scholarly journals Clinical Features, Radiological Findings and Treatment Outcome in Patients with Pulmonary Nocardiosis – A Retrospective Analysis

2021 ◽  
Author(s):  
Prakrati Yadav ◽  
Durga S Meena ◽  
Deepak Kumar ◽  
Gopal K Bohra ◽  
Vidhi Jain ◽  
...  
Keyword(s):  
Clinical Features ◽  
High Index ◽  
Clinical Feature ◽  
Cell Mediated Immunity ◽  
Respiratory Pathogens ◽  
Duration Of Symptoms ◽  
Pulmonary Nocardiosis ◽  
Co Morbidity ◽  
The Common ◽  
The Mean

Abstract Introduction - Lack of specific clinical features makes the diagnosis difficult in Pulmonary Nocardiosis. High index of suspicion is required for diagnosis especially in cohort pre-existing risk factors. This study aimed at describing the clinical and radiological characteristics and outcome in patients with Pulmonary Nocardiosis.Methods - This was a retrospective observational study. Data of confirmed cases with Pulmonary Nocardiosis were collected from digital patient management system. Results - Total eight cases of Pulmonary Nocardiosis were included. The mean age of patients was 50 ± 14.3 years with female preponderance (62.5%). The most common co-morbidity was chronic lung disease (37.5%). The common clinical feature of pulmonary nocardiosis was cough with expectoration (50%). The mean duration of symptoms was 18 days. The common radiological (CT thorax) finding were consolidation, bronchiectasis, mediastinal lymphdenoathy and nodularity (50% each). One patient had extension of pulmonary disease in chest wall. Microbiological detection of Nocardia spp. was done in sputum samples (50%) and in BAL samples (50%). Culture was positive in two BAL samples. Intravenous empirical antibiotics in combination with oral trimethoprim sulfamethoxazole double standard (15 mg/kg trimethoprim) was started at the time of diagnosis. Ceftriaxone and amikacin were commonly used antimicrobials.Conclusion - Nocardia spp. commonly causes disease in patients with pre-exisitng lung pathological with or without defective cell mediated immunity. A high index of suspesion is required in patients with subacute to chronic respiratory symptoms, raised inflammatory markers and absence of common respiratory pathogens in evaluation.

scholarly journals Clinical profile of cardiac myxoma: 11 years’ experience of 90 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 18-22
Author(s):  
Md Toufiqur Rahman ◽  
Md Zulfikar Ali ◽  
Md Humayun Kabir ◽  
STM Abu Azam ◽  
AAS Majumder ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Primary Tumour ◽  
Correct Diagnosis ◽  
Cardiac Myxoma ◽  
Benign Neoplasm ◽  
Clinical Feature ◽  
Duration Of Symptoms ◽  
Pedal Oedema ◽  
Mechanical Interference ◽  
The Mean

Introduction: Cardiac myxoma is a benign neoplasm that represents the most common primary tumour of the heart. Because of nonspecific symptoms, early diagnosis may be a challenge. Although the left atrium is the most commonly involved site of origin in 75% of cases, it can arise from any of the cardiac chambers. Symptoms from a cardiac myxoma are more pronounced when the myxomas are left-sided, racemosus, and over 5 cm in diameter. Symptoms are produced by mechanical interference with cardiac function or embolization. Being intravascular and friable, myxomas account for most cases of tumor embolism. The site of embolism is dependent upon the location (left or right atrium) and the presence of an intracardiac shunt. Most atrial myxomas are benign and can be removed by surgical resection.Objectives: To see clinical presentation and echocardiographic profile of cardiac myoxomas.Methods: 90 cardiac myxoma patients who admitted both in cardiology and cardiac surgery departments of National Institute of Cardiovascular Diseases (NICVD), Dhaka from August 2003 to July, 2014 were studied clinically and by echocardiogram. Clinical histories were reviewed, noting age, gender, and clinical presentation.Results: There were 30 males and 60 females, ages ranged from 17 to 76 years. The commonest clinical feature was dyspnoea (94.44%), followed by palpitation (76.67%), chest discomfort (74.44%), constitutional symptoms (50%), pedal oedema (20%), syncope (14.44%), and embolization (7.7%). The mean duration of symptoms was 09.7 months.Conclusion: The clinical presentation of cardiac myxoma is often nonspecific, so high index of clinical suspicion is important for its early and correct diagnosis. The size and appearance of the myxomas correlated with the presenting symptoms.Bangladesh Heart Journal 2016; 31(1) : 18-22

CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

2021 ◽  
pp. 30-32
Author(s):  
Gulshan Bano ◽  
Anubha Prashad ◽  
Rakhee Soni ◽  
Mohammed Mishal
Keyword(s):  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Co Morbidity ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean ◽  
In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

scholarly journals AB1002 IS KAWASAKI DISEASE OR SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS IN CHILDREN WITH FEVER WITHOUT A SOURCE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1794.2-1794
Author(s):  
B. Sözeri ◽  
F. Demir ◽  
T. Merter ◽  
M. Karacan
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Kawasaki Disease ◽  
Clinical Features ◽  
Systemic Vasculitis ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Clinical Feature ◽  
Unknown Etiology ◽  
Ivig Treatment ◽  
Factors Affecting ◽  
The Mean

Background:Fever without a source (FWS) is caused by various diseases, making differential diagnosis difficult. Clinical similarities between Kawasaki disease (KD) and systemic Juvenile Idiopathic Arthritis (sJIA) are well known. Kawasaki disease (KD), a self-limiting systemic vasculitis, remains of unknown etiology and can cause irreversible coronary artery aneurysms (CAAs). SoJIA is sometimes confused with incomplete KD because both diseases have overlapping clinical features and can be accompanied with CAAs and/or SJIA with macrophage activation syndrome (MAS).Objectives:In this study, the frequency of both KD and SJIA among the patients evaluated with FWS and the clinical features of patients diagnosed with Kawasaki disease.Methods:Medical records of patients who first visited our department between January 2016 and December 2019 were reviewedResults:A total of 107 patients were enrolled in this study, including 43 patients (40.2%, 23 males) who fulfilled the criteria of Kawasaki disease and 64 patients (59.8%, 39 males) who did not fulfill them. In patients who fulfilled the criteria of classical FWS, 36(33.6%, 20 males) patients were diagnosed with systemic juvenile idiopathic arthritis. The mean age of the patients with Kawasaki disease was 30.0±20,4 months (median 25 months), the mean age of other patients was 52,6±40 months (median 39,5 months). The mean age of the patients with sJIA patients was 87,6±49,8 (median 80months). Kawasaki patients were younger than others (p=0.01). There was no difference in gender between groups.In Kawasaki patients, the most common clinical feature at diagnosis was fever (100%) followed by conjunctival congestion and mucosal changes (69%). The last two findings are more significant in kawasaki patients than others (p<0,00). Twenty-six (59%) patients had completed KD while 25% had incomplete KD. 7 (16%) patients had atypical KD. The mean fever duration was longer in sJIA patients than KD and others (median 14,8 and 7 days, p<0.00). All patients with KD received IVIG (2 g/kg, infusion in 12 h) and aspirin (60 mg/kg/day). 13.6% of the patients also received oral corticosteroids because of IVIG resistance. Thirty-one patients (72.1%) responded to IVIG treatment, whereas 12 (6 female, 6 male) were IVIG resistant. CAI was detected in echocardiography at diagnosis in 10 (22.7%) (6 female; 4 male) patients. We also detected 4 patients pericarditis with /without CIA.Conclusion:The clinical presentations of KD and sJIA are quite similar with fever, rash, hepatomegaly, and lymphadenopathy. All 2 entities may provide clues to potentially shared immunopathology.References:[1]Arslanoglu Aydin E et al. The factors affecting the disease course in Kawasaki disease. Rheumatol Int. 2019 Aug;39(8):1343-1349[2]Dong S et al. Diagnosis of systemic-onset juvenile idiopathic arthritis after treatment for presumed Kawasaki disease. J Pediatr. 2015 May;166(5):1283-8.Disclosure of Interests:None declared

scholarly journals Association of Serum Complement Components (C3 and C4) with Disease Activity in Yemeni Bronchial Asthmatic Patients

2020 ◽  
Vol 14 (1) ◽  
pp. 1-6
Author(s):  
Mahmoud Al-Azab ◽  
Mohammed Safi ◽  
Elina Idiiatullina ◽  
Mohammed Al Shaikh ◽  
Abdulbaki Al-Robasi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Bronchial Asthma ◽  
Statistical Tests ◽  
Complement C3 ◽  
Clinical Feature ◽  
Complement Components ◽  
Cross Sectional ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
The Mean

