scholarly journals Retrospective analysis of symptoms and outcomes of snakebite cases

2020 ◽  
Vol 11 (1) ◽  
pp. 1051-1054
Author(s):  
Ismail Y ◽  
Haja Nazeer Ahamed ◽  
Vijaya Vara Prasad M
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Tertiary Care ◽  
Time Lapse ◽  
Snake Bite ◽  
Care Hospital ◽  
Human Beings ◽  
General Medical Ward ◽  
Life Threatening ◽  
Overall Mortality

Usually, every part of the globe is found with snakes, varying with the species or variety of snakes found in a particular region. It is scientifically known that about 3000 types of snakes are prevalent in all parts of the globe. Among these 300, only 10% of the snakes are reportedly venomous, giving life-threatening risks in human beings.  Depending upon the snake group, neurotoxic or hemotoxic venom of the snake is manifested. Symptoms of swelling or without swelling at the site of the bite, flank bite marks, local pain are seen in moderate cases, and the severe cases may manifest with shock, renal failure, and/or coagulopathy. The retrospective data were collected from one tertiary care hospital in Nellore district, Andhra Pradesh, India.   A further retrospective analysis was carried out using snakebite victims or patients.  About 20 patients among these were excluded from the study based on incorrect labeling of snake bite.  Therefore, complete data for the study was collected from 72 patients for the study who were admitted into the general medical ward. When the duration time of the treatment is delayed, obviously, the snake bite becomes mortal in the case of the patient. This is because, like the time-lapse, the anti-venom action becomes ineffective. However, despite the above findings like clinical presentation, demographic characteristics, and timelines in both the groups. The overall mortality rate in the present study was reportedly 2%. It could be concluded from the study that by rapid administration of anti-venin in appropriate doses, the snakebite cases can be managed successfully. Thus, we suggest developing an inter-disciplinary approach to reducing the mortality rate of snakebite.

scholarly journals Surgical outcome of COVID-19 infected patients: experience in a tertiary care hospital in India

2021 ◽  
Vol 8 (3) ◽  
pp. 899
Author(s):  
Charan Singh ◽  
Lileswar Kaman ◽  
Aruj Shah ◽  
Uttam Kumar Thakur ◽  
Krishna Ramavath ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Surgical Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Adverse Impact ◽  
Surgical Patients ◽  
Care Hospital ◽  
Patients Experience ◽  
Serum Crp ◽  
Overall Mortality

Background: COVID-19 disease caused by SARS-COV-2 has become a pandemic. Outcome of surgical patients infected with COVID-19 is not very clear.Methods: Retrospective analysis of the surgical outcome of COVID-19 infected patients admitted in emergency and elective surgical settings in a designated COVID care center.Results: Total 53 patients were included. Surgery was done in 47.16% (n=25) patients and 52.84% (n=28) patients were managed non-operatively. Overall mortality was 37.7 % (n=20). In operated group it was 52% (n=13) and 25% (n=7) in the non-operative group (p=0.043). The total leukocyte (p=0.018), serum CRP (p=0.031), urea and creatinine level (p=0.025) were higher in the mortality group. Patients aged more than 50 years had a significantly higher mortality compared to less than 50 years (p=0.010). Patients having multiple comorbidities had higher mortality (p=0.159).Conclusions: COVID-19 infection has a definite adverse impact on the outcomes of surgical patients.

scholarly journals Profile of adult acute cholinesterase inhibitors substances poisoning – a 30 years analysis

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Eugen N. Gazzi ◽  
Victorita Sorodoc ◽  
Irina M. Jaba ◽  
Catalina Lionte ◽  
Cristina Bologa ◽  
...  
Keyword(s):  
Rural Areas ◽  
Alcohol Intake ◽  
Cholinesterase Inhibitors ◽  
Tertiary Care ◽  
Serum Cholinesterase ◽  
Care Hospital ◽  
Life Threatening ◽  
Clinic Hospital ◽  
Significant Statistical Association ◽  
Overall Mortality

