scholarly journals COVID-19 among patients with pre-existing renal impairment: experience in a tertiary care hospital of Bangladesh

2020 ◽  
pp. 23-28
Author(s):  
Muhammad Abdur Rahim ◽  
Tabassum Samad ◽  
Ishrat Jahan ◽  
Md Mashud Alam ◽  
Talha Sami Ul Haque ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Case Fatality ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk ◽  
Polymerase Chain

Background: Patients with chronic kidney disease (CKD) are at increased risk for infection because of immunosuppressed state. CKD is an independent risk factor for poor outcome in coronavirus disease 2019 (COVID-19). This study was designed to describe clinical and laboratory parameters of COVID-19 patients with preexisting CKD. Methods: This cross-sectional study was conducted in the Department of Nephrology, BIRDEM General Hospital from July to December 2020. Hospitalized adult patients with CKD not yet on dialysis, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR), irrespective of symptoms were included in this study. RT-PCR negative cases were excluded. Results: Total patients were 40 (mean age 58.3 years, 52.5% male). Common comorbidities were diabetes mellitus (92.5%), hypertension (67.5%) and ischaemic heart disease (27.5%). Fever, cough, shortness of breath, headache and fatigue were common presenting features. Nearly one-fifth had no COVID-related symptoms. Lymphopenia and high inflammatory markers (ESR, CRP) were common. Sixteen patients were complicated by acute kidney injury, four patients required haemodialysis and 23 had electrolyte imbalance. Most cases were mild to moderate; most were transferred to COVID-dedicated hospitals or discharged with home isolation protocols. Three patients required intensive care unit shifting and two patients died. Conclusion: Most CKD patients had comorbid conditions. Clinical presentation was typical in most cases. Case fatality rate was higher than Bangladeshi statistics. Birdem Med J 2020; 10, COVID Supplement: 23-28

scholarly journals Loss of Sense of Smell and Taste among Reverse Transcriptase Polymerase Chain Reaction Positive COVID-19 Patients of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 1561-1564
Author(s):  
Rajeev Shah ◽  
Bipin Koirala ◽  
Sangya Gyawali
Keyword(s):  
Tertiary Care Hospital ◽  
Strong Association ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Cross Sectional ◽  
Polymerase Chain ◽  
Taste And Smell

Results: A total of 166 patients were included in the study. The age of the patients ranged from 10 to 84 years with a mean age of 44.34 ± 23.059 years. Out of the 166 RT-PCR positive patients 103 (62%) had a loss of taste while 114 (68.7%) had a loss of smell. Nearly half of the subjects about 99 (51.6%) had dysfunction in both taste and smell. Conclusions: The present study shows the strong association between the olfactory and gustatory dysfunction with that of COVID infection. Patients with loss of taste and smell should be evaluated properly at the time of COVID pandemic. Olfactory and Gustatory dysfunction can be the early and only manifestation of COVID infection.   The prevalence of loss of smell and taste was similar to other studies done in similar settings.

scholarly journals Complete Recovery of Renal Function among Obstetric Patients with Acute Kidney Injury at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1289-1292
Author(s):  
Rakina Bhansakarya ◽  
Gehanath Baral ◽  
Shailendra Shrestha ◽  
Shanti Subedi ◽  
Sita Ghimire ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Acute kidney injury  is a rare complication of pregnancy and is associated with high maternal morbidity and mortality. Obstetric factors associated with it are preeclampsia/eclampsia, sepsis, hemorrhage and dehydration. Here, we aim to find out the prevalence of complete recovery of renal function among obstetric patients with acute kidney injury. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from 1st July 2020 to 30th June 2021 where obstetric patients who had developed acute kidney injury were included and followed till 6 weeks of diagnosis. Ethical approvalwas obtained from Institutional Review Committee of Nobel Medical College and Teaching Hospital (IRC- NMCTH 437/2020). The convenience sampling method was used. Data entry and analysis were done using Statistical Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 66 obstetric patients with acute kidney injury, 45 (68.2%) (57-79.3 at 95% Confidence Interval) had complete recovery of renal function. Rate of renal function recovery in Stage 1, Stage 2 and Stage 3 acute kidney injury were 19 (90%), 19 (86%) and 7 (58%) respectively. The most common causes of acute kidney injury were Preeclampsia/eclampsia 18 (40%), sepsis 23 (28.8%) and hemorrhage 10 (22.2%). Conclusions: The prevalence of complete recovery in obstetric patients with acute kidney injury was similar to findings from other studies done in similar settings.

