scholarly journals Predictive Accuracy of Procalcitonin in Diagnosing Bacteraemia in Adult Patients in a Tertiary Hospital in Madurai, India

2021 ◽  
Vol 8 (21) ◽  
pp. 1711-1716
Author(s):  
Virgin Joena
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Predictive Accuracy ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
P Value ◽  
Care Hospital ◽  
Presumptive Diagnosis ◽  
Two Samples ◽  
Significant Difference

BACKGROUND Bacteraemia is the presence of bacteria in the bloodstream that are alive and capable of reproducing. The incidence of bloodstream infections (BSI) either of the community-acquired origin or of hospital-acquired origin has dramatically increased. Identifying patients with high risk of bacteraemia in emergency department (ED) using predictive models is needed. The present study was conducted to evaluate the efficacy of procalcitonin as well as other biomarkers as diagnostic, predictive markers of bacteraemia in an adult patient population in India. METHODS A descriptive observational study was conducted at the ED of a tertiary care hospital in India. Fifteen years or older patients who were ready to give at least two samples of blood for blood culture were recruited. Data on demographic variables, predisposing conditions, clinical presentations, laboratory tests, and presumptive diagnosis was analysed using SPSS and P value of 0.05 was considered statistically significant. A logistic model was built using an iterative procedure which was later simplified into a coefficient-based scoring system. RESULTS Out of 78 patients, (66.67 %) from the emergency department and (33.33 %) from out-patient department (OPD) were enrolled. Among the study population, 40 (51.28 %) were with bacteraemia, and the remaining 38 (48.72 %) had no bacteraemia. There was no statistically significant difference in levels of procalcitonin, pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure, SPO2, total count, MCV, RDW, MPV, albumin, urea, creatinine between bacteraemia and no bacteraemia. (P value > 0.05). The mean procalcitonin was 33.02 ± 43.46. CONCLUSIONS Although, increased PCT levels can be useful as predictors of bacteremias in the emergency department, interpretation should be made carefully when deciding the prescription of antibiotics. KEYWORDS Procalcitonin, Bacteraemia, PCT levels

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

SOCIOECONOMIC STATUS EFFECT ON MANAGEMENT OF HYPERTENSION IN COMMUNITY PHARMACY IN SOUTH- SOUTH ZONE IN NIGERIA

2021 ◽  
Author(s):  
Mgbahurike AA ◽  
Oduogu SO ◽  
Bagbi BM
Keyword(s):  
Blood Pressure ◽  
Socioeconomic Status ◽  
Alcohol Consumption ◽  
Peer Review ◽  
Tertiary Care ◽  
Research Centre ◽  
Community Pharmacies ◽  
Care Hospital ◽  
Co Morbidity ◽  
Significant Difference

Background to study: Effective management of hypertension is influenced by several factors that center on social and economic status of the patient. Identification of these factors will enable informed intervention in the management of hypertensive patients. Objective: The study aimed to determine possible association between blood pressure control and socioeconomic status of patients who are managed in community pharmacies in Rivers State. Method: A descriptive cross-sectional survey of thirty-nine community pharmacies was conducted between July and December 2018.  A total of 195 respondents participated in the study. Every patient’s consent was obtained. Further information on patients’ demographics were extracted from pharmacists’ documentation files. Such include age, medication patient is on, duration of hypertension, co-morbidity, income/ social status, and habits like smoking, alcohol consumption, educational status, and mean blood pressure over the study period. The outcome measure taken as controlled blood pressure was mean BP ≤140/90 mm Hg for the general population and BP 130/80 mmHg for patients with diabetes as co-morbidity. BP >140/90 mm Hg was considered as uncontrolled blood pressure. Result: A total of 195 respondents participated in the study, of which 105(53.8%) were male and 90(46.2%) were female. Out of this number 75(38.5%) were below 40yrs of age, 105(53.8%) were between 41–50yrs of age and only 15(7.7%) were 60yrs and above. More female had BP control compared to the male (OR 1.89, 95% CI (1.16 - 3.0), P=0.009. Patients within ages 41 - 59yrs had more controlled BP compared to older age, 60yrs and above, OR 1.48, 95% CI (0.84 - 2.42) p 0.18. Uncontrolled BP was found more among employed patients and patients with highest monthly income, OR 1.05 95% CI (0.58 - 2.00); OR 1.16 95% CI (0.49 - 2.78) P, 0.36 respectively. Exercise activities have significant impact on BP control as alcohol consumption increased OR of BP control with no significant difference in OR on amount of monthly expenditure on medications. Conclusion: Male gender, employment, and high income earning have negative effect on BP control while exercise is associated with BP control.                    Peer Review History: Received: 4 September 2021; Revised: 10 October; Accepted: 21 October, Available online: 15 November 2021 Academic Editor:  Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: PRESCRIPTION PATTERN OF ANTI-HYPERTENSIVE DRUGS IN A TERTIARY CARE HOSPITAL IN KERALA AND ADHERENCE TO JNC-8 GUIDELINES

