scholarly journals Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

2021 ◽  
Vol 28 (4) ◽  
pp. 425-431
Author(s):  
Sudhir BHANDARI ◽  
◽  
Shivankan KAKKAR ◽  
Amitabh DUBE ◽  
Mohnish GROVER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
High Morbidity ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Invasive Fungal Diseases ◽  
Co Morbidity ◽  
History Of ◽  
Second Wave

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).

Sociodemographic Factors and Clinical Profile of Covid-19 Patients Admitted in a Tertiary Care Centre of Central Rajasthan, India

2021 ◽  
Vol 8 (13) ◽  
pp. 773-777
Author(s):  
Piyush Arora ◽  
Himanshu Mittal ◽  
Neeraj Gupta ◽  
Jose K. Jimmy ◽  
Khushboo Jain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Respiratory Diseases ◽  
Tertiary Care ◽  
Age Group ◽  
Care Centre ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Chronic Respiratory Diseases ◽  
Co Morbidity

BACKGROUND Covid-2019, caused by severe acute respiratory syndrome-coronavirus-2 (SARS CoV2), is an ongoing pandemic that emerged from China in November 2019. It has affected millions of people worldwide causing significant morbidity and mortality. We wanted to analyse the clinical and demographic profile of Covid-19 patients admitted in a tertiary-care-centre in the central part of Rajasthan, compare their characteristics with other studies published from parts of NorthernIndia and identify factors associated with delayed recovery and mortality. METHODS This was a retrospective observational analysis of the clinical features, and epidemiological profile of Covid-19 positive patients admitted at a tertiary-carecentre in the Central part of Rajasthan. RESULTS A total of 422 patients was enrolled in the study. The male: female ratio was 1.34 with a mean age of 34.1 years. Almost 195 (46.2 %) patients were in the age group of 20 - 40 years. Respiratory diseases were the most common co-morbidity seen in 36 patients (8.53 %), diabetes-mellitus in 28 patients (6.63 %), hypertension in 22 patients (5.2 %). Fever was the commonest presenting symptom (N = 98, 77.17 %), followed by cough (N = 85, 66.93 %), and breathlessness (N = 51, 45.67 %). Factors significantly associated with mortality were age group of 60 - 80 year (P < 0.001), presence of co-morbidities (P < 0.001) and history of smoking & alcohol consumption (P < 0.001). Among co-morbidities diabetes-mellitus, hypertension, chronic-respiratory-diseases & chronic-kidneydiseases had significant impact on mortality. Absence of co-morbidity, lack of addiction and symptoms at the time of presentation were associated with an earlier conversion of reverse transcription polymerase chain reaction (RT-PCR) report. CONCLUSIONS Clinical spectrum of COVID 19 varies widely. Presence of comorbidities, addiction, radiological features has a drastic impact on mortality and duration of infectivity. KEYWORDS SARS CoV-2, Covid-19, RT PCR, Coronavirus

scholarly journals Clinicoepidemiological study of acute invasive fungal rhinosinusitis in a tertiary care centre

2021 ◽  
Vol 7 (11) ◽  
pp. 1772
Author(s):  
Rajeshree Chaurpagar ◽  
Priyanka Garud ◽  
Apurva Pawde ◽  
Parag Doifode ◽  
Bhagyashree Chiplunkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
World Health ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
History Of ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>

scholarly journals Rhino-orbital COVID-19 associated mucormycosis- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 304-307
Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha
Keyword(s):  
Diabetes Mellitus ◽  
Infectious Disease ◽  
Case Report ◽  
Tertiary Care ◽  
Notifiable Disease ◽  
Health Ministry ◽  
First Case ◽  
Uncontrolled Diabetes ◽  
History Of ◽  
Second Wave

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.

scholarly journals Incidence of steroid modified tinea in tertiary care centre Lucknow

2018 ◽  
Vol 4 (4) ◽  
pp. 579
Author(s):  
Savita Chaudhary ◽  
Priyanka Shukla ◽  
Khushboo Gupta ◽  
Gaurav Paliwal
Keyword(s):  
Tertiary Care ◽  
Common Species ◽  
Topical Steroids ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Detailed History ◽  
Microbiological Profile ◽  
History Of ◽  
Common Variety

