scholarly journals NEUTROPHIL-LYMPHOCYTIC RATIO (NLR) OR ALBUMIN-GLOBULIN RATIO (AGR) WHICH ONE IS A BETTER PREDICTOR MARKER IN ASSESSMENT OF SEVERITY OF COVID-19 INFECTION

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Parul Barya ◽  
Sanjeev Narang ◽  
V. K. Jain ◽  
Romi Shrivastava
Keyword(s):  
Complete Blood Count ◽  
Demographic Data ◽  
Tertiary Care ◽  
Nasopharyngeal Swab ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Severity Scores ◽  
History Of ◽  
Sensitivity Specificity ◽  
G Ratio

The current study retrospectively enrolled, 75 confirmed COVID-19 patients who were hospitalized in a tertiary care hospital from December 2020 to February 2021. The diagnosis was confirmed by RT-PCR from nasopharyngeal swab. Demographic data and laboratory values were collected from medical records and patient file. The following variables were recorded for each COVID-19 patient: age, sex, chest CT severity scores of lung involvement at admission, history of Comorbidities like diabetes mellitus, hypertension were noted and laboratory findings like Absolute neutrophils count, Absolute lymphocytes count recorded from Complete blood count of patient and Serum albumin, globulin level recorded from Liver function test of patient. This study proves that N-L ratio is more accurate predictor of severity of SARS-COVID-19 infection than A-G ratio with more sensitivity, specificity, positive and negative predictive value and can be used as a severity marker in places where medical resources is limited. However, a larger study with more subjects requires for exact correlation. Keywords: NLR, AGR, Severity & COVID-19.

scholarly journals Brucellosis, Unravelling an Enigma: Eight Years of Experience from a Tertiary Care Hospital in Central Kerala, India

2020 ◽  
Author(s):  
M Ardra ◽  
Chithra Valsan ◽  
KA Sathiavathy
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Personal Contact ◽  
Human Brucellosis ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Middle East Countries

Introduction: Various emerging and re-emerging infectious diseases have made the existence of mankind in this world a great challenge. In the midst of these havocs, some important diseases has undermined in the dark. Brucellosis is an endemic zoonotic disease in most of the developing world and it has far-reaching and deleterious effects on humans and animals alike. In humans, brucellosis shows a variety of non-specific clinical signs. To recognise and diagnose this neglected but debilitating disease, the awareness and alertness of medical personnel has to be enhanced. Aim: To determine the prevalence of brucellosis in Tertiary Care Hospital. Materials and Methods: A retrospective study was conducted from June 2011 to May 2019, all culture proven cases of human brucellosis admitted in a Tertiary Care Hospital in central Kerala, India were reviewed. Demographic data, clinical presentations, laboratory parameters, treatment and outcomes of the same were analysed in Microsoft excel sheets as percentages. Results: Of the 12 culture proven Brucella cases, 11 presented as Pyrexia of Unknown Origin (PUO) cases and one was a soft tissue infection. Eleven patients had history of either consumption of unpasteurised milk products or had contact with animals before the symptoms developed. A 75% cases were imported cases from middle-east countries. In one case the route of entry was by close personal contact probably sexual transmission. All the patients complained of fever and malaise (100%), while low backache and arthralgia was noted in 83%. Most common clinical and laboratory findings associated with brucellosis were hepatosplenomegaly (41.7%) and anaemia (66.6%). Oral doxycycline for six weeks combined with either aminoglycoside or rifampicin was used for treatment. There was no death or relapses noted. Conclusion: This study emphasises the close collaboration of an alert clinician and an experienced microbiologist to correctly diagnose and treat an infection with multiple presentations as brucellosis, in endemic areas also.

scholarly journals Clinico-radiological profile of COVID-19 in a tertiary care hospital of western Rajasthan

2021 ◽  
Vol 6 (3) ◽  
pp. 152-155
Author(s):  
Priyanka Soni ◽  
Laxman Kumar Soni ◽  
K.C Agarwal
Keyword(s):  
Tertiary Care ◽  
Left Lung ◽  
Care Hospital ◽  
Lung Involvement ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Radiological Data ◽  
Life Threatening ◽  
History Of ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19) is a pandemic infectious disease caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection by COVID-19 can result in a range of clinical outcomes, from asymptomatic to severe life-threatening course or death. The purpose of our research was to evaluate the presentation of COVID19 disease based on the clinical and radiological characteristics of our population. 100 COVID19 patients recorded by RTPCR. Clinical, biochemical and radiological data from April-May, 2021. Of the 100 patients, in our study 66% were males and 26% patients had history of recent travel. Majority of patients were asymptomatic and don’t have comorbid illness. Thrombocytopenia and lymphopenia, increased levels of lactate dehydrogenase (LDH) and serum ferritin and C-reactive protein were common in these patients. CT finding were 63% had normal CT chest. Among the 37% patients who had CT chest findings, 25% had bilateral diseases, 8% patients had right lung involvement while 4% patients have left lung involvement.  COVID-19 disease has a relatively mild course in this part of the subcontinent. Clinical and laboratory findings are similar to those found in viral diseases. Studies involving larger sample size and interventional trials are need of the hour.

