scholarly journals Serum Electrolyte Profile of Children Less Than Five Years of Age Admitted with Pneumonia in a Tertiary Care Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 59-62
Author(s):  
Abu Hena Mostafa Kamal ◽  
Sharmin Afrozy ◽  
Marjina Khatun ◽  
Mst Shaheen Nawrozy ◽  
Most Merina Akhter
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Distribution Patterns ◽  
Care Hospital ◽  
Medical College ◽  
Efficient Test ◽  
Hospital Stays ◽  
Delayed Recovery ◽  
Student’S T ◽  
Student’S T Test

The study was done to observe whether there is any association of pneumonia with hyponatraemia, as well as to have a view to the patients’ hospital-stay in this regard. This study was conducted from July 2009 to September 2011 at the Department of Biochemistry of Shaheed Ziaur Rahman Medical College (SZMC), Bogra. Total 35 cases, 1 month to 5 years of age, who suffered from pneumonia, were included in this study. Their serum Na+, K+& Cl- levels were measured and their hospital stays in days were recorded for the comparison between normonatraemics and hyponatraemics. The distribution patterns were described as percentage of total. In addition, Student’s ‘t’ test and Pearson’s correlation co-efficient test were also used. Among 35 cases, 22 (63%) cases were male and 13 (37%) cases were female; 14 (40%) cases were hyponatraemic and 21 (60%) cases were normonatraemic. Mean (±SD) of age was 19.6 (±15.2) months. For all the cases, there was a positive correlation of serum Cl– with serum Na+ levels (p<0.001); but no correlation was observed between serum K+& Na+ levels (P>0.10). Hospital stay of hyponatraemic cases was higher than the normonatraemic cases (P<0.05). Children with pneumonia may develop hyponatraemia, which if not managed in due time, may lead to delayed recovery from illness. TAJ 2018; 31(2): 59-62

scholarly journals Duration of Hospital Stay and Treatment Pattern among Patients Undergoing Common Operative Procedures at tertiary care hospital in Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 27-35
Author(s):  
Sanjay Chaudhary ◽  
Lokeshwar Chaurasia ◽  
Jitendra Kumar Singh
Keyword(s):  
Hospital Stay ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Treatment Pattern ◽  
Operative Procedures ◽  
Care Hospital ◽  
Third Generation ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Significant Difference

Background and Objectives: Appendectomy, cholecystectomy, fistulectomy, and herniotomy or herniorrhaphy are the most common surgical operations in Nepal. Despite the high prevalence and complexity of the patient population served by general and universal surgery services, little has been reported about the services, treatment procedures and outcomes. Therefore, the study is designed to investigate the duration of hospital stay, and treatment pattern among patients undergoing common surgical operative procedures at Janaki Medical College, Janakpur, Nepal. Material and methods: A prospective observational study was conducted among patients undergoing common surgical operative procedures at surgery department of Janaki Medical College (JMC) over a period of one year from January 2018 to December 2018. Patients of all age groups and gender undergoing surgical operative procedures; appendectomy, herniotomy cholecystectomy and fistulectomy were included in the study. The patients were assessed preoperatively, intra-operatively and postoperatively. Results: In a total of 325 patients, 11.1% of patients underwent fistulectomy, 14.5% underwent appendectomy, 35.4% underwent herniorrhaphy and 39.1% underwent cholecystectomy. Mean duration of stay at hospital for cholecystectomy was slightly higher (8.13±2.40 days) than other operating procedures: fistulectomy (5.44 ±1.48 days), appendectomy (7.40±2.00 days), and operative procedure of hernia (6.17±1.59 days). Most commonly used antibiotic for control of preoperative and post operative infection was third generation cephalosporin’s, ceftriaxone and cefixime. Conclusion: The study demonstrates longer duration of hospital stay for cholecystectomy as compared to other operating procedures like fistulectomy, appendectomy, herniorrhaphy, hernioplasty and herniotomy with significant difference by types of surgery. Most commonly used antibiotic for control of infection was third generation cephalosporin, ceftriaxone and cefixime.