Oral paracetamol versus zolmitriptan to treat acute migraine attack in the emergency department

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Rescue Therapy ◽  
Tertiary Care ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Care Hospital ◽  
Acute Migraine ◽  
Pain Scores ◽  
Significant Difference

Background: Treatment provided in an emergency department is aimed at alleviating pain immediately with minimized adverse effects as well as warding off further migraine attacks. The primary aim of this article is to compare the effectiveness of oral paracetamol versus zolmitriptan in treating acute migraine attacks. Methods: This prospective, randomized, and controlled study was carried out at a tertiary care hospital visited by 95,000 patients annually. The study recruited 200 participants who were randomized into two groups. One group received 1000 mg paracetamol while the other group received 2.5 mg zolmitriptan orally. Baseline pain scores were recorded using the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 15, 30 and at 60 min following administration of the study drugs. Patients requiring further treatment were provided fentanyl at a dosage of 1 µg/kg as a rescue therapy. Results: A significant decrease was evident in VAS and NRS scores following the administration of the study drugs in both groups (P < 0.001). The change in VAS pain scores after 15, 30 and 60 min was calculated as 17.0 ± 13.9, 41.2 ± 16.3 and 61.2 ± 17.5 mm, respectively, in the paracetamol group and 14.2 ± 11.7, 39.2 ± 17.9 and 59.2± 19.3 mm, respectively, in the zolmitriptan group, which did not indicate significant differences (P = 0.103, P = 0.425, P = 0.483, respectively). Likewise, NRS pain scores showed a downward trend in line with VAS pain scores and did not yield a significant difference (P = 0.422). No significant difference concerning rescue therapy was noted between the two groups (P = 0.596). Conclusion: Oral paracetamol and zolmitriptan prove to be similarly effective and have low incidence of acute side effects in treating acute migraine cases without aura.

scholarly journals ACUTE MYOCARDIAL INFARCTION;

2013 ◽  
Vol 20 (03) ◽  
pp. 332-340
Author(s):  
ATIF SITWAT HAYAT ◽  
MUHAMMAD ADNAN BAWANY ◽  
JAWAD AHMED QADRI ◽  
Kiran Khalil
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Block ◽  
Complete Heart Block ◽  
Tertiary Care ◽  
Anterior Wall ◽  
P Value ◽  
Inferior Wall ◽  
Care Hospital ◽  
Significant Difference

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.

scholarly journals Ecology of Bloodstream Infections and Temporal Trends of Their Antibiograms with Respect to Source and Duration of Incubation: A 5-Year Retrospective Observational Analysis

2020 ◽  
Vol 12 (01) ◽  
pp. 56-67
Author(s):  
Amit Banik ◽  
Valarie W. Lyngdoh ◽  
Elantamilan Durairaj ◽  
Anil C. Phukan ◽  
Raghavendra Kotal
Keyword(s):  
Tertiary Care ◽  
Temporal Trends ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Blood Collection ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Disk Diffusion Method ◽  
Significant Difference

