scholarly journals Clinical profile and outcome of children with acute bacterial meningitis in a tertiary care centre in eastern Nepal

2021 ◽  
Vol 10 (2) ◽  
pp. 64-73
Author(s):  
Mukesh Bhatta ◽  
Shyam Prasad Kafle ◽  
Basant Rai ◽  
Rejeena Subedi
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Response To Treatment ◽  
Acute Bacterial Meningitis ◽  
Tertiary Care Centre ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Mortality And Morbidity

Background: Bacterial meningitis is a severe infection of the central nervous system with varied clinical presentations. It is associated with substantial mortality and morbidity. Objectives: The objective of this study was to assess the clinical profile, including the clinical features, laboratory and radiological parameters, clinical course, treatment, response to treatment, complications, and outcome of children at discharge. Methods: A prospective observational study was conducted among 52 inpatient children of acute bacterial meningitis aged one month to 14 years over a period of six months. The patients were enrolled during admission and followed up daily till discharge. Socio-demographic, clinical, and diagnostic details and outcomes were recorded and analysed using statistical package for social sciences version 20. Results: The median age of the patients was two years with male to female ratio of 2:1. Fever (45, 87%), vomiting (37, 71%), seizure (33, 64%) and headache (22, 46%) were the most common symptoms. The cerebrospinal fluid culture was positive in three (6%) cases. Complications were seen in 20 (39%) patients including four (7.7%) deaths. Patients with prolonged fever, malnutrition, loss of consciousness, ear discharge, presence of meningeal signs, abnormal pupil, high cerebrospinal fluid protein, positive cerebrospinal fluid, and blood culture, low blood pH, and hyperlactataemia were significantly associated with complications (p <0.05). Conclusion: Factors like malnutrition, longer duration of fever, and abnormal neurological and laboratory findings were associated with higher rates of complications.

scholarly journals Descriptive study of clinical profile and outcome in patients of acute on chronic liver failure, at a tertiary care center in Northern India

2020 ◽  
Vol 7 (11) ◽  
pp. 1687
Author(s):  
Rakesh Kumar ◽  
Vandana Rana ◽  
Varghese Koshy ◽  
Vandana Gangadharan ◽  
George Koshy
Keyword(s):  
Liver Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Chronic Liver ◽  
Clinical Profile ◽  
Chronic Liver Failure ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Common Cause

Background: Acute-on-chronic liver failure (ACLF) is a recently described syndrome that is characterized by abrupt deterioration in patients with chronic liver disease (CLD) and has high short-term mortality. The aim of this study was to describe the clinical profile, causes and outcomes of ACLF at a tertiary care centre in Northern India.Methods: In this descriptive study of 50 consecutive patients, were included, between August 2015 to January 2018, who were admitted and diagnosed as ACLF as defined by APASL. Causes of acute precipitating event and CLD and outcomes were assessed.Occurrence and severity of organ failure was also assessed.Results: 48 (96 %) were males and 2 (4%) were females with male to female ratio was 24:1. The mean age of male and female subjects was similar, 40.7±9.9 years and 39.2±9.4 years respectively. The most common cause of CLD was alcohol in 50% cases and next most common cause was hepato-tropic viruses HBV infection in 20%, HCV in 6% cases and there was unknown cause in 12 % cases. The most common precipitating factor of acute decompensation was alcohol in 50% cases, hepatotropic viruses in 30% cases. Excluded sepsis and GI bleed as precipitating events. The combined mortality at the end of 1-month and 3-months, in our study was 60%. CLIF-SOFA score was found to be the most reliable scoring system to discriminate between survivors and non survivors. Conclusions: Alcohol was the commonest precipitating cause of ACLF. Organ failures (OFs) are independently predictive of mortality.

scholarly journals Culture Proven Bacterial Meningitis in Children: Agents, Clinical Profile and Outcome

2012 ◽  
Vol 9 (1) ◽  
pp. 36-40 ◽  
Author(s):  
I Ansari ◽  
Y Pokhrel
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Clinical Profile ◽  
Cortical Atrophy ◽  
Acute Bacterial Meningitis ◽  
Influenza B ◽  
Haemophilus Influenza ◽  
Hemolytic Streptococcus ◽  
Young Infants ◽  
Nepalese Children

