STUDY OF TOXIN PRODUCTION IN PATIENTS WITH CLOSTRIDIUM DIFFICILE ASSOCIATED DIARRHOEA

2021 ◽  
pp. 167-168
Author(s):  
Sanjay Singh ◽  
Vaibhav Misra ◽  
Avtar Kishan Jaisinghani
Keyword(s):  
Tertiary Care ◽  
Toxin Production ◽  
Toxin A ◽  
Medical College ◽  
Severe Diarrhea ◽  
History Of ◽  
Stool Samples ◽  
Favorable Conditions ◽  
The Relationship ◽  
Clostridium Difficile Associated Diarrhoea

Introduction: Clostridium difcile infection (CDI) is dened as the presence of diarrheal symptoms and either a stool test result positive for C. difcile toxins or detection of toxigenic C. difcile, or colonoscopic ndings demonstrating pseudomembranous colitis. C.difcile produces toxin A (enterotoxin) and B (cytotoxin), under favorable conditions. Both toxins severely affect GIT. The relationship between the amount of toxins in the feces and the severity of symptoms has been found. Aim & Objectives : To detect C.difcile toxin production in stool samples with laboratory conrmed CDI and to correlate the presence of toxin with disease severity Material & Methods: A prospective laboratory based study done in a tertiary care Medical college and allied hospitals in Gwalior (MP) in a duration of 11 months, which included stool samples of 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected and correlated with the clinical condition. Toxin A & B study were performed on stool sample with ELFA (Enzyme Linked Fluorescent Assay) technology (VIDAS instruments). Results and Discussion: 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected in 08 patients. The toxin positivity rate was 6.79%. All of these hospitalized patients had severe diarrhea and history of administration of broad spectrum antibiotics Conclusion: Signicant toxin load in the fecal samples may be associated with the signicant deterioration of the general condition of the patient.

scholarly journals Thrombocytopenia in children: a clinico-etiological profile in an urban tertiary care hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 131
Author(s):  
Subramanian V. ◽  
Santosh Kumar K.
Keyword(s):  
Platelet Count ◽  
Viral Infections ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Induced ◽  
Medical College ◽  
Clinical Complications ◽  
Paediatric Department ◽  
The Relationship ◽  
Haematological Finding

Background: Thrombocytopenia is a common haematological finding that we come across while managing a sick child. Etiological profile and presentation of thrombocytopenia varies among children. The objective of this study was to study the clinical and laboratory profile of children with thrombocytopenia, associated clinical complications and assess the relationship between platelet levels and severity of disease.Methods: The study was carried out in 644 children between 1 month and 12 years, admitted in Paediatric Department of Raja Rajeshwari medical college and hospital, Bangalore between August 2012 to August 2014.Results: The commonest causes of thrombocytopenia in our study were of infectious aetiology (86.6%). Among Infections Viral infections were the major cause in more than 78% of cases. Other causes included haematological problems, drug induced thrombocytopenia and connective tissue disorders. Bleeding manifestations were present in 33.07% of patients and the commonest bleeds were skin and mucous membranes. Bleeding manifestations were seen most commonly in children with a platelet count less than 50000/µl.Conclusions: Viral Infections were the commonest cause for thrombocytopenia in Children. Platelet count was neither predictive of bleeding manifestations nor predictive of need for platelet transfusion.

scholarly journals VAGINAL DISCHARGE

2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI
Keyword(s):  
Vaginal Discharge ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Internally Displaced ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Medical College ◽  
Abnormal Growth ◽  
History Of

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. 

scholarly journals Accidental tramadol ingestion in children admitted in tertiary care centre

2019 ◽  
Vol 8 (12) ◽  
pp. 2661
Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra
Keyword(s):  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Care Centre ◽  
Medical College ◽  
History Of

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.

scholarly journals Cesarean scar defect and its association with clinical symptoms, uterine position and the number of cesarean sections

2020 ◽  
Vol 9 (10) ◽  
pp. 4091
Author(s):  
Madhangi V. B. ◽  
Ramany C.
Keyword(s):  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Multiple Logistic Regression Analysis ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
History Of ◽  
Caesarean Scar Defect ◽  
Relationship Of ◽  
The Relationship

