scholarly journals Lymphocyte-Neutrophil Ratio in the Diagnosis of Tubercular Pleural Effusion in a Tertiary Care Centre: A Descriptive Cross Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 1517-1521
Author(s):  
Rajneesh Jha ◽  
Ram Kumar Mehata ◽  
Puru Koirala
Keyword(s):  
Pleural Effusion ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Continuous Variables ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Tuberculosis is a common infection in our community. Tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis. Among the several causes of exudative pleural effusison tubercular remains the most common form in clinical practice. The aim of this study was to evaluate the significance of lymphocyte-neutrophil ratio(LN ratio) in cases of exudative effusion for diagnosis of tubercular effusion. Methods: This was a hospital based cross sectional studydone in Patients at tertiary care hospital from 1st September 2020 to 1st april 2021after taking ethical clearance from institutional reviw committee. Convienience samplingwas done. Statistical Analysis of data like percentages and frequencies  were used for categorical variables. Mean and SD (standard deviation) were used for describing continuous variables. Inferential statistical tools like Chi-Square test and Student’s t-test were used. P-value of <0.05 was considered statistically significant. Results: out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ratio (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and ADA (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensitivity and specificity of LN ratio and ADA level. Conclusion: Exudative pleural fluid L/N ratio >0.75 is an efficient means of diagnosing tuberculous pleural effusion and its combination with ADA level gives us more accuracy and surety about the diagnosis of tubercular pleural effusion.

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

scholarly journals Leptospira spp. seroprevalence in humans involved in a cross-sectional study in Garissa and Tana River Counties, Kenya

2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  
Keyword(s):  
Case Fatality ◽  
Cross Sectional Study ◽  
Wilcoxon Test ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Sectional Study ◽  
Test Statistic ◽  
Cross Sectional ◽  
Tana River

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.

scholarly journals A cross sectional study on demographic factors affecting low birth weight

2019 ◽  
Vol 6 (11) ◽  
pp. 4896
Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Affecting

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.

Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India

2021 ◽  
Vol 17 ◽  
Author(s):  
Swathi Karanth M.P ◽  
Somashekar M ◽  
Anushree Chakraborty ◽  
Swapna R ◽  
Akshata J.S ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Set Up

Background: The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. Objectives: 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. Methods: A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. Results: The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Conclusion: Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.

Increased frequency of fibromyalgia among patients with chronic pain presenting to internal medicine clinics of a tertiary care hospital: a cross sectional study

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel
Keyword(s):  
Internal Medicine ◽  
Tertiary Care ◽  
Chronic Fatigue ◽  
Cross Sectional Study ◽  
National Language ◽  
P Value ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  

scholarly journals Assessment of Knowledge, attitude and practices of Epilepsy Patients’ towards their illness and treatment in a tertiary care hospital in Kuantan Pahang Malaysia

2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical Science ◽  
Negative Attitude ◽  
Median Number ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Medical Attention ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553

scholarly journals Evaluation of smear microscopy and geneXpert for the rapid diagnosis of pulmonary and extrapulmonary tuberculosis in a tertiary care hospital in North India: a descriptive prospective study

2018 ◽  
Vol 6 (5) ◽  
pp. 1756
Author(s):  
Danish Zahoor ◽  
Anjum Farhana ◽  
Farhath Kanth ◽  
Munazah Bha
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Rapid Diagnosis ◽  
North India ◽  
Smear Microscopy ◽  
High Morbidity ◽  
Care Hospital ◽  
Cross Sectional ◽  
Xpert Assay

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.

scholarly journals KNOWLEDGE OF DENTAL PROFESSIONALS REGARDING TOOTH RESTORABILITY AT A PUBLIC SECTOR TERTIARY CARE HOSPITAL OF KARACHI, PAKISTAN

2019 ◽  
Vol 9 (2) ◽  
pp. 69-72
Author(s):  
Zulfiqar Ali Shaikh ◽  
Afifa Yaseen ◽  
Amna Yaseen ◽  
Subhana Akber
Keyword(s):  
Tertiary Care ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Inadequate Knowledge ◽  
Pain Symptoms ◽  
Dental Professionals

