scholarly journals Relationship between Radiological Findings with Bacterial Etiology of Community Acquired Pneumonia in Pediatric Population

2021 ◽  
Author(s):  
Nidhi Pandey ◽  
Garima Mittal ◽  
Nitika Agarwal ◽  
Barnali Kakati ◽  
R.K. Agarwal
Keyword(s):  
Sample Size ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
World Health ◽  
Care Hospital ◽  
Number Of Patients ◽  
The Right

Pneumonia continues to be a major cause of morbidity and mortality in children. Pneumonia is the leading killer of children worldwide. For the diagnosis of pneumonia, the World Health Organization has introduced guidelines for the management of cases to reduce the mortality of these diseases on the basis of simple clinical signs followed by the empirical treatment with antibiotics. More than 99% of deaths related to pneumonia among children occur in countries having a low and middle income. To study the Radiological finding of Community-Acquired Pneumonia (CAP) in children. Across sectional study was conducted in which the sample size for the study was calculated from the expected prevalence of CAP based on other studies (74%). The sample size calculated by the required criterion for this study is 96. I was able to cover 118 patients as per the inclusion criteria in this study. The Patients of pediatric age groups and either sex attending tertiary care hospital with complaints suggestive of CAP. In this study total number of patients are 118 included who presented with the signs and symptoms suggestive of pneumonia. The findings of chest X-Ray of Right Lung with respect to different bacterial agents. Consolidation of the Right upper lobe is found to be statistically significant with respect to Streptococcus pneumonia and consolidation of the right lower lobe is found to be statistically significant with respect to bacteria Staphylococcus aureus whereas there is no statistically significant association with respect to other bacteria. The radiological finding of CAP in children attending pediatric OPD was observed that there was no association with any other bacteria.

scholarly journals Study of procalcitonin in neonatal sepsis with blood culture in suspected sepsis in North India

2021 ◽  
Vol 8 (7) ◽  
pp. 1241
Author(s):  
Munna Lal Jaipal ◽  
Ajit Kumar Shrivastava ◽  
Prema Ram Choudhary
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Tertiary Care ◽  
Clinical Signs ◽  
North India ◽  
Care Hospital ◽  
Negative Blood Culture ◽  
Suspected Sepsis ◽  
Cross Sectional ◽  
Number Of Patients

Background: Sepsis can occasionally be difficult to demonstrate, and its difference from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT) assay is one of the biomarkers of sepsis. The aim of the study was to investigate the value of procalcitonin, in the early diagnosis of neonatal sepsis.Methods: A cross-sectional study was conducted at tertiary care hospital in New Delhi. It included all neonates with clinical signs of sepsis. The neonates were divided into two groups as sepsis, and healthy neonates. The PCT level was measured by using ELISA technique and compared between the two groups. Statistical analysis was performed using SPSS windows version 20.0 software.Results: In this study total number of patients included 350, out of which 175 were clinically suspected sepsis cases and 175 were healthy controls. 68 (39%) neonates were show positive blood culture and 107 (61%) neonates were representing negative blood culture report in study group. The mean serum value of PCT was significantly (p<0.001) higher in sepsis neonates. The serum PCT value was significantly increased in neonate’s sepsis with positive blood culture (p<0.001) and negative blood culture (p<0.001) as compared to healthy neonates.Conclusions: It is concluded from this study that the PCT assay was established to be a valuable biomarker of sepsis in this study. The assay might be performed and reported quickly and gave precious information before availability of culture results. This might assist in avoiding unnecessary antibiotic therapy.

scholarly journals A retrospective study on histomorphological spectrum of ovarian lesions in a tertiary care hospital

2020 ◽  
Vol 6 (7) ◽  
pp. 430-436
Author(s):  
Subashree Kannan ◽  
◽  
Sneha Ravindran ◽  
S. Balaji ◽  
◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Follicular Cyst ◽  
Serous Cystadenomas ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
The Right