Objective: To assess the role of the complement components (C3 and C4) in the pathogenesis and severity of bronchial asthma (BA) among Yemeni patients. Methods: This cross-sectional, clinic-based study was conducted in Sana’a city, Yemen in the period from March to June 2012. It included 100 BA patients, where demographic and clinical data were collected using a pre-designed, structured questionnaire. Blood samples then collected by venipuncture, and sera were then separated and tested for the levels of C3 and C4 by immunoturbidimetry assay. Data were analyzed using suitable statistical tests using IBM SPSS Statistics, version Results: Of 100 patients, 53% were males and 29% were older than 40 years. The mean age of patients was 34.7± 17.5 years (range: 6–80). The majority of patients had active asthma (81.0%) and experienced asthma for more than two years (66.0%). Dyspnea (81.0%) and cough (65.0%) were the most frequent clinical features, while edema (11.0%) was the least frequent clinical feature among asthmatic patients. The mean level of serum C3 among BA patients was elevated (127.9 ± 21.3 mg/dL) and was significantly higher among females, patients aged 40 years or older and those with active BA, but there was no statistically significant difference with respect to the duration of asthma. In contrast, the mean level of serum C4 was normal (27.6 ± 8.8 mg/dL) but was significantly higher among patients aged 40 years or older and those having asthma for more than two years. Wheezing was significantly associated with the mean level of serum C3 among BA patients. Similarly, the mean level of serum C4 was significantly higher among patients having cough. Conclusions: The majority of Yemeni patients with BA have elevated levels of serum C3, which can be significantly higher in females, patients older than 40 years and those with active asthma. On the other hand, the levels of serum C4 are normal among the majority of Yemeni patients with BA, but these can be elevated among those with severe clinical features or long-term asthma. Keywords: Active asthma, Bronchial asthma, Complement, C3, C4, Yemen

Pattern of Provoking Factors and Psychiatric Co- morbidity in Migraine Headache: A Study from Tertiary Care Hospital

2018 ◽  
Vol 16 (1) ◽  
pp. 7-10
Author(s):  
Tanveer Ahmed Khan
Keyword(s):  
Anxiety Disorder ◽  
Migraine Headache ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Co Morbidity ◽  
The Common ◽  
The Mean

Introduction: Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice among which migraine only accounts up to 30%. Certain factors are found to play role in the triggering of migraine headache. Avoidance of such factors is part of migraine management. Psychiatric co morbidities are common in migraine. Recognizing these co morbidities could therefore result in improved patient management. Methods: This study was done at Nepalgunj medical college hospital, Nepalgunj. Duration of study was six months i.e. from 1st July 2017 to 31st December 2017. All the new cases fulfilling diagnostic criteria of migraine headache visiting to psychiatric outpatient department were included in this study. The diagnosis of migraine was made based on criteria mentioned by the international classification of headache disorders (ICHD-II). Result: A total of 50 patients were enrolled in this study. The mean age of participants was 28.60 ± 10.388 years. There was significant predominance of female participants. Family history of migraine was found in 20 (40%) of participants. The mean age of onset was 22.76± 7.899 years. The commonest type of migraine was migraine without aura in 2/3rd number of cases. Psychiatric co-morbidity was found in 26 (52%) subjects among which the most common co-morbidity was anxiety disorder in 16 (32%) followed by depression in 8 (16%). Presence of provoking factors was found in 38 (76%) subjects. Light, smoke, smell, noise and lack of adequate sleep were the common provoking factors. Conclusion: Migraine predominantly affects females with common age of onset in second and third decade. Psychiatric co-morbidities are common in migraine patients. Anxiety disorder and depression are the commonest co-morbidities. The common provoking factors are light, smoke, smell, noise and lack of adequate sleep found in migraine. Avoidance of provoking factors and early detection and management of psychiatric co morbidities can result in better outcome.

scholarly journals Gastroesophageal refl ux disease and irritable bowel syndrome overlapping: unresolved issues

2021 ◽  
Vol 98 (9-10) ◽  
pp. 645-649
Author(s):  
A. A. Sheptulin ◽  
K. E. Vinogradskaya
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clinical Features ◽  
Gastrointestinal Motility ◽  
Clinical Picture ◽  
Endoscopic Examination ◽  
High Rate ◽  
Esophageal Ph ◽  
The Common ◽  
The Mean ◽  
Irritable Bowel

The review presents literature data concerning the rate and clinical features in cases of the gastroesоphageal refl ux disease (GERD) and irritable bowel syndrome (IBS )overlapping. The mean rate of GERD and IBS overlapping is 36–48 .8%, but in individual articles varies from 8–11% to 71–79%. A signifi cant variation in the rate is explained by diff erent approaches to the diagnosis of GERD and IBS in various studies (use of questionnaires, endoscopic examination, esophageal pH-impedancemetry). The high rate of GERD and IBS overlapping is related to the common pathogenetic mechanisms of both diseases (disorders оf gastrointestinal motility, visceral hypersensitivity). The features of the clinical picture and treatment in cases of GERD and IBS overlapping are studied insuffi ciently and require further research.

