A study to evaluate acute pancreatitis using modified CT severity index and correlating with clinical outcome in tertiary care hospital

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

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VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

10.36106/ijsr/7821858 ◽

2021 ◽

pp. 53-55

Author(s):

Harsimran Singh Das

Keyword(s):

Emergency Department ◽

Respiratory Failure ◽

Tertiary Care Hospital ◽

Clinical Status ◽

Tertiary Care ◽

Severity Index ◽

Adult Patients ◽

Care Hospital ◽

Oxygen Requirement ◽

Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

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Clinical outcome of infants younger than two months in children ward of a tertiary care hospital, Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v3i2.20269 ◽

2016 ◽

Vol 3 (2) ◽

pp. 15-18

Author(s):

Ganesh Shah ◽

Dinesh Dharel ◽

Anish K Shah ◽

Bikal Sapkota ◽

Asmita Bhattarai

Keyword(s):

Blood Culture ◽

Clinical Outcome ◽

Skin Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Facility ◽

Clinical Profile ◽

Care Hospital ◽

Young Infants ◽

Level Hospital

Introductions: Newborn and young infants are most vulnerable for preventable deaths, particularly in developing countries. This study was conducted to see the clinical profile and outcome of infants less than two months of age admitted in children ward of Patan Hospital.Methods: This descriptive retrospective study was conducted at Patan Hospital, over 12 months from April 2014 to March 2015. Hospital records of all admitted infants aged less than two months were reviewed. The demographic characteristics, clinical profile and clinical outcome were descriptively analyzed.Results: Out of 2062 admissions in children ward, 614 (29.8%) were infants aged less than two months, out of which 482 were neonates less than 28 days. Among these neonates, 114 were inborn. Out of 436 infections, blood culture was positive in 37 (8.9%). There were 4 (0.04%) deaths, 4 (0.04%) referral and 22 (0.25%) left against medical advice. Infection 436 (436) was the commonest cause of illness, of which neonatal sepsis was 163 (37.4%), pneumonia 130 (30%) staphylococcal skin infection 39 (8.7%) and UTI 34 (7.8%). There were 71 (11.6%) cases of neonatal hyperbilirubinemia. Blood culture was positive in 55 (9%) with CONS being the commonest organism isolated; 19 (51.3%).Conclusions: Children ward contributes significantly to the care of sick infants less than two months of age, especially out born ones, requiring neonatal care facility in tertiary level hospital of Nepal. As most admissions are for infection, followed by hyperbilirubinemia, pediatrics wards need to be equipped and staffed accordingly to meet the need of sick young infants.Journal of Patan Academy of Health Sciences. 2016 Dec;3(2):15-18

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Acute pancreatitis in children - a retrospective observational study in a South Indian tertiary care hospital

International Journal of Medical Reviews and Case Reports ◽

10.5455/ijmrcr.2020-07-246 ◽

2020 ◽

pp. 1

Author(s):

Arun AC ◽

Jenish Rajma

Keyword(s):

Acute Pancreatitis ◽

Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Retrospective Observational Study ◽

Care Hospital ◽

South Indian

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Vertical transmission and clinical outcome of the neonates born to SARS-CoV-2-positive mothers: a tertiary care hospital-based observational study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001193 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001193

Author(s):

Pradeep Kumar ◽

Fadila ◽

Arun Prasad ◽

Ambrin Akhtar ◽

Bhabesh Kant Chaudhary ◽

...

Keyword(s):

Clinical Outcome ◽

Observational Study ◽

Vertical Transmission ◽

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Stable Condition ◽

Nasopharyngeal Swab ◽

Care Hospital ◽

Rt Pcr

BackgroundNeonatal transmission of SARS-CoV-2 from positive mothers to their babies has been a real concern, opening the arena of research in this area.ObjectiveTo detect the possibility of vertical transmission of SARS-CoV-2 from COVID-19-positive mothers to their neonates and the clinicopathological outcome in them.DesignA single-centre, prospective, observational study involving 47 COVID-19-positive mothers and their neonates.SettingA tertiary care hospital in Eastern India.ParticipantsNeonates born to SARS-CoV-2-infected mothers.Main outcome measuresWe investigated the SARS-CoV-2 positivity rate by real-time reverse transcriptase-PCR (RT-PCR) done twice (on admission and after 24 hours of admission) in neonates born to SARS-CoV-2-positive mothers, who tested RT-PCR positive for this virus in their nasopharyngeal swab. Clinical outcome was also assessed in these neonates during their hospital stay.ResultsOut of 47 neonates born to SARS-CoV-2-positive mothers, four were SARS-CoV-2 positive by RT-PCR. All the neonates in our study were discharged home in stable condition after management of acute complications. None of them required readmission.ConclusionVertical transmission occurs in neonates born to COVID-19-positive mothers; however, the risk is small. Majority of the neonates remain asymptomatic with good clinical outcome.

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