scholarly journals Outcome of microbiologically proven pneumonia by nasopharyngeal aspirate of infant attending in a tertiary care hospital

2018 ◽  
Vol 9 (1) ◽  
pp. 267-270
Author(s):  
Marium Begum ◽  
Dipa Saha ◽  
Mahmuda Hasan ◽  
Wahida Hasin ◽  
Nadira Sultana ◽  
...  

Background : In Bangladesh, recent estimates suggests that 22% of under-five death and 13.1% of neonatal death is due to pneumonia. Its etiology usually remains unknown and problems is increasing with drug resistant infections.Objective : The aim of this study is to evaluate the outcome of microbiologically proved pneumonia of the infant by nasopharyngeal aspirate culture.Methods : This prospective study was conducted at the Department of Pediatrics and Neonatology, Addin Medical college hospital, Dhaka from January to July 2015. A total of 30 hospitalized infants of either sex with pneumonia fulfilling the WHO criteria and radiologically confirmed were enrolled in the study. Child with congenital heart disease or chronic respiratory disease, who did not give consent were excluded from the study. The study cases were divided into three groups on their final outcome as improved, not improved (prolonged hospital stay) and expired.Results : Among 30 study cases mean age was 39.7±45 days, most of them were male 19 (63%); case fatality rate was 10%. Organisms were isolated from 47.3% cases of nasopharyngeal aspirate culture, among them Gram-ve bacteria were 10 (34%), gram +ve 3 (10%) and fungal 1(3.3%). Mixed bacterial growth were 4(13%) and no growth were 12(40%) cases. Acinetobacter was found in 8 (26.7%), Coagulase negative staphylococcus 2(6.7%). Additionally, MRSA, pseudomonas and E.coli species were identified in 1 (3.3%), 1 (3.3%), and 1 (3.3%) of the cases respectively. All infant who had gram +ve 3(100%) and fungal 1(100%) growth on their nasopharyngeal culture were improved. On the other hand, among the gram –ve cases mortality rate was high 2(20%) and also required prolonged hospital stay 2(20%). Among the cases who had mixed organism 2(50%) of them were improved and 2(50%) required prolonged hospital stay. Majority of the cases were improved 10(83%) those who had no growth on their NPA culture followed by 1(8.3%) had prolonged hospitalization and 1(8.3%) was died.Conclusion : Infant with severe pneumonia having younger age were at greater risk of mortality. Gram – ve organism in nasopharyngeal aspirate culture indicated poorer outcome and required prolonged hospital stay.Northern International Medical College Journal Vol.9(1) July 2017: 267-270

Author(s):  
Rachana Kannambath ◽  
Rakhi Biswas ◽  
Jharna Mandal ◽  
Kolar V. Vinod ◽  
Biswajit Dubashi ◽  
...  

Abstract Context Clostridioides difficile infection (CDI) is one of the most common infectious causes of hospital-acquired diarrhea. The actual burden of the disease is underestimated in India due to inadequate diagnostic methods and limited studies conducted. Aims The aim of this study was to determine the burden and risk factors of CDI among patients with hospital-acquired diarrhea. Methods and Materials Stool specimen of patients (age > 1 year) with hospital-acquired diarrhea were screened for glutamate dehydrogenase antigen and toxin using an enzyme immunoassay. If both antigen and toxin were present, it was reported as positive for toxigenic CDI. Samples positive for antigen and negative for toxin were further tested with Cepheid GeneXpert assay for detecting the toxin producing gene. Results Of 75 patients (mean age 36.07 ± 20.79, 64% males), 14 (18.67%) patients were positive for toxigenic Clostridioides difficile (C. difficile) and 3 (4%) patients were nontoxigenic C. difficile. Addition of GeneXpert to the testing algorithm increased the yield of toxin detection in 5/14 patients who were negative by toxin assay. On analysis of risk factors, prolonged hospital stay was found to have significant association (p-value = 0.022). Patients with factors like intensive care unit stay, presence of diabetes mellitus as a comorbidity, and exposure to antibiotics like carbapenems and glycopeptides have been found to have a higher prevalence of CDI. Conclusions The prevalence of CDI in our population was 18.67% and the major risk factor associated was prolonged hospital stay. The addition of GeneXpert for the detection of toxin gene increased the yield from 12 to 18.68%.


2012 ◽  
Vol 1 (1) ◽  
pp. 19-23
Author(s):  
Rukhsana Parvin ◽  
Nazmul Haque ◽  
Naser Ahmed ◽  
Md Imran Ali ◽  
AKM Rafique Uddin

Background: Poisoning with various substances is a global problem. It is one of the most important reasons for emergency admission in the hospital. The earlier the initial resuscitations, gastric decontamination and use of specific antidotes, the better is the outcome. Epidemiology of poisoning differs from region to region. This study was carried out to determine the pattern and severity of poisoning in a tertiary care hospital. Objective: To characterize the poisoning cases admitted in Enam Medical College Hospital. Materials and Methods: All cases admitted to the emergency department of Enam Medical College Hospital during the period of April to December, 2010 were evaluated retrospectively. We reviewed data obtained from the hospital medical records and included the following factors: demographic characteristics, etiology and outcome of the acutely poisoned patients. Total 84 poisoning cases were found and they were included in the study. Results: The overall case fatality rate was 3.5%. More detailed data from 2010 reveals that two-thirds of the patients were 20-30 years old, 53% male and 47% female. Organophosphorus was the most common cause (73.9%) followed by unknown poisoning (9.5%), sedative (5.9%), harpic (4.7%), aluminium phosphide (2.4%), savlon (1.2%), paracetamol (1.2%) and amitryptiline (1.2%). 90.5% cases were suicidal and 9.5% were homicidal. Conclusion: This study provides important information on the characteristics of the poisoning in this region. Community education about the danger of the drugs and reduction of exposure to pesticides are recommended. DOI: http://dx.doi.org/10.3329/jemc.v1i1.11133J Enam Med Col 2011; 1(1): 19-23


Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 


2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women. 


2017 ◽  
Vol 6 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ashia Khatun ◽  
Khairun Nahar ◽  
Mst Nurunnahar Aktar ◽  
Fatema Mahbooba Akter ◽  
Habibur Rahman

Background: Patient's satisfaction over the health care services is very important issue in Bangladesh.Objective: The purpose of present study was to find out the level of satisfaction of women attending in the OPD of Obstetrics and Gynecology department at a tertiary care hospital in Dhaka.Methodology: This descriptive type of cross sectional study was carried out in the OPD of Obstetrics and Gynecology department at Dhaka Medical College from September 2011 to October 2011 for a period of one month. All the women attending in Obstetrics and Gynecology department in outdoor service at Dhaka Medical College Hospital, Dhaka with the age group of 22 to 40 years were selected as study population. A purposive sampling method was used to collect the data.Results: A total number of 200 cases were taken for this study. Highly satisfied over the services delivered by the doctors was reported in 135 (65.8%) cases and service of nurses was satisfied 111(55.8%) of cases. Satisfactory waiting time (two hours) was 143(7l.9%) of cases and the satisfactory hospital environment was 127 (63.8%) of cases.Conclusion: In conclusion most of the women are satisfied to the treatment delivered by the doctors at the OPD of a tertiary care hospital.J Shaheed Suhrawardy Med Coll, 2014; 6(2):79-81


2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117


2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31


2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.


2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77


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