Effect of tonsillectomy on recurrent sore throats in adults: patients' perspectives

2006 ◽  
Vol 120 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Adenike Folake Oluwasanmi ◽  
Martin Robert Thornton ◽  
Hisham Saleh Khalil ◽  
Paul Anthony Tierney
Keyword(s):  
Sore Throat ◽  
Adult Patients ◽  
Rank Test ◽  
Duration Of Symptoms ◽  
Signed Rank ◽  
Co Morbidity ◽  
Signed Rank Test ◽  
The Mean ◽  
Absence From Work ◽  
Retrospective Questionnaire

The aim of this study was to quantify the effect of tonsillectomy on the incidence of sore throats and its co-morbidity in adult patients. One hundred and nineteen adult patients were sent a standard questionnaire regarding their symptoms in the 12 months preceding and following their tonsillectomy. Outcome measures included the incidence of sore throats, total number of days with sore throat, amount of time taken off work or school, and number of visits to the general practitioner (GP). In addition, patients were asked to indicate the duration of their symptoms and whether or not they found the tonsillectomy effective in curing their sore throats.Sixty-six patients (55.5 per cent) returned completed questionnaires. The age of the patients ranged from 16 to 39 years. The mean duration of symptoms was 8.3 years. On average, patients had 8.1 different sore throat episodes, 42 sore throat days, 21.4 days of sore throat related absence from work or school, and 5.9 visits to the GP in the 12 months before their operation. For the 12 months after surgery, these reduced to 0.9 episodes, four days, 2.2 days and 0.6 visits, respectively. This reduction was very significant (p < 0.001, Wilcoxon signed rank test).After their surgery, more than half the patients achieved complete resolution of all the measured parameters mentioned above. Most of the remaining patients achieved at least 50 per cent resolution. Only three patients (4.8 per cent) achieved less than 50 per cent resolution. Ninety-five per cent of the patients found the operation effective in curing their sore throats and were glad they had had surgery.In conclusion, retrospective questionnaire data must be interpreted with some caution, but this study suggests that tonsillectomy is effective in reducing the incidence, duration and co-morbidity of recurrent sore throats in adults; this must be balanced against the post-operative problems in a minority of patients.

scholarly journals Predictors of outcome of subdural empyema in children

2019 ◽  
Vol 47 (2) ◽  
pp. E17 ◽  
Author(s):  
Subhas Konar ◽  
Dhaval Gohil ◽  
Dhaval Shukla ◽  
Nishanth Sadashiva ◽  
Alok Uppar ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Clinical Features ◽  
Subdural Empyema ◽  
Unfavorable Outcome ◽  
Burr Hole ◽  
Predictors Of Outcome ◽  
Duration Of Symptoms ◽  
Multivariable Logistic Regression ◽  
The Mean ◽  
Gcs Score

