scholarly journals A study to assess the clinico-radiological and spirometric proৎile of post tuberculosis patients in a tertiary care centre

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1350-1356
Author(s):  
Kavya S ◽  
Priya Joy ◽  
Gangadharan V
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Lung Parenchyma ◽  
Airway Disease ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Medical College ◽  
Small Airway Disease ◽  
Significant Difference ◽  
History Of

Tuberculosis is an infectious disease which has affected millions of people around the world. Ten million new TB cases were identified globally in 2018, with an estimated 1.2 million deaths.  Lung function impairment often occurs due to the destruction of the lung parenchyma. This causes ventilatory abnormalities, often of obstructive type. Radiological lesions are also a common consequence of pulmonary tuberculosis. This study aims to analyse the various clinical features and assess the spirometric and radiological findings in post TB patients. This is a prospective observational study. All patients visiting the Chest Medicine OPD of Saveetha Medical College and Hospital who had a history of treated pulmonary tuberculosis and were above 18 years of age were included in this study. Patients who had no signs of active Tuberculosis underwent spirometry, and a chest x-ray was taken. Clinical presentation, spirometric parameters and radiological lesion were analysed. Among the 76 patients included in this study, 73.7% were male with most patients aged between 51 to 60 years. 64.5% of the study population were smokers. Dyspnoea (94.73%) was found to be the most common presenting complaint. Obstructive pattern (49%) was found to be the most common type of spirometric pattern with 68.42% having small airway disease. Based on the Wilcox classification, Degree II (47.37%) was the most common extent of the radiological lesion. It was found that there is a statistically significant difference between smokers and non-smokers in post-bronchodilator FEV1 (p=0.037) and FEF25-75 values (p=0.010). This study reveals the presence of post tuberculosis lung impairment in the population with varying presentations and severity. Hence, further studies and interventions are required to improve the quality of life of post tuberculosis patients.

scholarly journals Accidental tramadol ingestion in children admitted in tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 2661
Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra
Keyword(s):  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Care Centre ◽  
Medical College ◽  
History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

scholarly journals Clinico-physiological profile of patients of pulmonary impairment after tuberculosis at a tertiary care centre

2018 ◽  
Vol 6 (9) ◽  
pp. 2999
Author(s):  
Gajendra V. Singh ◽  
Antriksh Srivastava ◽  
Vinisha Chandra ◽  
Santosh Kumar ◽  
Rishabh Goel
Keyword(s):  
Pulmonary Tuberculosis ◽  
Exercise Tolerance ◽  
Structural Changes ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Lung Parenchyma ◽  
Tertiary Care Centre ◽  
Physiological Profile ◽  
Pulmonary Impairment

Background: Pulmonary tuberculosis (TB) is a unique infectious disease that more often results in permanent structural changes in the lung parenchyma. It is by virtue of these changes that the patients even after bacteriological cure continue to suffer the after effects of the disease. Objective of study was to assess the clinico-physiological profile of patients of pulmonary impairment after tuberculosis (PIAT) attending S. N. Medical College, Agra, Uttar Pradesh, India.Methods: Over the time period of 2 years, 350 patients of healed pulmonary tuberculosis were identified and studied about their clinico-physiological profile. This profile included age, sex, category of treatment, pulmonary function test pattern, exercising capacity, exercise tolerance and quality of life.Results: It was found that majority of the patients were males, >60 years of age and had taken Category-II treatment. Most of the patients were having an obstructive pattern on PFT, poor exercise tolerance and exercise capacity and a poor quality of life.Conclusions: Patients of healed pulmonary TB continue to experience respiratory symptoms owing to the permanent anatomical changes in the lung conferred by the disease.

scholarly journals OCCURRENCE OF OBSTRUCTIVE AIRWAY DISEASE IN TREATED PATIENTS OF PULMONARY TUBERCULOSIS : A RETROSPECTIVE STUDY

