scholarly journals A STUDY ON RESPIRATORY COMPLICATIONS AND ITS OUTCOME IN ACUTE PANCREATITIS

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Abhijith Valsalan ◽  
Alfie J Kavalakat ◽  
Gowri Gopal ◽  
John Thomas P ◽  
Rashifa Vakiyath ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Early Death ◽  
Face Mask ◽  
First Episode ◽  
Respiratory Complications ◽  
Tertiary Care Centre ◽  
Respiratory Dysfunction ◽  
Ventilator Support

Background: Respiratory complications are frequent in acute pancreatitis, and respiratory dysfunction, presenting as Acute lung injury (ALI) or Acute Respiratory Distress Syndrome (ARDS), is a major component of multiple organ dysfunction syndrome (MODS), with a frequent need for ventilator support, which contributes to early death in severe acute pancreatitis. The current study was done with the objective of assessing the morbidity and mortality of acute pancreatitis cases with respiratory complications and to find out whether there is any association between the aetiology of acute pancreatitis and respiratory complications. Methodology: It was a prospective observational study conducted in a tertiary care centre in Kerala. All participants admitted with symptoms suggestive of acute pancreatitis were screened for potential enrolment. The inclusion criteria employed were that the patients should be aged above 18 years, and presenting with the first episode of pancreatitis, irrespective of aetiology. All the patients who were admitted were monitored daily for the worsening of any respiratory complications and provided with adequate respiratory supports. Results: Out of the 101 participants recruited, males were 84.2%. Mean (SD) age was 42.1 (11.4) years. Majority of cases (61%) had alcoholic aetiology. Fourteen patients required high flow nasal oxygen support, four patients were given face mask support, five patients required ventilator support and three patients required tracheostomy support. Respiratory complications and requirement of support were found to be associated with higher morbidity as well as mortality. Respiratory complications were higher in those with alcoholic etiology but this was not significant in univariate analysis. Conclusion: Respiratory complications pose challenges in clinical course of acute pancreatitis in terms of morbidity as well as mortality. Aetiology did not seem to play a major role in development of respiratory complications.

Haemorrhage in severe acute pancreatitis: Management and outcome at a tertiary care centre

Pancreatology ◽  
2014 ◽  
Vol 14 (2) ◽  
pp. S5
Author(s):  
P. Patnaik ◽  
V. Arun Kumar ◽  
R. Dhingra ◽  
Sujoy Pal ◽  
N.R. Dash ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

Impact of timing of presentation of acute pancreatitis to a tertiary care centre on the outcome

Pancreatology ◽  
2019 ◽  
Vol 19 (1) ◽  
pp. 143-148 ◽  
Author(s):  
Bipadabhanjan Mallick ◽  
Narendra Dhaka ◽  
Vishal Sharma ◽  
Sarthak Malik ◽  
Saroj K. Sinha ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

Radiotherapy in desmoid fibromatosis: a 10-year experience from a tertiary care centre

2019 ◽  
Vol 19 (3) ◽  
pp. 259-264
Author(s):  
Sunitha S. Varghese ◽  
Sharief Sidhique ◽  
Anne J. Prabhu ◽  
Simon P. Pavamani ◽  
B. Antonysamy ◽  
...  
Keyword(s):  
Local Control ◽  
Tumour Size ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Complete Resection ◽  
Tertiary Care Centre ◽  
Complete Excision ◽  
Desmoid Fibromatosis ◽  
Kaplan Meier ◽  
Common Location

AbstractAim of the study:To assess the relapse-free survival (RFS) and the factors influencing local recurrence in patients with desmoid fibromatosis (DF) treated at our centre and to determine the role of post-operative radiotherapy (RT) in improving local control.Methods:A retrospective analysis of 51 patients treated for DF from January 2004 to December 2013 was undertaken. The RFS was calculated using the Kaplan–Meier curve. Univariate analysis was done to assess correlation with tumour size, site, the extent of surgery, margin status and adjuvant RT with RFS.Results:The median age was 28 years with a male:female ratio of 1:3. The most common location of the tumour was anterior abdominal wall (47%). The median tumour size was 10 cm. Wide local excision was done in most patients. Complete resection with negative margin was achieved in eight patients. Post-operative RT was indicated for 43 patients of whom 19 received RT. At a median follow-up of 37 months, RFS in the complete resection with margin negative group was 100%. RFS for the patients with positive or close margins who received RT was 79% and for those who did not receive RT, it was 87%.Conclusions:Complete excision with negative margins gives the best local control in DF. The benefit of post-operative RT could not be ascertained.

scholarly journals Optic nerve compression in allergic fungal sinusitis

2011 ◽  
Vol 125 (4) ◽  
pp. 381-385 ◽  
Author(s):  
A Thakar ◽  
P Lal ◽  
M Dhiwakar ◽  
S Bahadur
Keyword(s):  
Optic Nerve ◽  
Visual Loss ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Nerve Compression ◽  
Fungal Sinusitis ◽  
Tertiary Care Centre ◽  
Allergic Fungal Sinusitis ◽  
Urgent Surgery ◽  
Optic Nerve Compression

