scholarly journals Acute pancreatitis in pregnancy: A 10-year, multi-center, retrospective study in Beijing

2021 ◽  
Author(s):  
Tingting Zhang ◽  
Guoxing Wang ◽  
Zheng Cao ◽  
Wenyang Huang ◽  
Hongli Xiao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Common Causes ◽  
High Level ◽  
Tertiary Care Hospitals ◽  
Beijing China ◽  
In Pregnancy

Abstract Objective Acute pancreatitis in pregnancy (APIP) is a rare and serious complication during pregnancy. It has acute onset and is difficult to diagnose and treat. The aim of the present study was to describe the etiology, clinical manifestations, and maternofetal outcomes of APIP. Methods We retrospectively reviewed 32 pregnant women who were treated at three tertiary care hospitals in Beijing, China. The correlation between the causes of APIP, severity, laboratory indices, and outcomes was analyzed. Results The most common causes of APIP were hypertriglyceridemia (56.2%,18/32) and gallstones (28.1%, 9/32). Hypertriglyceridemia-induced APIP was associated with a higher rate of severe acute pancreatitis (P = 0.025). Serum level of triglycerides showed a positive correlation with the severity of APIP (P = 0.039). The most frequent presentation of APIP was abdominal pain (93.7%, 30/32). There were no maternal or fetal deaths in our study. Neonatal asphyxia was correlated with the severity of APIP (P = 0.039). Conclusion High level of triglycerides may serve as a useful marker of the severity of APIP. The severity of APIP was associated with higher risk of neonate asphyxia. Appropriate timing of termination of pregnancy is a key imperative for APIP patients.

Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

2001 ◽  
Vol 22 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Tariq A. Madani ◽  
Nabeela A. Al-Abdullah ◽  
Ali A. Al-Sanousi ◽  
Tawfik M. Ghabrah ◽  
Shadia Z. Afandi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Total Mortality ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Tertiary Care Hospitals

AbstractObjective:To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.Design:Retrospective review for the year 1998.Setting:Two tertiary-care hospitals.Methods:Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.Results:Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.Conclusions:The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

scholarly journals The dilemma of using physical restraint in delirium tremens: a case report

2019 ◽  
Vol 7 (8) ◽  
pp. 3172
Author(s):  
Yogender Kumar Malik ◽  
Debasish Basu ◽  
Chandrima Naskar
Keyword(s):  
Case Report ◽  
Clinical Setting ◽  
Tertiary Care ◽  
Delirium Tremens ◽  
Physical Restraint ◽  
Common Presentation ◽  
Usual Dose ◽  
High Level ◽  
Tertiary Care Hospitals ◽  
Higher Doses

Delirium tremens (DT) is a common presentation in tertiary care hospitals. Refractory DT, though not very common, is a dreaded presentation in any clinical setting. Usually, patients with DT respond to standard doses of benzodiazepines, but sometimes we encounter patients requiring higher than the usual dose. Also, due to the high level of agitation, confusion and hallucinatory behaviour, physical restraint is frequently used in these patients. We hereby report a case of refractory DT in whom the dilemma of using physical restraint and need for higher doses of Benzodiazepine has been highlighted.

scholarly journals Awareness of human papilloma virus (HPV) vaccine female doctors working in tertiary care centres.

2021 ◽  
Vol 28 (04) ◽  
pp. 464-469
Author(s):  
Zahra Safdar ◽  
Faisal Ashraf ◽  
Alia Bashir
Keyword(s):  
Hpv Vaccine ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Common Causes ◽  
Tertiary Care Hospitals

