scholarly journals EPIDEMIOLOGICAL STUDY OF TRAUMA IN A TERTIARY CARE CENTRE IN NORTHWEST INDIA

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Vaibhav Lakhanpal ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Poojan Thakor ◽  
...  
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Total Mortality ◽  
Public Health Problem ◽  
Common Mechanism ◽  
Mechanism Of Injury ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Keywords Trauma ◽  
Number Of Patients

Objective: Traumatic injuries are a matter of concern worldwide. However, the rapidly changing socio economical dynamics in a developing country like India deeply influence the epidemiology behind trauma. The aim of this study was to document and analyze the epidemiological parameters and characteristics behind trauma victims admitted to our tertiary care centre. Methods: The observational study was carried out over a period of one year (January 2019 to December 2019) enrolling a total of 300 trauma patients. The age, sex, locality, delay in hospitalization, mechanism of injury, sites of injury and outcomes were documented. Results: Injuries occurred predominantly in the 20-40 age group with males being the chief victims. There was a considerable amount of delay in hospitalization ranging from one hour to more than 24 hours while only 7 patients arrived to the emergency within one hour of trauma. Vehicular trauma (54%) was the most common mechanism of injury. Injuries to the extremities (38.6%) and head (28.6%) were the most common sites. A considerable number of patients (45.3%) required care in the intensive care unit. A total of 172 patients required surgical interventions of various kinds and there was a total mortality rate of 6%. Amongst the polytrauma cases, 54 patients (81.8%) required ICU admission, 42 patients (63.6%) required surgical intervention and 6 patients (9.1%) died after admission. Conclusion: The results of this study highlight some of the problems with our existing infrastructure bringing to light the need for stricter enforcement of traffic safety laws and improvement of infrastructure particularly the roadways in rural areas as well as the referral systems. Vehicular trauma should be seen as a public health problem and appropriate interventions should be implemented. Keywords: Trauma, Road Traffic Accidents, Epidemiology, Head injuries

CLINICAL PROFILE OF OUTPATIENTS ATTENDING DERMATOLOGY DEPARTMENT DURING COVID-19 LOCKDOWN RELAXATION PERIOD IN A TERTIARY CARE CENTRE IN SOUTH INDIA – A CROSS-SECTIONAL ANALYTICAL STUDY

2021 ◽  
pp. 13-16
Author(s):  
Afthab Jameela Wahab ◽  
Pavithra Gunasekaran ◽  
P. Mohan ◽  
V. Sudha ◽  
L. Balamurugan ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Relaxation Period ◽  
Number Of Patients ◽  
Outpatient Practice ◽  
The Impact

Background - The cutaneous manifestations of the novel coronavirus have been well documented. However, there are few studies that relate to the clinical prole of regular dermatology outpatients seeking treatment during the lockdown relaxation period braving the pandemic. With the Aim - view to determine the changes seen in dermatology outpatient practice, this study analysed the clinical prole of new patients attending the Dermatology Outpatient Department (OPD) during the COVID-19 lockdown relaxation period in a tertiary care centre in a metropolitan suburb in South India. New dermatology outpatients during the months of May, June, July and August Method - 2020 were included in the study. Outpatient data for this period was analysed and compared with corresponding data for the same period in the previous two years. There was a Result – decrease in the OP census, number of patients in the extremes of life as well as those with asymptomatic dermatoses. There was an increase in the number of patients with infections, particularly dermatophytosis. There was also a noteworthy absence of dermatological emergencies. Conclusion - In essence, our study shows the impact of COVID-19 pandemic on the routine dermatology outpatient services with signicant changes in the clinical prole of outpatient practice following lockdown relaxation.

APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE

2021 ◽  
pp. 22-23
Author(s):  
Anil Kumar ◽  
Rekha Rani ◽  
Hamid Wani
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Common Symptom ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Lower Quadrant ◽  
Number Of Patients

Objective: Acute appendicitis is a common surgical condition presented to emergency. In this study we evaluated the clinical presentation, management and outcome of acute appendicitis complicating pregnancy at a tertiary care centre. Material And Methods: A total of 20 cases of pregnant women who were diagnosed as a case of acute appendicitis were studied from January 2018 to December 2020. Results: Total number of patients diagnosed with acute appendicitis were 20. There were 10 (50%) patients in rst trimester , 6 (30%) in second and 4 (20%) in the third trimester. Abdominal pain was the most common symptom seen in all patients. 12 (60%) patients were multigravida whereas 8 (40%) patients were primigravida. Duration of abdominal pain was 6 hours to 5 days with median of 30 hours. Right lower quadrant was the most common site of pain. Rebound tenderness was seen in 14 (70%) patients. Total leucocyte was raised in 14 (70%)cases. Ultrasound was done in all patients showing viable fetus and features of acute appendicitis in 12 (60%) cases. Surgery was done in 16 (80%) cases. Midline laparatomy was done in 3 patients whereas 4 (20%) patients were managed conservatively with antibiotics. Postoperative tocolytics were given in 6 patients. Postoperative complications such as wound infections seen in 5 cases and pelvic abscess in 1 case. Fetal loss was seen in 2 (10%)cases. Conclusion: Diagnosis of acute appendicitis during pregnancy can be difcult due to anatomical and biochemical changes during pregnancy. Correct diagnosis can be achieved by taking proper history, clinical examination and relevant investigations. Surgery remains the treatment of choice.

scholarly journals Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

2021 ◽  
Vol 8 (1) ◽  
pp. 39
Author(s):  
Mohan M. Desai ◽  
Deven R. Kuruwa ◽  
Easwar Elango ◽  
Roshan Wade
Keyword(s):  
Road Traffic ◽  
Tertiary Care ◽  
Age Groups ◽  
Control Measures ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Treatment Protocols ◽  
Female Ratio ◽  
Femur Fractures

<p class="abstract"><strong>Background: </strong>Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.</p><p class="abstract"><strong>Methods: </strong>Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.</p><p class="abstract"><strong>Results: </strong>43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.</p><p class="abstract"><strong>Conclusions: </strong>Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.</p>

scholarly journals Injury amongst Medicolegal Cases in Department of Forensic Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1277-1282
Author(s):  
Arbin Shakya ◽  
Jenash Acharya ◽  
Sunil Joshi
Keyword(s):  
Confidence Interval ◽  
Road Traffic ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Physical Assault ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Life Threatening

Introduction: Victim of injuries presenting to a hospital is a medico-legal issue. So, with medical management, proper documentation of injuries should be done as a legal duty by all physicians attending such cases. The study aims to find the prevalence of injury amongst medicolegal cases inthe Department of Forensic Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done amongst 328 medicolegal cases presenting at a tertiary center, from January 2019 to February 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 2603202101). Convenience sampling was used to select study samples. After detailed history regarding the incidence, injuries were examined and documented in a performa. The data were entered in Statistical Package for Social Sciences version 18. Point estimate at 95% Confidence Interval was calculated along with frequency and percentagefor binary data. Results: Among 328 cases presenting to hospital for medicolegal issues, 237 (72.25%) (67.40-77.09 at 95% Confidence Interval) had injuries, out of which 170 (71.73%) cases were due to physical assault, 64 (27%) cases due to accident; 2 (1.26%) were undetermined. Majority of victims of injury were adult males, with mean age of 32.41±13.96 years. In most accidental injuries internal organs were also injuries and life-threatening. Conclusions: The prevalence of injuries amongst medicolegal cases was found to be higher in our study in comparison to other studies done in similar settings. Most of the injuries were due to physical assault; however, the majority of road traffic injuries were life-threatening. These road traffic injuries could have been prevented by following a safe system approach to road safety.

scholarly journals COVID 19 pandemic and cancer treatment: experience at a tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 1055
Author(s):  
Abhishek Pathak ◽  
Anvesh Rathore ◽  
Rajan Kapoor ◽  
Subhash Ranjan ◽  
Alpana Gupta
Keyword(s):  
Cancer Treatment ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Delay ◽  
Treatment Experience ◽  
Exact Number ◽  
Number Of Patients ◽  
Working Principle