AbstractObjectives: The objective of this study was to assess the pattern and outcome of acute cholinesterase inhibitors substances (CIS) poisoning cases, in a cohort from a regional tertiary care hospital. Methods: cases admitted in the Toxicology Clinic of “Sf. Spiridon” Emergency Clinic Hospital Iasi, Romania between 1983 and 2013 were studied. Results: a total number of 606 patients were included. The reason for exposures was intentional in 70% of cases and the commonest route of poisoning was oral in 92.2%. The highest percent of cases was females (56.4), the age group 20-29 (25.4%) and the majority (66.7%) coming from rural areas, 28.2% being agricultural workers. 36.6% of cases were severe clinical forms. Overall mortality rates were 3.8%, more than half of the death patients (65.2%) had concomitant alcohol intake. It was a significant statistical association between decrease level of serum cholinesterase on admittance and severe forms (p 0.000) and between survival and deaths groups (p 0.000). The pattern of poisoning described by our retrospective study suggests that CIS poisoning are mainly preventable. The main effective goals for prevention are restriction in free accessibility to toxic pesticides, together with sustained efforts in education concerning the life-threatening danger of pesticide poisoning.

scholarly journals Analysis of Snake Bite Victims in a Tertiary Care Center

2015 ◽  
Vol 12 (1) ◽  
pp. 24-28
Author(s):  
V Dharma Rao ◽  
P Bickram ◽  
R P Ramyatha ◽  
N Sumalatha
Keyword(s):  
Mortality Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Assisted Ventilation ◽  
Snake Bite ◽  
Care Hospital ◽  
Hospital Referral ◽  
Snake Bites ◽  
Epidemiological Profile

Background: Snake-bite is a common cause of morbidity and mortality in tropical countries. In India, there are 216 species of snakes, of which only four (cobra, krait, Russell’s viper and saw scaled viper) are venomous. Objective: The aim of the study was to evaluate the epidemiological profile, clinical features, complications and mortality rate of snake bite victims admitted in a tertiary care hospital in Andhra Pradesh, India. Methods: The study was conducted at Mamata General Hospital, khammam from June 2010 to May 2012. A total of 39 cases with history of snake bite were analysed. Results: Out of 39 cases, majority of the cases were observed in the age group 20-50 year (66%). High incidence of snake bite was observed in males 62%). The common victims were farmers and housewives. The bite was commonly encountered while walking bare foot (30%) followed by while sleeping (14%). Fifty Four percent of victim were bitten during outdoor and agriculture related activities. Maximum number of cases (54%) presented within 12 hour of snake bite and 66% cases had 1-5 days of hospital stay. Majority (82%) were bitten on the legs below knee. Localized oedema at the site of bite was present in 70% victim. Fang/teeth marks were noted in (41%) cases. There were 59% neurotoxic snake bites, 26% haemolytic, 5% mixed and 8% non-poisonous snake bites. Most of the cases developed cellulitis at the site of snake bite (21%), shock (12%), and acute kidney injury (8%). One tenth of the cases required assisted ventilation and overall mortality rate was 8%.Conclusion: Snakebites are still common in the rural population of India. There is need to educate the public about the preventive measures of snake bite, advantages of early hospital referral and treatment.DOI: http://dx.doi.org/10.3126/hren.v12i1.11981        Health Renaissance 2014;12(1):24-28

scholarly journals Clinicoetiological and imaging profile of intracerebral haemorrhage in a tertiary care hospital of Western Odisha

2020 ◽  
Vol 8 (12) ◽  
pp. 4369
Author(s):  
Purna Chandra Karua ◽  
Shiny Joy
Keyword(s):  
Basal Ganglia ◽  
Mortality Rate ◽  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hematoma Volume ◽  
The Mean ◽  
Diagnosis Of Hypertension ◽  
Overall Mortality