<p class="abstract"><strong>Background:</strong> Rampant use and abuse of topical steroids has led to increase in number of cases of superficial dermatophytosis of skin, nail and hair. In most of the cases they are resistant to topical as well as oral antifungals even after prolong course of treatment. Our study aims to analyse epidemiological and microbiological profile of steroid modified tinea (SMT).</p><p class="abstract"><strong>Methods:</strong> Clinically diagnosed tinea patients with history of usage of topical steroids were included in our study. Detailed history was taken and clinical examination along with KOH mount and culture was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> 980 patients were screened of which 550 patients with history of using topical steroids were included in our study. Most common age group was 20 to 29 years with male: female of ratio approximately 3:1 and disseminated form was the most common variety. KOH mount was positive in 76% cases and culture was positive in 72% cases. Most common species came out to be <em>T. Mentagrophytes</em> followed by <em>T. rubrum</em>. Among non-dermatophyte group, Candida was the commonest.</p><p class="abstract"><strong>Conclusions:</strong> There is<strong> </strong>rise in incidence of dermatophytosis, especially steroid modified one and cases of disseminated tinea are rising.</p>

scholarly journals MUCORMYCOSIS UBIQUITOUS FUNGUS THRIVING IN IMMUNOCOMPROMISED COVID PATIENT IN PATNA

2021 ◽  
pp. 20-23
Author(s):  
Manish Ranjan ◽  
Vineet Sinha ◽  
Neha Giri ◽  
Abhisek Kishore Dayal ◽  
Surbhi Surbhi ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Intracranial Extension ◽  
Virus Infections ◽  
Tertiary Care Centre ◽  
History Of ◽  
Ethmoid Sinuses ◽  
Second Wave ◽  
Nasal Biopsy

OBJECTIVE. To study various predisposition for sudden upsurge in mucormycosis in second wave of COVID To study pattern of involvement and spread of disease and to correlate clinicoradiologically METHOD: A prospective observational study was conducted at a tertiary care centre over 2months, involving all patients with mucormycosis of paranasal sinuses with history of corona virus infections and having postive KOH fungal staining on nasal biopsy. RESULT: 30 patients were studied.maxillary and ethmoid sinuses were most affected sinuses.eye involvement was seen in 83.3 percent cases while intracranial extension was seen in 13.3 percent.22 patients gives the history of steroid usage.comorbid condition Diabetes mellitus was being the most common. CONCLUSION:The association between coronavirus and mucormycosis of paranasal sinuses must be given utmost importance.uncontrolled Diabetes and overuse of steroids are main factors.

scholarly journals Study of risk factors of acute respiratory infections in children admitted in a tertiary care hospital of Southern Maharashtra

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Alka C. Kaware ◽  
Nitin H. Kamble ◽  
S. K. Mangulikar
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
High Morbidity ◽  
Acute Respiratory Infections ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of ◽  
Tract Infections

Background: Acute respiratory infections (ARI) is an important cause of mortality and morbidity in children. In India, it constitutes 15% of under five deaths. Various risk factors are responsible for ARI in children. Study of risk factors will help to reduce the high morbidity and mortality due to ARI. The objectives were to study risk factors responsible for acute respiratory infections in children and to find out case fatality rate &/ outcome of acute respiratory infections ARI in children.Methods: A hospital based cross sectional study was done in 2013-14 in a tertiary care centre to study the risk factors associated with ARI in children. All the pediatric patients between 0-12 years admitted in a tertiary care centre at Solapur were enrolled in the study.Results: Acute respiratory tract infections (ARI) were more common in 1-4 years age group i.e. 57.31% (196). It was more common in males i.e. 64.33% (220) than females i.e. 35.67% (122). ARI was more common in lower socio-economic classes i.e. class V (50.58%), class IV (22.52%); in patients whose mothers were illiterate 43.28% and who had history of parental smoking 84.21%. Maximum patients of ARI were having history of overcrowding 75.73%, inadequate cross-ventilation 81.87% and use of smoky chullah 78.65% in their home. Statistically significant association found between ARI cases and these socio-demographic factors. 46.78% (160) were incompletely immunized and 16.37% (56) were not immunized at all. Only 36.84% (126) were completely immunized for their age. Maximum cases of ARI (50.88%) occurred in winter season followed by rainy season (26.90%). Outcome showed that 91.52% (313) were cured, while 1.75% (6) patients died due to ARI.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ARI which can be prevented by effective health education and an appropriate initiative taken by the government.

