scholarly journals Persistent Symptoms in Post-COVID-19 Patients Attending Follow-Up OPD at Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu, Nepal

2021 ◽  
Vol 6 (3) ◽  
pp. 113
Author(s):  
Anup Bastola ◽  
Richa Nepal ◽  
Bikesh Shrestha ◽  
Kijan Maharjan ◽  
Sanjay Shrestha ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Long Term Effects ◽  
Persistent Symptoms ◽  
History Of ◽  
Polymerase Chain ◽  
Disease Hospital ◽  
Time Of Presentation

The long-term effects of COVID-19 among survivors is a matter of concern. This research aimed to study persistent symptoms in post-COVID-19 patients attending a follow-up clinic at a tertiary care hospital in Nepal. All patients, presenting to the outpatient clinic during the study duration of six weeks, with history of positive reverse transcriptase- polymerase chain reaction for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at least two weeks prior to presentation, were included. The duration of follow-up ranged from 15 till 150 days with the mean duration of 28 days after diagnosis of COVID-19. Of 118 patients, 43 (36.4%) had a history of mild COVID-19, 15 (12.8%) had moderate, and 60 (50.8%) had severe. At the time of presentation, 97 (82.2%) patients reported that they had at least one persistent/new symptom beyond two weeks from the diagnosis of COVID-19. Dyspnea, fatigue, chest heaviness, and cough were the commonest persistent complaints in 48 (40.7%), 39 (33.1%), 33 (28%), and 32 (27.1%) patients, respectively. The findings in our study highlight the need for extended monitoring of post-COVID-19 patients following discharge, in order to understand and mitigate long-term implications of the disease.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

scholarly journals Outcomes of pleural decortication in a tertiary care hospital of Telangana state

2020 ◽  
Vol 7 (4) ◽  
pp. 1009
Author(s):  
Madhusudan Kummari ◽  
Amaresh Rao Malempati ◽  
Surya S. Gopal Palanki ◽  
Kaladhar Bomma ◽  
Chakravarthy Goutham
Keyword(s):  
Postoperative Complications ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Air Leak ◽  
History Of ◽  
The Common ◽  
Lung Infections ◽  
Surgery Outcomes

Background: The objective of the study was to study the clinical profile, incidence of postoperative complications in patients undergoing pleural decortication.Methods: The subjects for the study were selected from the cases admitted in a single unit of Department of Cardiothoracic Surgery, Nizam’s Institute of Medical Sciences, Hyderabad during the period of 2016 to 2018 and due ethics committee approval was taken.  Collection of data is done from the database including admission record, ICU charts, discharge records and follow-up records. 50 patients underwent surgery. Outcomes and complications were analyzed for 3 years duration.Results: 50 patients were included in this study with different aetiologies that required pleural decortication. The average age of patients in our study was 34 years. Most patients in our study were male (80%) and had history of infection with tuberculosis (42%) and pyogenic (28%) infection. A few patients had history of trauma (12%). Most of the patients suffered from cough (88%), dyspnoea (74%), fever (82%) and haemoptysis (22%). The common postoperative complications we encountered were pleural air leak (37.5%) bleeding (25%) infection (25%) and recurrence (2%). Overall morbidity from pleural decortication was seen in 16 patients, and there was no mortality.Conclusions: The most common reason for pleural decortication is still empyema thoracis secondary to infection in the developing countries. Tuberculosis is still the most common cause leading to fibrothorax requiring pleural decortication followed closely by pyogenic lung infections and trauma.

scholarly journals Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

2022 ◽  
Author(s):  
Rajesh Verma ◽  
Rajarshi Chakraborty ◽  
Keerthiraj DB ◽  
Kingzang Wangda ◽  
Veerendra Verma ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Public Awareness ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Imaging Features ◽  
Initial State ◽  
Northern India ◽  
History Of

Abstract Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

Clinical profile and outcome of acute nephritic syndrome in children from a tertiary care centre in south India: a descriptive study

2017 ◽  
Vol 4 (3) ◽  
pp. 769
Author(s):  
Shemeena Valiyat ◽  
Harsha T. Valoor
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Nephritic Syndrome ◽  
Long Term Follow Up ◽  
Acute Nephritic Syndrome

Background: Acute nephritic syndrome (ANS) is major cause of morbidity in developing countries. This study is an attempt to evaluate the clinical characteristics, complications and outcome of acute nephritic syndrome.Methods:This hospital based descriptive study was conducted at a tertiary care hospital in Kerala, South India. 103 children with ANS were analysed. Detailed clinical examination and relevant laboratory investigations were done. These children were followed up for 1 year.Results: Out of 103 patients studied 64% were male and 36% were female. The peak age group was 6 to 8 years. Skin infection was the most common predisposing condition (68.9%). Hypertension was present in 60.1% of patients. 26.2% of patients developed complications. Of these Acute renal failures was the most commonly encountered complication (18.4%). Proteinuria (87.4%) and microscopic hematuria (80.6%) were the most consistent features.  82.5 % patients had low C3 at the time of diagnosis. Majority of patients with low C3 level had positive ASO titre. (p = 0.014). At 3month follow up C3 became normal in 95.2% of patients. At 3 months’ majority of patients with normal C3 had incomplete recovery. (p = 0.010). At the end of 12m, microscopic heamaturia was present in 4 patients, persistent hypertension in 2 patients, 11 patients had proteinuria. These patients are kept under long term follow up.Conclusions:Complications and morbidity is significantly high during the acute phase in ANS. This study highlights the need for long term follow up of these patients. 

