Study of Absolute Lymphocyte Count as a Marker of COVID 19 Disease Severity in Tertiary Care Centre, Suryapet

BACKGROUND The World Health Organization (WHO) has declared Coronavirus disease 2019 (COVID - 19) as a global public health pandemic. Clinical and laboratory biomarkers to predict the severity of corona virus 2019 are essential in this pandemic. Lymphocyte count has been a marker of interest in order to investigate the association of lymphocyte count and severity of COVID-19. We would like to analyse the relationship between absolute lymphocyte count (ALC) & COVID-19 disease severity. METHODS We performed a retrospective study on patients admitted to Government general hospital, Suryapet for COVID-19 illness from September 1st 2020 to September 16th 2020. Age, gender and complete blood count of patients admitted in the hospital was collected. Haemoglobin, total leucocyte count (TLC), absolute neutrophilic count (ANC), absolute lymphocyte count (ALC) and platelet counts were compared between ICU and Non-ICU groups and comparison of absolute lymphocyte counts in each group - ICU alive, ICU death and non-ICU groups was carried out. RESULTS 134 patients who were admitted in the hospital were analysed. Mean age and gender were compared between ICU and Non-ICU groups. We compared ALC between ICU alive, ICU death and non-ICU groups. Mean ALC in ICU death group was 0.81, in ICU alive group 1.04 and in non-ICU as 1.75. We found that patients with disease severity have lower absolute lymphocyte counts. In addition to this we also found that there was neutrophilia and lower haemoglobin levels in ICU patients. CONCLUSIONS We conclude that lymphopenia, defined as absolute lymphocyte count less than 1.1 x 109 /L may be useful in predicting the severity of COVID-19 illness. KEYWORDS COVID-19, Absolute Lymphocyte Count (ALC), Lymphopenia, SARS COV2

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A study of hematological parameters in patients with COVID-19 infection at a tertiary care centre

Journal of Pathology of Nepal ◽

10.3126/jpn.v11i1.31401 ◽

2021 ◽

Vol 11 (1) ◽

pp. 1852-1858

Author(s):

Keval Arvindbhai Patel ◽

Bimal Patel ◽

Riddhi A Parmar ◽

Bhawana S Sharma ◽

Mansi Thacker ◽

...

Keyword(s):

World Literature ◽

Virus Disease ◽

Hematological Parameters ◽

Tertiary Care ◽

Absolute Lymphocyte Count ◽

World Health ◽

Total Leukocyte Count ◽

Tertiary Care Centre ◽

Male Predominance ◽

Health Organization

Background: The corona virus disease 2019 is caused by the virus SARS-CoV-2 and is declared as a global pandemic by World Health Organization. Alterations in various hematological parameters have been recently documented in the world literature in SARS-Cov-2 infection. However, still there is paucity of hematological data in these patients. Hence this study is an attempt to evaluate the pattern of the hematological parameters in COVID-19 patients in the Indian population in our region. The objective of the study is to see the pattern of alteration in hematological parameters with emphasis on total leukocyte count, absolute lymphocyte count and platelet count in COVID 19 positive patients.Materials and Methods: This is an observational study in 50 patients with laboratory-confirmed COVID-19 status admitted to G.K. General Hospital & Gujarat Adani Institute of Medical Sciences, Bhuj, from 1st April 2020 to 30th June 2020. Statistical analysis of the data was carried out, and relevant findings were presented.Results: Among the 50 patients, there were 35 (70%) males and 15 (30%) females with an age range from 6 months to 82 years with twenty-five patients above 50 years. There was lymphopenia in 18 patients (36%), leukopenia in 2 patients (4%) and thrombocytopenia in 8 (16%) patients.Conclusions: Majority of the patients were elderly, and there was a male predominance. There was moderate to severe lymphopenia and mild thrombocytopenia.

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Study of Absolute Neutrophil Absolute Lymphocyte count ratio in Community Acquired Pneumonia patients as a prognostic indicator at a tertiary care centre

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i9.38008 ◽

2021 ◽

Vol 12 (9) ◽

pp. 69-74

Author(s):

Dyaneshwar Nirgude ◽

Mahadev Hanmantappa Malge ◽

Swetha Rajoli ◽

Avinash Hanbe Rajanna

Keyword(s):

