scholarly journals A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

2016 ◽  
Vol 10 (3) ◽  
pp. 47-50
Author(s):  
Nasim Zamani ◽  
◽  
Leila Modir-Fallah Rad ◽  
Kambiz Soltaninejad ◽  
Shahin Shadnia ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Tertiary Referral Center

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

scholarly journals Identification of Novel Classes for Patients With Lupus Nephritis Using Two-step Cluster Model

2021 ◽  
Author(s):  
Ting Huang ◽  
Shasha Xie ◽  
Liqing Ding ◽  
Hui Luo
Keyword(s):  
Cluster Analysis ◽  
Evaluation System ◽  
Demographic Data ◽  
White Blood Cells ◽  
Damage Index ◽  
Cross Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Mild Disease ◽  
Cluster 2

Abstract Objectives: To identify and reclassify the patients in the LN cohort, and to further analyze the prominent clinical features and clinical significance of each cluster of patients.Methods: This is a cross-sectional study of a cohort of 635 LN patients from the Rheumatology Department of Xiangya Hospital of Central South University. Demographic data, laboratory findings and clinical evaluation system include physician’s global assessment and the SLICC/ACR Damage Index were collected. Using two-step cluster analysis, patients with similar clinical property were identified and compared.Results: Among the 635 LN patients, 599 patients (94.3%) were female. The mean age of the patients were 33.8 ± 10.4 years. Three subgroups were identified by two-step cluster analysis. Cluster 1 included 130 (20.5%) patients, Cluster 2 included 132(20.8%) patients and Cluster 3 included 373 (58.7%) patients. Cluster 3 was the largest group of mild disease activity, patients in this cluster had lower white blood cells, neutrophils, lymphocytes and mean SDI scores compared to those in the other two clusters. Cluster 1 was the smallest group of severe damage, patients in this cluster had multiple positive auto-antibodies, higher SDI scores and lower complement level. Patients of cluster 2 had the highest levels of granulocytes, but the results of other laboratory tests were roughly between the cluster 1 and cluster 3.Conclusions: This study reclassified three groups of LN patients in a large cohort. Our research shows that the multiple positive ANA antibody may be related to the high SDI score of LN patients. Clinicians can identify patients at different stages through cluster analysis to better implement prognosis.

scholarly journals Dermatoses among patients aged 60 years and above attending a tertiary referral center: A cross-sectional study from North Kerala

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Muhammed Kutty Simin ◽  
Sarita Sasidharanpillai ◽  
Uma Rajan ◽  
Najeeba Riyaz
Keyword(s):  
Fungal Infections ◽  
Significant Proportion ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Tertiary Referral ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Life Expectancy At Birth

Objectives: With the rise in life expectancy at birth, geriatric population contributes to a significant proportion of those seeking medical aid. Skin problems in the elderly are very common and vary according to region and ethnicity. It is essential for dermatologists to have a better understanding of the pathophysiology of geriatric skin disorders to formulate quality management guidelines. This study was undertaken to document the frequency and the clinical pattern of various physiological and pathological changes in the elderly skin. Materials and Methods: A cross-sectional study was carried out in 200 consecutive patients aged 60 years and above and who attended the Dermatology outpatient clinic of a tertiary referral center in North Kerala. A pre-set pro forma was used to document the patient characteristics, the comorbidities, the medications used, and the clinical findings. Results: All the study participants (100%) had one or more dermatoses. The age of the study population ranged from 60 to 89 years (mean 67.7 ± 6.2 years). This was a female preponderant study with a female to male ratio of 1.4:1. Hypertension (36%), hyperlipidemia (27%) and diabetes mellitus (26%) were the common comorbidities observed. Graying of hair was the most common physiological change, followed by wrinkling. Pruritus was the most common presenting complaint (136, 68%). Statistically significant association was noted between xerosis and generalized pruritus. Fungal infections (30.5%) outnumbered other infections and infestations. Changes of severe photoaging were less frequent. One patient had skin malignancy (basal cell carcinoma). Significant association was noted between photoaging and male sex, smoking, and sun exposure. Limitations: Study conducted in a tertiary referral center not reflecting the status in the community was the major limitation. Conclusion: Photoaging and skin cancers are less frequent in darker skin type. Healthy lifestyle, nutritious diet, frequent application of emollient, better skin care, and judicious use of sunscreen can delay the process of cutaneous aging. More prospective studies in different population groups may go a long way in improving the current knowledge about the less known aspects of geriatric dermatoses.