Objectives: The aim of the study is to assess the awareness about various aspects of HPV infection and vaccine among female doctors working in tertiary care centres. Study Design: Cross Sectional study. Setting: 3 Tertiary Care Hospitals Lahore. Period: Jan 2018 Jan 2019. Material & Methods: 478 female doctors from 03 tertiary care hospitals (Lady Atchison hospital, Lahore General Hospital and Services Institute of Medical Sciences) in Lahore who voluntarily filled 18-point self-administered questionnaire assessing their knowledge about HPV infection (8) HPV vaccine (5) and opinions about it (5). Knowledge score (range 0-8), assuming adequate knowledge > median. Factors associated with opinions were explored and analysed. Results: Most replied knowledge questions correctly 67.2%, 39.5% perceived it as frequently occurring infection. Median knowledge was 6 out of 8 questions; lack of knowledge was associated with non ob-gynae speciality or junior level. None of the participants were immunized but 46.3% were willing to get vaccinated themselves 78.1% were willing to get their daughters vaccinated. Self-perceived under exposure of HPV infection was 67.9%. Lack of feeling it as important in our social setting (28.6%), and expensiveness (19.4%) were most common causes of not counselling the patient about HPV vaccine and counselling to get vaccinated was most commonly done as it saves patients from cervical cancer (86.8%). Conclusions: Despite adequate knowledge of HPV infection and effectiveness of its vaccination, female doctors working in tertiary care hospitals of Lahore’s are not efficiently spreading awareness to the society and prescription of the vaccination is also deficient.

scholarly journals Challenge: Tertiary Care Hospitals to Management of High Alert Medicine for Reduce the Medication Error

2017 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Medication Error ◽  
Health Care Organizations ◽  
Medication Management ◽  
Tertiary Care ◽  
Near Miss ◽  
Patient Report ◽  
Healthcare Settings ◽  
Common Causes ◽  
Tertiary Care Hospitals ◽  
Current Incidence

Medication errors are one of the most common causes of avoidable harm to patients in health care organizations. Medications that have the highest risk of causing injury when used wrongly are known as high-alert medications in JCI accredited hospitals. Safe practices can reduce the potential for harm. Because of the significant nature of the potential adverse effects such as bleeding or hypoglycemia. Many of these medications are also more likely to be associated with dosing errors, due to issues such as the need to frequently calculate dosing based on weight. A separate list for community and ambulatory healthcare settings is also available from ISMP. In case of LASA medication regular updating of regular LASA medication list on the basis of current incidence need to be under observation of Pharmacy and Therapeutics Committee. Prescription review by clinical pharmacist in relation with patient report, indication and instruction for the dilution was to be done before administration. This may lead to convert medication error into near miss error. All High alert medication has to be audited for every step in MMU (Medication Management and Use) like prescription, indenting, dispensing and administration. Double checking is compulsory follow in every step.

scholarly journals Clinical manifestations of benign ovarian tumors

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Al Fareed Zafar ◽  
Aqeela Fazil ◽  
Al Asifa ◽  
Attiya Karim ◽  
Noreen Akmal
Keyword(s):  
Abdominal Pain ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Abdominal Distension ◽  
Common Cause ◽  
Emergency Cesarean ◽  
Benign Ovarian Tumours ◽  
Number Of Patients ◽  
Ovarian Tumours ◽  
Palpable Tumour

Aims and objectives: To examine the cases of Benign Ovarian Tumours and their clinical manifestations. Design:- Prospective study of consecutive cases of Ovarian tumours, identified using gynaecological case records. Place: Tertiary care teaching hospital affiliated with Fatima Jinnah Medical College Lahore, managing more than 1500 gynaecological cases annually. Subjects: 50 cases of Ovarian tumours managed in Department of Gynaecology & Obstetrics Sir Ganga Ram Hospital, Lahore between 1st May 2004 to 1st May 2005. Results: The most common presenting complaints were abdominal pain or discomfort and palpable tumour causing abdominal distension. Abdominal pain was present in 70% of benign ovarian tumours. 20% of the patients had pain due to torsion of ovarian cyst. The complaint of a palpable tumour was found in 4 7% of cases. Vague abdominal and bowel complaints were present in 2 2.5% of cases. 6(15%) patients were asymptomatic. Of these 2 were diagnosed by ultrasound and 3 at the time of emergency Cesarean section and one on routine pelvic examination. Menstrual irregularity and urinary complaints were present in a small number of patients. None of the patient complaint of weight loss or post menopausal bleeding. Conclusion: Benign Ovarian Tumours are most common cause of ovarian enlargement and a very common cause of hospital admission. Symptoms and signs are non specific and presentation is a late stage.