Background: Caesarean scar defect (CSD), also called isthmocele or niche is a long-term complication, which can be asymptomatic or can give rise to chronic pelvic pain, dyspareunia and postmenstrual spotting. The objective of this study was to assess the association of CSD with clinical symptoms, position of the uterus and the number of caesarean sections.Methods: This was a prospective observational study done at a tertiary care teaching hospital from January 2019 to December 2019. The study included women with history of previous one or more caesarean sections with demonstrable CSD on transvaginal ultrasound. Various scar dimensions noted were width and depth of the scar. A deficiency ratio was calculated as a ratio of residual myometrium at the scar to the adjacent myometrium.Univariate analysis was done to assess the relationship of clinical symptoms with the defect parameters and number of previous caesarean sections. Multiple logistic regression analysis was done to find out the association between symptoms and number of previous caesarean sections with the scar defect dimensions.Results: The width, depth and deficiency ratio of the CSD were significantly higher in study subjects with a greater number of caesarean sections. Retroflexed uteri had larger CSD. There was no association of clinical features with the defect dimensions and the position of the uterus.Conclusions: CSD dimensions and deficiency ratio correlate with the number of previous caesarean sections and the position of the uterus. There was no association of clinical symptoms with the defect parameters.

scholarly journals Epidemiologic Characteristics of Patients Presenting with Head Injury due to Road Traffic Accident and Factors Associated with Outcome: Experience of a Tertiary Care Center in Northern Kerala

2019 ◽  
Vol 08 (01) ◽  
pp. 039-046
Author(s):  
Mandaka Rajeev ◽  
Vattaparambil Shinihas ◽  
Pankaj Chauhan
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Alcohol Intake ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Health Resources ◽  
Medical College ◽  
History Of ◽  
Limited Health

Abstract Background In India, most factors related to road traffic accident (RTA) causation and outcome go improperly documented, and database regarding RTA-related traumatic brain injury (TBI) seems inadequate. Two-wheeler drivers form the largest segment of people affected by RTA. The socioeconomic and neurologic burden, imposed by TBI due to RTAs (largely preventable), is overwhelmingly significant, especially for a developing country like India. Materials and Methods Descriptive study involving patients, presenting to the casualty of Government Medical College, Kozhikode, Kerala, was performed, and various demographic features were analyzed. Usage of helmet and history of alcohol intake were also noted. Patients were evaluated according to their presenting Glasgow coma scale (GCS), investigated and either operated or managed conservatively, and their outcome was assessed with Glasgow outcome score (GOS) at 3 months. Results Bike drivers formed the single largest proportion of RTA victims (53.7%). Proportion of helmet users was 17.9%, whereas 21.9% were found with history of alcohol intake. There was a consistent trend toward a favorable outcome in patients with no alcohol intake (17.08% deaths compared with 34.07% patients with alcohol intake) and with helmet usage (14.55% compared with 22.18% in patients without helmet). However, the absolute contribution of these factors cannot be inferred. Conclusion Various factors related to RTA need evaluation for pooling and compilation of data at regional and national levels. Mandatory helmet laws and strict implementation and provision of subsidized helmets (standard, full coverage) will go a long way in reducing the burden on limited health resources.

scholarly journals A Clinico-epidemiological Study of Malaria Patients Admitted in A Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Diagnostic Test ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Clinical Aspects ◽  
Case Report Form ◽  
Care Hospital ◽  
Mosquito Net ◽  
College Hospital ◽  
Medical College ◽  
History Of

Malaria is a public health problem in 90 countries around the world affecting 300 million people and responsible for about 1 million deaths annually. Bangladesh is considered as one of the malaria endemic countries in Asia. Every year large number of people suffered for malaria. But there is little studies about clinico-epidemiology of malaria. Aim: To study the epidemiological and clinical aspects of malaria. Methods: This is a Prospective observational study that was conducted in all medicine unit of Chittagong Medical College Hospital, Chittagong, Bangladesh during August 2017 to June 2018. Total 55 patients were included in the study having malaria diagnosed by blood slide examination or rapid diagnostic test. Patients were enrolled in this study after getting written informed consent from the patient or attendant. Detail demographic and clinical data were recorded in structured case report form. Patients were regularly followed up and outcome recorded. Results: Results showed males (65.5%) of 25±15.109 years of age were the main sufferer. Majority (45%) came from low socio-economic condition (<5000 taka/month). 65.5% patients denied any history of recent travel to malarias’ area. 69.1% cases give history of using mosquito net, but only 25.5% have insecticide treated mosquito net. Majority (89.1%) were diagnosed as severe malaria and only few (10.9%) as uncomplicated malaria. Most of the diagnosis done at Chittagong Medical College Hospital, mainly presenting with coma or altered consciousness and convulsion. At field level diagnostic test done in 67.27% cases, of which RDT in 14.5%, BSE in 45.5% and both in 7.3% cases. 78.2% cases outcome were good with improvement and death occurred in 21.8% cases, mainly due to acute renal failure. Conclusion: Though we are making significant effort to control malaria, still we have to improve in controlling malaria based on both preventing the infection and on prompt effective treatment of the infection and illness when it does occur.

