scholarly journals Risk factors which affect the change of antibiotics in neonatal pneumonia observed in a tertiary care hospital

2015 ◽  
Vol 6 (1) ◽  
pp. 21-24
Author(s):  
Mirza Md Ziaul Islam ◽  
M Monir Hossain ◽  
Md Abdullah Al Mamun ◽  
Salahuddin Mahmud ◽  
BH Nazma Yasmeen
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Rural Areas ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Laboratory Parameters ◽  
Medical College

Background : Neonatal pneumonia accounts for significant morbidity and mortality specially in developing countries like Bangladesh. Perhaps because of its etiologic complexity, pneumomia in neonates has been relatively refractory to reduce its severity and improve the prognosis. Re- evaluation of the antibiotic therapy is necessary in patients to have at 48 hours after diagnosis. Physician should suspect inappropriate antibiotic therapy in cases with persistence of symptoms.Objective: This study was carried out to find the risk factors (clinical and laboratory parameters) which affect the change of antibiotic in neonatal pneumonia and its effect on morbidity and mortality .Methodology: This prospective observational study was conducted in Dhaka Shishu (children) Hospital from July 2009 to June 2010. A total of 115 neonates who met the inclusion criteria were enrolled in the study. The neonates were managed using a standard protocol. They were closely followed up to see the outcome with the change in antibiotics.Results : Total 115 neonates were admitted with mean age 16.2±5.9 days, mean weight 2857.6±580.6gm,58% were male & 42% female,26% were preterm & 74% were term and majority of them (73%) were from rural areas. Among the neonates, 36 (31,3%) needed a change in antibiotics. Fever, positive CRP, low O2 saturation, low PaO2 , high alveolar-arterial O2 gradient, low arterial-alveloar O2 tension and low pH were significantly associated with change in antibiotics.Conclusion : Addressing the clinical and laboratory parameters appropriately the change in antibiotic in selected cases can reduce both morbidity and mortality of neonates with pneumonia.Northern International Medical College Journal Vol.6(1) 2014: 21-24

A STUDY ON ASSESSMENT OF RISK FACTORS, COMPLICATIONS AND QUALITY OF LIFE OF PATIENTS WITH HYPOTHYROIDISM IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 38-40
Author(s):  
CH. Sridev ◽  
Samhitha Karnati ◽  
Likhitha Madari ◽  
Liyaqath Ali ◽  
Raviteja Nethula
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Total N ◽  
Sf 36 ◽  
High Bmi

Background: Hypothyroidism is a syndrome which results from decreased production of thyroid hormones from thyroid gland and hence it can also be termed as underactive thyroid disease. Objectives: To assess the quality of life in patients with denovo hypothyroidism. To assess risk factors, complications in patients with hypothyroidism. Materials and methods: There was a total (N=100) number of participants enrolled in the study and are evaluated for risk factors and complications and among 100, 40 patients are Denovo hypothyroid who are assessed for quality of life. This is a prospective observational study in which the risk factors, complications and quality of life of patients is evaluated for those patients who are willing to give informed consent and meet the inclusion criteria. Results and Discussion: Referring to the ndings, the patients with high BMI, females and age around 20-30 are more prevalent. Patients who do not adhere to medications develop complications such as goiter and cvs problems but mostly obesity is seen and QOL of patients was studied using SF-36 and HADS scales. The initial mean was found to be less compared to the nal mean in SF-36 whereas in HADS the initial mean is high compared to the nal mean. The Patient's BMI was high initially and then reduced to normal.This implies that after educating the patient about the disease and need of medication the nal result shows there is improvement in the patient's QOL. P values of SF 36 and HADS are 0.0001 and 0.0314 respectively, which by conventional criteria was found to be statistically signicant. Conclusion: This study simply showed that the females, patients with high BMI and age around 20-30 are the major risk factors. Proper patient education, care and medication adherence are the cornerstones to help avoid complications and improve patients quality of life.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

scholarly journals Assessment of adverse drug reaction profile of the disease-modifying anti-rheumatic drugs at the department of orthopaedics in a tertiary care hospital, Silchar, Assam, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1007
Author(s):  
Vijoy S. Kairi ◽  
Pinaki Chakravarty ◽  
Arun Kumar Sipani
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Case Record ◽  
Medical College ◽  
Disease Modifying ◽  
Reaction Profile

