scholarly journals Vitamin Cobalamin deficiency in macrocytic anemia reporting at a Tertiary Care Hospital.

2021 ◽  
Vol 28 (04) ◽  
pp. 527-532
Author(s):  
Kashif Rasheed Shaikh ◽  
Shumaila Shaikh ◽  
Sadia Tabassum ◽  
Shagufta Memon ◽  
Umair Ali Soomro ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Macrocytic Anemia ◽  
Cobalamin Deficiency ◽  
Categorical Variables ◽  
Care Hospital ◽  
Female Ratio ◽  
Male And Female ◽  
Significant Difference

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.

scholarly journals Clinicohematological profile of pancytopenia: a study from a tertiary care hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 478
Author(s):  
Rakesh Kumar Yadav ◽  
Sujit Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Clinical Feature ◽  
Study Group ◽  
Care Hospital ◽  
Female Ratio ◽  
B12 Deficiency

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Detection of SARS-CoV-2 and Other Infectious Agents in Lower Respiratory Tract Samples Belonging to Patients Admitted to Intensive Care Units of a Tertiary-Care Hospital, Located in an Epidemic Area, during the Italian Lockdown

2021 ◽  
Vol 9 (1) ◽  
pp. 185
Author(s):  
Adriana Calderaro ◽  
Mirko Buttrini ◽  
Sara Montecchini ◽  
Giovanna Piccolo ◽  
Monica Martinelli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Infectious Agents ◽  
Epidemic Area ◽  
Significant Difference

The aim of this study was the detection of infectious agents from lower respiratory tract (LRT) samples in order to describe their distribution in patients with severe acute respiratory failure and hospitalized in intensive care units (ICU) in an Italian tertiary-care hospital. LRT samples from 154 patients admitted to ICU from 27 February to 10 May 2020 were prospectively examined for respiratory viruses, including SARS-CoV-2, bacteria and/or fungi. SARS-CoV-2 was revealed in 90 patients (58.4%, 72 males, mean age 65 years). No significant difference was observed between SARS-CoV-2 positives and SARS-CoV-2 negatives with regard to sex, age and bacterial and/or fungal infections. Nonetheless, fungi were more frequently detected among SARS-CoV-2 positives (44/54, 81.4%, p = 0.0053). Candida albicans was the overall most frequently isolated agent, followed by Enterococcus faecalis among SARS-CoV-2 positives and Staphylococcus aureus among SARS-CoV-2 negatives. Overall mortality rate was 40.4%, accounting for 53 deaths: 37 among SARS-CoV-2 positives (mean age 69 years) and 16 among SARS-CoV-2 negatives (mean age 63 years). This study highlights the different patterns of infectious agents between the two patient categories: fungi were prevalently involved among SARS-CoV-2-positive patients and bacteria among the SARS-CoV-2-negative patients. The different therapies and the length of the ICU stay could have influenced these different patterns of infectious agents.

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals Clinical and biochemical profile of obese and overweight children at a Tertiary Care Hospital.

2020 ◽  
Vol 27 (06) ◽  
pp. 1119-1123
Author(s):  
Asif Ali Khuhro ◽  
Fazal Ur Rehman ◽  
Waqas Ali ◽  
Najmi Usman ◽  
Sanam Bano Rajper
Keyword(s):  
Metabolic Syndrome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Biochemical Profile ◽  
Overweight Children ◽  
Cross Sectional ◽  
Female Ratio ◽  
Study Participants

Objectives: Childhood and adolescent obesity is increasing especially in developing countries like Pakistan. It seem to affect most socio-economic classes as well as all ethnicities and geographies. We planned this study to analyze the clinical and biochemical profile of obese as well as overweight children at a tertiary care hospital for the existence of metabolic syndrome. Study Design: Cross sectional study. Setting: Department of Pediatrics Medicine, Children Hospital Chandka Medical College / Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. Period: 1st July 2018 to 31st December 2018. Material & Methods: Children, aged 5 to 16 years, both gender, having BMI > 85th percentile regarding age and gender were enrolled. Demographic characteristics along with history, lifestyle parameters and physical examination were noted for all the study participants. Metabolic syndrome (Met S) was evaluated while overall results were presented in terms of proportions, mean and standard deviations. Results: A total of 78 cases were enrolled during the study period. There were 46 (58.9%) male and 32 (41.1%) female, with a male to female ratio of 1.4:1. Mean age amongst study participants was 10.8 years. We had 56 (71.8%) children as overweight whereas 22 (28.2%) obese. Acanthosis nigricans was the most common entity seen in 55 (70.1%) children during clinical examination. Metabolic syndrome was found to be present in 31 (39.7%) participants. Conclusion: Met S is not only limited to obese children as it can also affect children who are overweight.

