scholarly journals Trends of variation of the laboratory parameters during the course of COVID-19 Illness

2021 ◽  
Vol 12 (12) ◽  
pp. 9-16
Author(s):  
Anjali Goyal ◽  
Chandni Gadara ◽  
Heta Patel ◽  
Misha Antani ◽  
Nilay Suthar
Keyword(s):  
Disease Progression ◽  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Serum Lactate ◽  
Serum Lactate Dehydrogenase ◽  
Disease Course ◽  
Acute Phase Reactants ◽  
Laboratory Parameters

Background: The coronavirus pandemic which had its origin in the Wuhan China has been spreading across the globe with far reaching complications and a variable clinical course. A variation of the laboratory parameters during the disease course remains a constant parameter to monitor the disease course and progression. Since the laboratory parameters are standardized globally, these may also act as uniform guidelines for the patients monitoring and treatment. Aims and Objectives: The aim of the study was to serial charting of the laboratory parameters in the recovered and expired patients of COVID-19 and to determine an associated prognostic significance. Materials and Methods: A retrospective observational study from the laboratory and medical records was conducted on the patients admitted from March 17, 2020, to May 31, 2020, at the tertiary care center dedicated to the treatment of RT-PCR confirmed COVID-19 positive patients. Results: The group of parameters showing a poor prognosis include a rising WBC count, high neutrophilic percentage, low lymphocyte percentage (<10) an NLR > 15, low lymphocyte monocyte ratio < 3, rising blood urea nitrogen, serum creatinine levels, and serum electrolyte levels. The liver function tests variation reflecting a poor metabolic activity of the liver, namely, a low serum albumin and albumin globulin ratio, rising SGOT levels, and total bilirubin levels. A highly significant variation in the acute phase reactants showing an exponential rise such as the serum lactate dehydrogenase levels, serum ferritin, fibrinogen, C-reactive protein, and IL 6 levels an increased level of D Dimer (>3) and a prolongation of the APTT. Conclusion: The variation of the laboratory parameters acts as a fair marker for the disease progression. Since the disease shows a variable progression with a sudden worsening of the clinical symptoms, a comprehensive monitoring of the laboratory parameters serves to diagnose and treat the disease progression.

scholarly journals Maintaining an Adult Hematology/Oncology Service at a Tertiary Care Center during the SARS-CoV-2 Pandemic: An Eight-Week-Experience with a Newly Implemented Procedural Plan

2021 ◽  
pp. 1-6
Author(s):  
Philipp G. Hemmati ◽  
Dorothea Fischer ◽  
Frank Breywisch ◽  
Sabine Wohlfarth ◽  
Matthias Kramer ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Cancer Center ◽  
Staff Members ◽  
Oncology Service ◽  
Containment Measures ◽  
Vulnerable Patient ◽  
Set Up ◽  
Oncology Unit

Treatment of cancer patients has become challenging when large parts of hospital services need to be shut down as a consequence of a local COVID-19 outbreak that requires rapid containment measures, in conjunction with the shifting of priorities to vital services. Reports providing conceptual frameworks and first experiences on how to maintain a clinical hematology/oncology service during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are scarce. Here, we report our first 8 weeks of experience after implementing a procedural plan at a hematology/oncology unit with its associated cancer center at a large academic teaching hospital in Germany. By strictly separating team workflows and implementing vigorous testing for SARS-CoV-2 infections for all patients and staff members irrespective of clinical symptoms, we were successful in maintaining a comprehensive hematology/oncology service to allow for the continuation of treatment for our patients. Notably, this was achieved without introducing or further transmitting SARS-CoV-2 infections within the unit and the entire center. Although challenging, our approach appears safe and feasible and may help others to set up or optimize their procedures for cancer treatment or for other exceedingly vulnerable patient cohorts.

