STUDY OF CLINICAL PRESENTATIONS OF PATIENTS WITH HYPERPROLACTINAEMIA VISITING A TERTIARY CARE HOSPITAL

Introduction: This study was conducted to evaluate the clinical presentations and management of various Orbito-ocular malignancies in Nepal. Materials and methods: This is a prospective study of ocular malignant cases conducted at a tertiary care eye hospital in Kathmandu, Nepal. One hundred and seventeen newly diagnosed eyes with ocular malignancy of 106 patients presenting to the clinic in a year from September 2018 to August 2019 were included for analysis. Patients’ demography, clinical features, various types of malignancies seen in eyes and their management were evaluated. Results: The mean age of patients was 30.35 years with a range from 1 month to 84 years and standard deviation of 26.63. 56% of the total were male. Red eyes and visible mass were the most common symptoms in 23% with intraocular contents in 48% being the most common site involved. Different types of ocular malignancies were detected, among which retinoblastoma was the most common in 38% of patients. Diagnosis in most patients was clinical and/or radiological; incision biopsy was required in 1.7% patients only. Surgical excision of the tumor was the most common treatment done in 29% followed by enucleation in 27% of eyes. Bilateral involvement of the eyes was seen in 10% of the patients. Conclusion: Malignant orbito-ocular tumors can be seen in any age group. Retinoblastoma is the commonest malignancy seen. With the help of imaging, diagnosis is near accurate; hence biopsy is not required in most cases before commencing treatment.

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Clinical manifestations of nocardiosis: Study of risk factors and outcomes in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_111_16 ◽

2017 ◽

Vol 9 (04) ◽

pp. 288-295 ◽

Cited By ~ 1

Author(s):

Teena Wadhwa ◽

Usha Baveja ◽

Navin Kumar ◽

Deepak Govil ◽

Sharmila Sengupta

Keyword(s):

Risk Factors ◽

Retrospective Analysis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Manifestations ◽

Immunosuppressive Drugs ◽

Care Hospital ◽

Immunocompromised Patients ◽

Radiological Findings ◽

Clinical Presentations

Abstract PURPOSE: The aim of this study is to evaluate the predisposing risk factors, clinical presentations, laboratory parameters, and treatments taken and outcomes in patients of nocardiosis in the span of 5 years in a tertiary care hospital. MATERIALS AND METHODS: The patients whose specimens showed Nocardia like organism in Gram-staining, Kinyoun staining and characteristic colonies in culture were included in the retrospective analysis study. Retrospective analysis of associated risk factors, clinical presentations, and radiological findings was performed. RESULTS: Of the thirteen patients, 11 (76.9%) had immunosuppressive pathologies including solid organ transplantation, autoimmune disease, use of steroids, and immunosuppressive drugs as important risk factors. Four types of clinical manifestations were observed, pulmonary (46.1%), cutaneous (23.07%), cerebral (15.3%), and bacteremia (15.3%). The most common presentation was pulmonary with steroid therapy as a significant risk factor. Consolidation and pleural effusion were the common radiological findings in these cases. In eight of the nine patients anti-nocrdial drugs were given. Cotrimoxazole as monotherapy was given in four cases (44.44%), cotrimoxazole in combination with meropenem in two cases (22.22%); minocycline and linezolid were given in one case each. The overall mortality was 36.36% and was seen in patients with pulmonary nocardiosis. CONCLUSIONS: The study indicates that Nocardial infections are re-emerging on account of an increase in numbers of immunocompromised patients due to increased organ transplants, autoimmune diseases, malignancies, and use of immunosuppressive drugs and steroids. The diagnosis is often missed/not suspected and delayed because of the clinical resemblance to many other infections. Nocardial infection should be suspected and assessed particularly in immunocompromised patients not responding to treatment/improving clinically.

