scholarly journals PREDICTORS OF MORTALITY IN CHILDREN WITH CYSTIC FIBROSIS

2021 ◽  
Author(s):  
Hardeep Kaur ◽  
Shivam Pandey ◽  
Kana Jat ◽  
RAKESH LODHA ◽  
Sushil Kabra
Keyword(s):  
Cystic Fibrosis ◽  
Early Diagnosis ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Indian Children ◽  
Neonatal Complications ◽  
Factors Associated ◽  
Increased Risk ◽  
Low Bmi

Background: There is a lack of studies on outcomes in cystic fibrosis (CF) in children from developing countries like India. Identifying risk factors for mortality may help identify the high-risk group and plan policy management of such patients. Objective: To determine the factors associated with outcomes among Indian children with CF. Design: Retrospective analysis of data collected from January 2010 to Dec 2020. Setting: Tertiary care hospital in Northern India. Participants: Children diagnosed with CF during the study period. Methods: We extracted data related to demography, clinical features, laboratory data and outcome from children’s medical records with CF. Bivariate and multivariate analysis was performed to identify variables associated with mortality. Results: We enrolled 178 children, and there were 32 (18.0%) deaths. Significant factors associated with mortality included history of neonatal complications; hazard ratio (HR): 8.5 (95% CI, 3.0 - 23.9, p < 0.001), low Z-scores for body mass index (BMI) at the time of diagnosis; HR: 7.1 (95% CI 2.3 - 22.0, p < 0.001), FEV1/FVC at the time of diagnosis; HR: 5.1 (95% CI, 1.65 - 15.4, p-value < 0.004), and FEV1 25-75; HR: 3.6 (95% CI, 1.1- 11.8, p-value = 0.03). Conclusions: Factors associated with increased risk of mortality included presence of neonatal complications, low BMI and lower pulmonary function test results. Low BMI and low PFT indices are modifiable and possibly can be improved by early diagnosis. A new-born screening test may help in early diagnosis and identification of the neonatal problem of CF.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Predictors of mortality in adult patients with dengue: a study from South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1605 ◽  
Author(s):  
Vasudeva Acharya ◽  
Mohammed Fahad Khan ◽  
Srinivas Kosuru ◽  
Sneha Mallya
Keyword(s):  
Renal Failure ◽  
Prothrombin Time ◽  
Tertiary Care ◽  
P Value ◽  
Bleeding Tendency ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Prolonged Prothrombin Time ◽  
Risk Of Death ◽  
Increased Risk

Background: Dengue is one of the important causes of acute febrile illnesses in India. Dengue can be a fatal disease, however there are no reliable markers which can predict mortality among these patients.Methods: A prospective cross sectional study was done in patients who were admitted to a tertiary care hospital with features of dengue fever. A total of 364 patients with IgM dengue serology positive were included in the study. Relevant clinical and laboratory parameters were collected from all patients. Association between clinico-laboratory parameters with mortality was studied using appropriate statistical methods.Results: Among the 364 patients recruited in this study, 14 (3.85%) patients died. Mortality among patients with age group 18-40 years was 2.04%, in patients aged above 40 years was 7.56%. Mortality among patients with hypotension was 42.42% (14 out of 33), bleeding manifestations was 15.38% (8/52), platelets <20,000/mm3 was 10.41% (10/96), ALT >200 was 13.04% (6/46), AST>200 was 12.34% (10/81), prolonged prothrombin time was 60%(12/20), renal failure was 28%(14/50), encephalopathy was 31.57% (6/19), multi organ dysfunction syndrome(MODS) was 43.33% (13/30), acute respiratory distress syndrome (ARDS) was 45.45% (5/11), pleural effusion was 7.5% (6/80).Conclusions: The overall mortality in the present study was 3.85%. Following variables were associated with increased risk of death among the dengue patients: Age >40 years, presence of hypotension, platelets <20000 cells/mm3, ALT>200U/L, AST>200U/L, prolonged prothrombin time, presence of renal failure, encephalopathy, MODS, ARDS and bleeding tendency (p value <0.05). Early identification of factors associated with mortality can help to make appropriate decision on care required.

