EFFICACY OF SUPPLEMENTATION OF PROBIOTICS ALONG WITH ANTIMICROBIAL AGENTS IN VULVOVAGINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Objectives: The objectives of the study were to ascertain the efficacy of probiotics along with antimicrobials in the treatment of vulvovaginitis and to evaluate the rate of recurrence. Methods: The study was done on 60 patients who were randomly selected and divided into two groups of 30 each. Prior permission from the Institutional Ethics Committee and higher authorities was obtained before conducting the study. One group received standard treatment including antibacterial, antiviral, and antifungal as per the gynecologist discretion and in other group along with standard treatment, probiotic capsules containing combination of Saccharomyces boulardii, Lactobacillus sporogenes (50 million), Streptococcus faecalis (30 million), Clostridium butyricum (2 million), and Bacillus mesentericus (1 million) given orally twice daily and followed up for a period of 3 months. The drugs were started on the 5th day after menstruation taking starting of the bleeding as day 1. Results: The parameters compared were symptoms and signs (significantly reduced – p-value), clue cells (significantly reduced in number), and recurrence rates (significantly reduced), in 80% of patients smears which were not consistent with BV. Maximum number of patients showed negative KOH mount (71.5%), saline wet mount was negative in 80% of patients in antimicrobial agents + probiotics group. Conclusion: From the present interventional study, probiotics along with antimicrobial agents showed better improvement than antimicrobial agents alone. Hence, supplementation of probiotics along with antimicrobial agents provides better efficacy than antimicrobial agents alone in treating vulvovaginal infections.

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Epidemiological profile of patients presenting to dermatology department of a tertiary care hospital during nationwide lockdown due to COVID-19: a retrospective study from north India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210421 ◽

2021 ◽

Vol 9 (2) ◽

pp. 443

Author(s):

Faizan Younus Shah ◽

Irfan Tasaduq ◽

Yaqzata Bashir ◽

Ifrah Shafat Kitab ◽

Aaqib Aslam Shah ◽

...

Keyword(s):

Herpes Zoster ◽

Hair Loss ◽

Seborrheic Dermatitis ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Dermatology Department ◽

Female Pattern Hair Loss ◽

Number Of Patients ◽

Male Pattern

Background: The COVID-19 pandemic has seen an unprecedented lockdown with restrictions on human movement and interaction, imposed throughout the world to contain the spread of the disease. This gave us the unique opportunity to study the pattern of patients presenting to the dermatology out-patient department during this period.Methods: The study was a retrospective observational study involving the assessment of patient records from 25th March 2020 to 7th June 2020. This period corresponds to the duration of strictly imposed nationwide lockdown which was relaxed with phased resumption from 8th June 2020, termed as unlock 1.Results: A decrease in the absolute as well as proportional number of patients was seen in majority of the cases with a statistically significant proportional decline being seen in cases of allergic contact dermatitis (p-value =0.007), acne (p value <0.001), male pattern hair loss (p value <0.001) and female pattern hair loss (p value <0.001), verrucae (p value=0.01), seborrheic dermatitis (p value <0.001), ephelids (p value <0.001), melasma (p value<0.001), post-inflammatory hyperpigmentation (p value=0.006). However, there were certain disorders whose proportionate representation increased significantly during the lockdown period contrary to prevalent belief. These disorders included urticaria (p value <0.001), herpes zoster (p value <0.001), scabies (p value =0.01), generalized pruritus (p value <0.001) and prurigo (p value <0.001).Conclusions: Disorders like acne, male pattern hair loss, female pattern hair loss, verrucae, seborrheic dermatitis, ephelids, melasma and post-inflammatory hyperpigmentation which do not cause significant morbidity showed a significant decrease in proportional representation. The proportionate representation of disorders like urticaria, herpes zoster, scabies, generalized pruritus and prurigo increased significantly during the lockdown period.

