Clinico-epidemiological study and microbiological correlation of tinea incognito at a tertiary care hospital

Tinea incognito also known as steroid-modified tinea are dermatophytic infections modified by the use of topical or systemic corticosteroids. Dermatophytic infection being very common and very simple to diagnose, is a diagnostic dilemma due to steroid abuse. Hence making a simple curable infection into a chronic persistent dermatological condition. As a treating doctor it’s important to recognize and educate the patients regarding the tinea infections and steroid abuse. To study the various morphological presentations, epidemiology and etiological agent of tinea incognito. An observational study was performed with 100 cases from 2017 to 2019 in the department of Dermatology & Venerology, SS Institute of Medical Sciences and Research, Davangere, Karnataka, India. The baseline data, thorough general physical, local, and systemic examination were done with reference to clinical features of tinea incognito. Skin scraping were collected and subjected to potassium hydroxide (KOH) preparation. The part of the sample was inoculated into Sabouraud’s Dextrose Agar (SDA) media for fungal culture. Later the fungus was identified by standard techniques. The mean age of study population was 32.83 years. The males outnumbered females in our study. Almost 29% cases remain asymptomatic followed by 34% itching and 37% burning sensation. The source of drug responsible for tinea incognito were highly suggested by friends (29%) with the combination use of drugs account for 35% of study population. 77% cases showed erythema followed by 48% of hypopigmentation. The scraping of lesion showed positive KOH mount in 71% and T.mentagrophytes were the most common dermatophyte grown in SDA medium. Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.

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

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20211704 ◽

2021 ◽

Vol 7 (3) ◽

pp. 429

Author(s):

Rajesh Munuswamy ◽

Pramodhini Subramanian

Keyword(s):

Clinical Diagnosis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Skin Lesions ◽

Climatic Conditions ◽

Fungal Culture ◽

Care Hospital ◽

Age Group ◽

Male Preponderance ◽

Study Population

Background: 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.Methods: 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.Results: 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 Tinea corporis in 47.50% of the population., followed by Tinea Unguium in 28% and Tinea cruris 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 Trichophyton mentagrophyte (10%), followed by Trichophyton rubrum (9.5%) and Trichophyton tonsurans (5.5%). 55 (27.5%) of the people had both culture and KOH positive.Conclusions: 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.

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EVALUATION OF CLINICAL AND LABORATORY PROFILE OF ANAEMIA PATIENTS AT A TERTIARY CARE HOSPITAL

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i1.1705 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Bishwajit Prasad Azad ◽

Papu Kumar Safi ◽

Sachin Sinha ◽

Annushree Kalyan Dhengle

Keyword(s):

Complete Blood Count ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

General Medicine ◽

Care Hospital ◽

Age Group ◽

General Physical Examination ◽

Laboratory Profile ◽

General Physical ◽

Systemic Examination

Background: Globally, anaemia is the burning health problem with significant disability associated with it. Iron deficiency anaemia (IDA) is the commonest cause of anaemia more so in developing and underdeveloped part of world. Aim: To provide clinical and laboratory profile of anaemia patients at a tertiary care hospital in Bihar, India. Material and methods: This was a prospective observational study conducted in the Department of General Medicine Nalanda Medical College and Hospital, Patna, Bihar, India from November 2019 to June 2020. In all 120 patients thorough history was taken, general physical examination and systemic examination were done. Patients were subjected to routine blood investigations including complete blood count, peripheral smear study and serology for viral markers. Results: Among 120 patients studied 35(29.17%) were males and 85(70.83%) were females. In our study it was found that anaemia had its highest occurrence in the age group of 20-30 years 65(57.17%) followed by below 20 year age group 25(20.83%). 59 (49.17%) were easy fatiguability and generalised weakness the most common symptoms of anaemia in our study. Conclusion: We conclude that some extensive steps taken by WHO and Government bodies in educating and treating people about the disease. Keywords: Anaemia, Clinical profile, Laboratory profile

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Fungal Keratitis in Northern Thailand: Spectrum of Agents, Risk Factors and Putative Virulence Factors

Journal of Fungi ◽

10.3390/jof7060475 ◽

2021 ◽

Vol 7 (6) ◽

pp. 475

Author(s):

Siriporn Chongkae ◽

Sirida Youngchim ◽

Joshua D. Nosanchuk ◽

Angkana Laliam ◽

Chulaluck Tangmonkongvoragul ◽

...

