scholarly journals Battling the Emerging Epidemic of Rhino-Orbital-Cerebral Mucormycosis (ROCM) in COVID-19 Pandemic: A Prospective Interventional Study

2021 ◽  
Author(s):  
Aastha Gandhi ◽  
Anurag Narula ◽  
Shreya Chandra ◽  
Dhwanee Agarwal ◽  
Anuj Mehta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
New Delhi ◽  
Interventional Study ◽  
Tertiary Care Centre ◽  
Aggressive Approach ◽  
Stage 4 ◽  
Male Preponderance ◽  
Facial Edema ◽  
Intravenous Amphotericin

Abstract Purpose: The most recent challenge being faced by the healthcare system during the worldwide COVID-19 pandemic is increase in the incidence rate of coinfection or superinfection; one of the most fatal being mucormycosis. This study aimed to estimate the risk factors, symptoms and signs, treatment outcome and prognosis of COVID-19-associated mucormycosis (CAM) patients. Methods: This is a prospective, interventional study of 35 patients diagnosed and managed as CAM at a tertiary care centre in New Delhi, India. Results: The mean age of patients was 40.45± 6 years with a male preponderance. CAM did not affect healthy individuals; the major risk factors included diabetes in 65.7% and injudicious steroid use in 51.4% patients. Orbital/facial edema was the most common presenting symptom (25.7%) as well as sign (28.57%). 68.5% patients were stage 3 (involvement of orbit) at presentation; 33.3% showed medial wall involvement. Treatment included intravenous amphotericin and oral posaconazole in all patients, paranasal sinus (PNS) debridement in 94.2%, orbital exenteration was done in 8 patients. Adjuvant retrobulbar amphotericin B injection was administered in 12 patients with radiological resolution seen in 50% after 1 cycle. In patients with Stage 4 disease who underwent exenteration along with PNS debridement, survival rate was 100% at 30 days, and disease reduction occurred in 87.5% patients (P<0.01). Overall, 68.5 % responded to therapy, 8.5 % showed progression and mortality rate was 22.85 %, at a mean follow up period of 59.5 days.Conclusion: A multidisciplinary and aggressive approach is essential in the management of CAM patients.

scholarly journals Risk factors for childhood refractory epilepsy in a tertiary care centre, Chennai, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1432
Author(s):  
Thannoli Gowthami Gowrinathan ◽  
Senthil Kumar A.
Keyword(s):  
Risk Factors ◽  
Chromosomal Abnormalities ◽  
Tertiary Care ◽  
Intractable Epilepsy ◽  
Febrile Seizures ◽  
Tertiary Care Centre ◽  
Male Preponderance ◽  
Symptomatic Epilepsy ◽  
Study Population ◽  
Active Epilepsy

Background: Intractable epilepsy is the pragmatic problem during the treatment of active epilepsy in children. Several risk factors are associated with incidence of intractable/recurrent epilepsy. The current study was done to identify the risk and prognostic factors associated with recurrent epilepsy (RE).Methods: This descriptive study was conducted on 152 children with idiopathic or symptomatic epilepsy who are on two or more AEDs and who were in follow up in Neurology OPD and inpatients in medical ward at ICH&HC, Chennai. All patients underwent relevant investigations to identify the possible risk factors for incidence of RE in study population. Karyotyping was done for idiopathic cases.Results: Male preponderance was seen in the study (M:F-2:1). Risk factors such as male sex, age onset of seizures, type of seizures, developmental delay, CNS congenital anomalies, h/o perinatal injury, neuroabnormality, abnormal MRI and EEG was found to have statistically significant association with incidence of RE. No significant association was observed for the factors microcephaly, behavioural abnormalities, h/o febrile seizures and h/o status epilepticus with incidence of RE. No chromosomal abnormalities were detected in idiopathic cases.Conclusions: Early identification, risk factor analysis and understanding in the dynamics of the disease helps the physician in initiating the appropriate treatment, thereby avoiding the wrong therapy, low dose therapy and infrequent therapy. Above all identification of the risk factors helps in parental counseling and prepare them for expected outcome.

