scholarly journals Study of Absolute Neutrophil Absolute Lymphocyte count ratio in Community Acquired Pneumonia patients as a prognostic indicator at a tertiary care centre

2021 ◽  
Vol 12 (9) ◽  
pp. 69-74
Author(s):  
Dyaneshwar Nirgude ◽  
Mahadev Hanmantappa Malge ◽  
Swetha Rajoli ◽  
Avinash Hanbe Rajanna
Keyword(s):  
Lymphocyte Count ◽  
Tertiary Care ◽  
Age Groups ◽  
Absolute Lymphocyte Count ◽  
Prognostic Indicator ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Tertiary Care Centre ◽  
Nitrogen Levels ◽  
Count Ratio

Background: Community acquired pneumonia refers to pneumonia contracted by a person with little or no contact with health care system. Following endotoxemia the number of circulating neutrophils increases while lymphocyte counts decrease. Combining both parameters seems a logical step and the ratio of neutrophil and lymphocyte counts is increasingly used in several clinical circumstances. Initially, this so-called neutrophil-lymphocyte count ratio (NLCR) was studied as an infection marker in ICU patients and found to correlate well with disease severity and outcome, according to APACHE-II and SOFA scores. In the current study, we explored the value of the NLCR in patients admitted with Community acquired pneumonia. Aims and Objectives: 1) To find out the value of Neutrophil-Lymphocyte Count Ratio (NLCR)in Community Acquired Pneumonia (CAP). 2) To study Neutrophil-Lymphocyte Count Ratio (NLCR) as prognostic indicator in Community Acquired Pneumonia (CAP). Materials and Methods: This prospective study was conducted on minimum of 100 patients admitted to hospitals from November 2015 to September 2017 from Bangalore. After admission of cases based on CURB-65 scores, a detailed history and clinical examination was done along with chest x-ray to establish the diagnosis. Before taking into the study all patients had signed the informed consent. Routine haematological investigations done on day 1,3 & 7 were carried out. Serum c-reactive protein levels, Urea nitrogen levels, Sputum for culture and sensitivity and Acid-fast bacilli (AFB) was done on the same day of admission. ANC (Absolute neutrophil count), ALC (Absolute lymphocyte count) and NLCR were calculated. Results: Our study included age groups above 18yrs. Majority of the patients in the study were between 58-67 years (30%) followed by 48-57 years (27%). As the CURB-65 score increased from score 0 to score 4–5, the NLCR consistently increased, while the lymphocyte counts consistently decreased. In patients who died there was a significantly higher NLCR at presentation compared to patients that survived (15.18±3.55 versus 11.73±3.01, p-value,0.003). Conclusion: In our study increased NLCR carried poor prognosis which correlated with high CURB65 score and ICU admission. In patients who died there was a significantly higher NLCR at presentation compared to patients those survived.

Study of Absolute Lymphocyte Count as a Marker of COVID 19 Disease Severity in Tertiary Care Centre, Suryapet

2021 ◽  
Vol 8 (23) ◽  
pp. 1960-1965
Author(s):  
Bellala Venkata Anuradha Devi ◽  
Cigiri Saritha ◽  
Ravuri Swarupa ◽  
Jeshtadi Anunayi
Keyword(s):  
Disease Severity ◽  
Lymphocyte Count ◽  
Complete Blood Count ◽  
Tertiary Care ◽  
Absolute Lymphocyte Count ◽  
World Health ◽  
Total Leucocyte Count ◽  
Global Public Health ◽  
Tertiary Care Centre ◽  
Absolute Lymphocyte Counts