scholarly journals Obstetric and neonatal outcome in women with a history of recurrent miscarriage at tertiary care hospital, Karnataka: a retrospective cross-sectional study

2018 ◽  
Vol 7 (2) ◽  
pp. 648 ◽  
Author(s):  
Chintan Upadhyay ◽  
Nisha Upadhyay
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Tertiary Care ◽  
Previous History ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
History Of

Background: When clinical pregnancy is established, the risk of spontaneous pregnancy loss is ~12-14%, and therefore the incidence of Recurrent Pregnancy Loss (RPL) by chance alone would be in the order of 0.35%. It occurs in 0.5-3% of women. The objective of this study was to evaluate the obstetric outcome in pregnancies with history of one or more abortions.Methods: It is a retrospective cross-sectional study done at Obstetrics and Gynecology Department, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore. Record review of cases was done from January 2005 to December 2009. Inclusion criteria were pregnancies with history of previous abortions.Results: There were 400 cases with previous history of abortions. There were 266 (66.4%) booked cases while 134 (33.5%) were unbooked cases. 272 (68.0%) patients crossed viable period of pregnancy (more than 28 weeks). Around 56 (14.0%) cases had repeat abortions, 276 (69.0%) cases underwent vaginal delivery and 124 (31.0%) underwent cesarean section. Almost 91 (22.8%) of Babies were low birth weight while others were above 2.5 kg. There were 52 (13.0%) preterm babies and 28 (7.0%) Intrauterine demise of fetuses.Conclusions: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.

scholarly journals Causes of mid trimester pregnancy loss in a tertiary care hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 64-69
Author(s):  
Bushra Zardad ◽  
Anisa Fawad ◽  
Ayesha Ismail ◽  
Shazia Mehreen ◽  
Sadia Bibi
Keyword(s):  
Pregnancy Loss ◽  
Tertiary Care ◽  
Relevant Information ◽  
Management Plan ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Second Trimester ◽  
Cross Sectional ◽  
Trimester Pregnancy ◽  
Increased Risk

Introduction: Mid trimester of pregnancy is relatively a safe time of pregnancy with minimal and no complications. Mid trimester pregnancy loss constitutes 1 to 5 % of total miscarriages. The purpose of this study is to evaluate the causes of second trimester miscarriages so as to improve the outcome in future pregnancies. Materials & Methods: This was a prospective cross-sectional study. Demographic features, relevant information and risk factors were recorded in a predesigned proforma. Detailed history was followed by thorough clinical examination and appropriate investigations were advised. Results: Total number of miscarriages admitted in the unit over the period of two years were 336 and among them 30 patients presented with second trimester miscarriages (8.9%). The mean age of the patients was 31.4 years. In 19 patients (63.4%) there were identifiable causes for the miscarriage. 7 patients (23.33%) had fibroids in the uterus, 5 patients (16.67%) had bacterial vaginosis, 4 patients (13.33%) had cervical incompetence and in 3 patients (10%) there were congenital abnormalities in the uterus. Conclusion: Patients with second trimester pregnancy loss are at significantly increased risk (10 times more likely) for recurrent second trimester loss. In 50 to 70% of patients no cause can be identified. After single loss there is 80% chance of successful pregnancy outcome in future. Even after two and three mid trimester losses still there is 60% chance of alive pregnancy next time, so thorough evaluation and management plan is needed to prevent this mishap in future pregnancies.

scholarly journals Clinico-demographic profile of deceased patients with coronavirus disease in a tertiary care centre of central India

2021 ◽  
Vol 8 (5) ◽  
pp. 2474
Author(s):  
Rupali A. Patle ◽  
Ashok R. Jadhao ◽  
Priya B. Dhengre ◽  
Manjusha A. Dhoble
Keyword(s):  
Clinical Characteristics ◽  
Tertiary Care ◽  
Case Fatality ◽  
Central India ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Difference