scholarly journals A Comparative Study of Serum 25-Hydroxy Vitamin D Levels in Children with Seizures Receiving Monotherapy and Polytherapy

2021 ◽  
Vol 11 (01) ◽  
pp. e331-e337
Author(s):  
Nazeem Fathima A. ◽  
Radha Kumar ◽  
Dev Kumar V. ◽  
Devanand Gulab Chaudhary
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Tertiary Care ◽  
Hospital Setting ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

AbstractThe association between serum 25-hydroxy vitamin D (25(OH)D) antiepileptic drugs (AEDs) and bone health in individuals with epilepsy has been recognized for more than 30 years. Several studies indicate an increased risk for bone loss in patients on antiepileptic medication as well as low levels of serum 25(OH)D. Patients on polytherapy AED are at a higher risk of adverse drug effects compared with those on monotherapy. The present study assessed serum 25(OH)D levels in children receiving AED and compares those children receiving monotherapy versus polytherapy. This is a prospective cross-sectional study conducted in a tertiary care hospital setting on children with seizures receiving AEDs for period of more than 6 months. Participants were enrolled in three groups: 25 children on monotherapy, 25 children on polytherapy, and 25 healthy controls. Serum 25(OH)D level was performed for all children and analyzed. Serum 25(OH)D levels were normal in 52%, insufficient levels in 43.3%, and deficient in 6.7% of children. Vitamin D level was insufficient in 40% of children receiving monotherapy and 52% receiving polytherapy AED. Vitamin D deficiency was present in 4% in monotherapy group and 16% in polytherapy group which was statistically significant (p-value 0.047). Vitamin D deficiency was higher in children receiving AED compared with normal controls. Vitamin D deficiency and insufficiency were higher in children on polytherapy. Our study emphasized the importance of monitoring vitamin D levels in children receiving AED to detect abnormalities in vitamin D levels.

scholarly journals A STUDY ONCYTOPENIAS AND THE FACTORS ASSOCIATED WITH CYTOPENIAS AMONG HIV INFECTED PATIENTS ADMITTED AT A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 9 (08) ◽  
pp. 172-179
Author(s):  
Manju Rose Sebastian ◽  
Seena Sankar ◽  
Mary George
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Prevalence Ratio ◽  
Developed Countries ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Hiv Patients ◽  
Factors Associated

Introduction: India has the third highest burden of HIV in the world. Haematological complications are common in HIV patients, of which cytopenias are the most frequently encountered. The cytopenias have been found to adversely affect the outcome of HIV patients with greater mortality and decreased quality of life. Aims and Objective: To assess the prevalence of cytopenias among patients admitted in a tertiary care hospital and to assess the factors associated with the cytopenias. Materials and Methods: The present study was conducted in the department of general medicine at a tertiary care hospital and 191 patients admitted in the hospital during the study period were taken for the study. The baseline investigations at the time of admission were taken into consideration. Patients were interviewed and charts reviewed to collect the data. The data collected was analysed with SPSS-2018. Continuous variables were expressed as mean +/- standard deviation and as median and interquartile ranges as appropriate. Categorical variables were expressed as percentages and frequencies. Comparisons between data was done by student’s t test and chi square. The factors associated with various cytopenias was assessed using log binomial regression. A p value of < 0.05 was taken as significant. Results: The overall prevalence of any cytopenia was found to be 85.9%. The most common cytopenia was anaemia with a prevalence of 78.5% followed by thrombocytopenia and leucopenia with prevalences of 28.8% and 24.1% respectively. Anaemia was found to be more prevalent among females with a prevalence ratio of 3.05 (95% CI: 1.39- 10.16, p value 0.009) when compared to males. The most common cause of anaemia was found to be B12 deficiency. There was significant association between leucopenia and CDC staging with the prevalence of leucopenia being higher among patient with CDC stage 3. [Prevalence ratio:1.46 (95% CI 0.67-3.17, p 0.024)]. No significant association was found with gender, duration of HIV, ART regimen, CDC stage or presence of opportunistic infections and thrombocytopenia. Conclusion: The prevalence of cytopenias among HIV patients was found to high – 85.9% especially compared to other developed countries. The most common cytopenia among the patients was found to be anaemia with a prevalence of 78%. The next most common cytopenia was thrombocytopenia, followed by leucopenia. The factors associated with these cytopenias can help to screen for patients at higher risk of developing these cytopenias and hence establish preventive strategies against them.

