A Retrospective Study of Pemphigus in a Tertiary Care Centre in South India

BACKGROUND Pemphigus is a group of rare, life-threatening autoimmune bullous diseases of the skin and mucosa which result in intraepidermal blistering. Associated autoimmune conditions and the extensive mucocutaneous detachment impair the quality of life. Immunosuppressive treatment adds to the morbidity in patients. We wanted to assess the clinical presentation of pemphigus among the study subjects along with the outcome of pemphigus patients with the extent of the disease and results of pus culture. METHODS Retrospective analysis of case records of patients with pemphigus in a tertiary care hospital during a period of 3 years was done in 2015. Demographic data, clinical findings, underlying medical disorders, details of deaths, investigation reports and treatment details were recorded. RESULTS Common age group affected was 51-60 years (31.5 %) among a total of 54 pemphigus patients. There were 26 males and 28 (51. 9 %) females and in majority of the patients (44.4 %) duration was less than 6 months. Out of 47 patients, oral mucosal involvement was grade 1 in 20 (37 %) cases, grade 2 in 12 (22.2 %) and in 15 (27.8 %) patients it was grade 3.Histopathological examination showed suprabasal cleft in 82.1 %, subcorneal blister in 5.7 %, acantholytic cells in 48.6 % and row of tombstone appearance in 9.4 %. Out of 36 patients, DIF test reported intercellular IgG in 65 % and C3 in 50 % .Diabetes was found in 14 (25.9 %), candidiasis in 12 (22.2 %), thyroid disease in 6 (11.1 %) and hypertension in 3 patients. Three patients died. Among 10 patients with more than 30 % body surface area involvement, 1 (10 %) patient died. Two (13 %) deaths occurred among 15 patients in whom pus C&S was positive. CONCLUSIONS Pemphigus patients were of slightly higher (51 - 70 years) age group and the 3 patients died were females. Autoimmune disorders like diabetes and thyroid disorders were found among many patients and their family members. Infection could be an important cause of death, but no statistically significant association was found in the present study. KEYWORDS Pemphigus, Steroids, Comorbidity, Deaths

Download Full-text

HAEMATOLOGICAL PARAMETERS IN COVID-19 PATIENTS: OUR EXPERIENCE IN A TERTIARY CARE HOSPITAL IN THE NORTH EAST INDIA

10.36106/ijsr/2518605 ◽

2021 ◽

pp. 38-40

Author(s):

Junu Devi ◽

Nilay Talukdar

Keyword(s):

Demographic Data ◽

Tertiary Care ◽

Laboratory Data ◽

Haematological Parameters ◽

Care Hospital ◽

Age Group ◽

Tertiary Care Centre ◽

College Hospital ◽

North East ◽

Laboratory Test Results

BACKGROUND: Covid-19 is a disease caused by Severe Acute Respiratory Distress syndrome Coronavirus 2 (SARS-CoV-2). Various changes occur in different haematological parameters in Covid-19 patients. Objective of the study is to evaluate the changes in primary haematological parameters and their signicance in different groups of Covid-19 patients. METHODS: Laboratory data of randomly selected 100 laboratory conrmed SARS-CoV-2 positive patients (Covid 19) in a tertiary care centre (Gauhati Medical College Hospital)were retrospectively collected. Demographic data and laboratory test results of the patients were analysed. RESULTS: Covid 19 is more common in above 50 years of age. It slightly more common in males. Leukocytosis, lymphopenia(P<0.008), thrombocytopenia, decreased haemoglobin levels(P<0.01), decrease red blood cell count(P<0.0001) were most commonly seen in above 50 age group(P<0.05). Monocytosis(P<0.006) was seen in below 50 years age groups. CONCLUSION: Covid-19 is more common in above 50 years age group. Changes in haematological parameters are good index and can be useful as indicators of disease progression and also helpful in disease prevention.