Background: The covid pandemic started from Hubei, Wuhan in December 2020 then covered many other countries including India. Understanding the demographic and clinical characteristics of deceased COVID-19 patients could inform public health interventions focusing on preventing mortality due to COVID-19. The present study was done with the objective of studying the socio-demographic and clinical profile of deceased patients with coronavirus disease.Methods: This is a hospital based cross-sectional study on 1190 deceased patients of coronavirus disease in a tertiary care hospital of central India which is a dedicated covid hospital from 11 March 2020 to 28 February 2021. Socio-demographic and clinical characteristics of deceased patients were recorded.Results: Overall case fatality rate was 13.24%. Maximum number of deaths occurred in the month of August 2020 and September 2020 were 372 (31.26%) and 477 (40.08%). It was higher in the males 791 (66.47%) as compared to females 399 (33.53%), but the difference was not significant. The most common symptom was fever on hospitalization 924 (77.65%), followed by generalized weakness 771 (64.79%). 352 (29.58%) patients died within 24 hours of the admission to hospital. Hypertension and type 2 diabetes mellitus were the most prevalent morbidity in 557 (46.80%) and 357 (30.00%). It was found that 232 (19.50%) deceased patients had oxygen saturation less than 50% on admission.Conclusions: Higher age and presence of co-morbidities at the time of admission were significantly associated with mortality.

scholarly journals Clinical Spectrum and Management of Diabetic Ketoacidosis: Experience in A Tertiary Care Hospital

2012 ◽  
Vol 1 (1) ◽  
pp. 15-20
Author(s):  
MA Rahim ◽  
KN Uddin ◽  
S Zaman ◽  
AKM Musa ◽  
MR Rahman ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Electrolyte Imbalance ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Metabolic Complication

Background: Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes mellitus (DM). It may be the presenting feature in type 1 DM, but more commonly it complicates previously diagnosed diabetic patients, both type 1 and type 2. If not recognized early and treated in a judicious way the outcome is often fatal. Objectives: The objectives of this study was to see the common presenting features of DKA, their precipitating causes, patterns of electrolyte imbalance, treatment requirement in early hours and to see the outcome. Materials and methods: This cross sectional study was done in BIRDEM General Hospital on fifty adult patients who presented with DKA over a period of nine months (January 2007 to September 2007). Results: Total number of patients were 50, male were 24 and female were 26 (M:F =12:13). Mean age was 27.6 ± 3.7 years. The incidence of DKA was more in known diabetic patients (32, 64%), in comparison with new cases (18, 36%). Frequency was more in poor village people (31, 62%). Vomiting (24, 48%) was the most frequent complaint, followed by fever (19, 38%), nausea (16, 32%), abdominal pain (14, 28%), weakness (13, 26%), polyuria (12, 24%) and polydypsia ( 8, 16%). Infection (18, 36%) was the most common precipitating cause, closely followed by inadherence to insulin therapy (17, 34%). In 12 (24%) cases no cause could be identified. Glycaemic control was poor, HbA1c was >7% in 98% cases. Severe acidosis (pH < 7) was less common (4, 8%) and gross electrolyte imbalance was uncommon but all patients required potassium supplementation in course of treatment. Neutrophilic leukocytosis was present in 44 (88%) cases, irrespective of presence of infection. Mortality was low (3, 6%). Conclusion: Diagnosis and treatment of DKA is not difficult if recognized early. So, high index of suspicion is necessary, particularly in previously undiagnosed cases. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12380 Birdem Med J 2011; 1(1): 15-20

scholarly journals Spectrum of Bacterial Co-Infections of the Lower Respiratory Tract in COVID 19 Patients Admitted to the ICU of a Tertiary Care Hospital

2021 ◽  
pp. 99-109
Author(s):  
Shoaib Khan ◽  
Asifa Nazir ◽  
Humaira Bashir ◽  
Umara Amin
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Bronchoalveolar Lavage ◽  
Lower Respiratory Tract ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Rt Pcr ◽  
Endotracheal Aspirate ◽  
Cross Sectional