Lymphocyte Count ◽

Tertiary Care ◽

Age Groups ◽

Absolute Lymphocyte Count ◽

Prognostic Indicator ◽

Community Acquired Pneumonia ◽

P Value ◽

Tertiary Care Centre ◽

Nitrogen Levels ◽

Count Ratio

Background: Community acquired pneumonia refers to pneumonia contracted by a person with little or no contact with health care system. Following endotoxemia the number of circulating neutrophils increases while lymphocyte counts decrease. Combining both parameters seems a logical step and the ratio of neutrophil and lymphocyte counts is increasingly used in several clinical circumstances. Initially, this so-called neutrophil-lymphocyte count ratio (NLCR) was studied as an infection marker in ICU patients and found to correlate well with disease severity and outcome, according to APACHE-II and SOFA scores. In the current study, we explored the value of the NLCR in patients admitted with Community acquired pneumonia. Aims and Objectives: 1) To find out the value of Neutrophil-Lymphocyte Count Ratio (NLCR)in Community Acquired Pneumonia (CAP). 2) To study Neutrophil-Lymphocyte Count Ratio (NLCR) as prognostic indicator in Community Acquired Pneumonia (CAP). Materials and Methods: This prospective study was conducted on minimum of 100 patients admitted to hospitals from November 2015 to September 2017 from Bangalore. After admission of cases based on CURB-65 scores, a detailed history and clinical examination was done along with chest x-ray to establish the diagnosis. Before taking into the study all patients had signed the informed consent. Routine haematological investigations done on day 1,3 & 7 were carried out. Serum c-reactive protein levels, Urea nitrogen levels, Sputum for culture and sensitivity and Acid-fast bacilli (AFB) was done on the same day of admission. ANC (Absolute neutrophil count), ALC (Absolute lymphocyte count) and NLCR were calculated. Results: Our study included age groups above 18yrs. Majority of the patients in the study were between 58-67 years (30%) followed by 48-57 years (27%). As the CURB-65 score increased from score 0 to score 4–5, the NLCR consistently increased, while the lymphocyte counts consistently decreased. In patients who died there was a significantly higher NLCR at presentation compared to patients that survived (15.18±3.55 versus 11.73±3.01, p-value,0.003). Conclusion: In our study increased NLCR carried poor prognosis which correlated with high CURB65 score and ICU admission. In patients who died there was a significantly higher NLCR at presentation compared to patients those survived.

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Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽

10.33883/jms.v23i1.747 ◽

2020 ◽

Vol 23 (1) ◽

pp. 48-49

Author(s):

Javaid Ahmad Bhat ◽

Shariq Rashid Masoodi

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Tertiary Care ◽

Resistance Mechanisms ◽

North India ◽

Global Public Health ◽

Care Centre ◽

Tertiary Care Centre ◽

Effective Prevention ◽

Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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A pilot study comparing pattern of damage sustained among instruments from different surgical units in a tertiary care centre in Nepal – reappraising the role of instrument reprocessing in retaining their value

F1000Research ◽

10.12688/f1000research.13699.1 ◽

2018 ◽

Vol 7 ◽

pp. 102

Author(s):

Sunil Munakomi ◽

Roshan Shah ◽

Sangam Shrestha

Keyword(s):

Tertiary Care ◽

Health Spending ◽

Pivotal Role ◽

World Health ◽

Tertiary Care Centre ◽

Surgical Equipment ◽

Surgical Units ◽

Wear And Tear ◽

Health Organization

Background: The quality of instruments plays a pivotal role in governing safe operating room culture. The reprocessing system followed in the institution determines their durability thereby ensuring patient safety as well as minimizing health spending. Rigorous reprocessing in a centralized instrument reprocessing department by well trained staff following formulated guidelines helps to achieve the target of “safe surgery saves lives” as formulated by the World Health Organization. Methods: We sought to determine the patterns of wear and tear sustained among sets of surgical equipment from two surgical units that had been sent to the repair department within a year of their purchase. Analysis of similar changes in the joints of the instrument, as well as pattern of fractures sustained was performed. Results: All patterns of wear and tear were common in both the general surgical arm and neurosurgical counterpart, with the exception of fractures and mal-alignments. Similar study was performed examining changes in the joints. Stains were the most commonly observed change pattern in both sets of instruments. Fractures were most frequent in the working ends in both sets of instruments. Conclusion: There is an alarming incidence of wear and tear patterns in the instruments used in the surgical units, even within the first year of their use. This supports the strict implementation of reprocessing guidelines by well trained workers and their quality assessments via audit checks. The quality of the purchased instruments also plays a pivotal role.