BACKGROUND The World Health Organization (WHO) has declared Coronavirus disease 2019 (COVID - 19) as a global public health pandemic. Clinical and laboratory biomarkers to predict the severity of corona virus 2019 are essential in this pandemic. Lymphocyte count has been a marker of interest in order to investigate the association of lymphocyte count and severity of COVID-19. We would like to analyse the relationship between absolute lymphocyte count (ALC) & COVID-19 disease severity. METHODS We performed a retrospective study on patients admitted to Government general hospital, Suryapet for COVID-19 illness from September 1st 2020 to September 16th 2020. Age, gender and complete blood count of patients admitted in the hospital was collected. Haemoglobin, total leucocyte count (TLC), absolute neutrophilic count (ANC), absolute lymphocyte count (ALC) and platelet counts were compared between ICU and Non-ICU groups and comparison of absolute lymphocyte counts in each group - ICU alive, ICU death and non-ICU groups was carried out. RESULTS 134 patients who were admitted in the hospital were analysed. Mean age and gender were compared between ICU and Non-ICU groups. We compared ALC between ICU alive, ICU death and non-ICU groups. Mean ALC in ICU death group was 0.81, in ICU alive group 1.04 and in non-ICU as 1.75. We found that patients with disease severity have lower absolute lymphocyte counts. In addition to this we also found that there was neutrophilia and lower haemoglobin levels in ICU patients. CONCLUSIONS We conclude that lymphopenia, defined as absolute lymphocyte count less than 1.1 x 109 /L may be useful in predicting the severity of COVID-19 illness. KEYWORDS COVID-19, Absolute Lymphocyte Count (ALC), Lymphopenia, SARS COV2

scholarly journals Role of pretreatment neutophil to lymphocyte ratio as an independent prognostic factor in oral squamous cell carcinoma patients: a prospective study in a tertiary care centre

2018 ◽  
Vol 6 (6) ◽  
pp. 1977
Author(s):  
Shashwat Tiwari ◽  
Shivani Nautiyal
Keyword(s):  
Tertiary Care ◽  
Prognostic Index ◽  
Absolute Lymphocyte Count ◽  
Prognostic Scores ◽  
P Value ◽  
Tertiary Care Centre ◽  
High Group ◽  
Potential Biomarker ◽  
Significant Difference ◽  
The Absolute

Background: More recently, established systemic inflammation-based prognostic scores have been explored extensively, such as NLR and serum C-reactive protein (CRP). We postulated that NLR might be a readily available and inexpensive objective prognostic index that could be used in daily oncologic clinical practice and could help to stratify patients in clinical trials.Methods: In total, there were 150 patients with OSCC treated at GSVM medical college, Kanpur between October 2012 and January 2015 whose clinical information and laboratory parameters were obtained. The NLR was determined by dividing the absolute neutrophil count by the absolute lymphocyte count, and the NLR data were then dichotomized and divided into two groups as NLR-low and -high.Results: The 3-year OS rate of the NLR-high group tended to be significantly lower than that of the NLR-low group, this relationship was found to be statistically significant (p value <0.05). The 3-year DFS rate in the NLR-high group was lower than that in the NLR-low group; however, there were no significant difference between the two groups.Conclusions: Our findings reported herein demonstrated that pre-treatment NLR is a potential biomarker for predicting the overall survival in oral SCC patients. Combined with other markers, NLR may be used in decision-making and the selection of treatment modality in patients with oral SCC.

scholarly journals Assessment and Correlation of Uric Acid Concentration in Saliva and Serum of Patients Attending Tertiary Care Centre

2020 ◽  
Vol 16 (4) ◽  
pp. 222-229
Author(s):  
Surakchhya Gautam ◽  
Sangita Thapa ◽  
Anju Khapung
Keyword(s):  
Uric Acid ◽  
Demographic Data ◽  
Adult Population ◽  
Tertiary Care ◽  
Age Groups ◽  
Screening Tools ◽  
P Value ◽  
Uric Acid Concentration ◽  
Tertiary Care Centre ◽  
Significant Difference