Clinical factors associated with work disability in epilepsy: A cross-sectional study at a tertiary referral hospital

2021 ◽  
Vol 124 ◽  
pp. 108310
Author(s):  
Gea Mireia ◽  
Grau-López Lara ◽  
Jiménez Marta ◽  
Hernández-Stahl Marina ◽  
Fumanal Alejandra ◽  
...  
Keyword(s):  
Work Disability ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Clinical Factors ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals Clinical differences between eosinophilic and non-eosinophilic acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a multicenter cross-sectional study

2020 ◽  
Author(s):  
Guangming Dai ◽  
Yajuan Ran ◽  
Jiajia Wang ◽  
Xingru Chen ◽  
Junnan Peng ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract Background AECOPD is highly heterogeneous with respect to etiology and inflammation. COPD with higher blood eosinophils is associated with increased readmission rates and better corticosteroid response. However, the clinical features of eosinophilic AECOPD aren’t well explored. Then, the aim of this study was to investigate the clinical differences between eosinophilic and non-eosinophilic AECOPD. Methods A total of 643 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 455 were included, 214 in normal eosinophils AECOPD (NEOS-AECOPD) group, 63 in mild increased eosinophils AECOPD (MEOS-AECOPD) group, and 138 in severe increased eosinophils AECOPD (SEOS-AECOPD) group. Then, demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistic regression was performed to identify the independent factors associated with blood EOS. Correlations between blood EOS and its associated independent factors were evaluated. Results The significant differences in 19 factors, including underlying disease, clinical symptom, and laboratory parameters, were identified by univariate analysis. Subsequently, multiple logistic regression revealed that lymphocytes%, neutrophils% (NS%), procalcitonin (PCT), and anion gap (AG) were associated with blood EOS in AECOPD. Both blood EOS counts and EOS% significantly correlated with lymphocytes%, NS%, PCT, and AG. Conclusions The blood EOS was independently associated with lymphocytes%, NS%, PCT, and AG in AECOPD patients. Lymphocytes% was lower, and, NS%, PCT, and AG were higher in eosinophilic AECOPD. Our results indicate that viral dominant infections probably were the major etiology of eosinophilic AECOPD. Non-eosinophilic AECOPD was more likely associated with bacterial dominant infections. The systemic inflammation in non-eosinophilic AECOPD was more severe.

scholarly journals The cross-sectional study of hospitalized coronavirus disease 2019 patients in Xiangyang, Hubei province

2020 ◽  
Author(s):  
Jin-Wei Ai ◽  
Jun-Wen Chen ◽  
Yong Wang ◽  
Xiao-Yun Liu ◽  
Wu-Feng Fan ◽  
...  
Keyword(s):  
Real Time ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Subsequent Development ◽  
Severe Case ◽  
Multiple Organ ◽  
Ct Scans ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Cross Sectional

SummaryObjectiveTo describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 (COVID-19) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment.MethodsWe included 102 confirmed COVID-19 cases hospitalized in Xiangyang No.1 people’s hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed.FindingsAll cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever (86[84.3%] of 102 patients), cough (58[57%]), fatigue (28[27%]), shortness of breath (24[23%]), diarrhea (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure, three had multiple organ failure and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results.InterpretationMost COVID-19 patients in Xiangyang were secondary cases without sex difference, and the rate of severe case and death was low. Middle-to-old-age individuals were more susceptible to the virus infection and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively.

scholarly journals Procalcitonin Uptake and Effect on Antibiotics Stewardship: A Single Institution Experience

2020 ◽  
Vol 5 (09) ◽  
pp. 395-399
Author(s):  
Hycienth Ahaneku, MD DrPH ◽  
Chukwuemeka A. Umeh, MD DrPH ◽  
Mike Cao, MD ◽  
Bradley Kapten, MD ◽  
Baher Elhalwagi, MD ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Respiratory Infections ◽  
Medical Center ◽  
Demographic Data ◽  
Public Health Problem ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Antibiotics Resistance ◽  
Cross Sectional ◽  
Antibiotics Use

Background: In the face of antibiotics resistance and adverse effects, emerging evidence suggests that procalcitonin guided therapy can help enhance appropriate use of antibiotics especially in patients with respiratory infections and sepsis. We seek to assess the uptake of procalcitonin among clinicians in a US hospital and assess its correlation with amount and duration of antibiotics use. We also seek to identify factors significantly associated with antibiotic use. Methodology: Retrospective cross-sectional study of patients with sepsis and COPD at a Medical Center in Texas USA. A total 48 COPD and 62 Sepsis patients were assessed. We collected demographic data such as age, weight, height, gender, and race/ethnicity. We also collected data on procalcitonin, number of antibiotics used, duration of antibiotics, and WBC levels at admission. We conducted bivariate analyses and logistic regression analyses to assess factor associated with procalcitonin, number of antibiotics used and duration of antibiotics. Results: We had 48 COPD patients and 62 sepsis patients in this study. Overall physicians ordered Procalcitonin on only 11.8% of patients. Procalcitonin was not significantly associated with antibiotics use. However, patients who had procalcitonin ordered had significantly lower WBC count than those without procalcitonin (10.1 vs. 12.9, p:0.026). Number of antibiotics was significantly associated with type of diagnosis (Sepsis 66.7% vs. COPD 50.7%, p = 0.001). In the logistic regression analysis, after adjusting for other variables patients with sepsis were significantly more likely to be on higher number antibiotics (OR 6.08, p <0.001) and longer duration of antibiotics (OR 7.44, p < 0.001). Conclusion: Inappropriate use of antibiotics is a public health problem. Procalcitonin has been touted as a biomarker that is effective in reducing use of antibiotics. Our study showed a low utilization of Procalcitonin by physicians and that patients with lower WBC counts were more likely to have procalcitonin ordered. However, our study did not find any association between procalcitonin and the number and duration of antibiotics use.

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