scholarly journals A clinical and mycological study of dermatophytosis in a tertiary care hospital

Author(s):  
Rajesh Munuswamy ◽  
Pramodhini Subramanian

<p class="abstract"><strong>Background:</strong> With changing climatic conditions, socio-demographic profile, economic conditions and occupational profile of the population, the profile of the dermatophyte infections is also changing. Hence, the study was done to find out the prevalence of various clinical pattern of dermatophytosis and correlate the clinical diagnosis with KOH positivity and fungal culture positivity.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study was conducted in a tertiary care hospital, Puducherry. The study included patients presenting to the dermatology outpatient department with skin lesions suggestive of dermatophyte infections between January 2016 to July 2017. The KOH test and fungal culture were done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients was 33.65±11.61 years, with the majority belonging to 16 to 30 years of age group. There was a high male preponderance 72% with male:female ratio of 2.57:1. The most common clinical diagnosis was <em>Tinea corporis</em> in 47.50% of the population., followed by <em>Tinea Unguium</em> in 28% and <em>Tinea cruris</em> in 19.50%. KOH positivity was seen in 86 (43%) out of 200 cases in the study population. The culture was positive in 55 (27.50%) of the study population. The most common organism isolated in culture was <em>Trichophyton mentagrophyte</em> (10%), followed by <em>Trichophyton rubrum</em> (9.5%) and <em>Trichophyton tonsurans</em> (5.5%). 55 (27.5%) of the people had both culture and KOH positive.</p><p class="abstract"><strong>Conclusions:</strong> Dermatophyte infections commonly affect the young and economically productive age group of 16 to 30-year, with high male preponderance. KOH tends to show a higher proportion of positivity as compared to culture.</p>

Author(s):  
Nisha Gupta ◽  
Rekha Sharma ◽  
Rukma L. Sharma

<p><strong>Background:</strong> Alopecia areata is a condition that is characterized by a well-defined round or oval patches of non-scaring hair loss in scalp or any hairy area of the body. Alopecia areata has become a major health problem faced by people all over the world. This research was done to ascertain the prevalence of alopecia areata in different age group and to study its association with autoimmune diseases and systemic illnesses.</p><p><strong>Methods:</strong> The present hospital based descriptive study includes 52 alopecia areata patients attending dermatology out-patient department.</p><p><strong>Results:</strong> It was seen that the disease can occur at any age group mostly affecting those between 21-40 years. The age of presentation varied from 14 to 48 years with male preponderance. It was found that arthritis was associated in 30.7%, ANA was positive in 7.7% and 12% had hypothyroidism. Eosinophilia was found in 34.6% and 7.7% had asthma among then.</p><p><strong>Conclusions:</strong> Our study shows that it could be associated with autoimmunity, thyroid abnormality, atopy and inflammation.</p>


Author(s):  
BHUVANESHWARI S ◽  
VIJAYA D

Objectives: This study was planned to study the association of ramipril and telmisartan with hyponatremia and to compare the hyponatremia effect of ramipril and telmisartan. Methods: The study was conducted in a tertiary care hospital. Serum sodium levels were assayed in patients taking ramipril and telmisartan. Fifty-one patients were recruited. The patient’s age, gender, drug dosage, and frequency of drug administration were collected using a pro forma. Statistical analysis of data was performed using SPSS version 23.0. Results: About 35.3% (28 out of 51) of the study population administered with ramipril and telmisartan developed hyponatremia. Predisposition to develop hyponatremia was high in males compared to females. Incidence of hyponatremia was 43.8% (7 out of 16) in the age group of 50–60 years. Although, incidence of hyponatremia was 56.5% (13 out of 23) in ramipril group compared to 17.9% (5 out of 28) in telmisartan group, it was not statistically significant. Conclusion: The current study laid emphasis on the requisite for monitoring of serum sodium level in patients on ramipril and telmisartan administration to avoid morbidity and mortality due to unexpected adverse reactions.