Abstract Purpose Blood is one of the most important connective tissues of human body. Bloodstream infection can range from inapparent bacteremia till fulminant septic shock with high mortality. Presence of microbes in blood whether continuously, intermittently, or transiently is a grave risk to every organ of body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy. Objective The aim of the study is to perform bacteriological analysis and assess drug sensitivity patterns of blood culture isolates and compare in light of other associated variables. Design Retrospective observational study was conducted from January 2009 to December 2013 at a tertiary care hospital at Shillong, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified by standard biochemical tests and subjected to sensitivity testing according to Modified Kirby Bauer disk diffusion method. Data for source of blood collection and duration of incubation were noted and compared. Results A total of 658 (11.2%) pathogens were isolated from 5,867 bacteremia-suspected patient blood specimens. Contamination was observed at the rate of 1.21%. Gram-negative organisms were the predominant pathogens recovered, Klebsiella pneumoniae being the most common. No significant difference was observed between the number of organisms isolated within or beyond 48 hours. Acinetobacter baumannii and K. pneumoniae have significantly higher chances (p < 0.05) of isolation from central line catheters compared with peripheral venipuncture. Conclusion Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

Surgical-site infections in emergency abdominal paediatric surgeries at a tertiary-care hospital in Pakistan

2020 ◽  
pp. 1-9
Author(s):  
Ali Faisal Saleem ◽  
Huma Faiz Halepota ◽  
Hasaan Omar ◽  
Areeba Zain ◽  
Muhammad Arif Mateen Khan
Keyword(s):  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Stable Condition ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Site Infection ◽  
Significant Difference ◽  
Pathogen Occurrence

Abstract A retrospective chart review was carried out in children (neonates to 18 years) who underwent acute surgical abdominal exploration during 2012-2016 at the Aga Khan University Hospital, Karachi, to evaluate the post-operative surgical site infection rates in emergency paediatric abdominal surgery. Incidence of surgical site infection (SSI) was estimated. P-value was calculated, chi-square and non-parametric tests were performed by comparing pre-surgical and post-surgical procedure pathogen occurrence and pre-procedure wound status. Pathogen occurrence related to time-trend of 98 paediatric patients who underwent emergency abdominal surgery was plotted. Of the 94 who were discharged in stable condition, it was found that there was no significant difference between pre- and post-surgical pathogens. Escherichia coli (n=10) was found to be the most common pathogen. Contaminated wounds were associated with higher SSI (p=0.036, OR 1.95 95% CI 0.7-5.4). Continuous...  

scholarly journals Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region

2020 ◽  
Vol 17 (12) ◽  
pp. 4516 ◽  
Author(s):  
Narcisa Muresu ◽  
Giovanni Sotgiu ◽  
Laura Saderi ◽  
Illari Sechi ◽  
Antonio Cossu ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Tertiary Care ◽  
Scale Up ◽  
Anal Carcinoma ◽  
Detection Methods ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Hpv Genotypes

Objectives: Anal cancer is a rare disease. However, its incidence is increasing in some population groups. Infection caused by Human Papillomavirus (HPV) is strongly associated with the risk of anal cancer, whose variability depends on samples, histology, and HPV detection methods. The aim of the study was to assess prevalence and distribution of HPV genotypes in patients diagnosed with anal carcinoma. Methods: An observational, retrospective study was carried out in a tertiary care hospital in North Sardinia, Italy. Specimens of anal cancer diagnosed from 2002–2018 were selected. Demographic, epidemiological, and clinical variables were collected to assess their relationship with the occurrence of anal cancer. Results: The overall HPV positivity was 70.0% (21/30), with HPV-16 being the predominant genotype (~85%). The highest prevalence of anal cancer was in patients aged ≥55 years. HPV positivity was higher in women (p-value > 0.05) and in moderately differentiated samples (G2) (p-value < 0.05). p16INK4a and E6-transcript positivity were found in 57% and 24% of the HPV positive samples, respectively. The OS (overall survival) showed a not statistically significant difference in prognosis between HPV positive sand negatives (10, 47.6%, vs. 4, 44.4%; p-value = 0.25). Conclusions: HPV-DNA and p16INK4a positivity confirmed the role of HPV in anal carcinoma. Our findings could support the implementation and scale-up of HPV vaccination in males and females to decrease the incidence of HPV-associated cancers. Further studies are needed to better clarify the prognostic role of HPV/p16 status.