Background: Intracerebral hemorrhage has an annual incidence of 10-30/100,000 population, accounting for 2 million (10-15%) of about 15 million strokes worldwide each year. The outcome of ICH depends on the clinical presentation and radiological parameters. The objective of current study was to study the etiology, clinical patterns and imaging profile in patients of intracerebral hemorrhage.Methods: All patients admitted in department of medicine, VIMSAR, Burla, with a diagnosis of ICH during a period of November 2017 to October 2019 were evaluated for their clinical presentation, etiology and radiological parameters.Results: A total of 105 patients with a diagnosis of ICH were included in the study. The sites of ICH were basal ganglia (49%) followed by lobar (19%), thalamus (14%), cerebellum (11%) and brain stem (8%). A pre-diagnosis of hypertension was present in 33% of the cases. Headache was the most common presenting symptom, present in 38.2% of patients followed by paralysis in 29.5%, vomiting in 27.6% and seizures in 20.9% of cases. Overall mortality rate was 39%. The mean GCS of patients who expired was 8.8 when compared to 11.28 of those patients who survived (p=0.00009). The mean hematoma size of patients who expired was 20.98 while that of those who survived was 17.41 (p=0.047). The presence of IVC was associated with mortality (p=0.006).Conclusions: A lower GCS at presentation and a mean hematoma volume >20 ml with intraventricular extension at presentation are associated with increased mortality in ICH.

scholarly journals Epidemiological changes in child surgical activity. Analysis of 17 years in a tertiary care hospital in Mexico

2020 ◽  
Author(s):  
Maria Fernanda Pizarro-Altamirano ◽  
Michelle Trousselle-Peralta ◽  
Rosa Eugenia Soriano-Rosales ◽  
Silvio Carmona-Librado ◽  
Marcelino Esparza-Aguilar ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
Health Coverage ◽  
Tertiary Center ◽  
Epidemiological Changes ◽  
Epidemiological Profile ◽  
Universal Health ◽  
Overall Mortality

Abstract Background: Surgical care is an essential component to achieve universal health coverage. An increase in children's surgical burden is recognized worldwide, but changes in the epidemiological profile associated with global geographic heterogeneity are to be expected. The aims of this study are to analyse the prevalence and epidemiological changes of surgical activity in a tertiary center in Mexico. Methods: Ambispective cohort study. Institutional records were reviewed searching for children’s surgeries in the period comprising 2001-2017. The variables analyzed were age, sex, number of surgeries per subject, and mortality rate; regarding the interventions, kind of inward stay, kind of surgery (ICD 9 CM), ward or department responsible, and perioperative mortality rate (POMR). Results: Of the 104,578 institutional admissions, 37% were surgical procedures of preschool-aged children (30.2%), and infants (27.3%). These tended to decrease, while for adolescents to increase. A total of 84,859 surgeries were performed (1.36 per operating room/day), averaging 4.992 per year, with a marginal tendency to increase. 65.8% of procedures required hospitalization. The systems more frequently intervened were: musculoskeletal system (20.1%, tending to increase), digestive system (19.5%), and cardiovascular system (11.3%). The overall mortality rate of surgical admissions was 5.5%, with POMR of 1.54%. Conclusion: The institutional epidemiological profile has changed, and relevant trends were identified. We corroborated the presence of global geographic heterogeneity with analogous hospitals

scholarly journals A study on clinical profile of paraquat poisoning in a tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1088
Author(s):  
Jagadeesan M. ◽  
Nithyananthan P. ◽  
Banupriya M. ◽  
Mahendrakumar K. ◽  
Prasanna Karthik S. ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Metabolic Acidosis ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Care Hospital ◽  
Paraquat Poisoning ◽  
Hospital Patients ◽  
Life Threatening ◽  
Overall Mortality

Background: Paraquat poisoning is a weedicide used rarely for suicide. It is now being increasingly as this type of suicidal poisoning is almost always fatal as there is no specific antidote for paraquat poison. ARDS, acute kidney injury with metabolic acidosis or multi-organ failure are the frequent causes of mortality.Methods: The study aimed to study the morbidity and mortality rates of Paraquat poisoning in tertiary care teaching hospital. Patients admitted with Paraquat poisoning were included, and the data were collected and analysed.Results: The total number of cases admitted with paraquat poisoning in intensive care unit in three years duration were 10. All the cases were suicidal in nature. 80% of the cases had acute kidney injury with severe metabolic acidosis and 20% had mediastinitis. 70% of cases died within 48 hours of ingestion. The overall mortality rate was 100% in spite of active management.Conclusions: Of all registered herbicides, Paraquat is the most serious and life threatening. Inspite of early haemodialysis, steroids and cyclophosphamide therapy, it was ineffective in reducing the mortality rates. Newer treatment like early hemoperfusion may help to reduce the mortality in future. 