scholarly journals A Documentation of Hepatitis Outbreak in Chittagong

2019 ◽  
Vol 17 (2) ◽  
pp. 2-5
Author(s):  
Rajat Sanker Roy Biswas ◽  
Fahim Ul Hasan ◽  
Aklima Sultana ◽  
Md Kamal Uddin ◽  
Debashis Chowdhury ◽  
...  
Keyword(s):  
Hepatic Failure ◽  
Demographic Data ◽  
Tertiary Care ◽  
Age Groups ◽  
Hepatitis E ◽  
Uneventful Recovery ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Dark Color

Introduction: Hepatitis E Virus (HEV) causes outbreaks of jaundice and it is associated with morbidity and higher maternal mortality. There is a recent outbreak of hepatitis in the Chittagong city and present study is aimed to observe the clinical and serological trends along with outcome of hepatitis cases visiting two tertiary care hospitals Chittagong, Bangladesh. Methods: It was an observational study done in two tertiary care hospital of Chittagong in a period of 3 months (May, June & July 2018) among 230 patients of hepatitis. After inclusion with written informed consent patients were introduced a questionnaire. Their demographic data, risk behaviors were noted, history related to hepatitis were recorded. Examination was done and evaluation regarding presence of hepatic encephalopathy at bed site was noted. Later serological findings were evaluated. After collection of all data it were compiled and analyzed by SPSS- 20. Results: Among 230 cases age group, gender and locality of the study patients were analyzed where younger age groups specially 21-30 years 114(49.6%) and 31-40 years 38(16.5%) were the most affected group. Gender distribution was found mostly same. Halishahar area which is located in western part of the Chittagong city was found mostly affected 196(85.2%). Use of water from WASA (Water and Sewerage Authority) supply was 168(73%) and deep tubewel water was 56(24.3%). Among them 80(34.8%) subjects do not boil water Anorexia (74.8%) nausea (77.4%) vomiting (83.5%) history of fever (89.6%) passage of dark color urine (99.1%) and weakness (97.4%) were some common presenting complaints. Family history of jaundice was found in 40.9% of cases. Among all 216(93.91%) had clinical jaundice, 91(39.56%) had right upper quadrant of the abdomen pain, 41(17.8%) had hepatomegally, 14(6.1%) had spleenomegally, 24(10.4%) had signs of hepatic failure and 34(14.8%) female were pregnant. Anti HEV was found positive in 164(71.3%) cases, 12(5.2%) were positive for anti HAV, 6(2.6%) were positive for HBsAg. None was found anti HCV positive. Among all 4(1.8%) cases died due to hepatic failure or multi-organ failure with AKI. All of them were pregnant. Two pregnant lady had missed abortion. Among all 11(4.7%) cases loosed follow and 213(92.60%) cases had uneventful recovery. Conclusion: This outbreak of HEV was of usual pattern of morbidity and mortality, and therefore points to water supply and sanitation issues. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 2-5

scholarly journals DERMATOPHYTOSIS PROFILE IN A MADHUBANI MEDICAL COLLEGE AND TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Shahid Hassan
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Clinical History ◽  
Epidemiologic Studies ◽  
World Population ◽  
Care Hospital ◽  
Indirect Contact ◽  
Medical College ◽  
Number Of Patients ◽  
History Of