AbstractObjective:To describe the syndrome of optic nerve involvement in cases of allergic fungal sinusitis.Setting:Academic tertiary care centre.Methods:Analysis of prospectively accrued data for 10 consecutive cases (three bilateral, giving 13 eyes) with visual loss secondary to optic nerve compression, from a total of 70 cases of allergic fungal sinusitis undergoing surgical treatment between June 1997 and May 2007.Results:The mean duration of rhinological symptoms prior to the onset of visual loss was 22 months. At presentation, visual loss ranged from a visual acuity of 6/12 to complete loss of light perception. Bilateral involvement was noted in three of the 10 cases. Urgent surgical decompression with removal of all fungal debris and decompression of the optic nerve resulted in visual recovery in seven of the 13 eyes. On univariate analysis, recovery was less likely in cases with long standing visual loss, and in cases with complete visual loss.Conclusion:Long standing allergic fungal sinusitis may be complicated by visual loss due to compression of the optic nerve. Urgent surgery to clear the sinuses and decompress the optic nerve is successful in reversing visual loss in cases with partial visual loss.

Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome

Open Medicine ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. 642-647
Author(s):  
Sanja Hromis ◽  
Biljana Zvezdin ◽  
Ivan Kopitovic ◽  
Senka Milutinov ◽  
Violeta Kolarov ◽  
...  
Keyword(s):  
Chest Pain ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Sudden Onset ◽  
Recurrent Event ◽  
First Episode ◽  
Close Monitoring ◽  
Tertiary Care Centre ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum

AbstractSpontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.

scholarly journals Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Polychronis Pavlidis ◽  
Siobhan Crichton ◽  
Joanna Lemmich Smith ◽  
David Morrison ◽  
Simon Atkinson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Severity Index ◽  
Apache Ii Score ◽  
Tertiary Care Centre

Background. Severe acute pancreatitis (SAP) is associated with serious morbidity and mortality. Our objective was to describe the case mix, management, and outcome of patients with SAP receiving modern critical care in the Intensive Care Unit (ICU).Methods. Retrospective analysis of patients with SAP admitted to the ICU in a single tertiary care centre in the UK between January 2005 and December 2010.Results. Fifty SAP patients were admitted to ICU (62% male, mean age 51.7 (SD 14.8)). The most common aetiologies were alcohol (40%) and gallstones (30%). On admission to ICU, the median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17, the pancreatitis outcome prediction score was 8, and the median Computed Tomography Severity Index (CTSI) was 4. Forty patients (80%) tolerated enteral nutrition, and 46% received antibiotics for non-SAP reasons. Acute kidney injury was significantly more common among hospital nonsurvivors compared to survivors (100% versus 42%, ). ICU mortality and hospital mortality were 16% and 20%, respectively, and median lengths of stay in ICU and hospital were 13.5 and 30 days, respectively. Among hospital survivors, 27.5% developed diabetes mellitus and 5% needed long-term renal replacement therapy.Conclusions. The outcome of patients with SAP in ICU was better than previously reported but associated with a resource demanding hospital stay and long-term morbidity.

scholarly journals Psychosocial Needs of the Families with a Person with First Episode Psychosis

2019 ◽  
Vol 10 (1) ◽  
pp. 56
Author(s):  
Praful Prabhuappa Kapse ◽  
Manisha Kiran
Keyword(s):  
Tertiary Care ◽  
Family Members ◽  
First Episode Psychosis ◽  
First Episode ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Episode Psychosis ◽  
The Family ◽  
Expressed Emotions

Background: The people who experience psychotic symptoms first time can be frightening for them and their close family members. It is crucial to provide family support and care to persons with first episode psychosis. Aim: To assess the needs of family members presenting to a tertiary care centre. Methods: Cross-sectional outpatient based study design was adapted to collect data from the family members of persons with first episode psychosis presented to a tertiary care centre. Total 60 family members were randomly selected for the study and assessed for the burden, attitude, ways of coping and quality of life. Results: Study results indicate the high burden; it has noted that high negative expressed emotions among family members. Negative coping styles were also found and the family members and having a poor quality of life. Conclusion: First episode of psychosis can traumatizing to the patients and their family members. Family members can experience the burden of caregiving including financial burden, can have faulty ways of coping and negative expressed emotions towards their own wards having psychosis which can lead to poor treatment outcome. Findings indicated that need to provide psychosocial intervention for family members of persons with first episode psychosis. Keyword: Family, psychosocial intervention, needs, first episode psychosis, expressed emotions, burden

scholarly journals Quality of life among people living with HIV/AIDS in tertiary care centre of Himachal Pradesh

2020 ◽  
Vol 7 (12) ◽  
pp. 5144
Author(s):  
Sunita . ◽  
D. S. Dhadwal ◽  
Anmol Gupta ◽  
Anjali Mahajan ◽  
Deepesh Barall
Keyword(s):  
Quality Of Life ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
World Health ◽  
Value Systems ◽  
People Living With Hiv ◽  
Tertiary Care Centre ◽  
Living With Hiv ◽  
Hiv Aids