scholarly journals 1147. Short Course of Voriconazole Therapy as a Risk Factor for Relapse of Invasive Pulmonary Aspergillosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S600-S601
Author(s):  
Dong Hoon Shin ◽  
Seung-Jin Yoo ◽  
Jongtak Jung ◽  
Kang Il Jun ◽  
Hyungjin Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Tertiary Care ◽  
Invasive Pulmonary Aspergillosis ◽  
Care Hospital ◽  
Pulmonary Aspergillosis ◽  
Treatment Termination ◽  
Duration Of Therapy ◽  
Short Course ◽  
Life Threatening

Abstract Background Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection which usually occurs in immunocompromised patients. Recommended duration of voriconazole therapy is a minimum of 6-12 weeks for IPA, despite the lack of any firm evidence. In addition, risk factors for relapse of IPA are still unclear. Here, we explored risk factors for IPA relapse after initial treatment. Methods All patients with proven or probable IPA who had finished voriconazole treatment between 2005 and 2019 in a tertiary-care hospital were reviewed. IPA relapse was defined as re-diagnosis of proven or probable IPA at the same site within 1 year after treatment termination. Short course of voriconazole treatment was defined as a treatment less than 9 weeks, which is a median of the recommended minimum duration of therapy from the Infectious Disease Society of America. The radiological response was defined as a reduction in IPA burden by more than 50% on chest computed tomography (CT). Results Of 87 patients who had completed voriconazole treatment, 14 (16.1%) experienced IPA relapse. Multivariable Cox regression identified that short voriconazole treatment duration (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 1.1–12.3; P=0.033) and radiological non-response (aHR, 4.6; 95% CI, 1.2–17.5; P=0.026) were independently associated with relapse of IPA after adjusting for several clinical risk factors. Conclusion Less improvement in CT, and short duration of voriconazole therapy were the independent risk factors for relapse after treatment of IPA. Longer duration of therapy should be considered for those at higher risk of relapse. Disclosures All Authors: No reported disclosures

Rising Economic Impact of Clostridium difficile-Associated Disease in Adult Hospitalized Patient Population

2008 ◽  
Vol 29 (9) ◽  
pp. 823-828 ◽  
Author(s):  
Xiaoyan Song ◽  
John G Bartlett ◽  
Kathleen Speck ◽  
April Naegeli ◽  
Karen Carroll ◽  
...  
Keyword(s):  
At Risk ◽  
Mortality Rate ◽  
Clostridium Difficile ◽  
Economic Burden ◽  
Excess Mortality ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Adult Patients ◽  
Care Hospital ◽  
Course Of Illness

Background.Clostridium difficile-associated disease (CDAD) is responsible for increased morbidity and a substantial economic burden. Incidences of CDAD, including those with a severe course of illness, have been increasing rapidly.Objective.To evaluate the excess mortality, increased length of stay (LOS) in the hospital, and additional costs associated with CDAD.Design.A retrospective matched cohort study.Patients.Adult patients admitted to a large tertiary care hospital between January 2000 and October 2005.Methods.Adult patients were tested with a C. difficile laboratory assay at admission or 72 hours after admission. Infected patients had lor more positive assay results and were individually matched to 1 uninfected patient who had negative assay results, by exposure time, age, ward, and at least 2 measurements for comorbidity and severity of illness.Results.The incidence rate of CDAD among adult patients increased from 0.57 cases per 1,000 patient-days at risk before 2004 to 0.88 cases per 1,000 patient-days at risk after 2004 (P < .001). The 630 infected patients had a mortality rate of 11.9%; the 630 uninfected patients had a mortality rate of 15.1% (P = .02). After adjustment in the multivariate analysis, we found that the LOS for infected patients was 4 days longer than that for uninfected patients (P < .001). If CDAD occurred after 2004, the additional LOS increased to 5.5 days. The direct cost associated with CDAD was $306 per case; after year 2004, it increased to $6,326 per case.Conclusions.There may be no excess mortality among patients with CDAD, compared with patients without it, but the economic burden of CDAD is increasing. By 2004, CDAD-associated medical expenditures approached $1,000,000 per year at our institution alone.

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