Background: In these era COVID Pandemic patients are missing their chemotherapy due to multiple reasons. This study was undertaken to quantify the exact number of patients who had missed their appointment for chemotherapy.Methods: All patients who had appointments for chemotherapy from 20th Mar to 20th Apr were included in the study. Details of malignancies, chemotherapy, duration of delay in patients coming for chemotherapy to be recorded.Results: The total number appointments given for chemotherapy for various malignancies were 301 patients for various malignancies for the duration 20th March to 20th April. The total number of appointments given were 301. Out of the total of 301 patients who had appointment for chemotherapy during this period 131 patients could be given chemotherapy and 170 could not be given chemotherapy. The average delay was of 9 days. The data was distributed into four weeks from 20th March to 20th April. Just before the country wide lock down in first week 20th, 70 patients receiving chemotherapy which drastically reduced in later weeks. Both the cases who could come for chemotherapy and those who could not have been kept under follow up, up to 6 months to reassess their response.Conclusions: This article has been written to highlight the number of patients who could not receive chemotherapy due to ongoing Pandemic with an intention to follow them up for 6 months. Since this pandemic is here to stay it is very important that formulate the working principle for administering chemotherapy.

scholarly journals TO SEE THE IMPACT OF LOCKDOWN IN COVID19 PANDEMIC ON TUBERCULAR PATIENTS IN A TERTIARY CARE CENTRE OF HILLY AREA.

2020 ◽  
pp. 33-34
Author(s):  
Subhash Chander ◽  
Ritin Sharma ◽  
Ankit Chaudhary ◽  
Rakesh Chauhan
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Healthcare Services ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Tuberculosis Patients ◽  
Hilly Area ◽  
Number Of Patients ◽  
Group B ◽  
The Impact

Aim: To see the impact of lockdown in Covid19 Pandemic on Tubercular patients in a Tertiary care Centre of hilly area. Material and Methods: The study was conducted among adult patients in a tertiary health centre in a rural area. Study was conducted through lockdown period, comparing it with corresponding period in 2019. Tuberculosis patients or suspects were categorized in two groups. Group A was designated for participants in the year 2020 during lockdown period. Group B was data taken from time period similar to lockdown period in the year 2019. Data from two groups was compared. Observations: There was a 44.1% decline in number of male patients, whose sputum was examined by microscopy for tuberculosis. In case of female patients, decline was 68.6%. This decrease was present in all phases, more in 1st phase, 69.1%. During lockdown period number of patients presenting to medicine department were 45% compared to previous year ( 5129 vs 11280), sputum positive diagnosed during lockdown and similar period in 2019 were (84.4%) 27 vs 32 ( p 0.016). OPD declined by 54.5% during lockdown, however diagnosed tubercular cases by CBNAAT declined by 44.4%. Conclusion: COVID 19 pandemic greatly affected the routine healthcare services. Lockdown period saw a decline in number of patients presenting to outdoor as well as indoor patients. There was a decline in number of tuberculosis suspects as well as number of diagnosed tuberculosis patients. However decline in tuberculosis patients was less as compared to overall patients.

scholarly journals Dengue: experience from a tertiary care centre in Northern Karnataka, India

2019 ◽  
Vol 7 (7) ◽  
pp. 2803
Author(s):  
Mohammad A. Waheed
Keyword(s):  
Dengue Infection ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Febrile Illness ◽  
Severe Thrombocytopenia ◽  
Acute Febrile Illness ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Old Patients ◽  
Function Test

Background: Epidemiology of dengue infection is evolving, and research gap exists in the region. The clinical features, laboratory parameters, complications and treatment outcomes of patients diagnosed of dengue infection at a tertiary care centre were analysed in the present study.Methods: More than 12 years old patients, presenting with features suggestive of acute febrile illness were subjected to detailed history taking and thorough clinical examination. All the suspected cases were further evaluated with complete blood count, liver function test, kidney function test, along with ultrasonography of abdomen. Blood samples were tested for dengue antibodies (IgG and IgM) by hemagglutination inhibition method for confirmation of the diagnosis. The clinical course was closely monitored during hospital stay and complications and deaths, if any, were noted.Results: Total 140 patients were studied. Fever (100%), headache (80%) and myalgia (73.6%) were the commonest symptoms. Thrombocytopenia (136, 97.1%) was the commonest hematological finding, while severe thrombocytopenia (<50,000/cu. mm) was observed in 38 (27.1%) cases. Hepatomegaly (61, 43.6%), splenomegaly (42, 30.0%), ascites (54, 38.6%), pleural effusion and gall bladder edema (18, 12.9% each) were the commonest findings on ultrasonography. Shock and ARDS were the major complications.Conclusions: Dengue remains an important public health problem even at a tertiary care centre and strong suspicion is needed in adult patients with acute febrile illness. The management should focus on averting shock and ARDS, which would help in larger aim of reduction in mortality.