Keyword(s):

Virulence Factors ◽

Vision Loss ◽

Proteolytic Enzymes ◽

Tertiary Care ◽

Fungal Keratitis ◽

High Rate ◽

Ocular Infection ◽

Fungal Culture ◽

Care Hospital ◽

Northern Thailand

Fungal keratitis (FK) is a serious ocular infection that can result in various degrees of vision loss, including blindness. The aim of the study was to identify and retrospectively review all FK cases diagnosed between August 2012 and December 2020 at a tertiary care hospital in northern Thailand with a specific focus on epidemiologic features, including season, patient sex and age, the spectrum of pathogens, and presence of certain putative virulence factors. Of 1237 patients with corneal ulcers, 294 (23.8%) were confirmed by direct microscopic examination and/or fungal culture. For the positive cases, direct examinations of Calcofluor white (CW) stains and KOH mounts were found in 97.3% (286/294) and 76.5% (225/294), respectively (p < 0.05). Of the cases diagnosed by microscopy and culture, fungi were isolated in 152 (51.7%), with Fusarium spp. being the most frequently identified (n = 69, 45.5%) followed by dematiaceous fungi (n = 45, 29.6%) and Aspergillus spp. (n = 18, 11.8%). The incidence of FK was higher in the rainy season of July to October. The mean age was 54.4 ± 14.4 (SD) years, with a range of 9–88 years. Males (75.8%) were affected significantly more than females (24.2%) (p < 0.05). Of 294 patients, 132 (44.9%) were middle-aged adults (41–60 years) and 107 (36.4%) were older than 60 years. Trauma to the eye by soil or vegetative matter were the most common preceding factors (188/294; 64.0%). We assessed two virulence factors. First, 142 of the 152 culture-positive FK cases were due to molds, indicating that hyphal morphogenesis is extremely important in disease. We also demonstrated that fungal melanization occurs in the molds during the course of FK by applying a melanin-specific monoclonal antibody (MAb) that labeled fungal elements in corneal samples of patients, and melanin particles derived from the hyphae were also recovered after treatment of the samples with proteolytic enzymes, denaturant and hot concentrated acid. In summary, we demonstrate that northern Thailand has a high rate of FK that is influenced by season and males engaged in outside activities are at highest risk for disease. Moulds are significantly more commonly responsible for FK, in part due to their capacity to form hyphae and melanins. Future studies will examine models of fungal corneal interactions and assess additional factors of virulence, such as secreted enzymes, to more deeply decipher the pathogenesis of FK.

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Adverse Drug Reaction Policy in a Tertiary Care Hospital

International Journal of Research Foundation of Hospital and Health Care Administration ◽

10.5005/jp-journals-10035-1035 ◽

2015 ◽

Vol 3 (1) ◽

pp. 41-47

Author(s):

V Aggarwal ◽

Shakti Kumar Gupta ◽

DK Sharma ◽

S Arya ◽

S Singh

Keyword(s):

Adverse Drug Reaction ◽

Drug Reaction ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Study Population ◽

Personnel Paramédical

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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Steroid-induced Rosacea- A Study From a Tertiary Care Hospital of Eastern Nepal

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.35952 ◽

2021 ◽

Vol 19 (1) ◽

pp. 25-29

Author(s):

