scholarly journals The Baseline Characteristics of Patients with COVID-19 and Impact of Various Risk Factors on the Outcome of Patients Admitted in Tertiary Care Hospital.

Author(s):  
Samiullah Shaikh ◽  
Faiza Deedar ◽  
Tara Chand Devrajani

Abstract Background: The outbreak caused by novel coronavirus was first reported in Wuhan, China in December 2019 when a new pathogen was discovered from the bronchoalveolar lavage fluid of the patient suffering from pneumonia. Globally over 81.47 million confirmed cases and 1.79 million deaths has been reported. The clinical spectrum ranges from mild influenza-like illness to severe life threatening respiratory disease requiring ventilatory support to death. The purpose of this study was to evaluate the baseline carecteristic of the patients and impact of various risk factors on the outcome of patients admitted in tertiary care hospital. MATERIALS AND METHODSStudy Area and Period: This study was conducted at Liaquat University Hospital from April 2020 to September 2020. Study Design: Cross-Sectional Descriptive.Inclusion Criteria: The patients were included on the basis of diagnosis of COVID-19 confirmed on reverse transcription Polymerase Chain reaction (RT-PCR) test. Categorical variables such as age, sex, Gram-Covid risk category ,diabetes mellitus, hypertension, renal, pulmonary disease, obesity, outcome of patient were presented as frequency and percentage RESULTS: This study included 235 consecutive patients admitted at Liaquat University Hospital from April 2020 to September 2020. There were 187(79.6%) male and 48(20.4 %) female. The age < 65 years were present in 80 ( 34%) and ≥ 65 155(66%) patients. The most prevalent symptoms were fever ,breathlessness, cough, anorexia, fatigue in all 235(100% ) patients. Severity of illness according to Gram-Covid Score 18 (7.7%) patients were in low-risk group, 93(39.6%) in moderate risk group and 124 (52.8%) in High risk group.There were no risk factors in 121(51.5%) , one risk factor in 49(20.9%), two risk factors in32(13.6%) , three risk factors in 18( 7.7%) and four risk factors in 15(6.4%) patients.The outcome of patients showed 57(24.3%) deaths, 107 (45.5%) patients had prolong stay and 71(30.2%) patients recovered. A strong relationship was observed between the outcome of patient with age, number of risk factors, severity of illness according to gram - Covid score whereas insignificant relationship with the sex of patients.Conclusion: COVID-19 patients clinically present with fever, cough and breathlessness. Majority of patients present with moderate to high severity. Patient with advanced age, high risk on gram-Covid score with multiple comorbidities are particularly susceptible to adverse outcome.

2020 ◽  
Vol 11 (3) ◽  
pp. 3710-3718
Author(s):  
Sonal Gupta ◽  
Sujata R. Kanetkar

Myeloproliferative neoplasms (MPNs) are a group of disorders of hematopoietic stem cells which were initially recognised by William Dameshek in 1951. Objectives of the study were to diagnose and classify cases of myeloproliferative neoplasms according to 2016 revision of WHO classification of myeloid neoplasms and acute leukaemias, to study various haematological parameters of cases of MPNs (Peripheral smear findings, bone marrow aspirate and trephine biopsy) and their clinical manifestations, to record the cytogenetic/molecular genetic abnormalities of the cases and to categorise CML patients according to Hasford Risk Score as a predictor of prognosis. This study was a prospective study carried out in the Department of Pathology of a tertiary care hospital over two years from June 2016 to September 2018. The study included a total of 41 cases of MPNs. The cases of CMLs were diagnosed on peripheral blood findings, Bone marrow aspiration, Trephine biopsy Serum LDH and uric acid. CML was the most common MPN encountered (37/41; 90.24%) in the present study. Maximum serum LDH elevation was observed in CML cases with a mean value of 1396.6 U/L. Of the 37 CML cases, as per Hasford score, 17 cases were categorised into a low-risk group, 17 cases into an intermediate-risk group and 3 cases into a high-risk group. In the present study of Hasford score in CML cases, it was found that it helps in making a better-informed decision about the adaption of alternative high-risk treatment, and was of value in oncology practice.


Author(s):  
Ahsanu Zaman Kunnath ◽  
Anwar Sadath Choolakkaparambu Aboobakker ◽  
Bashir Nalakath Kunjimon ◽  
Sandeep Sreedhar

<p class="abstract"><strong>Background:</strong> Hearing is necessary for the proper mental and social development of a new-borns child. Delay in diagnosis leads to improper development of social and mental skills. The prevalence of congenital hearing loss is greater than prevalence of screened metabolic syndromes. There are multiple maternal and intrapartum risk factors associated with hearing impairment. Most of the causes are treatable. Objectives was to find out the proportion of hearing impairment in neonates and its risk factors in a tertiary care hospital in north Kerala.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional research was performed in a tertiary care hospital in Northern Kerala between January 2018 and June 2019 after obtaining informed consent and institutional ethical committee clearance among those who fulfilled the inclusion and exclusion criteria. All the high-risk new-borns were subjected to Otoacoustic examination. Those who did not pass the first OAE were subjected to second OAE after one month. Those who did not pass in the examination were subjected to BERA. Those high risk children who did not pass the BERA were considered having hearing impairment and were subjected to further investigation and appropriate management.   </p><p class="abstract"><strong>Results:</strong> The prevalence of hearing impairment was 0.5%. 0.25% were unilateral and 0.25% were bilateral. Pregnancy induced hypertension, premature labour, lower segment Caesarian section, low birth weight, small for gestational age, respiratory distress, hyperbilirubinemia and presence of congenital malformations were significantly associated with hearing impairment.  </p><p class="abstract"><strong>Conclusions:</strong> Since most of the congenital hearing loss among high risk neonates can be treated, a nationwide standardized hearing assessment program is advocated for the early detection of high risk children with hearing loss.</p>


2021 ◽  
Vol 7 (4) ◽  
pp. 267
Author(s):  
Ivana Mareković ◽  
Sanja Pleško ◽  
Violeta Rezo Vranješ ◽  
Zoran Herljević ◽  
Tomislav Kuliš ◽  
...  

Invasive candidosis is the most common invasive fungal infection in hospitalized patients and is associated with a high mortality rate. This is the first study from a Croatian tertiary care hospital describing epidemiology, risk factors and species distribution in patients with candidemia. A three-year retrospective observational study, from 2018 to 2020, was performed at the University Hospital Centre Zagreb, Zagreb, Croatia. A total of 160 patients with candidemia (n = 170 isolates) were enrolled. Candidemia incidence increased from 0.47 to 0.69 per 1000 admissions in 2018 and 2020, respectively. Ninety-five patients (58.38%) were in the intensive care unit. The main risk factors for candidemia were central venous catheter (CVC) (84.38%), previous surgical procedure (56.88%) and invasive mechanical ventilation (42.50%). Candida albicans was identified in 43.53% of isolates, followed by C. parapsilosis (31.76%) and C. glabrata (12.36%), C. krusei (5.29%), C. tropicalis (2.35%) and C. lusitaniae (2.35%). The study discovered a shift to non-albicansCandida species, particularly C. parapsilosis, and made it possible to determine the main tasks we should focus on to prevent candidemia in the hospital, these being mainly infection control measures directed towards prevention of catheter-related bloodstream infections, specifically comprising hand hygiene and CVC bundles of care. The potential benefit of fluconazole prophylaxis in certain populations of surgical patients could also be considered.


Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


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