Case-Control and Vector Studies of Nosocomial Acquisition of Pseudomonas Cepacia in Adult Patients with Cystic Fibrosis

1993 ◽  
Vol 14 (3) ◽  
pp. 127-130 ◽  
Author(s):  
David R. Burdge ◽  
E.M. Nakielna ◽  
M.A. Noble
Keyword(s):  
Cystic Fibrosis ◽  
Tertiary Care ◽  
Air Sampling ◽  
Case Control ◽  
Adult Patients ◽  
University Hospital ◽  
Pseudomonas Cepacia ◽  
Factors Associated ◽  
Increased Risk ◽  
Negative Sputum

AbstractObjective:To examine factors associated with nosocomial acquisition of Pseudomonas cepacia in adult patients with cystic fibrosis.Design:A retrospective case-control study of 5 patients with nosocomial acquisition of P cepacia versus 20 matched controls who failed to develop P cepacia infection. Selective handwashing, air sampling, and respiratory equipment sampling also were performed.Setting:A university hospital providing tertiary care to 95 adult cystic fibrosis patients.Patience:All patients are adults with known cystic fibrosis. Case definition required multiple negative sputum cultures for P cepacia prior to and during admission, with a positive sputum culture prior to discharge. Controls had negative sputum cultures for P cepacia prior to and throughout hospitalization. Controls were matched for age, gender, disease severity, and frequency of hospitalizations.Results:Factors associated with increased risk of nosocomial acquisition of P cepacia included receiving humidifier or nebulized treatments (60% versus 5%, p = .016, odds ratio= 28.5, 95% confidence interval= 1.93 to 420.58). Factors without significance included ward, room, teaching versus nonteaching status, use of steroids, sharing a hospital room with another cystic fibrosis patient, antibiotic use, presence of portocath in situ, or socializing with another individual with cystic fibrosis known to be P cepacia -positive. Air sampling studies failed to demonstrate aerosolization of P cepacia by coughing cystic fibrosis patients over a 1-hour sampling time. Handwashing studies failed to demonstrate P cepacia on hands of cystic fibrosis patients, nurses, or physiotherapists (before or after physiotherapy). Reservoirs from nebulizers consistently grew P cepacia following therapy.Conclusions:Respiratory equipment may be an important source of nosocomial acquisition of P cepacia in adult cystic fibrosis patients.