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Study of pregnancy outcome of threatened abortion and its correlation with risk factors in a tertiary care hospital of Mumbai, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184514 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4598

Author(s):

Dipali S. Sivasane ◽

Rekha G. Daver

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Pregnancy Loss ◽

Demographic Data ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Number Of Patients ◽

Significant Difference ◽

Threatened Abortion

Background: Early pregnancy loss is very common and, in most cases, it can be considered as nature’s method to select for a genetically normal offspring. Threatened abortion is a relatively common complication during pregnancy, occurring in approximately 20% of all pregnancies. Maternal age, Outcome of previous pregnancies, health of mother, any infection etc can be decisive factors in the risk of pregnancy loss.Methods: The present study was a cross sectional study where patients admitted with threatened abortion were interviewed using pretested semi-structured questionnaire after the treatment. Outcome of pregnancy was recorded. Their basic socio-demographic data along with possible risk factors were recorded. TORCH Ig M and Ig G were done in all patients.Results: Out of 95 patients admitted with threatened abortion, 42 (44%) patients undergone abortion whereas in 53 (56%) patients, pregnancy was continued. Out of total 60 patients admitted with the complain of only vaginal spotting, in 39 pregnancy continued and in 21 patients pregnancy was aborted. (p-value<0.05). 50.52% were from age group of 21 to 25 years of age. It was also seen that after 35 years of age, significant number of patients aborted. Out of these 11 patients with high BMI, pregnancy was continued only one patient. Out of total 20 patients positive for IgM of toxoplasma infection, pregnancy was aborted in 13 (65%) patients. Out of total 15 patients positive for IgM of cytomegalo virus infection, pregnancy was continued in 11 (73.3%) patients.Conclusions: Patients of threatened abortion with only symptom of spotting per vagina have good chances of continuation of the pregnancy. Increased maternal age above 35, Overweight and bad obstetric history are also associated with pregnancy loss. Though there was no statistically significant difference it was evident that among all TORCH infections, IgM toxoplasma and Rubella are associated more with pregnancy loss.

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Frequency of Retinopathy in low birth weight infant at tertiary care hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.4001 ◽

2020 ◽

Vol 27 (02) ◽

pp. 365-370

Author(s):

Muhammad Younis Tahir ◽

Iftikhar Ahmad ◽

Soufia Farrukh

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Oxygen Supplementation ◽

Low Birth Weight Infant ◽

Number Of Patients ◽

Department Of Ophthalmology

Objectives: To find out the frequency of retinopathy in low birth weight infant presenting at tertiary care hospital, Bahawalpur. Study Design: Cross sectional study. Setting: Department of Ophthalmology, Bahawal Victoria Hospital, Bahawalpur. Period: From July 2018 to December 2018. Material & Methods: Neonatal eye examination was performed for ROP. Results: Total 78 neonates were recruited for present study and ROP was assessed. Mean gestational age of neonates was 32.54 ± 3.79 weeks. Mean weight was 1445.51 ± 517.373 grams. Out of 78 neonates, ROP was observed in 28 (36%) neonates. ROP was found in 27 (42.19%) neonates of premature group and in 1 (7.14%) neonates of at term group. ROP was found in 1 (3.23%), 5 (29.41%) and 22 (73.33%) neonates respectively in weight group 1500-2500 g, 1000-1500 g and <1000 g group. Male neonates were 35 (44.87%) and female neonates were 43 (55.13%). Development of ROP was not significantly (P = 0.248) associated with gender of the neonates. Statistically significant association between ROP and oxygen supplementation was observed with p value 0.021. Conclusion: Results showed higher number of patients with ROP. Association of development of ROP with gestation was highly significant. Oxygen supplementation and oxygen concentration was also associated with ROP. Findings also showed no effect of gender and duration of hospital stay on ROP.

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Comparison of Attendance of Patients Pre-lockdown and during Lockdown in Gynaecology and Antenatal Outpatient Department in a Tertiary Care Hospital of Nadia, West Bengal, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45920.14567 ◽

2021 ◽

Author(s):

Suvobrata Sarkar ◽

Ranita Roy Chowdhury ◽

Jayeeta Mukherji ◽

Manaswita Samanta ◽

Gairik Bera

Keyword(s):

Cancer Detection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Outpatient Department ◽