scholarly journals Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

2021 ◽  
Vol 7 (5) ◽  
pp. 647
Author(s):  
Subrata Kumar Das ◽  
Saptadipa Das
Keyword(s):  
Metabolic Syndrome ◽  
Observational Study ◽  
Alopecia Areata ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Number Of Patients

<p class="abstract"><strong>Background:</strong> The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).</p><p class="abstract"><strong>Methods:</strong> This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17  patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44  had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.</p><p class="abstract"><strong>Conclusions:</strong> In the present study we did not observe any significant derangement of clinical and laboratory parameters of  MS  in patients of alopecia areata.</p>

scholarly journals LDH LEVEL IN ACUTE ORGANOPHOSPHORUS POISONING AND ITS RELATION WITH SEVERITY AND MORTALITY: A TERTIARY CARE HOSPITAL EXPERIENCE

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Suresh Kumar Nagar ◽  
Maniram Kumhar ◽  
V. B. Singh ◽  
Mayank Srivastav
Keyword(s):  
Organophosphorus Compounds ◽  
Tertiary Care ◽  
Crop Protection ◽  
Serum Lactate ◽  
Spectrophotometric Analysis ◽  
Serum Lactate Dehydrogenase ◽  
Care Hospital ◽  
Significant Difference ◽  
Organophosphorus Poisoning ◽  
Acute Organophosphorus Poisoning

Background: Organophosphorus compounds have been widely used for a few decades in agriculture for crop protection and pest control. In India Organophosphorus poisoning is the most common. The objective of our study was to measure the  LDH Level in acute organophosphorus poisoning Methods: This study was conducted among minimum 100 patients acute organophosphorus poisoning admitted in Casualty ward, MICU and attending medical ward of JLN hospital, Ajmer during Aug 2018 to July 2020. Serum lactate dehydrogenase estimation by spectrophotometric analysis using Beckman Coalter AU 680 Results: These were significantly higher among deaths on day 1 and 3(810±372.99 and 1027.09±458.26, respectively) in comparison to survivors on day 1 and 3 (538.18±300.42 and 365.19±175.49, respectively). Significant difference was found between mean values of different levels of severity of LDH on day 1 and 3. Conclusion: In conclusion, this study found that Serum LDH can be used as biomarker in diagnosis or stratifying severity of acute OP poisoning, as it is cheap and easily available, especially in developing countries. Serial measurements of serum LDH levels in acute OP poisoning can predict the prognosis. Keywords: LDH, OP poisoning, Severity

P060 Childhood uveitis: epidemiological, clinical and etiological profile, about 52 cases

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Sakhi ◽  
R Chahir ◽  
A Elkettani ◽  
K Bouayed
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Posterior Uveitis ◽  
Disease Course ◽  
Behcet's Disease ◽  
Pediatric Uveitis

Abstract Background Childhood uveitis is a rare, often serious condition, and accounts for 2% to13% of all uveitis. It is characterized by an asymptomatic onset delaying the diagnosis and exposing a high risk of complications. The etiological profile of childhood uveitis seems to be different from that of adults. The objective of our work is to analyze the epidemiological, clinical, etiological, therapeutic and disease course characteristics of pediatric uveitis. Method This retrospective study, carried out in a tertiary care center, involved a number of 87 eyes in 52 children under the age of 16, collected over a period extending between January 2015 and September 2019 with a minimum follow-up of 6 months. Results The patients mean age was 8.15 years with a sex ratio of 1.47 and a mean consultation delay of 6.7 months. Uveitis was bilateral in 67.3% of cases. Pan-uveitis predominated, followed by intermediate, anterior and posterior uveitis in 50%, 21%, 17% and 12% of cases, respectively. Uveitis was idiopathic in 67.3% of cases. Inflammatory uveitis was the most frequent aetiology with 5 cases of Behçet's disease, 2 cases of juvenile idiopathic arthritis (JIA) and 2 cases of TINU syndrome. Ophthalmologic complications were dominated by iridocrystalline synechiae in 13.5%, retinal detachment in 10.4%, cataract in 5.4% and macular oedema in 2.7%. Corticosteroid therapy was administered to all children, combined with immunosuppressive therapy in 48% of cases (azathioprine, methotrexate). The use of anti-TNF alpha was justified in 11 patients. The disease course was marked by complete remission in 11 children and partial remission in 15 patients, 26 children presented relapses of their uveitis with satisfactory final visual acuity in 73% of cases. Conclusion Our results show the predominance of panuveitis, probably due to diagnostic delay. Idiopathic uveitis, as described in the literature, and inflammatory causes of Behçet's disease are at the top of the list of etiologies. Pediatric uveitis is a particular entity, which requires regular monitoring by a team of experts in order to avoid eye complications and amblyopia in the youngest.

