scholarly journals Study of Proportion and Pattern of Sick Euthyroid Syndrome in Patients with Sepsis in Intensive Care Unit of a Tertiary Care Hospital in South Kerala

2020 ◽  
Vol 7 (51) ◽  
pp. 3094-3098
Author(s):  
Akhil Krishna ◽  
Mohammed Naseem Yakoobali ◽  
Sunil Prasobh Prabhakaran
Keyword(s):  
Thyroid Hormone ◽  
Tertiary Care ◽  
Previous History ◽  
Consensus Conference ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Common Pattern ◽  
Cross Sectional ◽  
Low T3 ◽  
Sick Euthyroid

BACKGROUND Patients with critical illness can have changes in thyroid hormone metabolism along with changes within the hypothalamus-pituitary-thyroid axis, even though there is no previous history of thyroid disease. Such changes have been named as “Sick Euthyroid Syndrome” or “Non-Thyroidal Illness Syndrome (NTIS)”. Such alterations in thyroid function can be seen in patients with sepsis and they are known to affect the prognosis of the disease. The most common abnormality in sick euthyroid syndrome is low serum T3. This study aims to find the proportion and pattern of sick euthyroid syndrome in patients with sepsis. METHODS This was a hospital based cross sectional study done in the Department of Internal Medicine in a tertiary care centre in south Kerala. 100 patients with diagnosis of sepsis were selected based on American College of Chest Physician / Society of Critical Care Medicine 2001 Consensus Conference definitions, and included in the study. Serum levels of total T3, total T4 and TSH were measured and the proportion of patients with various abnormalities in thyroid hormone levels and the pattern of abnormalities were analysed. RESULTS The mean age of study group was 67.9 years (with standard deviation of 7.184). Female to male ratio was 1.08:1. Proportion of sick euthyroid syndrome in patients with sepsis was 71 %. Low T3 was seen in 69 % patients, low T4 in 11 % and low TSH in 11 %. TSH was above reference range in 3 % patients. The most common pattern of sick euthyroid syndrome was low T3 with normal T4 and TSH in 54 % patients. Low T3 with low T4 and normal TSH was seen in 6 % patients; low T3, T4, TSH in 5 % patients; low T3, elevated TSH, normal T4 in 3 % patients; low TSH with normal T3 and T4 in 2 % patients and low T3, low TSH and normal T4 in 1 % patients. CONCLUSIONS Proportion of sick euthyroid syndrome in sepsis was 71 % and the most common pattern was low T3 with normal T4 and TSH seen in 54 % patients. KEYWORDS Sick Euthyroid Syndrome, T3, T4, TSH

scholarly journals Study of thyroid function in patients admitted in intensive care unit in a tertiary care centre

2018 ◽  
Vol 6 (8) ◽  
pp. 2717
Author(s):  
T. V. D. Sasi Sekhar ◽  
Ramya Appalaneni ◽  
Avinash Jada ◽  
Shalima Pinnamaneni
Keyword(s):  
Intensive Care ◽  
Venous Blood ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Reverse T3 ◽  
Cross Sectional ◽  
Hormone Levels ◽  
Low T3

Background: Thyroid hormones play a key role in the maintenance of body growth by modulating metabolism and the immune system. These alterations in thyroid hormone levels are referred to as “euthyroid sick syndrome” or “non thyroidal illness syndrome” (NTIS), which is characterized by low serum levels of free and total triiodothyronine (T3) and high levels of reverse T3 (rT3) accompanied by normal or low levels of thyroxine (T4) and thyroid-stimulating hormone (TSH). During critical illness, changes in circulating hormone levels are a common phenomenon. These alterations are correlated with the severity of morbidity and the outcomes of patients in ICU.Methods: This study was carried out at a tertiary care hospital. 100 patients of age above 18yrs, both sexes, admitted to intensive care units with following diseases Septicemia, ARF, Respiratory failure, CCF, DKA, Stroke were taken into the cross-sectional study. Relevant hematological and radiological examination are done. Fasting venous blood samples were collected immediately on admission to ICU from all patients and were subjected for hormone analyses. Samples were tested for total T3, total T4, and TSH. The hormone estimation was done by chemiluminescence assay.Results: Patients (59%) had low T3 level, 41(41%) patients had normal T3, 31 patients (31%) had low T4, 69 patients (69%) had normal T4 level and TSH was low in 11 patients (11%), 76 patients (76%) had normal TSH and 14 patients (14%) slightly high. Our study showed low T3 (59%) is the commonest abnormality in ICU admitted patients. There is a significant relation present between T3 and mortality (p value-0.0001) and need for ventilation (p value 0.004).Conclusions: Our study suggests that low T3 is an important marker of mortality in ICU admitted patients. We suggest that in ICU patients T3 levels should be done and used as a prognostic marker for mortality and need for ventilation.

scholarly journals A cross sectional study on demographic factors affecting low birth weight

2019 ◽  
Vol 6 (11) ◽  
pp. 4896
Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Affecting

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.

Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India

2021 ◽  
Vol 17 ◽  
Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Set Up

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.