scholarly journals A prospective clinico-etiological study of 100 cases of pancytopenia in a tertiary care hospital in Eastern India

2021 ◽  
Vol 11 (2) ◽  
pp. 236-240
Author(s):  
Palai Sabita ◽  
Swain Santosh Kumar ◽  
Nayak Rajeeb Kumar ◽  
Majhi Majha ◽  
Padhi Prabhat Kumar ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Megaloblastic Anemia ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Macrocytic Anemia ◽  
General Medicine ◽  
Good Prognosis ◽  
Total Leucocyte Count ◽  
Care Hospital ◽  
Hematological And Biochemical Parameters

Pancytopenia is a hematological entity which is relatively common. Its evaluation is important for arriving at an early and correct diagnosis, to aid in appropriate management.It was an observational study conducted in the Department of General Medicine and Clinical Hematology of our institute from June 2019 to May 2020. Clinical, hematological and biochemical parameters of 100 pancytopenic patients were evaluated and descriptive statistics was used. The age ranged from 18-75 years. The commonest presentation was easy fatigability and fever. Besides pallor, splenomegaly and hepatomegaly were the presenting signs. Megaloblastic anaemia was detected in 64% followed by aplastic anaemia in 12% and acute leukemia in 6% patients. Among infective etiologies, two cases of malaria (P. falciparum). And each case of HIV, tuberculosis and dengue were seen. Lowest Hb% of 1.8 gm/dl, lowest total leucocyte count (TLC) of 500cells/cmm and lowest total platelet count (TPC) of 4000 cells/cmm was noted in a case of aplastic anemia. Macrocytic anemia was predominant blood picture. Hypercellular marrow was noted in 70(70%) cases and common cause was megaloblastic anemia, followed by leukaemia. Hypocellular marrow was noted in 12(12%) patients with aplastic anemia being commonest cause. In our study diagnosis of pancytopenia and its causes were ascertained by hematological investigations. An early and prompt treatment was given according to the cause and severity. Most of the cases had good prognosis due to a treatable cause.

scholarly journals Clinico-radiological Observations in Meconium Aspiration Syndrome

2018 ◽  
Vol 56 (209) ◽  
pp. 510-515 ◽  
Author(s):  
Susana Lama ◽  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Nikhil Agrawal ◽  
Santosh Pathak ◽  
...  
Keyword(s):  
Apgar Score ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Radiological Findings ◽  
Female Ratio ◽  
Meconium Aspiration ◽  
Significant Difference

Introduction: To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal. Methods: An observational study carried out for a year in 2014-15 in all babies with MAS. Clinical and radiological profiles of MAS in relation to gender, gestational age, mode of delivery, birth weight, Apgar score, thickness of meconium, age at admission and the immediate outcome were studied. Results: Out of 584 admitted newborns (male=389; female=186) during the study period, 78 (13.4%) had meconium aspiration syndrome with male: female ratio of 1.2:1. Majority of babies admitted to NICU had thick meconium [n=52 (66.7%)]. There was no statistical significant difference in various parameters such as Apgar score at 1 and 5 minutes, respiratory distress, birth asphyxia, duration of oxygen use, MAS severity and chest x-ray in those with thick MAS compared to thin. Among all newborns with MAS, 59% (n=46) had abnormal radiological findings with over two-folds in those with thick MAS (71.7%)] compared to thin (28%). Hyperinflation (47.8%), diffuse patchy infiltration (37%), consolidation (21.7%) collapse (8.7%), right lung fissure (6.5%) and pneumothorax (8.7%) were the abnormal radiological findings seen in MAS babies. The odds of having APGAR score at 1 minute at least 7 or more was twice unlikely in those having thick meconium compared to thin (P=0.02) Conclusions: Thick meconium is relatively common with more significant abnormal radiological findings and low Apgar score.