scholarly journals 1174. Epidemiology of Carbapenem-Resistant Enterobacteriaceae, a 5-Year Experience at a Tertiary Care Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S354-S355
Author(s):  
Darunee Chotiprasitsakul ◽  
Sirawat Srichatrapimuk ◽  
Suppachok Kirdlarp ◽  
Pitak Santanirand
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Defined Daily Doses ◽  
Expected Increase ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) has been increasing worldwide. Our objectives were to study the epidemiology of CRE and compare risk factors and mortality of carbapenem nonsusceptibility to ertapenem alone Enterobacteriaceae (NSEE) with nonsusceptibility to other carbapenems (imipenem, meropenem, or doripenem) Enterobacteriaceae (NSOCE) at a tertiary care hospital in Thailand. Methods All CRE isolated from clinical and surveillance cultures were identified from December 2011 to December 2016. Quarterly incidence rate per 100,000 patient-days was estimated. Hospital-wide carbapenem consumption were calculated as defined daily doses (DDD) per 1,000 patient-days. Relationships between hospital-wide carbapenem consumption and incidence of CRE were tested using Poisson regression. Comparative analysis of factors associated with NSEE and NSOCE, and risk factors associated with 14- and 30-day mortality in patients with CRE infection was conducted in adult patients. Results The quarterly CRE incidence of unique patients increased significantly from 3.37 per 100,000 patient-days in the last quarter of 2011 to 32.49 per 100,000 patient-days in the last quarter of 2016. Quarterly CRE incidence increased 1.07 per 100,000 patient-days (95% confidence interval [CI], 0.49–1.06; P-value for trend &lt;0.001). Quarterly hospital-wide carbapenem consumption increased 1.58 DDD per 1,000 patient-days (95% CI, 0.56–2.59; P-value for trend = 0.004). The expected increase of CRE incidence was 1.02 per 100,000 patient-days for a one DDD per 1,000 patient-days increase in carbapenem consumption (95% CI, 1.01–1.03; P &lt; 0.001). There were 40 patients with NSEE and 134 patients with NSOCE. In the multivariate analysis, lower carbapenem exposure was significantly associated with the NSEE group (adjusted odds ratio: 0.25; 95% CI, 0.11–0.56). No difference in 14-day and 30-day all-cause mortality between NSEE group and NSOCE group was observed. Conclusion The incidence of CRE has risen significantly over a 5-year period at our institution. The important risk factor for nonsusceptibility to other carbapenems compared with nonsusceptibility to ertapenem alone was previous carbapenem use. Our hospital-wide carbapenem use has significantly increased over time, and associated with the increasing incidence of CRE. Disclosures All authors: No reported disclosures.

scholarly journals Epidemiological and Clinical factors associated with mortality of confirmed Covid-19 cases admitted and treated in a tertiary care hospital of Patna, Bihar

2021 ◽  
Vol 33 (1) ◽  
pp. 30-40
Author(s):  
Alok Ranjan ◽  
Sanjay Pandey ◽  
C M Singh ◽  
Pragya Kumar ◽  
Arshad Ayub ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Case Fatality ◽  
P Value ◽  
Care Hospital ◽  
Clinical Factors ◽  
Cross Sectional ◽  
Female Ratio ◽  
Factors Associated

Background: A significant proportion of the individuals having the illness of moderate to severe nature due to COVID-19 infection require immediate critical care. High incidence of mortality among elderly population or those with comorbid conditions were reported. Objectives: The study was carried out with objectives to assess the epidemiological and clinical factors associated with mortality among the COVID-19 cases admitted and treated in AIIMS, Patna. Methods: This was a hospital‑based cross‑sectional analytical study of epidemiological and clinical features of COVID‑19‑positive patients admitted and treated during the outbreak from March 20, to August 31, 2020. Results: The median age of COVID-19 cases was 51.5 years (IQR : 37-62 years) which was significantly higher (p-value = 0.001) as compared to females. Male-female ratio of cases was 2.88:1. Out of 1696 cases, the case-fatality rate was 309 (18.22%). The mean age of cases who died due to COVID-19 was significantly higher (p-value=0.001) as compared to those who survived. The odds of mortality was significantly higher in males as compared to females (Adjusted OR = 1.534, 95% CI = 1.10 – 2.13, p=0.011). The odds of mortality showed a significant increasing trend with increasing age (Mantel-Hanszel p-value for trend = 0.015). The covariates like gender, age groups 45-59, 60-74 and 75>=, breathlessness and CKD were found to be significantly associated with mortality after controlling for the confounders. Conclusions: Factors like gender, higher age, lower oxygen saturation causing breathlessness and chronic kidney diseases could be attributed to high risk of mortality in COVID-19 patients.

scholarly journals Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India

2020 ◽  
Author(s):  
Animesh Ray ◽  
Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