Clinical Profile of Polycystic Ovarian Syndrome Patients In Tertiary Care Hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 99-103
Author(s):  
Dr. Urmila Gavali ◽  
Dr. Mayuri Pawar ◽  
Dr. Gautam Aher ◽  
Dr. Suhas Shinde
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Genetic Disorder ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Complex Genetic Disorder ◽  
Uncertain Etiology ◽  
Ovarian Syndrome

ABSTRACT: Background: Polycystic ovarian syndrome (PCOS)is common gynecological endocrinopathy characterized by chronic anovulation and hyperandrogenism affecting 5-10% of women worldwide.  It is a heterogenous, multifactorial, complex genetic disorder with uncertain etiology and is one of the most common treatable cause of infertility. AIM: To study the various clinical presentations in polycystic ovarian syndrome. MATERIALS AND METHODS: Present study is cross sectional observational study carried out in tertiary care centre. This study was performed in the Out Patient Department of Obstetrics and Gynecology. RESULTS: The mean age of 41 patients in the study was 23.6 years. Most common presenting symptom in patients is menstrual irregularities (89%) followed by infertility and hirsutism. USG (abdo+pelvis) showing polycystic ovarian syndrome ovaries. Around 39% patients with PCOS developed insulin resistance. KEYWORDS: - Amenorrhea, Infertility, Oligomenorrhea, Polycystic Ovarian Syndrome.

scholarly journals Assessment of Knowledge, attitude and practices of Epilepsy Patients’ towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia

2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Negative Attitude ◽  
Median Number ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Medical Attention ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553

scholarly journals A study to determine the prevalence of urinary incontinence in antenatal women at a tertiary care centre in central India

2020 ◽  
Vol 9 (3) ◽  
pp. 956
Author(s):  
Deepa Joshi ◽  
Sheetal Achale ◽  
Nilesh Dalal ◽  
Alka Patel
Keyword(s):  
Urinary Incontinence ◽  
Pregnant Women ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Previous History ◽  
Case Report Form ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Pregnancy And Postpartum ◽  
In Pregnancy

Background: Urinary incontinence is a common condition in pregnancy and postpartum. There are more than a thousand articles on urinary incontinence (UI) in pregnancy but very limited literature from Indian subcontinent is available. Incidence and prevalence figures of UI in association with pregnancy vary substantially. Not many reviews have focused solely on incidence and prevalence of UI in association with pregnancy. Prevalence of UI in pregnancy ranges from 32% to 64%.Methods: A cross sectional observational study was conducted in the department of obstetrics and gynecology, MGM Medical College and M.Y. Hospital, Indore over the period of 6 months on 1000 pregnant women who were following antenatal care (ANC) clinic. Pregnant women, who were severely sick, diagnosed with kidney or urinary infection and vaginal infections women were excluded from the study. The data were collected using a structured questionnaire. After the purpose of the study was explained, written consent was obtained from each voluntary participant. This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA 12.1.Results: In the present study the prevalence of urinary incontinence reported is 16.4% of women during pregnancy.Conclusions: In this study the prevalence of UI during current pregnancy was found to be lower compared to previous studies conducted. The previous history of surgery, constipation, obesity and respiratory problems were found to be significantly associated with UI during pregnancy.

Various presentations of preeclampsia at tertiary care hospital of Sindh: A Cross-Sectional Study

2019 ◽  
Vol 15 ◽  
Author(s):  
Feriha Fatima Khidri
Keyword(s):  
Hellp Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous History ◽  
Cross Sectional Study ◽  
Severe Preeclampsia ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mild Preeclampsia

Background: Preeclampsia is the multi-systemic hypertensive pregnancy disorder accompanied by proteinuria. Objectives: To determine the frequency of different presentations of preeclampsia in tertiary care hospital and find out its risk factors. Materials and Methods: Present study was hospital based cross-sectional study and conducted from 1st August 2015 to 31st July 2016 in Gynaecology and Obstetrics department, Liaquat University of medical and health sciences (LUMHS), Hyderabad after ethical approval. A total of 112 pre-eclamptic women were enrolled during the study period by non-probability consecutive sampling. Patients were divided on the basis of their presentations into mild preeclampsia, severe preeclampsia, antepartum eclampsia, intrapartum eclampsia, HELLP syndrome, postpartum preeclampsia, postpartum eclampsia and atypical preeclampsia/eclampsia. All the socio-demographic factors and clinical variables were noted. Frequency and percentage were calculated for categorical variable and mean/standard deviation (SD) for continuous variables. Results: Of the 112 preeclamptic women, 54.5% admitted with antepartum eclampsia, 12.5% with severe preeclampsia, 8.9% with atypical preeclampsia/eclampsia, 8% with mild preeclampsia, 8% with postpartum eclampsia, 3.6% with HELLP syndrome, 2.7% with intrapartum eclampsia and 1.8% with postpartum preeclampsia. Over all, majority of the patients were primigravida (57%), had gestational age >34 weeks at presentation (58.9%) and <7 antenatal visits (88.3%) during their pregnancy. Over all 17.8% had previous bad obstetrical event, 11.6% had previous history of preeclampsia and 64.3% had consanguineous marriages. Conclusion: Different presentations of preeclampsia may help obstetricians to rule out high risk pregnancies and provide antenatal care to patients earlier to prevent complications to both mother and fetus.

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

scholarly journals Patients’ knowledge of prescribed medication: a cross sectional study in a tertiary care centre, Mumbai

2019 ◽  
Vol 6 (10) ◽  
pp. 4238
Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate
Keyword(s):  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Study Population

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.

scholarly journals Psychiatric Disorders in Adolescents Attending Psychiatry Outpatient Department in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Neelam Joshi ◽  
Asim Shrestha ◽  
Deepika Karki ◽  
Pradip Man Singh
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Psychotic Disorders ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.

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