Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

scholarly journals Effectiveness of Transjugular Intrahepatic Portosystemic Shunt in Variceal Bleeding: An Audit from a Tertiary Care Center in North India

2017 ◽  
Vol 01 (03) ◽  
pp. 150-155
Author(s):  
Arun Gupta ◽  
Ajay Mehta ◽  
Nitin Mishra ◽  
Rajendra Bansal ◽  
Ajit Yadav
Keyword(s):  
Variceal Bleeding ◽  
Patency Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Portosystemic Shunt ◽  
North India ◽  
Related Complication ◽  
Variceal Bleed ◽  
Intrahepatic Portosystemic Shunt

AbstractVariceal bleeding is one of the most feared complications of cirrhosis and portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective minimally invasive option to achieve adequate decompression of the portal system. The aim of the study was to assess the efficacy and complications of TIPS in patients presenting with variceal bleed. It was a retrospective study done in a tertiary care center in North India in cirrhotic patients with acute or recurrent variceal bleed who underwent TIPS from April 2010 to October 2013. All the patients were followed up till April 2014. We could successfully implant TIPS in 100% of our patients with 100% success rate in controlling variceal bleeding immediately and during the follow-up period. Our primary patency rate was 94.5% and overall patency rate was 100%. Major TIPS-related complication was hepatic encephalopathy in 20% of patients; 7 of 22 patients died during the follow-up period. TIPS is a safe and effective procedure for control of acute or recurrent variceal bleed. Emerging evidence in favor of early TIPS is further going to expand its indication in variceal bleed. Hepatic encephalopathy was the major procedure-related complication in our study consistent with previous literature reports.

scholarly journals DEPRESSION IN OLDER ADULTS- A STUDY ON PATIENTS VISITING A TERTIARY CARE CENTER IN NORTH INDIA

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Indrajeet Singh Gambhir ◽  
Amit Raj Sharma ◽  
Sankha Shubhra Chakrabarti ◽  
Upinder Kaur ◽  
Bindu Prakash
Keyword(s):  
Logistic Regression ◽  
Marital Status ◽  
Short Form ◽  
Care Center ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Depression Score ◽  
North India ◽  
Geriatric Depression ◽  
Depression Prevalence

Background: Depression is the commonest psychiatric disorder in the elderly. We attempted to analyze the prevalence and correlates of depression in the north Indian elderly. Methods: An observational study was carried out taking cases from patients attending the geriatric clinic for the first time. Depression was diagnosed by the Geriatric Depression Score short form (≥5). Various epidemiological parameters were assessed in 504 subjects (M = 304, F = 200; mean age = 66.47±13.71 years). Results: Depression prevalence was 45%. A significant correlation was found between depression prevalence and gender (F>M, p=0.011), level of education (p=0.002), marital status (p<0.001) and insomnia (p<0.001) on univariate analysis. On binomial logistic regression analysis, marital status (widowed > married, p=0.008) and insomnia (present > absent, p<0.001) showed significant correlation with depression prevalence.    Conclusion: Our study highlights certain epidemiological aspects of depression in the aged Indian population presenting to the tertiary hospital. Spousal loss and insomnia are documented as possible depression risks but longitudinal studies are needed to confirm the same. Keywords: Geriatrics, Depression, Epidemiology, Geriatric Depression Score, Prevalence, Logistic Regression

scholarly journals Comparison between conventional tube method and gel card technique for blood crossmatching: A study in a tertiary care center of north India

2020 ◽  
Vol 11 (4) ◽  
pp. 6500-6503
Author(s):  
Ragini Singh ◽  
Prachi Garg ◽  
Anoop Kumar ◽  
Sucheta ◽  
Meenal Babra
Keyword(s):  
Blood Transfusion ◽  
Sensitivity And Specificity ◽  
Care Center ◽  
Tertiary Care ◽  
Test Tube ◽  
North India ◽  
Advantages And Disadvantages ◽  
Time Required ◽  
Spin Tube ◽  
Cross Matching

The cross-matching of blood can be performed by various methods like saline tube method and gel card technique. Saline tube method is most commonly used in blood banks, whereas the latest method used is Gel card technique for cross-matching. Both techniques have their advantages and disadvantages. The main aim of this study was the comparison of gel card and conventional tube test for sensitivity and specificity, time and efficacy. This prospective study was done at the Department of Blood Transfusion, BPS GMC Khanpur Kalan, Sonipat, Haryana. A total of 500 samples collected at the Department of Blood Transfusion, were cross-matched using conventional tube method (spin tube method) with and without using AHG and Gel card Method. 497 (99.4%) samples were compatible, and 3 (0.6%) samples were incompatible with Gel card method, but by test tube method 492 (98.4%) samples were consistent, and 05(1.6%) were false positive (FP). Incompatibility of those 05 samples (FP) disappeared after incubation with AHG reagent at 37°C saline tube method. The sensitivity and specificity of both gel card method and saline tube method with AHG methods is 100% whereas the specificity of saline tube method without AHG is 98.9%. The average time taken by Gel card method was 20-30 minutes for a single compatibility test whereas in conventional spin tube method with the use of AHG (IAT) average time required was 90 minutes and without AHG it was 45-60minutes. The sensitivity and specificity of the spin tube method and the gel card method are comparable to each other. But the gel card method is easy to perform, rapid, reliable procedure and results can be recorded. In contrast, spin saline tube method is more time consuming, and results cannot be preserved. Thus gel card technique can be preferred over the spin tube method.

scholarly journals Purulent pericardial effusion in children: Experience from a tertiary care center in North India

2020 ◽  
Vol 13 (4) ◽  
pp. 289
Author(s):  
Anika Agrawal ◽  
Urmila Jhamb ◽  
Arima Nigam ◽  
Shipra Agrwal ◽  
Romit Saxena
Keyword(s):  
Pericardial Effusion ◽  
Care Center ◽  
Tertiary Care ◽  
North India ◽  
Tertiary Care Center
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