scholarly journals TO STUDY THE VARIOUS ETIOLOGICAL FACTORS OF SPONTANEOUS PNEUMOTHORAX AT TERTIARY CARE CENTER JAIPUR, RAJASTHAN, INDIA

Author(s):  
Dr. Mukesh Kumar Mandawariya ◽  
Dr. Nalin Joshi ◽  
Dr. S.P. Agnihotri ◽  
Rekha Mandawariya

Background: Primary spontaneous pneumothoraces (PSP) affect patients who do not have clinically apparent lung disorders.  Secondary pneumothoraces occur in the setting of underlying pulmonary disease.  Methods: A total of 100 patients, including both males and females, admitted during the given period to the hospital with a diagnosis of spontaneous Pneumothorax (SP) were included in the study after applying to the inclusion and exclusion criteria. Results: COPD was the most common cause (45.6%) followed by Tuberculosis (30%). Silicosis was seen in 18.9% of SSP cases. Other less common causes were Bronchiectasis (3.3%), Pneumonia (1.1%) and Malignancy (1.1%). Conclusion:  Secondary spontaneous pneumothorax is far more common than primary spontaneous pneumothoraces and COPD is the predominant underlying cause of secondary spontaneous pneumothorax followed by pulmonary tuberculosis. We also found that silicosis is a significant contributor to secondary spontaneous pneumothorax, after COPD and pulmonary tuberculosis. Keywords: COPD, TB, Etiology

Author(s):  
Ajay Sharma ◽  
Ashok Sharma ◽  
Pramod Jaret ◽  
Malay Sarkar ◽  
Sanjeev Sharma

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The spontaneous pneumothorax has been classified as major cause of morbidity and mortality among respiratory diseases. The objectives of the study were to determine the incidence and aetiology of spontaneous pneumothorax and to assess the clinical profile of affected patients admitted in our institute</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A hospital based prospective study was conducted in year 2011-12 in the Department of Medicine, IGMC Shimla (H.P.) India. During study period the total admissions were 7335 out of which 30 patients were diagnosed as spontaneous pneumothorax and treated as cases under study. The data was collected on proforma includes demographic profile, probable cause, clinical and outcome indicators of Spontaneous Pneumothorax, master chart framed and analysed into frequency percentage. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Incidence of spontaneous pneumothorax was found to be 408.99/yr/100000 admissions in the department of medicine. Incidence of primary spontaneous pneumothorax was 81.79/yr/100000 admissions. Incidence of secondary spontaneous pneumothorax was 327.19/yr/100000 admissions. Majority of the patients of primary spontaneous pneumothorax were of the 20-29yrs age group. Higher proportions of cases were from male gender (93.33%). Secondary pneumothorax patients were mostly of 50 to 59 years age group. The predominant aetiology for secondary spontaneous pneumothorax was COPD (36.66%) followed by Pulmonary tuberculosis (33.33%)</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Spontaneous pneumothorax was more common in men. The predominant aetiology for secondary spontaneous pneumothorax was COPD (36.66%) followed by pulmonary tuberculosis (33.33%). </span></p><p class="abstract"> </p>


2005 ◽  
Vol 44 (158) ◽  
Author(s):  
Sudha Khakurel ◽  
P R Satyal ◽  
R K Agrawal ◽  
P K Chhetri ◽  
R Hada

From July 1998 to July 1999, 45 cases of acute renal failure were treated at Bir Hospital, Kathmandu. Outof which 24 were male and 21 were female. Age ranged from 11 months to 84 years with mean age being 35years and 9 cases were below 10 years.Four cases with pre-renal azotaemia and twenty five cases of acute tubular necrosis (ATN) accounted for64% of all cases. These were due to gastroenteritis 10, sepsis 6, post surgical 1, trauma 1 and obstreticalcomplications 5. Multiple hornet stings were responsible for acute renal failure in 3 cases, acute urate nephropathy in 1 case and miscellaneous causes in 2 cases.Glomerulonephritis / vasculitis accounted for 17.7%, acute interstitial nephritis 4.4%, haemotytic uraemicsyndrome (HUS) 6.6%, and post renal azotaemia in 6.6% of all cases. Mean serum creatinine was 8 mg/dl,mean blood urea 190 mg/dl. Eight cases were treated only conservatively, eighteen received haemodialysis,fourteen received peritoneal dialysis, three received both and two refused for dialysis. Average duration ofhospital stay was 13.6 days. Out of the forty-five cases twenty-nine recovered normal renal function, tenexpired, two recovered partially, two progressed to chronic renal failure and two left against medical advice.Overall mortality was 22.2%.Common causes of acute renal failure in our setting were gastroenteritis (22%) and sepsis (20%). HUS wasexclusively seen in children following bacillary dysentery. Multiple hornet stings is an important cause ofacute renal failure in our country.


2020 ◽  
Vol 7 (11) ◽  
pp. 1687
Author(s):  
Rakesh Kumar ◽  
Vandana Rana ◽  
Varghese Koshy ◽  
Vandana Gangadharan ◽  
George Koshy

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.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.