TO DETERMINE THE PREVALENCE AND OCCURANCE OF VISUAL MORBIDITY IN PATIENTS OF PTERYGIUM ATTENDING EYE OPD IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2021 ◽  
pp. 80-81
Author(s):  
Vandana Parasar ◽  
Vidyabhushan Kumar ◽  
Ankita Singh ◽  
Nilesh Mohan
Keyword(s):  
Socioeconomic Status ◽  
Tertiary Care ◽  
Living Condition ◽  
Age Group ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Male Preponderance ◽  
Uvb Exposure ◽  
Epidemiological Trends

To determine the prevalence and occurrence of visual morbidity in patients of pterygium attending eye opd in a tertiary care centre of Bihar. Methods: In this observational study a total of 193 patients, diagnosed with pterygium, underwent complete ocular examination by an ophthalmologist. Epidemiological trends including age, sex, occupation, effect of living condition and socioeconomic status were analyzed. Results: There is a male preponderance of 58.03%. The age incidence of the group showed that the incidence of pterygium was 10.36% in the age group of less than 30 years. It rises to a maximum of 29.53% in the age of 41-50 years and then gradually declines.. The incidence was found to be maximum among farmers(39.86%) followed by miners(31%). Conclusion: People who work outdoors are at a greater risk because they are subjected to involuntary UVB exposure. The highest exposure occurs during the two hours on either side of noon. Workers must be aware and should take appropriate measures like wearing protective glasses, caps, etc

A Study on Prevalence and Seasonal Distribution of Dengue at a Tertiary Care Centre of North India

Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 100-107
Author(s):  
Arti Agrawal ◽  
Vikas Kumar ◽  
Sanjeev Kumar ◽  
Neha K Mani
Keyword(s):  
Monsoon Season ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Seasonal Distribution ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Post Monsoon ◽  
Post Monsoon Season ◽  
Male Preponderance

Introduction: Dengue virus infection is a major public health issue prevalent in tropical and sub-tropical countries all over the world mostly in urban and semi-urban areas. WHO estimates about 50-100 million dengue infections worldwide every year. The present study is aimed to assess the prevalence and seasonal distribution of dengue disease during three consecutive years from 2016-2018 at a tertiary care centre of North India. Method: This is an observational retrospective study conducted on total 6,481 clinical suspected cases referred from indoor and outdoor departments of Medicine and Pediatrics of one of the medical colleges of Agra during the period from 1st January 2016 to 31st December 2018. Results: The maximum positivity was recorded in the year 2016 (16.66%), followed by 2017 (14.07%) and 2018(13.56%).Our study shows male preponderance with maximum cases in the year 2018 was recorded in the month of October (22.75%) whereas the lowest in the month of May (1.96%). Most of the cases were in the age group 0-30 years with a male preponderance. The outbreak occurred during the months of August to November indicating vector transmission in the monsoon and post-monsoon season. Conclusion: From the analysis, this study reflects that the numbers of dengue cases in 2016 were maximum and outnumbered the dengue cases among three consecutive years from 2016 to 2018. The peak in dengue positivity was observed during September to October. As this disease affects the population in the monsoon and post monsoon months therefore continuous monitoring of dengue infection is important during the post-monsoon season.

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

scholarly journals Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India

2021 ◽  
Author(s):  
Yamini Marimuthu ◽  
Radhika Kunnavil ◽  
NS Anil ◽  
Sharath Burugina Nagaraja ◽  
N Satyanarayana ◽  
...  
Keyword(s):  
Risk Factors ◽  
South India ◽  
Linear Models ◽  
Tertiary Care ◽  
Male Gender ◽  
Clinical Profile ◽  
Rank Test ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.

scholarly journals Evaluation of Risk Factors for Retinopathy of Prematurity in Premature Born Infants in Tertiary Care Centre in Punjab

2020 ◽  
Vol 9 (1) ◽  
pp. 1-5
Author(s):  
Jatinder Singh ◽  
Vaneeta Bhardwar ◽  
Harshdhawann Singh ◽  
Isha Bhardwaj ◽  
Sushmita Choudhary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Premature Born

scholarly journals Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

2015 ◽  
Vol 04 (01) ◽  
pp. 015-017 ◽  
Author(s):  
Kumar Narendra ◽  
Tapesh Bhattacharyya ◽  
Chanchalani Karan ◽  
Praveen Shalunke ◽  
B D Radotra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Overall Survival ◽  
External Beam Radiotherapy ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Changing Trends ◽  
Common Location ◽  
Male Preponderance ◽  
Radiotherapy Alone