OBJECTIVEThe aim of this study was to report the etiology, clinical features, microbiology, surgical outcome, and predictors of outcome of spontaneous subdural empyema (SDE).METHODSThe authors conducted a retrospective study in a tertiary hospital. Children up to 18 years of age, with a diagnosis of SDE with infective etiology, were included in the present cohort. Patients with posttraumatic, postsurgery, and tubercular origin of SDE were excluded from the study. The Glasgow Outcome Scale was used for outcome assessment at the end of 3 months. For analysis purposes, the demographic data, clinical features, radiological data, microbiology, type of surgery, and complication data were categorized, and univariate and multivariable logistic regression analyses were performed to identify the factors associated with outcome.RESULTSNinety-eight children were included in the study and the mean age was 10.9 years. Otogenic origin (34.7%) was the most common source of infection, followed by meningitis (14.3%). The mean duration of symptoms was 12 days. Seventy-six children presented with Glasgow Coma Scale (GCS) score > 8 and the supratentorial location was the most common location. Almost 75% of the children underwent craniotomy or craniectomy and the rest had burr-hole evacuation. Beta-hemolytic Streptococcus (10%) was the most common organism isolated. Cerebral venous thrombosis (CVT; 10.2%) was the most frequent complication in this cohort. The other complications were infarction (6.1%), new-onset seizure (4.1%), and bone flap osteomyelitis (4.1%). Thirteen cases had a recurrence of pus collection, which was more common in the craniotomy group than in the burr-hole group. Age (p = 0.02), GCS score ≤ 8 (OR 8.15, p = 0.001), CVT (OR 15.17, p = 0.001), and presence of infarction (OR 7, p = 0.05) were strongly associated with unfavorable outcome. In multivariable logistic regression analysis, only GCS score ≤ 8 (p = 0.01), CVT (p = 0.02), and presence of infarction (p = 0.04) had a significant impact on unfavorable outcome.CONCLUSIONSPrompt diagnosis and immediate intervention is the goal of management of SDE, especially in children as a delay in diagnosis can result in unconsciousness and secondary complications such as CVT and infarction, which adversely affect outcome.

scholarly journals Study on clinical features and factors associated with thickness of chronic subdural hematoma in adult

2018 ◽  
Vol 11 (3) ◽  
pp. 209
Author(s):  
Ruhul Kuddus ◽  
M. Afzal Hossain ◽  
S. K. Sader Hossain ◽  
A. T. M. Mosharef Hossain ◽  
Haradan Debnath ◽  
...  
Keyword(s):  
Clinical Features ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Complete Recovery ◽  
Factors Associated ◽  
Co Morbidity ◽  
Axial Ct ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

<p class="Abstract">Patients with chronic subdural hematoma encounter certain difficulties in diagnosis, especially in elderly, due to the characteristically non-specific symptoms and signs. Early diagnosis and proper operative treatment, on the other hand, results in complete recovery in most of the cases. In this study, the clinical features and factors of 31 patients with chronic subdural hematoma, associated with the thickness of chronic subdural hematoma were analyzed. The mean age was 62 ± 13.9 years. The maximum hematoma thickness in the axial CT scan was 25 mm. The thickness of hematoma obtained from axial plain CT had a positive relationship with the patient’s age where r=0.895 and p&lt;0.001 signifies that the thickness of hematoma increased with the increasing age. But the hematoma thickness was not related to co-morbidity such as diabetes mellitus, hypertension and ischemic heart disease. The presentation of the patient with higher hematoma thickness with hemiparesis was statistically significant and with lower thickness with headache and vomiting.</p>

scholarly journals Clinical features and etiology of patients with community-acquired pneumonia in southern China

2020 ◽  
Author(s):  
Caiyan Gan ◽  
Sudong Liu ◽  
Xuemin Guo ◽  
Ruiqiang Weng ◽  
Xiaodong Gu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Southern China ◽  
Systemic Disease ◽  
Community Acquired Pneumonia ◽  
Single Infection ◽  
Respiratory Pathogens ◽  
Increased Risk ◽  
Study Population ◽  
Mrsa Infection ◽  
The Mean

Abstract Background: The aim of this study was to investigate the clinical features and etiology in patients with community-acquired pneumonia (CAP) in southern China. Methods: A total of 342 patients who presented community-acquired pneumonia (CAP) from January 2019 to December 2019 were enrolled in this study. The respiratory pathogens in nine test and loop-mediated isothermal amplification (LAMP) detection were used to identify pathogens. Results: The mean age of this study population was 60.89 ± 18.87 years. The total incidences of CAP were more prevalent in males (60.5%, 207/342) than females (39.5%, 135/342), and the percentage was 65.8% (225/342) CAP patients in summer and autumn. The main causative pathogens were identified in 96/342 (28.1 %) patients. Of these, 14 (14.6 %) were MP infection, the most frequently isolated microorganism. Bacterial infection in the single infection was present in 47 (47/96, 49.0%). Mixed infections were demonstrated in 26 (26/96, 27.1%). MRSA infection was close to patients with systemic diseases (P = 0.001). Factors that were associated with systemic disease was the age >65 (OR 5.555, 95%CI 3.402-9.071, P<0.001). Conclusions: MP is common organisms isolated in community-acquired pneumonia. The year of above 65, the count of WBC and mixed pathogens infections may be associated with an increased risk of CAP patients with systemic disease.

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