Manoj Chaudhary ◽

Sudha Agrawal

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Case Series ◽

Sun Exposure ◽

Care Hospital ◽

Facial Erythema ◽

Case Series Study ◽

The Face ◽

Triggering Factor ◽

Study Population

Introduction: Topical corticosteroids (TC) are useful for treatment of various dermatological conditions in all age groups. Due to its cosmetic application TCs misuse is intertwined with fairness creams in our colour conscious society where people are obsessed with fair colour. Aims and Objectives: To find the clinical presentations of steroid induced rosacea like-dermatitis on the face and to evaluate the purpose behind misusing TCs on the face. Materials and methods: Descriptive prospective questionnaire-type case series study was approved by Institutional Ethical Committee of BPKIHS which involved 205 patients diagnosed as Steroid Induced Rosacea who consulted Dermatology OPD between March to June 2017. Results: Among 205 patients enrolled, majority were from second to fourth decade (87.31%) of their life and maximum being females I.e. 91.2%. Around 97% of the study population were unaware of side effects of TCs. Most patients use Mometasone fuorate (58.04%) for melisma (88.29%). Friends acted as source of prescription (29.75%), followed by Pharmacist (24.88%) & Beauty centers (20%). Dermatologists prescribed TCs in only 6.34% cases. Sun exposure was identified as the triggering factor for steroid induced rosacea in 73.17% patients. Cheek was the commonest site involve in 92.19%, followed by forehead (65.36%), perioral area (46.83%), and chin (9.75%). Mixed type of lesions was the commonest lesion found in 52.20% patients, followed by diffuse facial erythema (36.09%), & telangiectasia (33.17%). Conclusion: TCs misuse in the younger people for the sake of fairer skin with little or no knowledge about the adverse effects of this medication should be stopped.

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Retrospective analysis of the most common cause of rejection of donors for blood donation

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20210604 ◽

2021 ◽

Vol 8 (3) ◽

pp. 444

Author(s):

Garima Vijayvergiya ◽

Parag Fulzele ◽

Naveen Vairyamoorthy

Keyword(s):

Blood Pressure ◽

Blood Donor ◽

Blood Donation ◽

Tertiary Care ◽

Geographical Area ◽

Rejection Rate ◽

Developed Countries ◽

Care Hospital ◽

Systemic Examination ◽

Safe Blood

Background: A significant imbalance in access to safe blood is seen between the developing and developed countries. Donor selection has a pivotal role in preventing transfusion related complications and provide safety to the recipients. In this study, we aimed to find out rate and causes of blood donor rejection in our hospital. Methods: A retrospective study conducted in a tertiary care hospital involving both the voluntary and replacement donors during the period September 2017 to December 2018. We included all those donors who were considered unfit for blood donation. All those who came for blood donation at our hospital were asked to fill up an enrolment form for a blood donor. A general and systemic examination were done. We calculated the rejection rate, listed the reasons for donor rejection, and analyzed the data.Results: Among 150 rejected blood donors, most were males [129 (86%)], and the rest were females [21 (14%)]. The rejection rate in our study was 3.29%. We found that the rejection rate of donors was different among voluntary and replacement donors. It showed that the most common reason for the temporary rejection of blood donation was low hemoglobin level, followed by abnormal blood pressure. Conclusions: A vast majority of donors were rejected temporarily [132 (88%)], while the rest of them were rejected permanently [18 (12%)]. Low Hb in females and abnormal blood pressure in males were the commonest causes of blood donor rejection. Many factors affect the similarities and variations between the most typical causes of blood donor rejection, such as geographical area, cultural, socio-economic, and educational factors.

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Frequency of familial short stature identified in children presenting with short stature at a Tertiary Care Hospital in Multan, Pakistan.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.07.5328 ◽

2021 ◽

Vol 28 (7) ◽

pp. 993-996

Author(s):

Waqas Imran Khan ◽

◽

Asia Noreen ◽

Summera Tabasum ◽

◽

...

Keyword(s):

Short Stature ◽

Tertiary Care ◽

Female Gender ◽

P Value ◽

Care Hospital ◽

Pediatric Endocrinology ◽

Multicenter Studies ◽

Study Population ◽

Age Range ◽

Study Setting

Objectives: The objective of my study was to determine the frequency of familial short height in children aged 3 to 14 years with short height. Study Design: Descriptive study. Setting: Department of Pediatric Endocrinology at The Children Hospital & Institute of Child health Multan (CH& ICH). Period: 1st November 2018 to 31st October 2019. Material & Methods: Eighty four patients were enrolled after taking informed consent from parents/guardians. Heights of all patients, parental heights, mid parental heights were plotted on CDC growth charts. Patients having familial short stature were noted down. Results: Out of 84 patients, 59 (70.2%) were males and 25 (29.85%) were females. Age range was 3-14 years. Mean age of the population was 8.68 ± 3.42 years and mean height and weight were 114.29 ± 24.62cm and 28.95±10.01 kg, respectively. Mean height for mother and father of the patients were 154.39 ±4.56cm and 171.10 ± 3.52cm, respectively. Out of 84 children, 21 (25%) patients had FSS. In our study population FSS was more seen in children < 8 years of age, female gender and families with income of > 20K/months with p value of 0.879, 0.129 and 0.592 respectively. Conclusion: Majority of children presenting with short stature have FSS and CDG and do not have an endocrine disorder. In our study, frequency of familial short stature in children aged 3 to 14 years was 25%. The results should be validated in multicenter studies.