Aims: We aimed to evaluate the burden of bacterial co-infections in patients with COVID-19 and to ensure judicious use of antibiotics. Study Design: Hospital based, cross sectional study. Place and Duration of Study: Postgraduate department of Microbiology, Government Medical College, Srinagar, and associated hospitals, between July 2020 and February 2021. Methodology: A total of 70 patients diagnosed with COVID-19 by RT PCR of nasopharyngeal/oropharyngeal samples were included in the study. Lower respiratory specimen like endotracheal aspirate (ETA), sputum, and bronchoalveolar lavage (BAL) from COVID-19 patients admitted in the ICU were collected as per standard protocol and subjected to quantitative cultures in the laboratory. Antimicrobial susceptibility testing was carried out in line with CLSI recommendations. Results: Of the 70 lower respiratory tract specimens (Endotracheal aspirate n=53, sputum n=15, and Bronchoalveolar lavage n=02) taken from RT-PCR confirmed COVID-19 patients, 51 (72.9%) showed microbiological evidence of bacterial infection by culture positivity. 28/51 (55%) were males and 23/51 (45%) were females, mean age was 54 years (range= 16-85 years). Majority of the organisms recovered (n=51, 83%) were Gram-negative bacilli, among which Acinetobacter spp. (n=27, 53%) followed by Klebsiella pneumoniae (n=06, 12%) were the most common. Among Gram positive organisms, methicillin resistant Staphylococcus aureus and Enterococcus sp were most commonly isolated. Conclusion: It is evident from our study that superinfection in COVID-19 patients due to Acinetobacter baumannii and Staphylococcus aureus is of serious concern. Timely treatment of these infections is pivotal to decrease the morbidity and mortality rates in COVID-19-infected patients.

scholarly journals Prevalence of Diabetes and Dyslipidemia in Hypertensive Young Adults in a Tertiary Care Centre in Nepal, a Cross Sectional Study

2020 ◽  
Vol 42 (2) ◽  
pp. 21-25
Author(s):  
Kamal Sharma Lamsal ◽  
Keshab R Neupane ◽  
Niranjan Acharya ◽  
Dinesh K Lamsal ◽  
Niraj Karmacharya ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Cardiovascular Complications ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Increased Risk

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the aver­age was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.

scholarly journals Viral clearance in COVID-19 patients admitted in designated COVID hospital in Western India

2021 ◽  
Vol 8 (9) ◽  
pp. 4303
Author(s):  
Harpreet Singh ◽  
Kanwaljit Kaur ◽  
S. K. Ghai ◽  
Pranaya Gurmeet ◽  
Raju Agarwal ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Viral Clearance ◽  
Care Hospital ◽  
Sectional Study ◽  
Rt Pcr ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Chi Square Test

Background: COVID-19 pandemic is one of the greatest challenges faced worldwide and has not only posed health crisis but also had social, economic and political devastating effects. The speedy transmission risk enforced bygone practices of quarantine of healthy persons and isolation of all positive patients. The basis of all key policy making is the understanding of virus clearance from the body so that transmission can be ceased. The aim of the study was to understand the viral clearance and its’ co-relates for guiding infection control and transmission practices in COVID-19.Methods: Cross sectional study in a tertiary care hospital. A cross-sectional study of total 398 patients admitted for COVID-19 between June 2020 and November 2020 at a tertiary care centre. Statistical analysis used: frequency, percentage, and chi square test Chi square test for linear trend and was used to find association.Results: 88.19% were males and 11.81% were female patients, mean age of study participants was 34.84 years. 61.56% were symptomatic and among them 1.64% presented with severe symptoms. Mean duration to turn RT-PCR negative was 11.83 days. No significant difference in time taken to turn RT-PCR negative among asymptomatic and symptomatic cases is suggestive of no difference in viral load and its clearance in symptomatic vs asymptomatic cases.Conclusions: The disease profile of COVID-19 in our setup was alike the national disease profile and the recovery rate being 98.76%. Presence of co-morbidities affects viral clearance in COVID-19.

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