scholarly journals A Comparative Study of CURB-65 and Expanded CURB-65 Scoring Systems in Community Acquired Pneumonia in a Tertiary Care Centre of Patna

2021 ◽  
Vol 8 (16) ◽  
pp. 1074-1078
Author(s):  
Debjit Mitra ◽  
Uttiya Roy ◽  
Abhay Kumar Sinha ◽  
Shiv Shankar Bharti
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Scoring System ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Co Morbidity ◽  
Significant Difference

BACKGROUND A variety of organisms cause community-acquired pneumonia, including bacteria, viruses and fungi. Pathogens vary in age and other factors, but the relative importance of each pneumonia as a cause of community-acquired pneumonia remains uncertain because most patients do not undergo thorough testing and because even when tested, specific agents are found in < 50 percent of cases. This study was conducted to evaluate a severity scoring system for community acquired pneumonia and compare it with the standard confusion, urea, respiratory rate, blood pressure and 65 years of age or older (CURB-65) scoring system in a tertiary care centre in Patna Medical College. METHODS This hospital based prospective study was conducted among 100 consecutive patients of community-acquired pneumonia (CAP) attending OPD or getting admitted in General Medicine ward of Patna Medical College. The CURB-65 and Expanded CURB-65 scores for these patients were calculated and the accuracy of either in predicting outcomes was statistically analysed, during the period September 2018 - May 2019. RESULTS The mean age of CAP patients in our study was 59.09 ± 12.942 years, the most common co-morbidity observed was diabetes mellitus followed by chronic obstructive pulmonary disorders (COPD), cardiovascular disease, chronic liver disease and chronic renal disease. Our study showed that the mortality rate of the study population was 12 % and 30 % patients needed admission in the ICU and 24 % patients needed invasive mechanical ventilation. In the above analysis for 30-day mortality rate, ICU admission rate, and the need for mechanical ventilation among 0 - 2 and 3 - 5 CURB 65 scores, we found no statistically significant difference (P-value = > 0.05). CONCLUSIONS The extended CURB-65 score gives priority to both clinical and laboratory parameters and is a more accurate marker for the evaluation of CAP severity and may boost the effectiveness of predicting mortality in CAP patients compared to the current CURB-65 score system. KEYWORDS CAP, CURB-65, Expanded CURB-65

scholarly journals Comparison of Clinical Profile between P. vivax and P. falciparum Malaria in Children: A Tertiary Care Centre Perspective from India

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jagdish Prasad Goyal ◽  
Aarti M. Makwana
Keyword(s):  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Western India ◽  
Care Centre ◽  
Inclusion Criteria ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Significant Difference ◽  
Malaria Antigen ◽  
Low Incidence

Background. Malaria is a one of the leading causes of morbidity and mortality in tropical countries. Plasmodium vivax (P. vivax) is usually thought to be causing benign malaria with low incidence of complications as compared to Plasmodium falciparum (P. falciparum). Methods. This retrospective observational study included malaria patients who were admitted to K.T. Children Hospital and P.D.U. Government Medical College, Rajkot, a tertiary care teaching hospital, Gujarat, western India, during the period January 2012 to December 2012. Inclusion criteria were patients in whom either P. falciparum or P. vivax was positive on rapid malaria antigen test and peripheral blood smear. Patients showing mixed infections were excluded from study. Results. A total of 79 subjects (mean age 5.4±3.6 years) were included in the study. It consisted of 47 P. vivax and 32 P. falciparum cases. The P. vivax cases consisted of 33 (70.2%) males and 11 (19.8%) females while P. falciparum cases consisted of 14 (43.8%) males and 18 (56.2%) females. One patient of each P. vivax and P. falciparum expired. There was no statistical significant difference found between complications such as anemia, thrombocytopenia, liver and renal dysfunction, ARDS, and cerebral malaria between P. vivax and P. falciparum. Conclusion. We conclude that P. vivax monoinfection tends to have as similar course and complications as compared to malaria due to P. falciparum monoinfection.

A STUDY OF THE CLINICAL PROFILE OF PATIENTS WITH HYPOSPADIAS AT A TERTIARY CARE CENTRE AT KANPUR, INDIA

2021 ◽  
pp. 65-66
Author(s):  
R. K. Maurya ◽  
Shraddha Verma ◽  
R. K. Tripathi ◽  
Amit Yadav
Keyword(s):  
Prospective Observational Study ◽  
Undescended Testis ◽  
Tertiary Care ◽  
Care Centre ◽  
Common Site ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Treatment History ◽  
Congenital Hernia ◽  
Distal Hypospadias

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study the clinical prole of hypospadias. Settings and Design:This was a prospective, observational study. Methods: This prospective study was conducted at Department of General Surgery, LLR & Associated Hospitals, GSVM Medical College, Kanpur, India, from January 2019 to October 2020, on 72 patients of hypospadias, after taking clearance from the Institutional Ethical Committee, and taking proper informed consent for participation. Data collected for each patient included age, sex, demography, symptoms with duration, and relevant past and treatment history. Results: The most common age of presentation was between 1-5years of age (48.61%, n=35). Distal hypospadias (DH) was the most common site. (47.22%, n=34). 4.16% (n=3) patients presented with urethrocutaneous stula. Chordee was more commonly seen in patients with mid & proximal penile hypospadias (64.70%, n=33). In the present study, 4.1% (n=3) had associated undescended testis, 4.1% (n=3) had an associated bid scrotum and 1.3% (n=1) had an associated congenital hernia. Conclusions: Most cases of hypospadias present before 10 years of age. Distal hypospadias is the most common type. Chordee is associated most commonly with proximal penile and mid penile hypospadias. It may also be associated with other congenital anomalies like, undescended testis, bid scrotum or congenital hernias