P Value ◽

Care Hospital ◽

Old Patients ◽

Medical Termination ◽

Number Of Patients ◽

Daily Attendance

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has brought about a paramount change in the life. This has lead to a reduction in the number of routine patients visiting the Outpatient Department (OPD) of various hospitals and this department was no exception. Aim: To compare the attendance of patient in Antenatal Care (ANC) and Gynaecology Out Patient Department (GOPD) between pre-lockdown and lockdown period due to COVID-19 pandemic. Materials and Methods: The study was conducted among patients attending the OPD in ANC and Gynaecology for 70 days lockdown from 23rd March to 31st May and 70 days immediate pre-lockdown period from 12th January to 22nd March 2020. Daily attendance was noted and types of patient attending in different sub clinics in Gynaecology OPD compared. Enrolment of new ANC patient and old booked cases was compared during both periods. Descriptive statistics were used and displayed as percentages. Results: There was a significant reduction in number of patients attending OPD in lockdown period. There was a total of 6088 (87.3%) reduction in number of patients in Gynaecology OPD and 2235 (69.6%) reduction of patients in ANC OPD which was found to be significant with p-value <0.001. Reduction of patient in lockdown days among new ANC was 574 while it was 1661 in case of old patients. The different sub clinics of GOPD like infertility (704), endocrine (1450), uro-gynaecology (656), STD/PID (732), postpartum (597), cancer detection (316), abortion and medical termination of pregnancy (MTP) (330), others (1303) also witnessed a diminution of attendance. Conclusion: COVID-19 caused a significant decrease in footfall of patients in outpatient department due to lockdown, though the percentage of types of patient attending Gynaecology OPD was almost same.

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An Assessment of Retinopathy in Type-II Diabetics along with Microalbuminuria

10.53350/pjmhs211571749 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1749-1751

Author(s):

Muhammad Zafar Iqbal ◽

Muhammad Khalid ◽

Muhammad Haroon Bilal

Keyword(s):

Diabetes Mellitus ◽

Tertiary Care ◽

Type Ii Diabetes Mellitus ◽

P Value ◽

Care Hospital ◽

Type Ii ◽

Diabetes Mellitus Type Ii ◽

Number Of Patients ◽

Type Ii Diabetics ◽

Study Population

Objective: To assessment of retinopathy in type-II diabetics along with microalbuminuria at tertiary care hospital. Material and methods: This study was done at Department of Medicine, D.G Khan Hospital, D.G Khan from April 2020 to October 2020 over the period 6 months. Total 295 patients of type-II diabetes mellitus along with microalbuminuria having age between 45-80 years either male or female were selected. Diabetic retinopathy was evaluated in selected patients. Results: Total 295 patients were selected according to inclusion criteria. The mean age of patients was 58.13 ± 9.412 years. Out of 295 patients, retinopathy was noted in 67 (23%) patients. Out of 147 (49.83%) male patients, retinopathy was noted in 39 (26.5%) patients. Out of 148 (50.17%) female patients, retinopathy was noted in 28 (18.9%) patients. Statistically insignificant association of retinopathy with gender was noted with p value 0.119. Conclusion: Findings of this study showed a higher percentage of retinopathy in patients of type-II diabeties along with microalbuminuria. Most of the victims were males as compared to females and no association of development of retinopathy with gender was detected. Higher number of patients belonged to 4th and 5th decade of life. Four to five years of duration was noted among the half of the study population. Keywords: Retinopathy, Diabetes mellitus type II, Microalbuminauria

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Attitude and Self Care Practice on Hypertension among Antihypertensive Medication Users in a Tertiary Care Hospital Nepal

10.21203/rs.3.rs-149687/v1 ◽

2021 ◽

Author(s):

Jyoti Shrestha ◽

Sabina Sanhi ◽

Rajendra lamichhane ◽

Nabin Raj Marasini ◽

Nirmal Raj Marasine

Keyword(s):