scholarly journals Correlation of Hormonal Profile and Lipid Levels with Female Adult Acne in a Tertiary Care Center of Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Smriti Shrestha
Keyword(s):  
Lipid Profile ◽  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Bivariate Analysis ◽  
Female Adult ◽  
Chi Square ◽  
Chi Square Test ◽  
Relationship Of

 Background: Acne beyond 25 years of age is frequently associated with hormonal derangement in women. Hormonal association provides the impetus for hormonal therapy as well as underpins the need for blood investigations in this population. Hence, we aim to estimate the presence of hormonal derangement and lipid alteration in female adult acne.Methods: A prospective, observational study was conducted in Dhulikhel Hospital from July 2015 to February 2016. Females older than 25 years with acne were taken in the study after informed consent. Total 100 patients were enrolled aftersample sizeestimation. Hormonal paneland lipid profile were measured. Hormones tested were androgens, C-peptide and thyroid stimulating hormone. Data analysis was done with SPSS-23. Bivariate analysis was done by chi-square test for categorical data.Results: In this study, majority of patients were younger than 30 years (70.5%) and perioral area most commonly involved. Hormonal alteration was seen in 37.2% patients, among which 17.9% had hyperandrogenism, 15.4% had abnormal thyroid level and 10.3% had high C-peptides respectively. Lipid profile was altered in 15.4% patients. Hormonal alteration had significant association with irregular menstruation (P<0.05) but not acne severity.Conclusions: We observed hormonal alteration frequently in females with adult acne, which comprised of various hormonal parameters including hyperandrogenism. Hormonal alteration reflects deranged metabolic milieu and we suggestthat wide hormonal panel should be done in female adult acne. Relationship of hormones with menstrual irregularity but not with acne severity, suggest that clinical symptoms should lead hormonal investigations in all grades of acne.

scholarly journals 1481. A Study for Risk Factors of Acute Kidney Injury in Leptospirosis in a Tertiary Health Center in South India

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S540-S540
Author(s):  
Bhavana Surapareddy ◽  
Muralidhar Varma ◽  
Shashidhar V
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Early Recognition ◽  
Care Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Kidney Injury ◽  
Serum Lactate ◽  
Significant Difference ◽  
Serum Bicarbonate Level