2020 ◽  
pp. 1-2
Author(s):  
Shivprasad Kasat ◽  
Ashish Deshmukh ◽  
Sunil Jadhav ◽  
Hafiz Deshmukh ◽  
Ashish Kendre
Keyword(s):  
Pulmonary Tuberculosis ◽  
Previous History ◽  
Previous Treatment ◽  
Airway Disease ◽  
Clinical Findings ◽  
Obstructive Airway Disease ◽  
Medical College ◽  
Duration Of Illness ◽  
History Of ◽  
Obstructive Airway Diseases

Aim: To study occurence of obstructive airway disease in treated patients of pulmonary tuberculosis. Materials and methods: 50 patients data collected from Respiratory medicine department, MGM medical college, Aurangabad, who visited OPD for various respiratory symptoms. It is ensured that patients who are participated in the study are non smokers. Previous history of pulmonary tuberculosis and treatment history is noted. Evidences of previous treatment and radiological images were collected. Each patient was subjected to a thorough clinical examination and spirometry. Results: Based on clinical findings, radiological findings, and spirometry findings, of the 50 patients studied, it is observed that 11(22%) patients had developed obstructive airway disease.4 (8%) patients have developed extensive fibrosis post tuberculosis. 3 (6%) patients have developed cavitation with fibrosis. 4 (8%) patients have developed bronchiectasis. Conclusion: It is not uncommon that obstructive airway disease occurs as a complication of post tuberculosis sequale. 22 percent of the patients studied, have developed different types of obstructive airway diseases. Many factors may influence in post tuberculosis complications such as extensiveness of parenchymal involvement, duration of illness, socio-economic factors. Obstructive airway disease can be a sequel of pulmonary tuberculosis and should be overlooked, especially in those patients complaining of dyspnea even in the absence of any history of smoking. Post-tuberculous obstructive airway disease as a cause of COPD in nonsmokers should be now more recognized in countries where the prevalence of pulmonary tuberculosis is still high.

scholarly journals SEROPREVALENCE OF HIV INFECTION IN PULMONARY TUBERCULOSIS PATIENTS.

2020 ◽  
pp. 1-3
Author(s):  
K.G.R. Mallan ◽  
A. Fathahudeen ◽  
Manjula V.D.
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Medical College ◽  
Elimination Programme ◽  
Kerala State

Aim : To Determine the seroprevalence of Human immunodeficiency virus infection among Pulmonary Tuberculosis patients in a tertiary care teaching institution, in Ernakulam district of Kerala state in India. Methods : Study was conducted in Respiratory medicine department and integrated counselling and testing centre (ICTC) of Government Medical College, Ernakulam With approval of IEC after getting written informed consent , a cross sectional study was conducted among 384 pulmonary TB patients who were registered under the National TB elimination Programme (RNTCP). Result :The prevalence of HIV among study population was 1.3 %. There was no gender difference while the highest age group less than 30 followed by 30-60. The major respiratory pathology among study subjects was consolidation (42.7%) followed by fibrosis(25.3%).Consolidation was a predominant presenting pathology seen in female pulmonary TB patients.The sensitivity of sputum smear against CBNAAT was 60.4% and specificity was 83%. Conclusion : The prevalence is low compared with the national average of 3 to 3.4 % HIV co infection among Tuberculosis patients during the study period.

scholarly journals Pattern of Congenital Overt and Occult Pediatric Surgical Anomalies in a Tertiary Care Centre Over 5 Years

2021 ◽  
Vol 6 (4) ◽  
pp. 16-20
Author(s):  
Sam Varkey ◽  
Aravind C. S ◽  
Reeti Rajan
Keyword(s):  
Congenital Anomalies ◽  
Pediatric Surgery ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Low Socioeconomic ◽  
Medical College ◽  
Common System ◽  
History Of