INTRODUCTION: The current perception among dermatologists based on their experience in the outpatient’s clinics is that there is a huge change in clinical profile, both qualitative and quantitative, in the patients presenting with dermatophytosis. The prevalence of superficial mycotic infection is about 20%–25% of the world population, and dermatophytes is the leading microorganism responsible. Now there is a changing trend in the dermatophytic infections, the cases are presenting as chronic, not responding to usual treatment and also there are recurrent cases. Dermatophytosis is a contagious disease that spreads by direct or indirect contact. Until a few years ago, it had been a disease treated with ease using antifungal agents. In the recent past, there has been a failure of treatment with conventional therapy and emergence of an epidemic of recurrent and chronic dermatophytosis in India. MATERIAL AND METHODS: Our study population included 112 patients who were clinically diagnosed as dematophytosis in the Outpatient department (OPD). Clinical history of all patients was taken. Demographic data such as age, sex, occupation, duration of disease, history of recurrence, habits and associated diseases was recorded. Culture were done in all suspected cases. Nail scrapings, clippings and sub-ungual debris were collected. RESULTS: In present study there were in all 112 patients among which maximum number of patients about 33% belonged to age group 11 to 20, majority of which were males 66.96% whereas 33.04% were females. 50% were culture positive among all patients and microscopy was positive in 58.93% of cases. Trichophytonrubrum species was isolated predominantly in 57.1% cases, Trichophytonmentagrophyte was found in 23.2% of patients followed by microscoporumgypsium isolated in 12.5% cases and E.floccosum was seen isolated in 7.1% among all clinical types. Percentage of tineacorporis, tineacapitis and tineacruris was 39.3%, 18.8% and 13.4% respectively. CONCLUSION: Dermatophytosis was found to be common in second decade of life and male were commonly affected. T. rubrum was most common isolate. The need of the hour is carry out multicentric large epidemiologic studies that can effectively establish the prevalence of fungal isolates and its antifungal resistance status.

scholarly journals IMPACT OF COVID-19 ON HEMATOLOGICAL PARAMETERS-A SINGLE CENTRE STUDY, INDIA.

2020 ◽  
pp. 4-6
Author(s):  
Reshma Anegundi ◽  
Talari Rajeswari ◽  
Arathi C A ◽  
Raghavendra M S
Keyword(s):  
Complete Blood Count ◽  
Hematological Parameters ◽  
Demographic Data ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Single Centre ◽  
Cross Sectional ◽  
Distribution Width

Aims and Objectives: To analyze various hematological parameters in Covid-19 infected patients. Patients/Materials and Methods: This is a retrospective, single centre cross sectional study conducted in a tertiary care hospital, located in a tri-state region. Data was collected from patients admitted in Covid-19 ward and ICU between 28 July to 7 September 2020, confirmed positive for Covid-19 infection. Basic demographic data was collected from Laboratory Information System(LIS) of our hospital . Whole blood EDTA sample sent from Covid-19 ward and ICU were processed in LH780/DXH 500(Beckman coulter) for complete blood counts. Further patients laboratory features were analyzed . Results: Findings of 338 patients, both from ward and ICU, showed varied hematological parameters. Demographic data revealed age range from 1day to 86 years. Males constituted 205(60.65%) and females 133(39.34%).Complete blood count showed Hemoglobin(Hb) concentration ranged from 5.8 -18.5gm/dL and median value 13.6gm/dL. Red cell distribution width(RDW) ranged from 11.4-39.9% with median value of 13.6%. Leucocytosis was observed in 13.9% of patients, high absolute neutrophil count in 15.6% ,high Neutrophil to Lymphocyte ratio(NLR) in 10.05% patients and eosinophil count ranged from 0-15.3%. Conclusion: Baseline alterations in CBC parameters of 10-15% of patients in the present study along with articles reviewed from various countries indicate Covid -19 infection causes systemic infection involving multiple organs and systems.

scholarly journals Comprehensive Overview of 473 Cases of COVID-19: Outcome Experiences of a Dedicated Hospital in Dhaka, Bangladesh

2021 ◽  
pp. 39-45
Author(s):  
Perveen RA ◽  
Nasir M ◽  
Ferdous J ◽  
Murshed M ◽  
Nazneen R ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Nasopharyngeal Swab ◽  
Care Hospital ◽  
Rt Pcr ◽  
Comprehensive Overview ◽  
College Hospital ◽  
Medical College ◽  
Severe Group

Aim: The study aimed to observe and compare the demographic, comorbidities, biomarkers in different categories of diagnosed COVID-19 patients admitted to a COVID dedicated tertiary care hospital in the pic time of the pandemic, 2020, at Dhaka, Bangladesh. Methods: This retrospective study was conducted from May to September 2020 in 720 bed Holy Family Red Crescent Medical College Hospital. Four hundred seventy-three patients included in this study, diagnosed by RT-PCR of the nasopharyngeal swab, were divided into four groups. The mild group includes 254 patients, the moderate group has 82 patients, 38 patents in the severe group, and the critical group who were admitted to ICU, 99 patients. Demographic data, available investigation reports of individual patients, obtained from hospital records manually and compared between all four different categories of patients.