Download Full-text

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

10.36106/ijsr/9100939 ◽

2021 ◽

pp. 25-27

Author(s):

P. Mohan ◽

P. Revathi Guru ◽

V. Sudha ◽

L. Balamurugan ◽

Pavithra Gunasekaran ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Sudden Onset ◽

The Body ◽

Care Hospital ◽

Age Group ◽

Common Condition ◽

Tertiary Care Centre ◽

Linear Lesions ◽

Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

Download Full-text

A clinico-histopathological review of ovarian masses at a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184142 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4139

Author(s):

Michelle N. Fonseca ◽

Madhavi J.

Keyword(s):

Tertiary Care ◽

Young Patients ◽

Mucinous Cystadenoma ◽

Reproductive Age ◽

Care Hospital ◽

Age Group ◽

Tertiary Care Centre ◽

Benign Ovarian Tumours ◽

Ovarian Tumours ◽

Ovarian Masses

Background: Ovarian tumours can be seen at all stages of life but they differ in type, being mostly germ cell tumours in childhood, functional cysts in the reproductive age group (up to 45 years) and becoming increasingly malignant towards and after menopause. It also accounts for most prevalent cause of hospital admissions.Methods: This is a retrospective study conducted in the Department of Obstetrics and Gynaecology at a tertiary care hospital in Mumbai from August 2017 to August 2018. All patients with ovarian masses who were surgically managed were included in the study. The data of 30 patients was collected in excel sheet and analyzed by descriptive statistics.Results: Out of the 30 ovarian masses, 50 % were functional cysts, 46.6% were benign ovarian masses and 3.3% were borderline malignant. 46% of tumours were seen in the age group 21-30 years. More than 50 % tumours were seen in parous women. Most common presenting clinical symptom was pain in abdomen irrespective of the type of tumour. Most common complication was haemorrhage in the cyst. Laparoscopy was done in 4 patients and 26 required exploratory laparotomy. Most common surgery performed was unilateral cystectomy for functional ovarian cysts and benign ovarian tumours. Mucinous cystadenoma was the most common benign ovarian tumour, followed by dermoid cyst.Conclusions: Pre-operative diagnostic approach to a patient with ovarian mass includes careful history taking, thorough clinical examination, ultrasound and tumour marker assays in selected cases. Conservative surgery should be the goal to preserve fertility in young patients with ovarian tumours.

Download Full-text

Impact and outcome of cardiac diseases in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205432 ◽

2020 ◽

Vol 10 (1) ◽

pp. 102

Author(s):

Gira Dabhi ◽

Jignesh Chauhan ◽

Munjal Pandya ◽

Rahul Sinhar

Keyword(s):

Heart Disease ◽

Cardiac Disease ◽

Nyha Class ◽

Demographic Data ◽

Tertiary Care ◽

Mode Of Delivery ◽

Close Monitoring ◽

Care Hospital ◽

Tertiary Care Centre ◽

In Pregnancy

Background: Present study done to study incidence, effect of pregnancy on cardiac disease and vice-versa and feto-maternal outcome in patients with cardiac disease in pregnancy at tertiary care hospital.Methods: It’s a retrospective observational study conducted in Department of OBGY at tertiary care hospital between 01 June 2019 to 31 May 2020. 28 cases of cardiac disease out of 8659 patients registered included in the study. Demographic data like age, parity, etiological factors of cardiac disease, mode of delivery, neonatal outcome noted from case records.Results: In study, 32% were unregistered cases and 10.7% had never sought any medical care before. Majority (53.6%) cases belonged to 20-25 years. Heart disease noted to be more in primipara (35.7%). 71.4% belonged to NYHA class 1+2 and had a relatively uneventful peripartum period. Majority (53.6%) patients had rheumatic valvular disease. Cases of Congenital heart disease were17.8%, pulmonary artery hypertension was 25%, Maternal mortality were 2(7.2%). 46.5% women delivered with caesarean section. PIH (18%) and anemia (7.2%) were most commonly associated conditions. 85.6% women delivered live newborns and full term, pre-term deliveries and IUGR were 71.4%, 17.8% and 10.7% respectively.Conclusions: Rheumatic origin is the most common cardiac disease associated with pregnancy. The availability of early diagnostic techniques and reference to tertiary care centre, timely admission and close monitoring of patient and delivery with multidisciplinary approach include specialized cardiologic care, high risk obstetric support and neonatology expertise can minimize feto-maternal morbidity and mortality. Pre-conceptional counselling, regular antenatal check-ups and contraceptive advice must be included in counselling part.