Background: The mainstay of treatment of Rheumatoid Arthritis (RA) is the use of the disease-modifying anti-rheumatic drugs (DMARDs). Methotrexate, sulfasalazine and hydroxychloroquine are some of the DMARDs which are used in combination for the treatment of RA. The current study was undertaken to assess the adverse drug reactions (ADRs) of DMARDs that are commonly encountered with the treatment of RA.Methods: The present study was designed as a prospective, observational study on newly diagnosed patients with RA. Patients diagnosed with RA above 18 years (excluding pregnant women) of either sex who were prescribed DMARDs in combination were included. ADRs reported spontaneously by the patients and also responses obtained in a questionnaire related to likely ADRs from the patients was recorded in the case record form. Statistical analysis was done using graph pad and p value <0.05 was considered to be statistically significant.Results: A total of 47 patients attending the Outpatient Department of Orthopaedics, Silchar Medical College and Hospital, Silchar, Assam, India were screened for the study. ADRs were monitored up to the last visit on 41 patients excluding the patients who were lost and who were not able to adhere to the treatment. A total of 27 ADRs were reported from 19 ADR forms. Gastrointestinal manifestations were the most common adverse effects of combination DMARDs seen in 10 patients (24.39%). Severity assessment done using modified Hartwig and Siegel scale that showed majority of the ADRs were mild (74.07%).Conclusions: Present study showed that DMARDs are well-tolerated and have an acceptable toxicity profile as majority of ADRs seen were mild. It was however difficult to prevent the occurrence of ADRs. Proper monitoring of therapy is needed for early recognition of ADRs.

scholarly journals AN OBSERVATIONAL STUDY OF CESAREAN TRENDS AT A TEACHING HOSPITAL IN PUNJAB

2021 ◽  
pp. 109-113
Author(s):  
SUPARNA GROVER ◽  
SUNITA MEENA ◽  
AJAY CHHABRA
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Caesarean Delivery ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Medical College ◽  
Government Hospitals ◽  
Patient Groups ◽  
Group 5

Objectives: The objective of the study was to study the indications and risk factors for caesarean section (CS) and to study the caesarean rates in various patient groups as per Robson’s classification. Methods: This prospective observational study was conducted at Government Medical College Amritsar over a period of six months. All the patients admitted for delivery beyond 22 weeks were allotted to Robson groups on admission and the indications of all CS were recorded. The data collected were tabulated and analyzed statistically. Results: There were 553 deliveries in the study period, of which there were 241 CS amounting to a caesarean rate of 43.6%. Nulliparity, previous caesarean delivery and malpresentation were significant risk factors for CS but induction of labor was not associated with increased probability of caesarean delivery. Previous caesarean delivery was the most common indication of CS followed by foetal distress. Among Robson groups, group 10 had the biggest group size and biggest contribution to cesarean rates followed by group 5. Conclusion: Tertiary care government hospitals have a higher cesarean rates due to referral of high-risk pregnancies. Increasing the rates of trial of labour after caesarean is one of the interventions that may serve to decrease the caesarean rates in such institutions.

scholarly journals Study on Risk factors, presentation and management of stroke in a tertiary care hospital

2014 ◽  
Vol 2 (1) ◽  
pp. 35-43
Author(s):  
S Sapkota ◽  
H Chhetri ◽  
RP Sharma
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Tertiary Care ◽  
Medical Science ◽  
Developed Countries ◽  
Health Condition ◽  
Care Hospital ◽  
Management Pattern ◽  
Medical College ◽  
The Developed Countries