Intravenous paracetamol for neonates: long-term diseases not escalated during 5 years of follow-up

2020 ◽  
pp. fetalneonatal-2020-319069
Author(s):  
Sanna Juujärvi ◽  
Timo Saarela ◽  
Tytti Pokka ◽  
Mikko Hallman ◽  
Outi Aikio
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Epidemiological Studies ◽  
Speech Disorders ◽  
University Hospital ◽  
Care Hospital ◽  
Intravenous Paracetamol

ObjectiveTo evaluate the long-term adverse reactions of paracetamol in children who required intensive care shortly after birth. Paracetamol is a widely used analgesic in neonates, but the long-term studies are lacking. Previous epidemiological studies have reported associations between early paracetamol intake and diseases in childhood.DesignFive-year follow-up cohort of children who required intensive care shortly after birth.SettingSingle tertiary care hospital; neonatal and paediatric intensive care units.InterventionsIntravenous paracetamol was administered for pain and discomfort to the neonates during their intensive care, while for the control infants, it was not available.Main outcome measuresThe primary outcome was the incidence of asthma; secondary outcomes were neonatal diseases and long-term morbidities (atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy). Long-term morbidities were adjusted based on antenatal and neonatal risk factors.ResultsWe screened all neonates admitted to the intensive care units soon after birth in Oulu University Hospital, Oulu, Finland, during 1 October 2007 to 31 December 2013. Altogether, 1552 infants needed intensive care. Of them, 735 (47%) were treated with intravenous paracetamol. We obtained their long-term data from the Finnish National Institute for Health and Welfare, including all physician-made diagnoses from all primary healthcare units and hospitals in Finland. We found no difference in the asthma incidence or in other long-term morbidities between paracetamol-treated and non-exposed infants.ConclusionsIntravenous paracetamol given to neonates did not associate with childhood disorders compared with the non-exposed infants during the 5-year follow-up. The previous hypothesis that early paracetamol use causes childhood morbidities was not confirmed.

scholarly journals Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Bryan Walker ◽  
Eric Heidel ◽  
Mahmoud Shorman
Keyword(s):  
Staphylococcus Aureus ◽  
Rare Complication ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Risk Patients ◽  
History Of ◽  
A Site ◽  
Lost To Follow Up

Abstract Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

Long-Term Complications of Osteocutaneous Free Flaps in Head and Neck Reconstruction

2020 ◽  
Vol 162 (5) ◽  
pp. 641-648 ◽  
Author(s):  
Brian Swendseid ◽  
Ayan Kumar ◽  
Larissa Sweeny ◽  
Mark K. Wax ◽  
Tingting Zhan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Perioperative Complications ◽  
Tertiary Care ◽  
Free Flaps ◽  
Head And Neck Reconstruction ◽  
Free Flap Reconstruction ◽  
Wound Breakdown ◽  
History Of

Objective To determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long-term complications and identify predisposing perioperative factors. Study Design A prospectively maintained database of free flaps performed at a single institution over a 10-year period was queried. Setting Single tertiary care referral center. Subjects and Methods In total, 250 osseous or osteocutaneous free flaps (OCFFs) for mandibular or maxillary reconstruction were analyzed. Data were collected on demographics, preoperative therapy, resection location, adjuvant treatment, complications, and subsequent surgeries, and multivariate analysis was performed. Subgroup analysis based on perioperative factors was performed. Results The median follow-up time was 23 months. In 185 patients with at least 6 months of follow-up, 17.3% had at least 1 long-term complication, most commonly wound breakdown, fistula or plate extrusion (13.5%), osteoradionecrosis or nonunion (6.5%), and infected hardware (5.9%). Prior chemoradiotherapy and cancer diagnosis predisposed patients to long-term complications. At the 5-year follow-up, 21.7% of patients had experienced a long-term complication. Conclusions Long-term complications after OCFF occurred in 17% of patients. In this series, a preoperative history of chemoradiation and those undergoing maxillary reconstruction were at high risk for the development of long-term complications and thus warrant diligent follow-up. However, OCFFs can often enjoy long-term viability and survival, even in the case of perioperative complications and salvage surgery.

scholarly journals Long-Term Clinical Outcomes of Peritoneal Dialysis Patients: 9-Year Experience of a Single Center from North India

2014 ◽  
Vol 34 (4) ◽  
pp. 426-433 ◽  
Author(s):  
Sanjay Vikrant
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
North India ◽  
Published Data ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Single Center