2017 ◽  
Vol 4 (1) ◽  
pp. 27-29
Author(s):  
M. Belbase ◽  
J. Adhikari ◽  
T.A. Khan ◽  
R.K. Jalan

Introduction: Schizophrenia is one of the severe mental health problem and its guarded treatment response and association with as the stigma makes it a chronic debilitating personal, family and social problem of all the psychiatric illness. Timely Identification and management of this condition is important as early diagnosis and management gives better treatment response.Methods: This is a descriptive study done in patients attending psychiatry OPD of Nepalgunj Medical College, Kohalpur for 12 months from June 2013 to May 2014.Results: Out of the 86 study subjects (n=86), males were 54 in number followed by 32 females. The most common age group was 21-40 years representing 46(53.4%), followed by 41-60 years 24(28%), <20 years 12(13.9%) and >60 years 4(4.7%). The most common first contact of the patient with schizophrenia was with faith healers 54 (62.8%) followed by consultation with psychiatrist 18(20.9%). Among the study population, 38(44.2%) visited to the psychiatrist after >41 weeks of the beginning of the illness followed by 34(39.5%) visited in <10 weeks of the beginning of the schizophrenia.Conclusions: Faith healers were the most common first contact person for the patients with schizophrenia followed by psychiatrist . Most of the schizophrenia patients come to psychiatrist after 40 weeks of their illness.


2018 ◽  
Vol 5 (9) ◽  
pp. 3078
Author(s):  
Mahesh S. V. ◽  
Dilip Kumar Reddy ◽  
Hota P. K.

Background: Non-traumatic gastrointestinal perforations have received far less attention in the recent medical literature than inflammations, tumoral or traumatic lesions of solid abdominal organs. The objective is to study perforations among patients at a tertiary care hospital.Methods: Patients diagnosed as non-traumatic perforations of the internal organs as diagnosed by authors were planned to be included for the present study. Diagnosis was based on history, clinical examination, and required investigations. All such patients were included in the present study that was enrolled for the present study during the study period. Such 50 patients could be studied. Non-traumatic perforation with regard to age, sex, causes, clinical presentation, diagnostic modalities required was evaluated.Results: Most common age group involved is in 3rd to 4th decade in the present study. Male preponderance (82%) was seen; with a male to female ratio was 4.6:1. The time lapse between onset of symptoms and presentation at the hospital was more than 24 hours in 24% of the study population. Abdominal pain was the most consistent symptom and was seen in 100% of the study population in the present study followed by vomiting (52%) and fever (46%). Distended abdomen was seen in 46% of study population in the present study. Tenderness was seen in all the cases and is more prominent at the site of perforation. Guarding/rigidity and absent bowel sounds were seen in 92% of the study population. Sensitivity of imaging in detecting gas under diaphragm was 72% by USG abdomen and 80% by plain radiography.Conclusions: Risk factors for increased morbidity and mortality in the present study include older age group, delayed presentation and features of shock.


Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.


Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.


2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.


2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nadia Gulnaz ◽  
Sadia Tasleem ◽  
Farooq Abdullah

Abstract Traditionally acute appendicitis has been a clinical diagnosis based on patients' history and physical examination, but the accuracy of clinical diagnosis ranges from 70-95%. Pre-operative diagnosis of acute appendicitis still remains an enigmatic challenge, because no single test alone can reduce the rate of negative appendectomy. Hence some authors have recommended a combination of two or more investigations to increase accuracy and therefore the use of imaging is gaining support. The objective of the study was to determine the clinical accuracy of ultrasound, combined with inflammatory markers such as CRP, WBC, and neutrophilia keeping histopathology as the gold standard. Methods The study was conducted in a Tertiary care hospital in Peshawar from September 2014 to March 2015 on 250 patients who were clinically diagnosed with acute appendicitis. All these patients underwent u/sound scanning in addition to blood tests. Findings In this study, WBC had the highest sensitivity (77.68%) followed by neutrophil% (69.96%), CRP(67.10%), and U/Sound (62.96%) respectively. While U/Sound had the highest specificity (70.59%) followed by CRP and TLC (64.71% each) and neutrophil% (58.82%) respectively. When all the four tests were combined the sensitivity, specificity, (99.17% and 98.45%) increased significantly. When all four tests were negative, appendicitis could be safely ruled out. Conclusion Acute appendicitis is very unlikely and surgery can be safely deferred in these patients when all tests are negative thereby reducing the negative appendicectomy rates. 


Author(s):  
V Aggarwal ◽  
Shakti Kumar Gupta ◽  
DK Sharma ◽  
S Arya ◽  
S Singh

ABSTRACT Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality and contribute to the incidence of adverse events, resulting in increased healthcare costs. Healthcare providers need to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs. The purpose of this study is to provide guidelines regarding the procedure of reporting ADRs to hospital authority. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from one public and two private hospitals. Interaction was done with study population against the back drop of the checklist and ADR policy was formulated. How to cite this article Singh S, Gupta SK, Arya S, Sharma DK, Aggarwal V. Adverse Drug Reaction Policy in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):41-47.


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