scholarly journals Prevalence and Causes of Infertility in Overweight and Obese Women in a Tertiary Care Hospital Setup in Mangalore - A Retrospective Secondary Data Analysis

2021 ◽  
Vol 8 (29) ◽  
pp. 2656-2660
Author(s):  
Keerthana Dhandapani ◽  
Bhagyalakshmi Kodavanji ◽  
Vinodini N.A ◽  
Priyadarisini N.J ◽  
Shripad B. Deshpande
Keyword(s):  
Healthy Lifestyle ◽  
Tertiary Care ◽  
Secondary Data ◽  
Care Hospital ◽  
Obese Women ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Medical College ◽  
Ovulatory Dysfunction ◽  
History Of

BACKGROUND Obesity has become an epidemic worldwide. Several mechanisms are involved in the relationship of fertility and obesity, including metabolic and reproductive functions. In light of the fact that most of the causes of infertility are treatable, there is a need to document the diagnostic findings in overweight and obese infertile women. The causes of infertility prevalent in a particular region can be provided by hospital-based studies. So, the present study is designed to find out the common causes of infertility in overweight & obese women and to gain knowledge regarding the prevalence of primary and secondary infertility among these infertile women. METHODS The data of 115 infertile women (18 to 45 years) were collected from hospitals under Kasturba Medical College (KMC), Mangalore retrospectively. Data of history of previous conception, body mass index (BMI), type of infertility, duration of infertility, age and the causes of infertility were collected. The prevalence of each cause was evaluated. RESULTS Among 115 infertile women, 92 (80 %) were pre–obese and 23 (20 %) were obese (P - .001). Primary infertility was most common in pre obese women and secondary infertility in obese women which was statistically significant (P < .05). Ovulatory dysfunction was the most common cause in obese infertile women (P - .004), whereas in pre obese women, it was uterine and adnexal causes. CONCLUSIONS Comparatively, maintaining a healthy lifestyle can avoid fertility problems in pre obese women, because the effect of BMI on hypothalamic–pituitary-gonadal (HPG) axis is higher in obese women in whom ovulatory disorders were the leading cause. The significance of weight reduction before pregnancy should be informed to overweight and obese patients and should be aided to lose weight. Treatment of anaemia itself may resolve the infertility issues and should be taken as a first line treatment in all cases. KEYWORDS Female Infertility, Adipose Tissue, Obesity, Infertility Causes, Ovulatory Dysfunction

scholarly journals Epidemiological and clinical profile of various plant poisons in a tertiary care center in South Tamilnadu, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3517
Author(s):  
Meena Kumari ◽  
Pattu Swarna Latha ◽  
Kalyanasundaram .
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Tertiary Care Center ◽  
Active Components ◽  
Medical College ◽  
Suicidal Intention ◽  
History Of ◽  
Plant Constituents ◽  
Plant Poisoning

Background: Plant poisoning is a common scenario in a toxicology unit . Some of the plants contain active components used as medicines. However, some of the plant constituents are poisonous with wide variety of clinical manifestations. Authors aimed to study the pattern of various types of plant poisons and clinical presentations and complications of various plant poisons admitted in our toxicological unit.Methods: A total of 87 patients admitted with history of plant poison ingestion, in toxicological unit of Tirunelveli medical college were studied . It was a retrospective observational study and was done over a period of one year.Results:  Out of 87 cases studied, 92%were due to consumption with suicidal intention. Plant poisoning ranks second only to pesticide poisoning . among the plant poisons encountered 66.6% were due to Oleander poison, followed by Datura (8%) and Glory lily(5.7%). Common parts of plant consumed by patients include seeds and plant oils . Vomiting and abdominal pain were the commonest presentations. Encephalopathy, dyselectrolytemia and arrhythmias were the notable complications in our study.Conclusions: Early admission and prompt first aid and monitoring at tertiary care center are key to the reduced mortality. The study throws light on various manifestations, toxic parts and complications of plant poisons.