scholarly journals Study of malaria and associated co-morbidity in children admitted with fever manifestation in a tertiary care centre

2020 ◽  
Vol 7 (8) ◽  
pp. 1705
Author(s):  
Pawan Ghanghoriya ◽  
Rahul Borkar ◽  
Monica Lazarus ◽  
Manish Ajmariya
Keyword(s):  
Severe Malaria ◽  
Severe Acute Malnutrition ◽  
Care Center ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Acute Malnutrition ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Co Morbidity

Background: Children under five year of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with anti-malarial medications. Authors set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in tertiary care center NSCB Medical college Jabalpur, India.Methods: This prospective and analytic study focused on children admitted with fever in pediatric unit of N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India. If any co-morbidity present with malaria their manifestation was noted. Association of co-morbidity with malaria was done, and effect of co-morbidity on severity of malaria and outcome of patients was noted.Results: A total number of 1950 of children suspected to have malaria who were tested by RDT and microscopy (PSMP), out of them 100 children were positive. Mean age calculated was 7.3±4.3 years. Maximum number of severe malaria cases (40.6%) were found in 6 months to <5 years age group. Most common co-morbidity associated with malaria was anemia (53%) followed by pneumonia (36%) hepatitis (26%), diarrhea (24%), enteric fever (15%), septicemia and meningoencephalitis (10%) each, UTI (4%), and AKI (6%), while dengue (3%) and severe acute malnutrition (2%). Out of 69 cases of severe malaria 46.3% cases had two and 34.7% cases had more than two co-morbidities while in 31 cases of uncomplicated malaria 38.7% cases had two co-morbidity and only 3% had more than two co-morbidity.Conclusions: All RDT positive cases have associated co-morbidity with malaria in our study, more is the co-morbidity is longer were the duration of stay and higher the complications and even mortality. 

scholarly journals A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India

2020 ◽  
Vol 9 (2) ◽  
pp. 682
Author(s):  
Subha Ranjan Samantaray ◽  
Ipsita Mohapatra ◽  
Achanta Vivekanada
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Life Threatening ◽  
History Of

Background: Ectopic pregnancy (EP) is a life-threatening obstetrics emergency in early trimester, associated with a high morbidity and mortality if not timely intervened.  High index of clinical suspicion is required for early diagnosis, specifically in women presenting with amenorrhoea, pain abdomen and vaginal bleeding. Aim of this study is to determine the incidence, risk factors, clinical presentation, management and outcome of ectopic pregnancy.Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology, at Prathima institute of medical sciences, Telangana from July 2012 to June 2019, for a period of 7 years. A total of 53 cases of ectopic pregnancy were analyzed for parameters like age, gravidity, gestational age, risk factors, clinical presentation, management and morbidity.Results: Incidence of ectopic pregnancy was 5.3 per thousand deliveries. Majority of cases were in age group of 20 to 25 years (52.8%) and were gravida 3 and above (68%). The commonest risk factors identified were history of previous pelvic surgeries (37.7%) followed by history of abortion (18.8%). Commonest symptoms were abdominal pain (90.6%), amenorrhoea (75.5%) and vaginal bleeding (47.2%). Only 41.5 % of cases had triad of symptoms. Fallopian tube (92.4%), specifically ampulla (62.3%) was the most frequent site affected. About 73.6% cases presented with ruptured tube. Surgery (94.3%) was the mainstay of therapy.Conclusions: ectopic pregnancy is a life-threatening emergency, early diagnosis and treatment will improve the prognosis.