2021 ◽  
pp. 68-69
Author(s):  
Neha Damor ◽  
Mahendra Kumar Bainara ◽  
Prem Chand

Background: Clinical and radiographic manifestation of tuberculosis in elderly patients varies from young adults and not specic, often mistaken with other disease which may cause delay of therapy. For this we conducted study on clinical and radiographic manifestation of pulmonary tuberculosis in elderly patients. This study Methods: analyzed 100 pulmonary tuberculosis cases. We divided these patients in 2 groups i.e young adults (aged <60 years) and elderly(aged ≥60 years). This study was conducted in the Department of TB & Respiratory Diseases, RNT Medical College, Udaipur and analyzed by using Microsoft excel. We found that this study is Result: dominated by male patients. Chest pain, cough, dyspnoea, hemoptysis were found in-signicantly, while expectoration was found signicantly higher in young adults (p < 0.01). Fever was more in young whereas anorexia was more common in elderly group and in physical signs, icterus was found signicantly more in young adults as the p value is <0.05. Radiological bilateral involvement was found more in elderly group compared to adults (p = 0.67). Mixed and upper zone in adult patients consist majority patients. Elderly patients of PTB presented Conclusion: with recognized clinical and radiological features of disease.


2021 ◽  
pp. 1-2
Author(s):  
Akhilesh Behra

Background- Psoriasis is a chronic inammatory relapsing skin disorder. Environmental and genetic factors play an important role in the development of disease. HLA-Cw6 most strongly associated with disease. There is also a difference in HLA-Cw6 positivity in respect to gender, which affect occurrence of disease in males and females. Aims & Objectives- This study was aimed to determine the association of HLA-Cw6 positive and negative psoriasis individuals had any signicant differences in respect to disease onset among male and female Materials & Methods- An Institute based Cross sectional study was done in a tertiary care center in eastern India. All patients attending skin OPD were included in the study. Detailed history and blood samples were collected from patients. HLA-Cw6 typing has done by sequence-specic PCR method. Results- HLA-Cw6 positive female patients had a signicantly early age of onset than male patients (p value-0.009334) (20.88 vs. 27.91yr), while HLA-Cw6 negative patients did not show any signicant difference of age of onset between male and female ( p value- 0.406905) Conclusion- Although men are more commonly affected than female, HLA-Cw6 positive psoriasis female patients show earlier disease onset. This results show that genetic variations in terms of HLA-Cw6 are reected in the age of onset among males and females.


2012 ◽  
Vol 18 (1) ◽  
pp. 30-35
Author(s):  
R Nepali ◽  
B Sigdel ◽  
P Baniya

Allergic rhinitis, despite its complex patho-physiology, is a global health problem with the increasing prevalence. The current study which was conducted at one of the tertiary care center in the country comprised of 548 diagnosed cases of allergic rhinitis and thus treated during the period extending from January 2010 to June 2011. In the study, males and females were almost equally distributed, constituting the ratio of 1:0.9. Among them, the patients from 20 –29 year of age group was the most commonly affected (38.1%). In our study most of the patients were housewives (30.3%) and the house dusts mites (76.3%), was the most common etiological factors. Majority of the patients presented with sneezing (86.7%) as the chief complaint. Of the total subjects, 18.6% presented with co-morbidity of allergic conjunctivitis and 8.9% with that of sinusitis. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10411  Bangladesh J Otorhinolaryngol 2012; 18(1): 30-35


2016 ◽  
Vol 6 (1) ◽  
pp. 7-11
Author(s):  
Muhammad Abdur Rahimi ◽  
AKM Shaheen Ahmed ◽  
Md Delwar Hossain ◽  
Md Raziur Rahman ◽  
Swapan Kumar Ghosh ◽  
...  

Background: Fever of unknown origin (FUO) is not an uncommon problem in general medical practice. Sometimes extensive investigations fail to reach an aetiological diagnosis; on the other hand, in few cases, fever resolves spontaneously. This study was aimed to evaluate the aetiology of FUO in a tertiary care setting.Methods: This cross-sectional study was done in the Department of Internal Medicine of BIRDEM General Hospital, Dhaka, Bangladesh from July 2012 to June 2013.Results: Among the 33 patients studied (1.23% of total admissions), 22 (66.7%) were male. Mean age of the study population was 40.2±7.9 years. Most patients (84.8%) were diabetic. Infection (20, 60.6%) was the commonest cause, followed by malignancy (9, 27.3%). Among the infective causes (20), extra-pulmonary tuberculosis (5, 25%) was the commonest, followed by liver abscess (4, 20%). Other less common causes were Kala-azar (1), malaria (2), histoplasmosis (2), melioidosis (1), cholecystitis (1), renal abscess (1), rickettsial fever (1), apical dental abscess (1) and infective endocarditis (1). Non-Hodgkin’s lymphoma (6), renal cell carcinoma (2) and hepatocellular carcinoma (1) constituted the malignant causes of FUO in this series. Systemic lupus erythematosus was the aetiology of FUO in 1 case. One case remained undiagnosed and 2 patients left hospital before a definite diagnosis could be made.Conclusion: Extra-pulmonary tuberculosis and non-Hodgkin’s lymphoma were the two most common causes of FUO in this study. Repeated history taking, clinical examinations and careful stepwise investigations can diagnose the aetiolgy in most cases of FUO.Birdem Med J 2016; 6(1): 7-11


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