scholarly journals Changes in ECG among patients with drug induced poisoning in a tertiary care hospital

2019 ◽  
Vol 44 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Ashraf Ur Rahman ◽  
AW Chowdhury ◽  
S Jabeen
Keyword(s):  
Qt Interval ◽  
Atrial Tachycardia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Channel Blockers ◽  
Care Hospital ◽  
Ecg Changes ◽  
Drug Induced ◽  
Female Ratio ◽  
Pr Interval

Background: A wide variety of ECG changes can be seen with cardiac and noncardiac agents and may occur at therapeutic or toxic levels. Wide QRS and QT prolongation may be seen in poisoning cases; are potentially dangerous and indicate the necessity of continuous cardiac monitoring.The objective of this study was to determine the changes in ECG among patients admitted with pharmaceutical drug induced poisoning in a tertiary care hospital in Dhaka. Methods: This cross sectional study was carried out at the Department of Medicine, Dhaka Medical College Hospital (DMCH) during July-December, 2013. Detailed information were obtained; clinical examination and relevant investigations including ECG were done in each case according to protocol. Results: Among 66 cases mean age was 22.9 (±6.47) years and male to female ratio was 1: 2.14 (21 Vs 45). Common drug groups taken by the study population were benzodiazepines in 31(47.0%) and tricyclic antidepressants (TCA) in 18(27.3%) cases.Normal ECG findings were found in 28 (42.4%) cases, 18 (27.3%) cases revealed sinus tachycardia, 11(16.7%) showed prolong QT Interval, 6(9.1%) had atrial tachycardia, 5(7.6%) showed wide QRS and 3(4.6%) cases revealed prolong PR interval. Patients withTCA poisoning developedsinus tachycardia in 11(61.1%), prolong QT Interval in 6(33.3%), wide QRS in 5(27.8%),atrial tachycardia in 5(27.8%), prolong PR Interval in 2(11.1%), and Tall R in aVRin 2(11.1%) cases. Prolong QT Interval were found among 3 (75.0%) patients with K+ efflux channel blockers (chlorpromazine, chlorpheniramine and quetiapine) overdose.Patients with beta blocker overdose developed sinus bradycardia in 4 (100.0%) and prolong PR Interval in 1(25.0%) cases. Conclusion: Common drugs taken by the patients were amitriptyline sedatives. Wide QRS, prolong QT interval and some other ECG changes were observed by TCA poisoning in higher doses. TCA, benzodiazepines and K channel blockers induced prolong QT Interval in higher doses.Careful interpretation of ECG findings can provide key information to guide management of the poisoned patients. Bangladesh Med Res Counc Bull 2018; 44: 160-167

scholarly journals Etiology and clinical spectrum of acute undifferentiated fever illness in patients in a tertiary care hospital Sheri Kashmir institute of medical science Soura, Jammu and Kashmir

2021 ◽  
Vol 9 (1) ◽  
pp. 15
Author(s):  
Sheenam Gazala ◽  
Mohmad Saleem Chesti ◽  
Syed Mushfiq
Keyword(s):  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Categorical Variables ◽  
Care Hospital ◽  
Continuous Variables ◽  
Jammu And Kashmir ◽  
And Gender

Background: Current study aimed at s to delineate the etiology and clinical parameters associated with AUFI presenting to emergency department in a tertiary care hospital.Methods: This was a prospective hospital based study carried out at emergency medicine, SKIMS hospital, Soura Kashmir, India July 2017 to august 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever.Results: Total numbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patients were diagnosed enteric fever (N=59, 33.9%) followed by UTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%) while rest of cases were associated with other viral illnesses (N=70, 40.5%) based on clinical basis and inconclusive laboratory results.Conclusions: Enteric fever was found to be the most common cause of acute undifferentiated fever followed by dengue and other viral illnesses, although causes and clinic spectrum of AUFI is varied.

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