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 ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Fatality ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Nasopharyngeal Aspirate ◽  
Prolonged Hospital Stay ◽  
College Hospital ◽  
Medical College ◽  
Prolonged Hospital

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

scholarly journals 1492. Comparison of Acute Cholangitis in Patients With or Without Cancer

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S543-S544
Author(s):  
Aurélien Sokal ◽  
Sylvain Chawki ◽  
Yann Nguyen ◽  
Alain Sauvanet ◽  
Philippe Ponsot ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care ◽  
Acute Cholangitis ◽  
Care Hospital ◽  
Reactive Protein ◽  
Cancer Management ◽  
History Of ◽  
Hospital Stays ◽  
Student’S T ◽  
History Of Cancer

Abstract Background Cancer-associated acute cholangitis (CAAC) are becoming more frequent and their characteristics may be changing with the evolution of cancer management. Our aim was to compare clinical, microbiological and outcome characteristics of CAAC to those of cancer-free acute cholangitis (CFAC). Methods All consecutive cases of acute cholangitis (AC) from November 2015 to March 2017 were collected retrospectively in a single tertiary care hospital in Clichy, France, specialized in gastroenterology. Hospital stays referred as AC by coding were screened. Patients fulfilling the 2018 Tokyo Guidelines diagnostic criteria for definite AC were included. Data were collected using a standardized form. CAAC were defined as AC that occurred in patients who had active cancer or history of cancer in the five previous years. CFAC were defined as AC in patient who no history of cancer, or in remission for more than 5 years. Comparison was made using Fisher or Student’s t-test. P < 0.05 was considered as significant. Results 156 episodes of AC in 130 patients were analyzed. 101 had CAAC and 55 had CFAC. Age and sex did not differ (table 1), but CAAC had a higher Charlson’s comorbidity index (4.4 vs. 1.7, P < 0.0001). Despite similar clinical presentation, CAAC had more pronounced cholestasis (Gamma GT 659 vs. 391UI/L; Alkaline phosphatases 526 vs. 309 UI/L; P < 0.0001 for both) and C-reactive protein level (133 vs. 97mg/L, P = 0.008, Table 2). E. coli was more common in CFAC (72.4% vs. 54% of positive blood cultures, P = 0.004). In bile cultures, Enterococci and multi-drug-resistant Gram negatives tended to be more frequent in CAAC than in CFAC (63 vs. 17%, P = 0.07 and 9.1% vs. 4.1%, P = 0.33, Table 2), respectively. CAAC more frequently required drainage (86.1% of cases vs. 43.6% in CFAC (P < 0.0001), including radiological drainage (42.5% vs. 12.5%; P = 0.008) and with multiple sessions (28.7% vs. 8.3%, P < 0.0001, Table 3). Antibiotherapy duration did not differ between the two groups. Despite similar initial severity, only 51.5% of patients with CAAC were alive, without febrile recurrence or other biliary drainage at day 28, vs. 85.5% of patients with CFAC (P < 0.0001, Table 3). Conclusion Despite comparable initial clinical presentation, management is more complex and outcome less favorable in CAAC vs. CFAC. Disclosures All authors: No reported disclosures.

scholarly journals A Study of D-Dimer Levels in Acute Febrile Non Covid Conditions in a Tertiary Care Hospital

2021 ◽  
pp. 137-141
Author(s):  
S. Caroline Sylvia ◽  
S. Vinoth
Keyword(s):  
Differential Diagnosis ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Acute Febrile Illness ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
A Prospective Study ◽  
D Dimer