Background and Objectives: Many studies in recent years have focused attention on identification of risk factors associated with stroke. However, most of these studies have been conducted in the developed countries. Only few studies have been conducted in Nepal. So the present study has been undertaken with the aim of determining the risk factors and management pattern of stroke and makes the people aware of those factors. Material and Methods: It is a descriptive prospective study conducted with 50 consecutive patients who presented in medicine and emergency department at Universal College of Medical Science, Bhairahawa, Nepal from December 2009 to July 2010. Data were collected using a standard questionnaire and encounter form after receiving a verbal consent from the patient. The collected data were coded, tabulated and analyzed using SPSS version- 16. Results: The present study showed that 56% of stroke patients were male. Hemorrhagic stroke (60%) was more than the ischemic stroke (40%).The age was common non modifiable risk factor. The common–modifiable risk factors were hypertension (86%), alcohol consumption (74%) and smoking (56%). Calcium channel blocker (44.18%) and combination of it with Diuretic (18.60%) and ACE inhibitors (20.93%) were the commonly prescribed drugs for lowering blood pressure. Prescribed drugs therapy and lifestyle modification improved the health condition of patients (80%). The non compliance to the drugs was due to multiple dosages (51.52%), side effects (18.18%) and forgetfulness (18.18%). Conclusion: Finding of this study will be helpful for the practitioners as well as researcher in the future. Practitioners can make people aware on the risk factors and preventive measures of the stroke. Researchers will be helped by knowing the commonest risk factors of stroke and its management pattern. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11394 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 35-43

scholarly journals Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon

2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Brazilian Amazon ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Laboratory Parameters ◽  
Hiv Aids

Abstract Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.

scholarly journals Whipple's pancreaticoduodenectomy: perioperative outcomes in a tertiary care hospital in Dhaka, Bangladesh

2021 ◽  
Vol 9 (3) ◽  
pp. 696
Author(s):  
A. B. M. Bayezid Hossain ◽  
Sadia Afroz ◽  
M. Tasnimul Khair Shovon ◽  
Nabila Anjuman ◽  
Mitul Chackraborty
Keyword(s):  
Mortality Rate ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Perioperative Outcomes ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Presenting Symptoms ◽  
Critical Care Management ◽  
Considerable Morbidity

Background: Pancreaticoduodenectomy is one of the most complex surgery with significant mortality and morbidity. Though the mortality rate has steadily improved, morbidity continues to be high. The aim of this study was to demonstrate the perioperative outcome following this procedure at our hospital.Methods: This retrospective study was conducted in the department of Surgery, Sir Salimullah medical college and Mitford hospital from July 2018 to December 2019. A total of 29 patients who undergone pancreaticoduodenectomy were included in the study. Preoperative, intra-operative and post-operative data were analyzed with emphasis on the morbidity and mortality rates. None of the operated patients received any types of neoadjuvant therapy.Results: Out of 29 patients who underwent PD, 18 (62.1%) were male and 11 (37.9%) were female with a median age of 53.7 years. The most common (34.5%) age group of the patients were 51-60 years. Jaundice was the commonest (89.7%) presenting symptoms followed by anorexia (75.9%) and abdominal pain (48.3%). Overall complications occurred in 37.9% patients, including wound infections (31.0%) and post-operative pancreatic fistula (6.9%). The post-operative mortality rate was 6.9%.Conclusions: PD still causes considerable morbidity and mortality. With careful patient selection, adequate preoperative preparation, surgical technique, excellent critical care management PD can be performed safely. At our center we have a reasonable volume and our data are comparable to literature data. 

scholarly journals Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1289
Author(s):  
Murali Thandavarayan ◽  
Sureshkumar Ramaswamy ◽  
Priyadarsini Bose ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Time Of Arrival ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children. 

scholarly journals A Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh

2014 ◽  
Vol 13 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
History Of

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993  

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