Antihypertensive Medication ◽

Family Income ◽

Tertiary Care ◽

Self Care ◽

Care Practice ◽

P Value ◽

Care Hospital ◽

Hypertensive Patients ◽

Attitude And Practice ◽

Number Of Patients

Abstract Background:Hypertension a “silent killer” is a serious global health problem, whose prevalence is increasing in Nepal. This study aimed to determine the attitude and practice of hypertension among antihypertensive medication users in a tertiary care teaching hospital in western Nepal.Methodology: A hospital-based cross-sectional study was conducted among 136 hypertensive patients under medication, aged ≥30 years, and visiting medical outpatient department, medical ward, and geriatric ward, using a non-probability convenience sampling technique. Semistructured questionnaires were used for data collection through interviews. Descriptive and inferential statistics were used, and a p-value < 0.05 was considered statistically significant.Results: The maximum number of patients (36; 26.5%) was in the age range of 50-60 years with a mean (SD) of 56.74 (12.58). Most of 77(56.6%) were male, Hindu, 95(69.9%), upper caste people (40; 29.4%), illiterate (30; 22.1%), house maker (37; 27.2), and monthly family income of 21,000 and above (66; 48.5).Almost half of the patients (69; 50.7%) had a positive attitude and more than half (71; 52.2%) had performed adequate self-care practice. Selected variables such as educational status and dietary pattern and attitude were significantly associated, whereas no association was found between sociodemographic variables and self-care practice. Attitude and self-care practices were found strongly associated with one another (p=0.002).Conclusion: Hypertensive patients were found with better level of attitude and adequate self-care practice. Educational interventions and awareness programs on dietary aspects should be focused for improving the attitude and practice of all the patient groups.

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STUDY OF INFLAMMATORY MARKERS IN RELATION TO RADIOLOGICAL FINDINGS IN COVID 19

10.36106/ijsr/9604567 ◽

2021 ◽

pp. 48-50

Author(s):

Kalyanisri. Koneru ◽

V M Kiran Ogirala ◽

Kommavarapu. Kalyani Madhuri ◽

Bokam. Bhanu Rekha

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

X Rays ◽

X Ray ◽

Duration Of Hospital Stay ◽

Number Of Patients ◽

Chest X Ray ◽

Severity Of The Disease

BACKGROUND Currently, the Coronavirus disease 2019 (COVID-19) has become pandemic globally. Elevated inammatory markers are observed and are a common pathophysiological response to acute illness. Chest X-ray changes are also commonly seen in COVID -19 patients. The present study was undertaken to determine the relationship between inammatory markers to chest X-ray ndings in COVID-19 patients. METHODS This is a prospective observational study of COVID-19 patients admitted to tertiary care hospital from may 2020-November 2020. Comorbidities, inammatory markers, and Chest X ray were collected and analyzed. Correlations between radiological and inammatory markers were studied. AIMS & OBJECTIVES: Ÿ Correlation of inammatory markers to radiographic ndings and their outcome in COVID 19 patients Ÿ The outcome was studied in terms of: Ÿ Patients requiring oxygen/ NIVsupport Ÿ duration of hospital stay Ÿ Number of patients Recovered/death RESULTS: Ÿ Out of 500 patients studied, the mean age was 49.41 years, and (295)59% of patients were male,(205)41% were females. (455)91% patients discharged and (43)8.6% died. We found a positive correlation between inammatory markers and Chest X-ray ndings at the time of admission with a signicant statistical P-value. The inammatory markers CRP, ESR, D-Dimer & Sr.ferritin compared with the mode of ventilation(O2 & NIV, duration of hospital stay and outcome also showed signicant statistical P-value. CONCLUSIONS We conclude that in patients with raised inammatory markers there were increased abnormalities on Chest X-rays which required an increase in oxygen or NIVsupport. This can be a useful predictor of the severity of the disease and assessment of outcome.

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Causality assessment and the severity of the adverse drug reactions in tertiary care hospital: a pharmacovigilance study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20175073 ◽

2017 ◽

Vol 6 (12) ◽

pp. 2800

Author(s):

S. G. S. Rajeshreddy V. ◽

Lokesh V. Patil

Keyword(s):

Adverse Drug Reactions ◽

Antimicrobial Agents ◽

Causality Assessment ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Problem ◽

Care Hospital ◽

Drug Reactions ◽

Number Of Patients ◽

Care Costs

Background: Adverse drug reactions (ADRs) constitute a major clinical problem in terms of human suffering and increased health care costs. To study the adverse drug reactions reported in a tertiary care hospital and study of causality assessment and severity of adverse drug reaction (ADR) cases reported.Methods: A prospective observational study was conducted as part of pharmacovigilance program over 12months between September 2015 and August 2016. Adverse drug reactions reported from hospital were filled into Suspected ADR - CDSCO forms and submitted to pharmacovigilance unit. Causal relationship was assessed and categorized by Naranjo’s algorithm and WHO - UMC causality scale. The severity of each ADR was assessed using Modified Hartwig and Siegel scale.Results: Total 120 cases were reported over 12 months. Among them, 66% were in males and 55% were in females. The majority of ADRs were due to antimicrobial agents (40.78%) followed by haematinics (12%) and anti-epileptics (10%). Maximum number of patients (30.25%) reported with dermatological manifestations. Highest number of ADRs was reported from the department of medicine (45%). As per Naranjo’s scale, 54% reports were assessed as probable and 46% classified as possible. Majority of cases were mild to moderate in severity.Conclusions: The pattern of ADRs reported in our hospital is similar with the pattern of studies conducted in other hospitals elsewhere. This study provides a database of ADRs due to commonly used drugs in our hospital, which will help clinicians for their optimum and safe use. Hence effective pharmacovigilance is required for the use of these drugs and their safety assessment.