Introduction: Acute undifferentiated febrile illness (AUFI) is caused by a multitude of diverse pathogens, with significant morbidity and mortality in the developing world. This study aims to highlight the gaps in our understanding of  the various differential diagnosis of acute febrile illness  and their prognostic outcomes. In this study, We used d-dimer levels to arrive at a differential diagnosis in acute febrile illness and also used it as a biomarker of disease severity and prognostic outcome. Materials and Methods: A prospective study was conducted at medicine department, Saveetha  medical college and hospital, Thandalam, India  for a period of 3 months from January 2020 - March 2020. Patients who presented to the medicine outpatient department with symptoms of acute febrile illness with non specific symptoms were registered after getting written consent in the study. The plasma concentration of D -dimer levels ,prothrombin time , APTT from which INR were measured. The duration of hospital stay of patients in study was recorded. The data collected was entered into an excel sheet and analysed using SPCC software. Results: A total of 50  patients with acute febrile illness were enrolled in the study. Out of which 37 patients (74./. of patients)  were found to have elevated D dimer levels. These 37 patients with elevated D – dimer levels required longer duration of hospital stay, reflecting the need for more days for recovery.

SEROPREVALENCE OF HIV AND HBsAg AMONGST BLOOD DONORS IN A TERTIARY CARE HOSPITAL, CHHATTISGARH.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Anusha P ◽  
Bankar Nandkishor J ◽  
Karan Jain ◽  
Ramdas Brahmane ◽  
Dhrubha Hari Chandi
Keyword(s):  
Hepatitis B ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Tertiary Care ◽  
Laboratory Diagnosis ◽  
Blood Bank ◽  
Care Hospital ◽  
Medical College ◽  
The World ◽  
First Time

INTRODUCTION: India being the second highly populated nation in the world. HIV/AIDS has acquired pandemic proportion in the world. Estimate by WHO for current infection rate in Asia. India has the third largest HIV epidemic in the world. HIV prevalence in the age group 15-49 yrs was an estimate of 0.2%. India has been classified as an intermediate in the Hepatitis B Virus (HBV) endemic (HBsAg carriage 2-7%) zone with the second largest global pool of chronic HBV infections. Safety assessment of the blood supply, the quality of screening measures and the risk of transfusion transmitted infectious diseases (TTIs) in any country can be estimated by scrutinizing the files of blood donors. After the introduction of the blood banks and improved storage facilities, it became more extensively used. Blood is one of the major sources of TTIs like hepatitis B, hepatitis C, HIV, syphilis, and many other blood borne diseases. Disclosure of these threats brought a dramatic change in attitude of physicians and patients about blood transfusion. The objective of this study is to determine the seroprevalence of transfusion transmitted infections amidst voluntary blood donors at a rural tertiary healthcare teaching hospital in Chhattisgarh. MATERIAL AND METHODS: This retrospective study was carried out in Chandulal Chandrakar Memorial Medical College, Kachandur, Durg. Blood donors were volunteers, or and commercial donors who donated the blood and paid by patients, their families, or friends to replace blood used or expected to be used for patients from the blood bank of the hospital. After proper donation of blood routine screening of blood was carried out according to standard protocol. Laboratory diagnosis of HIV 1 and HIV 2 was carried out by ELISA test. Hepatitis B surface antigen was screened by using ELISA. RESULTS: A total of 1915 consecutive blood donors’ sera were screened at Chandulal Chandrakar Memorial Medical College, blood bank during study period. Of these 1914 were male and 1 female. The mean age of patients was found to be 29.34 years with standard deviation (SD) of 11.65 Years. Among all blood donors in present study, 759(39.63%) were first time donors and 1156(60.37%) were repeated donors. 1 patient was HIV positive in first donation group while 3 (75%) were positive in repeat donation group. 7 (38.9%) were HBsAg positive in in first donation group while 11(61.1%) were positive in repeat donation group. Two patients in first donation group had dual infection of HIV and HBsAg. CONCLUSION: Seropositivity was high in repeated donors as compared to first time donors. The incidence of HIV is observed to be 0.2% and that of HBsAg is 0.94%. Strict selection of blood donors should be done to avoid transfusion-transmissible infections during the window period.