Download Full-text

Does advanced maternal age influence obstetric outcome: a study in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190976 ◽

2019 ◽

Vol 8 (4) ◽

pp. 1313

Author(s):

Jose C. V. ◽

Lissiamma George ◽

Sunitha Sukumaran

Keyword(s):

High Risk ◽

Gestational Diabetes ◽

Maternal Age ◽

Tertiary Care ◽

Advanced Maternal Age ◽

Chronic Hypertension ◽

Care Hospital ◽

Tertiary Care Centre ◽

Younger Women ◽

Medical Disorders

Background: Advanced maternal age defined as age 35 years and older at estimated date of delivery has become increasingly common in last two to three decades. The International Federation of Gynaecology and Obstetrics in 1958 recommended that all women going through their first pregnancy over the age of 35 years should be considered high risk for pregnancy and included in this category 1.Methods: A one-year prospective observational study conducted in a tertiary care hospital after institutional ethical clearance. All 165 women above 35yrs who delivered during this period were taken as Cohort 1. Same number of women aged between 20 and 34 years were randomly selected as comparison group (Cohort 2). Both the groups were compared in terms of preexisting medical disorders, obstetrical morbidities, antenatal complications, intrapartum complications.Results: Older and younger women had similar antenatal booking, occupational and socioeconomic status. The main reason for pregnancy at advanced age group was late marriage. The risk of chronic hypertension, gestational diabetes mellitus, pre-existing medical disorders were higher in advanced maternal age.Conclusions: Increasing maternal age is associated with elevated risks for pregnancy complications. They are at high risk for gestational diabetes, cesarean section and to have low birth weight babies. Since these women are at higher risk of complications, they should be advised to adhere to frequent antenatal visits and close supervision.

Download Full-text

Clinico-epidemiological study of childhood lichen planus at a tertiary care centre in South India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20182005 ◽

2018 ◽

Vol 4 (3) ◽

pp. 346

Author(s):

Srirath Madappally Kambil

Keyword(s):

Lichen Planus ◽

South India ◽

Tertiary Care ◽

Autoimmune Disorder ◽

Skin Lesions ◽

Age Group ◽

Tertiary Care Centre ◽

Main Site ◽

Epidemiological Features ◽

Mucosal Involvement

Background: Lichen planus (LP) is an autoimmune disorder occurring infrequently in children. LP is mainly seen in adults of both sexes. There are only a few studies on childhood LP in South India.Methods: 52 children under 14 years of age with LP were evaluated. The study was done in the Dermatology outpatient department from April 2016 to March 2018. The various clinical and epidemiological features observed are recorded in the study.Results: LP was slightly more common in boys and the age group mainly affected was 5-9years. Classical LP was the most common clinical type and extremities were the main site of skin lesions. Erosive lesions on buccal mucosa were the commonest type of mucosal involvement. Koebners phenomenon was seen in a significant number of cases.Conclusions: LP is not rare in children and resembles adult LP in most aspects. Mucosal and nail involvement is seen in many cases. Knowledge about the various clinical patterns of LP will help in early diagnosis and proper treatment.