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Risk Factors Associated with Peritoneal Involvement in Acute appendicitis in Territory of Punjab, Pakistan

10.53350/pjmhs2115113076 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3076-3077

Author(s):

Fauzia Siraj ◽

Rabbiah Manzoor Malik ◽

Zafar Iqbal ◽

Rifat Shamim ◽

Attya Zaheer ◽

...

Keyword(s):

Risk Factors ◽

Acute Appendicitis ◽

Tertiary Care ◽

Previous History ◽

P Value ◽

Care Hospital ◽

Factors Associated ◽

Time Of Surgery ◽

Number Of Patients ◽

History Of

Aim: To study the frequency and factors associated with peritoneal involvement among patients operated for acute appendicitis in a tertiary care hospital. Place and duration of study: Department of Surgery, Benazir Bhutto Hospital Rawalpindi Pakistan from 1stJuly 2020 to 30thJune 2021. Methodology: This comparative cross-sectional study 500 patients diagnosed as acute appendicitis and operated by consultant surgeon were included. Peritoneal involvement was defined as signs of inflammation or infection on abdominal lining observed by operating surgeon during the time of surgery. Factors like age, gender, presence of comorbid illnesses and history of previous abdominal surgeries were associated with presence of peritoneal involvement. Results: There were 305 (61%) males while 195 (39%) were females with mean age was 32.331±4.544 years.Four hundred and forty two (88.4%) did not show any peritoneal involvement at the time of surgery while 58 (11.6%) had peritoneal involvement. Chi-square test revealed that history of previous abdominal surgeries and advancing age had statistically significant association with peritoneal involvement among the study participants (p-value<0.05). Conclusion: Peritoneal involvement was found in considerable number of patients operated as acute appendicitis by the treating surgeons. Patients with previous history of abdominal surgeries and advancing age were more at risk of having peritoneal involvement in our study. Keywords: Acuteappendicitis, Peritonitis, Risk factors, Frequency

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COMPARATIVE STUDY ON PREVALENCE AND ASSESSMENT OF ALTERED SENSORIUM AMONG SODIUM ABNORMALITY PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i6.1565 ◽

2021 ◽

Vol 10 (6) ◽

pp. 3837-3839

Author(s):

G.N Sharma

Keyword(s):

Serum Sodium ◽

Tertiary Care ◽

Plasma Sodium ◽

P Value ◽

Care Hospital ◽

Altered Level ◽

Altered Sensorium ◽

Number Of Patients ◽

Significant Difference ◽

Level Of Consciousness

Altered sensorium or altered level of consciousness is a common complaint among electrolyte abnormality patients and has several synonyms like altered behaviour, generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate behaviour, inattention, confusion, hallucination. The aim of the study was to evaluate the prevalence and to assess the level of consciousness dysnatremic patients at a tertiary care hospital. A prospective observational study, serum sodium level and other clinical profiles were recorded in a data collection form. GCS was used to analyses the level of consciousness among the enrolled patients. SPSS 22.0 statistical software was used for data analysis. During the study period, a total of 482 patients were enrolled in the study. Based on the serum sodium, they were categorized into Hyponatraemic (410) and Hyponatraemic (72) patients. Our study found a greater number of patients in the age group above 60 years and found that sodium imbalance increases generally in males with increasing age. Our study found that altered sensorium (60%) was predominant more in hyponatremia patients. Chi square test was performed to find statistically significant difference in level of consciousness between hypo and Hyponatraemic patients and was found to be significant p value (≤ 0.05). Abnormalities of plasma sodium are probably the most common electrolyte disorders and they are associated with serious morbidity including a poorer long-term neurologic outcome.

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