ongenital anomalies are important cause of infant and childhood deaths, chronic illness and disability. The proportion of deaths and disability due to congenital anomalies has increased, as deaths due to other diseases have decreased over the years due to better health care. Hence it is essential to have basic epidemiological information of these anomalies. This is a hospital based, cross-sectional, record based study, conducted in the Department of Pediatric Surgery, Govt. Medical College Thiruvananthapuram, Kerala. Sample size included 300 children below the age of 12years admitted in the department of pediatric surgery with various major congenital anomalies, over a period of 5 years. More than half of these children were admitted after infancy for treatment, male children were more compared to females. Majority of these children were from low socioeconomic group. Only in 5.6% cases there was a history of consanguineous marriage. In 7.33% there was family history of congenital anomalies. In 32% cases the anomalies were detected in the antenatal period. Most of the anomalies were isolated anomalies. Genitourinary system was the most common system to be involved followed by, gastrointestinal tract. 91.67% children underwent surgical treatment, and only 10.67% children had major complications in postoperative period. This study shows that congenital anomalies are a major cause of hospital admissions in children of all ages. Pattern of anomalies seen in various centers are different. Knowledge of the pattern of congenital anomalies may be useful in planning health services. Keywords: Congenital, Anomalies, Pediatric surgery.

scholarly journals Assessment of tuberculosis spatial hotspot areas among smear positive pulmonary tuberculosis patients attending JSS: a tertiary health care centre from Mysore district, South India

2019 ◽  
Vol 6 (10) ◽  
pp. 4322
Author(s):  
Krishna Karthik Manthravadi ◽  
Tejashree Anantharaj ◽  
Satya Sai Badveti
Keyword(s):  
Spatial Distribution ◽  
Pulmonary Tuberculosis ◽  
Hot Spot ◽  
Demographic Data ◽  
Tertiary Care ◽  
Health Concern ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Smear Positive Pulmonary Tuberculosis

Background: Tuberculosis (TB) is a disease of public health concern, with a varying distribution across settings depending on socio-economic status, HIV burden, availability and performance of the health system. In 2017, TB caused an estimated 1.3 million deaths (range, 1.2–1.4 million) among HIV-negative people, and there were an additional 300 000 deaths from TB (range, 266 000–335 000) among HIV-positive people. The current TB program reports are often compiled and reported at higher administrative units and there is limited information about the spatial distribution of the disease. Hence, we aimed to assess the spatial distribution and hot spot areas of the disease among the patients attending a tertiary care centre in Mysore over a period of 3 years.Methods: This is a taluk based study, the spatial analysis and hot spot area identification was done by collecting the demographic data from the smear positive pulmonary tuberculosis patients attending JSS a tertiary care centre from Mysore district. Hot spot areas and areas with TB transmission are identified and estimated using GIS software tool. Distribution of TB incidence was mapped with the population density from 2016-2018.Results: Spatial mapping of smear positive tuberculosis revealed that majority of cases were recorded from Mysore city followed by T. N. Pura and Hunsur taluk regions.Conclusions: This study emphasized on finding hot spot areas and local clusters involved in TB transmission.

scholarly journals When the Disease is Known but the Patient is not. Outcome of 118 such Patients at a Tertiary Care Centre

2018 ◽  
Vol 32 (2) ◽  
pp. 505-512
Author(s):  
Gaurav Jaiswal ◽  
Praveen Kumar Tripathi ◽  
Vardan Kulshreshtha ◽  
Tarun Kumar Gupta
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Tertiary Care ◽  
Good Recovery ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Discharged Patients ◽  
History Of ◽  
A Prospective Study ◽  
Lost To Follow Up

Abstract This is a prospective study, carried out at the Department of Neurosurgery at M.B.G Hospital, R.N.T Medical College, Udaipur, Rajasthan (India). Many patients with history of trauma with head injury, whose identity cannot be ascertained, are admitted in our hospital. The management of these unattended patients from pre-hospital till discharge, rehabilitation or death is full of difficulties especially when surgical intervention has to be done. From March 16, 2015, until March 30, 2016, 118 consecutive patients unattended patients admitted in our department with history of head injury were enrolled in the study. Out of 118 patients, 107 (91%) were male, most were in the age group of 30-39 years. In majority of patients, 115 (97%) principal cause of head injury was road traffic accident. Majority of the patients 49 (41%) had Glasgow coma scale >13 on admission. Twenty three patients 23 (20%) died in hospital, 71 (60%) patients had good recovery. During the course of treatment identity of 115 patients was established and 92 (78%) patients, who survived were discharged to home. Three (3%) patients were shifted to destitute home. All discharged patients were followed at 1 month and 6 month interval. 78 (82%) & 76 (80%) patients showed good recovery (GOS) at 1 month & 6 month respectively. One patient expired at home within one month of discharge and 6 patients lost to follow up at 6 months.