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

scholarly journals Tracheostomy in Postoperative Pediatric Cardiac Surgical Patients—The Earlier, the Better

2021 ◽  
Author(s):  
Chalattil Bipin ◽  
Manoj K. Sahu ◽  
Sarvesh P. Singh ◽  
Velayoudam Devagourou ◽  
Palleti Rajashekar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Nutrition Supplementation

Abstract Objectives This study was aimed to assess the benefits of early tracheostomy (ET) compared with late tracheostomy (LT) on postoperative outcomes in pediatric cardiac surgical patients. Design Present one is a prospective, observational study. Setting The study was conducted at a cardiac surgical intensive care unit (ICU) of a tertiary care hospital. Participants All pediatric patients below 10 years of age, who underwent tracheostomy after cardiac surgery from January2019 to december2019, were subdivided into two groups according to the timing of tracheostomy: “early” if done before 7 days or “late” if done after 7 days postcardiac surgery. Interventions ET versus LT was measured in the study. Results Out of all 1,084 pediatric patients who underwent cardiac surgery over the study period, 41 (3.7%) received tracheostomy. Sixteen (39%) patients underwent ET and 25 (61%) underwent LT. ET had advantages by having reduced risk associations with the following variables: preoperative hospital stay (p = 0.0016), sepsis (p = 0.03), high risk surgery (p = 0.04), postoperative sepsis (p = 0.001), C-reactive protein (p = 0.04), ventilator-associated pneumonia (VAP; p = 0.006), antibiotic escalation (p = 0.006), and antifungal therapy (p = 0.01) requirement. Furthermore, ET was associated with lesser duration of mechanical ventilation (p = 0.0027), length of ICU stay (LOICUS; p = 0.01), length of hospital stay (LOHS; p = 0.001), lesser days of feed interruption (p = 0.0017), and tracheostomy tube change (p = 0.02). ET group of children, who had higher total ventilation-free days (p = 0.02), were decannulated earlier (p = 0.03) and discharged earlier (p = 0.0089). Conclusion ET had significant benefits in reduction of postoperative morbidities with overall shorter mechanical ventilation, LOICUS, and LOHS, better nutrition supplementation, lesser infection, etc. These benefits may promote faster patient convalescence and rehabilitation with reduced hospital costs.

A STUDY OF THE MORPHOLOGY OF PLACENTA IN TERTIARY CARE HOSPITAL OF CENTRAL KARNATAKA, INDIA

2021 ◽  
pp. 51-53
Author(s):  
Saryu Sain ◽  
Tupakula Sharmila ◽  
Uttam Kumar ◽  
Anita Anita
Keyword(s):  
Tap Water ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Careful Examination ◽  
Minimum Length ◽  
Care Hospital ◽  
Dispersal Pattern ◽  
Medical College ◽  
Foetal Membranes ◽  
Morphology And Morphometry

Introduction: Placenta is a temporary structure, developed during Pregnancy and discarded at Parturition. Human Placenta is of Discoid and Haemo-Chorial type. It connects the foetus with the mother's womb. It is formed by the contribution of two Individuals - both Mother and Baby. At 1 term four- fth of Placenta is of foetal origin and one- fth is of maternal. Along with Amnion, Chorion, Allantois and Yolk sac, Placenta can also be considered as one of the foetal membranes, which acts as Nutritive and Protective to the developing Embryo. Method: - The present study was done on morphology and morphometry of 150 placentae carried at the Department of Anatomy, Basaveshwara Medical College & Hospital (BMCH), Chitradurga. The placentae were collected with prior ethical clearance and proper consent. Soon after the delivery the placental surface was washed thoroughly under running tap water which were then weighed, tagged and brought to the department of Anatomy, BMCH. The parameters like size, shape and attachment of umbilical cord were noted down. Gross examination was carried out according to the proforma. Result: - The maximum number of placentae belong to the range of 501-600 gms (38.7%). Least placental weight is recorded as 205 gms, showing dispersal pattern. The maximum recorded weight is 835 gms and the average being 491.4 gms. The majority of the placentae are discoid (63.3%). The minimum length recorded is 8.9 cms, maximum as 23.80 cms and the average being 18.3 cms. Conclusion: - Careful examination of Placenta can help in explaining adverse outcomes, their management in subsequent pregnancies and assessment of new born risk.

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