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Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital

Surgery Research and Practice ◽

10.1155/2015/847681 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Siripong Sirikurnpiboon ◽

Suparat Amornpornchareon

Keyword(s):

Acute Appendicitis ◽

Elderly Patients ◽

Medical Records ◽

Tertiary Care Hospital ◽

Demographic Data ◽

Tertiary Care ◽

Perforated Appendicitis ◽

Care Hospital ◽

Clinical Presentations ◽

Perforation Group

Background. The incidence of perforated appendicitis in elderly patients is high and carries increased morbidity and mortality rates. The aim of this study was to identify risk factors of perforation in elderly patients who presented with clinical of acute appendicitis.Methods. This was a retrospective study, reviewing medical records of patients over the age of 60 years who had a confirmed diagnosis of acute appendicitis. Patients were classified into two groups: those with perforated appendicitis and those with nonperforated appendicitis. Demographic data, clinical presentations, and laboratory analysis were compared.Results. Of the 206 acute appendicitis patients over the age of 60 years, perforated appendicitis was found in 106 (50%) patients. The four factors which predicted appendiceal rupture were as follows: male; duration of pain in preadmission period; fever (>38°C); and anorexia. The overall complication rate was 34% in the perforation group and 12.6% in the nonperforation group.Conclusions. The incidence of perforated appendicitis in elderly patients was higher in males and those who had certain clinical features such as fever and anorexia. Duration of pain in the preadmission period was also an important factor in appendiceal rupture. Early diagnosis may decrease the incidence of perforated appendicitis in elderly patients.

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Prevalence, risk factors and clinical presentations of patients with peripheral vertigo: a retrospective study from a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20160199 ◽

2016 ◽

pp. 106-109

Author(s):

Raveendran Rahul ◽

Chakramakal Andrews ◽

Karuthedath Sridevi ◽

Arayamparambil Vinayakumar

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Clinical Presentations ◽

Peripheral Vertigo

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EP.FRI.56 Spectrum of Clinical Presentation, Radiological Findings and Management of Tuberculosis on the Surgical Floor - An Experience from a Tertiary Care Hospital in Pakistan

British Journal of Surgery ◽

10.1093/bjs/znab312.013 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hamza Waqar Bhatti ◽

Marryam Riaz Farooqui ◽

Ayesha Khalid ◽

Saad Ullah Sarfaraz Janjua ◽

Huma Sabir Khan ◽

...

Keyword(s):

Intestinal Perforation ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Intestinal Tuberculosis ◽

Preoperative Assessment ◽

Right Hemicolectomy ◽

Anatomical Site ◽

Care Hospital ◽

X Ray ◽

Clinical Presentations

Abstract Aim Abdominal tuberculosis has varied presentation and can be confused with other conditions. The aim of the study is to assess and evaluate various clinical presentations and management of intestinal tuberculosis presenting to our tertiary care hospital. Methods This 3-year descriptive study was conducted on patients with diagnosed intestinal tuberculosis (by histopathology) in Surgical Unit-II, from Jan 2017 to Jan 2020. Detailed history and clinical examination were performed in all the cases. Investigations like Blood CP and ESR, Albumin, Ultrasound abdomen, X-Ray abdomen were carried out in all the cases. Preoperative assessment of anatomical site and variety of lesions were also noted. Per-operative findings and procedure performed was recorded. Results A total of 85 patients with diagnosis of intestinal tuberculosis were admitted and operated. Diagnosis was confirmed by histopathology. Among these, 35 (40.7%) were male, and 50 (59.3%) were female. Variable clinical presentations were seen. Majority of patients 76(89.3%) had abdominal pain 55 (64.8%) had vomiting. Most common per-op findings included strictures 42 (50%), intestinal perforation 35 (40.7%) and multiples tubercles in abdomen 24 (28.7%). Most common procedures performed were ileostomy 45 (52.8%) and right hemicolectomy 28 (33.3%). X ray and Ultrasound findings were positive in 79(91.6%) and 67 (79.6%) cases only respectively. Conclusion High clinical suspicion is required for diagnosis of TB. Intestinal perforation, and strictures were the commonest lesions. Definitive surgical procedure like ilecolostomy and right hemicolectomy are the main surgical options.