Introduction: Gynecological morbidity is defined as any condition, disease, or dysfunction of thereproductive system which is not related to pregnancy, abortion, or childbirth. A significant numberof ovarian lesions have been known to cause Gynecological morbidity among most females. With theincreased use of screening modalities, ovarian lesions have increasingly been encountered forpathological analysis. It is important to evaluate the pattern of clinical presentation, corroboratingwith histological diagnosis. Purpose: The present study was carried out to evaluate thehistomorphological spectrum of various ovarian lesions among women in Puducherry. Material andMethods: This retrospective study was conducted on 350 ovarian samples received for five years inthe Department of Pathology, of our tertiary teaching hospital. Clinicopathological data wereretrieved from the hospital records. The histomorphological analysis was reviewed and neoplasticand non-neoplastic ovarian lesions were segregated according to the World Health Organizationclassification. Results: Based on histology, the predominant ovarian lesions diagnosed were non-neoplastic conditions including simple and follicular cyst, corpus luteal cyst, corpus hemorrhagiccyst, and cystic follicles constituting 40.6% on the right side and 34% on the left side. Malignancywas predominant on the right side (1.7%) while the same was 0.6% on the left side. Conclusion:The present study has identified that non-neoplastic lesions are more common in ovaries thanneoplastic lesions and it has identified that serous cystadenomas are the most common ovarianneoplastic lesions.

scholarly journals Epidemiology and clinical features of community acquired pneumonia: hospital based study

2018 ◽  
Vol 6 (7) ◽  
pp. 2260
Author(s):  
Avinash Lamb ◽  
Amol Harinathrao Patil
Keyword(s):  
Streptococcus Pneumoniae ◽  
Clinical Features ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
Care Hospital ◽  
Female Ratio ◽  
Female Patients ◽  
Common Organism

Background: Community acquired pneumonia (CAP) is an infection affecting a significant proportion of population from all age groups across the globe with considerable morbidity and mortality. There is a need for data from various parts of India to better understand the epidemiology of CAP. Present study is an attempt to present the relevant data from a tertiary care hospital in Rajkot, Gujarat during the study period.Methods: This observational prospective descriptive study was done during November 2014 to April 2016 at Department of TB and chest diseases, PDU Hospital at Rajkot in Gujarat. 50 patients with clinical features suggestive of CAP were enrolled. Male and female patients (above age of 12 years) admitted to TB and Chest ward or patients on OPD basis were selected for the study. The diagnosis of CAP was mainly clinical with some assistance from radiological picture. All patients were thoroughly examined particularly with regards to detailed history, clinical examination, predisposing factors and associated co-morbid conditions. Sputum examination-gram stain and culture sensitivity was done in all patients, where sputum was available. Sputum examination for acid fast bacilli (AFB) by Ziehl Nelson staining technique was done. Age and sex distribution of patients, microorganisms isolated and the clinical features were described and analyzed.Results: The mean age was 38.38±17.41 (SD) years. Male patients were 34 (68%) and female patients were 16 (32%). Male to female ratio was 2.1:1. In this study, 47 (94%) patients were admitted in the hospital for the management and 3 (6%) patients were treated on the OPD basis. Fever and cough were most common symptoms whereas dull note on affected side and crepitations were the commonest signs elicited. In this study, the most common predisposing factor was smoking which accounted for 20 (40%) patients. The most common lobe involved was Left Lower lobe accounting for 20 (40%) patients and least common lobe involved was left upper lobe accounting for 2 (4%) patients. Streptococcus pneumoniae was the most common organism isolated in 8 (16%) patients and second common organism was Klebsiella isolated in 7 (14%) patients.Conclusions: Males, especially smokers were more commonly affected and Streptococcus pneumoniae was the most common organism isolated. The study gives the hospital based data from the region regarding epidemiology and clinical features of community acquired pneumonia.

scholarly journals Analysis of caesarean section in a tertiary care hospital, Assam, India

2018 ◽  
Vol 7 (4) ◽  
pp. 1514
Author(s):  
Alaka Banerjee ◽  
Banasree Bhadra ◽  
Kiriti R. Dey
Keyword(s):  
Caesarean Section ◽  
Rural Areas ◽  
Tertiary Care ◽  
World Health ◽  
Multiple Gestation ◽  
Care Hospital ◽  
Foetal Distress ◽  
Number Of Patients ◽  
Evidenced Based ◽  
Health Organization