Background Meningitis is a serious infection. Little is known about the bacterial agents and their antibacterial sensitivity in Nepalese children. Objectives To study bacteriological agents, clinical profile and immediate outcome in patients admitted to children’s ward of Patan Hospital with meningitis. Methods Prospective observational study conducted in paediatric ward of Patan Hospital. All the children admitted to the ward, with the diagnosis of culture proven bacterial meningitis’ on discharge were eligible. Results Out of 7,751 children, 296 (3.8%) had meningitis. This was a group ranging from neonates to adolescents aged 18 years. Only 13 (4.4%) of cerebrospinal fluid samples taken from them yielded positive culture reports. The organisms were pneumococcus (6), Haemophilus influenza ‘b’ (3), ?-hemolytic Streptococcus (1), ?-hemolytic Streptococcus (1), N. meningitides (1) and Pseudomonas (1). Whereas Haemophilus influenza ‘b’ was isolated from young infants, pneumococci were found in the young as well as the old. Fever, vomiting, high leukocyte count with left shift were all commonly present. All but one had cerebrospinal fluid pleocytosis. Low sugar and high protein was found in most specimens. Neuroimaging was done in six children of which three were abnormal (all young infants and pneumococci cases). Ceftriaxone was given to all but one child. Everybody recovered but three had complications – profound hearing loss and cortical atrophy with subdural collection in pneumococcal and septic arthritis with persistence of fever in Haemophilus influenzae ‘b’ meningitis. Conclusion The present study corroborates most of the epidemiological and clinical features of acute bacterial meningitis and sheds light on the causative agents of bacterial meningitis in Nepalese children. http://dx.doi.org/10.3126/kumj.v9i1.6260 Kathmandu Univ Med J 2011;9(1):36-40

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit (NICU) at a Tertiary Care Centre in Eastern Nepal

2013 ◽  
Vol 33 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gauri Shankar Shah ◽  
Satish Yadav ◽  
Anil Thapa ◽  
Lokraj Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Development Goals

Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447   J. Nepal Paediatr. Soc. 2013;33(3):177-181

scholarly journals Clinical profile of patients with steroid sensitive nephrotic syndrome at tertiary care centre in Gujarat, India

2018 ◽  
Vol 5 (4) ◽  
pp. 1172 ◽  
Author(s):  
Nimisha K. Pandya ◽  
Kedar G. Mehta
Keyword(s):  
Nephrotic Syndrome ◽  
Chronic Renal Disease ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Response To Treatment ◽  
Renal Diseases ◽  
Sex Distribution ◽  
Tertiary Care Centre ◽  
Steroid Dependence ◽  
Special Clinic

Background: Nephrotic syndrome is a significant cause of chronic renal disease in children. The objective of the study was to analyze demographic profile, response to steroids and associated complications, in children with Nephrotic syndrome.Methods: A retrospective study of all patients referred to Renal diseases clinic at GMERS Medical College Gotri Vadodara was done. Period of study was from year 2014 to June 2017. Variables assessed were sex distribution, age at presentation for first attack, occurrence of complications, steroid responsiveness and use of steroid sparing agents. Study was done from special clinic cards used for documentation of visits of patients in Nephrotic disease special clinic.Results: 59 patients were studied. Mean age at presentation of was 4.08 years. Sex distribution ratio was 1.18:1. 88% of cases were infrequent relapsers. Steroid dependence was observed in 8.4% of cases. Complications were noted in 38% children. UTI was the commonest complication 13.5%. Associated renal conditions were present in 5% of children.Conclusions: In the present study clinical profile of children with Nephrotic syndrome was concordant with typical nephrotic syndrome in children. Pattern of nephrotic syndrome and response to treatment did not differ significantly from other studies.

scholarly journals A Clinico-Etiological Study of Erythroderma in Adults in a Tertiary Care Centre

2021 ◽  
Vol 10 (37) ◽  
pp. 3213-3219
Author(s):  
Jagaragallu Amrutha ◽  
Narasimha Rao Netha Gurram ◽  
Padmaja Pinjala ◽  
Bhumesh Kumar Katakam ◽  
Rajeev Singh Thakur
Keyword(s):  
Clinical Laboratory ◽  
Age Of Onset ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Etiological Study