ABSTRACT Background Serum uric acid (UA) is associated with many health conditions, including renal, cardiovascular and metabolic disorders. Diagnosis and monitoring often require painful invasive procedures which will add undue stress to the patients. The aim of this study was to correlate salivary and serum UA, so that, salivary sampling will help to bypass these measures and evaluate the condition of both healthy and the diseased. Methods This hospital based descriptive cross sectional study was conducted in 100 participants between age groups 21 to 82 years. Demographic data including height, weight and blood pressure were recorded. Serum and salivary samples were collected and UA level in both type of samples were estimated and correlation statistics was carried out. Results Total participants are categorized in three groups, 20-40, 41-60 and more than 60 years, among which maximum participants 43% are between 41-60 years of age. Average of body mass index (BMI) was found to be 24.46, where 50% were within normal range. Mean serum and salivary UA(mg/dl) was 4.15 and 1.90 respectively, exhibiting moderate positive correlation. They were correlated with significant “p-value” according to gender, age groups and disease conditions. Paired t- test was done between the measured and calculated salivary UA and no statistically significant difference in mean of these two values was obtained. Conclusions Salivary and serum UA are associated in our study so salivary UA can be used as a biomarker. Salivary UA was found to be more gender specific and specific among adults. Salivary UA can also be used as a screening tools for young and adult population.

scholarly journals Hydrostatic reducibility of intussusception among different age groups in paediatric population-a descriptive study

2017 ◽  
Vol 4 (2) ◽  
pp. 732
Author(s):  
Sreejith Haridas ◽  
Vineed S. ◽  
K. Sivakumar
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Descriptive Study ◽  
Favourable Effect ◽  
P Value ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Duration Of Symptoms ◽  
Hydrostatic Reduction ◽  
Paediatric Age

Background: Intussusception is one of the most frequent causes of bowel obstruction in infants and toddlers. In children, it is often an idiopathic condition and treated non-surgically by radiologic reduction. Primary aim of study was to analyse the outcome of hydrostatic reduction of intussusception across different paediatric age group patients admitted in a medical college hospital.Methods: This is a hospital based descriptive study conducted in tertiary care centre for one year duration in 2014-2015. 90 patients admitted with diagnosis of intussusceptions for hydrostatic reduction were interviewed with the proforma and details were collected. The procedural detail of hydrostatic reduction was also collected. Patients were followed up for a period of 48 hours post successful hydrostatic reduction.Results: Hydrostatic reducibility of intussusception was 63.3% in less than 3 months age group compared to 93.3% each in other two groups. Overall hydrostatic reducibility was of 83.3%, while 16.7% went for laparotomy. First group had 36.7% cases gone for laparotomy. Analysis of each of the study variables was done to find out their association with hydrostatic reducibility. Only duration, bleeding per rectum, lethargy, dehydration, side of lesion and total count were found to have a statistically significant p value. Logistic regression analysis of the above five variables revealed that only the ‘duration of symptoms’ had a statistically significant independent association with hydrostatic reducibility of intussusception ,with a p value of 0.033 and odds ratio 12.477. 5.3% of cases of first group had recurrence within 48 hours of hydrostatic reduction, while 10.7% and 21.4% of cases from second and third group respectively had recurrence within 48 hours of reduction. Overall recurrence of intussusception within 48hours is 13.3%.Conclusions: Hydrostatic reduction of intussusception is more successful in paediatric age group > 3 months compared to < 3 months. Shorter duration of symptoms, especially < 48 hours may have a favourable effect on hydrostatic reducibility of pediatric intussusception. Rate of recurrence of intussusception within 48 hours of successful hydrostatic reduction is 13.3 per 100 paediatric cases.

scholarly journals Role of Thyroid Stimulating Immunoglobulins (TSI) in Early Diagnosis of Patients with Euthyroid Grave’s Ophthalmopathy

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Mohammad Idris ◽  
Muhammad Zubair Umer ◽  
Eemaz Nathaniel ◽  
Muhammad Iqbal ◽  
Adnan Zar
Keyword(s):  
Early Diagnosis ◽  
Tertiary Care ◽  
Age Groups ◽  
Sampling Technique ◽  
P Value ◽  
Thyroid Function Tests ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Department Of Ophthalmology