Download Full-text

Clinicopathological profile of sinonasal masses-a tertiary care centre study in rural India

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204182 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1821

Author(s):

Vidya Rokade ◽

Kiran J. Shinde ◽

Girishkumar R. More

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Rural India ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Tertiary Care Centre ◽

Radiological Investigation ◽

Male Predominance ◽

Neoplastic Lesion ◽

Neoplastic Lesions

Background: A variety of mass lesions occur within the paranasal sinus (PNS) and nasal cavity and thus it becomes mandatory for otorhinolaryngologist to elicit detailed history and thorough examination before reaching a final diagnosis. This is retrospective study of all sinonasal masses who were undergone surgical management in the institute of rural India and so in the environment.Methods: This is a retrospective observational study of 70 patients with sinonasal masses treated at a rural tertiary care hospital in rural western Maharashtra from period of Jan 2016 to May 2018. History, clinical assessment and histopathological examination (HPE) was done in all cases as per hospital record supplemented by radiological investigation as per requirement. The patients were grouped as per their histopathological diagnosis as non-neoplastic/inflammatory and neoplastic.Results: A total of 70 patients were analysed age ranging (11-70 years). Majority of the patients were in the age groups 21-40 years (47%). There were 43 (61%) male and 27 (39%) female with M:F ratio 1.6:1. On HPE, 50 (71%) cases were non neoplastic/inflammatory and 20 (29%) cases were neoplastic lesions. HPE revealed that 50 (71%) cases were non neoplastic and 20 (29%) cases were neoplastic lesions.Conclusions: Sinonasal masses have various differential diagnoses. They are fairly common with male predominance. Benign conditions show a peak during 2nd to 4th decade of life while malignancy increasing with the age after 4th decade. In non-neoplastic lesion, Allergic nasal polyp is the commonest histological pattern seen while in malignant lesions squamous cell carcinoma is noted with 100% male predominance.

Download Full-text

Study of Drug Utilization on Acute Poisoning Cases Treated at Tertiary Care Hospital

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i10/457 ◽

2018 ◽

Vol 3 (10) ◽

Author(s):

Dr. Sreya Todi

Keyword(s):

Drug Utilization ◽

Urban Areas ◽

Tertiary Care ◽

Acute Poisoning ◽

Medical Emergency ◽

Poison Control ◽

Care Hospital ◽

Age Group ◽

Tertiary Care Centre ◽

Cross Sectional

Acute poisoning is common everywhere in medical emergency. Acute poisoning may be due to deliberate exposure to drugs, chemicals and natural toxins or accidental which is emergency for common medical health. The main aim of this study was to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with treated acute poisoning. Material and Methods: This prospective cross sectional study was carried out in the emergency department of a tertiary care centre over a one year period. Result: During the period of 1 year total 310 Acute poisoning cases were recorded by us. Out of 310 acute poisoning cases 170(54.8%) were male where as females were 140(45.2%). The majority of cases were from age group of 20 -50 years in males whereas mean age of female patients was 37.3 years and majority of the cases were from 25-50 age group. The most common route of exposure to poisons (69.6%) was ingestion and followed by dermal exposure (in cases of venomous animal exposures) (25.8%) and inhalation (4.6%).The most common symptomatic treatments given to the patients were antimicrobials (88.7% of cases), antiemetics (82.6%% of cases), H2 blockers (72.9% of cases) and Atropine (51% of cases), pralidoxime (41.6% of cases) Proton pump inhibitors and Vasopressor agents etc respectively. The most commonly prescribed specific antidotes were Anti-snake venom (ASV) (12.9% of cases).Conclusion: In the present study, the main causes of poisoning were identified as household products in urban areas of India. Awareness about the dangers of such poisons should be the added responsibility of health and hospital authorities. Poison control center establishment in the region will also help in preventing and controlling such poisoning events.

