetes mellitus attending outpatient department of medicine in a tertiary care centre in Sasaram, Bihar were evaluated clinically and biochemically. Subclinical hypothyroid and overt hypothyroidism was diagnosed as per standard definitions. The results obtained were statistically analysed by using chi square test and finding odds ratio.Results: Out of 200 patients, 75.5% were euthyroid while 24.5% were hypothyroid. Out of 49 hypothyroid patients, subclinical hypothyroid (SC-Hypo) was present in 41 patients and overt hypothyroid (C-Hypo) was present in only 8 patients. The prevalence of hypothyroidism was found more in males, age ≥60 years, patients with HbA1c value ≥7%, patients with diabetes duration less than 5 years and in hypertensive patients.Conclusions: Thyroid dysfunction screening should be done in all type 2 diabetic patients periodically and appropriate individualized treatments in addition to thyroid function test should be given to diabetes mellitus patients with subclinical hypothyroidism as well.

scholarly journals Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India

2018 ◽  
Vol 5 (9) ◽  
pp. 4065
Author(s):  
Vivek Nagar ◽  
Pankaj Prasad ◽  
Arun Mitra ◽  
Saket Kale ◽  
Kriti Yadav ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Global Public Health ◽  
Tertiary Care Centre ◽  
Family History Of Diabetes ◽  
Poor Knowledge ◽  
Level Of Knowledge

Background: Diabetes mellitus (DM) is one of the major fast growing non-communicable disease (NCD) and causes threats to global public health. Prior to initiating an educational program or interventions for diabetic patients, their current level of knowledge (K), attitude (A), and practice (P) should be evaluated. The purpose of this study was thus to determined current diabetes-related knowledge, attitude, and practices (KAP) of adults with Diabetes mellitus..Methods: Current study was cross sectional study from August to December 2014 in medicine outpatient department of Tertiary care hospital of Bhopal. A semi‑structured interviewer administered questionnaire was used for data collection, and it consisted of four sections.Results: A total of 150 study participants were enrolled for the study. Among them, 58% were male and 425 were female diabetic patients. Around 16% of the participants having good level of knowledge, 34.6% of participants have poor knowledge and 49.3% having moderate knowledge. Out of the total participant 43.3% have positive attitude and only 34% patients had positive practice.Conclusions: In our study most of the patients belong to moderate and poor knowledge score as well as negative practice and negative attitude that emphasizes the need for increasing diabetes awareness activities. The efforts should be more focussed on female patients, younger patients and those who have no family history of diabetes.

scholarly journals Study of ovarian cancer at a tertiary care centre

2020 ◽  
Vol 9 (8) ◽  
pp. 3228
Author(s):  
Jayashree Mulik ◽  
Swapnil Khadse
Keyword(s):  
Ovarian Cancer ◽  
Tertiary Care ◽  
Case Fatality ◽  
Final Diagnosis ◽  
World Health ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
History Of ◽  
Associated Risk Factors

Background: Despite major advances in case management, ovarian cancer continues to have the highest case fatality rate of all gynaecologic malignancies. There is paucity of meaningful screening and diagnostic protocols. Present study was planned with the objective of assessment of the prevalence of ovarian cancer and the associated risk factors at a tertiary care centre.Methods: The present prevalence study was conducted at a tertiary care government hospital and entailed analysis of data of 73 patients of ovarian cancer. All the participants were subjected to comprehensive history taking, followed by general, systemic, per-speculum and per-vaginal examination. Serum tumour markers of the patients were assessed. Imaging studies including ultrasound, CT or MRI abdomen/pelvis were done as per need. Final diagnosis was confirmed on histopathology and the cases were classified according to histological classification of World Health Organization.Results: Majority (41, 56.2%) were aged more than 45 years and above, most of them with one to two previous issues (64.3%). The disease was observed to be more common in postmenopausal women (65, 89%). Three fourth participants had negative family history of ovarian or breast cancer. Out of 73 patients, 31 had value of CA 125 between 150-400 U/mL and 42 had values >400 U/mL. Epithelial ovarian cancer (serous- 33, 45.2%, mucinous- 18, 24.7%) was observed to be the commonest histological type.Conclusions: To diagnose ovarian tumours early using multipronged approach with focussed risk factor identification and screening with CA-125 is very important and is strongly recommended.

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