Psychiatric Co-morbidity in Geriatric Medical Outpatients of Tertiary Care Hospital

2017 ◽  
Author(s):  
S N Shah ◽  
N D Desai ◽  
P D Chvavda ◽  
E R Sharma ◽  
S H Shah
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Co Morbidity ◽  
Medical Outpatients

scholarly journals A study on seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India with maternal and perinatal outcomes

2018 ◽  
Vol 7 (6) ◽  
pp. 2429
Author(s):  
Shruthi M. N. ◽  
Srinivas K. Jois
Keyword(s):  
Vertical Transmission ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Obstetric Outcomes ◽  
Care Hospital ◽  
Adequate Treatment ◽  
Co Morbidity

Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced.

Comparison of Predictors of Mortality between Young and Elder Covid-19 Patients Admitted in Covid-19 Designated Tertiary Care Hospital

Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 46-54
Author(s):  
Sonal Shah ◽  
Manisha Kapdi ◽  
Jyoti Vora ◽  
Kuldeep Joshi ◽  
Pratik Patel ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Facility ◽  
Health Care Facility ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Predictors Of Mortality ◽  
Co Morbidity

Background: The outbreak of Covid-19 has led to a health emergency and economic crisis worldwide. Mortality in productive age further worsens the crisis, so it is important to understand reasons for death in productive age group. Objective: To identify predictors of mortality and to compare the intensity of rise in inflammatory markers of amongst young Covid-19 decedents in comparison with elder Covid-19 decedents. Method: Record based study of Covid-19 infected admitted patients was conducted in tertiary care hospital. Information of all (n=3131, 209 deceased and 2922 recovered patients) Covid-19 positive patient assessed . Their clinico epidemiological markers were compared between younger (18-45 years) decedents in comparision with elder decedents (>45 years). Mann–Whitney U-test and the Chi-square test for significance were used. Bivariate Multiple logistic regression was used to identify predictors in younger and elder decedents. Results: Case Fatality Rate (CFR) in Covid-19 infected patients was 2.4% and 9.7% amongst younger and elder group respectively. (OR 8.83 : 95% CI 5.9-13.2; p < 0.001). Biomarkers were raised and similar in both groups except Neutrophil Lymphocyte Ratio (NLR) was significantly higher in elder decedent while LDH was significantly higher in younger decedents. Conclusions: Males had higher CFR than females after 45 years of age, which was due to co-morbidity. Reaching late to the health care facility and high LDH were predictors in younger decedent, while male gender, co morbidities and high NLR were more important predictors in elder group.

scholarly journals Guideline adherence and control of diabetes mellitus with or without co-morbidities in various wards of a tertiary hospital in Malaysia

2014 ◽  
Vol 3 (8) ◽  
pp. 309-312 ◽  
Author(s):  
Muhammad Zahid Iqbal ◽  
Muhammad Shahid Iqbal ◽  
Dayana Nicholas ◽  
Jamaluddin Awang ◽  
Amer Hayat Khan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
General Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Negative Association ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Co Morbidity

To assess the adherence of physicians involved in the management of diabetes mellitus with or without co-morbidities with reference to Clinical Practice Guideline 2009 given by Ministry of Health Malaysia in the tertiary care hospital, Pinang General Hospital Malaysia. Cross-sectional study was done at tertiary care hospital, Penang, Malaysia. The total 51 physicians and 1020 patient’s prescriptions written by same physicians were taken from the record of the Penang General Hospital (20 prescriptions for each enrolled physician). All 1020 patients were suffering from diabetes mellitus with or without co-morbidities. These patients were recruited from the different wards of the Penang General Hospital. Depending on the recommendations of CPG 2009 the prescriptions of patients were divided into adherent and non-adherent prescriptions. The overall good level of physician adherence was seen with respect to the recommendations of CPG 2009 in all prescriptions. A statistically significant negative association (?= 0.094, p-value=0.003) was observed between diabetes mellitus control and co-morbidities. CPG adherent had statistically weak negative association (?= -0.081, p-value=0.010) with patients having co-morbidities. No statistically significant association was observed between CPG adherence and any other co-morbidity. The study explored the several features of prescription pattern of physicians involved in the management of diabetes mellitus with or without co-morbidities and recognized the need for improvement in their prescription pattern for treating the diabetes mellitus.DOI: http://dx.doi.org/10.3329/icpj.v3i8.19405 International Current Pharmaceutical Journal, July 2014, 3(8): 309-312

scholarly journals A descriptive study of COVID-19 at a tertiary care hospital

2021 ◽  
pp. 48-51
Author(s):  
Amit Mittal ◽  
Manoj Kumar Singh ◽  
Rajeev Kumar ◽  
Deepti Mandsorwale
Keyword(s):  
Median Duration ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Data Entry ◽  
Descriptive Study ◽  
Study Data ◽  
Care Hospital ◽  
Duration Of Stay ◽  
Co Morbidity ◽  
Novel Coronavirus