scholarly journals The nature of language problem in Bangladeshi children with cerebral palsy: an observation using neurolinguistic approach

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 22-27
Author(s):  
F Ferdous ◽  
MF Alam ◽  
MMR Chisty ◽  
JI Ali ◽  
NMW Rahman
Keyword(s):  
Cerebral Palsy ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Childhood Disability ◽  
Medical College ◽  
Complex Sentences ◽  
History Of ◽  
Children Development ◽  
Tertiary Care Hospitals

Cerebral palsy (CP) is the leading cause of childhood disability affecting function and development. The objective of the study was to look into the language problems in Bangladeshi children with CP on the basis of neurolinguistic approach and was conducted during the period of April 2014 to December 2014 at the Department of Linguistics, University of Dhaka among children aged between 3 to 18 years. In the study, a total of 10 children with CP were enrolled purposively from two tertiary care hospitals in Dhaka (Children Development Centre of Sir Salimullah Medical College and Mitford Hospital and National Institute of Mental Health). The mean±SD age was 8.9±4.8 years. Male was predominant (60.0%). History of prolonged labour was 100%, and home attended by untrained birth attendants in 70.0%. The 90.0% of the children understood simple meaningful sentences using two words. The children were unable to understand complex sentences. The 80.0% children did not want to play or make friendship with other children; 40.0% did not understand others’ speech, 50.0% did not express their own speech, and 10.0% did not understand & express their own speech. All the children had deep thong articulation changed to mono thong in case of semi vowel articulation. In case of history of delayed crying at birth, phoneme omission occurred when the children tried to articulate any word. To the best of knowledge, this was the first study done on the neurolinguistic approach in Bengali children, but the limitation of the study were that it was with small sample size, city based and short duration. Therefore, generalization of the results would be difficult. Further studies using larger sample would be better to visualize the extent of the issue in order to insert the children with CP in their social context and to give them quality of life.Mediscope Vol. 5, No. 1: Jan 2018, Page 22-27

Metagenomic profiling of gut microbiome in early chronic kidney disease

2020 ◽  
Author(s):  
Noriaki Sato ◽  
Masanori Kakuta ◽  
Takanori Hasegawa ◽  
Rui Yamaguchi ◽  
Eiichiro Uchino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gut Microbiome ◽  
Short Chain Fatty Acids ◽  
Toxin Production ◽  
Metagenomic Sequencing ◽  
Stool Samples ◽  
The Mean ◽  
Estimated Glomerular Filtration Rates ◽  
The Relationship

Abstract Background The relationship between chronic kidney disease (CKD) and the gut microbiome, which interact through chronic inflammation, uraemic toxin production and immune response regulation, has gained interest in the development of CKD therapies. However, reports using shotgun metagenomic analysis of the gut microbiome are scarce, especially for early CKD. Here we characterized gut microbiome differences between non-CKD participants and ones with early CKD using metagenomic sequencing. Methods In total, 74 non-CKD participants and 37 participants with early CKD were included based on propensity score matching, controlling for various factors including dietary intake. Stool samples were collected from participants and subjected to shotgun sequencing. Bacterial and pathway abundances were profiled at the species level with MetaPhlAn2 and HUMAnN2, respectively, and overall microbiome differences were determined using Bray–Curtis dissimilarities. Diabetic and non-diabetic populations were analysed separately. Results For diabetic and non-diabetic participants, the mean estimated glomerular filtration rates of the CKD group were 53.71 [standard deviation (SD) 3.87] and 53.72 (SD 4.44), whereas those of the non-CKD group were 72.63 (SD 7.72) and 76.10 (SD 9.84), respectively. Alpha and beta diversities were not significantly different between groups. Based on taxonomic analysis, butyrate-producing species Roseburia inulinivorans, Ruminococcus torques and Ruminococcus lactaris were more abundant in the non-CKD group, whereas Bacteroides caccae and Bacteroides coprocora were more abundant in the non-diabetic CKD group. Conclusions Although gut microbiome changes in individuals with early CKD were subtle, the results suggest that changes related to producing short-chain fatty acids can already be observed in early CKD.

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