BACKGROUND Erythroderma is a clinical entity that may cause severe systemic manifestations. The difficulty with erythroderma lies in finding the underlying aetiology. It is imperative to demonstrate precise aetiology whenever possible so that distinct therapy may be initiated. At times, despite finding the aetiology, relapses constitute a great menace. The purpose of our study was to assess the clinical profile and aetiology of erythroderma. Besides, the study also illustrated factors leading to relapses; such studies are rare in literature. METHODS This hospital-based, cross-sectional study included 88 patients of erythroderma of either sex and age more than 18 years; their clinical, laboratory, histopathological findings, treatment and outcome were studied. RESULTS The mean age of onset was 47.3 ± 12.35 years with the male to female ratio being 2.38:1. The most common cause of erythroderma was pre-existing dermatoses (67 %) followed by drugs (10.2 %), infections (3.4 %), malignancies (4.54 %), and idiopathic (14.7 %). Psoriasis was the predominant aetiology (45.4 %) among the pre-existing dermatoses with a maximum number of relapses (P = 0.02). Psoriasis was significantly associated with pruritus (P = 0.001), subungual hyperkeratosis (P = 0.0001), palmoplantar keratoderma (P = 0.001). Clinicohistological association was found in 64.6 % of cases. Mortality was seen in 6.8 % of cases. CONCLUSIONS As in previous studies, pre-existing dermatoses were the most common causes in our study; albeit, a special emphasis on factors leading to relapses was given to prevent further episodes. The most common factor of relapse was uncontrolled comorbid disorders (diabetes and hypertension) followed by medication nonadherence. Hence, our study suggests a need for more effective comorbidity management and creating awareness regarding judicial use of drugs which can go far in preventing mortality and morbidity. KEY WORDS Erythroderma, Adults, Aetiology, Relapses, Comorbidities.

scholarly journals Laryngopharyngeal reflux- diagnosis and management at a tertiary care centre

2019 ◽  
Vol 5 (5) ◽  
pp. 1330
Author(s):  
Afshan Fathima ◽  
Vivekanand A. ◽  
M. D. Prakash
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Endoscopic Examination ◽  
Clinical Entity ◽  
Clinical Profile ◽  
Response To Treatment ◽  
Common Symptom ◽  
Reflux Symptom Index ◽  
Tertiary Care Centre ◽  
Diagnosis And Management

<p class="abstract"><strong>Background:</strong> Laryngopharyngeal reflux (LPR) disease is a clinical entity due to the retrograde flow of gastric contents into the pharynx. It can be considered as an extraesophageal syndrome of gastroesophageal reflux disease (GERD). The objective of the present study is to study the clinical profile of LPR and their response to treatment.</p><p class="abstract"><strong>Methods:</strong> 100 consecutive patients attending the outpatient department of ENT, presenting with a clinical profile of LPR were selected in the present study. The patients’ symptoms were evaluated based on the reflux symptom index (RSI) and was followed by an endoscopic examination of larynx and a scoring was made based on reflux finding score (RFS). An RSI score of ≥13 and RFS of &gt;7 were considered for starting patients on LPR treatment. The patients were then put on treatment and followed up for 3 months.  </p><p class="abstract"><strong>Results:</strong> In our study population the most common symptom was foreign body sensation in throat (52%). The most common sign noted on endoscopic examination of larynx was hyperemia/erythema of laryngeal tissue particularly bilateral arytenoids. Majority of our patients responded well to combination of pantoprazole (40 mg) and domperidon (30 mg) for 4 weeks. This was evaluated in terms of reduction in the RSI and RFS scores.</p><p class="abstract"><strong>Conclusions:</strong> LPR is more commonly encountered clinical entity and the otorhinolaryngologist should bear it in mind while treating patients for chronic complaints of throat pain, change in voice etc. Appropriate diagnosis and management of LPR can prevent unwarranted use of antibiotics and surgeries in these patients.</p>

A Cross-Sectional Study of Clinical Profile and Outcome in Children with Foreign Body Aspiration at a Tertiary Care Centre in Telangana

2021 ◽  
Vol 8 (26) ◽  
pp. 2306-2310
Author(s):  
Sreelatha Martha ◽  
Nirmala Cherukuri ◽  
Usharani Thota ◽  
Prasanna Kumar Korvani ◽  
Keerti Neelgiri ◽  
...  
Keyword(s):  
Foreign Body ◽  
Clinical Features ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Tertiary Care ◽  
Foreign Body Aspiration ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mortality And Morbidity