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Imaging Manifestations of Accessory Cavitated Uterine Mass—A Rare Mullerian Anomaly

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1735504 ◽

2021 ◽

Author(s):

Tharani Putta ◽

Reetu John ◽

Betty Simon ◽

Kirthi Sathyakumar ◽

Anuradha Chandramohan ◽

...

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Imaging Characteristics ◽

Clinical Presentations ◽

Endometrial Cavity ◽

Mullerian Anomaly

Abstract Context Accessory cavitated uterine mass (ACUM) is an uncommon and under-recognized entity with distinct imaging characteristics and causing significant patient distress. Differentiating it from its other clinical and radiological differentials is therefore extremely important and prevents delay in surgical management which is the treatment of choice. Aims The aim of the study is to describe the MRI appearance of the surgically and pathologically proven ACUM cases from our institution in the last 2 years. Settings and Design This is a retrospective study in a tertiary care hospital in South India. Methods and Material We reviewed the clinical presentations and imaging findings of seven surgically proven cases of ACUM qualifying the proposed diagnostic criteria. Results All patients presented with chronic pelvic pain, dysmenorrhea, and prolonged post-menstrual pain. MRI in all seven cases showed an intramural, noncommunicating, and cavitating lesion near the uterine cornua with internal contents similar to that of endometrioma. Although the cavity was lined by endometrium in all the cases (proven in pathology), it was well appreciable on MRI in only five cases. The rest of the uterine myometrium and main endometrial cavity were normal with no features of adenomyosis. Conclusion MRI is a reliable diagnostic tool for accurate diagnosis of ACUM, and more importantly, in distinguishing it from other causes of chronic pelvic pain like adenomyosis and endometriosis and other imaging differentials like adenomyoma, noncommunicating uterine horn, and degenerating leiomyoma.

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Looking into Array of Clinical Presentations of Patients with Leprosy and their Clinico-epidemiological Profile: A Retrospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49116.15055 ◽

2021 ◽

Author(s):

Seema Goel ◽

Dimple Chopra ◽

Geetika Gera

Keyword(s):

Retrospective Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

World Health Organisation ◽

North India ◽

World Health ◽

Care Hospital ◽

Case Detection ◽

Who Grade ◽

Clinical Presentations

Introduction: The prevalence of leprosy in India has decreased to <1 per 10,000 population by 2016 after the introduction of Multidrug Therapy (MDT) in 1982; still wide variations in Prevalence Rates (PR) continue to exist across the states and regions in the country. Aim: To determine the current clinical profile of leprosy and study various presenting features of patients with leprosy at a tertiary care hospital in North India. Materials and Methods: A retrospective study, based on seven years data, was conducted on patients diagnosed and registered in the leprosy clinic of a tertiary care hospital in North India, from January 2013 to December 2019. Data regarding their demographic details, presenting complaints, clinical features, associated complications and treatment administered was analysed and was entered into Microsoft Excel and presented as tables. Results: A total of 181 patients of leprosy were registered over a period of seven years. There were 133 males and 48 females with M:F ratio of 2.77:1. Of the total patients registered, 3.86% were children (≤14 years) and 97.8 % patients were immigrants from the adjoining states. The most common clinical type was Multibacillary (MB) leprosy in 88.95% patients whereas most frequent morphological type was Borderline Tuberculoid (BT) leprosy (72.93%). Thirty-three (18.23%) patients presented with leprosy reaction (Type 1 reaction in 16.6% and Type 2 reaction in 1.66%). World Health Organisation (WHO) grade 2 deformities (G2D) were diagnosed in 3 (1.66%) patients, with claw hand being the most common deformity (1.10%). Anaesthetic to hypoaesthetic patches were the most common presenting feature (64.1%). Conclusion: Despite statistical elimination, MB disease and leprosy reactions are commonly seen as presenting manifestations. It highlights the need for high quality leprosy services including good referral system for an active case detection. Varied clinical presentations of leprosy should be contemplated while examining patients that can assist in an early and better case detection that will prevent delay in therapy and associated deformities and also decrease the transmission of disease in the community.

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