Download Full-text

HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM IN WOMEN WITH ABNORMAL UTERINE BLEEDING

10.36106/ijsr/6103945 ◽

2021 ◽

pp. 30-33

Author(s):

Bhakti D Deshmukh ◽

Anuradha Malpani ◽

Alka V Gosavi ◽

Kalpana R Sulhyan ◽

Rucha M Pimpalkhute

Keyword(s):

Histopathological Examination ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Intraepithelial Neoplasia ◽

Mucinous Carcinoma ◽

Uterine Bleeding ◽

Serous Carcinoma ◽

Histopathological Study ◽

Care Hospital ◽

Age Group

BACKGROUND –Abnormal uterine bleeding (AUB) is dened as a bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle. The term dysfunctional uterine bleeding (DUB) is used to describe abnormal uterine bleeding for which no specic cause has been found. AUB is one of the most common gynaecological problems. This study was done to evaluate histological patterns of endometrium in women with abnormal uterine bleeding. AIMS AND OBJECTIVE – To study various histological patterns of endometrium in abnormal uterine bleeding and correlate it with age, parity and symptoms. MATERIAL AND METHODS –This is a retrospective study, conducted in the Department of Pathology, in a tertiary care hospital from 1st July 2016 to 30th June 2019. Total 718 specimens with AUB were included in the study from the age group of 21 to 95 years. The specimens received were hysterectomy (74.65 %), endometrial biopsies (21.45%), dilatation and curettage (2.79 %) and transcervical resection of endometrium (1.11 %). RESULTS –The patients with AUB were mainly from the age group 41-50 years with menorrhagia as the chief complaint. Most of the women with AUB were multiparous (84.54%). The most common pattern observed on histopathological examination was proliferative endometrium (49.86%) followed by atrophic endometrium (10.31%). Malignancy was found in 2.23% (Endometrioid carcinoma – 1.81%, serous carcinoma - 0.14% and mucinous carcinoma – 0.28%). Endometrial hyperplasia without atypia (23 cases, 3.20%) was more common than endometrial atypical hyperplasia (EAH) / endometrioid intraepithelial neoplasia {EIN} (4 cases, 0.56 %). Various other patterns of endometrium on histopathology were endometritis (6.82 %) followed by endometrial polyp (4.46 %). CONCLUSION – Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.

Download Full-text

Profile of Blood Donor Deferrals in a Tertiary Care Centre-Our Institutional Experience

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i55b33848 ◽

2021 ◽

pp. 75-80

Author(s):

D. Rajeswari Thivya ◽

R. Vijayashree ◽

K. Meghanath

Keyword(s):

Blood Donor ◽

Demographic Data ◽

Tertiary Care ◽

Blood Bank ◽

Care Hospital ◽

Blood Products ◽

Tertiary Care Centre ◽

Donor Pool ◽

Common Cause ◽

Donor Deferral

Background: It is the prime duty of transfusion services to provide safe, adequate and timely need of blood and the blood products. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and educate and motivate temporarily deferred donors in order to maintain a safe and adequate supply of blood products. Aims of the Study: To evaluate and analyze the blood donor deferral pattern in a tertiary care hospital blood bank and to review its influence on blood safety. Methodology: This retrospective study was conducted in the blood bank, CHRI from the year January 2015 to December 2018. Data like demographic data, clinical history, physical examination, haematological examination, stored in the blood bank was retrived. The donors will be deferred based on standard WHO guidelines. The collected deferral data was analyzed using SPSS software 2011version 20. Results: During the study period there were 7010 registered blood donors. The deferral rate was 5.19%. Among the donor deferrals, females were more commonly deferred ie 31.66%. The deferral rate among voluntary and replacement donors are 4.71% and 11.62% respectively. The rate of permanent deferral (17.86%) was less compared to temporary deferral (82.14%). Among temporary deferral anaemia is the most common cause (27.75%). Seropositive for Hepatitis B is the most common cause for permenant deferral (52.30%). Conclusion: In our study temporary deferral is higher this necessities the need of education, motivation of these donors for future donation to maintain a healthy and safe donor pool.

Download Full-text