scholarly journals Clinico-Epidemiological Profile of Patients with COVID-19 in a Tertiary Care Centre of Mid-Western Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 429-432
Author(s):  
Shravya Singh Karki ◽  
Pragya S Basnet ◽  
Sauharda S Karki ◽  
Basant Lamichhane ◽  
Damodar Sharma ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Travel History ◽  
Young Males ◽  
Targeted Testing ◽  
History Of ◽  
Epidemiological Profile ◽  
The Impact

Introduction: With little to no research done that sheds light on the COVID-19 pandemic in the Mid-Western region of Nepal, this study attempts to educate the general populace and concerned authorities on the impact of the pandemic in the region.Materials and Methods: Patients presenting at Rapti Academy of Health Sciences between 14 May 2020 to December 21, 2020, diagnosed with COVID-19 were included in the study. These patients were reviewed for age, sex, address, recent travel history, and presenting symptoms.Results: A total of 3895 COVID -19 positive individuals were included in the study. The mean age of the patients was 33.6 ± 13.8 years, a majority (49.5%) of the cases were in the 20-29 years age group. 73.7% were male. 82.9% of the patients were from Dang, 86% of the cases of Dang were from urban areas, and the districts bordering India accounted for 88.5% of cases. Most of the positive patients were asymptomatic (97.1%), Amongst the symptomatic cases, the most frequent clinical manifestation was both fever and cough. 8.5% of the patients also reported travel history, of which a majority had returned from India.Conclusions: The patients were mostly young males belonging to the economically active age group who were mostly affected by COVID-19 in Mid-Western Nepal. It is important to carry out age-group targeted testing to flatten the infection curve. Testing must be done irrespective of observable symptoms to overcome this public health emergency.

scholarly journals A Clinico-epidemiological study of patients with lichen planus and associated metabolic complications at a tertiary care centre

2021 ◽  
Vol 12 (e) ◽  
pp. 1-6
Author(s):  
Astha Sharma ◽  
Ashok K Khare ◽  
Lalit K Gupta ◽  
Asit Mittal ◽  
Sharad Mehta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Lichen Planus ◽  
Tertiary Care ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Metabolic Complications ◽  
Female Ratio ◽  
Nail Involvement

Background: An association between lichen planus and systemic disorders such as diabetes mellitus, dyslipidemia and metabolic syndrome has been reported. Aim: To assess the clinico-epidemiological profile of lichen planus, evaluate prevalence of underlying metabolic complications and compare the clinical profile of patients with and without metabolic syndrome. Material and methods: All the patients with lichen planus attending dermatology out patient department of a tertiary care centre in South Rajasthan over a period of one year were studied. Patients with lichenoid drug eruptions and those receiving systemic treatment for lichen planus were excluded from the study. Statistical analysis was done using the chi – square test. A p value < 0.05 was considered significant. Results: A total of 270 patients of lichen planus were enrolled. Male to female ratio was found to be 0.76: 1. Maximum (64; 23.7%) patients belonged to the age group of 31 – 40 years. Classical morphology was the most common (128; 47.4%) cutaneous pattern. Mucosal and nail involvement was seen in 80 (29.6%) and 87 (32.2%) patients respectively. Koebner phenomenon was present in 57 (21.1%) patients. The investigations were completed by 175 (64.8%) patients. Diabetes mellitus and hypertension were found in 12.6% (22/175) and 14.3% (25/175) patients respectively. The diagnostic criteria for dyslipidemia and metabolic syndrome were fulfilled by 39.4% (69/175) and 27.4% (48/175) patients respectively. Majority (81.2%) of the patients with metabolic syndrome belonged to age group 40 years and above, and oral and nail involvement was found to be more common in them. It is recommended that these patients should be screened for complications like diabetes, hypertension, dyslipidemia and metabolic syndrome. Conclusion: Significant numbers of lichen planus patients were found to have dyslipidemia and metabolic syndrome. Patients aged 40 years and above, with oral and nail involvement have higher propensity to be associated with metabolic syndrome and therefore such patients should be screened for metabolic complications. Timely screening and early intervention may reduce the risk of related morbidity and mortality. Limitations: Lack of control group is the drawback of our study. Age and sex matched comparative studies are required for confirmation of the results.

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