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

scholarly journals Occurrence of Alcohol Dependence, Pattern of Alcohol Use, and Psychiatric Comorbidity in a Tertiary Care Centre in Upper Assam, India

2021 ◽  
Vol 8 (21) ◽  
pp. 1674-1678
Author(s):  
Kamala Deka ◽  
Manju Partha Baruah ◽  
Dipjyoti Bora
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Psychiatric Comorbidity ◽  
Tertiary Care ◽  
Occupancy Rate ◽  
Care Centre ◽  
Bed Occupancy ◽  
Tertiary Care Centre ◽  
Co Morbidity ◽  
Alcohol Dependent

BACKGROUND There has been an increased rate of diagnosis of alcohol dependent syndrome (ADS) observed in our psychiatry clinic constituting a major portion of them into inpatients care. Evaluation of psychiatric complaints in patients with alcohol dependant syndrome is challenging at times. Depression has been found to be a common psychological association seen in them. Suicidality and other selfharming behaviour as a co morbidity are also not uncommon. There is dearth of information available on occurrence of alcohol dependent syndrome in psychiatry attendees and pattern of alcohol use especially from this part of north-eastern region of Assam. We wanted to assess the occurrence and pattern of alcohol use disorder amongst patients attending psychiatry unit of a tertiary care centre in upper Assam, estimate its bed occupancy rate, and determine psychiatric comorbidity among them. METHODS A hospital based cross sectional study was conducted among 104 consecutive subjects attending Psychiatry department of Jorhat Medical College, Assam. After thorough examination and informed written consent subjects were administered with alcohol use disorder identification test (AUDIT) and MINI plus. Semi structured socio demographic Proforma was used to collect information on demographic data and different variables. As it was a descriptive study, data collected were organized in frequency tables and analysed using percentage. RESULTS In present study, prevalence of alcohol dependent syndrome in psychiatry set up was 12.68 % and bed occupancy rate of ADS was 13 %. Majority were between the age 28 and 47 years, males, Hindus, married, belonged to nuclear family and hailed from upper lower social class followed by lower middle class. Approximately 18 % of cases had psychiatric co morbidity and majority of them had depression and suicidality. CONCLUSIONS A major number of alcohol dependant patients attended psychiatry OPD and occupied almost half of the beds as inpatients of a tertiary care hospital. Mood disorder was the commonest comorbid condition in these patients. Though the results cannot be generalized, it may definitely reflect the magnitude of alcohol use in this region. Hence forth a psychiatry unit like ours warrant a full-fledged department for treatment of ADS and alcohol related problems and some policy to work for its prevention. KEYWORDS ADS, Occurrence, Bed Occupancy, Psychiatric Co-Morbidity

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

A PROSPECTIVE HISTOPATHOLOGICAL STUDY OF MENINGIOMAS IN A TERTIARY CARE CENTRE OF VIJAYAWADA

2021 ◽  
pp. 11-13
Author(s):  
C.Bhanu Sree ◽  
P. Annapurna ◽  
M. Rajani
Keyword(s):  
Surgical Resection ◽  
Tertiary Care ◽  
Histopathological Study ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Histological Appearance ◽  
Classi Cation ◽  
A Prospective Study

Background: Meningiomas are neoplasms arising from the arachnoidal cap cells in the meningeal coverings of the spinal cord and brain. These are the most common benign intracranial tumours and account for about 13-26% of all primary brain neoplasms. These are generally benign neoplasms of adults most often seen in middle age, but about 10% are atypical or malignant. These neoplasms are graded by WHO as Grade I , II and III . Benign meningiomas can be cured by surgical resection where as higher grade meningiomas require radiotherapy after surgical resection as these higher grade meningiomas have greater recurrence and aggressive behavior. Aims and Objectives: To study the variants and histopathological spectrum of meningioma and prognosis of variants. Material & Methods: The present study is a prospective study conducted in the department of Pathology, Siddhartha medical college from June 2019-May 2020. During this study, 16 cases of meningiomas were diagnosed and reviewed. Result:In our study of 16 cases females were 62.5%. The most common age group is 41-60 yrs (68.75%). Most common variant was noted to be transitional meningioma followed by meningothelial meningioma. Out of the 16 cases, grade I were 81.25%. Conclusion: Meningiomas account for 28-30% of primary central nervous system tumors and unveil a heterogeneous histopathology. The histological appearance of meningioma determines the grading for the management of the various subtypes and also associated with patient's prognosis. Hence a continuous revision of histopathological classication systems is required to improve the diagnostic accuracy. Benign meningiomas are the most common type. From our study, we conclude that transitional meningioma is the most common benign variant.

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