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The Utility and Validation of Intraepithelial Lymphocyte Count in Duodenal Biopsies in A Tertiary Care Centre in South India

Annals of Pathology and Laboratory Medicine ◽

10.21276/apalm.2511 ◽

2019 ◽

Vol 6 (10) ◽

pp. A544-549

Author(s):

Priyavadhana Balasubramanian ◽

◽

Bhawana Ashok Badhe ◽

Rajesh Nachiappa Ganesh ◽

Lakshmi C Panicker ◽

...

Keyword(s):

Lymphocyte Count ◽

South India ◽

Tertiary Care ◽

Intraepithelial Lymphocyte ◽

Care Centre ◽

Tertiary Care Centre ◽

Duodenal Biopsies

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25-Hydroxy vitamin D levels in chronic urticaria and its correlation with disease severity from a tertiary care centre in South India

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2013-1014 ◽

2014 ◽

Vol 52 (6) ◽

Cited By ~ 13

Author(s):

Laxmisha Chandrashekar ◽

Medha Rajappa ◽

Malathi Munisamy ◽

Palghat Hariharan Ananthanarayanan ◽

Devinder Mohan Thappa ◽

...

Keyword(s):

Vitamin D ◽

Disease Severity ◽

Chronic Urticaria ◽

South India ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D

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446. Prognostic Value of Absolute Lymphocyte Count for Disease Severity and Clinical Outcomes in Adult COVID-19 Inpatients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.645 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S324-S324

Author(s):

Jianli Niu ◽

Candice Sareli ◽

Maria Deane ◽

Aharon E Sareli

Keyword(s):

Lactate Dehydrogenase ◽

Clinical Outcomes ◽

Disease Severity ◽

Interleukin 6 ◽

Lymphocyte Count ◽

Absolute Lymphocyte Count ◽

Serum Levels ◽

C Reactive Protein ◽

Icu Admission ◽

Reactive Protein

Abstract Background Lymphopenia has been reported as a relatively frequent finding in patients with coronavirus disease 2019 (COVID-19). This study aimed to assess the use of absolute lymphocyte count (ALC) as a prognostic biomarker for disease severity and clinical outcomes. Methods A cohort of adult patients with COVID-19 admitted to Memorial Healthcare System, Hollywood, Florida from March 7, 2020 to January 18, 2021 was retrospectively analyzed. An absolute lymphocyte count (ALC) < 1.1 × 109/L was used as cutoff point to define lymphopenia. Correlations of ALC upon admission with age and serum levels of C-reactive protein, interleukin-6, lactate dehydrogenase, and creatinine were analyzed. Univariate and multivariate regression models were developed to assess the association of lymphopenia with the risk of ICU admission and clinical outcomes. Results 4,485 hospitalized patients were included in the final analyses. Median age was 61 (interquartile range, 47-73) years and 2,311 (51.5%) were men. Lymphopenia was more frequent in patients admitted to the ICU compared to those that were not admitted to the ICU, with an odds ratio of 2.14 (95% conﬁdence interval [CI], 1.78-2.56, p < .0001) (Figure 1). The actual value of the ALC was negatively correlated with age and serum levels of C-reactive protein, interleukin-6, lactate dehydrogenase, and creatinine (all p < 0.005). Patients with lymphopenia (n=2,409) compared to those without lymphopenia (n=2,076) had multivariable-adjusted odds ratios of 1.85 (95% CI, 1.53-2.24) for ICU admission, 2.08 (95% CI, 1.67-2.58) for intubation, 1.98 (95% CI, 1.31-3.00) for development of acute kidney failure, and 2.23 (95% CI, 1.79-2.79) for in-hospital mortality (Table 1). Analyses were adjusted for age, gender, race, hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, malignancy, obesity, and smoking. Conclusion Lymphopenia in adult COVID -19 hospitalized patients was associated with increased risk of disease severity (as evidenced by need for ICU admission) and poor clinical outcomes. Absolute lymphocyte count may help with prognostication in individuals hospitalized with COVID-19. Disclosures All Authors: No reported disclosures

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Recommending form of anticancer drugs in oncology unit of a tertiary care teaching hospital

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i2.4658 ◽

2021 ◽

Vol 12 (2) ◽

pp. 1201-1207

Author(s):

Pandiamunian Jayabal ◽

Nithiya Dhanasekaran ◽

Shanmugasundaram S

Keyword(s):