Background: Panoptic knowledge of dental professionals is required to provide care for patients with any dental problem which ranges from screening, emergency care or referral to alleviation of pain symptoms. Ideally to provide dental care, dental practice should be based on current clinical concepts originating from evidence-based dentistry which clearly demarcates a level between a tooth that is able to be restored so that intervention is done on it for esthetic and functional stability, or ready for extraction. Dental professionals' knowledge regarding tooth restorability is very crucial in restorative and preventive dentistry. The aim of this study was to assess the knowledge of dental professionals regarding tooth restorability. Methods: Knowledge regarding tooth restorability of dental professionals of Dow University of Health Sciences was assessed through a multi centered cross sectional study. A sample size of 140 participants was calculated using through open Epi version 3, and a convenient non-probability sampling technique was used. The study was conducted in May-June, 2018. An informed consent prior to the study was taken. The dental professionals were evaluated through a self- administered, structured questionnaire in English. The SPSS-23 was used to obtain results. The knowledge of the students was graded as adequate if >12 and inadequate if<12. Results: Out of 140 study participants, 113 (81%) dental professionals had significantly adequate knowledge (p-value <0.05); while 27 (19%) had inadequate knowledge. Among the respondents, 56% said that the traumatic dental injury must be treated by dentist whereas the others considered it to be treated by private doctor or by nearest hospital casualty. Conclusion: The knowledge of dental professionals working at teaching institutes is adequate; and as per their knowledge they might be taking right decisions regarding tooth restorability.

scholarly journals Frequency of infantile colic in neonates presenting At Tertiary Care Hospital.

2020 ◽  
Vol 27 (11) ◽  
pp. 2357-2362
Author(s):  
Anwar Muhammad ◽  
Muhammad Asghar Ali ◽  
Ali Hammad
Keyword(s):  
Gestational Age ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Care Hospital ◽  
Infantile Colic ◽  
Cross Sectional ◽  
Alternative Measures ◽  
Hospital Study

Objectives: To determine the frequency of infantile colic in neonates presenting at tertiary care hospital. Study Design: Cross Sectional Study. Setting: Department of Neonatology, Civil Hospital, Bahawalpur. Period: From January 2018 to August 2018. Material & Methods: Total 467 neonates either male or female were selected for this study. Total 467 neonates with complaints of crying and fussing either male or female were selected for this study and infantile colic was assessed in selected neonates by using Wessel criteria. Results: Total 467 neonates were selected for this study.  Mean age of the neonates was 24.94 ± 2.39 months, mean gestational age and mean weight was 39.42 ± 1.22 weeks and 3.27 ± 0.62g respectively.   Infantile colic was found in 322 (69%) neonates.  Infantile colic was found in 61 (33.33%) neonates, 136 (94.44%) neonates, 75 (87.21%) neonates and 50 (92.59%) neonates respectively.  Statistically significant association between infantile colic and type of feeding with p value 0.000.  Infantile colic was found in 147 (84.97%), 95 (67.86), 62 (49.21%) and 18 (64.29%) neonates respectively in 37 weeks, 38 weeks, 39 weeks and 40 weeks gestational age group.  Statistically insignificant association between infantile colic and gestational age was noted with p value 0.000. Conclusion: Results of present study showed higher rate of colic in infants.  Development of colic was highly associated with gestational age, birth weight and type of feeding.  There is no effective medical treatment (like anti-colic and herbal drugs) but alternative measures may relieve or prevent further colic attacks.

scholarly journals Patients’ knowledge of prescribed medication: a cross sectional study in a tertiary care centre, Mumbai

2019 ◽  
Vol 6 (10) ◽  
pp. 4238
Author(s):  
Ashis Samuel John ◽  
Kamaxi M. Bhate
Keyword(s):  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Study Population

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.

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