Background: One of the commonest surgery performed worldwide is caesarean Section (CS). The World Health Organization (WHO) has identified an ideal caesarean section (CS) rate for a nation of around 10-15%. In recent times the proportion of delivery conducted by caesarean section has increased.Methods: This is a retrospective study of all the caesarean deliveries performed between 1st January 2010 to 31st December 2018 in the Department of Obstetrics and Gynaecology in Silchar Medical College. The caesarean rate was calculated as: (total number of caesarean deliveries/ total number of deliveries) × 100. The indications for CS included foetal distress, malpresentation, previous caesarean section, multiple gestation, failed induction, failed progression, cephalopelvic disproportion, maternal indications, obstetric indication and foetal indications.Results: During the study period a total of 75685 patients delivered. 25805 patients had undergone CS with the CS rate being around 34.1%. Majority of the CS (75.6%) were performed as emergency procedure. Maximum number of patients were between 21-30 years (73.24%) and 54.47% were primipara. Majority of the patients (68.37%) belonged to the rural areas. Foetal distress (32.8%) was the commonest indication followed by post caesarean pregnancy (26.76%).Conclusions: The rate of caesarean section is increasing with time. As primary caesarean section usually determines the lady’s future obstetric course, it is of prime importance to give effort for safe reduction of caesarean. Individualization of the indication and careful evaluation, following standardized guidelines and practice of evidenced-based obstetrics followed by audits in the institution, can help us limit the caesarean rates.

scholarly journals Radiological Findings of Pneumonia In Neonates Hospitalized in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 155-158
Author(s):  
Nahid Farzana ◽  
Md Ruhul Amin
Keyword(s):  
Imaging Modality ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Care Hospital ◽  
Radiological Findings ◽  
X Ray ◽  
Neonatal Deaths ◽  
Chest X Ray ◽  
The Right ◽  
Early Diagnose

Background: Pneumonia contributes to between 750,000 and 1.2 million neonatal deaths worldwide annually and neonatal pneumonia accounts for 10% of global child mortality. Chest radiography is the primary and most important imaging modality in the evaluation of neonatal pneumonia. The study was conducted to evaluate the common radiological findings of pneumonia among neonates to early diagnose the disease.Methodology: This prospective observational study was conducted in Dhaka Shishu (children) Hospital from April to September 2014. A total of 50 neonates admitted in the inpatient department were included who fulfilled the inclusion criteria’s like having difficult breathing, fast breathing>60 /min, severe chest indrawing, grunting, cyanosis, cough or fever. Diagnosis was confirmed by Chest X-ray. Positive X-ray findings like lobar or segmental consolidation, nodular or coarse patchy parenchymal infiltrate, diffuse haziness or granularity, air bronchogram were included into the study. X-ray changes were assessed.Results: Most commonly identified abnormality was patchy opacities (included nodular or coarse patchy opacities, diffuse haziness, air bronchogram), noted in 31(62.0%) cases. Followed by homogenous opacities (consolidation) were found in 19(38.0%) cases. Multifocal area involvement were found more 56.0 %(28) than single area. On right side radiological changes commonly noted, especially right upper zone involvement was the commonest 30 (66.0%). A comparison between severe and non- severe cases revealed that both types of opacities were found equally. But right sided Involvement was common in both groups.Conclusion: Multifocal patchy opacities were the most common radiological finding in cases of neonatal pneumonia. Pneumonia lesions were more common in the right lung among neonates and common site was right upper zone.Bangladesh J Child Health 2017; VOL 41 (3) :155-158

Community acquired pneumonia-current scenario among immunocompromised patients in a tertiary care hospital

2016 ◽  
Vol 5 (01) ◽  
pp. 4715
Author(s):  
A. V. Sowmya* ◽  
G. Jayalakshmi ◽  
David Agatha
Keyword(s):  
Diabetes Mellitus ◽  
Antimicrobial Therapy ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Polymicrobial Infection ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Immunocompromised Patients ◽  
Drug Resistant ◽  
Etiologic Agents