scholarly journals CLINICAL CHARACTERISTICS, LABORATORY ABNORMALITIES AND OUTCOME OF COVID-19 POSITIVE PATIENTS ADMITTED IN TERTIARY CARE HOSPITAL OF KARACHI

2021 ◽  
Vol 9 (5) ◽  
pp. 894-901
Author(s):  
Muhammad Farooq ◽  
◽  
Arshad ali ◽  
Furquana Niaz ◽  
Nadia Shams ◽  
...  
Keyword(s):  
Virus Disease ◽  
Average Length ◽  
Demographic Data ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Small Scale ◽  
Common Symptom ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Icu Admission

Background and Objective:COVID-19 is a corona virus disease infecting people worldwide. There are few local small-scale studies addressing this. We planned a study with good sample size to reveal clinical features and laboratory abnormalities in relation to ICU admission and mortality. Methods and Materials: This observational study was conducted at Dept. of Medicine Liyari General Hospital Karachi after ethical approval. The indoorconfirmed COVID-19 (PCR positive) patients (age>18 years) were included. Pregnant/lactating women, outdoor cases were excluded. Their demographic data, symptoms and signs,co morbidities, laboratory findings (blood complete picture, renal/liver function tests, inflammatory markers (i.e., CRP, ESR, ferritin, LDH, D dimers, troponins), area and duration of admission, disease severity, outcome as death or recovery were documented. Data was collected manually from record of the patients admitted from 15th March till 30th September 2020. The data was analyzed by SPSS software. Chi-square test applied with significant p<0.05. Results:Amongst879 patients 773(87.9%) were admitted in isolation wards whereas 106(12.1%) admitted in ICU. Mortality was 3.9% overall and average length of stay was 11 days. The mean age was 51.8+18.4 years. Most cases were male (65%) and > 50 yearsage (58.9%).Frequent co morbidities were diabetes(26.1%), dyslipidemia (23%), hypertension (19.9%) and ischemic heart disease (17.3%). Fever wasmost common symptom. Tachycardia, hypotension, anemia and lymphocytopenia wereassociated with ICU admission and mortality.Inflammatory markers were elevated in most of the cases but only LDH, ferritin and D-dimers were statistically associated with ICU admission and mortality. Conclusion:This study concludes that COVID-19 positive patients with age above fifty, tachycardia, hypotension elevated LDH, Ferritin, D dimers anemia and lymphocytopenia were associated with mortality and ICU admission.

scholarly journals Neonatal seizures and outcome in a NICU of a tertiary care hospital of Andhra Pradesh-an two year study

2017 ◽  
Vol 4 (3) ◽  
pp. 1004 ◽  
Author(s):  
Punith Patak Nagaram ◽  
Pratima Piduru ◽  
Venkata Krishna Munagala
Keyword(s):  
Tertiary Care Hospital ◽  
Demographic Data ◽  
Tertiary Care ◽  
Neurological Dysfunction ◽  
Care Hospital ◽  
Neonatal Seizures ◽  
Cross Sectional ◽  
Central Nervous System Dysfunction ◽  
Hypoxia Ischemia ◽  
History Of

 Background: Seizures are the most frequent clinical manifestation of central nervous system dysfunction in the newborn with the incidence varying from 1-5%. Neonatal seizures often signal an underlying ominous neurological condition, most commonly hypoxia-ischemia, and others include stroke, intraventricular hemorrhage or intraparenchymal hemorrhage, meningitis, sepsis, and metabolic disorders. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity and "prime" the brain to increased damage from seizures later in life. The present study was undertaken to delineate the various aspects of neonatal seizures, with special reference to etiology, clinical spectrum, and outcome in the Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital.Methods: A prospective cross sectional study was conducted in an NICU of a tertiary care hospital with 65 neonates in the study group for a period of 2 years. Gestational age assessment is done by modified Ballard’s scoring system and detailed neurological assessment was done. Antenatal history of mother, demographic data, and clinical history of neonate was noted and evaluated. Laboratory investigations were done and results noted and outcome was recorded.Results: Subtle seizure was the commonest (40%) clinical seizures in our study followed by tonic (21.5%). Tonic seizures were common in preterm and in full term subtle seizures. Babies with myoclonic seizures had 100% mortality. Hypoxic ischemic encephalopathy was the commonest cause (41.5%) of mortality in our study. The worst outcome was with CNS malformation (50%). A total of 10 deaths were recorded (15.4%) with maximum association in cases with history of onset 7 days (100%).Conclusions: Neonatal seizures are common and may be the first manifestation of neurological dysfunction after a variety of insults. Seizures may interfere with cardio-respiratory function and nutrition and may have detrimental effects on cerebral development. Global cerebral hypoxia-ischemia is the most common etiology of neonatal seizures, followed by intracranial bleed, hypoglycemia, septicemia, hypocalcemia, BE, CNS malformations. 