Abstract Background Leptospirosis is the most widespread zoonotic disease in the world. In India, it is endemic in coast lined states. Renal failure is a severe complication with mortality approaching 22%, early recognition of which helps clinicians in acting fast. This study aimed to investigate the predictors of Acute Kidney Injury (AKI) in Leptospirosis Methods This is a prospective, case–control study done in a tertiary care center in Southern India carried out between October 2017 and December 2018. Patients with confirmed Leptospirosis as per CDC 2013 and Faine’s criteria (2012) having AKI as per KDIGO criteria were defined as cases. Subjects without AKI were controls. Demographic, clinical and laboratory data were compared between the groups and analyzed. Logistic regression was performed to analyze the possible risk factors associated with AKI in Leptospirosis. Results A total of 329 subjects met the inclusion criteria of the study. 187 patients with AKI (CASES) and 142 patients without AKI (CONTROLS) were studied. Patients with AKI were older, (mean age- 46.99 ± 13.21 vs. 42.99 ± 15.15 years) had longer hospital stay (9.04 ± 5.62 vs. 6.27 ± 3.27 days) had higher SOFA (7.97 ±2.9 vs. 3.37 ± 2.6) and APACHE 2 scores (14.37±5.93 vs. 4.66 ± 4.4), lower mean arterial pressure (84.01 ± 14.45 vs. 89.01 ± 10.63 mmHg; P = 0.001) lower serum bicarbonate level (21.70 ± 2.35 vs. 18.73 ± 3.78 mEq/dL; P < 0.001). Factors like serum lactate, AST, ALT had no significant difference between the groups. Serovar identification was done in 88 patients, of which 57 had AKI. Australis (16.7%), Pyrogenes (16.7%) and Grippotyphosa (11.1%) were the commonest serovars isolated. Serovar most commonly associated with AKI was Pyrogenes (17.5%) Predictors for AKI were jaundice (P = 0.01, OR 2.25; CI 1.21 –3.26), vomiting (P = 0.017, OR 1.9, CI 1.12- 3.26) Hypotension (P = 0.02, OR = 12.3, CI 1.85 – 107.2), tachypnea (P = 0.006, OR = 2.55, CI 1.11- 3.24), leukocytosis (P < 0.001, OR 5.45, CI 1.86- 4.89), thrombocytopenia (P < 0.001, OR 6.49, CI 2.33 – 6.75) Conclusion Identification of features like hypotension, tachypnea, acidosis, leukocytosis, thrombocytopenia, the occurrence of serovar Pyrogenes should alert the clinician on risk of developing AKI Disclosures All authors: No reported disclosures.

scholarly journals Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Nitesh Gupta ◽  
Pranav Ish ◽  
Rohit Kumar ◽  
Nishanth Dev ◽  
Siddharth Raj Yadav ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Sofa Score ◽  
Care Center ◽  
Tertiary Care ◽  
Nasopharyngeal Swab ◽  
Common Symptom ◽  
Pulmonary Medicine ◽  
Laboratory Parameters ◽  
Male Predominance ◽  
Icu Admission

COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a high modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India.   *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmonary Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology) 

Demystifying Biclonal Gammopathy: A Pathologist’s Perspective

2019 ◽  
Vol 50 (4) ◽  
pp. 357-363 ◽  
Author(s):  
Sudha Sharma ◽  
Parikshaa Gupta ◽  
Ritu Aggarwal ◽  
Pankaj Malhotra ◽  
Ranjana Walker Minz ◽  
...  
Keyword(s):  
Medical Literature ◽  
Case Reports ◽  
Care Center ◽  
Tertiary Care ◽  
Protein Electrophoresis ◽  
Disease Course ◽  
Immunofixation Electrophoresis ◽  
Biclonal Gammopathy ◽  
Monoclonal Proteins

Abstract Background The production of 2 monoclonal proteins characterizes biclonal gammopathic manifestations (BGMs). The available medical literature from India is chiefly restricted to case reports. Objective To study the incidence of BGMs in a tertiary care center in Chandigarh, India, during a 4-year period. We evaluated these cases further for their laboratory characteristics. Methods We scrutinized the contents of a database containing information from the studied 4-year period. Cases reported as BGMs on serum protein electrophoresis (SPEP) and confirmed by serum immunofixation electrophoresis (SIFE) were included. Results A total of 15 cases, from a cohort of 914 cases of monoclonal gammopathic manifestations (MGMs), were available. On SPEP, 2 M bands were observed in 12 cases. On SIFE, 4 cases were reported as being of true BGMs. The most common heavy-chain combination observed was immunoglobulin (Ig)A-IgG. Follow-up was available in 2 patients. Conclusion Identification of BGMs increases diagnostic precision, despite that the treatment is similar to that for monoclonal gammopathic manifestations (MGMs). BGMs can be transitory and may be observed at presentation or during the disease course.

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