OBJECTIVE: to determine the role of thyroid stimulating immunoglobulin (TSI) in early diagnosis of patients with euthyroid grave’s ophthalmopathy visiting Oculoplastic service of a tertiary care centre        Study design: cross sectional descriptive study  Place and Duration of Study: Oculoplastic service, out patient department of ophthalmology, -------from August 2015 to August 2016. Methodology: ninety patients of both the genders with euthyroid Greave`s Ophthalmopathy at any stage of severity of the disease by non-probability purposive sampling technique. One-way ANOVA test was also done for TSI with Age groups and Gender. RESULTS: Among 90 patients, Females were more than males, 68.9% and 31.1% respectively. 4 age groups were made in which age group of 41 – 55 years patients were more (37.8%) and after that was patients of more than 56 years of age (32.2%). 84% had their thyroid stimulating immunoglobulin (TSI) test positive. Cross tabulation was performed for TSI with Gender. 84.4% of the males and females had their TSI positive with females having more tests positive than males, 55.6% and 28.9% respectively with a p value of 0.139.  CONCLUSION: TSI is positive in majority of female Euthroid Graves ophthalmopathy patients visiting Oculoplastics clinics in age having 41 – 55 years. The association of TSI with gender showed higher significance than age. Early diagnosis with the help of TSI without any expensive investigations even when other thyroid function tests are normal can prevent complications especially ophthalmopathy by timely referral to endocrinologist.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Case Study of Pediatric Cerebral Sinus Venous Thrombosis Center of a Low Middle-Income Country

2021 ◽  
Vol 27 ◽  
pp. 107602962110228
Author(s):  
Bushra Moiz ◽  
Ronika Devi Ukrani ◽  
Aiman Arif ◽  
Inaara Akbar ◽  
Muhammed Wahhaab Sadiq ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Activated Protein C ◽  
Positive Association ◽  
Cerebral Venous Sinus Thrombosis ◽  
P Value ◽  
Middle Income ◽  
Duration Of Symptoms

Pediatric cerebral venous sinus thrombosis (CVST) is rare but a potentially fatal disease requiring its understanding in local setting. In this study, we observed the clinical course, management, and outcome of pediatric patients with sinus thrombosis in a tertiary care center at Pakistan. Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were included. Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Of 143492 pediatric admissions, 32 (21 males and 11 females) patients with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 18.5 CVST events per million pediatric admissions. Adolescents were mostly affected, and the overall mortality was 7%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Activated protein C resistance (44%) was the most common inherited thrombophilia. Twenty-one (66%) patients were anemic with a mean (±SD) hemoglobin of 9.0 g/dL (±2.3). Regression analysis showed a positive association of anemia with multiple sinus involvement ( P-value 0.009) but not with duration of symptoms ( P-value 0.344), hospital stay ( P-value 0.466), age ( P-value 0.863) or gender ( P-value 0.542) of the patients. SARS-COV2 was negative in patients during 2020. Adolescents were primarily affected by sinus thrombosis and infections was the predominant risk factor for all age groups, with a low all-cause mortality. A high index of clinical suspicion is required for prompt diagnosis and intervention.

scholarly journals The Utility and Validation of Intraepithelial Lymphocyte Count in Duodenal Biopsies in A Tertiary Care Centre in South India

2019 ◽  
Vol 6 (10) ◽  
pp. A544-549
Author(s):  
Priyavadhana Balasubramanian ◽  
◽  
Bhawana Ashok Badhe ◽  
Rajesh Nachiappa Ganesh ◽  
Lakshmi C Panicker ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
South India ◽  
Tertiary Care ◽  
Intraepithelial Lymphocyte ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Duodenal Biopsies

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

scholarly journals Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar

2015 ◽  
Vol 1 (2) ◽  
pp. 3-9
Author(s):  
Riaz Gul ◽  
Sumaira Naz
Keyword(s):  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Age Groups ◽  
Ischemic Heart ◽  
P Value ◽  
Age Group ◽  
Ischemic Heart Diseases ◽  
Sedentary Life ◽  
Tertiary Care Hospitals

Objectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group.

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