Abstract Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009–2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

scholarly journals Evaluation of Specific Risk Factors and Outcomes of Colistin-Resistant Klebsiella pneumoniae Infections in a Tertiary Care Centre - An Observational Study

2021 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Prakash Shastri ◽  
Shamanth A Shankarnarayan
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Multidrug Resistant ◽  
Automated System ◽  
Tertiary Care Centre ◽  
Broth Microdilution Method

Background: Incidence of multidrug resistant Klebsiella pnumoniae infections are increasing globally especially in ICUs. Aim: We evaluated the burden of colistin resistant K. pneumoniae (ColR KP) and the risk factors associated with the outcome of these patients. Methods: Consecutive patients developing K. pneumoniae infections were included. K. pneumoniae from endotracheal tube and catheterized urine sample, having cell count <105 cfu/ml, and which did not necessitate a change in antibiotics as per the treating physicians was considered as colonizer. Demographic and clinical details were collected and samples were processed as per standard protocol. Any growth was identified and its antimicrobial susceptibility was carried out by using Vitek 2 automated system. Minimum inhibitory concentration of >4 μg/ml for Colistin was considered as resistant. The resistant isolates were confirmed with Broth microdilution method. Risk factor associated with the outcome of ColR KP was analyzed. Findings: Burden of K. pneumoniae infection was 50.02 per 1000 admissions. K. pneumonie (n=155) was isolated from patients with ventilator associated pneumonia (84, 54.2%), followed by blood stream infection (49, 31.6%) and urinary tract infection (22, 14.2%). ColR KP and intermediate (ColI KP) isolates were 58 (37.41%) and 97 (62.6%) respectively. Among ColR KP infected patients 32 (55.1%) died whereas 26 (44.8%) patients were discharged. Higher mortality was witnessed in ColI KP cases (75, 77.3%) compared to ColR-KP cases (32, 55.1%) (p=0.004; OR=2.77; 95% CI=1.37 to 5.59). Colistin resistance and presence of central line were independently associated with mortality. Conclusion: Colistin resistant K. pneumoniae infections among ICU patients are on rise. Presence of central venous catheter and resistance to colistin were independent predictors of mortality.

scholarly journals A seven year experience in patients undergoing total thyroidectomy for benign diseases in a single unit of tertiary care centre: a retrospective case study

2019 ◽  
Vol 7 (9) ◽  
pp. 3317
Author(s):  
Dheer S. Kalwaniya ◽  
Jaspreet S. Bajwa ◽  
Gowtham K. Gowda ◽  
Akshay Narayan ◽  
Rohit Choudhary
Keyword(s):  
Total Thyroidectomy ◽  
Single Unit ◽  
Tertiary Care ◽  
Average Weight ◽  
New Delhi ◽  
Safe Procedure ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Benign Diseases ◽  
Female Ratio

Background: Thyroidectomy is a common surgical procedure performed worldwide by surgeons with varied training. It is the experience and the skills by which a surgeon performs, the indication of surgery and the extent of surgery which determines the outcome and the complication rates.Method: This study is a retrospective study performed from January 2012 to December 2018 when a total of 170 patients underwent total thyroidectomy via kocher’s incision for benign diseases with clinically in hypothyroid state at Safdarjung Hospital, New Delhi in a single unit of a tertiary care hospital.Results: The male: female ratio was 1:7.09 with average age of patients being 40years. The overall complication rate was 18.82% (32 patients). Postoperative transient hypocalcaemia being the most common complication. There was no case of permanent hypocalcaemia. There was no injury to any nerve (recurrent or superior laryngeal). Transient recurrent laryngeal paresis was noted in 4(2.35%) which resolved with conservative management. Complications like wound infection, sympathetic chain injury were not noted. The characteristic feature of this study was five cases of giant secondary retrosternal goitre which had average weight of greater than 500 grams which were operated using kocher’s incision. The average weight of other 165 patients was 70grams +/- 12 grams. There were no major post-operative complications except for post-operative recurrent laryngeal nerve paresis and seroma formation which was evacuated after 3 weeks of surgery.Conclusion: Hence, from this it is concluded that it is the surgical experience and skills of the surgeon which make total thyroidectomy a safe procedure providing permanent cure with a low post-operative morbidity risk even with large sized retrosternal thyroid glands which can be operated via neck incision.

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