Coronavirus disease 2019 (abbreviated “COVID-19”) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The cases of COVID-19 infection since then were showing increasing trend in all over the world. The aim: to study the epidemiological distribution and determinants of COVID-19 pandemic. Methods: it is a descriptive study carried out at a tertiary care hospital of India. The population comprised of patients admitted in the hospital. Sample size comprised of all the subjects admitted in the hospital with established COVID 19 +ve cases. The duration of study was April 2020 to June 2020. The study was approved by the Institutional Ethical committee and Informed consent was obtained from each subject before the conduct of the study. Data collection was done by a pre-structured questionnaire. Data entry and analysis was done using SPSS version 20 software. Results: out of total 38 COVID-19 +ve cases, 95 % were male and 5 % female ant the maximum numbers of cases ranges between 36–40 years of age group with the median age of 32 years.53 % of cases were Muslim and 47 % Hindu by religion. The median duration of stay in hospital of all COVID-19 +ve cases was11 day that on further differentiation with co-morbidity was 15 days and 11.5 without any co-morbidity. The median duration taken between 1st sample taken and report provided was 2 days, between 2nd sample taken and report provided 1 day and between 1st and 2nd sample taken was 11 days. Conclusions: present study concluded that middle age persons were affected in majority which may be due to more exposure to public places. Co-morbidities are strong predictors of requirement for admission and duration of stay at hospital

scholarly journals Demographic and Clinical Status of COVID-19 Patients in a Tertiary Care Hospital in Chengalpattu District, Tamil Nadu: An Observational Study

2020 ◽  
Author(s):  
P Getrude Banumathi ◽  
S Sujatha ◽  
A Arul Murugan
Keyword(s):  
Observational Study ◽  
Tamil Nadu ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Case Fatality ◽  
World Health ◽  
Care Hospital ◽  
Age Group ◽  
Co Morbidity

Introduction: The ongoing outbreak of the coronavirus disease 2019 (COVID-19) infection has posed significant threats to international health and economy. On 30th January 2020, the World Health Organisation (WHO) declared it to be a Public Health Emergency of International Concern. Despite exponential rise of COVID-19 cases, there are limited studies on COVID-19, so an observational study to assess the demographic and clinical status of COVID-19 patients at a Tertiary Care Centre was conducted. Aim: To study the demographic and clinical status of COVID-19 patients in a tertiary care hospital in Chengalpattu district. To assess the co-morbid status and its influence on the outcome among the study population. To find the doubling rate and weekly trend of COVID-19 cases. Materials and Methods: A cross-sectional study was conducted in Chengalpattu Medical College Hospital, Chengalpattu district among the COVID-19 patients during April to June 2020. By non-probability sampling technique (convenient sampling), all the COVID-19 patients (n=3028) admitted in the institution during the study period were included. A semi-structured questionnaire was administered to collect the data.The questionnaire had three sections A, B, and C. Section A dealt with sociodemographic details, Section B with symptom status and co-morbidity status and section C with COVID test results. Ethical clearance was obtained from the Institutional Ethics Committee. Data was entered in MS Excel and analysis was done using SPSS Software. Results: In this study, there were 1932 (64%) males and 1096 (36%) females; 1489 (49%) were affected in the age group of 21-40 years, which was the most commonly affected group; 704 (23%) were in the age group above 50 years; 2574 (85%) of cases were from urban areas of Chengalpattu district; 1145 (38%) were found to be symptomatic, fever being the pre-dominant symptom 753 (66%); 712 (24%) of the patients were associated with co-morbid conditions, the most common being diabetes mellitus 391 (55%); mean duration of stay was found to be 9.21±3.26 days; doubling rate was found to be 18.91 days; the overall swab positivity rate was 14.56%; the overall case fatality rate was 2.47%; 3028 (59%) of the district cases were treated in the institution. Conclusion: This study found that the patients aged >50 years with co-morbidity are at a higher risk of mortality than others. The present work predicts that the number of cases double in 19 days. Hence, strict containment measures are recommended to lengthen the doubling rate.

scholarly journals Aetiology of new onset seizures in cases admitted to an intensive care unit of a tertiary care hospital: a two year study

2019 ◽  
Vol 6 (3) ◽  
pp. 744
Author(s):  
Ramesh Babu Pannem ◽  
Venkata Subrahmanyam Chintha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical History ◽  
Care Hospital ◽  
Generalized Seizures ◽  
Co Morbidity ◽  
A Prospective Study ◽  
New Onset

Background: Seizures are a common neurological disorder encountered globally in regular medical practice. Hospital onset seizures may occur in patients who never had a history of seizure before hospitalization and may be due to causes that lead to hospitalization or acquired during hospitalization like stroke, neuro infection etc. The objectives of this study were the purpose of the present study was to study the incidence and to describe demographic and clinical characteristics of patients developing new onset seizures in an intensive care unit of a tertiary care hospital.Methods: A prospective study for two years was conducted on cases of seizures admitted in an intensive care unit of a tertiary care hospital. The etiology of all the cases was recorded based on the clinical history and necessary investigations like EEG and imaging studies of the brain in cases if required.Results: About 238 cases with males 177 and females 61 cases were enrolled, and 31-50 years was most common age group. Diabetes was the most common co morbidity associated and generalized seizures were most common. CVA was most common etiology (26.89%) and idiopathic next common. Infarct was most common cause of CVA and meningitis in infections. Generalized tonic clonic seizures was most common in cases with CVA as the aetiology followed by infective cases.Conclusions: It is mandatory to deal cautiously and carefully the cases of seizures developing in an ICU in addition to proper history and examination, each patient must undergo detailed EEG, imaging investigations and other ancillary investigations if necessary.