BACKGROUND Foreign body aspiration (FBA) in children is one of the major causes of death in developing countries, the diagnosis of which can be missed due to varied presentation. It is one of the causes of choking among children which, if not recognized early may lead to fatal consequences. Early recognition and prompt intervention may reduce the mortality and morbidity. In this study, we wanted to assess the clinical profile of children with foreign body aspiration/ingestion, determine the nature and location of foreign body and also determine the outcome among children with foreign body aspiration at a tertiary care centre. METHODS This cross-sectional study was taken up to analyse the clinical profile, to study the types, location and the outcome of children with foreign body aspiration. All children in the age group of 2 months to 12 years admitted to Niloufer hospital, Hyderabad from January 2018 to December 2019 with either history of FBA or clinical features suggestive of FBA even in the absence of history were included in the study. Age, sex, clinical features (C/F), duration of illness were noted. A chest X-ray was done in all cases, whereas a computed tomography (CT) scan was done in children where clinical features & chest X-rays were inconclusive. All children fulfilling the inclusion criteria were subjected to bronchoscopy under general anaesthesia by ENT surgeons. The findings like type and location of the foreign bodies were noted. Statistical analysis was done by statistical package for social sciences (SPSS) software version 10.0. RESULTS Of 108 children studied, 60 % of cases were males and 40 % were females. 55 % of cases were below the age of 3 years. Common symptoms were rapid breathing (68 %) and cough (38.8 %). Nuts & seeds were the common foreign bodies seen in 47.30 %, out of which groundnuts were the most common. Organic foreign bodies accounted for 58.11 % while inorganic was 41.89 %. The common site of lodgement of foreign body was right main bronchus (35.59 %), followed by left main bronchus (27.11 %) and sub-glottis (8.47 %). CONCLUSIONS Foreign body aspiration is difficult to diagnose in children and a delay in diagnosis can lead to mortality and morbidity. Early intervention by bronchoscopy goes a long way in improving survival. Clinical suspicion is the key to the diagnosis. KEYWORDS Foreign Body, Bronchoscopy, Children

scholarly journals Clinical Profile of Bacterial Meningitis in Children and Comparative Inter-Alia Analysis of Various Microbiological Tests

2020 ◽  
Vol 10 (01) ◽  
pp. e38-e44
Author(s):  
Rohan Halder ◽  
Richa Malik ◽  
K.C Aggarwal ◽  
Deepthi Nair ◽  
Shobha Sharma
Keyword(s):  
Bacterial Meningitis ◽  
Low Income ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Profile ◽  
Acute Bacterial Meningitis ◽  
Care Hospital ◽  
Gram Stain ◽  
Cranial Nerve Palsies ◽  
Meningitis In Children

AbstractAcute bacterial meningitis (ABM) is a life-threatening and neurologically debilitating infectious disease. We studied the clinical profile, organisms involved in bacterial meningitis in children, and compared the tests on cerebrospinal fluid (CSF), latex agglutination test (LAT), polymerase chain reaction (PCR), Gram stain (conventional) and Cyto-Tek cytospin centrifuge Gram stain to culture which is the gold standard. This was an observational cross-sectional study (age range 3 to 12 months) conducted in a tertiary care hospital, New Delhi, India over 1 year. A total of 101 patients were enrolled and divided into three age groups, namely, < 1 year, 1 to 5 years, and > 5 years. Fever was the most common presenting symptom in all groups (84.2%). Refusal to feed, headache, altered sensorium, vomiting, and blurring of vision were significantly associated with bacterial meningitis in all age groups. Cranial nerve palsies and neck rigidity were significantly higher in older children. Age < 5years, low-socioeconomic status, overcrowding, and smoke exposure were identified as risk factors for meningitis. Eight children died within 48 hours of admission and the rest (n = 93) recovered without complications. CSF culture was positive in 35.6% cases, with streptococcus pneumoniae being the most common organism. PCR was most sensitive (86.1%) and cytospin gram stain showed positivity in 65% cases which was statistically higher compared with conventional gram stain. Cytospin-prepared Gram stain was a viable low-cost alternative for early diagnosis of meningitis in low-income countries like India.

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