Anticancer Drugs ◽

Care Delivery ◽

Demographic Data ◽

Tertiary Care ◽

Dose Intensity ◽

World Health ◽

Tertiary Care Centre ◽

Cost Effective Treatment ◽

The World ◽

Oncology Unit

Cancer has become a chief ailment and danger to the global society. It is one of the foremost reasons for demise in the world. A survey by the World Health Organization (WHO) indicates that 8.2 million people died from cancer in 2012 and it may rise to 19 million by 2025. Drug interactions connected through anticancer drugs are a global concern and should not be ignored. Nausea, vomiting or some other mild response to extreme myelosuppression may vary from adverse drug reactions. Analysis of prescription trend is a possible method in ascertaining the position of drugs in culture and it has to be taken out at every hospital regularly. The research is developed to examine the prescription pattern of anticancer drugs in the clinical oncology unit of a tertiary care centre in India. The patient's demographic data, medication name, type, dose, intensity and duration etc., have been analyzed in each prescription Commonly utilized anticancer narcotics and different forms of cancer were identified and the national essential drug list percentage of the medicines used was analysed. The current study intended to assess the tendencies and pattern of prescribing anticancer drugs. The prescribing practises were apposite and were in agreement with WHO strategies. The present study seemed to sustenance best proposing performs in order to endorse cost effective treatment and improved health care delivery.

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Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20183596 ◽

2018 ◽

Vol 5 (9) ◽

pp. 4065

Author(s):

Vivek Nagar ◽

Pankaj Prasad ◽

Arun Mitra ◽

Saket Kale ◽

Kriti Yadav ◽

...

Keyword(s):

Diabetes Mellitus ◽

Communicable Disease ◽

Tertiary Care ◽

Diabetic Patients ◽

Care Hospital ◽

Global Public Health ◽

Tertiary Care Centre ◽

Family History Of Diabetes ◽

Poor Knowledge ◽

Level Of Knowledge

Background: Diabetes mellitus (DM) is one of the major fast growing non-communicable disease (NCD) and causes threats to global public health. Prior to initiating an educational program or interventions for diabetic patients, their current level of knowledge (K), attitude (A), and practice (P) should be evaluated. The purpose of this study was thus to determined current diabetes-related knowledge, attitude, and practices (KAP) of adults with Diabetes mellitus..Methods: Current study was cross sectional study from August to December 2014 in medicine outpatient department of Tertiary care hospital of Bhopal. A semi‑structured interviewer administered questionnaire was used for data collection, and it consisted of four sections.Results: A total of 150 study participants were enrolled for the study. Among them, 58% were male and 425 were female diabetic patients. Around 16% of the participants having good level of knowledge, 34.6% of participants have poor knowledge and 49.3% having moderate knowledge. Out of the total participant 43.3% have positive attitude and only 34% patients had positive practice.Conclusions: In our study most of the patients belong to moderate and poor knowledge score as well as negative practice and negative attitude that emphasizes the need for increasing diabetes awareness activities. The efforts should be more focussed on female patients, younger patients and those who have no family history of diabetes.

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Study of ovarian cancer at a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203300 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3228

Author(s):

Jayashree Mulik ◽

Swapnil Khadse

Keyword(s):

Ovarian Cancer ◽

Tertiary Care ◽

Case Fatality ◽

Final Diagnosis ◽

World Health ◽

Ca 125 ◽

Tertiary Care Centre ◽

History Of ◽

Associated Risk Factors

Background: Despite major advances in case management, ovarian cancer continues to have the highest case fatality rate of all gynaecologic malignancies. There is paucity of meaningful screening and diagnostic protocols. Present study was planned with the objective of assessment of the prevalence of ovarian cancer and the associated risk factors at a tertiary care centre.Methods: The present prevalence study was conducted at a tertiary care government hospital and entailed analysis of data of 73 patients of ovarian cancer. All the participants were subjected to comprehensive history taking, followed by general, systemic, per-speculum and per-vaginal examination. Serum tumour markers of the patients were assessed. Imaging studies including ultrasound, CT or MRI abdomen/pelvis were done as per need. Final diagnosis was confirmed on histopathology and the cases were classified according to histological classification of World Health Organization.Results: Majority (41, 56.2%) were aged more than 45 years and above, most of them with one to two previous issues (64.3%). The disease was observed to be more common in postmenopausal women (65, 89%). Three fourth participants had negative family history of ovarian or breast cancer. Out of 73 patients, 31 had value of CA 125 between 150-400 U/mL and 42 had values >400 U/mL. Epithelial ovarian cancer (serous- 33, 45.2%, mucinous- 18, 24.7%) was observed to be the commonest histological type.Conclusions: To diagnose ovarian tumours early using multipronged approach with focussed risk factor identification and screening with CA-125 is very important and is strongly recommended.

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