scholarly journals Profile of chest injuries in a tertiary care centre

2020 ◽  
Vol 7 (3) ◽  
pp. 714
Author(s):  
Rajesh K. Jegoda
Keyword(s):  
Chest Trauma ◽  
Road Traffic ◽  
Tertiary Care ◽  
Clinical History ◽  
Blunt Injury ◽  
Trauma Patients ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Chest Injuries ◽  
A Prospective Study

Background: Trauma is a major cause of mortality worldwide. This study is aimed at the patterns of chest trauma, their presentation and the outcome of management.Methods: A prospective study of trauma patients admitted to a tertiary care centre was carried out the clinical history, physical examination and outcome of management recorded in a predesigned proforma were analysed with SPSS 15 and the patients were followed up in the surgical department.Results: A total of 638 patients were admitted. 57 patents were identified with chest trauma, 43 (75%) were males and 14 (24.56%) were females. The age range was from 3-78 years and the most affected age was in the range of 20 to 39 years. Blunt injury constituted 82.4% while road traffic accident was responsible for 70.1%. The average time taken between accident and admission was 11 hours 12 minutes while the average duration of hospital stay was 11 days. The injury pattern mainly included rib fracture and hemopneumothorax. The mortality rate was 1.75%.Conclusions: Most patients arriving at the hospital survived, requiring general resuscitation or simple tube thoracostomy with few complications. Mortalities from trauma and cause of death at the site of accident are often not accounted for due to non-presentation to the hospital and lack of autopsy for those who present.

EPIDEMIOLOGICAL PROFILE OF FUNGAL KERATITIS IN PATIENTS ATTENDING A TERTIARY CARE CENTRE IN BIHAR

2021 ◽  
pp. 32-34
Author(s):  
Kumar Vikram ◽  
Gyan Bhaskar ◽  
Shailesh Kumar ◽  
Rakesh Kumar ◽  
Namrata Kumari
Keyword(s):  
Tertiary Care ◽  
Public Health Problem ◽  
Fungal Species ◽  
Fungal Keratitis ◽  
Agricultural Activity ◽  
Major Public Health Problem ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Epidemiological Characteristics

Introduction: Corneal blindness is a major public health problem worldwide and fungal keratitis is one of its predominant causes. The etiological and epidemiological pattern of fungal keratitis varies signicantly with patient population, geographical region and prevailing socioeconomic conditions. Objectives:The objective of the study was to identify the specic pathogenic agents and to study epidemiological characteristics of fungal keratitis presenting at a tertiary care centre in Patna, Bihar. Materials And Methods: Corneal scrapings were obtained from clinically suspected patients of keratomycosis during the period of 18 months from May 2015 to October 2016. The scraping material was processed and identied by standard laboratory techniques. Demographic and clinical features of the patients were also collected. Results: Out of total 115 suspected fungal corneal ulcers, 63(54.78%) were positive for fungal etiology. Of these, 53(84.13%) were positive on KOH mount. 40(63.49%) and 35(55.56%) were positive in Gram stain and culture respectively. In culture, aspergillus spp (16;45.71%) were the predominant fungal species, followed by fusarium spp (12;34.29%). Males (35/63;55.56%) were more commonly affected. 22 out of 63 patients (34.92%) were of age group 31-45 years. Majority of patients were farmers (68.25%). Corneal trauma (50.79%) was the most common predisposing factor in which trauma due to vegetative matter (53.13%) was most signicant. Conclusion: Fungal keratitis continues to be a cause of concern to ophthalmologists. Agricultural activity and related ocular trauma are principal causes of mycotic keratitis. A potassium hydroxide (KOH) wet mount preparation is a simple, and sensitive, method for diagnosis.

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