ObjectiveThere is a paucity of published data on the outcome of maintenance peritoneal dialysis (PD) since the initiation of continuous ambulatory PD (CAPD) in India in 1991. The purpose of this study is to report long-term clinical outcomes of PD patients at a single center.DesignRetrospective study.SettingA government-owned tertiary-care hospital in North India.PatientsPatients who were initiated on CAPD between October 2002 and June 2011, and who survived and/or had more than 6 months’ follow-up on this treatment with last follow-up till December 31, 2011, were studied.ResultsA total of 60 patients were included in the analysis. The mean age of the patients was 60.2 ± 9.2 years. The majority (65%) of the patients lived in rural areas. A high proportion (47%) were diabetic and 62% had ≥ 2 comorbidities. Total duration on peritoneal dialysis treatment was 1,773 patient-months (148 patient-years) with a mean duration of 29.6 ± 23 patient-months and median duration of 25 patient-months (range 6 – 110 patient-months). Overall patient and technique survival at 1, 2, 3, 4 and 5 years was 77%, 53%, 25%, 15%, and 10% respectively. Patient survival of diabetics vs non-diabetics at 1, 2, 3, 4, and 5 years was 68% vs 84%, 54% vs 53%, 14% vs 34%, 11% vs 19%, and 11% vs 13%, respectively. The mortality in non-diabetics (16/32) was less than that in diabetic (18/28) patients (p = not significant). The main cause of mortality in these patients was cardiac followed by sepsis. There were 58 episodes of peritonitis. The rate of peritonitis was 1 episode per 30.6 patient-months or 0.39 episodes per patient-year. Furthermore, the total number of episodes of peritonitis and number of episodes of peritonitis per patient were higher in the non-survival group (p < 0.05). The incidence of tuberculosis (TB), herpes zoster (HZ) and hernias was 15%, 10% and 5% respectively.ConclusionThe study reports long-term outcomes of the PD patients, the majority of whom were elderly with a high burden of comorbidities. There was a high proportion of diabetics. The survival of diabetic vs non-diabetic and elderly vs non-elderly PD patients was similar in our study. The mortality in non-diabetics was less than that in diabetic patients. TB and HZ were common causes of morbidity. Peritonitis was associated with mortality in these patients.

scholarly journals Umbilical endometriosis in a 42 years old parous woman: A Case Report

2018 ◽  
Vol 28 (1) ◽  
pp. 48-51
Author(s):  
Mosammat Nargis Shamima ◽  
Mohd Alamgir Hossain ◽  
Shahela Jesmin ◽  
Nargis Jahan ◽  
Arpita Das
Keyword(s):  
Case Report ◽  
Tertiary Care ◽  
Previous History ◽  
Needle Aspiration ◽  
Care Hospital ◽  
History Of ◽  
Needle Aspiration Cytology ◽  
High Resolution Ultrasonography ◽  
Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51

scholarly journals Percutaneous Vertebroplasty Using a Rotary Cutter for Treating Kümmell’s Disease with Intravertebral Vacuum Cleft

2021 ◽  
pp. E477-E482
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Long Term Follow Up ◽  
Kummell’S Disease ◽  
And Control ◽  
Kümmell’S Disease

BACKGROUND: Reported data indicate that the curative effect of percutaneous vertebroplasty (PVP) on the patients with intravertebral vacuum cleft (IVC) is worse than on those without IVC. OBJECTIVES: This study was to prospectively investigate the advantage of rotary cutter-PVP (RC-PVP) in patients with Kümmell’s disease with IVC. STUDY DESIGN: A prospective outcome study. SETTING: A tertiary care hospital. METHODS: Patients who underwent conventional PVP served as the control group. For the RC-PVP group, the rotary cutters were applied before the cement injection to destroy the IVC structure and the surrounding necrotic bone. The following data were compared between the two groups: the cement filling patterns, effective therapeutic rate, the pre- to post-procedural changes of spinal geometry, and the subsequent fractures. RESULTS: This study included a total of 64 patients (30 and 34 patients in RC-PVP group and control group, respectively). In the RC-PVP group, the cement in 26 cases was filled as a mixed pattern, while the filling pattern in the control group was mainly the cystic type (n = 31). There were no significant differences in the height restoration rate between the RC-PVP and control groups (32.7 ± 13.6 and 32.4 ± 13.9, respectively, P = 0.93). The RC-PVP group had a higher effective rate during the first week and the first month (93.3% vs. 70.6%, P = 0.02) and at 3 months (90.4% vs. 73.9%, P = 0.03). Long-term follow-up indicated that vertebral recollapse of the same treated vertebral body occurred in 5 patients after conventional PVP, which was not observed in the RC-PVP group. LIMITATIONS: The small number of included patients and no long-term follow-up. CONCLUSIONS: RC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications. KEY WORDS: Back pain, bone cements, osteonecrosis, vertebroplasty

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