Background: The world health organization (WHO) has defined quality of life as an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. The objective of study was to assess the quality of life among people living with HIV/AIDS by comparison of mean scores of their quality of life in physical, psychological, social and environmental domain.Methods: This cross-sectional study was conducted among PLWHA on ART during 2016-17. Data were collected using WHOQOLHIV‑BREF scale and mean±SD of score was calculated. The difference in mean scores of various domains were analysed using ANOVA test. All variables with p<0.2 on univariate analysis were included in multivariate linear regression model.Results: The total score of QOL was 61.71±9.43. The scores of QOL was highest in physical and lowest in environmental domains with 69.55±12.27 and 57.14±10.61 respectively. 71.25% patients rated their QOL good and only 10% were dissatisfied with their health. Currently ill status was the most associated factor under all except social domain. Males with higher education or living with their spouse had significantly better QOL scores.Conclusions: Being a male, educated, employed in the government sector, belonging to general caste category and living with their married spouse were the factors for their better QOL in comparison to their counterparts. Along with ART, other factors should be taken into consideration to improve QOL of PLWHA.

scholarly journals A clinical study of risk factors of acute pancreatitis in a tertiary care centre in north India

2017 ◽  
Vol 4 (6) ◽  
pp. 1878 ◽  
Author(s):  
Pawan Kumar Jha ◽  
Rajnish Chandran ◽  
Pradeep Jaiswal ◽  
Kumari Seema
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Organ Systems ◽  
Mild Acute Pancreatitis ◽  
A Prospective Study

Background: According to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. The objective of this study was to know the risk factors of acute pancreatitis in patients admitted in a tertiary care centre in north IndiaMethods: A prospective study was performed with admitted cases of patients with acute pancreatitis over 2 years period. Total 104 patients were selected for study. All data concerning aetiology were recorded and analysed in all patients forming study groups.Results: Among 104 patients with acute pancreatitis 68 (65%) were females and 36 (35%) were males. Mean age of our study group was 40.9 years and maximum incidence was seen in 36-45 years. Most common cause was biliary pancreatitis (63%) followed by alcohol (27%), idiopathic (6%), trauma (3%), infections (1%). In females, most common aetiology was gall stone (88%), in males most commonly by alcohol (78%). As per Atlanta classification 81 patients (77.8%) had acute mild pancreatitis and 23 patients (22.2%) had acute severe pancreatitis. Majority females (66.7%) were admitted in mild acute pancreatitis. The mean age of patients in mild acute pancreatitis was 39.6 years and in severe group was 45.4 years. Gall stone were the leading cause in both mild and severe acute pancreatitis.Conclusions: Females were more commonly affected than men by acute pancreatitis. The most common aetiology was gall stone followed by alcohol which was leading cause in the males.

scholarly journals Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

2016 ◽  
Vol 102 (4) ◽  
pp. 316-322 ◽  
Author(s):  
Camille Aupiais ◽  
Romain Basmaci ◽  
Brice Ilharreborde ◽  
Audrey Blachier ◽  
Marie Desmarest ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Septic Arthritis ◽  
Tertiary Care ◽  
Age At Onset ◽  
First Episode ◽  
Tertiary Care Centre ◽  
Term Outcome ◽  
Duration Of Symptoms ◽  
Disease Evolution ◽  
Joint Aspiration

AimChildhood arthritis arises from several causes. The aim of this observational study is to compare the clinical and biological features and short-term outcome of different types of arthritis because they have different treatment and prognoses.MethodsChildren <16 years of age hospitalised in a French tertiary care centre for a first episode of arthritis lasting for less than 6 weeks who underwent joint aspiration were retrospectively included. We performed non-parametrical tests to compare groups (septic arthritis (SA), juvenile idiopathic arthritis (JIA) and arthritis with no definitive diagnosis). The time before apyrexia or C reactive protein (CRP) <10 mg/L was analysed using the Kaplan-Meier method.ResultsWe studied 125 children with a sex ratio (M/F) of 1.1 and a median age of 2.2 years (range 0.3 to 14.6). SA was associated with a lower age at onset (1.5 years, IQR 1.2–3.0 vs 3.6 years, IQR 2.2–5.6), shorter duration of symptoms before diagnosis (2 days, IQR 1–4 vs 7 days, IQR 1–19) and higher synovial white blood cell count (147 cells ×103/mm3, IQR 71–227, vs 51 cells ×103/mm3, IQR 12–113), than JIA. Apyrexia occurred later in children with JIA (40% after 2 days, 95% CI 17% to 75%) than children with SA (82%, 95% CI 68% to 92%), as did CRP<10 mg/L (18% at 7 days, 95% CI 6.3% to 29.6% vs 82.1%, 95% CI 76.1% to 89.7%, p=0.01).ConclusionsThere were no sufficiently reliable predictors for differentiating between SA and JIA at onset. The outcomes were different; JIA should be considered in cases of poor disease evolution after antibiotic treatment and joint aspiration.

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