scholarly journals A Comparative Study of CURB-65 and Expanded CURB-65 Scoring Systems in Community Acquired Pneumonia in a Tertiary Care Centre of Patna

2021 ◽  
Vol 8 (16) ◽  
pp. 1074-1078
Author(s):  
Debjit Mitra ◽  
Uttiya Roy ◽  
Abhay Kumar Sinha ◽  
Shiv Shankar Bharti
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Scoring System ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Co Morbidity ◽  
Significant Difference

BACKGROUND A variety of organisms cause community-acquired pneumonia, including bacteria, viruses and fungi. Pathogens vary in age and other factors, but the relative importance of each pneumonia as a cause of community-acquired pneumonia remains uncertain because most patients do not undergo thorough testing and because even when tested, specific agents are found in < 50 percent of cases. This study was conducted to evaluate a severity scoring system for community acquired pneumonia and compare it with the standard confusion, urea, respiratory rate, blood pressure and 65 years of age or older (CURB-65) scoring system in a tertiary care centre in Patna Medical College. METHODS This hospital based prospective study was conducted among 100 consecutive patients of community-acquired pneumonia (CAP) attending OPD or getting admitted in General Medicine ward of Patna Medical College. The CURB-65 and Expanded CURB-65 scores for these patients were calculated and the accuracy of either in predicting outcomes was statistically analysed, during the period September 2018 - May 2019. RESULTS The mean age of CAP patients in our study was 59.09 ± 12.942 years, the most common co-morbidity observed was diabetes mellitus followed by chronic obstructive pulmonary disorders (COPD), cardiovascular disease, chronic liver disease and chronic renal disease. Our study showed that the mortality rate of the study population was 12 % and 30 % patients needed admission in the ICU and 24 % patients needed invasive mechanical ventilation. In the above analysis for 30-day mortality rate, ICU admission rate, and the need for mechanical ventilation among 0 - 2 and 3 - 5 CURB 65 scores, we found no statistically significant difference (P-value = > 0.05). CONCLUSIONS The extended CURB-65 score gives priority to both clinical and laboratory parameters and is a more accurate marker for the evaluation of CAP severity and may boost the effectiveness of predicting mortality in CAP patients compared to the current CURB-65 score system. KEYWORDS CAP, CURB-65, Expanded CURB-65

scholarly journals Comparison of Clinical Profile between P. vivax and P. falciparum Malaria in Children: A Tertiary Care Centre Perspective from India

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jagdish Prasad Goyal ◽  
Aarti M. Makwana
Keyword(s):  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Western India ◽  
Care Centre ◽  
Inclusion Criteria ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Significant Difference ◽  
Malaria Antigen ◽  
Low Incidence

Background. Malaria is a one of the leading causes of morbidity and mortality in tropical countries. Plasmodium vivax (P. vivax) is usually thought to be causing benign malaria with low incidence of complications as compared to Plasmodium falciparum (P. falciparum). Methods. This retrospective observational study included malaria patients who were admitted to K.T. Children Hospital and P.D.U. Government Medical College, Rajkot, a tertiary care teaching hospital, Gujarat, western India, during the period January 2012 to December 2012. Inclusion criteria were patients in whom either P. falciparum or P. vivax was positive on rapid malaria antigen test and peripheral blood smear. Patients showing mixed infections were excluded from study. Results. A total of 79 subjects (mean age 5.4±3.6 years) were included in the study. It consisted of 47 P. vivax and 32 P. falciparum cases. The P. vivax cases consisted of 33 (70.2%) males and 11 (19.8%) females while P. falciparum cases consisted of 14 (43.8%) males and 18 (56.2%) females. One patient of each P. vivax and P. falciparum expired. There was no statistical significant difference found between complications such as anemia, thrombocytopenia, liver and renal dysfunction, ARDS, and cerebral malaria between P. vivax and P. falciparum. Conclusion. We conclude that P. vivax monoinfection tends to have as similar course and complications as compared to malaria due to P. falciparum monoinfection.

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