scholarly journals Paradox of Predictors in Critically ill COVID-19 Patients: Outcome of a COVID-dedicated Intensive Care Unit

2021 ◽  
Author(s):  
Morshed Nasir ◽  
Rawshan Ara Perveen ◽  
Rumana Nazneen ◽  
Tahmina Zahan ◽  
Sonia Nasreen Ahmad ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Demographic Data ◽  
Tertiary Care ◽  
Predictive Biomarkers ◽  
Nasopharyngeal Swab ◽  
Treatment Schedule ◽  
Care Hospital ◽  
Icu Stay ◽  
Significant Difference

Background: The study aimed to analyze the demographic, comorbidities, biomarkers, pharmacotherapy, and ICU-stay with the mortality outcome of COVID-19 patients admitted in the intensive care unit of a tertiary care hospital in a low-middle income country, Bangladesh. Methods: The retrospective cohort study was done in Holy Family Red Crescent Medical College Hospital from May to September 2020. All 112 patients who were admitted to ICU as COVID-19 cases (confirmed by RT-PCR of the nasopharyngeal swab) were included in the study. Demographic data, laboratory reports of predictive biomarkers, treatment schedule, and duration of ICU-stay of 99 patients were available and obtained from hospital records (non-electronic) and treatment sheets, and compared between the survived and deceased patients. Results: Out of 99 patients admitted in ICU with COVID-19, 72 were male and 27 were female. The mean age was 61.08 years. Most of the ICU patients were in the 60 - 69 years of age group and the highest mortality rates (35.89%) were observed in this age range. Diabetes mellitus and hypertension were the predominant comorbidities in the deceased group of patients. A significant difference was observed in neutrophil count, creatinine and, NLR, d-NLR levels that raised in deceased patients. There was no significant difference as a survival outcome of antiviral drugs remdesivir or favipiravir, while the use of cephalosporin was found much higher in the survived group than the deceased group (46.66% vs 20.51%) in ICU. Conclusions: Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males aged more than 60 years. There were wide variations of the biomarkers in critical COVID-19 patients in a different population, which put the healthcare workers into far more challenge to minimize the mortality in ICU in Bangladesh and around the globe during the peak of the pandemic.

scholarly journals Acute Urticaria in Children in a Tertiary Care Hospital: A Cross-sectional Study

2021 ◽  
Author(s):  
Kannu Priya ◽  
Anupama Vinayak Mauskar
Keyword(s):  
Complete Blood Count ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Prick Test ◽  
Acute Urticaria ◽  
Excessive Heat ◽  
History Of

Introduction: Urticaria is a highly prevalent condition resulting in a large number of medical consultancies worldwide. Urticaria is derived from the Latin word “urere” meaning “to burn”. Urticaria usually manifests as a transient, itchy, polymorphic skin eruption. It can occur in any age group. Aim: To study the prevalence and possible triggers of acute urticaria in children. Materials and Methods: All children of age group six months to 12 years visiting the Institute from June 2018 to April 2019, with the complaint of acute urticaria with or without angioedema were included in the study while those with chronic urticaria and only angioedema were excluded. Sixty five children presented with acute urticaria with or without angioedema. Patients were diagnosed based on history and clinical examination. All patients were subjected to a detailed history, general physical examination and, necessary investigations like Complete Blood Count (CBC), absolute eosinophil count, Erythrocyte Sedimentation Rate (ESR), C-reactive Protein (CRP), Skin Prick test as indicated. They received appropriate treatment and their clinical outcome was studied. Results: Prevalence of acute urticaria was found to be 0.23. It was more commonly seen in males (63.08%) and more in the age group of 1 to 5 years (56.92%). The focus of infection was found in 44.6% of children, while 21% of children had a history of consumption of some form of medications leading to urticaria. Conclusion: Urticaria can be prevented in children by preventing them from infection and avoiding the use of amoxicillin-clavulanic acid unless very necessary. Those children with a family history of acute urticaria should be prevented from exposure to excessive heat, cold, pressure, vibration, etc. Investigations are also recommended as an important diagnostic tool to find out the aetiology of acute urticaria.

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