scholarly journals Dengue Outbreak in Children During 2019: Experience at A Tertiary Care teaching Hospital

2021 ◽  
Vol 20 (1) ◽  
pp. 46-50
Author(s):  
Mitra Datta ◽  
Asma Ferdousi ◽  
Salina Haque ◽  
Rifat Jahan ◽  
Aparup Das ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pleural Effusion ◽  
Dengue Fever ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Warning Signs ◽  
Severe Dengue ◽  
College Hospital ◽  
Dengue Outbreak

 Background: Dengue outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. This study was aimed to describe the clinico-epidemiological profile and outcome of dengue infected children during 2019 dengue outbreak in Chattogram. Materials and methods: This hospital based prospective observational study was carried out in the Department of Pediatrics in Chattogram Medical College Hospital. Serologically positive dengue cases (Aged £12 years) admitted from July 2019 to December 2019 were enrolled in the study. Hospital outcome of the patient’s was recorded in terms of mortality, Length of Hospital Stay (LOS) need for ICU. Results: Out of total 192 patients as per the National Guideline 66.7% cases were classified as dengue fever without warning signs, 21.9% as dengue fever with warning signs and 11.5% as severe dengue. Overall the mean age was 7.04 (±3.23) years with male preponderance (59%). Along with fever main complaints were abdominal pain (91.7%), vomiting (47.9%) and headache (23.6%). Marked thrombocytopenia (Below 50,000) was present in 37.9%, leucopenia in 27.9% and raised haematocrit in 10.9% of cases. Average LOS was 5.2 (±1.9) days, 18 (9.5%) patients need ICU admission and there was no fatality in this series. Some clinical (Vomiting, flusihing, shock, reduced urinary output) and laboratory (Marked thrombocytopenia, leucopenia, hemoconcentration, pleural effusion and hepatomegaly) variables were associated with severity. Conclusion: Fever with abdominal pain were common presentations of dengue fever. Severe dengue patients presented with vomiting, flashing and shock. Marked thrombocytopenia and pleural effusion and/or ascites were related to shock. Appropriate and timely management is very effective in reducing case fatality. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 46-50

Idiopathic spontaneous haemoperitoneum at 4 weeks gestation

2021 ◽  
Vol 14 (9) ◽  
pp. e244470
Author(s):  
Emily O'Brien ◽  
Rehan Feroz ◽  
Sona Jasani
Keyword(s):  
Abdominal Pain ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Clinical Picture ◽  
Unusual Case ◽  
Early Stage ◽  
Acute Onset ◽  
Bleeding Source ◽  
Pregnancy Of Unknown Location ◽  
In Pregnancy

A 20-year-old nulliparous patient with acute-onset abdominal pain and imaging suggestive of haemoperitoneum was admitted for observation. Though, initially, haemodynamically stable, her clinical picture worsened throughout her hospitalisation and warranted two separate laparoscopies that revealed 1200 mL and 50 mL of haemoperitoneum, respectively, without an identifiable bleeding source. After serial β-human chorionic gonadotropin levels and ultrasound confirmation of a viable pregnancy 23 days later, the patient underwent a normal antenatal course and delivered a healthy infant at 37 weeks gestation. This unusual case highlights the need to consider spontaneous haemoperitoneum in pregnancy as a diagnosis, particularly in the setting of pregnancy of unknown location, even at an early stage of pregnancy.

scholarly journals Acute Pancreatitis after Kidney Transplantation

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Mithat Tabakovic ◽  
Nermin N. Salkic ◽  
Jasmina Bosnjic ◽  
Ervin Alibegovic
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Mortality Rate ◽  
Diagnostic Procedure ◽  
Acute Onset ◽  
Biliary Pancreatitis ◽  
Life Threatening ◽  
Life Threatening Complication

Acute pancreatitis is a rare but life-threatening complication in patients with transplanted kidney. The incidence of acute pancreatitis after kidney transplantation ranges from 2% to 7%, with mortality rate between 50 and 100%. We report a case of a female patient aged 46 years, developing an interstitial acute pancreatitis 8 years following a renal transplantation. The specific aethiological factor was not clearly established, although possibility of biliary pancreatitis with spontaneous stone elimination and/or medication-induced pancreatitis remains the strongest. Every patient after renal transplantation with an acute onset of abdominal pain should be promptly evaluated for presence of pancreatitis with a careful application of the most appropriate diagnostic procedure for each individual patient.