Pneumonia is a common illness accounting for majority of hospitalizations worldwide with significant mortality and morbidity. Antimicrobial therapy, being the main stay of treatment, the choices of antibiotics depends on the nature of the etiologic agents and the host factors. The current study was aimed to identify the bacterial & fungal etiologic agents of Community Acquired Pneumonia (CAP) in Immunocompromised (IC) patients, with their antimicrobial resistant pattern and to analyze the associated immunocompromised states. Various respiratory samples from study group of 75 immunocompromised patients with features of pneumonia were collected, processed and the isolates were identified with their antimicrobial susceptibility& resistance pattern according to CLSI guidelines. The results were analyzed statistically. Diabetes mellitus is the most common immunocompromised state (48%) associated with CAP. Monomicrobial and polymicrobial infection rates were 80.36% and 19.64% respectively. Gram negative pathogens and fungal pathogens were identified in 60% and 25.37% of culture positive cases respectively. Diabetes mellitus is commonly found in association with polymicrobial infection (19.44%) and fungal infection (16.66%). Drug resistant strains comprise about 75% of MRSA strains, 72.72 % of ESBL producers and 3.44% of Amp C producers. As the number of elderly people with associated IC state is on rise, with change in the pattern of microbial etiologic agents causing CAP, a prior knowledge of the host and microbial factors will help in formulating empirical antimicrobial therapy and proper treatment thereby curbing the spread of infections by drug resistant pathogens and the associated morbidity and mortality.

scholarly journals Facing Death: Attitudes toward Physician-Assisted End of Life among Physicians Working at a Tertiary-Care-Hospital in Israel

2021 ◽  
Vol 18 (12) ◽  
pp. 6396
Author(s):  
Keren Dopelt ◽  
Dganit Cohen ◽  
Einat Amar-Krispel ◽  
Nadav Davidovitch ◽  
Paul Barach
Keyword(s):  
End Of Life ◽  
Tertiary Care Hospital ◽  
Human Life ◽  
Tertiary Care ◽  
Terminally Ill ◽  
Background Information ◽  
Care Hospital ◽  
Medical Assistance In Dying ◽  
Terminally Ill Patients ◽  
The Right

The demand for medical assistance in dying remains high and controversial with a large knowledge gap to support optimal patient care. The study aimed to explore physicians’ attitudes regarding euthanasia and examine the factors that related to these attitudes. We surveyed 135 physicians working at a tertiary-care hospital in Israel. The questionnaire was comprised of demographic and background information, DNR procedure information, encounters with terminally ill patients, familiarity with the law regarding end-of-life questions, and Attitudes toward Euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should be allowed, while 29% thought that physicians should preserve a patients’ life even when they expressed the wish to die. A negative statistically significant relationship was found between the level of religiosity and attitudes toward euthanasia. The physicians’ attitudes towards euthanasia are quite positive when compared to other countries. The data shows a conflict of values: the sacredness of human life versus the desire to alleviate patients’ suffering. The Coronavirus-19 outbreak reinforces the importance of supporting physicians’ efforts to provide ethical and empathic communication for terminally ill patients. Future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to end-of-life requests.

Morphological Presentation of Orofacial Clefts: An Epidemiological Study of 5004 Patients in a Tertiary Care Hospital of Central India

2021 ◽  
pp. 105566562110577
Author(s):  
Jaideep Singh Chauhan ◽  
Sarwpriya Sharma
Keyword(s):  
Cleft Palate ◽  
Epidemiological Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Orofacial Clefts ◽  
Chi Square ◽  
The Right

Objective: To analyse the morphological presentation of orofacial clefts, gender, syndromes and systemic anomalies associated with them. Design: This was an epidemiological study performed in the patients who were registered for cleft lip and palate surgeries in our centre. The data was evaluated both retrospectively as well as prospectively. Patients/ Participants: The patients registered from November 2006 to April 2021 were studied. Out of 5276 patients, data of 5004 cases were analysed, rest 272 patients were excluded due to lack of information. Statistical analysis and Chi square test were applied. Results: Cleft deformities were more common in males than females. Cleft lip with palate was the commonest phenotype (52.2%). It was followed by isolated cleft lip (22.9%), isolated cleft palate (22.1%), rare clefts (1.62%) and syndromic clefts (1.18%). Unilateral variants were more frequent than bilateral. In unilateral, left side was more common than the right side. Among bilateral, most of the cases had premaxillary protrusion. In the present study, 3.46% of all the patients had associated anomalies affecting their other organs. Less common cleft phenotypes like microform cleft lip and submucous cleft palate ± bifid uvula showed frequency of 0.62% and 0.64% respectively. Conclusion: Thorough examination of cleft deformity should be done as it may appear as an isolated deformity or part of a syndrome and have associated systemic anomalies. This may help us to deliver comprehensive care to the patients and can prevent potential operative complications.

To Determine the Prevalence of Obesity in Breast Cancer Patients

2021 ◽  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
World Health ◽  
Care Hospital ◽  
Breast Cancer Patients ◽  
Prevalence Of Obesity

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.

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