scholarly journals Clinical and biomarker profile of COVID-19 patients admitted in a tertiary care hospital

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 268-273
Author(s):  
Archana Bhat ◽  
Don Gregory Mascarenhas ◽  
J Manjunath ◽  
Anand Kumar R ◽  
Sucharitha Suresh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
Clinical Signs And Symptoms ◽  
D Dimer

Introduction and Aim:A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19.   Materials and Methods:This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity.   Results:A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe groupwere19.03 vs 4.2, 1025cells/cumm vs 1740cells/cumm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively.   Conclusion:An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.

scholarly journals Retrospective study of clinical profile and management of patients with swine flu at tertiary care hospital

2018 ◽  
Vol 7 (1) ◽  
pp. 251
Author(s):  
Varuna Jethani ◽  
Rakhee Khanduri ◽  
Sushant Khanduri ◽  
Neha Taneja ◽  
Ankit Aggarwal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Swine Influenza Virus ◽  
Swine Influenza ◽  
Swine Flu ◽  
Common Symptom ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Co Morbidity ◽  
Bilateral Lung

Background: The first isolation of a swine influenza virus from a human occurred in 1974. There are no unique clinical features that distinguish swine influenza in humans from typical influenza. Thus, clinical course and management were recorded as per a planned pro forma and analysed. This type of study has not been done previously in Himalayan region.Methods: Retrospective observational study done in a group of patients diagnosed with swine flu admitted in department of pulmonary medicine at the tertiary care hospital from November 2016 to July 2017.Results: Out of 30 patients, 53.3% were male, mean age was 48.8±17.7, history of travel or contact to infected person was only 13.3%. Most common symptom recorded was fever (83.3%), followed by dyspnoea, cough, throat pain. Most common co-morbidity was diabetes and presence were significantly associated with admission in an ICU (P<0.05). Bilateral lung infiltrate seen in 53.3% on chest X-ray. Organ involved other than respiratory were renal followed by liver involvement. 40% of patients received corticosteroid for an average of 6days, mostly given in patients with sepsis, septic shock, multi organ involvement. Out of 40%, 16.6% patient expired, 6.6% left against medical advice and 16.6% were discharged, corticosteroid doesn’t help in reducing mortality.Conclusions: A multivariate model to identify independent predictors associated with mortality in swine flu were the use of vasopressor, respiratory failure, requirement of mechanical ventilation and number of organ failure. Use of corticosteroid is controversial.

scholarly journals Management of prostatic abscess, our experience over 5 year

2020 ◽  
Vol 7 (9) ◽  
pp. 2955
Author(s):  
Sanjay Lakshminarayan Paul ◽  
Manharsinh Rajput ◽  
P. M. Deka ◽  
Priyanku Pratik Sarma
Keyword(s):  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Specific Antigen ◽  
Generation Cephalosporin ◽  
Treatment Modalities ◽  
Perineal Pain ◽  
Care Hospital ◽  
Prostatic Abscess ◽  
Co Morbidity

Background: The objective of our study was to perform retrospective analysis of management of prostatic abscess in a tertiary care hospital in northeast India.Methods: This was a single tertiary care hospital based retrospective analysis of management of 24 patients diagnosed with prostatic abscess, between January 2015 and January 2020. Diagnosis of prostatic abscess was confirmed by trans-rectal ultrasonography (TRUS) and/or computed tomography (CT) scan/magnetic resonance imaging (MRI) prostate. Various treatment modalities used in our study were conservative, transurethral resection of prostatic abscess (TURP), TRUS-guided trans-rectal drainage/aspiration, trans-urethral drainage (TUD) + trans-urethral incision (TUI).Results: On analysing 24 patients diagnosed with prostatic abscess, mean age was 46.12 years (range, 17 to 73 years), the mean prostate-specific antigen (PSA) was 17.3 ng/ml (range, 2 to 40.0 ng/ml), mean prostatic abscess volume was 33 cubic mm (range, 10 to 75 gm). All patients were hospitalised, on admission all patients were started on intravenous antibiotics (3rd-generation cephalosporin along with an amino-glycoside) or antibiotics as per urine culture report. Diabetes mellitus was most common associated co-morbidity present in almost 50% of patients. Patients presented with dysuria (75%), urinary retention (29%) fever (25%) and perineal pain. Cases were managed by surgical approach after failure of conservative management.Conclusions: Early surgical intervention for prostatic abscess reduces morbidity and mortality associated with it. TRUS guided drainage can be performed under local anaesthesia, are better suited for small localised abscess but associated with increase hospital stay. Trans-urethral drainage are better suited for elderly patient with large prostate volume.

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