scholarly journals CYTOMEGALOVIRUS-INDUCED GASTROINTESTINAL BLEEDING AND PANCREATITIS COMPLICATING SEVERE COVID-19 PNEUMONIA: A PARADIGMATIC CASE.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020060 ◽  
Author(s):  
Giacomo Marchi ◽  
Alice Vianello ◽  
Ernesto Crisafulli ◽  
Alessio Maroccia ◽  
Stefano Francesco Crinò ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Immune Dysregulation ◽  
Multiple Infections ◽  
Key Points ◽  
Gi Symptoms ◽  
Clinical Description ◽  
High Level

Key points: COVID-19 is a novel pandemic disease whose pathophysiology and clinical description are still not completely defined. Besides respiratory symptoms, gastrointestinal (GI) symptoms (especially including anorexia, diarrhea, and abdominal pain) represent the commonest clinical manifestations. Emerging data point out that severe SARS-CoV-2 infection causes an immune dysregulation, which in turn may favor other infections. Here we describe a patient with severe COVID-19 pneumonia who developed in the resolving phase abdominal pain associated to cytomegalovirus (CMV)-induced duodenitis with bleeding, and pancreatitis. A high level of suspicion toward multiple infections, including CMV, should be maintained in COVID-19 patients with heterogeneous clinical manifestations.

scholarly journals Surgery Management of Pancreatitis with Complication: A Review Article

2022 ◽  
Vol 6 (1) ◽  
pp. 01-03
Author(s):  
Nanda Rachmad Putra Gofur ◽  
Aisyah Rachmadani Putri Gofur ◽  
Soesilaningtyas Soesilaningtyas ◽  
Rizki Nur Rachman Putra Gofur ◽  
Mega Kahdina ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Necrotizing Pancreatitis ◽  
Clinical Manifestations ◽  
Healing Time ◽  
Acute Necrotizing Pancreatitis ◽  
Close Monitoring ◽  
Necrotic Tissue ◽  
Acute Necrotizing ◽  
Walled Off Necrosis

Introduction: Acute pancreatitis is an inflammatory disease of the pancreas with clinical manifestations that vary from mild to severe manifestations to death. The incidence of pancreatitis varies in various countries in the world and depends on the cause such as alcohol, gallstones, and metabolic factors. The clinical picture and the main symptom in patients with acute pancreatitis is abdominal pain. Abdominal pain varies from mild to severe and excruciating. Abdominal pain that is felt is constant and dull, and is usually felt in the epigastrium and periumbilicus and often spreads to the back, chest, waist, and lower abdomen. Discussion: The onset of acute pancreatitis, the patient should be evaluated for hemodynamic status immediately and receive the necessary resuscitation measures. Patients with acute pancreatitis should receive aggressive intravenous rehydration (250 - 500 ml/hour with isotonic crystalloid fluid) as early as possible with close monitoring, unless contraindicated with cardiovascular and/or renal comorbidities. It is most effective within the first 12-24 hours, but after that the benefits may diminish. Debridement (necrosectomy) is the gold standard in infected acute necrotizing pancreatitis and peripancreatic necrosis. Indications for intervention either through radiological, endoscopic or surgical procedures in necrotizing pancreatitis are suspected or proven infected necrotizing pancreatitis with clinical deterioration, especially after the necrotic tissue has been encapsulated with thick walls (walled-off necrosis). Sterile necrotizing pancreatitis with persistent organ failure several weeks after the onset of acute pancreatitis, particularly after the necrotic tissue has been encapsulated with thick walls (walled-off necrosis). Conclusion: Surgical management is often used in pancreatitis associated with gallstones. Cholecystectomy within 48 hours of the complaint can increase healing time. In addition, cholecystectomy performed early may not increase the risk of complications secondary to surgery. Surgery is not performed in acute necrotizing pancreatitis until the inflammation is reduced and the fluid accumulation no longer increases in size.

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