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Study of anaemia profile in a tertiary care hospital in Karnataka, India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20201081 ◽

2020 ◽

Vol 7 (4) ◽

pp. 582

Author(s):

Appu Patil

Keyword(s):

Tertiary Care ◽

Public Health Problem ◽

Severe Anaemia ◽

Common Finding ◽

Major Public Health Problem ◽

Care Hospital ◽

Common Cause ◽

Working Age ◽

Systemic Examination ◽

A Prospective Study

Background: Anaemia is a major public health problem worldwide especially in developing countries like India. Nutritional cause of anaemia continues to predominate as the most common cause of anaemia. Objective of this study is to determine the clinical and laboratory profile of anaemia among patients admitted to our hospital.Methods: Our study was a prospective study in which thirty nine patients of anemia admitted to Medicine ward in SNMC and HSK hospital were studied for their clinical and laboratory characteristics. Duration of the study was 7 months from July 2019 to January 2020.Results: Anaemia was more common among females (65.1% of total patients). Patients aged less than 60 years contributed to 85% of patients. Pallor was the universal finding present in 100% of patients. On systemic examination haemic murmurs on auscultation was the most common finding present in 28.2% followed by hepatomegaly (17.94%). Microcytic and dimorphic anaemia constitute the bulk of anaemia.Conclusions: Nutritional anaemia particularly iron deficiency anaemia is the most common cause of anaemia. It tends to affect the working age group and females predominantly. Patients continue to present with severe anaemia to the hospital.

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A PROSPECTIVE OBSERVATIONAL STUDY OF CLINICAL PROFILE IN ETIOLOGY OF ANEMIA IN ELDERLY-A HOSPITAL BASED STUDY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

International Journal of Advanced Research ◽

10.21474/ijar01/13508 ◽

2021 ◽

Vol 9 (09) ◽

pp. 961-972

Author(s):

K. Shivaraju ◽

◽

Karanam Sai Arun ◽

Mandhala Saikrishna ◽

◽

...

Keyword(s):

Tertiary Care ◽

The Elderly ◽

Moderate Degree ◽

Care Hospital ◽

Tertiary Care Centre ◽

Total Study Population ◽

Study Population ◽

Poor Outcomes ◽

One Year ◽

Severe Degree

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.

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A study of secondary hyperparathyroidism in patients with chronic kidney disease in a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20190558 ◽

2019 ◽

Vol 6 (2) ◽

pp. 271

Author(s):

Vishnu Shankar H. ◽

Mahendra Kumar K. ◽

Jagadeesan M. ◽

Kannan R. ◽

Chitrambalam P. ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Secondary Hyperparathyroidism ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Study Population ◽

Chronic Morbidity ◽

Spss Software

Background: Secondary hyperparathyroidism (SHPT) is one of the less recognized complications in patients with chronic kidney disease (CKD). The prevalence of SHPT in various stages of CKD was evaluated by measuring the levels of intact parathyroid hormone (iPTH).Methods: This cross-sectional study was carried out in 100 CKD patients. Serum creatinine, calcium, phosphorous and iPTH levels were measured and statistical analysis was carried out using the SPSS software (IBM, NY, USA).Results: Among the 100 participants, the mean age (SD) was 59.3 (7.8) years. In our study population, 52% were men and the rest were females. Hypertension (75%) was the most common chronic morbidity. Prevalence of hyperparathyroidism among chronic kidney disease patients was 22% (95% CI: 14.7-30.9%). The prevalence of secondary hyperparathyroidism among dialysis and non-dialysis patients were 30% and 14% respectively which was statistically significant.Conclusions: SHPT is an important complication which is often underdiagnosed. Secondary hyperparathyroidism starts to develop when eGFR falls below 60ml/min. PTH levels starts to rise as the disease progress. Hence it is important for the treating physicians to monitor the PTH levels early in the course of CKD to prevent and treat bone mineral disease.

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