Background: Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of the anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India. Method: This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum samples by the ELISA method. Results: A total of 212 hospitalized patients were recruited in the study with mean age (+/-SD) of 41.2 (+/-15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8% patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity. Conclusion: Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21) Key Words: SARS-CoV-2 IgG Antibody, Seroprevalence, Hospitalized patient, COVID-19

scholarly journals A study on role of thrombocytopenia in retinopathy of prematurity

2020 ◽  
Vol 7 (2) ◽  
pp. 346
Author(s):  
Aswathy Benedict ◽  
Mario Joseph Bukelo
Keyword(s):  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Tertiary Care ◽  
Significant Risk ◽  
P Value ◽  
Care Hospital ◽  
Hospital Data ◽  
Retrospective Case ◽  
Oxygen Exposure ◽  
Increased Risk

Background: Retinopathy of Prematurity (ROP) is one of the causes of avoidable blindness in India. Globally ROP is estimated to affect more than 50,000 infants annually and in India, every year, 500 children are estimated to become blind from ROP. Many a times, lack of trained professionals and lack of timely referral are found to be setbacks in ROP diagnosis and treatment in developing nations. The aim of the study was to study if thrombocytopenia is a risk factor for retinopathy of prematurity and does supplemental oxygen with thrombocytopenia increases the risk of ROP.Methods: It was a retrospective case control study done in a tertiary care hospital. Data was collected from 177 preterm admitted to NICU over a period of 3 years from March 2015-2018.Results: A total of 177 preterm admitted to the NICU was included in this study. 77 had ROP and were taken as cases, while 100 were controls. Out of the cases, 55.6% had thrombocytopenia (OR-2.47, p value: 0.003). 89% (n =69) of cases had significant oxygen exposure (OR-8.65, p value 0.0001; 95% CI: 2.00-10.75). Oxygen exposure and thrombocytopenia coexisted in 57% of cases, with 4 times increased risk of ROP (OR-4.51, p value: 0.0001).Conclusions: Thrombocytopenia is a significant risk factor for retinopathy of prematurity in preterm. The presence of thrombocytopenia with significant oxygen exposure tends to accentuate the risk further. Future prospective studies with long term follow up are warranted to establish other risk factors.

scholarly journals Correlation of decayed, missing and filled teeth with risk factors for dental caries in children attending outpatient department in tertiary care hospital

2019 ◽  
Vol 6 (4) ◽  
pp. 1510
Author(s):  
V. Arunagirinathan ◽  
P. Venkatesh
Keyword(s):  
Risk Factors ◽  
Oral Health ◽  
Dental Caries ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Deciduous Teeth ◽  
P Value ◽  
Care Hospital ◽  
Increased Risk

Background: Oral health is of vital importance to humans’ general health. Despite the marked improvement in oral health, caries occurs in both developed and developing countries worldwide. The patient’s age is important for determining caries risk. Special attention must be paid to children’s oral health when deciduous teeth start erupting and occlusion has formed in 2 to 3-year-old children. To assess the correlation of decayed, missing and filled teeth (dmft/DMFT) with risk factors for dental caries in children and with knowledge, attitude, and practices of parents regarding dental caries.Methods: Cross-sectional study included 96 children with dental caries attending paediatric outpatient department of Government Stanley Medical College, Chennai, Tamil Nadu, India between 2018 March to November. Clinical evaluation, dmft score, and knowledge, attitude and practices of parents were assessed using pre-formed questionnaire.Results: Patients with high dmft score were found to have low practice score with the Pearson correlation coefficient(r) value -0.41 and P value was 0.01. Corresponding values of knowledge and attitude were not statistically significant. Children who nap/sleep with bottle/pacifier have increased risk (P value-0.01).Conclusions: An oral health risk assessment should be done periodically by Paediatrician who has regular contact with children for early identification of dental caries, to impart healthy oral practices and make them aware of preventive measures.

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