scholarly journals Prostatic lesions: Histopathological study in a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 12-19
Author(s):  
S. Bhatta ◽  
S. Hirachan
Keyword(s):  
Histopathological Examination ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Histopathological Study ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference ◽  
Nodular Hyperplasia ◽  
Malignant Lesions ◽  
The Mean

Background: Prostatic lesions like Nodular hyperplasia of prostate, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with age. This study was conducted with the objective of evaluating histopathological pattern of prostatic lesions.Methods: This was a retrospective study conducted at KIST Medical College from Jan 2014 to Jan 2018. The study included ninety six prostatic specimens received in department of pathology. Hematoxylin and Eosin stained slides were retrieved and reviewed. The specimens and slides were analyzed according to type of specimen, age of patient, histopathological pattern and final diagnosis. Results were analyzed using Statistical Package for Social Science (SPSS, version 21) for Windows. Independent t test was used to correlate the mean age between patients with benign and malignant lesions. P value less than 0.05 was considered as statistically significant.Results: The most common benign lesion was nodular hyperplasia of prostate 86(89.58%). Malignant lesions comprised 8 (8.34%) cases of all prostatic lesions. All the cases of prostate carcinoma were adenocarcinoma. The most frequent Gleason score was 9. Mean age for benign and malignant lesions were 69.6 ± 8.1 years and 72.9 ± 5.2 years respectively. There was no significant difference in the mean age between patients with benign and malignant lesions (p value 0.27).Conclusion: Benign lesions of prostate are more common than malignant lesions. Histopathological examination of prostate specimens have important role in diagnosing various benign and malignant lesions, especially to rule out incidental carcinoma.JMMIHS.2018;4(1):12-19

scholarly journals Validation of Modified Paediatric Triage Score in a Tertiary Care Hospital

2020 ◽  
Author(s):  
Bandya Sahoo ◽  
Reshmi Mishra ◽  
Mukesh Kumar Jain ◽  
Sibabratta Patnaik
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Scoring System ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Clinical Variables ◽  
Icu Admission ◽  
Physical Variables

Introduction: The global burden of paediatric mortality is high and majority of the deaths are preventable by providing timely access to specialised emergency care. An appropriate triage in a busy emergency department can identify the sickest patient for early intervention. Aim: To develop a simple score based on physical variables alone and assess its validation so as to predict Intensive Care Unit (ICU) admission. Materials and Methods: This prospective hospital based study included 936 children, aged 1 month to 18 years. Baseline demographic data along with clinical variables were noted in a pre-designed proforma at the time of admission. A scoring system was developed based on severity of various clinical variables i.e., heart rate, respiratory rate, respiratory effort, Oxygen Saturation (SpO2), Capillary Refill Time (CFT), temperature, level of consciousness and behaviour. The outcome i.e., admission to ward or Pediatric Intensive Care Unit (PICU) of the patient was correlated with the study variables and total score. An association of modified PETS with the PICU admission was done using Chi-square test. A p-value of <0.01 was considered as statistically significant. Results: The modified Paediatric Triage Score (PETS) which is developed based on eight physical variables, is reliable in discriminating the children with ward and ICU admission. A score of ≥6 leads to 14.8 times higher risk of getting admitted to ICU as compared to a child with score of <6. A cut-off of ≥6 for modified PETS score has a sensitivity of 79.6% and specificity of 79.2% in predicting ICU admission. Conclusion: This simple clinically developed scoring system based on physical variables alone with an optimal cut-off of ≥6 can predict severity of illness and need for PICU admission in Emergency Department with acceptable validity and can serve as a potentially excellent screening tool.

Sign in / Sign up

Export Citation Format

Share Document